Registered number: 01430090 Charity number: 509014
ST GILES HOSPICE
(A company limited by guarantee)
TRUSTEES’ REPORT AND FINANCIAL STATEMENTS
FOR THE YEAR ENDED 31 MARCH 2024
ST GILES HOSPICE
(A company limited by guarantee)
TN
CONTENTS
| Page | |
|---|---|
| Reference and administrative details ofthe company, its Trustees and advisers | 1-2 |
| Trustees’ report | 3-22 |
| Independent auditors’ report on the financial statements | 23 - 26 |
| Consolidated statement offinancial activities | 27 |
| Consolidated balance sheet | 28 |
| Company balance sheet | 29 |
| Consolidated statement ofcash flows | 30 |
| Notestothefinancialstatements | 31-57 |
ST GILES HOSPICE (A company limited by guarantee)
ee REFERENCE AND ADMINISTRATIVE DETAILS OF THE COMPANY, ITS TRUSTEES AND ADVISERS FOR THE YEAR ENDED 31 MARCH 2024
| Trustees | Robin Vickers, Chair |
|---|---|
| Stephen Ridler | |
| Catherine Finn | |
| Simon James | |
| Paul Jennings | |
| Val Jones | |
| Sarbjit Basi | |
| Nighat Hussain | |
| Peter Ingham | |
| Nicholas Shanahan | |
| Emma Roderick (appointed 10 January 2024) | |
| Sally Bedford (appointed 25 March 2024) | |
| Company registered | |
| number | 01430090 |
| Charity registered | |
| number | 509014 |
| Registered office | Fisherwick Road |
| Whittington | |
| Lichfield | |
| Staffs | |
| WS14 9LH | |
| Company secretary | Joanne Marie Lowe |
| Interim Chiefexecutive | — Elinor Kathryn Eustace |
| officer | |
| Independent auditors | Crowe U.K. LLP |
| Black Country House | |
| Rounds Green Road | |
| Oldbury | |
| West Midlands | |
| B69 2DG | |
| Solicitors | Pickerings Solicitors LLP |
| Etchell House | |
| Bonehill Road | |
| Tamworth | |
| Staffordshire | |
| B78 3HQ | |
| Keely's LLP | |
| 28 Dam Street | |
| Lichfield | |
| Staffordshire | |
| WS136AA |
Page 1
ST GILES HOSPICE (A company limited by guarantee)
REFERENCE AND ADMINISTRATIVE DETAILS OF THE COMPANY, ITS TRUSTEES AND ADVISERS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
Investment Advisor Cannacord Genuity Wealth Management 41 Lothbury London EC2R 7AE
CCLA Investment Management Ltd Senator House 85 Queen Victoria Street London EC4V 4ET
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i ST GILES HOSPICE (A company limited by guarantee) ——— TRUSTEES' REPORT FOR THE YEAR ENDED 31 MARCH 2024 ee The Trustees present their annual report together with the audited financial statements of the company for the year 1 April 2023 to 31 March 2024. The Annual report serves the purposes of both a Trustees’ report and a Directors' report under company law. The Trustees confirm that the Annual report and financial statements of the charitable company comply with the current statutory requirements, the requirements of the charitable company's governing document and the provisions of the Statement of Recommended Practice (SORP) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS102) (effective 1 January 2019).
Introduction
The Trustees of the Charity St Giles Hospice, (sometimes referred to in this report as “the Company’), who are also Directors of the Company for the purposes of the Companies Act 2006 are pleased to publish their Annual Report, including the Strategic Report, and audited financial statements for the year ended 31 March 2024.
The financial statements comply with the Companies Act 2006, the Memorandum and Articles of Association and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015). The Trustees also have due regard to the requirements of the Charities Act 2011 and to the public benefit guidance published by the Charity Commission.
St Giles Hospice is a registered charity offering high-quality specialist care for people living with diseases which may not be curable, as well as providing support for their families and carers.
Services include a team of community-based St Giles clinical nurse specialists, a state of the art in-patient unit, Hospice at Home, Community based services, Family Support, and a Lymphoedema service. Patients come from across the hospice's catchment area, which ranges from Ashby-de-la-Zouch and Atherstone in the east, to Cannock and Walsall in the west — and from Burton and Uttoxeter in the north, to Sutton Coldfield and Coleshill in the south. Care is offered at the hospice's centres in Whittington and Sutton Coldfield and in patients' own homes across the region. St Giles spends close to 10 million pounds a year providing its specialist services and with little more than a third of this funded by the Government, the registered charity relies heavily on donations and income generation from the local community.
The Board of Trustees, the Executive Leadership Team (ELT) and all staff and volunteers at the Charity are committed to providing individualised care for patients and their families. The Charity aims to achieve this by providing consistent high quality, cost effective care underpinned by sound governance across all aspects of the organisation. Care is based on an active collaboration with patients, their families and carers to establish their wishes and needs, underpinned by expert holistic assessment by multi-professional teams.
Structure, governance and management
a. Structure
St Giles Hospice was incorporated on 15 June 1979 and received its first in-patient on 12 April 1983. It is governed by a Memorandum and Articles of Association, which were last subject to full review in December 2023. The Charity’s overriding objective, as defined in the Memorandum, continues to be the relief of sickness and the preservation of health. The Charity’s aims fully reflect the legal objects and purposes the Charity was set up to further.
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ST GILES HOSPICE (A company limited by guarantee)
SS TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
b. The Governing Body
The Board of Trustees (the Board) is the governing body of St Giles Hospice. The purpose of the Board is to enable the Hospice to fulfil its charitable objectives by ensuring sound governance of the Charity.
All Trustees give their time voluntarily and receive no benefits from the Charity. When new Trustees are appointed, an induction programme is arranged, including a tour of the Hospice sites and visits to the subsidiary companies, a briefing from the CEO on current developments both at the Hospice and in palliative care more generally, meeting with all members of the ELT to discuss their respective roles and portfolio, statutory and mandatory training modules and meetings with the Chairman and members of the Board of Trustees.
The Board meets once every three months to review performance in the previous quarter, plus additional Board Meetings should the need arise. The quorum for Board and Governance meetings is two Charity Trustees or the number nearest to one third of the total number of Charity Trustees, whichever is greater, or such larger number that the Charity Trustees may decide from time to time. The total attendances were one hundred out of a possible total of one hundred and twenty nine. In addition to this, the Chair and Group Chief Executive meet on a monthly basis or more often if it is required, and Trustees are frequently onsite spending time with ELT and service leads.
Trustees are elected for a term of office of three years, after which a Trustee may stand for re-election. Trustees may offer themselves for re-election up to a maximum of two times, the maximum term of office being nine years. The maximum term of nine years, was implemented in 2019, in accordance with 2017 Charity Governance Code. At the 2023 Annual General Meeting, seven Trustees were re-elected, Robin Vickers, Cath Finn, Paul Jennings, Noel Shanahan, Peter Ingham, Nighat Hussain and Sarbjit Basi. There were no resignations or appointments at the 2023 Annual General Meeting. During the financial year 2023 — 2024, Emma Roderick and Sally Bedford were appointed to the role of Trustee — for formal appointment at the AGM on 6 November 2024. As at 31 March 2024, there were twelve Trustees.
In 2023/2024, the Board and the Executive Leadership Team focused on the sustainability of the charity and the continuous challenges as a result of the cost-of-living crisis. There was one extra-ordinary Board meeting in this financial year.
The Remuneration, Skills and Recruitment Committee meet as a sub-committee of the Board to ensure that the Trustee Board has the skills and experience required to meet its legal requirements and to support the achievement of the strategic direction of St Giles. This Committee also interviews and makes recommendations to the Trustee Board regarding the appointment of new Trustees and members of the Executive Leadership Team/Senior Management Team.
Membership of the Company is open to anyone, subject only to formal approval by the Board. There are currently thirty two members of the Company.
During 2023/2024, there were four main governance committees: Strategy & Delivery Assurance; Finance, Audit and Risk Assurance; Research Assurance and the Combined Trading Companies (CTC) Board. Each committee, chaired by a Trustee, comprises of some Trustees and selected members of the Executive Leadership Team. The Assurance Committees meet four times a year or more frequently if required.
In addition, the Board of Trustees oversees Corporate Governance Assurance.
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ST GILES HOSPICE (A company limited by guarantee)
TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
The Trustees agree strategy and supporting objectives, delegating their execution to the Group Chief Executive and the Executive Leadership Team. During the financial year 2023 — 2024, the Executive Leadership Team met on a weekly basis to further establish the executive team and ensure high level discussion and communication between the executive leads. The Board of Trustees tasked the Executive Leadership Team with producing the new strategy for the hospice group by December 2022, which was implemented in April 2023. The Executive Leadership Team have focused on the delivery of Year 1 of the 2023-2026 Strategy during the financial year 2023-2024.
The Senior Management Team met on a weekly basis, with input from the Executive Leadership Team. The Senior Management Team meetings were chaired by an elected member of the SMT, and a new Chair elected every six months.
During 2023 — 2024, there were monthly Hospice Briefs for staff and volunteers across group, chaired by the CEO/wider ELT. A staff and volunteers survey was undertaken in June 2023, and there were six main categories that the survey focused on; communications and leadership; ways of working; your job; your wellbeing; people management and training and development. We identified key themes from the survey results and have created an internal people and organisational development programme “SGH Thrive” that we focused on developing for positive impact. The five main themes of the programme are 1) Pay & Benefits, 2) Equality, Diversity & Inclusion, 3) Learning & Development, 4) Workplace Wellbeing and 5) Communications & Engagement. Survey communications are “You Said, We Did” for example, we conducted a full pay and benefits audit and rolled out a new organisational wide pay policy and structure; implemented new staff benefits and implemented an internal communications model including a new intranet.
Qualifying third party indemnity provision is in place for the benefit of all Trustees of the charitable Company. This cover is up to £5m and cost £1,364.40.
The Trustees sponsor and are committed to a culture of continuous improvement. They have adopted the 2017 Charity Governance Code, and endeavour to meet its recommended practices and outcomes based upon its seven principles: Organisational purpose; Leadership; Integrity; Decision making; Risk and control; Board effectiveness; Diversity; Openness and accountability.
c. Subsidiary Companies
The Company had three subsidiary companies during the financial year 2023 — 2024; St Giles Hospice Shops Ltd, St Giles Hospice (Promotions) Ltd, and Walsall Hospice Trading Ltd, all limited by shares wholly owned by the Hospice.
The Shops Company acts as an agent for the Hospice in both the sale of donated goods and in reclaiming Gift Aid on donations arising from the sale of donated goods. The Shops Company also sells new, bought -in goods. The Promotions Company runs the Hospice Lottery. Walsall Hospice Trading holds shops’ leases but otherwise does not trade.
Oversight of the trading companies controlled by St Giles is through the Combined Trading Companies Board (CTC). The CTC Board has influence over the strategy and operational management of the businesses. The Board is chaired by a Trustee, comprises of some Trustees, Non-Executive Directors (NEDs) and the Executive Leadership Team. The Board meets quarterly or more frequently as required.
d. Pay policy for key management personnel
Remuneration of the Executive Leadership Team is approved by a Remuneration Committee made up of the Chair, and Chairs of the Audit & Risk Committee, Strategy & Delivery Committee and CTC Board. For clinical staff, we attempt to match the salary and conditions of those employed in the NHS wherever possible.
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ST GILES HOSPICE (A company limited by guarantee)
TE
ee TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
Objectives and activities
a. Objectives
The objectives of St Giles Hospice, as detailed in the Memorandum and Articles are specifically restricted to the relief of sickness and the preservation of health, in such ways as the Charity shall from time to time determine, within England and Wales. This purpose is further detailed in the Charity Commission return as providing high quality individual care for local people with cancer and other serious illnesses, as well as offering support for their families and carers. This care incorporates a range of services including specialist care at home, inpatient care, lymphoedema services, outpatient services, bereavement services and a range of therapies. In addition to direct patient care services, St Giles has a proactive community engagement agenda and an education and research agenda aiming to improve palliative and end of life care.
Quality of care is at the heart of what we do at St Giles. Cicely Saunders, the founder of the modern hospice movement said, “How people die remains in the memory of those who live on”. At St Giles, we know from the feedback we receive from family members how true this is. We also know from patients how much they appreciate the support for their families leading up to and after their bereavement, knowing that their loved ones are not going to be alone. Our governance, policies, protocols, audits and education all aim to ensure the highest quality of care for our patients and their families; this commitment runs throughout St Giles at all levels and in all roles.
Our focus remains on providing high quality care for patients with specialist palliative care needs. The majority of care that we provide is in the community.
St Giles Hospice is committed to offer care on the basis of need and not diagnosis. The Charity recognises the increasing need for high quality end of life care for people living with multiple conditions as well as single diagnoses such as cancer, dementia and heart failure. In each of the strategic aims, the Charity seeks partnerships with others who share their aims in order to address increasing complexity of health and social need in an environment of limited resources.
Clinical Effectiveness & Activity
Our Advice and Referral Centre continue to maintain a high degree of responsiveness to referrals received.
A total of 1,743 referrals were received, of which 1,192 went on to receive care from our Community Specialist Palliative Care Team, and 121 were offered but declined our service.
- ° All referrals received were triaged within the 2 day, 5 day or 10 day urgency allocation of the referrer. . 97% of urgent 2 day referrals were contacted within 1 day. . 93% of 5 day referrals were contacted within 2 days. . 92% of 10 day referrals were contacted within 3 days.
Of the referrals not proceeding, 68 patients died whilst their referral was being processed within the urgency allocated by the referrer, and the remaining referrals without identified Specialist Palliative Care Needs were signposted to other services.
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ST GILES HOSPICE (A company limited by guarantee)
go i TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
b. Activities
Core Charitable Activities Data - detailed below is the activity data outlining St Giles’ performance of core charitable activities for 2023/2024. The data includes key quality measures that are reportable to statutory commissioners. a
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ST GILES HOSPICE (A company limited by guarantee)
hts sss TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
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St Giles continues to be heavily reliant on volunteers in delivering its charitable objects:
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ST GILES HOSPICE (A company limited by guarantee)
TNUUee TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
Research
St Giles Hospice has made solid progress in becoming research active over the past twelve months through several research activities.
The following research studies have recruited at St Giles, and are now completed with dissemination activities being circulated to staff and volunteers involved:
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Harding, R. Kings College London. Understanding and improving community palliative care out of hours — Delphi Study.
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2: Allen, F. University of Nottingham. ACTION falls prevention programme for use in hospice care. 3. Fisher, N. SGH / University of Birmingham Management of seizures in neurological cancer patients: a Clinical audit.
SGH is currently recruiting or planing to recruit for the following studies:
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Davies, A. Surrey University. A cluster randomised trial of clinically assisted hydration in patients in the last days of life. CHELsea II Trial (CHELsea II study). Investigates the use of clinically assisted hydration in patients who are end of life.
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Bailey, C. SGH / University of Birmingham. Accelerated Hospice Beds Service Evaluation. 3. Weetman, K. University of Birmingham. Discharge communication from hospices and hospitals. 4. Millard, A. University of Birmingham (PhD under Bailey's supervision). Assessing and implementing spirituality at the end-of-life.
The hospice has also been involved in developing evidence-based education through the accreditation of study days with UoB (e.g. Dementia Course for Care Home Staff) and including research in mandatory training for clinical staff. St Giles has contributed to the design, development and delivery of a Midlands-wide online end-of life education toolkit for staff, carers, volunteers and patients’ involvement which will go live later this year.
Assurance for NHS Commissioners in year
St Giles Hospice has sent the two principle Integrated Care Boards (ICBs) with which it contracts a Quarterly Quality Report. We have met regularly with these Commissioners throughout the year, where the content of these reports form the basis for discussion and review.
The reports cover key patient safety topics including the reporting, monitoring, prevention and management of: Falls, Pressure Ulcers, Accidents, Incidents and Near Misses, Safeguarding (including where associated with Deprivation of Liberty and Mental Capacity), Infection Control, Medicines Management, Complaints and Patient and Family Reported Outcome Measures. In year there were no areas of concern raised which required action.
The Hospice is rated outstanding by the Care Quality Commission (“CQC”) and is inspected under the CQC category of Independent Hospitals.
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ST GILES HOSPICE (A company limited by guarantee)
TE ee TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
Strategic report
a. Strategic Aims
Financial sustainability for St Giles Hospice, like many hospices across the UK, remains a significant challenge. Hospices face a number of issues including a real terms reduction in income received from the NHS and challenges in our ability to raise voluntary income in the current financial climate.
We have actively engaged with our Integrated Care Board (ICB) colleagues throughout 2023/2024 in order to raise awareness of the breadth and depth of services on offer for our population. Our main NHS commissioner, Staffordshire and Stoke-on-Trent Integrated Care Board (SSoT ICB) maintained our previous grant funding through 2023/24, which in real terms created a further financial challenge due to annual inflation in general running costs and staff cost of living increases.
Through this active engagement with statutory colleagues, we have seen small increases from Birmingham and Solihull Integrated Care Board (BSol ICB) and supported our NHS colleagues with a contract for the provision of Accelerated Discharge Beds though the winter months January — March, allowing hospice access to those at End of Life who may otherwise die in hospital.
At St Giles, our vision is for ‘A world where everyone has fair access to specialist palliative and end of life care’, and it is only with appropriate funding from the Government that we can meet this vision. We continue to work with our healthcare partners to negotiate adequate funding for hospice care, but the situation is critical.
In 2022, as we approached our 40th anniversary year, we started our journey on creating a new strategic plan to build resilience for the future of our hospice. After discussions and consultation with our patients and their loved ones, volunteers and staff we started to create a strategy based on engagement and feedback.
This collaborative approach enabled us to set out a plan that represented #TeamStGiles and identified our priorities for the next three years (2023-2026).
Our strategy for 2023-2026 focuses on delivering excellent care in a financially sustainable way and has 6 objectives upon which delivery plans have been developed that will help us reach our goals:
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To provide excellent care
-
To be an outstanding team
ou To be innovative
- To grow our income 5s To be sustainable 6. To communicate well
This strategy was formally launched on 1 April 2023 and will guide us in our direction of travel over the next three years so St Giles Hospice can continue to provide specialist palliative and end of life care for our communities in a sustainable way.
Year one (2023/2024) was an enabling period in which significant work was undertaken on operational processes and procedures, and operational cost reduction, to ensure we have the right foundations to deliver our long-term goals.
We continued to review and evolve our clinical and support service provision as the needs and expectations of our local population changed as a result of the pandemic, therefore as a hospice we have and continue to adapt our service provision and range of services to meet the requirements of this changing environment.
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ST GILES HOSPICE (A company limited by guarantee)
TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024
Governance
The appointment of a Head of Governance in 2022 supported the development of an organisational governance framework throughout 2023/2024. This has enabled both clinical and corporate governance to align under a centralised governance team and supported a standardised approach. Furthermore, this has allowed the Governance and Quality and Audit functions to merge and align data analysis to ensure we comply with all our statutory requirements and provide necessary assurances to our Board. We continue to actively implement good organisational governance practices to ensure the safe and effective running of the hospice.
Communications
Clear communication was identified through our staff survey as being vital for staff and how they feel when at work. We have therefore worked hard to develop an internal communications framework that allows staff full access to organisational communications regardless of their role. This framework crosses many communication channels from face-to-face organisational updates and managers briefing sessions, to development of intranet pages and a weekly hospice round up email communication. Staff engagement sessions across the workforce were undertaken in response to the staff survey, and greater frequency of face-to-face meetings with teams and ELT has led to positive feedback from staff and volunteers in terms of the style, content and frequency which we now communicate. We continue to encourage feedback from the workforce to enable positive change.
c. Financial recovery
Our strategy for 2023-2026 focuses on delivering excellent care in a financially sustainable way and has 6 objectives upon which delivery plans have been developed that will help us reach our goals:
-
To provide excellent care
-
To be an outstanding team
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3: To be innovative 4. To grow our income
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To be sustainable
-
To communicate well
This strategy was formally launched on1 April 2023 and will guide us in our direction of travel over the next three years.
2023/2024 was an enabling period in which significant work was undertaken on operational processes and procedures, and operational cost reduction, to ensure we have the right foundations to deliver our long-term goals. An accurate and realistic cost improvement programme (CIP) was applied in 2023/2024 to ensure we were identifying and delivering opportunities to drive efficiency and reduce costs across the hospice group. 20244/2025 will build on the success of year one with our main focus on Objective 5 — To be Sustainable, with a strong focus on our financial position. We remain committed to delivering excellent care and therefore closing the deficit gap must bea priority.
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d. Other activity
Other projects that St Giles
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In the year 2023/2024, 89 ri carers courses were provide
End of life Care Home Pro
The aim of this project is t achieved through weekly su empowerment approach. O following:
Do Not Attempt Cardiopulm¢ communications which may
The End-of-Life Care Home project is now known as a monthly/six weekly basis. F Staffordshire and 17 care ha
Total amount of residents s Total amount of residents s
Enhanced Respite Service
The aim of the service is tc respite care and education the carer, and increasing k those they are caring for.
Year 2023/2024 activity for
t