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2023-03-31-accounts

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LONDON'S AIR AMBULANCE LIMITED COMPANY LIMITED BY GUARANTEE

CONSOLIDATED FINANCIAL STATEMENTS

31 MARCH 2023

COMPANY REGISTRATION NUMBER 02337239 CHARITY REGISTRATION NUMBER 801013

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CONTENTS

CO
CONTENTS PAGE
Members of the Board and professional advisers 1
Glossary of terms 2
Chair’s statement 3
Chief Executive Officer’s statement 4
Trustees’ annual report 5
Independent auditor’s report 34
Consolidated statement of financial activities 39
Consolidated and charity balance sheets 40
Consolidated statement of cashflows 41
Notes to the financial statements 42

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MEMBERS OF THE BOARD AND PROFESSIONAL ADVISERS

The Board of Trustees Robert Forsyth (Chair)
Bianca Gill (Treasurer) Appointed 02/05/2022
Sheri Adigun Appointed 02/05/2022
Rita Chadha Appointed 02/05/2022
Nick Goodwyn Appointed 02/05/2022
Margot Gosney
Tim Hodgetts
Gordon Pitman Appointed 02/05/2022
Edmund Owen Resigned 24/11/2022
Gemma Sherrington
James Thomas
William Walden Resigned 25/07/22
Adrian Walker Resigned 31/03/22
Chief Executive Officer (CEO) Jonathan Jenkins
Chief Operating Officer/Deputy CEO Charles Newitt
Director of Fundraising and Marketing Anne Weatherill Interim 1/2/2022 – 31/5/2022
Jayne Clarke Joined 1/6/2022
Director of Finance, IT and Facilities Anna Bennett Joined 17/4/2023
Medical Director Dr Tom Hurst
Registered and principal office 5th Floor
77 Mansell Street
London
E1 8AN
Independent auditors Saffery LLP
Chartered Accountants
71 Queen Victoria Street
London
EC4V 4BE
Bankers Santander UK plc
Santander Corporate Banking
2 Triton Square
Regent’s Place
London
NW1 3AN

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GLOSSARY OF TERMS

AAUK – Air Ambulances UK

Barts Health – Barts Health NHS Trust

CAA – Civil Aviation Authority

CEM – Community Emergency Medicine

CGD – Clinical Governance Day

CRM – Customer Relationship Management

CQC – Care Quality Commission

DHSC – Department of Health and Social Care

ECLS – Extra corporeal life support

ECMO – Extra corporeal membrane oxygenation (technique to bypass the heart and lungs in patients experiencing cardiac arrest)

ED – Emergency Department

EOC – Emergency Operations Center (LAS Waterloo)

EPR – Emergency preservation and resuscitation

GDPR – General Data Protection Regulation

HEMS – Helicopter Emergency Medical Services

IoPHC – Institute of Pre-Hospital Care

LAS – London Ambulance Service NHS Trust

MI – Major Incident

PLN – Patient Liaison Nurse

PRU – Physician Response Unit

RC&Plasma – Red cell and plasma (blood product administered to patients suffering catastrophic bleeding).

REBOA – Resuscitative endovascular balloon occlusion of the aorta (technique to stem internal bleeding in patients at risk of bleeding to death by placing a balloon in the aorta).

SMS – Safety management system

SWIFT – Trial of the clinical and cost-effectiveness of pre-hospital whole blood administration versus standard care for traumatic haemorrhage

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CHAIR’S STATEMENT

Securing a world-leading service, Bob Forsyth – Chair of Trustees

We commenced the year with a refreshed, more diverse Board, energised to make a difference to this remarkable charity. And what a unique charity it is. Together with our partners we deliver the world’s leading pre-hospital trauma care of any city in the world – saving the lives of Londoners every day in their moment of acute need. And of course, the joint service leads the clinical response in moments of national emergency in our capital.

As I write this, the charity’s executive is working with the Board and collaborating with our partners to forge a new ambition for the next period of the charity’s development – examining the scope of our service and the extent of our role in applied research and innovation. As this is confirmed we will share this with all our stakeholders.

In that strategy development process, we have not only listened to our people’s views but also those of the clinicians who lead the service and our joint service partners, the NHS through Barts Health NHS Trust and London Ambulance Service NHS Trust. I have been impressed by the strength of support that the charity’s partners have expressed for the service going forward in a way that is fully integrated with their operations – providing an agile life-saving service in a capital where sadly the incidence and severity of trauma remains high. I see an ambition across the charity and the clinicians to raise further the impact of London’s Air Ambulance as we consider our scope of service and the level of innovation we can bring to the patient.

The Up Against Time appeal is in full swing as we need to replace our two helicopters by autumn 2024. Getting this done from a fundraising and change management point of view is our current priority. Its success is critical to keeping this vital service going and we welcome all support in making it happen.

I would like to thank all those involved in helping us support those life-saving interventions, including the clinicians, the operations crew, the charity staff, my fellow trustees and of course our many supporters, volunteers and donors without whom none of this would happen. And finally, we remain hugely grateful to HRH The Prince of Wales for his continuing support as our patron of the charity, opening doors that we could not do on our own.

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A look back with Chief Executive Officer, Jonathan Jenkins

The breadth of the work we do at London’s Air Ambulance has never been more apparent. There aren’t many places where fundraisers, clinical teams, operations staff and volunteers all come together.

Despite all of our teams working in different areas, what strikes me is that it feels more than ever like we are all striving to move in the same direction. We are all united by one central mission – to save lives across London every day. That sentiment lies at the heart of everything we do and is something that fills me with pride every time I go into work.

We don’t do it alone. Our collaboration with our partners at Barts Health NHS Trust (Barts Health) and London Ambulance Service (LAS) is vital to our continued success for both our Helicopter Emergency Medical Service (HEMS) and Physician Response Unit (PRU), and I can honestly say that the relationship has never felt more positive and aligned on key issues.

Our other most important partnership is with the people of the city we serve, and I’m pleased to say that the people of London have once again responded to our volunteers, fundraisers and communications. Despite the financial pressures for households in every corner of the capital, we have seen the public continue to dig deep to fund our work.

Clinically, it has been a hugely exciting time for our service. Along with NHS Blood & Transplant and a number of our fellow air ambulance charities nationwide, we’re participating in the Study of Whole Blood in Frontline Trauma (SWIFT) trial, looking at use of whole blood in an out-of-hospital setting. The trial is a textbook example of our medical teams at their innovative and imaginative best and over the next two years we hope to see a positive effect on patient outcomes.

Our PRU has continued to develop, launching a third car to expand the geographical footprint of the service to cover Barking, Havering and Redbridge, alongside the existing operations in Tower Hamlets, Newham and Waltham Forest.

This year also saw the public launch of our largest ever fundraising appeal, Up Against Time, as we look to fundraise an additional £15 million for the replacement of our helicopter fleet in autumn 2024. The campaign got off to an unbelievably strong start at our April 2022 gala, where we raised a record sum of over £1 million.

Our philanthropy and partnerships team continued their outstanding work by building on our long-standing relationship with the London Freemasons, resulting in a £3 million pledge of support for the campaign. This cornerstone support has been transformational for our conversations with other prospective donors and is, by some distance, the largest single pledge that we have ever received.

As custodians of a service that has been operating for over 34 years, our governance team are aware of the importance of future-proofing London’s Air Ambulance Charity and its work. Our team is putting together a long-term strategy in the form of our 15 year vision to ensure we can continue to save lives for many years to come.

We’re proud of these successes and the numerous additional achievements that I have not had the space to discuss in detail here.

The truth is, however, that nothing can compare to the pride we all feel when we speak to the patients, friends and family that we serve. Every hour, every day, someone from London’s Air Ambulance is working to save the next life in London – that is a privilege none of us take lightly.

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The trustees, who are also Directors for the purposes of the Companies Act, have pleasure in presenting their report and the consolidated financial statements of London’s Air Ambulance Limited (“the charity” or “the company”) for the year ended 31 March 2023.

ACHIEVEMENTS AND PERFORMANCE

1. Supporting our patients

Steve’s story

On New Year’s Day 2021, Steve was jogging up the road when a car lost control, mounted the pavement and hit him from behind at speed.

London’s Air Ambulance’s advanced trauma team was dispatched immediately. Upon assessment they quickly identified that he was not breathing effectively, was very pale and only had a central pulse. His blood pressure and oxygen levels were also extremely low. They suspected that Steve had, amongst many injuries, a life-threatening pelvic fracture from which he was bleeding internally, collapsed lungs and a badly broken leg.

The team started a blood transfusion for Steve, took over his breathing by inducing him into a coma and decompressed his chest to reinflate his collapsed lungs. Bleeding caused by a broken pelvis is notoriously difficult to control, which is why in 2014 London’s Air Ambulance developed an innovative procedure called REBOA that can be deployed in the pre-hospital phase to stop patients from bleeding to death. It involves passing a catheter through to the main artery in the body and inflating a balloon at the tip of the catheter to stop blood flow to the pelvis.

On the roadside, Steve underwent this high-risk procedure administered by London’s Air Ambulance’s crew, to give him the best chance of getting to hospital.

“It blows my mind what the team were able to do, there on the roadside on a freezing cold New Year’s Day,” said Steve’s wife, Clare. “We’re so lucky they got here in the time that they did. Any longer and Steve would not have made it.”

After three years of hard work and determination, intensive rehabilitation and physiotherapy, Steve is home with his family and back running. “I can do a lot of things that I used to be able to,” he said, “but nowhere near as fast or as far or as frequent. But the clinicians have said I am already in a position they never thought I would reach.

“When you realise the depth of the treatment and the skills that went into saving you at the scene – it’s astonishing. Anything I could do to thank them, I would.”

Clare said: “The trauma we’ve been through still stays with us – every time one of us is going out to run we are reminded of that day. The reality that something like that can happen to anyone at any time is scary. But when it did happen to my family, thank goodness London’s Air Ambulance was there.”

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2. Patient mission breakdown

HEMS trauma service

Our primary purpose is to provide critically injured patients with the world’s most innovative and effective pre-hospital care, getting to a patient’s side as quickly as possible when time is crucial. Our advanced trauma teams are delivered using a helicopter from 08:00 to sunset and rapid response cars by night and in adverse weather conditions. From 14:00 until 00:00, six days a week, we now have a second car-based advanced trauma team available for London.

The service treated 2,037 patients suffering from critical injury (trauma) and other medical emergencies in the financial year ending 31 March 2023 (1,773 in 2022).

The graph below displays the number and location of missions carried out in the calendar year January to December 2022 (1,977 patients).

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The graphs below display the headline statistics of patients treated by the service in the financial year 2022/23. By the very nature of our work, every one of our missions has the potential to have an enormous impact on the future of the patient, their family and the wider community, as well as having positive economic consequences.

Patients treated by gender Patient mission breakdown

61 366 1610 Female Male Other or Unknown

= 716 helicopter missions = 1,321 car missions

Patients treated by mechanism of injury

1 Apr 22 - 31 Dec 22

1 Jan 23 - 31 Mar 23

----- Start of picture text -----
Medical
7% Other
Other 13%
11% Assault
29%
Penetrating Accident
35%
13%
Fall
22%
Transport
18% Fall
14%
Traffic
25% Medical
13%
----- End of picture text -----

There has been a change in injury descriptions this year due to a new reporting technology used by the London Ambulance Service (LAS). This changes the categorisations that go into each group of injury type; for this financial year two graphs are provided, one from April 22 – December 22 and one from January 23 – March 23. The new descriptors will carry on from here forward.

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Patient destinations – London major trauma centres and other hospitals

----- Start of picture text -----
Other
18%
The Royal
London
St
Hospital
George's
35%
Hospital
12%
St Mary's King's
20% College
Hospital
15%
----- End of picture text -----

Strict data and patient confidentiality restrictions mean that it is difficult to quantify the exact impact and contribution we make to the outcome of our patients, however we are continuing our ambitious Digital Transformation Project which will help to enhance research and our understanding. The pre-hospital care of trauma patients has been recognised as a vital component of the trauma patient pathway from incident to rehabilitation. Outstanding pre-hospital care is recognised as an important contributor to the documented significant improvements in trauma mortality in the UK. The process for mapping out and measuring patient outcomes is inherently complex. Often, following our handover to the receiving hospital, our patients undergo complex treatment and rehabilitation via a number of care providers before discharge, due to the severity of their injuries.

The critical support provided by the major trauma centres and the hospitals of London who receive our patients, and all our emergency service colleagues are key to us continuing to provide rapid response and outstanding care.

Our Patient Liaison Nurses (PLNs) provide the critical interface between our service and our patients during their long and often difficult recoveries. In January 2022, we employed a second PLN part time, based at King’s College Hospital, and we are planning to recruit a third this year. Through this interface we receive anecdotal evidence of the impact our charity has on patients, as well as their families, friends, colleagues, employers and wider communities. Helping a patient is an extraordinary, combined effort of many, including the patient’s family, NHS staff, Metropolitan Police, London Fire Brigade, British Transport Police, the Royal National Lifeboat Institution (RNLI) and members of the public.

We recognise that we often meet our patients when the unimaginable has happened to them. This is frequently only the beginning of a life-changing and immeasurably challenging transition to a new way of life, or sadly for some of our patients, where their life ends.

Our first patient booklet, produced in 2018, focused on how our former patients could help others who find themselves in similar circumstances. It has been distributed to thousands of family members, patients and medical professionals.

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Over the last 18 months we have been working on a new version, with the aim being to provide support for families and friends of patients who have died because of their injuries. Much has been studied and written about death and bereavement in specialist areas of medicine, such as cancer care and heart disease. But very few resources are available, even globally, for those who find themselves very suddenly and unexpectedly bereaved due to an event that results in injury. Sadly, but importantly, and due to the nature of our work at London's Air Ambulance, we have developed an expertise in providing support during this awful time. In creating our new booklet, families and friends of our patients have come together to share pertinent thoughts on how the trauma they endured through their bereavement can be channeled to help others.

There’s never a good time to be injured, but the last few years have been particularly difficult for our patients and their families. The restrictions in hospitals have been challenging for patients and families at a time when that support network is most important. In response to these restrictions, our PLNs have adapted to providing additional support to patients and their families virtually, which has evolved into a very effective and far wider-reaching mode of support.

Physician Response Unit

Alongside the advanced trauma team, the PRU continues to provide care for patients every day. In the financial year 2022/23, the PRU treated 3,502 patients (2,946 in 2021/22), of whom (excluding July 2022 data) 77% were managed in the community rather than being conveyed to hospital via an ambulance. Due to technical issues surrounding the move to a new reporting system by LAS, July 2022 data has been excluded from this percentage due to inconsistency with numbers managed in the community for that month.

The PRU service continues to lead the emergence of Community Emergency Medicine (CEM) as a model of emergency care, with several other models developing elsewhere in the country and across the globe. This year has seen the development of a National CEM group, chaired by senior leaders from London’s PRU, which meets quarterly to update on progress from services around the country and share ideas, to continue to expand and improve CEM in this country.

Operating in partnership between London’s Air Ambulance Charity, Barts Health and LAS, the PRU now provides three teams Monday to Friday (a third car started in October 2022) and two teams on Saturday and Sunday, between 08:00 and 23:30. The geographical footprint also increased in October 2022 to include the boroughs of Barking, Havering, Redbridge and Dagenham, alongside our existing footprint which focussed on Tower Hamlets, Newham and Waltham Forest. The service is tasked to the full breadth of emergency conditions and is able to take the Emergency Department (ED) to the patient with extensive enhanced diagnostics and specialist treatments, alongside the doctor/ambulance clinician team plus a nurse on some shifts.

The PRU fellowship remains a highly competitive emergency medicine training fellowship, attracting doctors across the UK and further afield. A PRU secondment is also highly sought after by both the LAS Emergency Medical Technicians and The Royal London Hospital ED nurses, in addition to the military nurses, who make up the rest of our team.

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The PRU team continues to develop innovative clinical pathways to help provide the most effective emergency care for patients regardless of the nature of their complaint. During the pandemic, the service sought to support the most clinically vulnerable patients, such as patients that were immunocompromised due to cancer treatment, or those with complex frailty.

Of note, the PRU’s End of Life Care partnership with St Joseph’s Hospice was quoted in an All Party Parliamentary Group report on Hospice and End of Life Care in March 2023. This year the team also launched a new clinical pathway to ensure that patients with learning disabilities gain equitable access to essential urgent and emergency care in a well-supported and holistic manner.

PRU Missions

(Chart excludes the 247 patients treated in July 22) Due to technical issues surrounding the 1041 move to a new reporting system by LAS, July 2022 data has been excluded from this percentage due to inconsistency with numbers managed 2214 in the community for that month. Transported to hospital Remained in the community

3. The Institute of Pre-Hospital Care

The Institute of Pre-Hospital Care (IoPHC) is the training and education department of London’s Air Ambulance that delivers training not only to our own clinical teams of the HEMS and PRU services but also to other clinicians outside of London’s Air Ambulance.

During the 2022/23 year the IoPHC continued to raise its profile within the education sphere, attracting more students to both the BSc and MSc programmes in Pre-Hospital Medicine. Our two degree programmes are run in partnership with Queen Mary University of London and Barts and The London School of Medicine and Dentistry. Throughout the 2022/23 year we had 70 students on our programmes who joined us for our face-to-face programmes taught by world renowned faculty. We also hosted two large scale symposia during this time on the topics of Human Factors and Resuscitation Science. These were kindly supported by our funders James Tudor Foundation and Zoll. This support allows us to open up the events for networking in the field and opportunities for more clinicians to hear from world experts on their subjects.

In addition to our degree programmes, we run Clinical Courses which are a portfolio of shorter courses for both our own clinicians and clinicians from other pre-hospital services. Over the course of the 2022/23 year, we have spent time reviewing our courses and how they fit with our team’s needs, resulting in a refresh and restructure to our offering. This in turn has seen the creation of some new courses such as the Foundation Course that was launched this year and the evolution of the HEMS Training Course which both form part of the training for clinicians joining the service.

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We have also dedicated time to focussing on the development needs of the team. This encompasses everything from bespoke Underground Training in disused Underground stations thanks to the support from our colleagues at Transport for London, through to multi-agency major incident exercises, all of which are valuable opportunities for joint training with other emergency services and immersive high-fidelity simulation and training.

We work hard with our colleagues in the wider charity team to secure funding for many of our projects and this year have been successful in securing funding from The Sir Halley Stewart Trust in support of our Fellow in Emergency Preservation Resuscitation (EPR). We would also like to say a huge thank you to all our funders for their continued support: Zoll (The Resuscitation Science Symposium), James Tudor Foundation (Human Factors Symposium), The Company of Nurses Scholarship (MSc) and The Tallow Chandler’s Company Bursary (MSc).

4. Continuing pre-hospital care research

We are continually working to build and advance a culture of inquiry across all aspects of the organisation. Members of our team from multiple disciplines participate in research and quality improvement projects, in an effort to improve the care we provide to patients, innovate new therapies and advance pre-hospital care in support of our overall mission to save more lives in London through rapid response and cutting-edge care. In line with our value of ‘pioneering’, the reporting year saw our team share our experience of resuscitative thoracotomy (open chest surgery) at the well-respected London Trauma Conference, with submission to journals for publication in progress. Our team have also published research on the accuracy of pre-hospital diagnosis of injuries and a narrative review of our approach to case analysis and learning.

London’s Air Ambulance is a key participant in the national randomised controlled trial (RCT) of whole blood versus standard of care for bleeding patients. Along with other air ambulances and Barts Health we have funded this trial and our clinical service is the largest contributor of patients to it.

We are working in collaboration on projects with colleagues at the local level such as the Centre for Trauma Sciences at Queen Mary, University of London and LAS. In addition, we are building new partnerships with colleagues from air ambulance services across the UK through our participation in the National HEMS Research and Audit Forum. We recognise that the best science is delivered through strong partnerships and collaborations.

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CHARITY OBJECTIVES AND ORGANISATIONAL PURPOSE

Our charity purpose is to provide critically injured patients with the world’s most innovative and effective pre-hospital care delivered by our advanced trauma team to the 10 million people who live, work and travel in London. The charitable company’s objectives are:

“(1) The relief of sickness or physical injury by the provision of emergency medical services and equipment and in particular by the provision of a helicopter ambulance service or other emergency transportation; and

(2) The provision of training, research and education in the field of pre-hospital medicine for the treatment and/or prevention of sickness and physical injury.”

Based at The Royal London Hospital and founded in 1989, we operate 24/7, using a helicopter from 08:00 to sunset and rapid response cars at night and in adverse weather conditions. We have treated over 46,500 critically injured patients since our inception.

We work in partnership with Barts Health and LAS. Barts Health employ and remunerate the service’s doctors who are seconded for six-month placements and the consultants who are permanently associated with the service. They also provide the helipad space on top of The Royal London Hospital, as well as the medical supplies and some equipment. LAS employ and remunerate the majority of our paramedics who are seconded for 12-month placements and also provide the infrastructure for dispatching our teams. Patients are treated under the governance of the NHS. The regulatory requirements of the Care Quality Commission (CQC) are covered by Barts Health and LAS for all clinicians attached to the service.

London’s Air Ambulance has been involved in the emergency medical response to the majority of major incidents in London over the past 34 years. These incidents include the Fishmongers Hall, Westminster and London Bridge attacks; the Grenfell Tower fire; the Paddington, Cannon Street and Southall train crashes; the Bishopsgate and Aldwych terrorist attacks; the Soho nail bombings; and the 7 July terrorist attacks in 2005, when we dispatched 18 medical teams and flew medical supplies to the bombsites across London, helping to triage and treat over 700 patients. Through our partners, we are closely engaged in the reviews and inquiries of major incidents.

The Board is clear that the charity’s aims are being delivered effectively and with longterm sustainability through a clear strategy and investment. The Trustees have reconfirmed the vision, values and strategy of the charity in line with the charity’s objectives. They have ensured that there is appropriate governance in place, supported during the year by Audit and Risk Committees, reviewing financial control and risk respectively. Operational matters are delegated to the CEO, Jonathan Jenkins.

The Medical Director, Dr Tom Hurst, is jointly appointed by the Board and Barts Health and leads on clinical strategy for London’s Air Ambulance. His role is for a three year term, and Tom was reconfirmed recently for a second three year term. He is supported by a Lead Clinician who leads the 19 other consultants and a Lead Paramedic (provided by LAS). The PRU is now led by a Clinical Lead consultant as this service expands.

Aviation matters are overseen by the Charity’s Chief Pilot, (Captain Neil Jeffers for 2022/23 and David Rolfe from June 2023), and the AOC[1] Accountable Manager, Charles Newitt.

1 AOC = Air Operator Certificate, issued by the Civil Aviation Authority

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The trustees have given due regard to the Charity Commission’s guidance on public benefit when reviewing the aims and objectives and in planning the future activities of the charity.

STRATEGY AND PLANS FOR FUTURE PERIODS

The charity developed its mission statement and strategic objectives in 2018 and undertook a strategy review in 2020. Our mission remains the same:

‘To save more lives in London through rapid response and cutting-edge care’

There are five current strategic goals to achieve this. Our plans through to 2024 are set out against these five goals. Our mid/long term strategy is in the process of review, to create a 15 year vision, to run from 2024 through to 2039, our 50[th ] anniversary. This will be published during 2024.

2.Outstanding care – to improve patient care and to end preventable deaths.

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3.Connecting with the people of London – increase the number of charity givers in London who support our service and understand we are a charity.

4. Our culture – we continue to develop a supportive and enabling environment that gets the best out of our people from both the charity side and the integrated operations with our partners, also ensuring that our trustees are engaged and involved in this work.

5. Funding our ambitions – to ensure our financial security and sustainability and fund our organisational objectives, secure long-term diverse sustainable income streams.

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Progress against strategic objectives

In respect of the key strategic objectives for the financial year 2022/23, the Board of Trustees is able to report on the progress and outcomes as follows:

In partnership with Barts Health and LAS, to continue the HEMS provision 24 hours per day, seven days per week using our helicopters and a fleet of rapid response cars.

Having a second helicopter available during operational hours continues to provide us with operational availability of 98.5% of one aircraft (2021/22 in 98%). Availability of spare parts and steadily reducing maintenance support is becoming more challenging in the UK as we draw to a close our MD902 helicopters. In financial year 2022/23 we reached 35% of our patients by helicopter (36% in 2021/22). Our cars remain a critical part of our service when we cannot fly and 65% of our overall mission responses in London were reached by car (64% in 2021/22). The car percentage has increased from earlier years with the additional Medic 3 car launched in December 2021. We continue to fly extended hours in the summer until sunset from the end of March to mid September.

We have continued to train for and develop our major incident responses in conjunction with Barts Health and LAS, taking part in joint exercises as well as running our own. Since 2021, Bart’s Health consultants attached to London’s Air Ambulance have undertaken the role of on-scene Medical Advisor at any major incident declared in the capital. This role supports LAS in ensuring the best possible care for patients at these complex incidents.

Working closely with Barts Health and LAS to deliver improved pre-hospital care procedures and pathways

Clinical model and staffing

The continuous support from the medical staff attached to us from Barts Health and LAS has been fundamental to the charity over the years, not only through our service’s operations but also in supporting the charity’s fundraising activity. We operate a consultant led model of care with three duty teams per day, always comprising at least one doctor and one paramedic. We aim to have a consultant available to respond to incidents in London from 07:00-24:00, providing supervision, governance and clinical leadership.

As mentioned, in January 2022 we employed a part-time second PLN based at King’s College Hospital to support our patients and families. This is in addition to our full-time PLN.

Clinical governance days

Our service’s Clinical Governance Days (CGDs) centre on an ethos of delivering care of the highest possible standard for all our patients, at all times. This both enables and demands a high level of reflection, self-critique, learning from others and collective memory. As a result of a relentless focus on excellence, we continue to drive knowledgesharing via this platform. Post COVID-19 we have now moved back to in-person CGDs.

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Blood transfusion trials

In collaboration with the transfusion team at The Royal London Hospital we have completed a feasibility study into delivering a combined red cell and plasma (RC&Plasma) component in the pre-hospital setting to patients at risk of bleeding to death in London.

In collaboration with other air ambulances, NHS Blood and Transplant and the Ministry of Defence, we are involved in a randomised control trial of different blood products in the pre-hospital environment – the SWIFT trial. In this trial, patients are randomly allocated to receive a novel blood product – whole blood – or standard of care, which for our service is red blood cells and fresh frozen plasma. This new product may support a patient’s blood clotting system better, due to the presence of platelets, which would result in less blood loss.

ECMO and sub 30 trial

The charity has been supporting Barts Health in an ECMO trial called “sub-30”. This trial will assess the feasibility of delivering pre-hospital ECMO within 30 minutes of a call to the emergency services for selected patients suffering out-of-hospital cardiac arrest in London. The trial started in 2019 but was paused due to the COVID-19 pandemic; it restarted in May 2022 and is close to completion. Planning is ongoing for the next stage of our ECMO work.

Investment to help drive fundraising income

Emerging from a turbulent prior two years due to the COVID-19 pandemic and restrictions on fundraising, we finally returned to pre-pandemic face-to-face recruitment volumes. Our investment in face-to-face fundraising in particular gives us long-term stability due to the reliability of our regular giving and lottery income streams.

Following the launch of the private phase of the charity’s large-scale capital appeal in 2021, to raise an additional £15 million to fund its new helicopter fleet, in Autumn 2022 we launched the Appeal to the public with a new look and feel across our materials, a large-scale collection across the city of London and strong media coverage.

Individual supporters

The charity is reliant on regular giving and lottery players for around 70% of its income (2021/22: 70%). Income from individual donations increased by 26% over the period, in contrast to a 1% increase in the previous financial year. At the end of March 2023, the volume of active regular donors had grown year on year to 46,847 donors (2021/22: 37,729). This increase was driven primarily by the investment in our face-to-face fundraising activity, which saw a bumper year. We also continued to invest in digital channels to recruit new one off and regular donors.

Lottery

At the end of March 2023, the number of chances in our lottery had increased year on year to approximately 112,481 (up from 103,500 in March 2022). Income from the programme increased by 6% year on year due to the return of face-to-face fundraising at volume.

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Legacies

Income from legacies increased by 140% year on year. We are still in the relatively early stages of our legacy marketing programme, and because of this, income is very difficult to predict, with few known legacy pledgers. We have continued our legacy marketing programme and are tracking the movement of supporters across our pipeline – as a result we have now identified a potential legacy income pipeline of £17 million from our existing supporters (based on industry standard conversion rates). This is up from £13 million identified in the last financial year.

Fundraising regulation and compliance

The charity is registered with the Fundraising Regulator and adheres to the Code of Fundraising Practice. The charity is also licensed by the Gambling Commission to run its lottery and raffle. We continue to review and refresh our fundraising policies and procedures to ensure best practice – our aim is to exceed these standards by applying our own additional fundraising standards to ensure that we are open, honest and respectful in all cases.

We use third-party fundraising agencies to recruit regular donors and lottery supporters. Third-party provided canvassers are monitored and reviewed along with the agency, including regular updates and training. Canvassers are interviewed and training and performance monitored by third parties. They are trained quarterly by our team and performance is monitored frequently and reviewed with the agencies through regular meetings, welcome call listening and mystery shopping to ensure quality and compliance. Complaints are registered, monitored and reviewed on a regular basis.

Complaints

We record and report on complaints and feedback we receive from supporters and the public. We will respond on a one-to-one basis and complaints are acknowledged no later than two working days after they are received. We aim to provide a full resolution to complaints within this timeframe; however, if this is not possible, we will aim to respond fully within 10 working days. The charity received and responded to 12 significant complaints in the financial year 2022/23. The bulk of these were in response to face-toface fundraising. This represents a reduction from 2021/22 where we saw 40 complaints.

Philanthropy and partnerships

The Up Against Time appeal continued to be the key focus for our philanthropy and partnerships programme in the 2022/23 financial year. Our work with major donors, trusts, foundations and corporates continued to build momentum, as we utilised our programme of special events to engage prospects and existing supporters. A highlight was our campaign launch event at Drapers’ Hall in November, coinciding with the public phase launch with our wider supporter base and across the media. We were able to leverage this media activity in relationships with key donors and prospects, who saw the coverage across multiple print and TV outlets, including the BBC, ITV and our Newsquest partnership, which was secured in April 2023.

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Our private phase activity also benefitted from collaboration across our entire Fundraising and Marketing function through our Big City Collection, which allowed us to engage key corporate supporters and key connections across the city. For this, we were able to draw on the support of our key influencers across the Steering Group and Property Group, who continue to support us with introductions to senior decision makers and opportunities to host or attend events. Our Property Group, led by Mike Hussey, has secured £300,000 towards the appeal, and continues to cultivate approaches within the property and construction sector.

Our Gala Committee, another group of highly-engaged and high-performing key influencers, delivered a spectacular event in April last year raising over £1 million for the Appeal. They have since turned their attention to the next gala in February 2024, as we enter the final year of the appeal. Our annual Sunningdale Golf Day was also a huge success, raising £35,500. We are incredibly grateful to Julia Leal-Hartogs and Bernardo Hartogs for their pivotal role in both events and continued involvement in London’s Air Ambulance Charity.

Alongside our appeal activity, our Innovation Circle grew from eight to 11 members during the financial year, allowing us to raise vital unrestricted funds for our service. Whilst income from the Innovation Circle is directed towards our day to day work, the members are highly engaged with our appeal activity and many of whom have generously contributed to both, illustrating their engagement. We have also grown our larger appeal-focussed donor circle with significant pledges (over £50,000) from major donors:

Pilot’s Circle (over £100,000) Helipad Circle (over £50,000k+) Mr Rahul Moodgal Mr Russ and Dr Yoshimi DeLeon The Bake Foundation

Trusts, foundations and the City Livery Companies

Over 100 charitable trusts and foundations supported our work in 2022/23, providing vital donations to keep our services running and to fund core operational, clinical and educational needs. The support of trusts and foundations is essential in helping us replace our two helicopters in 2024, and we received more £250,000 towards our Up Against Time appeal during the year. The London Freemasons fulfilled their three-year pledge towards our advanced trauma car fleet a year early and have committed to raise a further £3 million to our Up Against Time appeal by 2024 – a truly wonderful cornerstone of support and a fifth of our appeal total.

Support from trusts and foundations also drives forward strategic charity projects, including continued grants towards our Digital Transformation Project and our Emergency Preservation and Resuscitation (EPR) Innovation project.

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Community engagement and challenge events

In 2022/23 we continued to build on developing a strong Community Engagement strategy that allows us to reach local communities across London to inform them about our work and the Up Against Time appeal, and inspire them to support the charity.

Our schools and youth engagement activity goes from strength to strength with 89 different school and youth organisation visits conducted by our Schools and Youth Engagement Lead. She interacted with over 10,000 young people across the year, informing them about the work we do and inspiring the next generation of Doctors, Paramedics, Pilots and charity supporters. This activity was bolstered by the continued success of our school email programme in which we have been reaching out to schools across London via an e-marketing campaign. This has resulted in increased engagement with new schools including assemblies, careers fairs and some schools undertaking fundraising activities.

In October 2022, we delivered our first Big City Collection. Integrated with the press launch of the Up Against Time appeal, an army of over 80 volunteers and employees took to the streets of London to raise funds for the appeal in bucket collections across the City of London. Many charity partners including the East London Mosque also hosted collections during the week, resulting in over £14,000 raised.

Challenge events continue to recover following the pandemic with the London Marathon taking place in October 2022 and returning to its traditional slot in April 2023. Our team of 42 in the October race raised just under £102,000. In September we were due to hold our annual Helipad Abseil with 280 participants signed up to take part. Following the passing of Queen Elizabeth II, we took the decision to postpone three days of the event and the remaining participants took part in June 2023. Despite this, the event still managed to raise £127,000 with additional fundraising from the rescheduled date in June 2023.

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Charity infrastructure

In April 2023 the charity created a new post of Director of Finance, IT and Facilities, in order to ensure that we continue to develop these areas as we grow. An IT roadmap for the next three years is being agreed, with a focus on supporting the charity’s strategy whilst remaining aware of cyber risks.

The charity has now selected a new CRM system, Microsoft Dynamics, and has employed a specialist project manager to guide us through the design, build and adoption of the new system. This includes building a modern data warehouse and implementing new data processes and policies across the charity.

In 2019 the charity commenced an operational digital strategy programme to support frontline clinicians by sharing patient data electronically and supporting improved integration with LAS, Barts Health and the London major trauma network to support patients from injury to recovery. Over the last couple of years we have had to reprioritise some aspects to link in with the digital development of our partners – this has often been complex and time consuming. Despite this we have seen significant benefits, made significant improvements against our original benchmarking and the momentum continues.

In late 2019 we initiated a joint project with Barts Heath to develop the helipad offices and facilities on The Royal London Hospital to include:

The new facilities were opened on 9 May 2022 and have made a considerable improvement to daily operations and training. This would not have been possible without the support of a DHSC grant, County Air Ambulance Trust and Barts Health.

London’s Air Ambulance Charity is a member of Air Ambulances UK and maintains close links with other air ambulances through this membership.

The charity benchmarked its environmental footprint in late 2022. Scope 1 (direct emissions) and 2 (indirect emissions) emissions were assessed and the charity has implemented a carbon neutral policy offsetting these emissions. As part of reducing our future emissions we are replacing our petrol and diesel rapid response car fleet with petrol hybrids and keeping under review the use of sustainable aviation fuel for our helicopters. The charity is also planning to review its Scope 3 (supply chain missions) emissions in the next phase.

The charity is a complex organisation that works across and is integrated with key NHS stakeholders and landlords (offices, helipad and garage). We are part of the Air Ambulance UK sustainability forum to share knowledge across the industry and progress. As with most businesses today, these aspects are being taken into consideration with the decisions that we make while at the same time ensuring that we can meet our operational requirements for our patients.

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Developing our culture

Following an independent ‘Culture, Diversity and Inclusion’ review and survey in September 2020, in October 2022 the charity ran a follow up Culture Survey of the entire service (including Barts Health and LAS secondees) to measure progress and inform the implementation of further initiatives to continue to improve and develop our culture.

Overall, survey results indicated a highly engaged and motivated workforce, with a strong culture of pride and compassion. Progress was made on the lower scoring areas from the previous survey and results showed sustained levels of engagement post pandemic.

Key actions to drive a high performing culture included activity identified in our Culture Survey around diversity and inclusion, values and behaviours, leadership, change management and communication and collaboration. A new People Team is in place this year to deliver on our people and culture strategy, and other activity focussed on fostering our learning culture and developing our managers and leaders.

In addition, following the appointment of Bob Forsyth as our new Chair of the Board in 2022, the Board have continued to increase their visibility throughout the charity by attending our weekly all-hands meetings, Clinical Governance Days and observing our clinical team on shifts.

Salary policy

The salary of all our employees, including the senior management team, is reviewed annually as part of our wider rewards and benefit offering. The policy is designed to allow a degree of flexibility and to attract and retain a skilled and expert workforce. To deliver a fair remuneration policy and process, London’s Air Ambulance Charity follows the Good Pay Guidelines set by Association of Chief Executives of Voluntary Organisations (ACEVO), the charity leaders’ network, and we embrace its ethos that good pay, transparently set and communicated, means value for money. Pay levels are benchmarked against the social sector annually and at the point of recruitment, to ensure fair pay and value for money on our investment in people so that we can attract, retain and develop great people.

This year we introduced an internal pay band framework to provide clarity on our salary policy at every level of responsibility. In addition, we offered a cost of living support payment to all charity employees from November 2022 to February 2023, to help with increased costs over winter. In the context of continuing global uncertainties and economic challenges, fair reward has continued to remain important in retaining good people this year.

Safeguarding and whistleblowing policy

Safeguarding and whistleblowing policies and codes of conduct apply across the whole organisation to reduce and manage the risk of harm to supporters, staff and volunteers. We recognise that we have additional responsibilities to safeguard children and vulnerable adults. We encourage individuals to report concerns and recognise that there are many barriers to vulnerable people reporting abuse and we are committed to reviewing and improving reporting mechanisms. When concerns are raised, we investigate the circumstances with a view to understanding both the immediate and the potential structural causes and how we can take steps to prevent similar occurrences. Employees can report any type of harassment through several mechanisms, including a whistleblowing procedure.

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Thank you

We couldn’t do what we do without our supporters. Donating, playing our lottery, sacrificing your time, committing to challenges – every generous action helps us be there when a patient is critically injured in London.

Whether you have been with us from the start, over 30 years ago, or have more recently joined our family, thank you. You are a vital part of our team and we are proud to be funded by you.

Ambassadors

Innovation Circle

Individual supporters

Gala Committee

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Trusts

Corporates

Community groups

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Details regarding the trustees, registered office and auditors can be found on page 1. The trustees may also be referred to as the Board of Trustees or Directors (where relevant) in this Trustees’ Annual Report.

Strategic report

Matters requiring disclosure in the Strategic Report and Directors’ Report are disclosed under ‘Achievements and Performance’ and ‘Plans for Future Periods’ on pages 13 to 23 and ‘Consolidated Financial Review’ and ‘Risk Management’ on pages 27 to 32.

2023 CORPORATE GOVERNANCE REPORT

Aims – High standards

The Board aims to operate high standards of charity governance commensurate with the importance of our role to the charity’s key stakeholders, including patients, donors, our NHS partners, the emergency services and relevant regulators – but also proportionate to the scale of the charity.

Principles – We follow the Code

The Board believes that the Charity Governance Code (the Code) is appropriate to meet this aim and applies all elements of the Code, explaining if we do not yet do so, as recommended by the Code.

Governance progress in 2022-23 – Taking the charity to the next level

In 2022-23 we have made further progress on key aspects of our governance including:

Refreshing the Board – A more diverse Board

As reported in the 2021-22 Annual Report, a process (supervised by the Nominations Committee) was initiated ahead of 2022-23 to identify high quality candidates to increase the diversity of characteristics, cognitive style and experience of the Board in a way that would more faithfully represent the communities we serve and provide the skills required to govern the responsibilities of the charity.

An independent executive search firm assisted the Nominations Committee in developing a competency-based process to assess the suitably of candidates for the roles that we needed for trustees and for the new Chair. As a result of this process, on 2 May 2022, we were able to appoint five new trustees with a rich diversity of experience, background, functional skill and cognitive style.

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With the addition of those trustees we expect the ongoing Board to be broadly representative of the London community in a number of respects including gender, ethnicity, sexual orientation, age and integration with the London communities we serve. The disciplines of the new trustees include finance, HR, aviation and charity governance.

After a similar competency-based recruitment process involving external and internal candidates, the Nominations Committee proposed a preferred candidate for Chair of the Board, Bob Forsyth, the previous Chair of the Audit and Risk Committee. The Nominations Committee considered that Bob Forsyth had the appropriate competencies in change management, leadership and chair skills to take the charity to the next level. The proposal was unanimously supported by the Board.

On appointment, in line with the recently adopted Board Charter, the Chair proposed that Gemma Sherrington be appointed as Deputy Chair given her complementary skills and leadership performance to date. Again, this was unanimously supported by the Board. At the same time Bianca Gill was appointed as Audit Committee Chair and James Thomas as Risk Committee Chair; a new construct established to give more time to the supervision of the charity’s risks, especially operational risks.

Board effectiveness review – Striving for continuous improvement.

Two years ago the Board appointed Prospectus to conduct an independent external review of the Board’s effectiveness.

The review found that for a charity of its size, turnover, profile, significant complexity and risk, the governance of the organisation was broadly good and benchmarked well against the Code. The recommendations for improvement from that report and our progress thereon is summarised in the table below.

Recommendation Progress
A more representative diversity on the
Board to reflect the communities we serve
and a stronger inclusivity strategy across
our charity.		 The Board is now broadly representative
of the London community, as a result of
the new appointments. We continue to
work on increasing inclusivity across the
charity and its partners.
The Board being more reflective on its
performance (the ‘how did we do’ test).		 The Board reflects on the approach to the
meeting with a Trustee-only session after
certain Board meetings.
More extensive touchpoints between
formal meetings to increase trustee
learning, visibility and impact		 Additional intra-board calls are now
provided to update trustees on key areas
including digitalisation, regulatory risk
and aviation safety.
Trustees attend weekly stand-up calls and
Town Hall meetings, as well as observer -
shifts to witness missions.

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Recommendation Progress
Perform regular effectiveness reviews An external review will be held every
three years with the new Chair and
Deputy Chair running an internal review
later in 2023.
Longer term succession plans for trustees
and key roles.		 The internal review of performance of the
Board and individual trustees will inform
the 2024 succession wave affecting four
trustees.

The Board keeps these recommendations under review and is in the course of reviewing other useful opportunities for improvement.

Alignment with the Code – Inclusion is our priority

The Board has conducted its annual review of its application of the Code taking into account the external effectiveness review in the prior year. The Code guidance has been applied by the Board with support from its committees including the Audit, Risk and Nominations Committees. In addition, a temporary Remuneration Committee was established to consider executive pay awards. The Board has applied the Code across its seven principles but with a challenge culture to continuously improve on how we execute on such principles.

The Board remains focused on supporting the charity’s strategies to improve inclusion at all levels and with our partners. In June 2022, the All Inclusive group was formed to support the Equity, Diversity and Inclusion (EDI) work of the organisation. This is a staffled network with an agreed purpose to advocate for and support London’s Air Ambulance Charity to be an inclusive environment in which all employees, partners and volunteers feel safe, valued and that they belong. Over the last 12 months, All Inclusive has supported the learning aims of the charity by sourcing (and supporting the roll out of) EDI workshops for all employees and managers. In addition, they have agreed a plan of cultural holidays and awareness events to promote and celebrate, both internally and externally. All Inclusive has been involved in designing the charity’s first ever EDI Strategy (due to be published in late-2023), where we will make public our aspirations to be representative of the communities we serve in London.

Legal status

London's Air Ambulance Limited is a registered charity, and follows the rules, regulations and guidance of the Charity Commission. It is incorporated under the Companies Act 2006 and is a company limited by guarantee, governed by its memorandum and articles of association. As of 31 March 2023, there were 10 trustees each of whom guarantee liability of £10 in the event of the charity winding up.

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The Group is made up of London’s Air Ambulance Limited and London’s Air Ambulance Trading Limited. The charity owns the whole of the issued ordinary share capital in London's Air Ambulance Trading Limited, a company registered in England and Wales with company registration number 04836606. The subsidiary is used for trading activities, namely a society lottery, the raffle, the sale of charity merchandise and generation of commercial sponsorship income. A second wholly owned subsidiary, The Institute of Pre-Hospital Care Limited, a company registered in England and Wales with company registration number 06777277, has been dormant for the full year following the transfer of activities to the charity in 2021.

The trustees are satisfied that these accounts comply with the current statutory requirements of the charity's Memorandum and Articles of Association and the Charity Statement of Recommended Practice (FRS102).

CONSOLIDATED FINANCIAL REVIEW

The Board of Trustees is pleased to report that the total group income for the year amounted to £16,098k (2022: £12,476k), an increase of 29% year on year. Staff costs associated with generating voluntary income amounted to 11% (2022: 23%) of total income.

Principal sources of restricted and unrestricted income included: lottery, retail and trading sales of £5,745k (2022: £5,482k); £6,983k (2022: £5,263k) donations from individuals and corporates; funding from the NHS of £375k (2022: £425k) through a service level arrangement with Barts Health; income from events of £1,319k (2022: £398k).

Costs in the same period totalled £14,895k (2022: £13,021k), an increase of 14%. This increase was notably due to the cost of running lottery activities (£1,746k compared to £920k in the prior year). This represents an investment in our face to face fundraising portfolio to increase the number of regular supporters we have. The investment into this stream pays back within 18 months and we have industry level high sign up rates – on average 1,000 a week and very low cancelation rates. The investment in activity whilst we are promoting the Appeal means that we will have sustainable income throughout the fallow years for fundraising post the Appeal, building resilience and sustainability. This will also allow us to develop diversification of our fundraising portfolio.

The cost of charitable activities was £6,811k (2022: £6,855k). Governance costs were £125k (2022: £95k).

London's Air Ambulance Trading Limited received a total income of £7,085k (2022: £5,887k). All profits from London’s Air Ambulance Trading Limited, including merchandise sales, sponsorship income and lottery are passed up to the charity as donations from time to time during the year leaving a sufficient margin for the trading company to operate efficiently in terms of periodic stock purchase and lottery running costs. In 2023, profits of £3,903k were gifted to the Charity (2022: £4,393k).

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INVESTMENT POLICY

The trustees have considered the liquidity requirements and cash flow forecasts for the charity and have agreed a policy to retain sufficient unrestricted cash of a minimum of six months’ running costs. Unrestricted cash at 31 March 2023 was £12,891k which amounts to approximately 10 months of running costs (21/22: £13,230k, 13 months). The Trustees are satisfied that this level is appropriate at the year end.

At present, the charity holds all other available reserves in cash, excluding some small listed investments gifted to the charity and disclosed in note 13. This is to ensure that sufficient liquid funds are available to meet the significant committed expenditure on new helicopters due in 2024. Once this final payment has been made, the trustees will agree an investment policy for charity funds.

RESERVES POLICY

Reserves are held to safeguard the operation of the service in the event of an unexpected drop in income or in case of unexpected significant expenditure. The charity has achieved this goal whilst balancing day-to-day running of the charity, including running of the helicopters, with planned future capital expenditure and operational objectives.

The charity defines free reserves as unrestricted reserves less the value of designated funds and fixed assets. The trustees have agreed an aim to hold not less than six months’ running costs (excluding costs which are covered by a restricted or designated funds). At 31 March 2023, free reserves were £11,836k (2021/22: £11,372k), sufficient to fund ten months of running costs. The Trustees are satisfied that this level is appropriate at the year end.

At 31 March 2023 designated funds of £5,045k (2021/22: £5,453k) have been earmarked towards the cost of new helicopters, the helipad redevelopment and CRM projects. The charity will continue to build on its reserves as it works towards the investment in new helicopters in 2024/25. The designated funds are expected to be spent over the next financial year.

Restricted reserves of £2,998k (2021/22: £1,558k) are comprised of balances of all funds held for specific purposes as listed in note 20 to the accounts below and includes the net book value of fixed assets purchased with restricted funds.

The reserves policy is reviewed annually by the trustees to ensure that any new or changed legislation or guidance is incorporated and to take into account any changes in the circumstances of the charity.

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Risk management covering both charity and its subsidiary

The Board has continued to place greater emphasis and focus on strategy, performance and assurance over the last year. The relationship between risk and decision making is an area that we are continually striving to improve. Delegated authorities for finance and risk were discharged through the Audit and Risk Committee and the Chief Executive. During the year the Audit and Risk Committee was split into two separate committees to better reflect the growth and complexity of the charity and to provide a more focussed analysis into these two key areas. These committees regularly review the finances and the major risks to which the charity is exposed reporting back to the main Board. Risk management has been incorporated into the Safety Management System approach adopted across the charity; this brings an enhanced focus to risk and risk management in conjunction with the aviation risk focus provided by the Civil Aviation Authority (CAA).

There are seven principle risk areas.

Mitigations: We always operate with two pilots to improve crew awareness on missions. We engage with local planning to ensure we are aware of new buildings and have daily briefings concerning new obstacles (cranes etc.) and commercial drone activity that will affect us. In accordance with any weather limitations we always fly above the legal minimum height, regulated by the CAA. The aircraft are maintained in accordance with an approved maintenance schedule and any issues identified by the pilots are addressed by an appropriately qualified engineer. We are also actively engaged with the Department for Transport and Transport for London on airspace development and control over London for future technologies.

Mitigations: IT is outsourced to a specialist service provider to ensure secure networks and updated software. We also employ an independent consultant to advise and support us and we regularly monitor security threats to our systems. Administrative access is controlled, data is backed up and penetration and disaster recovery testing carried out. IT security enhancements are reviewed and upgraded together with regular staff training to improve awareness of threats. We have closely monitored the increased risk due to hybrid working and continue to evolve our security posture.

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Mitigations: We continue to monitor the risk and enhance our GDPR processes, policies and improve training to update to latest regulatory guidance and threats. IT and information security is regularly reviewed and updated, with regular penetration testing. We continue to improve security of data and data transfers with external data managers and monitor the contracts and training of third-party data handlers. The majority of our work is now conducted through SharePoint and cloud systems rather than a Remote Desktop Server to reduce the risks in working in a hybrid environment. Longer term, our IT roadmap sets out our IT development plan to adapt to a changing working environment and the ever changing risk and threat landscape.

Mitigations: Third-party provided canvassers are monitored and reviewed along with the agency, including regular update and training. Canvassers are interviewed and training and performance monitored by third parties. They are trained quarterly by our team and performance is monitored frequently and reviewed with the agencies through regular meetings, welcome call listening and mystery shopping to ensure quality and compliance. Complaints are registered, monitored and reviewed on a regular basis.

Mitigations: Plans include measures to improve our supporters’ journeys to retain current regular givers and lottery players, and campaigns developed to ensure we remain in the public eye developing new ways of acquiring donors. Measures also include financial levers to be pulled if required to ensure that the operational delivery to our patients is not affected.

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Mitigations: Mitigating plans include measures to increase fundraising through a range of public and private measures, including major doners, trusts and corporations, and expansion of our donors through digital and face-to-face activities – this is all work in progress. Alongside this the charity has in place a financial option (contingency) to cover any shortfall that may materialise.

Mitigations: In addition to contracting a specialist aviation contract manager, we have also brought in specific support to assist London’s Air Ambulance aviation staff with the CAA compliance processes who have significant experience with the new helicopter type. We have and are recruiting additional pilots to manage the pilot training needs and to ensure that our day-to-day operations are not impacted. The detailed project plans incude the different development lines and key milestones with some slippage built in, this includes a change hazard and risk log. The CAA has been briefed and agreed the planning dates are achievable for them to meet an operational date of 1 Oct 2024.

Financial risk management objectives and policies

The Group’s activities expose it to a number of financial risks including credit risk, inflation risk, liquidity risk and foreign exchange risk.

Credit risk

The Group’s principal financial assets are bank balances and trade and other debtors. The credit risk is primarily attributable to its trade receivables which are presented net of allowances for bad debts. The Group has no significant concentration of credit risk with exposure spread over a large number of parties. The credit risk on liquid funds is limited because the counterparties are banks with high credit ratings assigned by international credit-rating agencies.

Inflation risk

The cost of running the activities of the Group are affected by inflation. With UK inflation increasing during the year, there is a risk to the Group that costs increase unsustainably. The Group prepares detailed budgets including estimates of inflation, and reforecasts these costs regularly to manage this risk.

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Liquidity risk

The liquidity risk is that the Group is unable to settle its liabilities as they fall due. The Group prepares regular cash flow forecasts to monitor its ability to meet liabilities and the Trustees have agreed a reserves policy, detailed on page 28, in order to manage this risk.

Foreign Exchange risk

The Group is committed to the final payments for the two new helicopters during 2024, which will be made in Euros. There is a risk that exchange rate fluctuations affect the ability of the Group to make these payments. The Group regularly reviews cashflows and the balance of cash raised from the Up Against Time appeal and restricted to the purchase and running costs of the new helicopters. Funds are then transferred to a fixed term deposit account in Euros when appropriate, so that the exchange rate risk is mitigated.

Health and safety

London's Air Ambulance Limited is committed to maintaining a safe and healthy working environment wherever it operates; it does this through adopting safe working practices and procedures which are regularly reviewed and updated. Each individual who is engaged by or on behalf of London's Air Ambulance Limited either as an employee or as a volunteer, is aware of their responsibility for meeting these requirements.

The charity’s Health and Safety Policy is a key part of our overall strategy and provides the framework for managers to implement necessary action points such as hazard prevention, control procedures and employee training.

Our approach to health and safety includes a Safety Management System (SMS) which is approved and audited by the CAA. SMS represents an organisational approach to health and safety and risk management and is further supplemented at the helipad by quarterly Safety Review Board meetings. These meetings are minuted and all reports are retained on a database with hardcopies available in an incident book that is kept on site.

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TRUSTEES’ RESPONSIBILITIES

The trustees (who are also Directors of London's Air Ambulance Limited for the purposes of company law) are responsible for preparing the Trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice), including Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).

Company law requires the trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charitable company and the Group and of the income and expenditure of the Charitable Group for that period. In preparing those financial statements, the trustees are required to:

The trustees are responsible for keeping proper accounting records, which disclose with reasonable accuracy at any time the financial position of the charitable company and the Group and enables them to ensure that the Financial Statements comply with the Companies Act 2006. The trustees are also responsible for safeguarding the assets of the charitable company and group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

In so far as the trustees are aware:

Registered office:

5[th] Floor 77 Mansell Street E1 8AN

Signed on behalf of the Trustees

Bianca Gill Member of the Board of Trustees

20 September 2023

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Opinion

We have audited the financial statements of London’s Air Ambulance (the ‘parent charitable company’) and its subsidiaries (the ‘group’) for the year ended 31 March 2023 which comprise consolidated statement of financial activities, consolidated and charity balance sheets, consolidated statement of cash flows, and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102, the Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group and parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the group or the parent charitable company's ability to continue as a going concern for a period of at least 12 months from when the financial statements are authorised for issue.

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Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The trustees are responsible for the other information. The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information; we are required to report that fact.

We have nothing to report in this regard.

Other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Annual Report and Strategic Report.

We have nothing to report in respect of the following matters where the Companies Act 2006 require us to report to you if, in our opinion:

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Responsibilities of trustees

As explained more fully in the Statement of Trustees’ Responsibilities set out on page 33, the trustees (who are also the Directors of the parent charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of the financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the group and the parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditors under the Companies Act 2006 and report in accordance with regulations made under that Act.

Our objectives are to obtain reasonable assurance about whether the group and parent financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud are detailed below.

Identifying and assessing risks related to irregularities:

We assessed the susceptibility of the group and parent charitable company’s financial statements to material misstatement and how fraud might occur, including through discussions with the trustees, discussions within our audit team planning meeting, updating our record of internal controls and ensuring these controls operated as intended. We evaluated possible incentives and opportunities for fraudulent manipulation of the financial statements. We identified laws and regulations that are of significance in the context of the group and parent charitable company by discussions with trustees and updating our understanding of the sectors in which the group and parent charitable company operate.

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Laws and regulations of direct significance in the context of the group and parent charitable company include the Companies Act 2006 and guidance issued by the Charity Commission for England and Wales.

Further the group is subject to other laws and regulations where the consequences of non-compliance could have a material effect on amounts or disclosures in the financial statements; through a significant fine, litigation or restrictions on the group’s operations. We identified the most significant laws and regulations to be those issued by the CAA covering safety requirements in the aviation industry and those issued by the Gambling Commission covering requirements for running a lottery.

Audit response to risks identified:

We considered the extent of compliance with these laws and regulations as part of our audit procedures on the related financial statement items including a review of financial statement disclosures. We reviewed the parent charitable company’s records of breaches of laws and regulations, minutes of meetings and correspondence with relevant authorities to identify potential material misstatements arising. We discussed the parent charitable company’s policies and procedures for compliance with laws and regulations with members of management responsible for compliance.

During the planning meeting with the audit team, the engagement partner drew attention to the key areas which might involve non-compliance with laws and regulations or fraud. We enquired of management whether they were aware of any instances of non-compliance with laws and regulations or knowledge of any actual, suspected or alleged fraud. We addressed the risk of fraud through management override of controls by testing the appropriateness of journal entries and identifying any significant transactions that were unusual or outside the normal course of business. We assessed whether judgements made in making accounting estimates gave rise to a possible indication of management bias. At the completion stage of the audit, the engagement partner’s review included ensuring that the team had approached their work with appropriate professional scepticism and thus the capacity to identify noncompliance with laws and regulations and fraud.

There are inherent limitations in the audit procedures described above and the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely we would become aware of it. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

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Use of our report

This report is made solely to the parent charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the parent charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the parent charitable company and the parent charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

…………………………………… 09/22/2023 Claire Wills (Senior Statutory Auditor) Date……………………. For and on behalf of Saffery LLP Chartered Accountants Statutory Auditors 71 Queen Victoria Street, London, EC4V 4BE

Saffery LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006

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31 March 2023

CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING THE INCOME AND EXPENDITURE ACCOUNT)

YEAR ENDED 31 MARCH 2023

Restricted Unrestricted Total Total
Funds Funds Funds Funds
2023 2023 2023 2022
Note £’000 £’000 £’000 £’000
INCOME FROM
Donations and legacies 2 1,103
7,263		 8,366 5,988
Trading activities 3 860
6,225		 7,085 5,887
Charitable activities 4 -
540		 540 555
Investment income 4
103		 107 29
Coronavirus Job Retention
Scheme		 -
-		 - 17
TOTAL INCOME 1,967
14,131		 16,098 12,476
EXPENDITURE ON
Raising funds 5
Cost of raising donations -
6,363		 6,363 5,224
Cost of trading company -
1,721		 1,721 942
Charitable activities 6 561
6,250		 6,811 6,855
TOTAL EXPENDITURE 561 14,334 14,895 13,021
NET INCOME /
(EXPENDITURE) BEFORE NET
GAIN ON INVESTMENTS		 1,406
(203)		 1,203 (545)
Net gain on investments 14 -
-		 - 1
Transfer between funds -
-		 - -
NET INCOME /
(EXPENDITURE) FOR THE
YEAR 10 1,406
(203)		 1,203 (544)
Other gains and losses
Foreign exchange
gains/(losses) -
158		 158 -
NET MOVEMENT IN FUNDS 1,406
(45)		 1,361 (544)
Balances brought forward 1,592
17,571		 19,163 19,707
Balances carried forward 2,998
17,526		 20,524 19,163

The Statement of Financial Activities includes all gains and losses recognised in the year. All of the above amounts relate to continuing activities.

The notes on pages 42 to 67 form part of these financial statements.

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31 March 2023

CONSOLIDATED AND CHARITY BALANCE SHEETS

AT 31 MARCH 2023

Note
FIXED ASSETS
Tangible assets
13
Investments
14
CURRENT ASSETS
Stock
Debtors
15
Cash at bank and in hand
CREDITORS: Amounts
falling due within one year
16
NET CURRENT ASSETS
NET ASSETS
FUNDS
Restricted
20
Unrestricted:
General Funds
21
Designated Funds
21
TOTAL FUNDS		 Group
2023
Group
2022
£’000
£’000

4,812
2,024
3
3
4,815
2,027
7
10
1,592
1,222
16,622
18,980
18,221
20,212
(2,512)
(3,076)
15,709
17,136
20,524
19,163
2,998
1,592
12,481
12,118
5,045
5,453
20,524
19,163		 Charity
2023
Charity
2022
£’000
£’000
4,812
2,024
3
3
4,815
2,027
-
-
3,193
1,523
14,728
18,217
17,921
19,740
(2,212)
(2,604)
15,709
17,136
20,524
19,163
2,998
1,592
12,481
12,118
5,045
5,453
20,524
19,163

As permitted by Section 408 of the Companies Act 2006, no separate Statement of Financial Activities has been presented for the charity alone. The net income for the charity for the year was £1,361k (2022: net expenditure £515k).

These financial statements were approved by the trustees on 20 September 2023 and are signed on their behalf by:

……………………………. Bianca Gill Member of the Board of Trustees London’s Air Ambulance Limited

Company registration number: 02337239

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31 March 2023

CONSOLIDATED STATEMENT OF CASHFLOWS

AT 31 MARCH 2023
Group
2023
£’000
Cash flows from operating activities
Net income / (expenditure)
1,203
Adjustments for:
Depreciation charge
522
(Gains) / losses on investments
-
Gains / (losses) on foreign exchange
158
Loss/ (gain) on disposal of fixed assets
-
Dividends and interest from investments
(107)
Decrease / (increase) in stock
3
(Increase) / decrease in debtors
(370)
Increase / (decrease) in creditors
(564)
Net cash provided by operating activities
845
Cash flows from investing activities
Dividends and interest from investments
107
Purchase of property, plant and equipment
(3,310)
Net cash (used in) / from investing activities
(3,203)
Change in cash and cash equivalents in the year
(2,358)
Cash and cash equivalents at the beginning of
the year
18,980
Cash and cash equivalents at the end of the year
16,622
Note A – Analysis of changes in net debt
At 1 April
2022
Cash
Flows
£’000
£’000
Cash
18,980
(2,358)
18,980
(2,358)		 AT 31 MARCH 2023
Group
2023
£’000
Cash flows from operating activities
Net income / (expenditure)
1,203
Adjustments for:
Depreciation charge
522
(Gains) / losses on investments
-
Gains / (losses) on foreign exchange
158
Loss/ (gain) on disposal of fixed assets
-
Dividends and interest from investments
(107)
Decrease / (increase) in stock
3
(Increase) / decrease in debtors
(370)
Increase / (decrease) in creditors
(564)
Net cash provided by operating activities
845
Cash flows from investing activities
Dividends and interest from investments
107
Purchase of property, plant and equipment
(3,310)
Net cash (used in) / from investing activities
(3,203)
Change in cash and cash equivalents in the year
(2,358)
Cash and cash equivalents at the beginning of
the year
18,980
Cash and cash equivalents at the end of the year
16,622
Note A – Analysis of changes in net debt
At 1 April
2022
Cash
Flows
£’000
£’000
Cash
18,980
(2,358)
18,980
(2,358)		 AT 31 MARCH 2023
Group
2023
£’000
Cash flows from operating activities
Net income / (expenditure)
1,203
Adjustments for:
Depreciation charge
522
(Gains) / losses on investments
-
Gains / (losses) on foreign exchange
158
Loss/ (gain) on disposal of fixed assets
-
Dividends and interest from investments
(107)
Decrease / (increase) in stock
3
(Increase) / decrease in debtors
(370)
Increase / (decrease) in creditors
(564)
Net cash provided by operating activities
845
Cash flows from investing activities
Dividends and interest from investments
107
Purchase of property, plant and equipment
(3,310)
Net cash (used in) / from investing activities
(3,203)
Change in cash and cash equivalents in the year
(2,358)
Cash and cash equivalents at the beginning of
the year
18,980
Cash and cash equivalents at the end of the year
16,622
Note A – Analysis of changes in net debt
At 1 April
2022
Cash
Flows
£’000
£’000
Cash
18,980
(2,358)
18,980
(2,358)		 AT 31 MARCH 2023
Group
2023
£’000
Cash flows from operating activities
Net income / (expenditure)
1,203
Adjustments for:
Depreciation charge
522
(Gains) / losses on investments
-
Gains / (losses) on foreign exchange
158
Loss/ (gain) on disposal of fixed assets
-
Dividends and interest from investments
(107)
Decrease / (increase) in stock
3
(Increase) / decrease in debtors
(370)
Increase / (decrease) in creditors
(564)
Net cash provided by operating activities
845
Cash flows from investing activities
Dividends and interest from investments
107
Purchase of property, plant and equipment
(3,310)
Net cash (used in) / from investing activities
(3,203)
Change in cash and cash equivalents in the year
(2,358)
Cash and cash equivalents at the beginning of
the year
18,980
Cash and cash equivalents at the end of the year
16,622
Note A – Analysis of changes in net debt
At 1 April
2022
Cash
Flows
£’000
£’000
Cash
18,980
(2,358)
18,980
(2,358)		 Group
2022
£’000
(544)
442
(1)
-
52
(29)
2
196
1,541
1,659
29
(24)
5
1,664
17,316
18,980
At 31 March
2023
£’000
16,622
845
107
(3,310)
(3,203)
(2,358)
18,980
16,622
Cash
Flows
£’000
(2,358)
(2,358)
18,980 16,622

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31 March 2023

1. ACCOUNTING POLICIES

General information

London’s Air Ambulance Limited is a private company limited by guarantee incorporated in England and Wales under the Companies Act (company number 02337239). The address of the registered office is 5[th] Floor, 77 Mansell Street, London, E1 8AN. The objectives of the charity are set out on page 12.

Basis of accounting

The financial statements have been prepared in compliance with 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) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

London’s Air Ambulance Limited meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note.

The functional currency of the charity is considered to be pounds sterling because that is the currency of the primary economic environment in which the charity operates.

The financial statements are also presented in pounds sterling to the nearest £’000, unless otherwise stated.

Basis of consolidation

These financial statements consolidate the results of the charity and its wholly owned trading subsidiaries, London’s Air Ambulance Trading Limited and The Institute of Pre-Hospital Care Limited, on a line-by-line basis.

Preparation of the accounts on a going concern basis

The accounts of the charity have been prepared on a going concern basis. The directors confirm that the going concern basis remains appropriate for the preparation of these accounts based on the following assessment process:

As a result, the Directors concluded that the charity and the group have sufficient resources to meet its liabilities and continue in operation to 31 December 2024.

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31 March 2023

1. ACCOUNTING POLICIES - continued

Fund accounting

Unrestricted funds are available to spend on activities that further any of the purposes of the charity.

Designated funds are unrestricted funds of the charity which the trustees have decided at their discretion to set aside to use for a specific purpose.

Restricted funds are funds that can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes.

Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the items of income have been met, it is probable that the income will be received and the amount can be measured reliably.

Income from donations and gifts is recognised when the charity has entitlement to the funds, it is probable that the income will be received and the amount can be measured reliably.

Income from government and other grants, whether ‘capital’ grants or ‘revenue’ grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

For legacies, entitlement is taken as the earlier of the date on which either: the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executors that a distribution will be made, or when a distribution is received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is a treated as a contingent asset and disclosed if material.

Donated professional services and donated facilities are recognised as income when the charity has control over the item, any conditions associated with the donated item have been met, the receipt of economic benefit from the use by the charity of the item is probable and that economic benefit can be measured reliably. On receipt, donated professional services and donated facilities are recognised on the basis of the value of the gift to the charity which is the amount the charity would have been willing to pay to obtain services or facilities of equivalent economic benefit on the open market; a corresponding amount is then recognised in expenditure in the period of receipt.

In accordance with the Charities SORP (FRS 102), the contribution of volunteers is not recognised in the accounts.

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1. ACCOUNTING POLICIES - continued

Income (continued)

Income for the provision of training, research and education in pre-hospital medical care is measured at the fair value of the consideration received or receivable and represents amounts receivable for services rendered, stated net of discounts and of Value Added Tax. Revenue from the rendering of services is measured by reference to the stage of completion of the service transaction at the end of the reporting period provided the outcome can be reliably estimated. When the outcome cannot be reliably estimated, revenue is recognised only to the extent that expenses recognised are recoverable.

Revenue from the sale of goods is recognised when the significant risks and rewards of ownership of the goods have transferred to the buyer, usually on despatch of the goods, the amount of revenue can be measured reliably, it is probable that the associated economic benefits will flow to the entity, and the costs incurred or to be incurred in respect of the transactions can be measured reliably.

Revenue from the weekly lottery is recognised when the draw takes place. Income received in advance of a lottery draw is recognised as deferred income on the balance sheet.

Revenue from commercial sponsorship is recognised based over the period the service is provided.

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the bank.

Expenditure and irrecoverable VAT

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably.

Expenditure is classified under the following activity headings:

Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.

Operating lease agreements

Rentals applicable to operating leases where substantially all of the benefits and risks of ownership remain with the lessor are charged against profits on a straightline basis over the period of the lease.

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31 March 2023

1. ACCOUNTING POLICIES - continued

Allocation of support costs

Support costs are those functions that assist the work of the charity but do not directly undertake charitable activities. Support costs include office costs, finance, staff costs, depreciation and governance costs. These costs have been allocated between cost of raising funds and expenditure on charitable activities. Support costs have been allocated on the basis of time spent on raising funds or charitable activities.

Fixed assets and depreciation

Tangible fixed assets are initially recorded at cost.

Depreciation is calculated so as to write off the cost of an asset, less its estimated residual value, over the useful economic life of that asset as follows:

Helicopters - over its useful life to 2025
Medical Equipment - over 3 years straight line basis
Office Improvements - over the life of the lease
Plant and Equipment - over 3 years straight line basis
Computer Equipment - over 3 years straight line basis
Office Equipment - over 3 years straight line basis
Motor Vehicle Equipment - over the period of the vehicle lease
Assets under construction - no depreciation as not yet brought into use

Investments

Listed investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price.

Foreign currencies

The consolidated financial statements are presented in pound sterling (£), which is the charity’s functional and presentation currency. Transactions denominated in foreign currencies are translated at the rate of exchange prevailing at the time of the transaction. Foreign currency balances are translated at the rate of exchange prevailing at the Balance Sheet date. Foreign exchange gains and losses incurred in respect of our overseas operations are included in the SOFA within expenditure on charitable activities for the period in which they are incurred.

Realised gains and losses

All gains and losses are taken to the Statement of Financial Activities (SOFA) as they arise. Realised gains and losses on investments are calculated as the difference between sales proceeds and their opening carrying value or their purchase value if acquired subsequent to the first day of the financial year. Unrealised gains and losses are calculated as the difference between the fair value at the year end and their carrying value. Realised and unrealised investment gains and losses are combined in the SOFA.

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1. ACCOUNTING POLICIES - continued

Subsidiary undertakings

The subsidiary undertakings have been included in the charity’s balance sheet at cost.

Stocks

Stocks are stated at the lower of cost and estimated selling price less costs to sell, which is equivalent to the net realisable value. Cost is calculated using the FIFO (firstin, first-out) method. Provision is made for obsolete, slow-moving or defective items where appropriate.

Debtors

Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

Cash at bank and in hand

Cash at bank and cash in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

Pension costs

Contributions to defined contribution plans are recognised as an expense in the period in which the related service is provided. Differences between contributions payable in the year and the contributions actually paid are shown as either accruals or prepayments on the balance sheet.

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1. ACCOUNTING POLICIES - continued

Critical accounting judgements and key sources of estimation uncertainty

In the application of the charity’s accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates. The estimates and underlying assumptions are reviewed on an ongoing basis.

The largest estimate within the accounts is the value of the helicopters, their estimated useful life and their residual value. As we come closer to the replacement of the helicopters, the residual value of the old helicopters has been reassessed by a professional helicopter valuation service. This has resulted in a change of estimate and additional depreciation of £81k in the year to 31 March 2023.

2. INCOME FROM DONATIONS AND LEGACIES

Current year
Corporate and individuals
Foundations
Collections – pots and buckets
Gifts in kind
Comparative year
Corporate and individuals
Foundations
Collections – pots and buckets
Gifts in kind		 Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
£’000
£’000
£’000
408
6,575
6,983
695
177
872
-
58
58
-
453
453
1,103
7,263
8,366
Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000
49
5,214
5,263
213
191
404
-
42
42
-
279
279
262
5,726
5,988

Unrestricted donations include a total of £nil received from trustees (2022: nil).

During the year, the company received gifts in kind in the form of:

The charity benefits greatly from the involvement and enthusiastic support of its many volunteers, details of which are given in the Trustees’ Report. In accordance with FRS 102 and the Charities SORP (FRS 102), the economic contribution of general volunteers is not recognised in the accounts.

47

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

3. INCOME FROM TRADING ACTIVITIES

Current year
Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
Total
Funds
2022
£’000
£’000
£’000
£’000
Lottery, corporate sponsorships
and retail shop
-
5,745
5,745
5,482
Events
860
459
1,319
398
Other trading activities
-
21
21
7
860
6,225
7,085
5,887
Comparative year
Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000
Lottery, corporate sponsorships
and retail shop
-
5,482
5,482
Events
2
396
398
Other trading activities
-
7
7
2
5,885
5,887
4.
INCOME FROM CHARITABLE ACTIVITIES
Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
Total and
Unrestricted
Funds 2022
£’000
£’000
£’000
£’000
Institute of Pre-Hospital Care
-
165
165
130
Grant income from Barts Health
NHS Trust
-
375
375
425
-
540
540
555
5.
COSTS OF RAISING FUNDS
Current year
Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
£’000
£’000
£’000
Direct staff and related costs
-
1,740
1,740
Appeals costs
-
2,908
2,908
Support costs
-
1,715
1,715
-
6,363
6,363
Lottery, corporate sponsorships and
retail shop
-
1,721
1,721
-
8,084
8,084		 Restricted
Funds
2023
£’000
-
860
-		 Restricted
Funds
2023
£’000
-
860
-


Unrestricted
Funds
2023
Total
Funds
2023
Total
Funds
2022
£’000
£’000
£’000

5,745
5,745
5,482

459
1,319
398

21
21
7
860
6,225
7,085
5,887
Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000
-
5,482
5,482
2
396
398
-
7
7
2
5,885
5,887



Unrestricted
Funds
2023
Total
Funds
2023
Total and
Unrestricted
Funds 2022
£’000
£’000
£’000

165
165
130

375
375
425
-
540
540
555
Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
£’000
£’000
£’000
-
1,740
1,740
-
2,908
2,908
-
1,715
1,715
-
6,363
6,363
-
1,721
1,721
-
8,084
8,084

48

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

5. COSTS OF RAISING FUNDS - continued

Comparative year
Direct staff and related costs
Appeals costs
Support costs
Lottery, corporate sponsorships and
retail shop		 Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000
-
1,451
1,451
-
2,216
2,216
-
1,557
1,557
-
5,224
5,224
-
942
942
-
6,166
6,166

Analysis of costs of raising funds:

Current year
Fundraising activities
Lottery and retail shop		 Staff and
related costs
Depreciation Other costs
Total Funds
2023
£’000
£’000
£’000
£’000
1,740
13
4,610
6,363
17
-
1,704
1,721
1,757
13
6,314
8,084
Comparative year
Fundraising activities
Lottery and retail shop		 Staff and
related costs
Depreciation Other costs
Total Funds
2022
£’000
£’000
£’000
£’000
1,428
5
3,790
5,223
23
-
920
943
1,451
5
4,710
6,166

49

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

6. CHARITABLE ACTIVITIES

Current year
Charitable Activities:
Helicopter maintenance
Direct helicopter costs
Fire-fighters costs
Vehicle leasing
Direct vehicle costs
Consultancy fees
Institute costs
Other related costs
Support costs
Comparative year
Charitable Activities:
Helicopter maintenance
Direct helicopter costs
Fire-fighters costs
Vehicle leasing
Direct vehicle costs
Consultancy fees
Institute costs
Other related costs
Support costs		 Restricted
Funds
2023
Unrestricted
Funds
2023
Total
Funds
2023
£’000
£’000
£’000
-
1,544
1,544
255
1,290
1,545
-
325
325
66
25
91
-
378
378
-
99
99
57
207
264
183
903
1,086
-
1,479
1,479
561
6,250
6,811
Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000
2
1,315
1,317
618
1,089
1,707
-
286
286
107
19
126
-
336
336
-
95
95
32
200
232
731
907
1,638
-
1,118
1,118
1,490
5,365
6,855

50

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

6. CHARITABLE ACTIVITIES - continued

Analysis of charitable activities:

Current year
Helicopter maintenance
Direct helicopter costs
Fire-fighters costs
Vehicle leasing
Direct vehicle costs
Consultancy fees
Institute costs
Other related costs
Support costs
Comparative year
Helicopter maintenance
Direct helicopter costs
Fire-fighters costs
Vehicle leasing
Direct vehicle costs
Consultancy fees
Institute costs
Other related costs
Support costs		 Staff and
related costs
Depreciation
Other costs
Total 2023
£’000
£’000
£’000
£’000
-
-
1,544
1,544
799
387
359
1,545
325
-
-
325
-
-
91
91
356
-
22
378
-
-
99
99
-
-
264
264
971
115
-
1,086
789
2
688
1,479
3,240
504
3,067
6,811
Staff and
related costs
Depreciation
Other costs
Total 2022
£’000
£’000
£’000
£’000
-
-
1,317
1,317
715
306
686
1,707
286
-
-
286
-
-
126
126
308
-
28
336
-
-
95
95
-
-
232
232
915
174
549
1,638
614
3
501
1,118
2,838
483
3,534
6,855

51

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

7. SUMMARY ANALYSIS OF EXPENDITURE AND RELATED INCOME FOR CHARITABLE ACTIVITIES

The cost of the two main charitable activities and the sources of income directly to support those activities is summarised below:

Current year
Grant income
Institute income
Total charitable income
Costs
Net cost funded from other income
Comparative year
Grant income
Institute income
Total charitable income
Costs
Net cost funded from other income		 Emergency
Medical
Service
Educational
Activities
Total
2023
£’000
£’000
£’000
375
-
375
-
165
165
375
165
540
(6,547)
(264)
(6,811)
(6,172)
(99)
(6,271)
Emergency
Medical
Service
Educational
Activities
Total
2022
£’000
£’000
£’000
425
-
425
-
130
130
425
130
555
(6,622)
(232)
(6,854)
(6,197)
(102)
(6,299)

52

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

8. SUPPORT COSTS

When allocating support costs the charity follows the below process:

Current year
Staff and related costs
Finance costs
Depreciation
Office costs
Governance costs (see note 9)
Comparative year
Staff and related costs
Finance costs
Depreciation
Office costs
Governance costs (see note 9)		 Raising
funds
Charitable
activities
Total
2023
£’000
£’000
£’000
965
826
1,791
-
7
7
4
7
11
746
514
1,260
-
125
125
1,715
1,479
3,194
Raising
funds
Charitable
activities
Total
2022
£’000
£’000
£’000
929
549
1,478
-
2
2
6
3
9
622
469
1,091
-
95
95
1,557
1,118
2,675

53

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

9. GOVERNANCE COSTS

Salary costs
Office costs
IT costs
Audit fees
Legal fees
10. NET INCOME
Net income is stated after charging:
Staff pension contributions
Operating lease costs – building
Operating lease costs - other
Depreciation
- on owned assets
Auditors' remuneration
- as auditors of the parent charity
- as auditors of the subsidiaries
- for other services
11. TAXATION		 Unrestricted
and Total
Funds 2023
Unrestricted
and Total
Funds 2022
£’000
£’000
82
62
8
9
9
2
25
18
1
4
125
95
2023
2022
£’000
£’000
367
334
117
174
196
33
522
493
25
22
20
14
3
5

The charity is exempt from tax on income and gains falling within section 505 of the Taxes Act 1988 or section 252 of the Taxation of Chargeable Gains Act 1992 to the extent that these are applied to its charitable objects.

54

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

12. STAFF COSTS

Wages and salaries
Social security costs
Pension costs		 2023
2022
£’000
£’000
3,999
3,573
430
370
367
345
4,796
4,288

Pension costs are allocated to activities in proportion to the related staffing costs.

The number of employees whose emoluments for the year fell within the following bands was:

bands was:
Number of employees Number of employees
2023 2022
£60,000 to £69,999 5 6
£70,000 to £79,999 3 6
£80,000 to £89,999 6 2
£90,000 to £99,999 1 2
£100,000 to £109,999 - 1
£110,000 to £119,999 - -
£120,000 to £129,999 - -
£130,000 to £139,999 2 2

There were pension contributions of £128,049 paid to higher paid staff during the year. (2022: £133,402). The number of higher paid employees accruing benefits under defined contribution pension schemes were 16 (2022: 18).

The key management personnel of the charity comprise the trustees, the Chief Executive Officer, the Chief Operating Officer and the Director of Fundraising and Marketing. The total employee benefits of the key management personnel of the charity were £334,178 (2022: £367,675).

The trustees have not received any remuneration during the year (2022: £nil).

No out-of-pocket expenses were reimbursed to trustees during the year (2022: £nil).

No charity trustee received payment for professional or other services supplied to the charity (2022: £nil).

The aggregate termination payments during the year totalled £9,847 (2022: £20,556). These amounts are included, where relevant, in the analysis of the number of employees earning over £60,000.

55

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

12. STAFF COSTS - continued

Particulars of employees:

The average number of staff employed by the Group during the year amounted to:

Fire fighters
Pilots
Operational
Fundraising		 Group
2023
Group
2022
No
No
5
5
5
5
33
36
37
32
80
78

13. TANGIBLE FIXED ASSETS GROUP

COST
At 1 April 2022
Additions
Disposals
At 31 March 2023
DEPRECIATION
At 1 April 2022
Charge for the
year
Eliminated on
disposal
At 31 March 2023
NET BOOK
VALUE
At 31 March 2023
At 31 March 2022		 Helicopters
Medical
Equipment
Office
Improve-
ments
Plant, Office
&
Computer
Equipment
Motor
Vehicle
Equipment
Assets under
construction
Total
£’000
£’000
£’000
£’000
£’000
£’000
£’000
4,983
633
265
448
32
-
6,361
-
-
53
26
-
3,231
3,310
-
-
-
-
(32)
-
(32)
4,983
633
318
474
-
3,231
9,639
3,122
478
265
440
32
-
4,337
387
115
8
12
-
-
522
-
-
-
-
(32)
-
(32)
3,509
593
273
452
-
-
4,827
1,474
40
45
22
-
3,231
4,812
1,861
155
-
8
-
-
2,024

Assets Under Construction represents the part payment, made in July 2022, for two new helicopters to be delivered in Summer 2024. The total cost of purchase and management of change process to bring the two new helicopters into operational service is £12.5m.

The charity has a capital commitment to pay a further 8.7m Euros in September/October 2024 when the helicopters come into operational service.

56

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

13. TANGIBLE FIXED ASSETS (continued)

CHARITY
Helicopters
Medical
Equipment
Office
Improve-
ments
Plant, Office
&
Computer
Equipment
Motor
Vehicle
Equipment
Assets under
construction
Total
£’000
£’000
£’000
£’000
£’000
£’000
£’000
COST
At 1 April 2022
4,983
629
265
416
32
-
6,325
Additions
-
-
53
26
-
3,231
3,310
Disposals
-
-
-
-
(32)
-
(32)
At 31 March 2023
4,983
629
318
442
-
3,231
9,603
DEPRECIATION
At 1 April 2022
3,122
474
265
408
32
-
4,301
Charge for the
year
387
115
8
12
-
-
522
Eliminated on
disposal
-
-
-
-
(32)
-
(32)
At 31 March 2023
3,509
589
273
420
-
-
4,791
NET BOOK
VALUE
At 31 March 2023
1,474
40
45
22
-
3,231
4,812
At 31 March 2022
1,861
155
-
8
-
-
2,024
14. INVESTMENTS
Unrestricted
Unrestricted
Group
2023
Group
2022
Charity
2023
Charity
2022
£’000
£’000
£’000
£’000
Market value at 1 April
3
2
3
2
Net gain on revaluation
-
1
-
1
Market value at 31 March
3
3
3
3
Analysis of investments at year end:
£’000
£’000
£’000
£’000
Unlisted UK subsidiary undertakings
-
-
-
-
Listed UK Equities
3
3
3
3
3
3
3
3		 CHARITY
Helicopters
Medical
Equipment
Office
Improve-
ments
Plant, Office
&
Computer
Equipment
Motor
Vehicle
Equipment
Assets under
construction
Total
£’000
£’000
£’000
£’000
£’000
£’000
£’000
COST
At 1 April 2022
4,983
629
265
416
32
-
6,325
Additions
-
-
53
26
-
3,231
3,310
Disposals
-
-
-
-
(32)
-
(32)
At 31 March 2023
4,983
629
318
442
-
3,231
9,603
DEPRECIATION
At 1 April 2022
3,122
474
265
408
32
-
4,301
Charge for the
year
387
115
8
12
-
-
522
Eliminated on
disposal
-
-
-
-
(32)
-
(32)
At 31 March 2023
3,509
589
273
420
-
-
4,791
NET BOOK
VALUE
At 31 March 2023
1,474
40
45
22
-
3,231
4,812
At 31 March 2022
1,861
155
-
8
-
-
2,024
14. INVESTMENTS
Unrestricted
Unrestricted
Group
2023
Group
2022
Charity
2023
Charity
2022
£’000
£’000
£’000
£’000
Market value at 1 April
3
2
3
2
Net gain on revaluation
-
1
-
1
Market value at 31 March
3
3
3
3
Analysis of investments at year end:
£’000
£’000
£’000
£’000
Unlisted UK subsidiary undertakings
-
-
-
-
Listed UK Equities
3
3
3
3
3
3
3
3		 CHARITY
Helicopters
Medical
Equipment
Office
Improve-
ments
Plant, Office
&
Computer
Equipment
Motor
Vehicle
Equipment
Assets under
construction
Total
£’000
£’000
£’000
£’000
£’000
£’000
£’000
COST
At 1 April 2022
4,983
629
265
416
32
-
6,325
Additions
-
-
53
26
-
3,231
3,310
Disposals
-
-
-
-
(32)
-
(32)
At 31 March 2023
4,983
629
318
442
-
3,231
9,603
DEPRECIATION
At 1 April 2022
3,122
474
265
408
32
-
4,301
Charge for the
year
387
115
8
12
-
-
522
Eliminated on
disposal
-
-
-
-
(32)
-
(32)
At 31 March 2023
3,509
589
273
420
-
-
4,791
NET BOOK
VALUE
At 31 March 2023
1,474
40
45
22
-
3,231
4,812
At 31 March 2022
1,861
155
-
8
-
-
2,024
14. INVESTMENTS
Unrestricted
Unrestricted
Group
2023
Group
2022
Charity
2023
Charity
2022
£’000
£’000
£’000
£’000
Market value at 1 April
3
2
3
2
Net gain on revaluation
-
1
-
1
Market value at 31 March
3
3
3
3
Analysis of investments at year end:
£’000
£’000
£’000
£’000
Unlisted UK subsidiary undertakings
-
-
-
-
Listed UK Equities
3
3
3
3
3
3
3
3
4,983
629
318
442
-
3,231
9,603
3,122
474
265
408
32
-
4,301
387
115
8
12
-
-
522
-
-
-
-
(32)
-
(32)
3,509
589
273
420
-
-
4,791
1,474
40		 45
22
-
3,231
4,812
-
8
-
-
2,024
Unrestricted
Unrestricted
Group
2023
Group
2022
Charity
2023
Charity
2022
£’000
£’000
£’000
£’000
3
2
3
2
-
1
-
1
3
3
3
3
£’000
£’000
£’000
£’000
-
-
-
-
3
3
3
3
3
3
3
3

57

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

14. INVESTMENTS – continued

All investments are carried at their fair value. Investments in equities are all traded in quoted public markets, primarily the London Stock Exchange. The basis of fair value for quoted investments is equivalent to the market value, using the bid price. Asset sales and purchases are recognised at the date of trade at cost.

London’s Air Ambulance Trading Limited

At 31 March 2023, the charity owned all of the ordinary share capital in London's Air Ambulance Trading Limited (registered number 04836606), a private company limited by shares registered in the UK. The registered office is 5[th] Floor, 77 Mansell Street, London, E1 8AN. The subsidiary, which is not itself a charity, is used for the purpose of trading, which in the year was the selling of charity merchandise, sourcing of corporate sponsorships and the running of a weekly lottery. All profits of London's Air Ambulance Trading Limited are gifted to the charity.

The summary financial performance of the subsidiary alone is:
2023 2022
£ £
Turnover 5,745,279 5,482,829
Cost of sales (1,657,527) (900,026)
Administrative expenses (184,395) (189,407)
Interest receivable - 4
Net profit 3,903,357 4,393,400
Reserves b/f
Amount gift aided to the charity (3,903,357) (4,393,400)
Retained in subsidiary - -
The assets and liabilities of the subsidiary were:
2023 2022
£ £
Fixed assets - -
Current assets 1,974,532 824,302
Current liabilities and provisions (1,974,530) (824,300)
Total net assets 2 2
Aggregate share capital and reserves 2 2

58

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14. INVESTMENTS – continued

The Institute of Pre-Hospital Care Limited

At 31 March 2023, the charity owned all of the ordinary share capital of The Institute of Pre-Hospital Care Limited (registered number 06777277), a private company limited by shares registered in the UK. The registered office is 5[th] Floor, 77 Mansell Street, London, E1 8AN. The IoPHC is used for the provision of training, research and education in pre-hospital medical care.

On 30 November 2020 the business of the Institute was transferred to come under the parent company, London’s Air Ambulance Limited. Following this transfer and the final gift aid distribution to the parent charity, the company is now dormant.

The summary financial performance of the subsidiary alone is:

Turnover
Cost of sales
Administrative expenses
Interest receivable
Other gains/losses – loan waiver
Tax
Net profit
Reserves b/f
Amount gift aided to the charity
Retained in subsidiary
The assets and liabilities of the subsidiary were:
Fixed assets
Current assets
Current liabilities
Total net assets
Aggregate share capital and reserves		 2023
2022
£
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
28,877
-
(28,877)
-
-
2023
2022
£
£
-
-
100
100
-
-
100
100
100
100

59

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

15. DEBTORS

Group Group Charity Charity
2023 2022 2023 2022
£’000 £’000 £’000 £’000
Trade debtors 37 20 37 19
Other debtors 434 178 361 177
Prepayments and accrued income 1,121 1,024 1,121 974
Amounts owed by Group undertakings - - 1,674 353
1,592 1,222 3,193 1,523

16. CREDITORS: Amounts falling due within one year

Trade creditors
Taxation and social security
Sundry Creditors
Accruals and deferred income		 Group
2023
Group
2022
Charity
2023
Charity
2022
£’000
£’000
£’000
£’000
1,320
1,320
1,268
1,250
118
102
118
101
155
177
146
122
919
1,477
680
1,131
2,512
3,076
2,212
2,604

17. DEFERRED INCOME

Balance at 1 April
Amount released to income
Amount deferred in the year
Balance at 31 March		 2023
2022
£’000
£’000
451
338
(451)
(338)
231
451
231
451

Deferred income comprises lottery receipts, funding and course income received in advance.

60

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

18. COMMITMENTS UNDER OPERATING LEASES

At the year end the charity had total minimum lease payments under noncancellable operating leases as set out below.

Group and charity

Group and charity
Operating leases which expire:
Within 1 year
Between 1 and 5 years		 2023
2022
Land and
buildings
Other
Land and
buildings
Other
£’000
£’000
£’000
£’000
187
65
187
45
295
82
482
39
482
147
669
84

19. ANALYSIS OF NET ASSETS IN FUNDS

Fund balances at 31 March 2023 are represented by:

Restricted funds
Unrestricted funds
General funds
Designated funds		 Tangible fixed
assets and
Investments
Cash at
bank
Other net
liabilities
Total
£’000
£’000
£’000
£’000
2,424
432
142
2,998
645
12,891
(1,055)
12,481
1,746
3,299
-
5,045
4,815
16,622
(913)
20,524

Fund balances at 31 March 2022 are represented by:

Restricted funds
Unrestricted funds
General funds
Designated funds		 Tangible fixed
assets and
Investments
Cash at
bank
Other net
liabilities
Total
£’000
£’000
£’000
£’000
1,280
5,840
(5,528)
1,592
747
7,687
3,684
12,118
-
5,453
-
5,453
2,027
18,980
(1,844)
19,163

61

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

20. RESTRICTED INCOME FUNDS

Current year
Helicopter Fund
Manikins Fund
Response Car Fund
Patient Liaison Nurse
Fund
Ultra Sounds
Thomas Packs
BSc Scholarships
Helipad Ops
Fellowship Fund
Patient Support
PRU
Institute Activity Fund
Helipad Redevelopment
Fund
Helicopter Costs
Restricted funds		 Balance at
1 April 2022
Income Expenditure
Transfer
Balance at
31 Mar 2023
£’000
£’000
£’000
£’000
£’000
1,207
1,567
(257)
-
2,517
23
13
(10)
-
26
37
217
(51)
-
203
38
-
(25)
-
13
5
70
(4)
-
71
5
-
-
-
5
2
-
-
-
2
101
67
(96)
-
72
63
-
(25)
-
38
15
-
(1)
-
14
4
-
(1)
-
3
11
30
(32)
-
9
81
-
(56)
-
25
-
3
(3)
-
-
1,592
1,967
(561)
-
2,998

62

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

20. RESTRICTED INCOME FUNDS - continued

Comparative year
Helicopter fund
Manikins fund
Response car fund
Patient Liaison Nurse
fund
Ultra sounds
Thomas packs
BSc scholarships
Presentation & outreach
equipment
Helipad ops
Fellowship fund
Patient support
PRU
Institute activity fund
Helivan fund
Helipad redevelopment
fund
Helicopter costs
Additional medical team
trial
Other restricted funds
Restricted funds		 Balance at
1 April 2021
Income Expenditure
Transfer
Balance at
31 Mar 2022
£’000
£’000
£’000
£’000
£’000
1,353
56
(202)
-
1,207
39
9
(25)
-
23
25
112
(100)
-
37
45
-
(7)
-
38
19
-
(14)
-
5
2
4
(1)
-
5
2
-
-
-
2
-
1
(1)
-
-
127
16
(42)
-
101
60
8
(5)
-
63
16
-
(1)
-
15
5
6
(7)
-
4
3
34
(26)
-
11
4
-
(4)
-
-
667
-
(620)
34
81
417
-
(417)
-
-
-
10
(10)
-
-
-
8
(8)
-
-
2,784
264
(1,490)
34
1,592

Name of fund Description, nature and purpose of fund

Helicopter fund To purchase an additional helicopter and fund its ongoing operations as well as extended daylight hours for 5 years. Manikins fund To purchase medical manikins for training purposes. Response car fund To contribute to the running cost of the response cars. Patient Liaison Nurse fund To fund the patient liaison nurse. Ultra sounds To purchase portable ultrasound equipment used in

To purchase portable ultrasound equipment used in roadside medical interventions.

Thomas packs BSc scholarships

To purchase portable medical equipment bags. To fund the student fees and medical conference fees for two students a year studying towards the Intercalated BSc in Pre-Hospital Care provided by Queen Mary University and The Institute of Pre-Hospital Care Ltd.

63

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

20. RESTRICTED INCOME FUNDS - continued

Presentation and outreach equipment To fund the purchase of laptops, tablets and other equipment to support our educational and outreach programmes. Helipad ops To purchase various items of equipment for use during missions and fund projects supporting operational delivery. Fellowship fund To pay for a three year fellowship for assistance with clinical research and co-ordination, particularly research into the causes of death during trauma. Patient support To pay for the ‘patient survivor’ booklet and a patient area of the charity’s website. PRU To contribute to the running cost of the PRU. Institute activity fund To support the activities of the Institute of Pre-Hospital Care. Helivan fund To purchase and fit out a van to support our educational and outreach programme. Helipad redevelopment fund To fund helipad improvements including office accommodation, training facilities and storage. Helicopter costs To fund helicopter costs, including funds to aid the continuation and expansion of the current helicopter service. Additional medical team trial

To fund costs associated with the trial of a third medical team.

64

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

21. UNRESTRICTED INCOME FUNDS

Current year Balance at Net gain Transfers
Balance at
1 April Income Expenditure on and other
31 March
2022 investment gains/losses
2023
£’000 £’000 £’000 £’000 £’000
£’000
General
funds 12,118 14,131 (13,926) -
158
12,481
Designated
helicopter
fund 4,000 - - -
-
4,000
Designated
CRM and
helipad
development 1,453 - (408) -
-
1,045
17,571 14,131 (14,334) -
158
17,526
The designated helicopter fund relates to funds set aside for the future helicopter
purchase.
The designated CRM and helipad development fund relates to the purchase and
implementation of a new CRM system and charity contribution towards the cost of
the helipad development.
Comparative Balance at Net gain Balance at
year 1 April Income Expenditure on Transfers
31 March
2021 investment 2022
£’000 £’000 £’000 £’000 £’000
£’000
General
funds 10,923 12,213 (10,983) -
(35)
12,118
Designated
helicopter
fund 4,000 - - -
-
4,000
Designated
CRM and
helipad
development 2,000 - (547) -
-
1,453
16,923 12,213 (11,530) -
(35)
17,571

65

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

22. RELATED PARTY TRANSACTIONS

London's Air Ambulance Trading Limited, a wholly owned trading subsidiary, made a payment of £3,903,357 (2022: £4,393,400) to the charity during the year under a deed of covenant. At the balance sheet date, the amount owing was £1,674,120 to the charity, which is included within debtors (2022: £352,838). This is an intercompany account between the charity and its wholly owned subsidiary. No interest is charged on the amount and regular repayments are made by the subsidiary.

The Institute of Pre-hospital Care Limited, a wholly owned trading subsidiary, had no taxable profits. A gift aid payment of £nil was made to gift historic reserves to the charity (2022: £28,877). At the balance sheet date, the amount due to the subsidiary was £100 (2022: £100). This is an inter-company account between the charity and its wholly owned subsidiary. No interest is charged on the amount and regular repayments are made by the subsidiary.

There were no other related party transactions during the year.

23. COMPANY LIMITED BY GUARANTEE

The Charitable Company is limited by guarantee and, as such, has no share capital. In the event of the company being wound up, the liability in respect of the guarantee is limited to £10 per member of the company. The total of such guarantees at 31 March 2023 was £100 (2022: £70).

24. FINANCIAL INSTRUMENTS

Group Group Charity Charity
2023 2022 2023 2022
£’000 £’000 £’000 £’000

Financial assets measured at fair value through statement of financial activities:

Investments 3 3 3 3

66

DocuSign Envelope ID: F4C59167-6437-48B9-A5F4-14DCD459D6DF

31 March 2023

25. COMPARATIVE STATEMENT OF FINANCIAL ACTIVITIES

The full consolidated statement of financial activities for the year ended 31 March 2022 is presented below:

INCOME FROM
Donations and legacies
Trading activities
Charitable activities
Investment income
Coronavirus job retention scheme
TOTAL INCOME
EXPENDITURE ON
Raising funds
Cost of raising donations
Cost of trading company
Charitable activities
TOTAL EXPENDITURE
Net income / (expenditure)
before net gain on investments
Net gain on investments
Transfer
NET INCOME / (EXPENDITURE) FOR
THE YEAR
Total funds brought forward
TOTAL FUNDS CARRIED FORWARD		 Restricted
Funds
2022
Unrestricted
Funds
2022
Total
Funds
2022
£’000
£’000
£’000

262
5,726
5,988
2
5,885
5,887
-
555
555
-
29
29
-
17
17
264
12,212
12,476
-
5,224
5,224
-
942
942
1,490
5,365
6,855

1,490
11,531
13,021
(1,226)
681
(545)
-
1
1
34
(34)
-
(1,192)
648
(544)
2,784
16,923
19,707
1,592
17,571
19,163

67