CARIN 4& Northern Arf Ireland Hospice Trustees Annual Report and Consolidated Financial Statements for the Financial Year ending 31 St March 2024 nihospice.org o@00 H••d OlficÈ,18 0'Ne511 Road. Newtownabbey. B736 6WB
Northern Ireland HosPI Trustees Report and Consolidated Financial Ststements For the Financial Year Ended 31 March 2024 Table of Contents Message from Chair and CEO ............................................................................................................. Trustees and Other information . Report of the Board of Trustees............................................................................................................ Our Future Plans.................................................................................................... .20 Financial Review . .22 IndependentAuditor's Report................................................................................... Company Statement of Financial Activities (Including an Income and Expenditure Account) for Financial Year Ended 31 March 2024................................................................................................ 41 .36 Consolidated Statement of Financial Activities (Including an Income and Expenditure Account) for Financial Year Ended 31 March 2024...................................................................... .42 Company Balan Sheet as at 31 March 2024.................................................................................. 43 Consolidated Balance Sheet as at 31 March 2024............................................... .44 Company Statement of Cash Flows for the Financial Year Ended 31 March 2024............................ 45 Consolidated Statement of Cashflows for the Financial Year Ended 31 March 2024................. .46 Note to Accounts................................................................................................................................ 47
Northern Ireland Hospice Trustees Report and Consolidated Financial Ststements For the Financial Year Ended 31 March 2024 Message from Chair and CEO It is our great privilege to present the 2023124 Annual Report. This year, we celebrated a significant milestone: 40 years of delivering eXptIOnal palliative care to our community. This achievement reflects the passion, commitment, and dedication of our staff, volunteers, and supporters, both past and present. We extend our deepest gratitude to everyone who has played a crucial role in providing specialist and compassionate care, making a real difference to patients and their families year after year. Every year, Northern Ireland Hospice cares for more than 4,000 babies, children and adults living with life-limiting conditions or facing the end of their lives. Our care not only wraps around our patients but also their families and loved ones with services such as bereavement counselling and other aspects of social care. The nature of the demands served by our charity are also changing with increasing medical and social complexity, along with an ageing population and later diagnoses. This presents ongoing challenges that we have risen to by innovating and adapting our services to meet the needs of patients, their families and loved ones. Our services are provided free at the point of use, yet unlike the NHS. we do not receive full state funding. While some government funding supports our work, most of our adult and children's services are funded by the generosity of our community, local businesses. trusts, foundations, and philanthropists locally and internationally. Reflecting on the past year and the previous four decades of remarkable progress, we must also acknowledge the challenges we have fad. The current cost-of- living crisis, an intricate economic and political landscape, and the reduction in statutory funding for our Children's Hospice services have made our work even more challenging. In Northern Ireland, specialist palliative care can be difficult to access for both children and adults, resulting in considerable unmet need. Too many people are unable to receive the care they deserve. In Northern Ireland Hospice we are committed to advocating for change that ensures equity of access to specialist palliative care. We are engaging with local government and political parties to secure the recurring funding necessary to sustain our vital services. To secure the sustainability of our Hospice ServiS, we introduced a new five-year strategy in 2023124, focusing on growing income and ensuring the long-term financial stability of the charity in order that we can continue to serve those who need our seprfices. The first phase of this strategy is dedicated to achieving financial stability while maintaining our existing services and building the capacity for future development. Our plan outlines a path to transition into a more sustainable financial model that allows us to invest in improved and new services for those in need of palliative care. This will be achieved through a series of strategic interventions, including a cost transformation programme, clearer servi definitions, and enhand cost management. We are pleased to report that, as of March 31, 2024, we achieved our planned financial targets a year ahead of schedule, thanks to improved income and effective cost-saving measures. To support our strategic goals, we embraced digital technologies to enhance our service delivery and improve patient outcomes. Our expanded retail business reflects our commitment to sustainability and community support and is a key enabler in our new strategy. Our educational initiatives, research contributions, and partnerships, such as those with the All-lreland Institute of Hospice and Palliative Care, further our mission. We are dedicated to sharing our expertise
Northern Ireland Hosplce Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 and improving palliative care standards across the region. As we review the financial outcomes of the past year, we want to address the de-recognition of a pension asset from our balance sheet, in compliance with updated accounting standards. This adjustment contributed to the operational deficit reported for 2023124, but it was necessary to ensure our financial reporting remains accurate and transparent. By making this change, we are reinforcing the integrity of our financial position, allowing us to focus on our mission with renewed strength. Looking ahead, we are filled with optimism. The strategic plan not only guides us toward financial stability and Se growth but also reinforces our mission to provide exceptional care to more individuals in need. By leveraging our strengths, embracing innovation, and advocating for necessary change, we are confident in our ability to meet the growing needs of our community. The success of Northern Ireland Hospice and Children's Hospi is a collective effort. It is made possible by our dedicated staff, volunteers, and the unwavering support of our donors and community partners. Your generosity and commitment enabled us to continue our vital work, and forthis, we extend our heartfelt thanks. As we move foDNard, we will remain steadfast in our dedication to enhancing the quality of life for our patients and their families. Thank you for being an integral part of our journey. With sincere gratitude, Dr. Gerry Millar MBE, Chairman Trevor Mccartney, Acting CEO.
Northern Ireland H05pice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Trustees and Other information Company Details Company Number: N1014817 Charity Number: NIC102337 HMRC Number XN45696 VAT Number: 308367790 Registered Office: 18 0'Neill Road. Newtownabbey, BT36 6WB President Paul Clark MBE Board of Trustees Dr Gerry Millar MBE Chair Vice Chair {Chair Elect from 27 June 2024) Treasurer (until 6 April 2024) Treasurer (from 9 May 2024) lan Sheppard Garth Calow (Resigned 6 April 2024) Martin Murphy Alan Dickson Dr Russell Houston Janice Smyth Andrew Talbot (Term ended 25 August 2023) Adele Martin Joanne Ramsay Patrick O'Hagan steven Cockcroft Paul Terrington CBE Three committees of the Board have been operational from April 2024. Finance & Business Committee (FBC) Martin Murphy (Chair), Alan Dickson, Paddy O'Hagan People and Culture Committee (PCC) Adele Martin (Chair), Janice Smyth, lan Sheppard Care Quality Committee (CQC) Dr Gerry Millar MBE (Chair), Dr Russell Houston, Jani Smyth, Joanne Ramsay
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Company Secretary Myles McKeown (until 31 July 2023) Gillian Wright (1 August 2023 to 9 May 2024) Michael Mawhinney (appointed 9 May 2024) Principal Bankers Danske Bank, Donegall Square West, Belfast, BT16JS Solicitors Edwards & Co Solicitors, 28 Hill Street, Belfast, BT12LA Auditors Finegan Gibson Ltd, Chartered Accountants & Statutory Auditors, Causeway Tower, 9 James St S, Belfast, BT2 8DN
Northern Ireland Hospice Trustees Report and Consolldated Flnancial Statements For the Financial Year Ended 31 March 2024 Report of the Board of Trustees The Board of Trustees presents this report together with the audited consolidated financial statements for the year ended 31 March 2024. We are Northern Ireland Hospice Northern Ireland Hospice is a local charity providing specialist palliative care to babies, children, and adults living with life limiting and life-threatening illnesses. Our holistic approach focuses on enhancing quality of life, managing symptoms, and providing emotional and spiritual support- notjust for patients, but also for their families. We do this through: Our Hospices We have two specialist Hospi units, Somerton House, our Adult In-Patient Unit and Horizon House, our Children's In-Patient Unit, which is the only children's hospice in Northern Ireland. Our multi- disciplinary teams provide high-quality patient-centered specialist palliative care as well as compassionate emotional and spiritual support, wrapping our care around the entire family unit. Our Community Services We have seven teams of Specialist Community Nurses that deliver care across Northern Ireland. These nurses support children, adults, and their families by working closely with social workers, GPS, District Nurses and community pharmacies to identify each person's needs and develop personalised care plans which reflect individual choice. Our Hospice at Home Servi provides one-to-one nursing care during the day, evening, or night to allow family members to have a break and look after their own well-being. As the largest Hospice care provider in Northern Ireland, we deliver bespoke, high-quality education programmes and contribute to research as a member of the All-lreland Institute of Hospice and Palliative Care and the Palliative Care Research Network Northern Ireland. This enables us to share our expertise for the betterment and furtherance of specialist palliative care for children and adults. Strategy 2023-2028. Northern Ireland Hospice, like many UK hospices, faces significant challenges ahead. Increasing inflationary costs. particularly in wages and medical expenses, coupled with the intricate political and economic climate in Northern Ireland, places a strain on our finances. In 2004 the government committed in a written agreement to fund hospice services to at least 500/0 of their care costs. This agreement has never been met, exarbatlng the financial challenges for hospice services. The demand for specialist palliative care services continues to increase, with the average age of a patient now under 65 and our patients are clinically more complex. There are many factors that have caused this shift, such as late diagnosis to name but one, however, unique specialist services in Northern Ireland have the skills, facilities and clinical expertise to deliver a Servi that meets these needs. Our services. however, remain undervalued as a key partner to our NHS here in Northern Ireland, particularly given the scale and diversity of our services, not least of which are the 13,833 community visits from our 7 specialist clinical community teams in the province who care for our patients
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 in their own homes. Our services are diverse, especially our children's service, which offers both respite and specialist end-of-life care. Furthermore, there has been a notable shift in the place of death, with more deaths occurring at home, aClerated by the Covid-19 pandemic but part of a longer-term trend. As already mentioned, this has increased the demand for home-based care from our community teams. The development of community and outreach services continues to be a key strategic intent for the charity. In this context, we have developed a robust five-year strategic approach focused on sustainability and growth with a relentless focus on providing specialist palliative care across the province to everyone with a life limiting condition. The first two years aim to achieve financial break-even while retaining our capacity for future seNice expansion. Following this, a three-year growth phase will expand our ServIS to meet the increasing demand for palliative care in a sustainable manner. As always, we rely on the continued support of the communities we serve and our partners to advocate for and deliver sustainable palliative care servIs. Despite the challenges, we are dedicated to sustaining and growing our services for those who need us most. Our Strategic Intentions Perpetuity We will support the delivery of our services with reliable income streams that can grow in line with cost and we will ensure we govem and operate the charity in line with all compliance, legal and regulatory standards. Performance We will ensure our performan¢e, both operational and financial. is explicitly described in order lo deliver an insightful, and transparent view of our organisalion. We will ensure our people have the skills and support across the organisation to enable the delivery of this care whilsl operating as efficiently as is possible. It is our intention lo Continue to provide specialist palliative care to our patients within the funding available. Perpetuity Performance P.eople People Patients Charitable Purpose Northern Ireland Hospice provides specialist palliative care serdices and support at no cost to patients with life-threatening and life-limiting illnesses, their carers and families. The objects of Hospice are.. To promote comfort and relieve the suffering caused by illness of children, young people and adults living with advancing progressive conditions and their families by delivering specialist palliative care services and support (including but not limited to physical, social. spiritual and psychological support) in Northern Ireland in particular, but not exclusively, through a range of facilities including in-patient hospice units and community servIs.
Northern Ireland Hospice Trustees Report and Consolidated Financlal Statements For the Financial Year Ended 31 March 2024 To advance health and well-being, in particular palliative care services and support, through the provision of training for healthcare professionals as well as staff, volunteers and others, and to conduct, or promote or encourage evaluation and research into the care and treatment of persons suffering from advancing progressive conditions in Northern Ireland and in any part of the world and to disseminate the results thereof. As the largest provider of children's and adult's specialist palliative care in Northern Ireland we will continue to work across all available networks to influence funding and improve delivery of palliative care servIs.
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Ouryear in Numbers 27 2,817 new famllles Introduced to tIRr.' Palllatlve & Ltfe Llmlted Servke ' ' Avg. stay in Somerton House for in thecommunlty 22.3 230 i• admissions atadult in-patient unit 3.884 lup from 1.9.2 702W231 total patients cad for In the communlty 6221 hou of.Hospice at Horne care provided to 118,472 volunteer hour5= £1.35m 278 in equivalent salary costs saved patients.used,our Hospits'atHome' 1,242 It took 51% £19.5m of patients admitted were under 65 to run Nl Hosplce and Children's Hospice in 2023124 lup fro t4a 309 Down 2015116) Children and theirfamilles cared for at Horizon House on the previousyear 38 familles pn)vided ongoing support by the PallSative & Llfe Limited Servlce ELEOBATIHG 40YEAR50F CARE 10 thITdrenwereadmltted for end of Ilfe care for Annual Report. I, io
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financlal Year Ended 31 March 2024 Expanding Community and Volunteer Engagement Our volunteers are the backbone of our organisation. In the coming year, we will focus on expanding our volunteer base and enhancing the roles available to them. This will not only support our service delivery but also strengthen our connection with the communities we serve. Innovating Retail Operations Our retail operations have been a significant source of income, and we plan to build on this success. We will continue to expand our network of shops and introduce innovative initiatives like the CaReCycle donation stations. These efforts align with our commitment to sustainability and will contribute to the financial stability of our organisation. Commitment to Education and Research We will further our role as a leader in palliative care by continuing to invest in education and research. Our partnerships with educational institutions and research networks will ensure that we remain at the forefront of palliative care innovation, sharing our knowledge and expertise to improve care standards regionally and nationally. Building a Supportive Work Culture Our people are our greatest asset. Over the next five years, we will continue to implement our People Strategy, focusing on professional development, wellbeing, and fostering a positive and inclusive work culture. This will ensure that our staff are supported, valued, and empowered to deliver their best. Shaping the Futu of Palliative Care In the face of economic and social challenges, we are committed to shaping the future of palliative care in Northern Ireland. By focusing on sustainability, innovation, and community engagement, we aim to extend our reach and impact, ensuring that every individual who needs palliative care reiVeS it with dignity. compassion, and respect. With these plans in place. we are confident in our ability to navigate the challenges ahead and continue our mission of providing exceptional care to those who need it most. We are deeply grateful for the continued support of our community, volunteers, and partners as we embark on this journey. 21
Northern Ireland Hospice Trustees Report and Con501idated Financial Statements For the Financial Year Ended 31 March 2024 Financial Review The consolidated financial statements comprise the results of Northern Ireland Hospi and Northern Ireland Hospice (Trading) Limited, together they are known as the 'Group'. (rrathry) Ltd (Substhryj (ConSorted? (Componyj Northern Ireland Hospice owns 100 % of the issued share capital of Northern Ireland Hospi (Trading) Limited, the results of which have been consolidated with the financial statements of Hospice on the basis of net profit before taxation. The Consolidated Statement of Financial Activities for the financial year ended 31 March 2024 and the Consolidated Balance Sheet at that date are set out on pages 42 and 44, respectively. The net movement in funds for the financial year, after depreciation and other recognised gains and losses, amounted to a £2.4M net expenditure (2022123: net income £3M). This arises due to a net expenditure of £0.4M coupled with the de-recognition of the prior year pension scheme asset valuation of £2.2M and gains on investments of £0.2M. Work continues to address the underlying net deficit. Income The main sources of income are from donations and legacies and from statutory grants. Overall, Group Income has increased by 4.6 % from £18.2M in 2022123 to £19.1 M in 2023124, primarily due to a £0.6M increase in Donations. 2024 £'ooo 8,581 6,899 3,430 188 2023 £'ooo 7,990 6,790 3,269 166 Change £'ooo 591 109 161 22 883 Group Income Donations and legacies Charitable activities Other trading activities - retail shops Investment and other income Totsl Grou Income 22
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Flnancial Year Ended 31 March 2024 Total Income by Type 25.000 20,000 15.000 10,000 7,990 6,899 6.790 5,000 188 166 Donations/Le8acies Charitable Activities Other Trading Activitie5 Investments and Other Income Total Income 2023/24 ll 2022123 Donations and legacies Income received from donations and legacies has increased by £0.6m or 7.4 % , from £8M in 2022123 to £8.6M in 2023124. This is primarily due to an increase in Donations received from £5.06M in 2022123 to £5.69M in 2023124. Charitable activities Income from charitable activities increased by £0.1 M, from £6.8M in 2022123 to £6.9M in 2023124. The £0.2M related to the statutory contracts and equated to a 3.50/0 increase, reflecting contract uplifts on the previous year, combined with over perf0rrnan against targets and funding for cost pressures in year. This increase was partially offset by the cessation of two contracts (INHSCT & DHSS), that led to a year-on-year decrease of£O.1 M against the aforementioned contracts. As noted previously, current funding levels are not sustainable and we are working with our Health Service partners to address this. Other trading activities - Retail Shops Northern Ireland Hospice (Trading) Limited's retail income increased £0.16M. from £3.27M in 2022123 to £3.43M in 2023124, driven by changes in consumer behaviour due to the Cost of Living crisis and ethical purchasing. Investment and other income Other income increased in the year from £0.17M in 2022123 to £0.19M in 2023124. This is due to additional investment income in the year related to higher interest rates. 23
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financlal Year Ended 31 March 2024 Expenditure Overall, Group Expenditure has decreased by £0.6M or 3 %, from £20.1 M in 2022123 to £19.5M in 2023124. 2023124 2022123 £'ooo £'ooo Change £'ooo Group Expenditure Raising funds Charitable activities Expenditure before retail shops. Other - retail sho Total Grou enditure Further analysed as follows.. Pay costs 14,807 14,382 Operating costs 4,030 5,073 reciation 657 657 Total Grou enditure 19,494 20.112 "Excludes the intercompany management charge of £191 K (2022123: £142K) It cost £19.5 million to operate the Hospi in 2023124, a decrease of £0.6 million or 3 % from the previous year. The reduction in operating costs by £1.043 million is primarily due to the de-recognition of the NILGOSC pension asset and related costs (£0.7 million) and the absence of the prior year's one- off Elmer campaign expenses in Fundraising (£0.33 million). However, this decrease was partially offset by an increase in pay costs of £0.4 million, driven by a 50/0 rise in Agenda for Change pay rates and a 9.8 % increase in the National Living Wage. The cost to operate the retail shops increased by £196K in 2023124, primarily due to a £120K increase in pay costs related to the rise in the National Living Wage. The net expenditure for 2023124 was £0.4M, a £1.5M improvement on the 2022123 net expenditure of £1.9M. 2,143 14,531 16,674 2,820 19,494 2,795 14,693 17,488 2,624 20,112 (652) 162 814 196 618 425 (1,043) 618 After considering the in-year one-off savings in operating costs, the risk of rising costs, primarily through wage pressures, continues to be of concern. Coupled with the constraints on statutory income contracts, via public sector budgetary cuts, has led to the deficit position in 2023124. We continue to address this by cost controls, working with our Health Service partners on statutory contracts, exploring new fundraising avenues. 24
Northern Ireland Hospice Trustees Report and Consolidated Financial Statement5 For the Financial Year Ended 31 March 2024 Total Expenditure by Type 25,000 20,000 19.494 20,112 15,000 14.531 14,693 10,000 5.000 2,143 2.795 2,820 2,624 Raising funds Charitable activities Other- retail shops Total Expenditure 2023124 ll 2022123 25
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Balance Sheet The Group Balance Sheet is presented in the table below. 2023124 2022123 £'ooo £'ooo Change £'ooo Fixed assets Net current assets Non-current assets/(liabilities) Total Restricted funds Unrestricted funds Total 20,272 3,154 21,407 2,401 1,979 25,787 338 25,449 25,787 (1,135) 753 (1,979) (2,361) (31) (2330) (2,361) 23,426 307 23,119 23,426 Fixed Assets -Tangible fixed assets have decreased by £457K in the year. Additions of £203K offset with depreciation of £657K and disposals of £15K. Investments have decreased by £680K to £5.3M primarily due to draw downs to facilitate operational cashflow. Intangible assets of £60K relate to website development work. Net Current Assets Net current assets have increased by £753K from 2022123. The main drivers of this increase are as follows: Increase in cash of £2.8M linked to the reduction in Trade Debtors & Legacies (noted below) and £1 M drawdown from Close Brothers investment Decrease in legacies of £874K due to the settlement of a large legacy from March 2023 Decrease in Trade Debtors of £419K relating to statutory funding Decrease in Gift Aid Recoverable £193K Increase in Prepayments and Accrued Income £57K Increase in Accruals £846K Decrease in Trade Creditors £156K Non-current AssetslLiabilities The Non-current asset relating to the NILGOSC pension scheme {£1.979M 2022123) has been de- recognised in accordance with accounting standard FRS102 and has a nil value at 31 March 2024. 26
Norihern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Reserves Policy The Board of Trustees recognises the requirement for reserves and aims to have a level of free reserves equivalent to three months, future running costs. At 31 March 2024, Northern Ireland Hospice has free reserves of £8.1 m, which covers 5 months of our planned operating expenditure going forward. These reserves help to ensure that the fInanS of the hospice remain in a sustainable position. Our reserve position is heavily impacted by our high asset base which includes specialist hospice properties which the Board have no intention of selling. The Trustees monitor our reserves position and the cash in bank balances on a regular basis to ensure there is no immediate risk to the Hospice. Investment Policy Northern Ireland Hospice has invested in short-term bank deposits with Danske Bank during the year, in line with the organisation's operational cash flow requirements. We have continued an investment portfolio with our investment advisors Close Brothers during 2023124. Close Brothers have been instructed to maximise the return on the funds invested within the constraints of a medium risk portfolio. The investment position of the organisation is reviewed by the Finance Committee on an ongoing basis throughout the year. Close Brothers report annually to the Board on the performan of the portfolio. Going Concern The financial statements have been prepared on the going conrn basis. The Trustees have reviewed Northern Ireland Hospice's financial position and consequently believe there are sufficient resources to manage any operational or financial risks. The Board considers there is a reasonable expectation that Hospice has adequate resources to continue in operational existence for at least 12 months from the date of signing of the accounts and the Board are unaware of any additional material uncertainties related to events or conditions that may cast significant doubt upon Northern Ireland Hospice's ability to continue as a going concern. Risks and Uncertainties Due to the historic structure of statutory income and the pressure of increasing costs, the group has been incurring an underlying deficit. Exacerbated by current economic and other external factors. Trustees are concerned about the underlying deficit risks and significant work to address these challenges and improve this position continues. The Trustees have taken into consideration the existing and anticipated effects of these risks and uncertainties on the organisation's activities and finances in its assessment of the appropriateness of the use of the going concern basis. We continue to adapt our fundraising plan to take account of the changing landscape and have reviewed and updated our strategy and related plans to deliver the best outcomes possible within the available resources. Management continues to carefully monitor the situation and evaluate its options during this time. No adjustments have been made to these financial statements as a result of this uncertainty. The Board therefore considers there is a reasonable expectation that Northern Ireland Hospice has adequate resources to continue in operational existence. The Board is aware that should circumstances 27
Northern Ireland Hospice Trustees Report and Consolidated Financial Statement5 For the Financial Year Ended 31 March 2024 change Servi levels will have to be revised in line with the income available. Post Balance Sheet Events There have been no significant events affecting Northern Ireland Hospice since the financial year end that would result in the adjustment of the financial statements or inclusion of a note therein. Principal Risks and Uncertainties The Board of Trustees and Corporate Leadership and Management Team, through the corporate governan framework, identify and manage the risks to which the charity is exposed. Our Board and Corporate Leadership and Management Team have monitored the activity of the organisation both in terms of service delivery and quality as well as financial reporting. We are satisfied that our continued vision for the people we support is to provide comfort and quality of life for our patients, whilst supporting their families and relieving fear and suffering associated with loss. Our work, which is based on the values of respect and acceptance, compassion, courage, and integrity, and being pioneering, professional and accountable, is very much in evidence from our activities during the financial year. The Board established our risk appetite. This identifies potential risk events that may affect the charity and seeks to manage those risks. It also seeks to provide reasonable assuran regarding the achievement of our strategic objectives. It is the role of Trustees and the Corporate Leadership and Management Team to assess the risk and define our operational objectives. assigning responsibility throughout the organisation to each manager and employee responsible for the appropriate management of risk. Directors and senior staff are accountable for strategic risk managementwithin areas under their control including the devolution of the risk management process to operational managers. Senior staff are accountable to the Chief Executive for implementation, annual reporting on the status of the Risk Register, ongoing maintenance of the Risk Register and ensuring compliance with risk assessment procedures. The Chief Executive is responsible for maintaining the Risk Register and for reviewing it bi-annually including proposing any changes to the Board for approval. Risk Management is a standing agenda item for all Board meetings. A comprehensive planning prosS, together with established systems and procedures, enables Trustees to assess and address risks associated with governance, strategy, clinical, health and safety, reputation, finance, operations, other external factors, and the future capacity to deliver services. Operational Risks Operational risk is the risk of loss resulting from inadequate or failed internal processes, systems, or human factors. Operational risk can manifest itself in various ways including shortage of key skills, clinical incidents. inappropriate behaviour of employees, failure to comply with applicable laws and regulations or failure to perform in line with contractual arrangements. These events could result in financial losses, litigation, and regulatory fines as well as other damage to the organisation. 28
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 The principal operational risks identified by Northern Ireland Hospi and the mitigating actions are noted below: Operational Risk Staffing Mitigating Actions Regular focused engagement with the Department of Health on regional workforce planning and recruitment. 3-year workforce planning in development with greater focus on succession planning. Future medical workforce planning reflects a hybrid model of trainee and non-trainee posts, reducing dependency on locums whilst retaining the Hospice status as a training centre. Finan Finance committee established with particular focus on budget and control. Regular management updates on budgetary position. Contingency planning scenarios developed with a focus on financing. Fundraising communications focused on online events, moving away from traditional fundraising activities. Ongoing discussions with SPPG and Department of Health on financial and material support through government grants and contract reviews. Ongoing planning of strategic income initiatives. Technology Development of Cyber Essentials to provide assurance on Hospice IT Security and compliance of standards. UPS configuration upgraded in main server room (Horizon) to include all IT infrastructure, phones and switches. Key software servers also upgraded. Engagement with staff on cyber risks has increased with improved vigilance. Telephone system development. Clinical Incidents Policies and procedures in place to prevent incidents as well as management of incidents and Implementation of learning. Bi-monthly reporting of incidents to Board as well as the ability to report serious incidents immediately if required. Risk and Dashboards monitored by clinical teams and Governance Committee. Incident reporting software now embedded and development continues to maximise use of analytic features. Quality audit of incident reporting completed by Governance Team. Adherence to regulatory requirements (RQIA and Charity Commission). 29
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 The principal operational risks identified by Nl Ireland Hospice and the mitigating actions are continued below: Governance and Hospice Reputation Effective policies and procedures put in place to ensure compliance with health and safety and other regulatory requirements. Corporate Quality Governance Committee continues with active Board oversight. Review of risk register process with established format and presentation of Strategic Corporate Risk Register. Engagement with external regulatory bodies around service delivery and performance (e.g., NIPSO, RQIA, Fundraising regulator, Charities Commission). Achievement of ISO Standards 9001 and 45001 for Estates department Quality Management and Safety Management activities including capital works, maintenance and asset management. Development and roll-out of risk management software ongoing. Data Analysis & Management Review of systems available to ensure data is managed effectively and to improve report functionality. Consideration of internal Quality Improvement Programme to regularly review dats accuracy and systems to ensure that the data is SMART. Independent assessment of data including analysis of statistical information. Quality Indices reports completion and review. Management and Governance Board Members and Structure As Trustees of a charitable company, all Trustees are the company directors. Trustees are from diverse backgrounds in health, business, and professional life. This ensures a broad range of experience and skills are brought to Board deliberations. A minimum of eight to a maximum of fourteen Trustees can be on the Board. Six members of the Board are elected from and by the members of the charitable company. Up to six Trustees are invited by the Board. The Board has the option to co-opt up to a further two Trustees. Both 'elected' and 'invited' Trustees may serve for a maximum of two terms of four years each, following which, they must stand down for a minimum of two years. The office bearers of Chair, Vice-chair and Treasurer are chosen from within the Board. The office bearers can remain in office for up to three years and this can be extended for a further three years. 30
Northern Ireland Hospice Trusteesjleport and Con501idated Financial Statements For the Financial Year Ended 31 March 2024 Induction is provided to new Trustees and training is provided as required in areas such as risk, safeguarding, child protection, and other relevant charity governance matters. Trustees adhere to a Code of Conduct and a Declaration of Interest is completed annually. Trustees are not in receipt of any remuneration for their services to Northern Ireland Hospice but are reimbursed for any incidental expenses claimed. There were no expenses claimed in this financial period. The Board is responsible for the strategic direction and governance of Northern Ireland Hospice. The Board's principal responsibilities include determining the overall strategy, policies, direction, and goals of Northern Ireland Hospi. protecting and promoting the identity and values of Hospi. fulfilling their statutory responsibilities. A scheme of delegation is in pla and the Board delegates the day-to-day operation of the organisation to the Chief Executive Officer (CEO) supported by the Director of Care and Quality Governance, the Director of Corporate Services, the Director of Finan and the Director of Commercial and Brand Development. Together they form the membership of the Corporate Leadership Team. The Corporate Leadership Team and the medical lead(s) attend Board meetings but have no voting rights. There are clear distinctions between the role of the Board and the Corporate Leadership Team. The Corporate Leadership Team is responsible for preparing policy, strategic planning, budgets, financial reports, and risk registers, which are approved by the Board. The Corporate Leadership Team implements the policy, plans, and budgets and leads all operational aspects of the charity with the Board continually monitoring these. The Corporate Leadership and Management Team, comprising of the Corporate Leadership Team and Department Heads, work collectively to lead and manage the various functions of Hospice with an emphasis on effective engagement, working in partnership, and valuing the contribution of all of our people in a supportive environment. In the 202312024 financial year, the Board was supported by five Committees, in the areas of Finance, Remuneration and Board Governan, Corporate Quality Governance, IT & Digital Governance, and People and Culture. Following a comprehensive governance review this was streamlined to three committees effective from 1st April 2024 (details of the current structure can be found on page 5).
CL E E (uz CL Q) Q) raiiiIu_ UU) o u o oc) o EtL E a> a> o) Q) x (2iioororrrff)iQiW c O o) U ii) 7) D D O lj o o o o) UL)(Ji (o <0 o L) Ip 0£ (J L) 1-£ ."7i.',8,:.oy: LU ÉOC CE Ct aLU(JU< L)OiiOOCiCg1
Northern Ireland H05pice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 Finance Committee The Finance Committee (FC) is responsible, on behalf of the Board for ensuring that all the finances of Northern Ireland Hospice are appropriately applied in securing the objects and strategic objectives of the charity and that its assets are properly safeguarded. The Committee is made up of at least two Trustees with relevant financial experience. The Chair of Ihe Committee is also the Treasurer and reports to the Board at the subsequent Board meeting. Remuneration and Board Governance Committee The Remuneration and Board Governan Committee (RBGC) is responsible for ensuring the appropriate composition of the Board of Trustees and that appropriate governance procedures are in place in Northern Ireland Hospice. The Committee keeps under review a skills matrix and a succession timetable for Trustees plus a succession process for the Corporate Leadership Team roles. Corporate Quality Governance Committee Corporate Quality Governance Committee (CQGC) is responsible, on behalf of the Board for ensuring all functions in the Charity are compliant with legislation and regulations. The committee focuses on ensuring a culture of quality improvement and learning in the Charity, providing assurance, and escalating risks to quality when necessary to the Board, Regulatory Bodies and Commissioners. People and Culture Committee The People and Culture Committee is responsible on behalf of the Board to ensure the culture, values and employee experience are upheld with a focus on health, well-being, and personal growth The Committee shall consist of not less than Iwo Trustees appointed by the Board. This can include the Chairperson. IT and Digital Governance Committee The IT and Digital Governance Committee is responsible for reviewing the IT and Digital Services that currently operate within the organisation and for making recommendations to the Board on Changes and improvements that meet the needs of Hospice now and in the future. Remuneration Policy Clinical staff remuneration is in line with Agenda for Change pay scales. Medical staff employed or engaged as consultants in Hospice are remunerated in line with National Consultant Terms and Conditions. Non-clinical staff remuneration is set within a policy that is appropriate for each specific role. This allows Northern Ireland Hospice to be externally competitive and internally fair in how it rewards its staff for non-clinical roles. The remuneration framework establishes an appropriate and relevant market-informed salary range for each role. This is in keeping with relevant industry benchmarks. It does however seek to promote development and encourage and reward excellence where performance is exceptional. The Corporate Leadership Team remuneration is recommended to the Remuneration and Board Governance Committee by the CEO. The CEO remuneration is reviewed by the Chair and recommended to the Board Governance and Remuneration Committee. The Committee considers a
Northern Ireland H05pice Trustees Report and Consolidated Financial Statements For the Financial Year Ended 31 March 2024 number of matters in arriving at its decisions, including performance and benchmarks with other healthcare charities and sectors. Northern Ireland Hospice operates an equal opportunities policy. Regulatory Environment In addition to all legal requirements, Northern Ireland Hospice operates in a regulatory environment, governed by the Regulation and Quality Improvement Authority (RQIA) and the Charity Commission for Northern Ireland. Northern Ireland Hospice also voluntarily subscribes to the requirements of the Fundraising Regulator. Subsidiaries Northern Ireland Hospice (Trading) Limited Northern Ireland Hospice owns 100 /0 of the issued share capital of Northern Ireland Hospice (Trading) Limited. The principal activity of Northern Ireland Hospice (Trading) Limited is the sale of donated goods and giftware. It operates a network of 24 retail shops in the local area and the Old Schoolhouse Cafe and generates income for Hospice services. The Trading Company donates qualifying charitable donations (covenanted donations) to Hospice under company gift aid rules. In addition, gift aided donations made to the Trading Company are accounted for in the books of Northern Ireland Hospice. Related Parties In addition to a register of interests held, declaration of conflicts of interest is a standing item on the agenda for all Northern Ireland Hospice Board, and Board Sub-committee meetings. There were no conflicts identified that required further action. Ex-Gratia Payments There were no ex-gratia payments made during the financial year ended 31 March 2024 or prior financial year ended 31 March 2023. Public Benefit In setting our objectives and planning our activities for the year, the Trustees have considered the Charity Commission for Northern Ireland's guidan on public benefit to ensure that the activities have helped to achieve the Charity's purposes and provide a benefit to the beneficiaries. Directors, Responsibilities in Relation to the Financial Statements Company law requires the Board of Trustees (the Board) to prepare financial statements for each year which give a true and fair view of the state of affairs of the Hospice, and of its profit and loss and cash flows for that year. In preparing those fsnancial statements, the Board is required to.. select suitable accounting policies and apply them consistently, make judgements and estimates that are reasonable and prudent, observe the methods and principles in the Charities SORP, State whether applicable accounting standards have been followed, subject to any material departures disclosed and explained in the accounts, and
Northern Ireland Hospice Trustees Report and Consolidated Financial Statements For the Flnancial Year Ended 31 March 2024 prepare the accounts on the going concern basis unless it is inappropriate to presume that the Hospice will continue in business. The Board is responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the Hospice and to enable it to confirm that the accounts comply with the Companies Act 2006. It is also responsible for safeguarding the assets of the Hospice and for taking reasonable steps for the prevention and detection of fraud and other irregularities. Disclosure of information to auditors In the case of each of the persons who are Trustees at the time the Trustee's Report and Financial Statements are approved: there is no relevant information, being information needed by the auditor in connection with preparing their report, of which the group's auditor is unaware, and the Trustees, having made enquiries of fellow Trustees and the Group's auditor that they ought to have individually taken, have each taken all steps that helshe is obliged to take, as a director in order to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information. Auditors The auditors, Finegan Gibson, has indicated its willingness to continue in office, and a resolution that the firm be re-appointed will be proposed at the Annual General Meeting. Approved by the Board of Trustees and signed on its behalf by.. illar E (Chair) Date: