Peace Hospice Care Annual Report 2018-19

EVERY PERSON MATTERS EVERY DAY COUNTS

annual report and accounts 2018/19

CONTENTS

Trustees’ report

2 - 61

Auditors’ report

62 - 64

Consolidated statement of financial activities

66

Consolidated balance sheet

67

Charity balance sheet

68

Consolidated cash flow statement

69

Notes forming part of the financial statements

70 - 94

Who’s who

96

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We are committed to empowering patients with life-limiting illnesses, supporting them to achieve the best quality of life possible. We also provide end of life care and support to families and carers. As well as supporting patients in our Hospice building, the majority of our services are delivered in the community, and all of our services are free. We are only able to do what we do because of the generous support and donations we receive from our community - individuals, organisations and businesses, as well as those who volunteer and donate items for us to sell in our charity shops. Over the last year that support has enabled us to care for, support, educate and collaborate with thousands of people - all to help individuals and their families, in our community, achieve the best quality of life possible.

THIS IS WHAT WE DO

THANK YOU FOR CARING AND FOR MAKING THAT POSSIBLE.

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a message from the CHAIRMAN

It is with a sense of pride and fulfilment that we present this report on our activities for the year to March 2019. During the year we commissioned a report from Kingston Smith (Fundraising and Management Consultants) to help us understand and in many cases validate, the social impact we have on the community we serve. Amongst many observations, it confirms how important our support is to patients, their families and carers so that they do not feel they are alone at a difficult time in their lives. It is also heartening to read that they “feel like a person not a patient” – real evidence that the values of our Hospice translate into actions. There is also a financial aspect to the impact analysis. Kingston Smith have calculated that Peace Hospice Care delivers £3.68 of “social value” for every £1 that we spend on our services. This value includes the contribution to patient care by our dedicated staff and volunteers across a very wide range of services. This is very encouraging for all those who help our patients directly on a day to day basis. It should re-assure our donors, our Clinical Commissioning Group and all those involved in fundraising and running our shops that every £1 raised and spent on our services has a significantly greater value than just the amount of money being spent. This also helps support a very powerful value-for- money argument for greater funding and support from our NHS partners – especially as the report also confirms that the provision of services by Peace Hospice Care allows the NHS to re-allocate over £6m of their funding that might otherwise be spent on patients in our care.

I hope that this analysis offers encouragement to everyone involved with Peace Hospice Care including our staff led so enthusiastically by Declan Carroll. If we need any inspiration to work harder to meet the needs of even more people, we need look no further than to our patients, their families and carers. They are why this charity exists. It is their courage, love and compassion that gives us the energy to do more and with your help, thoughts and support, we can. My heartfelt thanks go to all who have supported us in the past year in any way no matter how small. It all counts and has value. My plea is to ask you for your support again on behalf of those who need us.

THE SOCIAL VALUE THAT PEACE HOSPICE CARE IS CREATING IS VERY SIGNIFICANT and the organisation is delivering a much needed, greatly utilised and highly valued service to those in the Hertfordshire area. It is a beacon of hope and an extension of improved life quality for many.

Thank you.

Patrick Brennan CHAIRMAN

Peace Hospice Care Impact Report by Kingston Smith 2019

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a message from the CHIEF EXECUTIVE

Welcome to our 2018/19 Annual Report where I am proud to report back on our achievements over the past year. We, like other hospices, rely on the generous goodwill of individuals, organisations, trusts, businesses and other charities to enable us to deliver our free services as well as, to a greater or lesser extent, the NHS. The last year has been challenging and the sector is under increasing pressure to deliver more with less. We are confident, however, that our work, including a new Medium-Term Financial Strategy and a five- year Clinical Strategy, provides a solid base, moving forward. Research we have carried out this year, as part of our Clinical Strategy, gives us confidence in mapping out our activity to best support the population we serve. We recognise the importance, and need, to widen access to our services and to reach more people and have made significant progress in setting out how we will achieve that. Expanding our reach will be facilitated by our newly-established Widening Access Task and Finish group. The aim of the group is to examine, and combat, barriers to receiving care which will enable us to reach a wider range of people and better reflect the diversity of the community we serve. We know, however, that the delivery of our free services is not possible without robust financial planning and attracting and retaining the best talent. Our Medium-Term Financial Strategy, which is now in place, enables us to be better prepared for changing needs and income. We have also made significant progress on developing the groundwork for a People Strategy and a new Income Generation Strategy is being refined. I look forward to reporting back on that work in the next Annual Report.

I am excited that the strategic work we have been doing over the last year will feed into planning for our 2020-2025 Strategic Plan with a focus on five key themes: collaborations and partnerships; workforce; growth; sustainability; and communication. Those themes are already prevalent in the work we are doing and we will build on the successes we have seen over the last year, including, to highlight a few: our partnership working with The Hospice of St Francis, Rennie Grove Hospice Care and Herts Community NHS Trust to run the West Herts Palliative Care Referral Centre and pilot a Rapid Personalised Care Service to support the needs of the population we serve; our work in the community including trialling our successful volunteer-led Herts Neighbours Service in nursing homes, to expand the reach of the service. We are confident we are building a solid base from which we can meet the changing needs, pressures and demands of providing high quality care and support to patients, as well as their families and carers. What we have been able to do and achieve, so far, has only been possible thanks to our dedicated team of staff and volunteers, including our trustees. I would like to thank each and every one of them for their ongoing support and commitment.

WHAT WE DO REALLY DOES MAKE A DIFFERENCE You will see from this Annual Report that, this year, we have been able to demonstrate that difference, and our impact, more robustly than ever before. Going forward, we want to make an even bigger difference. Thank you for supporting us on our journey in trying to achieve that.

Declan Carroll CHIEF EXECUTIVE

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WHAT WE DO OUR VISION

We provide free specialist palliative care across South West Hertfordshire, and the wider area, for patients and their families facing a life-limiting illness. We help them manage their conditions and provide support at end of life too.

To be the leading provider of specialist palliative care services in our community.

OUR MISSION To provide outstanding specialist care and support to improve the quality of life for individuals, families and carers facing a life-limiting illness. Those who access our services are treated with respect for their dignity, beliefs and wishes and, where possible, in the setting of their choice.

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OUR AIMS

In April 2016, we launched our four-year strategy to improve care and support across Hertfordshire, and the wider area, and we set out the following strategic aims, to: Ensure access to high quality services along the patient journey and across our community

Engage with our partners and stakeholders to identify opportunities for collaboration

Make Peace Hospice Care the organisation of choice for staff and volunteers which recognises their value to the organisation Deliver high quality management of Peace Hospice Care which supports its ongoing sustainability

This report sets out the progress we have made, over the last year, to deliver on those strategic aims and our ambitions for the future.

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THANK YOU SUPPORT FOR YOUR

18,201

2,762 TOTAL REFERRAL S

£

£

£

£

£ £

£

£

HANDLED BY THE WES T HERT S PALLIAT IVE C ARE REFERRAL C ENTRE

MONE TARY DONAT IONS

H E R T F O R D S H I R E

36,500 DONATED BY OUR 21 PEAC E BUSINESS PARTNERS

£

SHOP

12 S H O P S

450 V O L UN T E E R S

195,280

RAISED THROUGH £108,790.42

5,000 P E O P L E & O R G A N I S A T I O N S S U P P O R T E D U S T H R O U G H D O N A T I O N S , E V E N T S & F U N D R A I S I N G

TRANSACT IONS IN OUR SHOPS

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OUR SERVICES

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OUR SERVICES

224 admissions

1,569 individual

INPATIENT UNIT Our Inpatient Unit offers dedicated support to our patients by providing symptom control and pain management, which allows many patients to return home after a short stay. We also provide end of life care.

STARLIGHT COUNSELLING SERVICES Our Starlight Counselling Service provides counselling to patients with life-limiting illnesses, as well as their families. We also offer bereavement support as well as short-term, one-on-one counselling for those suffering from anxiety and depression.

counselling sessions (Improving Access to Psychological Therapies)

1,937 Hospice at Home visits

HOSPICE AT HOME Our Hospice at Home team works out in the community, providing care and support which allows patients to remain at home. The team works alongside, and in partnership with, other health and care professionals to deliver the highest level of care which puts patients, their families and carers first. 869 visits made

2,762 total referrals were handled by the Centre

WEST HERTS PALLIATIVE CARE REFERRAL CENTRE We work with The Hospice of St Francis, Rennie Grove Hospice Care, and Hertfordshire Community NHS Trust to host a joint referral centre making it quicker and easier for health and care professionals to make referrals.

HERTS NEIGHBOURS Our Herts Neighbours service provides support to patients with life-limiting illnesses, in their own homes, or within their care setting.

349 total referrals

4,103 total attendances

THE RAPID PERSONALISED CARE SERVICE (RPCS)

STARLIGHT OUTPATIENT SERVICES

This is a pilot service hosted at Peace Hospice Care, commissioned by Herts Valleys Care Commissioning Group and managed by Rennie Grove Hospice Care in partnership with West Herts Hospices. It provides rapid access to care to patients at home who are in their last three months of life.

received since the service started in September 2018

Our Starlight Outpatient Services can support patients as they are diagnosed. We provide free rehabilitation and wellbeing services including counselling, spiritual support, exercise groups, creative arts and social groups.

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OUR SOCIAL IMPACT

For relatives there is a reduction in social isolation and anxiety, improved ability to cope with grief and hopelessness and consequent reduced strain on mental health The Hospice provides an environment where relatives can speak to others going through similar experiences and access counselling which is often seen as a lifeline at such a difficult time Our Volunteers experience a feeling that they are contributing to something bigger than themselves, that their life has more purpose – they experience a sense of being part of the Hospice family For other healthcare organisations our impact was seen in their increased knowledge and understanding of palliative care issues and practice – they saw us as an excellent partner to collaborate with The research also looked at the costs associated with delivering our services and the value for money we provide. We know that this work will help us in the future – help us in speaking to donors and fundraisers and showing them the added value, and impact, of their support. It will aid us, too, in discussions with commissioners of services to demonstrate that they get a good return on investment. We believe it will help the wider hospice sector too and encourage others to report in this way. We look forward to demonstrating how we use this work in future Annual Reports.

We commissioned an independent company, Kingston Smith, to carry out the necessary research which included focus groups, surveys and telephone interviews. While the full report on that research is still being finalised, we can highlight key findings and themes that have emerged. For charities, and hospices in particular, it has been challenging to demonstrate impact and show supporters the value of their donations. We have always believed, from what patients, families, carers, staff and volunteers have told us, that what we do makes a difference, but how can we prove and quantify that? Patients who access our Starlight Outpatient Services experience a reduction in social isolation and an increase in creativity and quality of life – patients are able to spend time as themselves away from the focus of their illness Increased independence and social interaction for those supported by our Community Services In our Inpatient Unit, patients experience reduced stress, feel more comfortable and experience more respect and dignity during their stay – the Hospice is seen as a much calmer, restful place for patients and their relatives, compared to hospital Here are some of the highlights from that research – this is our impact.

In last year’s Annual Report we outlined work we were planning to demonstrate, and put a value on, our social impact. Social impact is important because it looks at the causes, perceptions,

attitudes and behaviours associated with health and wellbeing.

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REDUCING SOCIAL ISOLATION AND INCREASING INDEPENDENCE Our volunteer-led Herts Neighbours has been successful in providing befriending home support. This year we piloted that support in nursing homes with positive results. We used pre and post questionnaires to survey views, and evaluation showed that the pilot had a positive impact and outcome on quality of life, wellbeing and feelings of loneliness. RESULTS:

OUR SOCIAL IMPACT IN ACTION Highlights from the Year

loneliness reduced by 83% enjoyment of life increased by 83%

quality of life improved by 50%

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MOTIVATING TO EXERCISE The Hospice Rehabilitation Service aims to maintain independence, build confidence, improve strength, reduce fatigue, side effects of treatments, depression and anxiety. The benefits of exercise for people living with long-term conditions - physically, emotionally and psychologically, are widely recognised. This year we worked in collaboration with a local gym, Everyone Active, to provide a Personal Trainer to support patients in accessing a local community gym for independent exercise. Our patients reported increased strength, mobility and fitness, and improved confidence. Two out of seven patients in the original group signed up for gym membership and one patient achieved his goal of getting back onto the golf course again.

IMPROVING WELLBEING AND QUALITY OF LIFE Our ‘Orchestra Outreach’ initiative is an example of innovative partnership working, empowering people to access creative opportunities, leading to increased wellbeing. The Hospice is situated near the Collosseum where a world- renowned orchestra rehearses. The orchestra manager invites our patients, carers, volunteers and staff to attend their rehearsals. This opens up wellbeing opportunities for all. The orchestra’s repertoire includes Opera, Big Band, and West end musicals. From October 2018 - May 2019, 70 members of our community have attended performances. Participants reported feelings of enjoyment and relaxation, as well as commenting on the special delight that comes with gaining a unique insight into that which is usually hidden from view. Staff members have talked enthusiastically about

CREATIVE ARTS

Our Creative Arts programme provides wellbeing support to patients as well as their families and carers. Involvement with the creative arts has many therapeutic benefits including relaxation, an increase in confidence, as well as the opportunity for emotional release in a supportive, group setting. The focus of our creative arts sessions is always in the process, rather than the end product, as we look to support patients on a journey. Our programme is varied and features classes from painting and mosaic-making, to dance and outreach sessions at a local café, where patients come together to knit and socialise. Patients who attend our Creative Arts sessions report feelings of “connection”, “friendship” and “expression”.

being immersed in music within their working day.

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REDUCING STRESS AND BRINGING CALM Mortality statistics and census information suggests approximately 370 parents die in Hertfordshire annually, leaving approximately 650 dependent children. Peer support is widely held to be an important way of helping children manage bereavement. Mindcraft is a peer-support programme (through the medium of art making and creative activities, games and group support) to empower and support children through grief/ loss with high level of emotional wellbeing. The programme supported both children and their parents/ carers.

COLLABORATING - SHARING OUR EXPERTISE TO BENEFIT OTHERS Over the year we continued to work with partners to deliver services to our community. We host the West Herts Palliative Care Referral Centre which we run jointly with The Hospice of St Francis, Rennie Grove Hospice Care and Herts Community Trust. It provides a single point of referral which reduces administrative time and costs – making it quicker and easier for health and care professionals to refer. Our multi-disciplinary team (MDT) works in close partnership with the local community team and is made up of clinical nurse specialists, nurses, healthcare assistants and doctors. This team provides support to patients in their own homes (this includes care homes). They have access to the wider MDT team and the team is supported by an administrator.

RESULTS: 73% of parents reported increase in their confidence levels and felt able to support their children more 80% of parents reported feeling supported with the bereavement by attending the workshop 73% of families felt decrease in isolation from attending the workshops

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KEY

achieved in progress

Our Ambitions for Those in our Care

Launched our five-year Clinical Strategy in November 2018

Create and start to implement a five- year Clinical strategy that addresses the changing needs of the local population we serve and enables us to reach more people at an earlier stage, helping them to improve their quality of life with a focus on delivering more with less, as we aim to continually review and remodel services and structures.

Conducted a Population Needs Assessment in South West Hertfordshire to understand the needs of the community to help shape our clinical and new corporate strategy

OUR 2018/19 AMBITIONS - ACHIEVEMENTS

Widening Access Task and Finish Group established and work plan in place

With support from the Graham Rowlandson Foundation we delivered Mindcraft, our new Children’s and Families bereavement support programme Developed and launched the Rapid Personalised Care Service in partnership with Rennie Grove Hospice Care and the Hospice of St Francis – providing carers for those patients in the last weeks of life to help them remain at home With grant support from Hospice UK, we have established weekly ‘one stop shop’ outpatient clinics to start from April 2019 – enabling us to reach more people Rotational working with West Hertfordshire Hospitals NHS Trust, we have a dedicated role, preceptorship staff nurse – benefitting from a shared placement We have agreed plans to remodel our Inpatient Unit Staff team, to increase access to additional beds, introducing a new role of Advanced Nurse Practitioner and Nursing Associates allowing our medical team to expand work into the community and outpatients’ settings

Grow and develop our current strategic partnerships, and build new ones, to further benefit the local community we serve and make best use of shared resources.

Diversify our service models only where they add value to our core activity and help us deliver an improved range and reach of services to the community.

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Our Ambitions for Staff & Volunteers

New posts introduced: In Memory & Legacy Manager and Database Coordinator to support income stream growth Consolidated and reviewed events calendar to ensure fit for purpose and meets Return on Investment ambitions

Look at opportunities available to us for growing current income streams and create new ones that appeal to, and engage, supporters and our local community.

Reviewed our recruitment process enabling us to reduce the time to recruitment and start by 10 days

Successfully Implemented the second phase of the Pay & Benefits Review, defining and raising awareness of our staff benefits package that makes us attractive and an employer of choice. Increased membership to our Volunteer Forum by 50% and made investment in appointing a new Volunteer Manager role to support our strategy to engage, train and recruit additional volunteers in 2019/2020 and beyond

Continue to recruit and train the best staff and volunteers to help us deliver our strategic aims.

Our Ambitions to Drive Efficiencies and Improve our Effectiveness

Put in place a five-year Financial Plan which will enable us to use resources effectively and efficiently to meet our strategic aims but, also, to better protect us in relation to cuts to our NHS funding. Continually improve communication internally and externally, building on our current media partnerships to continue to raise awareness. We will also be focusing on putting in place a digital strategy to support our new website and make our social media more effective.

Developed and launched our Medium-Term Financial Strategy to support budget setting and 2020-2025 strategic planning

Achieved 96% e-Learning Compliance across Peace Hospice Care

Introduced an Efficiency Plan to demonstrate value for money

Work is underway on a People Strategy to aid our recruitment and retention planning

New website designed and will go live in October 2019

Work underway on developing a new digital strategy for 2019/2020

Our Ambitions for Income Generation

Updated photography and filming in progress to support the new website

A draft five-year Income Generation Strategy was presented and will form the basis of our new strategic plan 2020-2025. Our plan will be implemented in April 2020

Develop a creative and inspirational five-year Income Generation Strategy.

Full retail review completed to inform the five-year strategy

Business case approved for new till system to drive forward business development approved and now at implementation stage

Strengthen our Retail division to better meet the needs of the competitive environment within which it operates.

New Apsley shop opened

Invested in full shop refurbishment and re-branding the portfolio to enhance shopping experience and income and improve working conditions

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Our Ambitions for Those in our Care

Deliver on second year of our Clinical Strategy with the aim of reaching more people

OUR 2019/20 AMBITIONS

Develop partnerships that only add value to our work and benefit the local community

Diversify our service models only where they add value to our core activity and help us deliver an improved range and reach of services to the community

Our Ambitions for Staff and Volunteers

Develop a greater understanding on the value that volunteering brings

Continue to provide staff and volunteers with enjoyable and rewarding experiences

We know that more hard work is needed to address the challenges ahead and to deliver on our four-year (2016/2020) Strategic Plan. We are in the process of developing our new Vision, Purpose and Strategic Ambitions – 2020-2025 and this next year will focus on our development plans to launch this.

Grow, develop and deliver our learning and development offer to staff and volunteers

Our Ambitions for Income Generation

Launch our five-year Income Generation strategy

Increase our income so we can provide even more care and support

Introduce new fundraising opportunities to enhance existing activities to engage current and new supporters

Review our Retail portfolio and seek new opportunities that deliver a positive return on investment

Our Ambitions to Drive Efficiencies and Improve our Effectiveness

Develop and launch our new 2020-2025 Strategic Plan, Vision and Purpose

Launch our new website and make our digital media more accessible and effective

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OUR VOLUNTEERS

Our Volunteers make it possible for us to deliver our free services. We simply couldn’t function without them. Our heartfelt thanks to each and every one of our Volunteers for their support. Whether you volunteer for us each and every week or you’ve given us a single hour of your time – thank you. From our work on quantifying our impact we know that our Volunteers feel like they are contributing to something bigger and that their life has more purpose as a result. They talk about being part of our Hospice family and we are very grateful that they are.

Barry Caplan has been a volunteer driver for us for three years, and his wife volunteers in our Bushey Shop. “It just gives me a buzz to be involved and know I’m helping people. I love going around the Shops and talking to the managers and volunteers. It’s great, you build up a nice rapport and just have a laugh and a joke together. I was very affected seeing patients in the Inpatient Unit for the first time, and I just thought `I have to do something here’ - I get quite emotional about it sometimes. But it has given me the drive to volunteer because the end product is always helping patients. You can’t live life taking all the time, you have to give back.”

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Celia Cook attends Starlight Outpatient Services groups and now also volunteers in Creative Arts groups at the Hospice. “My sister was my best friend and she died in the Inpatient Unit in November 2017. From the moment she arrived, everyone was so wonderful and being here provided so much comfort. During this time, I was asked if I wanted to attend the Talking Space group and since then, I haven’t missed one session. I didn’t think I could carry on after losing my sister, but being involved with Starlight groups taught me that life is worth living. I really believe that if it wasn’t for Peace Hospice Care, I wouldn’t be here today. The support I’ve had as a relative…I can’t measure it. It has changed my life.”

Ann Waterlow has been a Herts Neighbour since 2016.

“It’s the most wonderful, fulfilling relationship, all built on a patient’s needs. You meet a total stranger and after a few weeks you really get to know them. For the time I am with them they are the most important person in the room and to make them happy is so rewarding. I’ve been involved in a pilot project to support patients in nursing homes. One patient would just stay in their room but over time they have been coming down for meals and taking part in activities. It means a great deal to see that they are enjoying themselves much more now. I feel that what I am doing is making a difference.”

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Making a DIFFERENCE

“Going to the group exercise class at Everyone Active is very rewarding. I like to keep active and got involved with a gym when I was having chemotherapy and it’s nice to do all of that again. The exercise is so beneficial and I love being involved with the group as we all get on so well. The groups here have such a lovely atmosphere and I’ve met some really lovely people here who are now good friends. The Hospice is a big part of my life. I’ve always enjoyed getting creative and I love all of the writing I’m doing now in groups - I’m writing poetry and doing art. It’s all very fulfilling and coming here has helped me develop existing interests and do things I never thought I would be able to do.” Penny Gower attends Starlight Outpatient Services and has been on our exercise programme run in conjunction with Everyone Active.

Lucy Petagine’s mum, Yvonne, attended Starlight Outpatient Services and then was cared for in the Inpatient Unit in her last days. “The care my Mum received at the Hospice was exceptional and she felt so welcome thanks to all of the staff who cared for and supported her, as well as the rest of our family. Whilst my mum was in the Unit, I was able to stay in the family room so we could spend all of our time with Mum. I read the amazing messages from others who had stayed in the room, and I decided I wanted to start fundraising for the Hospice to give back after all of the kindness, help and support we received as a family.” Alisha Bowell attended a meditation group at the Hospice after she was diagnosed with stage 3 cancer aged 24. After Alisha had completed her treatment, her Dad was diagnosed with terminal cancer and referred to the Hospice. “Peace Hospice Care supported me and my family in those moments the best that anyone could ask for. It was a sad and vulnerable time for all of us, but the care and support given was amazing. Since I was

diagnosed, I have done fundraising every year. For me, it’s rewarding to give back after the support me and my family received.”

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Thanks to OUR FUNDRAISERS

We were assisted by a grant from: The Lord and Lady Lurgan Trust The D’oyly Carte Charitable Trust The Green Hall Foundation The Inlight Trust The Blandford Trust The Albert Hunt Trust The Shanly Foundation The Kobler Trust The Raven Charitable Trust Masonic Charitable Foundation The Donald Forrester Trust The David & Jennie Kirk Charitable Trust The Edgar E Lawley Foundation Sycamore Trust The Paragon Trust Christopher Laing Foundation The Lawton Trust Limited Pettit Charitable Trust The Childwick Trust Warsue Charitable Trust The Northwick Trust The Brewers’ Company

NBM Technology Solutions North West London MAG Procare Group SA Law SAE Logistics Ltd The Diamond Trust Trading Company Limited Utilitrack Warner Bros Studios Leavesden

HUGE THANKS FOR ALL YOUR SUPPORT. WE COULDN’T DOWHAT WE DO WITHOUT YOU. Our very grateful thanks to: The Graham Rowlandson Foundation and the Percy Bilton Trust, who helped us to refurbish our Starlight Lounge so that we can support our out-patients even better. Additional thanks to the Graham Rowlandson Foundation for also funding our Mindcraft bereavement sessions for children and young people throughout the year. The Wolfson Foundation for funding a new, automatic front-door and essential works to the car park and Hospice building, which has made our facilities safer and much more accessible for our patients. All the Trusts and Foundations who collectively gave £140,010 throughout the year, helping to fund so many important services for the families who need us.

Warner Bros Studios Leavesden, Porcelanosa, Ricoh UK, The Diamond Trust, HW Fisher & Co and Smith & Nephew – headline sponsors of our biggest fundraising events. The 517 people who helped to raise almost £26,000 by dedicating poppies and butterflies throughout the summer, and our friends at intu Watford for hosting a display for the second year running. The 519 people who responded to our appeal in September 2018, when our NHS funding was cut by 15%. Together you donated £33,543.85 in cash gifts and set up newmonthly gifts worth £16,362 per year. The schools, faith groups and community organisations who held fundraising events to support us, in particular – our Watford Support Group and Chorleywood & Rickmansworth Support Group, Irish & Holyrood Support Group, Oxhey Open Gardens, Chorleywood Classic Car Show, Watford Grammar School for Girls, Haberdashers’ Aske’s School for Girls and St Luke’s Church.

Our 21 wonderful Peace Business Partners who donated £36,500 through their monthly donations; Abbots (UK) Ltd Bahlsen LLP Braden Threadgold LTD Bushey Promotions & Incentives Camelot UK Lotteries Ltd Croxley Hardware

Peace Partnership Business

Flahive Brickwork Ltd Imperial Auto Services

KLBC (Kings Langley Business Centre LLP) M. K. Ginder & Sons - Central Administration MANE Contract Services Metro Bank Myers Clark Chartered Accountants

All those people who chose to help future generations by leaving a gift in their Will.

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FUNDRAISING As a local charity, we rely on the support of our community to fund what we do. Without this support, from Hertfordshire business and generous local people, we would not be able to provide care and comfort to families when they need us most. We are so grateful for every single donation, purchase in our shops, and every hour that is given in volunteering for us. Thank you. In 2018 the Fundraising Regulator launched a consultation on The Code of Fundraising Practice. The code outlines the standards expected of all charitable fundraising organisations across the UK. We took part in that consultation and a new fundraising code will come into effect in October 2019.

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Our Fundraising PROMISE

WE WILL COMMIT TO HIGH STANDARDS We will adhere to the Fundraising Code of Practice. We will monitor fundraisers, volunteers and third parties working with us to raise funds, to ensure that they comply with the Code of Fundraising Practice and with this Promise. We will comply with the law as it applies to charities and fundraising. We will display the Fundraising Regulator badge on our fundraising materials to show we are committed to good practice. WE WILL BE CLEAR, HONEST AND OPEN We will tell the truth and we will not exaggerate. We will do what we say we will with donations that we receive. We will give a clear explanation of how you can make a gift and change a regular donation. Where we ask a third party to fundraise on our behalf, we will make this relationship and the financial arrangement transparent. We will be able to explain our fundraising costs and show how they are in the best interests of our cause if challenged. We will ensure our complaints process is clear and easily accessible. We will provide clear and evidence-based reasons for our decisions on complaints. We will be clear about who we are and what we do.

WE WILL BE RESPECTFUL We will respect your rights and privacy.

We are members of, and committed to the standards set by, the Fundraising Regulator, to which we pay an annual levy. We will always be honest, open and transparent in our fundraising activities. We promise that:

including vulnerable people, from unreasonably intrusive or persistent fundraising approaches, and undue pressure to donate and do not undertake cold calling fundraising calls. We are aware of our obligations under the Charities (protection and Social Investment) Bill to ensure that any written agreements mandate adequate fundraising standards as required under the Bill, with appropriate safeguarding for vulnerable members of the public from intrusive or persistent approaches. We do not use commercial participators/professional fundraisers but do work with commercial partners that facilitate donations such as Local Hospice Lottery Limited. Trustees receive regular reports of fundraising progress. 2 fundraising complaints were received during the year. (2018 4). OUR FUNDRAISING PARTNERS We continue to work closely with our partners at Local Hospice Lottery Ltd (LHLL), a well-established company and wholly owned subsidiary of Farleigh Hospice that raises funds for hospices across the country through its weekly lottery. LHLL are licensed by the Gambling Commission and follow the Fundraising Regulator’s Codes of Practice, to ensure that they represent our organisation to the highest standards and stay true to our values. After marketing costs, Local Hospice Lottery will give between 55% and 80% of proceeds (from individuals playing to support Peace Hospice Care) to us. In addition to LHLL, our teams work with a number of designers, print and fulfilment houses and database providers who enable us to carry out our fundraising and marketing work. We have stringent processes and procedures in place to ensure that all those who work with us adhere to the highest standards of data protection as required by the 2018 General Data Protection Regulation (GDPR).

We will not put undue pressure on you to make a gift. If you do not want to give or wish to cease giving, we will respect your decision. We will have a procedure for dealing with people in vulnerable circumstances and it will be available on request. Where the law requires, we will get your consent before we contact you to fundraise. If you tell us that you don’t want us to contact you in a particular way we will not do so. We will work with the Telephone, Mail and Fundraising Preference Services to ensure that those who choose not to receive specific types of communication from us will not. WE WILL BE FAIR AND REASONABLE We will treat donors and the public fairly, showing sensitivity and adapting our approach depending on your needs. We will take care not to use any images or words that intentionally cause distress or anxiety. We will take care not to cause nuisance or disruption to the public. WE WILL BE ACCOUNTABLE AND RESPONSIBLE Although they are rare, when we receive complaints about our fundraising activities or events, we take them very seriously. We have clear procedures to ensure complaints and concerns are logged, investigated and responded to, and we report them to the Fundraising Regulator each year.

annual report and accounts 2018/19

We raise funds from a range of sources but take very seriously our duty to protect the public,

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This financial year PHC received a total of £5,889,675 of income (2018: £5,090,101) including £3,248,275 from donations and legacies (2018: £1,983,282), Clinical Commissioning Group funding of £997,914 (2018: £1,188,843) and £1,643,486 from other trading activities and investment income (2018: £1,917,976).

Financial REVIEW

Consolidated Income and Expenditure For the Year End 31 March 2019

The main increase in this year compared to 2018 is due to generously large legacies of £1,925,027 notified to PHC (2018: £780,862).

2019 £000

2018 £000

Income Voluntary Income

1,363 1,925

1,394

The Fundraising income excluding legacies equated to £1,323,248 (2018: £1,202,420) and when measured against the core fundraising costs of £463,574 (2018: £498,362) it resulted in a return of £2.85 : £1 (2018: £2.41 : £1). A number of income streams did not perform as well as expected but this was mainly offset by careful control of costs. Restricted fundraising income included grants totalling £140,510 (2018: £102,916) for various projects including the Starlight Lounge refurbishments.

Legacies

781

Statutory Funding

998

1,189 1,545

Other Trading Activities

1,429

Investments and Other Income

175

181

Total Income

5,890

5,090

Expenditure Fundraising Costs Hospice Services

777

789

3,028 1,057

3,302 1,117

Trading and Lottery Costs

REVIEW OF INCOME 2018-2019

REVIEW OF INCOME 2017-2018

Total Expenditure

4,862

5,208

Net (expenditure)/income for the period

1,028

(118)

Gains and losses on investments

(2)

17

Investment and other income

Investment and other income

Net movement in total funds

1,026

(101)

3 %

4 %

Consolidated Balance Sheet As at 31 March 2018

2019 £000 3,296 3,785 7,081

2018 £000 3,209 2,846 6,055

15% Legacies

23% Voluntary income

28% Voluntary income

Fixed Assets

Net Current Assets

33% Legacies

Total Assets less Liabilities

23% Statutory funding

Restricted Funds Unrestricted Funds Designated Funds

739

739

2,383 3,959 7,081

2,787 2,529 6,055

24% Trading and Lottery

Total Funds

17% Statutory funding

30% Trading and Lottery

annual report and accounts 2018/19

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The charity’s wholly owned subsidiary Peace Hospice Shops Limited generated a profit of £30,049 for the year (2018: £215,667), all of which has been paid to the charity under a Deed of Covenant. This figure does not include £165,812 (2018: £81,164) of donations under the Retail Gift Aid Scheme. If this is added to the above, Peace Hospice Shops Limited generated a profit of £195,861 for the year (2018: £296,831), our gift aid performance has been lagging compared to the charity sector. The income streams for Fundraising and Retail were disappointing in 2018/19 and these are being addressed for 2019/20 to achieve the budget targets. We will be introducing a new Income Generation Strategy through the year to support income growth.

REVIEW OF EXPENDITURE 2018-2019

REVIEW OF EXPENDITURE 2017-2018

21% Trading and Lottery costs

22% Trading and Lottery costs

Expenditure was below budget due to good financial management which has partly offset some of the income shortfalls. However, legacy income has been very good and has exceeded the budget target and this surplus has been transferred to the Legacy Buffer Fund. This Fund is used to top up the Legacy Budget in lean years if required and also to fund the new Five Year Capital Programme and Business Strategy Developments.

16% Fundraising costs

15% Fundraising costs

63% Hospice Services

63% Hospice Services

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Financial REVIEW

PLANS FOR COMING YEAR In 2018/19 the Medium Term Financial Strategy (MTFS) was introduced which provides financial planning over 5 years. This strategy will be further developed in 2019/20 and will be jointly owned by business management and Finance. It will also inform the other strategies that will be implemented in 2019/20, namely the Income Generation Strategy, People Strategy and the Volunteers Strategy. The Clinical Strategy was launched during 2018/19. PHC will be entering into a new contract with the Adult Community provider Central London Community Healthcare NHS Trust in October 2019 and this will be a five year contract which will provide some certainty over the medium term on this funding stream. A new Strategic Plan is currently being developed for the next 5 years for the period 2020 to 2025 to detail the strategic aims and ambitions of Peace Hospice Care based on the plans we have already developed.

RESERVES All charities are required to consider how much they need to hold in reserves. The extent varies depending on the scale and nature of the charity’s activity. Peace Hospice Care is dependent on a number of fluctuating income streams particularly fundraising, shop profits, legacy, trust and corporate donations. To enable the charity to make commitments to the community we work with, it needs to maintain a level of reserves so that it can continue its operation in the event that an unforeseen shortfall in voluntary income or increase in costs creates an imbalance of funding. The Trustees calculate the amount that is required to be held based on the assessment of risks affecting the income and expenditure of the charity. In assessing the amount of reserves required to be held, the risk of a shortfall in income or an increase in costs is estimated and a sum held to cover the shortfall for each element. The reserves held by Peace Hospice Care would allow it to continue operations even when there is an unforeseen downturn in any of these sources of income, or an unforeseen increase in costs. In May 2019, the People and Resources Committee reviewed the Legacy and Reserves Policy that included: An Operating Reserve: An amount estimated at between £1.2m and £1.4m (£1.38m at 31 March 2018) to cover the loss of Clinical Commissioning Groups (CCG) funding and/or a catastrophic loss of reputation. This rationale will allow the charity to meet its liabilities in the short term, under a variety of scenarios, whilst making alternative plans, for meeting our longer term obligations and ensuring the needs of our beneficiaries are met.

Investments With the exception of two small holdings in equities, the Trustees have agreed to invest surplus funds in short term deposits earning the maximum amount of interest available in the market for such deposits. During the year the invested funds held on deposit achieved an average rate of 2%.

The Board also authorised the use of surplus Legacy Funds to establish a Legacy Buffer Fund of £500,000. This draws from Legacy income received over the budget of £550,000 and will be used to top up the legacy line in the budget in lean years and mitigate against fluctuating legacy income. In 2018/19 this Fund increased significantly to £1,299,735 as legacy income exceeded the budget target. Any additional amounts in this reserve will be used for capital and one-off investment items that should be presented by the Executive Team to the Board with a full business case. At the balance sheet date the Charity holds both restricted funds (which can only be applied for specific purposes) of £738,661 (2018: £738,575) and unrestricted funds of £1,077,384 (2018: £901,716) (which can be expended at the discretion of the Trustees in furtherance of the charity’s objects). The Trustees have designated £2,443,505 to a Property Fund (2018: £2,443,505) to reflect the replacement cost of the assets held as land and buildings at 31 March 2019 excluding amounts included in restricted funds; £135,374 to the Capital Programme Fund (2018: £85,374) which will finance the Capital Programme and Strategic Business Developments. The Revaluation Reserve has £5,905 (2018: £5,905) allocated to reflect the unrealised gains on the increase in the market value of the listed investments. The Reserves policy is reviewed annually by the People and Resources Committee and the Board. Another review will be carried out in 2019/20 in line with the other strategies being finalised including the Medium Term Financial Strategy and we will be reviewing the Reserves and Investment Policy.

annual report and accounts 2018/19

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Financial REVIEW

RISK MANAGEMENT We have introduced a Risk Assurance Framework which focuses on the resilience of whole systems through ‘risk assurance’. Our robust framework ensures regular and consistent reporting to the Board of Trustees. The Charity has a risk management policy – updated in the year under review - which enables us to approach risk in a pragmatic and sensible way. Our framework ensures risks are assessed by the Board (top down) and by the Executive Team (bottom up) to identify and analyse risk-relevant activities and appetite to manage. Risks are assessed according to the potential impact on the charity and their likelihood of occurrence. Controls are in place, and these have been developed to manage risks appropriately. Key strategic risks are reviewed by the Board and Sub-Committees and managed by the Chief Executive. Peace Hospice Care understands that taking risks, when well assessed and managed, is critically important and often leads to innovation, improvement and growth. We recognise that we cannot become complacent in our response to risk and we actively work to improve our processes of assessing, managing and taking risks. Peace Hospice Care is committed to a sensible approach to risk across all its functions. We aim to ensure that whilst risks are identified, mitigated and managed, risk is not used as a way to avoid difficult decision taking that is important for us, and necessary, if we are to achieve our Mission.

GOVERNANCE Maintained by the Chairman, Board of Trustees and Executive Team. CLINICAL Maintained by the Clinical Governance Committee. HUMAN RESOURCES, FINANCE AND FACILITIES Maintained by the People and Resources Committee. FUNDRAISING AND RETAIL Maintained by the Fundraising and Retail Committee. reasonable (not absolute) assurance against material errors or loss. The current risk assurance registers are as follows: The Board of Trustees has overall responsibility for the system of internal controls for Peace Hospice Care. This includes ensuring that there are reasonable procedures in place for the prevention and detection of major risks, including fraud and other irregularities. All such frameworks are designed to mitigate (not eliminate) risks and to provide

Overleaf, we have set out the major risk areas and what is in place to manage those risks.

annual report and accounts 2018/19

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