Annual Report & Accounts 2014

ANNUAL REPORT AND ACCOUNTS FOR THE YEAR ENDED 31 MARCH 2014

Tyrwhitt House, Oaklawn Road, Leatherhead, Surrey KT22 0BX Tel: 01372 587100 Fax: 01372 587101 Email: contactus@combatstress.org.uk Website: www.combatstress.org.uk

Company Limited by Guarantee Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Trustees’ Report Vision, Mission, Values and Aims

4

Strategic Report

Review of 2013/14

Developing integrated Community and Outreach, Outpatient and Inpatient Services

6

Improving the evidence base

9

Sustaining our Financial base

10

Developing an appropriate brand and image to deliver excellence

13

Plans for the future

14

Financial review

16

Principal risks and uncertainties

18

Employment of disabled persons

19

Employee involvement

19

Public benefit, policies and governance

20

Statement of Trustees’ responsibilities

23

Auditor’s Report Independent auditor’s report to the Members and Trustees

24

Financial Statements Statement of Financial Activities

26

Balance Sheet

28

Cash Flow Statement

29

Notes to the Financial Statements

30

Legal and administrative information

44

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 3

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

TRUSTEES’ REPORT VISION, MISSION, VALUES AND AIMS Our Vision

Our strategic aims

Our Vision is that Veterans will be able to live free from the harmful effect of psychological wounds.

Over the five years from 2012 to 2017 we are focussing on the following strategic aims:

Our Mission

1. Developing integrated Community, Outreach, Outpatient and Inpatient services;

Our mission is to provide timely, effective clinical treatment and welfare support to Veterans who suffer from psychological wounds.

To realise this we must: Be accessible to those who need help Be expert at what we do and be recognised as such Work in partnership with others Raise awareness of Veterans’ needs Our Values Our Values are: Putting Veterans at the centre of our work Aspiring to achieve excellence in everything we do

2. Improving the evidence base of therapeutic practice; 3. Sustaining our financial base; 4. Developing an appropriate brand and image culture to deliver excellence.

These aims will enable Combat Stress to develop its services, to respond to a changing environment and the increased demand for our help.

This report details what we have done to achieve these aims in the year ended 31 March 2014 and our plans for the future.

Fostering a culture of respect and integrity

4 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Combat Stress has been providing mental health care for Veterans for 95 years since it was founded in 1919.

In 2014, as we commemorate the centenary of the start of World War 1, the reasons for the charity’s formation are poignantly remembered. The ‘shell shock’ suffered by those returning from the trenches 100 years ago is now much better understood and is recognised as Post Traumatic Stress Disorder (PTSD).

A lot has changed since the First World War but the mental scars left by conflict are still as devastating. Today, we are working with over 5,400 Veterans and are the leading charity for Veterans suffering from PTSD and other mental health conditions.

As we have done over the last 95 years, Combat Stress works with Government to improve mental healthcare provision for Veterans.

This takes the form of advocacy

in the areas of pensions, stigma reduction, specialist healthcare provision and improving the interface between the Defence Medical Services and 3rd sector medical organisations including for Reserve Forces. We are also developing innovative mental health services for Veterans which we seek to see adopted by the NHS. This year, our troops formally withdraw from Afghanistan and this marks the end of the longest continuous period of war fighting overseas for over 200 years. This has left a legacy of mental health issues, including depression, anxiety and PTSD for many exService personnel.

Combat Stress supports Veterans who have served in many areas of operations. During 2013/14 we supported 660 Veterans who served in Afghanistan (an increase of 67% on the previous year) and 960 who served in Iraq (an increase of 32% on 2012/13).

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5,473 Veterans actively received treatment and support from us (compared to 5,272 in 2012/13) We received 1,802 new referrals during 2013/14 (12% increase on last year) 1,086 Veterans were sufficiently recovered to no longer need our active support.

The average time between leaving military service and seeking help from Combat Stress is 12.4 years.

However, Veterans of recent conflicts are seeking our help earlier. The average time is just four years for those who have served in Afghanistan and eight years for Veterans of the Iraq conflict.

2014 Annual Report and Accounts | Combat Stress | 5

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

STRATEGIC REPORT REVIEW OF 2013/14 1. DEVELOPING INTEGRATED COMMUNITY AND OUTREACH, OUTPATIENT AND INPATIENT SERVICES We are recognised mental health experts and, working with partners including the NHS and other military service charities, we aim to deliver an integrated service that ensures that those in need of help receive the right support, in the right place, at the right time and from the right people.

We have developed integrated recovery-focused care pathways.

We have improved procedures to ensure that our service capacity is monitored and we can adjust activity to meet demand so that Veterans can receive timely access to services.

We have put new governance structures in place to support access to, and transition between, services. A key feature of the new structures is multi-disciplinary decision making, in which the new treatment plans are agreed with the Veteran and a combination of welfare, community and Inpatient services provide a more coherent care pathway.

During 2013/14 we commenced a project to implement a new clinical patient administration system, which will greatly enhance planning, Veteran management and sharing of information across all areas of our service.

Community and Outreach This year 945 Veterans were assessed by the Regional Welfare Officers (RWOs) (3% increase on the previous year). RWOs also provided 2,100 follow up welfare visits.

Over the last year our community based clinicians provided 561 support group sessions and 149 Veterans received individual community-based therapy.

To help meet increasing demand, we began a programme to expand our capacity by delivering clinicbased services in the community.

A new facility for ‘Combat Stress on the high street’ was opened in Liverpool in partnership with the Royal British Legion in one of their ‘Pop-In Centres’. Additional sites have been identified which will be opened over the course of the next year. Each ‘Pop-In Centre’ will provide dedicated clinical space for Combat Stress Veterans. These hubs will increase the number of Veterans we are able to reach and complement our existing Community and Outreach services to make the best use of our resources.

6 | Combat Stress | 2014 Annual Report and Accounts

Substance (including alcohol) misuse case management service We are piloting a new substance misuse case management service for Veterans with mental health problems, who also have substance misuse problems.

Funding has been secured of £2.6m for multiple years from the Ministry of Defence (Armed Forces Covenant Team) and from Big Lottery. This service will monitor and support Veterans from first referral through their whole treatment, including treatment provided by other organisations.

The service aims to ensure that Veterans suffering from substance misuse will be able to move from detox treatment through to therapies which will help them cope with the underlying causes of their substance misuse and help prevent relapse.

The first substance misuse management service has been established in partnership with Glasgow and Clyde NHS Trust.

Further pilot sites have been identified and discussions on recruitment into the roles are now progressing. In the first month 80 referrals have been made to the pilot service.

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Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Outpatient care We now have Outpatients services in each of our treatment centres to provide rapid assessment and access to appropriate treatment.

Remote Outpatient services in local communities were trialled in Essex, Plymouth and Exeter.

These clinics have been received positively by both Veterans and clinicians and promote the need for services to be provided as close to the Veteran’s home as possible. Further development of community clinics will be explored in 2014/15.

Inpatient care There have been 1,965 Veteran admissions to our residential treatment centres during 2013/14.

This is slightly lower than previous years due to the length of stay of 6 weeks for those on the specialised PTSD Intensive Treatment Programme.

Over the year 1,767 treatment sessions and 2,483 group sessions were provided in a range of treatments including trauma focused therapy, one to one counselling, anger and anxiety management and art psychotherapy.

A new transdiagnostic programme was introduced providing a more focused treatment plan for Veterans designed specifically to meet complex individual needs.

Whilst early in its review, initial feedback and analysis shows improved benefit from this programme over previous versions and it will be implemented in all treatment centres in 2014/15.

The increasingly specialised and clinical nature of our programmes led to a review of staffing within the treatment centres.

During 2013/14 we carried out a restructure within the centres to ensure that staff had the right experience and qualifications to provide expert treatment and care to Veterans. The process was difficult and at times painful for all employees and Veterans alike as some long serving employees left the Society. However, the remaining and new staff have excellent skills and together are better qualified to deliver improved services.

The workforce review has enabled us to develop further recovery programmes, confident that we have the right staff to deliver them. We have piloted new programmes in stabilisation, anger management, substance misuse and co-morbid PTSD and will deliver them in all treatment centres in 2014/15.

Quality Each treatment centre is subject to Quality Care Standards and is periodically inspected by the regulatory authority: the Care Quality Commission in England and the Care Inspectorate for Scotland. In 2013/14 the regulators carried out unannounced visits at all three treatment centres as follows: 16 April 2013 at Tyrwhitt House, Surrey. The Centre passed all care standards with the inspector noting that “treatment plans had been developed and the person had signed each plan. These plans identified what the person needed help with; what support was needed to achieve the person’s goals; and how staff would assist. One person told us “My keyworker understands me; they help me to sort out my

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issues”. We saw that treatment was provided in a number of ways to meet the needs of individuals.”

13 December 2013 at Audley Court, Shropshire. The Centre passed all care standards with the inspector noting that “people described their support and treatment as “exceptional”, “absolutely brilliant” and, “unique”. Comments from people included, “It’s like having a pair of arms thrown around us”. “Within a day or two of being here, you know it’s worth being here” and, “They’ve given me a new lease of life”.

People described the staff as welcoming and “experts in their field of work”. They considered staff were competent and knowledgeable and understood their individual needs. One person said, “The staff know us better than we know ourselves”.

Another person said, “Their commitment is unbounded and they are very proficient in what they do”.”

18 November 2013 at Hollybush House, Ayrshire, Scotland.

The Centre was assessed as ‘Very Good’ and the inspector summarised that “Hollybush House offers a very high standard of care and support, and acts as a lifeline to many of the Veterans. We found that the service had a very professional, knowledgeable and skilled staff group that offered very good support. The service uses a research-based approach to treatment and staff work very closely with the Veterans to ensure they are involved in all aspects of their treatment from admission to discharge.”

2014 Annual Report and Accounts | Combat Stress | 7

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Improved Facilities

Helpline

A significant refurbishment and expansion programme of all three of our treatment centres has been undertaken over the last few years to ensure that our buildings are fit for purpose. During 2013/14 the following improvements have been made:

Our Helpline is available 24 hours a day to the military and naval community, including Veterans, serving personnel, Reservists and their families. Trained employees are there to listen, give support and direct callers to our support workers or refer them for specialist help.

Extension at Audley Court for a new Outpatients department, counselling rooms and a training room; Fourth bedroom wing at Audley Court providing new bedrooms, including two for disabled users; Refurbishment of the Activity Centre at Audley Court including an excellent new kitchen where Veterans can learn cooking skills.; A new horticultural garden area at Tyrwhitt House for Veterans to grow their own produce and learn gardening skills.

We have also installed wireless internet access at all three treatment centres to help Veterans stay in touch with work, friends and family.

5000 2012/13 4000

2013/14

3000 2000 1000 0 Inbound calls

Inbound Outbound Outbound Voicemails hang-ups calls no response

Texts received

Emails received

The Helpline continues to be an invaluable lifeline for Veterans, with an increase in the number calling when in crisis.

Main Issues/Reason For Call 1800

2012/13

1600

2013/14

1400 1200 1000 800 600 400

8 | Combat Stress | 2014 Annual Report and Accounts

Other

Caller hung up

Complaint

Silent

Wrong service

Inappropriate

On-going support Menatl health issues Physical health Social support Practical support Crisis call

Promotional

0

General enquiry Support from another Signposting / information

200

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Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

2. IMPROVING THE EVIDENCE BASE OF THERAPEUTIC PRACTICE Our work can provide important evidence in relation to the unique mental health problems suffered

by Veterans. Together with partners and other providers we aim to establish an evidence base which will help inform national policy and development of treatments.

A new framework to assess care outcomes has been introduced.

This will ensure that baseline measures are recorded at initial assessment and improvement and progress along the recovery pathway can be tracked and measured. Staff received training in accurate data capture.

Outcomes are evidence-based and are derived from statistical analysis of our treatment programmes. However, as many of our programmes are new and are currently being piloted it will be some time before effectiveness can be determined fully. However, feedback from Veterans attending the programmes has provided good initial indicators.

The six week PTSD Intensive Treatment Programme has been running for two years. Evaluation indicates that the programme is effective in reducing the symptoms of PTSD and there are marked gains in the Veterans’ wellbeing.

Combat Stress has again been asked to provide evidence for two House of Commons Select Committees - Northern Ireland and Defence - on Veterans mental health issues.

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Of particular interest this year has been the foundation of the Armed Forces Health Partnership Working Group.

This group, a development from the Department of Health Third Sector Health Partnership, is cochaired by Combat Stress and the Royal British Legion. Membership includes the Department of Health, Ministry of Defence and NHS England alongside those Veterans’ charities that have an interest in Veterans’ health.

The Working Group provides expertise, strategic leadership and support to the NHS and Service charity sector, including Cobseo (Confederation of Service Charities), in shaping, delivering, implementing and communicating health and well-being policy for the Armed Forces community. It also seeks to identify areas and opportunities for joint working and pooling of expertise on research, policy and communications work across the NHS and Service charity sector.

We have worked with Help for Heroes to help them to develop their new low-level psychological services for Veterans and families.

These services will complement our own treatments and those provided by the NHS. We now have both a descriptive and numerical monthly report for all Helpline activity, which has provided us with accurate information about calls. As a result we were able to identify an additional training need for call centre workers which is being addressed.

2014 Annual Report and Accounts | Combat Stress | 9

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

3. SUSTAINING OUR FINANCIAL BASE We aim to secure funding in the ratio of 60% voluntary income to 40% from statutory providers and commissioned services. During 2013/14 we achieved a ratio of 51% voluntary to 49% statutory and commissioned income. However, the statutory income included £2m for a three-year project where the entire grant has been received in advance.

As our workload increases we are seeking funding in a postAfghanistan era where there will be less media coverage. We have increased our fundraising and communications activity to ensure that we maintain a high profile.

During 2013/14 we commenced an improvement programme of performance measurement throughout Combat Stress and now have departmental KPIs (key performance indicators) which will help us ensure that valuable resources are used effectively.

Fundraising summary As always, we are incredibly grateful to all our donors and volunteers who raise money for Combat Stress. We are also very fortunate to work with supportive and generous partners, including The Royal British Legion, Help for Heroes, ABF, RAFBF, RNRMC, SSAFA Forces Help, Comic Relief, Big Lottery and NHS networks.

We could not achieve any of our successes without the funds raised or grants provided.

We are especially grateful to the Forces benevolent societies whose foresight and understanding of the needs of Veterans has led them to support us over many years. Such foresight has been a key enabler in the development of the Society and established Combat Stress as a truly world class Veterans’ Mental Health operation.

During 2013/14 we were successful in securing three-year funding for a substance misuse case management service from the Military Covenant Reference Group which distributes funds to Service charities from the penalties imposed on banks after the ‘LIBOR’ scandal, and from the Big Lottery.

During the last year we improved our communications with donors and supporters interested in our events and activities. We have raised awareness and funds through a number of appeals including our ‘Armistice Appeal’ which raised £66k and the Christmas Appeal ‘Candle of Hope’ which raised £112k.

10 | Combat Stress | 2014 Annual Report and Accounts

We held a number of high profile events during the last year including: On 11th November 2013 a West End performance was given entitled ‘Dreams From the Pit’, followed by a panel discussion.

Walk on Wales took place in August 2013 and Combat Stress was one of two charities to benefit. Teams walked the entire length of the Welsh Coastal Path and raised a total of £73k for Combat Stress with more to follow when all the sponsorship is collected.

Combat Stress continues to be the nominated charity at the Annual Battle Proms each summer. In 2013 a fantastic amount of over £23k was raised during the six performances.

All of our supporters in the community find inventive ways to raise vital funds for Combat Stress, including sky-dives and sponsored cycle rides. Some examples included Tom Benson and Ed Straker who cycled 14,000 miles from Punta Arenas, Chile to Alaska, raising over £7k. Diana de Lisle raised £5k at a very special car boot sale at Bulwick Park. Ben Kane and friends raised £14k by walking the length of Hadrian’s Wall in full Roman uniform, Pegasus Masonic Lodge raised over £15k, In Scotland, the Trades House Ball raised £21k and Peterborough Council made us Charity of the Year raising more than £23k.

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Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Individual Giving had a very good year in 2013/14. Our Spring Appeal was a huge success, raising £138k. The added investment in Individual Giving in 2013/14 meant we recruited 1,400 more new donors than last year.

We also created a new bi-annual supporter newsletter entitled ‘Support Works’. The first issue in November attracted an amazing £61k in donations, the most any newsletter has produced. The main highlight of the year was our regular giving upgrade and conversion work. In June we sent out our first regular giving appeal, asking those who already give via Direct Debit to increase their donation and those who gave cash to convert to Direct Debit. The appeal performed exceptionally well.

Combat Stress secured the BBC TV Lifeline Appeal, presented by celebrity ambassador Sir Patrick Stewart. We have been successful in maintaining existing relationships with Thales, Network Rail and BAE Systems. During the final stage of the BAE Systems Charity of the Year Award, Combat Stress was adopted as the chosen charity partner across three sites: Filton, Telford and Newcastle. In addition, there has been active support from Thales, one of the leading manufacturers of defence and electronic products. Thales sponsored the Armistice Lecture and to coincide

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with Mental Health Week 2013, they hosted an Insight Lecture at their head office in Crawley and were able to raise awareness of our work and the stigma associated with mental health.

We give our sincere thanks to Dr Rami Ranger for introducing Combat Stress to the British Sikh and Punjabi communities, which resulted in a combined donation total of £20k from two dinners.

We also thank General Sir Richard and Lady Dannatt for hosting, and Bernard Jenkin MP and his wife Baroness Anne Jenkin for organising the Tower of London Dinner which raised £100k and resulted in a beautiful Richard Stone painting entitled ‘Soldier Back From Helmand’ being presented and unveiled to Second Battalion, Parachute Regiment. It now hangs in the headquarters of the 16th Air Assault Brigade.

In June 2013, 138 Combat Stress supporters attended the Supporters Dinner held at Goldsmith’s Hall in London which raised nearly £35k.

A huge thank you to each one of you and so many more we could mention – without your dedication we couldn’t do what we do.

Combat Stress is very grateful to our Patron, HRH The Prince of Wales KG, KT, GCB, OM, AK, QSO, PC, ADC, for his support during the year.

2014 Annual Report and Accounts | Combat Stress | 11

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Ongoing Contracts

MoD Funding

It has been important to maintain our contractual obligations and relationships with the NHS and devolved governments. The last year we forged relationships with new NHS commissioners, as a result of the changes within the NHS and we engaged with contacts in the newly formed Clinical Commissioning Groups.

Our key statutory funders are:

Under Article 21 of the Service Pension Order, the MoD is responsible for the provision of remedial treatment to those suffering from mental ill health that is attributable to or has been aggravated by their service prior to 2005. Where this treatment is not available in the NHS, another qualified provider can be paid to deliver the treatment. Many ex-Service personnel who are entitled to a War Pension for their disability have not registered their claim, but a declining number of Veterans are eligible. We have sought to improve access to War Pensions for those who are entitled to receive it and have negotiated increases in the amount paid to ensure that treatment costs are fully funded.

With the improvement of NHS treatment specifically tailored to meet Veterans’ needs (an outcome of the Murrison “Fighting Fit” paper) has come a reduction in Combat Stress income to treat qualifying War Pensioners.

To make this income stream more secure, Combat Stress and the SPVA/MOD have agreed the basis of a Memorandum of Understanding which makes clear what treatment can be paid for under Article 21 of the Service Pension Order.

NHS Funding Combat Stress achieved recognition from NHS England as a provider of high quality services for ex-Service personnel suffering mental health disorders.

Payment to deliver the residential PTSD Intensive Treatment Programme in England was funded by a National Specialised Commissioning contract during 2013/14. Similarly, in Scotland the NHS funded a contract to deliver the programme.

12 | Combat Stress | 2014 Annual Report and Accounts

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Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

4. DEVELOPING AN APPROPRIATE BRAND AND IMAGE TO DELIVER EXCELLENCE During 2013/14 we introduced our new brand, with clearer statements of our Vision, Mission and Values. Together they place Veterans at the heart of everything we do. We worked with key stakeholders - including our staff, Veterans and supporters - to develop our new branding and its visual identity. Our logo expresses expertise, heritage and pride, making us more approachable. It conveys hope, and the positive approach to recovery that lies at the heart of our vision for Veterans to live their lives free from the effects of psychological wounds.

The branding inspired one of our Veterans to create artwork which is now proudly on display on posters throughout our buildings.

they are again living fulfilling lives.

We want to make sure our brand conveys the essence of Combat Stress, and is memorable and easily recognisable to Veterans, health professionals, donors and all our stakeholders and partners.

We received funding from Comic Relief to support our work to reduce the stigma associated with mental health issues that still exists within the ex-Services community and the general public.

We know that the situation is slowly improving and Veterans are contacting us sooner after leaving Service. This indicates that perceptions are changing. Some of our celebrity patrons, such as Sir Patrick Stewart, have helped address mental health stigma by talking about personal experiences of family members suffering from

In particular, we are developing our new brand culture so that all of Combat Stress adopts our values and becomes more approachable, feels pride in achievement and works collaboratively to the benefit of our Veterans. We want Veterans to come to us faster and stay with their recovery programmes until

As part of the new branding we have refreshed our publications.

They explain the treatments and support we offer and increase awareness of symptoms.

We are also working in partnership with the NHS, Ministry of Defence, Royal British Legion and other Service charities to support Veterans on their recovery pathway. As part of this, we have developed manuals for our treatment programmes so other service providers will have detailed knowledge of the help we offer and be better able to refer Veterans to Combat Stress for specialist support.

Stigma

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Service related mental health issues. Martin Shaw presented a clip for the BBC’s Sport Relief event in March 2014 concerning PTSD suffered by Veterans which was watched by millions and further helped to raise awareness and de-stigmatise mental health problems.

We have improved access to our services by providing workshops and training in the symptoms of PTSD and other mental health issues and through our updated publications and website.

Through our new brand we have started to create a memorable persona that’s relevant and recognisable to Veterans, donors, medical professionals and anyone who might support or need us.

There has been considerable media coverage over the last year so the general public is more aware of Veterans’ mental health issues and the work of Combat Stress. All this has helped break down the barriers Veterans may feel in seeking help.

2014 Annual Report and Accounts | Combat Stress | 13

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

PLANS FOR THE FUTURE The key feature of our future plans is the integration of the Combat Stress / NHS healthcare pathway into a coherent plan for each Veteran. We will work with partners to build relevant holistic, integrated services for Veterans.

We seek innovative approaches to respond to our Veterans’ needs and to measure and monitor outcomes to demonstrate the effectiveness of this approach to mental healthcare providers.

1. DEVELOPING INTEGRATED COMMUNITY AND OUTREACH, OUTPATIENT AND INPATIENT SERVICES We plan to continue to expand our range of available treatments to meet the individual needs of Veterans so that we can design tailored care plans and support.

In addition, we plan to increase our capacity to meet the needs of more Veterans by increasing the availability and breadth of our community services.

Community and Outreach We will continue to work with the Royal British Legion to establish hub clinics on the high street to maximise understanding and access to services. The hub and spoke model for clinical services will continue to evolve as the Royal British Legion’s Pop-In Centres become available. The main benefits are expected to be: Increased capacity to treat more Veterans Improved integration of services through the whole treatment pathway A focus on occupational therapies, providing Veterans with life skills and vocational training, whilst building their resilience and improving selfesteem.

More local assessment and follow-up sessions for those Veterans who need residential treatment.

These services will be innovative and will add value to those services provided by the NHS and other providers by focusing on relapse prevention, which is currently overlooked.

14 | Combat Stress | 2014 Annual Report and Accounts

We will continue to offer welfare services and clinical visits to Veterans who cannot travel to the hubs.

Substance misuse case management service.

Following the introduction of the pilot service in Glasgow in 2013/14, we will roll out the service across England and Wales and in further regions in Scotland.

Outpatient services We will consider further expansion of community clinics, particularly as new facilities are opened on High Streets. We will monitor the time between first referral to Combat Stress and initial assessment enabling us to identify ways to shorten the time taken for Veterans to be assessed and subsequently receive treatment or referral to other organisations.

Inpatient programmes We will implement a new transdiagnostic programme in all treatment centres.

Where we have piloted new programmes in stabilisation, anger management, substance misuse and co-morbid PTSD, we will deliver them in all treatment centres in 2014/15.

We will continue to deliver the residential PTSD Intensive Treatment Programme and the short stay two week treatment programme in all treatment centres.

Helpline We aim to continue to provide the 24 hour a day Helpline and to monitor the usage and outcomes.

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Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

2. IMPROVING THE EVIDENCE BASE OF THERAPEUTIC PRACTICE With King’s College London we are establishing a research programme to understand the needs of Veterans. We will publish our outcomes and from this we will develop peer-reviewed and evidence-based measures of success.

The implementation of a new clinical Patient Administration System will be vital for monitoring Veterans’ progress along their treatment pathway and to measure outcomes. We anticipate that the new system will be operative in the Summer of 2015.

However, it is only when new

programmes have been running for some time that there will be sufficient data for statistical analysis of the outcomes.

processes and our treatments to see where we can do more for less. We have undergone considerable growth and change over recent years and we must now review our processes to ensure we maximise efficiency and effectiveness within our new structures and practices.

funding, from social media, corporate sponsors and major donors.

3. SUSTAINING OUR FINANCIAL BASE Improved engagement with funders will be a key feature of the work we do next year. We will continue to work with our partners to demonstrate clinical effectiveness and value for money.

We will explore opportunities to work in partnership to identify funding streams to support the core services we provide.

We will undertake a detailed analysis and costing of our

We continue to invest in our fundraising and will look for new and innovative ways to attract

We will launch a new Forces Lottery where individuals can support Combat Stress by purchasing a weekly lottery ticket.

We hope this initiative will also increase awareness of Combat Stress and create new supporters.

4. DEVELOPING AN APPROPRIATE BRAND AND IMAGE TO DELIVER EXCELLENCE We are developing a communications strategy that will embed our Vision, Mission and Values throughout the organisation, with an increased focus on staff engagement, communication and collaboration.

We will instil a culture of pride, respect and personal recovery in everything that we do. We will

develop a clear and appropriate ‘tone of voice’ for Combat Stress, to make us distinctive in our communications, and an overarching narrative and messages that are relevant and meaningful to our stakeholders.

Our focus on the Veteran as the centre of all we do, will

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in turn inform our external communications. It will allow us to build greater profile and awareness and engage with those outside the organisation to support our Mission as the ‘gold standard’ mental health charity for Veterans – a catalyst for better lives and stronger families.

2014 Annual Report and Accounts | Combat Stress | 15

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

FINANCIAL REVIEW In recent years, we have substantially increased and improved our services and facilities. Over the last ten years our charitable expenditure has increased from £5.0m in 2003/04 to £13.3m in 2013/14, an increase of 166%. This growth has only been possible as a result of generating surpluses each year which have funded capital projects, expansion of community based services and recruitment of skilled clinicians to give us capacity to treat more Veterans and to plan for increased expenditure on services in subsequent years.

Building projects to improve and expand our treatment centres over the last ten years have cost £.8.8m (cost of fixed assets at 1 April 2014 £13.3m, (2003/04: £4.5m)). The cost of the building improvements is depreciated over 40 years but careful planning and use of our surpluses has provided the necessary cash to finance the projects.

for our services will continue to rise and therefore we must work closely with statutory health and social care services to ensure they shoulder more of the burden, while we continue to reach out to new supporters and funders to ensure the Society can continue to deliver to each Veteran in need and demonstrate best practice.

The considerable development in our scope and size over recent years is reflected in the following summary. We believe that the number of referrals and demand

2004

2005

2006

2007

2008

2009

2010

2011

2012 restated

2013

2014

£’000

£’000

£’000

£’000

£’000

£’000

£’000

£’000

£’000

£’000

£’000

2,465

2,771

3,257

4,189

4,752

5,522

7,113

11,318

8,942

8,335

10,584**

208

433

384

448

860

907

971

431

578

470

696

Incoming Resources Voluntary income Activities for generating funds Charitable activities

2,724

2,876

3,091

3,352

4,072

4,318

4,454

4,411

6,196

6,698

6,098

Other incoming resources

11

12

4

727

17

10

7

6

39

64

7

Total incoming resources

5,408

6,092

6,736

8,716

9,701

10,757

12,545

16,166

15,754

15,567

17,385

Cost of generating funds

(582)

(621)

(627)

(551)

(761)

(778)

(1,201)

(1,469)

(1,307)

(1,667)*

(2,284)*

Incoming resources

4,826

5,471

6,109

8,165

8,940

9,979

11,344

14,697

14,447

13,900

15,101

4,898

5,020

5,252

5,799

6,855

8,362

9,072

10,451

10,837

12,083

13,509

Expenditure on charitable activities Charitable activities Governance costs

Net incoming/ (outgoing) resources (Decrease)/ Increase in cost of Tangible Fixed Assets

166

127

196

206

120

216

133

143

149

183

209

5,064

5,147

5,448

6,005

6,975

8,578

9,205

10,594

10,986

12,266

13,718

(235)

324

661

2,160

1,965

1,401

2,139

4,103

3,461

1,634

1,383

215

31

415

1,178

910

652

1,441

329

1,146

1,072

897

* Our fundraising costs for 2012/13 and for 2013/14 include expenditure invested in campaigns and appeals where income is expected to be received in future years. ** In 2013/14 our voluntary income included a restricted grant of £2m for a substance misuse case management service which will be spent over a three year period. The balance of unspent funds on this project at 31 March was £1.9m and therefore is the reason for the net incoming resources for the year. However, this funding does not contribute to our core treatments provided to Veterans in the community or in the treatment centres.

16 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Incoming resources The financial statements show total incoming resources for the year of £17.4m (2013: £15.6m), an increase of £1.8m (11.5%) on the previous year. Voluntary income has increased by 26.5% from £8.3m in 2012/13 to £10.5m in 2013/14. However, this includes the one-off three year restricted grant funding from the Military Covenant Reference Group of £2m to be spent on a new substance misuse case management service. These funds will not cover any of the expenditure on our core activities in the community or in our treatment centres.

Resources expended Total resources expended for 2013/14 was £16.0m [2012/13: £13.9m] with 84% being spent on service delivery [2012/13: 87%].

Our expenditure on charitable activities has increased by 11.6% from £12.1m in 2012/13 to £13.5m in 2013/14.

The cost of fundraising has increased from £1.6m in 2012/13 to £2.3m in 2013/14. Much of this increased investment was to fund additional campaigns and mailings, which are expected to generate income over the longer term. However, it is also indicative of the challenging economic environment which means that our fundraising efforts and costs have to increase in order to raise the required levels of income.

As we have diversified and improved our clinical treatments

7000

6,528

6,755 6,391

2013/14

6,098

6000

2012/13

5000 4000 3000 2,000

2000

1,695 1,329

1000

598

421

396

300

200

–

0

Clinical Donations Legacies Investment Statutory Other services & events income grants grants

170

Helpline

7

64

Other income

Our income from charitable activities has decreased by £0.6m (8.9%) from £6.7m in 2012/13 to £6.1m in 2013/14.

The chart above shows the relative sources of income for 2013/14 and 2012/13.

10000

9,148

2013/14

8,265

8000

2012/13

6000 3,654

4000

3,154 2,284 1,667

2000 210

195

440

469

57

0

209

183

0 Clinical services

Community outreach services

Helpline

Improving Substance Activities Governance access misuse for monitoring generating funds

we have recruited more qualified staff. This has resulted in higher employment costs. These have risen to £9.9m in 2013/14 from £8.96m in 2012/13 as shown in note 7 on page 34. Due to the review of the staffing within the treatment centres new, higher level posts were created during 2013/14.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 17

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

PRINCIPAL RISKS AND UNCERTAINTIES Combat Stress aims to achieve a culture where risk management is everyone’s business, embedded in the core processes, systems and business.

The Board of Trustees has overarching responsibility for risk.

However, the authority to develop and oversee risk management arrangements within Combat Stress and how they are being managed and mitigated has been delegated to the Audit and Risk Management Committee, which meets 4 times each year.

It monitors, reviews and reports to the Board on all processes of governance. This committee also reports on anything that threatens or adversely affects the accomplishment of Combat Stress aims and objectives, its assets, the reliability of its records and information, its compliance with all relevant laws, regulations, policies and its governing document.

Responsibility has been further delegated to the individual committees of Combat Stress to manage risk and implement such internal or external controls as are appropriate to their respective spans of control. The Chairs of each Committee make regular reports to the Board.

The risk management system is formalised. A Risk Register captures the risks faced by Combat Stress and identifies the Committee responsible for managing each one. It is based on an ongoing process designed to: identify those risks most likely to impact on the realisation of Combat Stress aims, objectives and policies, evaluate the likelihood of those risks being encountered and the impact should this occur and manage and prioritise actions to mitigate them efficiently, effectively and economically.

As part of the risk management process, major risks have been reviewed and actions taken in mitigation. Combat Stress complies with the Charity Commission’s list of internal financial controls in all material respects, though significant risks arise in the following areas: Service quality and delivery: Through service governance there is the requirement to ensure that the service provided is of the highest standard, which requires an adequate mix of skills in order to deliver best practice;

18 | Combat Stress | 2014 Annual Report and Accounts

Employee welfare: Combat Stress has a duty to protect its employees but there is risk to the physical and mental health of those staff working with Veterans. We have comprehensive supervision, support and protection procedures and policies in place to reduce the possibility of problems occurring; Funding: diversification of income streams such that Combat Stress is less dependent on fees received for the treatment of war pensioners whose disablement qualifies them for funding by the Ministry of Defence (Veterans Agency); and Demand for services: The increasing demand for our services is such that it might exceed resources and the ability to deliver those services.

The Trustees have responsibility for ensuring that Combat Stress has an appropriate system of controls, financial and otherwise.

They are also responsible for safeguarding the assets of Combat Stress and for taking reasonable steps for the prevention and detection of fraud and other irregularities, and to provide reasonable assurance that:

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

Combat Stress is operating efficiently and effectively; its assets are safeguarded against unauthorised use or disposition;

against material misstatement or loss. They include: an annual budget approved by the Trustees;

proper records are maintained and financial information used within Combat Stress or for publication is reliable; and

regular consideration by the Trustees of financial results, variance from budgets and non-financial performance indicators;

Combat Stress complies with relevant laws and regulations.

delegation of authority and segregation of duties; and

The systems of internal control are designed to provide reasonable, but not absolute, assurance

identification and management of risks;

development of a regular independent internal audit cycle to visit different areas of the business and comment on the policies, processes and controls implemented by the executive.

Clinical and service related incidents are reported to the Director of Operations and serious incidents to the Medical Services Committee, the Board of Trustees and externally through the appropriate mechanisms.

All incidents undergo full investigation and where required, have follow-up actions.

EMPLOYMENT OF DISABLED PERSONS The Society takes every practicable step to ensure that individuals are treated equally

and fairly and that decisions on recruitment, selection, training, conditions of work, promotion,

career, management and every other aspect of employment are based solely on objective criteria.

EMPLOYEE INVOLVEMENT The flow of information to staff has been maintained by our staff newsletter. Members of the management team regularly visit

branches and discuss matters of current interest and concern to the business with members of staff.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 19

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

PUBLIC BENEFIT, POLICIES AND GOVERNANCE Public benefit Whilst evaluating the public benefit provided by Combat Stress, the Trustees have referred to the Charity Commission’s general guidance. When reviewing our aims and objectives and in planning future activities the Trustees consider whether or not there are identifiable public benefits, what they are, how they are related to the aims, and how they are balanced against any detriment or harm.

Combat Stress is totally committed to reach out in order to access those Veterans who need help.

To achieve this, the Society will work with whoever is most appropriate to ensure that the right support and care are given at the right time, in the right place, by the right people. In this context, the Society’s work demonstrates clear and significant public benefit through its specialist help for Veterans. By doing this, it assists those suffering from psychological wounds to integrate more fully back into society, maximising their mental, physical and social capabilities.

Combat Stress is increasingly acknowledged within the medical profession and the NHS as a specialist in the treatment of

Veterans suffering from Servicerelated mental illness.

Combat Stress also has the respect of the Serving and ex-Service communities. By continuing to raise awareness of combat-related psychological injury within the Armed Forces and society at large the cost to society as a whole is reduced.

By successful campaigning and education Combat Stress contributes to a better understanding of mental illness in the country as a whole and particularly in the Armed Forces.

By working in partnership with the NHS, other service charities, statutory agencies and the media we are now seeing a growing understanding of the needs of those with wounded minds.

Investment policy and returns Under the Memorandum and Articles of Association, Combat Stress has the power to make any investment that the trustees see fit. The investment policy and performance are regularly reviewed and the investment policy has been confirmed during the course of the year.

During the year Combat Stress held its investment portfolio in the Schroder Charity Multi-Asset Fund. The investment objective

20 | Combat Stress | 2014 Annual Report and Accounts

is to preserve the capital in real terms over a three year period with a total return target of the Consumer Price Index plus 4%.

This should be achieved through a combination of income and capital growth and underpinned by a 3.25% income yield. The portfolio should be sufficiently diversified so as to reduce risk.

The market value of our equity portfolio showed an increase to £11.59m at 31 March 2014 [2013: £8.07m], representing capital growth of 43.6% [2013: 23.1%]. The income yield of £598k represents an average income return for the period of 5.6% [2013: 3.1%].

Cash balances totalling £3.29m [2013: £6.06m] were held by the investment manager at year end.

Reserves policy Combat Stress operates on the basis of a long-term commitment to registered Veterans. The trustees believe the level of free reserves (that is those funds not tied up in fixed assets, designated and restricted funds) should be between 9 and 12 months budgeted expenditure. This is necessary to meet working capital requirements essential for the maintenance of its operations, to even out cash flow fluctuations and to provide a prudent financial

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

base from which to continue to develop Combat Stress and its services. In setting the reserves policy the Trustees have also taken account of the financial demands which would arise in the event of a reduction in service or the inability to sustain continued operations.

The general reserve at 31 March 2014 stood at £10.94m representing 7.1 months expenditure [2012: £12.43m, or 8.8 months]. Whilst this amount does not reach the level of free reserves set out in the policy, the trustees have approved increased investment in fundraising expenditure over the last two financial years to 31 March 2014 with the objective of increasing income and achieving the target level of free reserves.

Restricted and designated funds are held for specific purposes, as detailed in note 19 to these accounts.

The actuarial valuation of the ExServices Mental Welfare Society 1974 Pension & Life Assurance Scheme 31 March 2014, as required

by FRS17, showed a funding surplus of £0.138m [2013: deficit of £0.15m]. This surplus has not been recognised and the value of the net asset of the pension scheme

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

in the accounts is shown as £nil.

The date of the last triennial actuarial valuation was 1 October 2011. As a result of this valuation, employer contributions were set at 30.3% of pensionable salaries with employee contributions being made at 5%. Combat Stress approved a Pension Recovery Plan to address the deficit over 8 years, through the payment of £0.2m per year. Following a consultation with active members the Scheme was closed to future accrual on 31 March 2013. Details of the Scheme are disclosed in Note 17 of the accounts.

Governance The Ex-Services Mental Welfare Society is a charitable company limited by guarantee. It was incorporated on 11 May 1931 and is governed by Memorandum and Articles of Association which were revised on 14 November 1991 and then amended by resolution on 21 September 2006, 20 September 2007 and 17 July 2008.

This governing document states that the objects of the charity are “to provide, establish and maintain recuperative homes, hospitals, sanatoria, schools of training, clubs, workshops and other centres, for all ranks of all branches of HM Forces, including

2014 Annual Report and Accounts | Combat Stress | 21

Combat Stress (Ex-Services Mental Welfare Society) – Trustees’ Report

the Merchant Navy, suffering from war psychoses and neuroses.” The charity operates throughout the United Kingdom.

Meeting. There is no age limit imposed on trustees. The trustees are the Directors of Combat Stress for the purposes of company law.

The Board of Trustees is responsible for selecting and recommending suitable trustees for election to office at the annual general meeting. A maximum of fifteen trustees are elected, each of whom serve for an initial period of three years. One third of the trustees shall retire from office at each Annual General Meeting. The retiring trustees are those who have been longest in office since the last election, but do not include ex-officio members of the Board of Trustees.

A retiring trustee is eligible for re-election and may serve a maximum of two consecutive terms of three years unless there is an extenuating reason for their retention approved by the Company in General Meeting, or they are elected to the position of Chairman, Vice Chairman or Honorary Treasurer. The Board of Trustees is empowered to appoint a Trustee to fill a casual vacancy until the next Annual General

New trustees are inducted through a process of briefings by the Chairman and executive management. They are provided with information relating to Combat Stress’s governance and operation. The induction process includes a visit to the treatment centre at Tyrwhitt House and the Head Office, and a trustee might also accompany a Regional Welfare Officer visiting Veterans in the community. Ongoing training and visits to treatment centres are encouraged.

During 2013/14 the Board of Trustees carried out a selfassessment exercise which included a skills audit and a review of effectiveness of the Board. The exercise showed that trustees bring a high level of skills to the Board but also provided insight into additional skills which could be sought when recruiting new trustees in future.

The Board of Trustees meets four times a year and has appointed committees with responsibility for finance, fundraising, audit and risk management, medical services, remuneration and nominations. A further committee is responsible for stewardship of the closed defined benefit pension scheme.

The Board delegates day to day control of activities to the Chief Executive and a team of operational directors.

22 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Auditor’s Report

STATEMENT OF TRUSTEES’ RESPONSIBILITIES The Trustees (who are also directors of Combat Stress for the purposes of company law) are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice.)

Company law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of the affairs of Combat Stress and of the incoming resources and application of resources, including the income and expenditure of Combat Stress for that period. In preparing these financial statements, the Trustees are required to: select suitable accounting policies and then apply them consistently; observe the methods and principles in the Statement of Recommended Practice (SORP), “Accounting and Reporting by Charities” (Revised 2005);

make judgements and estimates that are reasonable and prudent;

prevention and detection of fraud and other irregularities. In so far as the Trustees are aware:

state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; and

there is no relevant audit information of which the charitable company’s auditor is unaware; and

prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.

The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of Combat Stress and enable them to ensure that the financial statements comply with the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006. They are also responsible for safeguarding the assets of Combat Stress and hence for taking reasonable steps for the

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

the Trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information.

The Board of Trustees approved this Trustees report and Strategic Report on 26 August 2014.

R Ward Honorary Treasurer

2014 Annual Report and Accounts | Combat Stress | 23

Combat Stress (Ex-Services Mental Welfare Society) – Auditor’s Report

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF EX-SERVICES MENTAL WELFARE SOCIETY We have audited the financial statements of the Ex-Services Mental Welfare Society for the year ended 31 March 2014 which comprise the Statement of Financial Activities (including Income and Expenditure Account), the Balance Sheet, the Cash flow statement and the related notes.

The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

This report is made solely to the charity’s trustees and members, as a body, in accordance with

Chapter 3 of Part 16 of the Companies Act 2006 and the Charities and Trustee Investment (Scotland) Act 2005. Our audit work has been undertaken so that we might state to the charity’s trustees and members those matters we are required to state to them in an auditor’s report and for no other purpose.

To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charity and the charity’s trustees and members as a body, for our audit work, for this report, or for the opinions we have formed.

24 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Auditor’s Report

Respective responsibilities of trustees and auditor As explained more fully in the Statement of Trustees’ Responsibilities, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view.

We have been appointed as auditor under section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and under the Companies Act 2006 and report in accordance with regulations made under those Acts.

Our responsibility is to audit and express an opinion on the financial statements in accordance with applicable law and International Standards on Auditing (UK and Ireland). Those standards require us to comply with the Financial Reporting Council’s (FRC’s) Ethical Standards for Auditors.

Scope of the audit of the financial statements A description of the scope of an audit of financial statements is provided on the FRC’s website at www.frc.org.uk/auditscopeukprivate

Opinion on financial statements In our opinion the financial statements: give a true and fair view of the state of the charity’s affairs as at 31 March 2014 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended; have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and have been prepared in accordance with the requirements of the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006 (as amended).

Opinion on other matters prescribed by the Companies Act 2006

Matters on which we are required to report by exception We have nothing to report in respect of the following matters where the Companies Act 2006 and the Charities Accounts (Scotland) Regulations 2006 (as amended) requires us to report to you if, in our opinion: the charitable company has not kept proper and adequate accounting records or returns adequate for our audit have not been received from branches not visited by us; or the financial statements are not in agreement with the accounting records and returns; or certain disclosures of trustees’ remuneration specified by law are not made; or we have not received all the information and explanations we require for our audit.

In our opinion the information given in the report of the trustees, which includes the strategic report for the financial year for which the financial statements are prepared, is consistent with the financial statements.

Donald Bawtree Senior Statutory Auditor for and on behalf of BDO LLP, Statutory Auditor, Gatwick, West Sussex, United Kingdom Date 26 August 2014.

BDO LLP is a limited liability partnership registered in England and Wales (with registered number OC305127)

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 25

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING AN INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 MARCH 2014

26 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

Unrestricted Funds

Restricted Funds

Totals 2014

Totals 2013

Notes

£’000

£’000

£’000

£’000

2

5,711

4,873

10,584

8,335

Incoming resources Incoming resources from generated funds Voluntary income

98

-

98

49

598

-

598

421

6,098

-

6,098

6,098

Other incoming resources

7

-

7

64

Total incoming resources

12,512

4,873

17,385

15,567

2,216

-

2,216

1,614

68

-

68

53

2,284

-

2,284

1,667

Activities for generating funds Investment income Incoming Resources from charitable activities

3

Resources expended Costs of generating funds Cost of generating voluntary income Investment management fees

Charitable activities Clinical services

8,237

911

9,148

8,265

Community and Outreach Services

2,185

1,469

3,654

3,154

Helpline Raising awareness and improving access Substance misuse case management service Governance costs Total Resources Expended

4

Net incoming / (outgoing) resources before transfers Transfers between funds

19

Net incoming resources / (resources expended) before other recognised gains and losses Increase/(decrease) in value of investments Actuarial surplus/(loss) on defined benefit pension scheme

16

Net movement in funds

200

210

195

99

440

469

-

57

57

-

10,773

2,736

13,509

12,083

209

-

209

183

13,266

2,736

16,002

13,933

(754)

2,137

1,383

1,634

(2,312)

2,312

-

-

(3,066)

4,449

1,383

1,634

241

-

241

564

(30)

78

1,594

2,276

(30) (2,855)

Fund balances brought forward at 1 April Fund balances carried forward at 31 March

10 341

19

4,449

24,496

257

24,753

22,477

21,641

4,706

26,347

24,753

The notes on pages 29 to 42 form part of these financial statements.

All activities relate to continuing operations.

There are no gains and losses for either the current or prior years other than those recognised above. All items in the Statement of Financial Activities would appear in the Income and Expenditure Account with the exception of the realised and unrealised gain/(loss) on investments.

There is no difference between the net incoming resources before other recognised gains and losses and their historical cost equivalents.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 27

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

BALANCE SHEET AT 31 MARCH 2014 2014

2013

Notes

£’000

£’000

Tangible fixed assets

8

9,747

9,028

Fixed asset investments

9

Fixed assets 14,879

14,137

24,626

23,165

9

-

-

10

2,094

759

1,321

1,950

3,415

2,709

(1,694)

(974)

Current assets Investments Debtors Cash at bank and in hand Creditors: amounts falling due within one year

11

Net current assets excluding Pension Asset

1,721

1,735

Defined Benefit Pension Scheme Liability

16

-

(147)

Net assets

18

26,347

24,753

10,738

12,427

Funds Unrestricted funds General fund Investment revaluation reserve Defined benefit pension scheme deficit Designated funds Restricted funds Total Funds

19

1,106

288

-

(147)

9,797

11,928

21,641

24,496

4,706

257

26,347

24,753

The notes on pages 29 to 42 form part of these financial statements.

The accounts were approved and authorised for issue by the Board of Trustees on 26 August 2014 and signed on its behalf by:

AJN Graham Chairman

R Ward Honorary Treasurer

28 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

CASH FLOW STATEMENT FOR THE YEAR ENDED 31 MARCH 2014 2014 £’000 Net incoming resources before transfers

£’000

2013 £’000

1,383

£’000 1,634

Adjustment of net surplus / (deficit) to net cash outflow from operating activities Depreciation (Increase)/Decrease in debtors Increase/(Decrease) in creditors Pensions scheme costs under FRS 17

401

370

(1,335)

26

720

(114)

(177)

(492)

Net cash inflow / (outflow) from operating activities

(391)

(210)

992

1,424

Capital expenditure and financial investment Payments to acquire tangible fixed assets Purchase of investments Receipts from sales of investments Increase / (decrease) in cash

Changes in net funds during the year

(1,121)

(1,091)

(3,284)

(952)

10

(4,395)

(2,043)

(3,403)

(619)

At 1 April 2013

Cash flows

At 31 March 2014

£000

£000

£000

Cash at bank, in hand and short term deposits

1,950

(629)

1,321

Cash held by investment manager

6,062

(2,774)

3,288

8,012

(3,403)

4,609

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 29

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

NOTES FORMING PART OF THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2014 1 ACCOUNTING POLICIES a Basis of preparation The financial statements have been prepared under the historical cost convention, with the exception of investments which are included at market value.

The financial statements have been prepared in accordance with the Statement of Recommended Practice (SORP), “Accounting and Reporting by Charities” (Revised 2005) and applicable accounting standards.

The charity has presented its accounts as an individual undertaking, not as a group. The subsidiary has not been included as the results are immaterial to the charity accounts (see note 16). b Company status The Ex-Services Mental Welfare Society, also known as Combat Stress, is a company limited by guarantee. The directors of the company are the members of the Board of Trustees named on page 44.

In the event of Combat Stress being wound up, the liability in respect of the guarantee is limited to £1 per member. c Fund accounting General funds are unrestricted funds which are available for use at the discretion of the trustees in furtherance of the general objects of Combat Stress and which have not been designated for other purposes.

Designated funds comprise unrestricted funds that have been

set aside by the Board of Trustees for particular purposes. The aim and use of each designated fund is set out in the notes to the financial statements.

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised for particular purposes. The cost of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements. d Incoming resources All incoming resources are included in the SOFA when Combat Stress is legally entitled to the income, and the amount can be quantified with reasonable accuracy. The following specific policies apply to categories of income: Legacies Entitlement is the earlier of Combat Stress being notified of an impending distribution or the legacy being received. No value is included where the legacy is subject to a life interest held by another party.

Donated services and facilities These are included at the value to Combat Stress where this can be quantified. No amounts are included in the financial statements for services donated by volunteers.

30 | Combat Stress | 2014 Annual Report and Accounts

Conduit funds Combat Stress acts as agent for other organisations and receives funds on their behalf in respect of registered Veterans. These funds are not recognised as income and are excluded from the Statement of Financial Activities and Balance Sheet.

Grants received which are to be utilised over more than one year In accordance with the Charities Statement of Recommended Practice, Combat Stress has recognised the £2m grant funding for the substance misuse case management service in the year of receipt as a restricted grant.

The resources have been received in advance of the expenditure on the activity funded by the grant but the charity has entitlement to the resource with the timing of the expenditure being within the discretion of the charity.

Therefore, the incoming resources cannot be deferred but the unspent monies are carried forward as a restricted fund balance to be expended in future years. e Resources expended All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with use of the resources.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

Expenditure is allocated as follows:

i Cost of generating funds Fundraising costs are those incurred in seeking voluntary contributions and do not include the costs of disseminating information in support of the charitable activities. ii Clinical Services This represents all direct expenditure incurred in the running of Treatment Centres, including related payroll, office and other costs. A proportion of central support costs is allocated on the basis set out in note 5.

iii Community and Outreach Services Costs represent the direct expenditure on Community and Outreach Services and a proportion of central support costs allocated on the basis set out in note 5.

iv Helpline This represents the direct cost of providing the 24/7 Helpline and a proportion of central support costs allocated on the basis set out in note 5.

v Raising awareness and improving access This represents the direct costs of publicising and promoting our services directly to Veterans, their families and medical health professionals. It includes a proportion of central

support costs allocated on the basis set out in note 5.

g Investments

vi Substance misuse case management service This represents the direct cost of providing the substance misuse case management service and a proportion of central support costs allocated on the basis set out in note 5.

Investments are stated at market value. Valuations are kept up to date such that when investments are sold there is no gain or loss arising. As a result the statement of financial activities only includes those unrealised gains and losses arising from the revaluation of the investment portfolio throughout the year.

h Pension costs

vii Governance costs These costs are associated with the governance arrangements that relate to the central administration and statutory compliance of Combat Stress as a charity and a limited company.

Included within this category are costs associated with strategic management, costs of committees and Board meetings, and Audit fees.

It does not include the cost of day to day operational activities.

f Tangible fixed assets Tangible fixed assets are stated at cost less depreciation and provision for impairment. Only items over £1,000 are capitalised.

Repairs are written off as incurred.

Depreciation is provided from the date assets are brought into use, to write down cost to estimated residual value over the estimated useful life by equal annual instalments, as follows:

Pension costs and the pension provision for the defined benefit scheme are calculated on the basis of actuarial advice and are charged to the statement of financial activities on a basis to spread the costs over the employees’ working lives. Pension costs for the defined contribution scheme are charged to the accounts on an accruals basis in accordance with FRS 17. A pensions reserve has been created within unrestricted funds in compliance with paragraph 335 of the SORP. Details of the pension schemes are disclosed in Note 16 to the accounts. i Leases Rentals applicable to operating leases are charged to the Statement of Financial Activities over the period in which the cost is incurred.

Freehold property – 40 years Furniture and equipment – 5 years Computer equipment – 3 years

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 31

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

2 VOLUNTARY INCOME Unrestricted

Restricted

Totals 2014

Totals 2013

£’000

£’000

£’000

£’000

4,166

2,127

6,293

6,706

Donations

-

396

396

300

1,545

150

1,695

1,329

-

2,200

2,200

-

5,711

4,873

10,584

8,335

Unrestricted

Restricted

Totals 2014

Totals 2013

£’000

£’000

£’000

£’000

Ministry of Defence - Veterans Agency Fees

1,367

-

1,367

1,766

Contract funding

4,610

-

4,610

4,678

121

-

121

84

6,098

-

6,098

6,528

-

-

-

170

6,098

-

6,098

6,698

Activities undertaken directly

Allocated Support Costs

Total 2014

Total 2013 restated

£’000

£’000

£’000

£’000

2,095

189

2,284

1,667

7,906

1,242

9,148

8,265

3,210

444

3,654

3,154

Statutory Grants Legacies Other grants – Armed Forces Covenant

3 INCOMING RESOURCES FROM CHARITABLE ACTIVITIES

Clinical services

Other income Helpline

4 TOTAL RESOURCES EXPENDED

Cost of generating funds Charitable activities Clinical services Community and Outreach Services Helpline Awareness raising and improving access Substance misuse case management service Governance

201

9

210

195

403

37

440

469

53

4

57

-

11,773

1,736

13,509

12,083

200

9

209

183

14,068

1,934

16,002

13,933

2014 £’000

2013 £’000

19

11

4

1

Resources expended included:

Audit fee – charity Audit fee – pension scheme

11

-

Operating leases

303

321

Depreciation

401

370

Other accountancy and VAT services

32 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

5 SUPPORT COSTS

Activities for generating funds Clinical Services Community and Outreach

Finance

Management

Human Resources

Information Technology

2014 Total

£’000

£’000

£’000

£’000

£’000

90

7

42

50

189

350

63

364

465

1,242

133

23

132

156

444

Helpline Awareness raising and improving access Substance misuse case management service

Clinical Services Community and Outreach

-

-

-

9

1

8

10

37

2

-

1

1

4

9

-

-

-

9

611

94

547

682

1,934

Finance

Management

Human Resources

Information Technology

2013 Total

£’000

£’000

£’000

£’000

£’000

Governance

Activities for generating funds

9 18

52

18

19

41

130

240

133

147

373

893

98

52

57

124

331

6

-

-

-

6

13

2

3

5

23

6

-

-

-

6

415

205

226

543

1,389

Helpline Awareness raising and improving access Governance

Basis of allocation The support costs expenditure is allocated on the following bases: Finance costs

On the basis of the value of direct costs incurred by each activity

Human resource costs

On the basis of Full time equivalent numbers of employees directly employed in each activity

Information Technology

On the basis of the number of employees directly employed in each activity

Management costs

On the basis of the Full-time equivalent number of employees directly employed in each activity.

6 TRUSTEE EXPENSES Out of pocket expenses were reimbursed as follows.

Travel & Sundry Expenses

Number

2014 £’000

Number

2013 £’000

11

7

11

5

No members of the Board of Trustees received any remuneration or emoluments in respect of their services as a member of the Board of Trustees during the year (2013: £Nil) nor had any beneficial interest in any contract with Combat Stress during the year.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 33

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

7 STAFF COSTS 2014 £’000

2013 £’000

8,214

7,649

Social security costs

843

753

Pension costs

382

816

(280)

(492)

Wages and salaries

FRS 17

741

231

9,900

8,959

2014 Number

2013 Number

Between £60,001 - £70,000

2

2

Between £70,001 - £80,000

1

1

Between £90,001 - £100,000

3

2

Between £100,001 - £110,000

1

-

Other costs

The Remuneration Committee determines the salaries and benefits of the Executive Management Team.

Emoluments for employees above £60,000

Between £150,001 - £160,000

-

1

Between £160,001 - £170,000

1

-

8

6

Pension contributions for employees above £60,000 2014

2013

Number

£’000

Number

£’000

Defined contribution schemes

8

47

1

16

Defined benefit schemes

-

-

-

-

The number of employees including bank and casual staff, analysed by function was: 2014 Clinical services Community and Outreach

2013

Number

FTE*

Number

FTE*

192

173

190

152

64

63

63

59

1

1

-

-

Fundraising and communications

25

23

24

23

Management and administration

20

19

19

17

302

279

296

251

Substance misuse service

* FTE = Full Time Equivalent

34 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

8 TANGIBLE FIXED ASSETS Assets in the course of construction

Freehold property

Long term IT projects in progress

Furniture and Equipment

Total

£’000

£’000

£’000

£’000

£’000

At 1 April 2013

367

10,759

-

857

11,983

Additions

812

11

112

185

1,120

Disposals

-

-

-

(224)

(224)

Transfers

(1,177)

1,177

-

-

-

2

11,947

112

818

12,879

At 1 April 2013

-

2,388

-

567

2,955

Charge for period

-

269

-

132

401

Disposals

-

-

-

(224)

(224)

At 31 March 2014

-

2,657

-

475

3,132

367

8,371

-

290

9,028

2

9,290

113

343

9,747

Asset Cost

At 31 March 2014 Accumulated Depreciation

Net book values At 1 April 2013 At 31 March 2014

In 2011/12 restricted funding of £3.5m was received from Help for Heroes for an extension and refurbishment of Tyrwhitt House. A condition was attached to this funding such that if Combat Stress disposes of Tyrwhitt House or ceases to make use of it in accordance with its charitable objects then for a period of ten years from 31 March 2011 funding shall be repayable on reducing terms calculated as a proportion of the period yet to expire. The unexpired portion of this restricted funding at 31 March 2014 and the value of Freehold Property above represented by a restricted fund is £2.45m.

9 INVESTMENTS Fixed asset investments 2014

2013

£’000

£’000

14,137

13,134

(6,062)

(6,575)

Market value at start of the period

8,075

6,559

Additions at cost

3,284

952

Investments at start of the period Less cash held by investment manager

Disposal proceeds Net investment gain / (loss) Market value at end of period Cash held by investment manager Analysis of investments held at end of the period Schroders Charity Multi Asset Fund Historical cost of listed investments at end of period Unrealised gains / (losses)

(10)

-

11,349

7,511

241

564

11,590

8,075

3,289

6,062

14,879

14,137

11,590

8,075

10,484

7,211

1,106

864

The cash held by the investment manager is held for cash management purposes.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 35

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

10 DEBTORS

Fees Accrued income

2014

2013

£’000

£’000

1,086

192

539

149

Income tax recoverable

74

126

Other debtors

141

208

Prepayments

254

84

2,094

759

11 CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR 2014

2013

£’000

£’000

Trade creditors

548

406

Other taxes & national insurance

196

209

Accruals & Deferred Income

592

155

46

87

Pension fund

312

117

1,694

974

2014

2013 restated

£’000

£’000

In less than one year

43

69

In two to five years

32

153

0

12

Sundry Creditors

12 CAPITAL AND FINANCIAL COMMITMENTS

Annual commitments under non-cancellable leases expiring:

In later years

13 CONTINGENT LIABILITIES In 2011/12 restricted funding of £3.5m was received from Help for Heroes for refurbishment and to extend the facilities at Tyrwhitt House as follows: the refurbishment and extension to the Welfare Block the extension to the Activities Centre the extension of Tyrwhitt House – the “Living Zone” the reorganisation of the ground floor of Tyrwhitt House including the construction of a new main entrance other associated work including profession fees and expenses for design and project management, infrastructure, external works, furnishings and equipment If Combat Stress disposes of Tyrwhitt House or ceases to make use of it in accordance with its charitable objects then for a period of ten years from 31 March 2011 funding shall be repayable on reducing terms calculated as a proportion of the period yet to expire. The remaining value of the restricted fund at 31 March 2014 is £2.45m.

36 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

14 TAXATION As a registered charity the Ex-Services Mental Welfare Society is exempt from taxation of income and gains falling within Section 505 Income and Corporation Taxes Act 1988 or Section 256 Taxation of Chargeable Gains Act 1992 to the extent that these are applied to its charitable objectives. No tax charge has arisen in the year.

15 TRADING SUBSIDIARY The charity has one wholly owned trading subsidiary, Combat Stress Trading Limited, which is registered in England and Wales (Company registration number 07839816). The company was incorporated on 9 November 2011 and started to trade on 1 April 2013.The following is a summary of the assets and liabilities at 31 March 2014.

2014

2013 Restated

£

£

Net assets at 31 March Current assets Current liabilities Share Capital

57,704

79,121

(57,703)

(79,120)

1

1

Combat Stress Trading Limited’s issued share capital comprises two £1 ordinary shares, which are held by the charity.

The main source of income for the company has been the sale of merchandise and promotional material bearing the Combat Stress logo, such as the sale of Christmas cards, clothing and badges. An agreement is in place between Combat Stress and the trading subsidiary such that the profits are gifted annually to Combat Stress.

2014

Turnover

2013 Restated

£

£

57,479

154,437

(34,051)

(103,229)

Gross profit

23,428

51,208

Administrative costs

(8,986)

(7,040)

14,442

44,168

(14,442)

(44,168)

-

-

Cost of Sales

Profit for the year Gift aid donation to Combat Stress Retained profit for the year

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 37

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

16 PENSION COSTS 2014

2013

£’000

£’000

Defined benefit scheme

170

723

Defined contribution scheme

212

93

382

816

Defined contribution scheme The defined contribution scheme is a Group Personal Pension Scheme provided by Scottish Life. Employee contributions into the scheme are matched by Combat Stress up to a maximum of 10% of basic salary.

Ex-Services Mental Welfare Society 1974 Pension & Life Assurance Scheme The Ex-Services Mental Welfare Society 1974 Pension & Life Assurance Scheme is a defined benefit scheme which was closed to new entrants on 31 August 2000 and closed to future accrual on 31 March 2013.

Over time, under the projected unit method, the current service cost will increase as the members of the scheme approach retirement. The assets of the Scheme are held separately from Combat Stress in a Trustee-administered fund. The Trustees administer the fund in accordance with the Trust Deed and Rules of the Scheme, and in the best interest of the Scheme.

Contributions to the Scheme are determined by a qualified actuary on the bases of triennial valuations using the projected unit method. The last valuation of the Scheme was at 30 September 2011, which showed that the actuarial value of the Scheme’s assets represented 84% of the benefits that had accrued to members, after allowing for future increases in earnings. The market value of the scheme assets at the valuation date was £10,594,506 (Of which £5,220,000 related to the value of secured annuities).

The trustees agreed that during the period contributions would be paid at the overall rate of 35.3% of pensionable salaries, inclusive of employee’s contributions of 5% of pensionable salary. A new Pension Recovery Plan commenced from October 2013 with the employer contributing £200,000 per annum for a period of 8 years.

FRS 17 Disclosures In accordance with the requirements of Financial Reporting Standard 17 the full actuarial valuation dated 30 September 2011 has been updated at 31 March 2014 by a qualified actuary using membership data at 30 September 2011, updated for materially significant changes that occurred up to 31 March 2014.

Combat Stress has selected assumptions based on actuarial advice.

Investments have been valued, for this purpose, at market value. The major assumptions used for the actuarial valuation were: 2014

2013

Liability discount rate

4.30%

4.10%

Price Inflation

3.50%

2.80%

Pensionable salary increases

3.50%

2.80%

Revaluation of deferred benefits

3.50%

2.80%

Expected return on assets at end of year

5.30%

4.65%

3.00%

3.00%

Increases to pension in payment at 5% or RPI if less, subject to a minimum of 3% pa Pre 97 Pensions Post 97 Pensions Proportion of employees opting for early retirement Proportion of employees commuting pension for cash

38 | Combat Stress | 2014 Annual Report and Accounts

3.75%

3.30%

0.00%

0.00%

20.00%

0.00%

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

16 PENSION COSTS (CONTINUED) 2014

2013

Male

88.7 years

88.6 years

Female

91.3 years

91.1 years

Mortality Current Pensioners (born 1949) Future Pensioners (born 1969)

Male

91.8 years

91.6 years

Female

94.3 years

94.1 years

The amounts recognised in the Balance Sheet are as follows:

Present value of scheme liabilities

2014

2013

£’000

£’000

(12,316)

(12,220)

12,454

12,073

Fair value of scheme assets Net asset/(liability) Pension asset not recognised Net asset/(liability)

138

(147)

(138)

-

-

(147)

Analysis of the amount charged to the Statement of Financial Activities under FRS17

Current service cost Expected return on pension scheme assets Interest on pension scheme liabilities Total

2014

2013

£’000

£’000

-

253

(526)

(519)

491

509

(35)

243

Analysis of changes in the present value of the defined benefit obligations and fair value of assets

Present value of defined benefit obligation

Scheme liabilities at the start of the year Current service cost

Value of Scheme Assets

Net (Asset) / Liability Recognised in the Balance Sheet

2014

2013

2014

2013

2014

2013

£’000

£’000

£’000

£’000

£’000

£’000

12,220

11,077

12,073

10,360

147

717

-

253

-

-

-

253

491

509

-

-

491

509

Expected return on scheme assets

-

-

388

519

(388)

(519)

Employer contributions

-

-

280

735

(280)

(735)

Members contributions

-

43

-

43

-

-

(508)

(314)

(508)

(314)

-

-

113

652

83

730

30

(78)

12,316

12,220

12,316

12,073

-

147

Interest cost

Benefits received / paid Actuarial (gain) / loss Scheme liabilities at the end of the year

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 39

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

2014

2013

% of Scheme Assets

£’000

% of Scheme Assets

£’000

Experience adjustments on scheme liabilities

(1.0)%

(113)

(5.3)%

(652)

Experience adjustments on scheme assets

1.0%

83

6.0%

730

Actuarial (gain) / loss recognised in STRGL

0.0%

(30)

(10.9)%

78

% of Scheme Assets

Scheme Assets The assets of the scheme are invested in a Cash Accumulation Policy issued by Prudential. The market value of the assets has been taken as the amount available if the scheme had surrendered its policies with Prudential in accordance with the terms available on surrender. In addition the scheme holds an asset in respect of annuities in payment that have been fully secured with an insurance policy. The value of assets in respect of these policies is taken as equal to the value of the liabilities.

2014

2013

£’000

£’000

Estimated surrender value of Prudential Cash Accumulation Policy

5,399

6,003

Value of annuities secured in respect of pensions in payment

7,055

6,070

12,454

12,073

17 RELATED PARTY TRANSACTIONS A payment of £355 was made during the year to Mr A.N. Cameron, the son of the Chief Executive through the subsidiary trading company for the design of a Christmas card.

A payment of £7,500 was made during the year for a subscription to The Confederation of Service Charities, Cobseo, of which Commodore Andrew Cameron is on the Executive Committee of that organisation by virtue of his Chief Executive position at Combat Stress.

Advantage has been taken of exemption under FRS8 (Related Party Disclosures) not to disclose balances with or transactions between Combat Stress and Combat Stress Trading Limited which is a 100% owned subsidiary.

18 ANALYSIS OF NET ASSETS BETWEEN FUNDS Fund balances at 31 March 2014 are represented by: Restricted Funds

Designated Funds

Investment Revaluation reserve

General Funds

Total

£’000

£’000

£’000

£’000

£’000

Tangible Fixed Assets

2,450

7,297

-

-

9,747

Investments

1,500

1,000

1,106

11,273

14,879

756

1,500

-

1,159

3,415

-

-

-

(1,694)

(1,694)

4,706

9,797

1,106

10,738

26,347

Current assets Current liabilities

40 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

19 STATEMENT OF FUNDS At 1 April 2013

Income

Expenditure

Gains / (Losses)

Transfers

At 31 March 2014

£’000

£’000

£’000

£’000

£’000

£’000

12,427

12,512

(13,266)

211

(1,146)

10,738

288

-

-

-

818

1,106

(147)

-

-

-

147

-

Fixed asset fund

9,028

-

-

-

(1,731)

7,297

Audley Court project

1,400

-

-

-

(1,000)

400

-

-

-

-

500

500

Tyrwhitt House project

250

-

-

-

100

350

IT development fund

500

-

-

-

-

500

Property maintenance fund

750

-

-

-

-

750

24,496

12,512

(13,266)

211

(2,312)

21,641

General reserves Investment revaluation reserve Defined benefit pension scheme asset / (liability) Designated funds

Hollybush House project

Total unrestricted funds Restricted funds Treatment Centres:

3

9

(12)

-

-

-

Hollybush House

81

236

(317)

-

-

-

Tyrwhitt House

Audley Court

52

429

(481)

-

-

-

Community and Outreach

-

1,407

(1,274)

-

-

133

Helpline

-

200

(200)

-

-

-

-

250

(197)

-

-

53

Improving access

26

88

(99)

-

-

15

Clinical services

Reservists

95

8

(99)

-

-

4

Substance misuse case management service

-

2,093

(57)

-

-

2,036

Property – Audley Court

-

132

-

-

(132)

-

Property – Hollybush House

-

21

-

-

(6)

15

Property – Tyrwhitt House Total restricted funds Total funds

-

-

-

-

2,450

2,450

257

4,873

(2,736)

-

2,312

4,706

24,753

17,385

(16,002)

211

-

26,347

General (Free) Reserves: these are funds which are available for general use and are not designated or restricted to particular purposes.

Investment Revaluation Reserve: this represents the excess of the market value of investments over their historical cost at the balance sheet date.

Defined Benefits Pension Scheme liability: this represents the actuarial deficit calculated under the requirements of FRS 17 at 31 March 2014 the valuation of the pension scheme using FRS 17 principles showed a surplus of £138k. This surplus has not been recognised as it is considered that this surplus will not be realised. The provision for the scheme liability has been included at £nil as at 31 March 2014 (2013: deficit of £147k).

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 41

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

19 STATEMENT OF FUNDS (CONTINUED) Designated Funds: Fixed Asset Fund: this represents the net book value of fixed assets, less amounts represented by restricted funds, and reflects the fact that the reserve value is tied up in property and assets and therefore the funds cannot be spent on operational activity.

Audley Court, Tyrwhitt House and Hollybush House Project Funds: these are designated funds which have been set aside for planned capital work.

IT Development Fund enables Combat Stress to undertake planned development of the Information Technology infrastructure and database software.

The Property Maintenance Fund is to ensure that sufficient funds are set aside for any unforeseen major property issues.

Restricted funds Treatment centres: These funds have been received for use within the specific treatment centres.

Community and Outreach: These funds represent donations or grants which have been received for regional Community and Outreach Services.

Helpline: This represents grant funding for running the Helpline.

Reservists: This funding is from the Duke of Westminster’s Foundation and funds our work with those who have served in the Territorial Army or Reservists.

Improving access: This funding has been provided by Comic Relief to address stigma issues and to work to improve knowledge of the mental health problems encountered by Veterans so that ex-Service personnel are informed about our Services and can access them more easily.

Clinical services: this represents two donations, one from BAE Systems which goes towards the costs of The Head of Psychological Therapies, and the other from the Cabinet Office Young Philanthropist Syndicate which is to fund EMDR (Eye Movement and Desensitisation Reprocessing) Therapy.

Substance misuse case management service: This funding has been provided by the Ministry of Defence Armed Forces Covenant Team from the fund set up from collection of penalties incurred by banks for LIBOR fixing. The funding of

42 | Combat Stress | 2014 Annual Report and Accounts

£2m is to run a UK wide multiyear project providing a case management service for those Veterans with substance misuse disorders who may also have underlying mental health issues.

Substance misuse case management service: The Big Lottery have committed funding of £600K to provide substance misuse case management services in Scotland over 3 years. £93K of this was received in 2012-13.

Property – Audley Court: This fund comes from a number of funders and is to be used on building improvements at Audley Court.

Property – Hollybush House: This fund comes from a number of funders and is to be used on building improvements at Hollybush House.

Property – Tyrwhitt House: This restricted funding was from Help for Heroes in 2010/11 for £3.5m to fund major refurbishment and extension work. The restriction is released over 10 years on a straight line basis provided Combat Stress does not dispose of the property or cease using it for charitable purposes.

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Financial Statements

20 DISCLOSURE OF FUNDING Funding is acknowledged under the terms and conditions of the following grants: Funder

Purpose

Funding Received

Expenditure

ABF – The Soldiers’ Charity

Community and Outreach and clinical Treatment

£’000

£’000

270

270

Big Lottery Fund

Substance misuse case management service

93

14

Comic Relief

Anti-Stigma Campaign

88

73

Help for Heroes

Community and Outreach and clinical Treatment

1,000

1,000

Ministry of Defence (Armed Forces Covenant Team)

Helpline

200

200

Ministry of Defence (Armed Forces Covenant Team)

Substance misuse case management service

2,000

43

Royal Air Force Benevolent Fund

Community and Outreach and clinical Treatment

207

207

Royal Navy and Royal Marines Charity

Community and Outreach and clinical Treatment

100

100

Scottish Government – Section 10 Grant

Community and Outreach Scotland

200

200

Victims & Survivors Service – Northern Ireland

Community and Outreach – Northern Ireland

65

65

Welsh Assembly

Community and Outreach - Wales

14

14

Westminster Foundation

Reservists Community and Outreach

250

197

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 43

Combat Stress (Ex-Services Mental Welfare Society) – Legal and administrative information

LEGAL AND ADMINISTRATIVE INFORMATION Patron HRH The Prince of Wales KG, KT, GCB, OM, AK, QSO, PC, ADC President General Sir Redmond Watt KCB KCVO CBE

The members of the Board of Trustees are directors of the charitable company under The Companies Act and are also its trustees for the purposes of charity law. They are collectively referred to as the Trustees.

Those who served on the main board and the Society’s committees, supported by members of the Executive during the year and since the year-end were:

Remuneration

Nominations

Medical Services

Fundraising

Role

Audit & Risk Management

Name

Finance

Committees

X*

X*

TRUSTEES Lieutenant General AJN Graham CB CBE

Chair of Trustees

Air Commodore D Amroliwala OBE MA MBA FCIPD

A

P Allen

A

X X

Colonel P Baxter

X*

Major General APN Currie CB CBE

R

Air Commodore O Delany OBE MBA BA FCIPD FCMI FBIFM

R

JM Green OBE MA

X

Deputy Chair

X

J Hughes MA (Hons) LLB

A

Major General WEB Loudon CBE

R

CKB Melville WS NP TEP LLB Dip LP

A

X

X

M Molesworth-St.Aubyn DL

X

H Pernelet Lic en Droit; Dip Law

R

A Pollitt OBE MA

X

TB Royle MA FRSE

X

S G Smith FCA BA

X

R Thompson OBE FInstF

X*

Dr S Walton BSc MSc PhD CPsychol CSci CDir FRSA Colonel MRL Ward RM

X

X

X* Honorary Treasurer

X*

X

Professor Sir Simon C Wessely MA BM BCh MSc MD FRCP FKC FRCPsych FMedSci

X X

EXECUTIVE MANAGEMENT Commodore AJB Cameron MA, FCMI, RN

Chief Executive

Dr W Busuttil MB, ChB, MPhil, MRCGP, FRCPsych

Director of Medical Services

X

X

Tim Brawn BA

Director of Fundraising & Communications

X

Lieutenant Colonel PM Poole MBE, MILT

Director of Strategic Planning and Partnerships

X

Victoria Reynolds FCCA

Director of Finance, Information Management & Governance

Natalie Styles MSc MCIPD

Director of Corporate Management

X

Garrett Taylor RGN, DPSN, BSc (Hons), LLM

Director of Operations

X

X

X

X

X

X

X X X

X X X

* Committee Chair R Retired / resigned as a trustee on 25 September 2013 A Appointed as a trustee on 25 September 2013

44 | Combat Stress | 2014 Annual Report and Accounts

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

Combat Stress (Ex-Services Mental Welfare Society) – Legal and administrative information

Chief Executive

Solicitors

Commodore AJB Cameron MA, FCMI, RN

Buss Murton Law LLP Wellington Gate 7-9 Church Gate Tunbridge Wells Kent TN1 1HT

Company Secretary Victoria Reynolds, FCCA Registered Office Tyrwhitt House Oaklawn Road Leatherhead Surrey KT22 0BX Auditors BDO LLP 2 City Place Beehive Ring Road Gatwick West Sussex RH6 0PA

Brodies LLP 2 Blythswood Square Glasgow G2 4AD Weightmans St Philips Point Temple Row Birmingham West Midlands B2 5AF

Bankers National Westminster Bank plc City of London Office PO Box 12258 1 Princes Street London EC2R 8PA Investment Managers Cazenove Capital Management 12 Moorgate London EC2R 6DA

Company Limited by Guarantee | Registered in England and Wales No 256353 Charity Registration No England & Wales 206002 | Charity Registration No Scotland SC038828

2014 Annual Report and Accounts | Combat Stress | 45