KENT_SURREY_SUSSEX_AHSN_L - Accounts

The directors present their annual report and financial statements for the year ended 31 March 2023.

The principal activity of the company continued to be that of the creation of a sustainable network focused on healthcare innovation. The company is limited by guarantee.

On 1 April 2019 the company also entered into a Service Level Agreement with other members of the Academic Health Science Network (AHSN) to provide finance functions for the network. This is further explained in note 15 and referred to throughout the notes to the financial statements. The income and expenditure arising on these transactions has been accounted for within administrative expenses and nets to nil profit/(loss).

In October 2023, the Company announced that a new five year licence to operate as a health innovation provider has been agreed until 30 September 2028, and that the Company would be operating under a new trading name of Health Innovation Kent Surrey Sussex (Health Innovation KSS).

The directors who held office during the year and up to the date of signature of the financial statements were as follows:

Carpenter Box has indicated its willingness to be reappointed for another term and appropriate arrangements have been put in place for them to be deemed reappointed in the absence of an Annual General Meeting.

So far as each person who was a director at the date of approving this report is aware, there is no relevant audit information of which the company’s auditor is unaware. Additionally, the directors individually have taken all the necessary steps that they ought to have taken as directors in order to make themselves aware of all relevant audit information and to establish that the company’s auditor is aware of that information.

This report has been prepared in accordance with the provisions applicable to companies entitled to the small companies exemption.

The directors are responsible for preparing the annual report and the financial statements in accordance with applicable law and regulations.

Company law requires the directors to prepare financial statements for each financial year. Under that law the directors have elected to prepare the financial statements in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law). Under company law the directors must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the company and of the surplus or deficit of the company for that period. In preparing these financial statements, the directors are required to:

•     select suitable accounting policies and then apply them consistently;

•     make judgements and accounting estimates that are reasonable and prudent;

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

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

The directors are responsible for keeping adequate accounting records that are sufficient to show and explain the company’s transactions and disclose with reasonable accuracy at any time the financial position of the company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

We have audited the financial statements of Kent Surrey Sussex AHSN Limited (the 'company') for the year ended 31 March 2023 which comprise the statement of comprehensive income, the statement of financial position and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

•     give a true and fair view of the state of the company's affairs as at 31 March 2023 and of its loss 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.

Basis for opinion

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

Conclusions relating to going concern

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

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

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

Other information

The other information comprises the information included in the annual report other than the financial statements and our auditor's report thereon. The directors are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

• the information given in the directors' report for the financial year for which the financial statements are prepared is consistent with the financial statements; and

• the directors' report has been prepared in accordance with applicable legal requirements.

In the light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identified material misstatements in the directors' report.

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

•     adequate accounting records have not been kept, 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 remuneration specified by law are not made; or

•     we have not received all the information and explanations we require for our audit; or

•     the directors were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies' exemption in preparing the directors' report and take advantage of the small companies exemption from the requirement to prepare a strategic report.

As explained more fully in the directors' responsibilities statement, the directors are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the directors determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the directors are responsible for assessing the company's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the directors either intend to liquidate the company or to cease operations, or have no realistic alternative but to do so.

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

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

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, our procedures included the following:

• Obtaining an understanding of the legal and regulatory framework that the company operates in, focusing on those laws and regulations that had a direct effect on the financial statements and operations;

• Obtaining an understanding of the company’s policies and procedures on fraud risks, including knowledge of any actual, suspected or alleged fraud

• Discussing among the engagement team how and where fraud might occur in the financial statements and any potential indicators of fraud through our knowledge and understanding of the company and our sector-specific experience.

As a result of these procedures, we considered the opportunities and incentives that may exist within the company for fraud. We are also required to perform specific procedures to respond to the risk of management override. As a result of performing the above, we identified the following areas as those most likely to have an impact on the financial statements: health & safety, employment law, compliance with the NHS requirements and compliance with the UK Companies Act.

In addition to the above, our procedures to respond to risks identified included the following:

• Making enquiries of management about any known or suspected instances of non-compliance with laws and regulations and fraud;

• Reviewing minutes of meetings of the board and senior management;

• Reading correspondence with regulators;

• Challenging assumptions and judgements made by management in their significant accounting estimates, in particular in relation to deferred income and contract recognition; and

• Auditing the risk of management override of controls, including through testing journal entries and other adjustments for appropriateness.

Due to the inherent limitations of an audit, there is an unavoidable risk that some material misstatements in the financial statements may not be detected, even though the audit is properly planned and performed in accordance with the ISAs (UK). For instance, the further removed non-compliance is from the events and transactions reflected in the financial statements, the less likely the auditor is to become aware of it or to recognise the non-compliance.

Use of our report

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

These financial statements have been prepared in accordance with the provisions applicable to companies subject to the small companies regime.

Kent Surrey Sussex AHSN Limited is a private company limited by guarantee incorporated in England and Wales. The registered office is Amelia House, Crescent Road, Worthing, West Sussex, BN11 1RL.

Since October 2023 the Company has been operating under a new trading name, Health Innovation Kent Surrey Sussex (Health Innovation KSS).

These financial statements have been prepared in accordance with FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (“FRS 102”) and the requirements of the Companies Act 2006 as applicable to companies subject to the small companies regime. The disclosure requirements of section 1A of FRS 102 have been applied other than where additional disclosure is required to show a true and fair view.

The financial statements are prepared in sterling, which is the functional currency of the company. Monetary amounts in these financial statements are rounded to the nearest £1.

The financial statements have been prepared under the historical cost convention. The principal accounting policies adopted are set out below.

The financial statements have been prepared on a going concern basis. The directors have considered relevant information, including the annual budget, forecast future cash flows to 31 March 2025 and the impact of subsequent events in making their assessment.

On 1 April 2023 there was an extension to the master licence agreement for the period to 31 March 2024, which was terminated on 30 September 2023 and replaced by the new master licence agreement noted below. It was announced on 26 May 2023 that The Government and NHS England have confirmed their intention to relicense England’s 15 Academic Health Science Networks (AHSNs) under the revised name of ‘health innovation networks’, to reflect the company's key role in supporting development and spread of innovation across health services. NHS England will commission health innovation networks for 5 years until 2028. From 1 October 2023 a new Master License Agreement came into effect until 30 September 2028. There is a two year break clause at 30 September 2025.

Based on these assessments and having regard to the resources available to the entity, the directors have concluded that there is no material uncertainty in relation to the appropriateness of continuing to adopt the going concern basis in preparing the annual report and accounts.

Turnover is recognised at the fair value of the consideration received or receivable for services provided in the normal course of business, and is shown net of VAT and other sales related taxes.

Contracts with government bodies

A significant amount of the company's turnover is generated through contracts with government bodies including NHS England. As detailed in note 1.11, turnover of this nature is accounted for under the accrual model in line with Section 24 'Government Grants' of FRS 102. Amounts received in advance are recognised within creditors.

Other contracts

Turnover from other contracts is recognised by reference to the stage of completion. The stage of completion is calculated by comparing costs incurred as a proportion of total costs. Where the outcome cannot be estimated reliably, turnover is recognised only to the extent of the expenses recognised that it is probable will be recovered.

Other services

Turnover from the provision of other services is recognised at the time such services are provided.

Tangible fixed assets are initially measured at cost and subsequently measured at cost or valuation, net of depreciation and any impairment losses.

Depreciation is recognised so as to write off the cost or valuation of assets less their residual values over their useful lives on the following bases:

The gain or loss arising on the disposal of an asset is determined as the difference between the sale proceeds and the carrying value of the asset, and is credited or charged to surplus or deficit.

At each reporting period end date, the company reviews the carrying amounts of its tangible assets to determine whether there is any indication that those assets have suffered an impairment loss. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent of the impairment loss (if any).

Cash and cash equivalents are basic financial assets and include deposits held at call with banks.

The company has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instruments Issues’ of FRS 102 to all of its financial instruments.

Financial instruments are recognised in the company's statement of financial position when the company becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when

there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a

net basis or to realise the asset and settle the liability simultaneously.

Basic financial assets, which include trade and other debtors, are initially measured at transaction price including transaction costs and are subsequently carried at amortised cost using the effective interest method. Financial assets classified as receivable within one year are not amortised.

Financial liabilities are classified according to the substance of the contractual arrangements entered into. An equity instrument is any contract that evidences a residual interest in the assets of the company after deducting all of its liabilities.

Basic financial liabilities, including trade and other creditors, are initially recognised at transaction price unless the arrangement constitutes a financing transaction, where the debt instrument is measured at the present value of the future receipts discounted at a market rate of interest. Financial liabilities classified as payable within one year are not amortised.

The tax expense represents the sum of the tax currently payable and deferred tax.

The tax currently payable is based on taxable profit for the year. Taxable profit differs from net profit as reported in the income statement because it excludes items of income or expense that are taxable or deductible in other years and it further excludes items that are never taxable or deductible. The company’s liability for current tax is calculated using tax rates that have been enacted or substantively enacted by the reporting end date.

Deferred tax liabilities are generally recognised for all timing differences and deferred tax assets are recognised to the extent that it is probable that they will be recovered against the reversal of deferred tax liabilities or other future taxable profits.

The costs of short-term employee benefits are recognised as a liability and an expense.

The cost of any unused holiday entitlement is recognised in the period in which the employee’s services are received

For defined contribution schemes the amount charged to profit or loss is the contributions payable in the

year. Differences between contributions payable in the year and contributions actually paid are shown as

either accruals or prepayments.

Government grants are recognised at the fair value of the asset received or receivable when there is reasonable assurance that the grant conditions will be met and the grants will be received.

A grant that specifies performance conditions is recognised in turnover when the performance conditions are met. Where a grant does not specify performance conditions it is recognised in turnover when the proceeds are received or receivable. A grant received before the recognition criteria are satisfied is recognised as a liability.

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

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

The estimates and assumptions which have a significant risk of causing a material adjustment to the carrying amount of assets and liabilities are as follows.

Revenue derived from contracts include a judgement of the stage of completion at the period end. This judgement is used to determine the amount of revenue and profit to recognise in relation to each contract, and therefore how much revenue should be deferred at the year end. For NHS contracts there is nil profit or loss and therefore the stage of completion is based on the expenditure to date. For non-NHS contracts the stage of completion is based on the costs incurred for work performed in conjunction with expected final contract costs and overall profitability. Where this cannot be reliably estimated, revenue is recognised equivalent to the costs incurred.

On 27 September 2021 the business and assets of the analytical and evaluation department were transferred to another entity, Unity Insights Limited. This entity is limited by guarantee and 25% of this guarantee is held by the company. The above fees in the prior year represent profits generated by the department being transferred to the new entity.

The average monthly number of persons (including directors) employed by the company during the year was 46 (2022 - 49).

The number of directors for whom retirement benefits are accruing under defined contribution schemes amounted to 6 (2022 - 7).

Details of the company's associates at 31 March 2023 are as follows:

Each member has agreed to contribute an amount not exceeding £1 in the event of the company being wound up.

At the reporting end date the company had outstanding commitments for future minimum lease payments under non-cancellable operating leases, as follows:

D Holden, a director of the company, was also the medical director of Surrey and Sussex Healthcare NHS Trust, a director of South East Health Technologies Alliance (SEHTA), a not for profit organisation, and visiting professor of University of Surrey. During the year the company entered into the following transactions with these related parties:

• Purchases of project related services totalling £26,559 (2022 - £25,000). At the reporting date there was £26,153 (2022 - £nil) owed to Surrey and Sussex Healthcare NHS Trust;

• Purchases of project related services totalling £5,500 (2022 - £8,500) from South East Health Technologies Alliance (SEHTA); and

• Purchases of project related services totalling £176 (2022 - £62) from University of Surrey.

D Clayton-Smith, a director of the company, was also a director of Unity Insights limited and chair of Review of Priority Committees and IFR processes, NHS England and NHS Improvement – South East. During the year the company entered into the following transactions with these related parties:

Kent Surrey Sussex AHSN is a guarantor of Unity Insights Limited.

• Purchases of services totalling £675,144 (2022 - £1,184,076) and sales of £113,289 (2022 - £247,230) from Unity Insights Limited; and

• At the reporting date there was £125,387 (2022 - £477,717) owed to Unity Insights Limited and £5,952 (2022 - £34,681) owed by Unity Insights Limited.

• Sales of £3,841,179 (2022 - £3,773,244) from NHS England; and at the reporting date there was £57,246 (2022 - £37,800) owed by NHS England.

Jane Ollis, a director of the company, was also the director of East Kent Hospitals University Foundation Trust. During the year the company entered into the following transactions with this related party:

• Purchases of project related services totalling £2,306 (2022 - £nil).

The company has entered into the following transactions during the year with one of its guarantors, Royal Surrey County Hospital:

• Sales of project related services totalling £70,000 (2022 - £25,000);

• At the reporting date there was £29,665 (2022 - £121,706) owed to this related party and £70,000 (2022 - £30,000) owed by this related party; and

• Purchases in respect of the company’s staff costs, whose employment contract is hosted by Royal Surrey County Hospital, HR and payroll services totalling £467,388 (2022 - 700,044).

On 1 April 2019 the company entered into a Service Level Agreement with the other members of the Academic Health Science Network (AHSN) to provide finance functions for the network. The following amounts in relation to these functions are included in the financial statements:

Debit balances:

- Trade debtors                £208,050 (2022 - £3,163)

- Cash at bank and in hand        £1,284,512 (2022 - £886,725)

- Prepayments                £nil (2022 - £50,750)

- Other taxation and social security    £48,488 (2022 - £152,321)

Credit balances:

- Trade creditors                £533,281 (2022 - £199,163)

- Other creditors                £1,007,769 (2022 - £893,797)

During the year the total receipts from the network in relation to this service amounted to £3,709,450 (2022- £2,681,100) and the total costs incurred on behalf of the network amounted to £3,709,450 (2022 - £2,681,100), both of which are included within administrative expenses.