Integrated Care 24
Annual Report and Financial Statements
For the year ended 30 June 2023
Company Registration No. 03193182 (England and Wales)
Integrated Care 24
Company Information
Directors
D B Baines
D Brown
A Catto
K Gentleman
A Karki
S P King
A Oag
K Pitts
R Robinson
R T McEwan
K Eldridge
(Appointed 9 May 2023)
P Brooke
(Appointed 31 July 2023)
Company number
03193182
Registered office
Kingston House
Orbital Park
Ashford
Kent
TN24 0GP
Auditor
Moore Kingston Smith LLP
6th Floor
9 Appold Street
London
EC2A 2AP
Integrated Care 24
Contents
Page
Strategic report
1 - 5
Directors' report
6 - 10
Independent auditor's report
11-14
Consolidated statement of total comprehensive income
15
Group balance sheet
16
Company balance sheet
17
Group statement of changes in equity
18
Company statement of changes in equity
19
Consolidated statement of cash flows
20
Notes to the financial statements
21 - 44
Integrated Care 24
Strategic Report
For the year ended 30 June 2023
Page 1

The Directors present their report and financial statements for the year ended 30 June 2023.

Fair review of the business

This year has continued to be a challenging time in healthcare, with all NHS providers impacted by recovery from Covid-19 with ongoing care access and delivery problems.

 

The principal activity of the social enterprise continues to be that of providing unscheduled urgent integrated care (NHS111 and urgent primary care) to some 6.3 million patients.

 

Integrated Care 24 (IC24) also provides in-hours primary care to patients in Sussex.

 

The social enterprise owns 100% of the issued share capital of Brightdoc 24 Limited, which provides locum doctors to the organisation; Pharma Alert 24 Limited, which operates a pharmacy in Hastings; and 50% of the issued share capital of iDental Care 24 Ltd which provides out of hours dental care in Brighton.

 

IC24 were also commissioned in year to provide an England-wide National Service Advisor resilience service on a one-year contract from February 2023. IC24 continues to provide the unique, national NHS paediatric clinical assessment service (PCAS) which was initiated in August 2021 and is an exemplar of providing senior opinion at an early stage in the patient pathway.

 

IC24 continues to operate several smaller contracts in Sussex, including an overnight district nursing service, home visiting service, roving GP service and emergency department primary care service.

 

CLEO Systems 24 Ltd is a wholly owned subsidiary of IC24. CLEO Systems is a leading developer and integrator of digital solutions for primary, secondary, urgent and emergency care markets and has continued to evolve and grow in this financial year. CLEO Systems is committed to improving the digital experience of patients using Integrated Urgent Care (IUC) services and the most notable impact was the development and marketing of an NHS electronic prescribing solution (EPS).

Our Development and Performance
Financial performance

The financial statements include subsidiaries and have been consolidated to include the associate, iDental, using the equity method.

 

Results for the year show a decrease in turnover from £76.3m for 2022 to £73.0m in 2023. The group generated a surplus on ordinary activities after taxation of £4.1m (2022: £6.2m) for the year.

Integrated Care 24
Strategic Report (Continued)
For the year ended 30 June 2023
Page 2
Current Operating Position (including key performance indicators)

We have seen a revenue reduction in the current year. This is driven mainly by the loss of a large Health and Justice contract which ran for most of 2021/22. This impact was offset partially by the introduction of new services (Primary Care and National Service Advisors) as well as small increased revenue in Out of Hours and CAS in Essex and Norfolk, along with the full year benefit of the National Paediatric Service. Large-scale, long-term ICS based IUC contracts are unlikely to emerge in the current operating environment. However, the movement of IC24 into primary care services, a new national resilience service advisor contract and continued funding of the PCAS have challenged the view that new business opportunities are limited.

 

IC24 is responsible for answering 4% of all the calls into NHS 111 across England and answered 669,261 based on national NHS data for year ended 30th March 2023, a small reduction of 1.7% compared to the previous 12 months. Nationally, demand into 111 has dropped 3.7% in 2022/23, a reduction from the extreme demand seen in 2021/22 in relation to the response to the COVID pandemic.

 

However, IC24 NHS111 contact centre performance recovery was below expectation in the first 6 months of the year, and a successful performance improvement programme was instigated to improve experience for patients and improved commissioner confidence in the service going forwards.

 

Operational focus on the effectiveness of the clinical assessment service (CAS) has been maintained, with the aim of reducing downstream dispositions to statutory ambulance and acute trust providers. A key operational priority is ensuring that IC24 minimises the impact of urgent care demand on the systems in which we work. For example, in Mid and South Essex and Norfolk and Waveney, IC24 clinicians reviewed over 90% of all 111 calls that initially indicated an emergency referral to hospital (48,709) resulting in 26,664 patients appropriately diverted to a more suitable service, and thus reducing the load on hospital emergency services.

Similarly, IC24 clinicians reviewed over 59,000 calls which initially proposed sending a category 3 or 4 ambulance resulting in some 59% of these no longer requiring an ambulance to be dispatched.

CLEO Systems is achieving steady growth with a pipeline of new and potential contracts with NHS providers. The CLEO Board has ensured that the infrastructure and governance is in place to ensure safe, and sustained delivery and growth, in particular setting up a clinical safety oversight committee.

 

CLEO SOLO Electronic Prescribing System was launched in August 2022. A successful first of type pilot with Midlands Partnership NHS Foundation Trust, aided the Trust’s community clinicians to realise the productivity benefits of digital prescribing, whilst also enhancing prescription security.

Our People

We’ve continued to strive to make IC24 a great place to work for our people, as part of our strategy to deliver the best possible care to our patients.

We use the results of our annual employment engagement survey, b-Heard (from ‘bestcompanies’), and our mid-year pulse survey, to identify opportunities to make IC24 a better place to work.

 

These results inform The Times’ Top 100 lists and IC24 was recognised as a 'Good Organisation to work for in 2023', as well as being recognised in four other categories. Other achievements include:

 

Health & Social Care’s Top 5 Companies to work for Q1 2023

The UK’s Top 50 Best Large Companies to work for Q1 2023

East of England's Top 25 Best Companies to work for Q1 2023

The South East's Top 50 Best Companies to work for Q1 2023

Integrated Care 24
Strategic Report (Continued)
For the year ended 30 June 2023
Page 3
Equality, diversity, and inclusion
The IC24 Colleague Resource Groups (CRG) have strengthened over the past year, providing our people with a voice to celebrate and promote inclusion, equity, and diversity. The CRGs were established in 2021 and designed to provide a safe space for allyship, support and education for our people.

In year CRG achievements include an IC24 Anti-Racism Charter (early 2023), a 'see me first' campaign (March 2023), a commitment to being anti-racist and anti-discriminative and in May 2023, IC24 was awarded Level 2 Disability Confident Employer Accreditation.
Environmental, Social and Governance
IC24 has shown significant commitment to the Greener NHS programme. A Carbon Reduction Plan to play our part in the aim to achieve NHS Net Zero emissions by 2050 is under development, and we are reviewing our wider sustainability strategy. In 2022/23 there was an expansion in hybrid fleet vehicles used in our home visiting service alongside an expansion of remote consultation to minimise patient and clinician travel.  

In November 2022 the Care Quality Commission (CQC) rated IC24's services in Essex as Good in all 5 domains reviewed. The inspection covered the NHS 111 service, clinical assessment service and the ‘out of hours' service..

IC24 remained compliant with regulatory requirements during this period. Ensuring IC24 maintains a safe operating environment is a Board priority, and achievements this year include the award of Health and Safety ISO 14001 standard on 19th December 2022 and Cyber Essentials Plus on January 4, 2023.    

The IC24 Board of Directors has maintained a strategic oversight of the Company and subsidiaries. With clear functional reporting structures, the Board was adequately sighted on risk matters supporting the corporate objectives.  Board Directors review the key performance indicators at the Board and subcommittees with appropriate challenge and during the year continue to implement the findings of an externally commissioned governance review undertaken in May 2022.  We appointed an experienced Board governance manager in the reporting year.
Integrated Care 24
Strategic Report (Continued)
For the year ended 30 June 2023
Page 4
Principal risks and uncertainties

The purpose of IC24 is to improve the experience of people seeking urgent care and primary care. We do this by helping local NHS systems improve the way their urgent and primary care pathways / partnerships work, and deploying our values of innovation, care, and excellence, and in particular our digital system capabilities. There is a risk that our capability to help systems improve patient experience and system efficiency is overlooked due to the impact of the NHS system re-organisation into Integrated Care Systems (ICS) and the dominance of statutory NHS provider Trusts. This means that the contribution of 3rd sector / VSCE partners to improvement can be overlooked.

 

However, the new structures have presented opportunities to renew and revitalise some partnerships. For example, IC24 is a member of the East Kent Health and Care Partnership and the ICB Chair’s group in Kent and Medway ICS.

 

Our major IUC contracts are Norfolk and Waveney (extended to March 2025) and our mid and south Essex contract is in the fifth year of a 'five plus two’ contract. The inability to retain either of these contracts is a significant strategic risk to the organisation, although we continue to work with these systems to build a vision for a longer contractual period that enables the long-term partnership investments that are needed to deliver a better patient experience and system efficiency.

 

NHS England are seeking improved efficiency of contact centres through the development of a ‘single virtual contact centre’ (SVCC) model. The expected national launch in 2022 did not materialise but east of England commissioners remain committed to developing the model and we continue to work in partnership with them to optimising patient experience and outcomes. There are both risks and opportunities if this changed model of working is implemented.

 

The financial position of the NHS systems in which we work is a strategic risk. Our financial outcome for 2022-2023 was satisfactory, however inflation meant significantly increased staff costs towards the latter part of the year which was not reflected in contract inflationary increases. Looking forward, achieving financial balance will prove difficult as costs are increasing significantly ahead of contract values. The directors' view is that IC24 remains a going concern and will continue to meet the NHS Provider Licence conditions.

 

In common with statutory NHS partners, retaining and attracting sufficient workforce is an ever-present challenge. Our “Great Place to Work” Strategy is our principal mitigation. This includes the development of home and hybrid working opportunities for lay and clinical staff, improvements in rostering, a focus on tackling barriers to staff feeling included, and significant pay increases over and above the commissioner pay uplift allowance.

 

The proposed Provider Selection Regime (PSR) will be a new set of rules replacing the existing procurement rules for arranging healthcare services in England. The PSR will be introduced by regulations made under the Health and Care Bill. A supplementary consultation was undertaken in 2022 and the legislation will be enacted in early 2024. It is too early to know how the risk of the PSR will impact on IC24.

 

The principal risk to our fast growing Cleo Systems subsidiary is our capacity to manage significant growth whilst maintaining high quality support for customers.

 

The principal risks to our developing Primary care services are recruiting and retaining clinical staff whilst maintaining financial sustainability. We also need to implement the new ways of operating GP services in line with the “Fuller Report” recommendations to separate planned and urgent care to provide better patient experience and clinical outcomes.

Integrated Care 24
Strategic Report (Continued)
For the year ended 30 June 2023
Page 5
Research and development
The ambition for IC24 to become a research active organisation remains and we have strengthened our collaboration with the behavioural psychologists at Leeds Beckett University to better understand patient and call handler interaction. This has included papers submitted for publication based on research conducted in IC24 contact centres. Links have also been developed with the University of East Anglia and membership of the Kent, Surrey, Sussex Applied Research Community (KSS ARC). Although enablers are in place, internal bandwidth remains a rate limiting factor in developing our research capacity.
Future developments

2023-4 will see the publication of our revised strategy centred on Patients, People, and Partners. This is a response to NHS strategic priorities and operational planning guidance, the NHSE delivery plan for recovering urgent and emergency care services, and the Fuller Stocktake report.

Leadership and effective governance are key to successfully delivering our purpose. In 23-4 we will invest in leadership and board development and strengthen our systems of control and assurance. Improved Contact centre operational performance, a new people strategy, strengthened programme management office arrangements, and a redesign of the clinical operating model will be features of the next reporting period.

On behalf of the board

Dr Andrew Catto PhD FRCP
Chief Executive Officer
13 December 2023
Integrated Care 24
Directors' Report
For the year ended 30 June 2023
Page 6

The directors present their report and financial statements for the year ended 30 June 2023.

 

In accordance with s414c(11) of the Companies Act 2006, the information relating to future developments and financial risk management are included in the Strategic Report.

Directors

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

D B Baines
D Brown
A Catto
K Gentleman
A Karki
S P King
J Mills
(Resigned 26 May 2023)
A Oag
K Pitts
R Robinson
R T McEwan
D L Supple
(Appointed 11 July 2022 and resigned 31 July 2023)
K Eldridge
(Appointed 9 May 2023)
P Brooke
(Appointed 31 July 2023)
Financial Results

The results for the year are set out on page 15.

Our Social Purpose

We are an NHS Social Enterprise. We do not distribute profits to shareholders but invest any surplus funds to improve NHS health systems and services. The purpose of IC24 is to improve the experience of people seeking urgent care and primary care.

What we do

We are the leading Social Enterprise providing Integrated Urgent Care to patients 24/7 in the South East and East of England. We deploy our values of innovation, care, excellence and respect to improve patient’s experience of urgent and Primary care. In particular we use our technological expertise to improve health system services by developing innovative IT systems and solutions that improve patient safety and quality as well as organisational efficiency.

Integrated Care 24
Directors' Report (Continued)
For the year ended 30 June 2023
Page 7
Statement by the directors relating to their statutory duties under section 172(1) of the Companies Act 2006

The directors, in line with their duties under s172 of the Companies Act 2006, act individually and collectively in the way they consider, in good faith, would be most likely to promote the success of the group for the benefit of its stakeholders, and in doing so have regard, amongst other matters, to the:

 

Stakeholders

The board understands the importance of engagement with all of its stakeholders and gives appropriate weighting to the outcome of its decisions for the relevant stakeholder in weighing up how best to promote the success of the group. The board regularly discusses issues concerning partners, suppliers, employees, community and environment, regulators and its members, which it takes into account in its discussions and in its decision-making process. In addition to this, the board seeks to understand the interests and views of the group's stakeholders by engaging with them directly when required. The below summarises the key stakeholders and how we engage with each:

Working with partners

We work in some formal and many informal partnerships. Our key skill is helping integrate work between partners. We work closely with NHS GP services to help them manage their patients' urgent care needs, ambulance services and accident and emergency services to reduce the numbers of people who use their scarce resources unnecessarily and of course, NHS commissioners and many other NHS providers to improve patient safety and experience. We are grateful to commissioners for entrusting us with the Primary Care needs of the populations for whom they are responsible.

Suppliers
We work with a range of suppliers to ensure we create sustainable, long-term relationships utilising other social enterprises where practical. The Group has, where relevant, procedures in place requiring due diligence of suppliers as to their internal governance, including for example, their anti-bribery and corruption practices, data protection policies and modern slavery matters. The group has systems and processes in place to ensure suppliers are paid in a timely manner.
Commitment to Quality and Safety
Our overriding priority is to ensure the safety of the public, patients and our people and the quality of service people experience from us. We aim to embed a quality and safety culture, with a network of quality champions, systematic clinical oversight and an enquiring and open approach to investigating incidents so we can learn from them. CQC inspections of our services have rated us as “Good”. We play our part in the “Greener NHS programme as part of the wider NHS commitment to achieve net zero by 2050.
Freedom to Speak Up
We also know sometimes things go wrong. So, we encourage our people to “Speak Up” when they see something that they do not think is right.  We have an appointed “Freedom to speak up” guardian whose role is to ensure people are heard, and FTSU champions to encourage and support people to speak up. We encourage colleagues to come forward as part of our open and honest culture so we can look into the concern and determine what, if any, changes need to be made as a result.
Integrated Care 24
Directors' Report (Continued)
For the year ended 30 June 2023
Page 8
Employee involvement and inclusion
We want to be a great place to work for everyone. We aim to go far beyond our statutory requirements to inform and consult with colleagues, and make sure everyone feels included. We have developed a range of channels and work groups to help colleagues understand their role and feel included in the organisation, , and most importantly, to harness their ideas for improving our services. We understand that involved and engaged people are at the heart of delivering the quality we strive for. We have specific groups to help ensure we have active staff engagement and participation in areas which impact them the most.
Commitment to people with disabilities
One in five working-age adults reports having a disability. We are positive about harnessing the skills and talents of people who have disabilities as colleagues in our teams. IC24 are a Disability Confident ‘Committed' employer.  We carry the Disability Confident badge to show disabled people that we recognise the value they can bring to our business and are working towards disability confident level 3.
Diversity and inclusion
We have engaged in a listening programme and initiated a number of colleague forums to enable the organisation to listen to and encourage the participation of diverse colleagues in our business. Our aim is to ensure our organisation is not only open to all colleagues but provides equity and equality of opportunity within our working environment.
Reducing our Environmental impact
We take our environmental responsibilities seriously. We understand the importance of the environment and the need to manage energy use and waste to ensure our impact on the environment and climate change is reduced “as far as is reasonably practicable”.

To comply with the requirements of the Governments Energy Savings Opportunity Scheme (ESOS), We record energy use throughout our organisation, where it is possible to measure it. Due to the nature of some of the locations where we operate, we are not always in a position to measure energy use, for example in hospitals and clinics.

To gather the relevant information, invoices/utility bills have been used to collect usage figures. Regional offices record monthly meter readings to help identify usage issues early and to enable more frequent actual meter readings to be provided to the suppliers.
The table below shows the main resources used by the Group and the associated greenhouse emissions.
Y/E 2022/23
Y/E 2021/22 (as restated)
Difference (greenhouse gas emissions)
Utility
Recorded Usage
Associated Greenhouse Emissions (Kgs) (CO2e)
Recorded Usage
Associated Greenhouse Emissions (Kgs) (CO2e)
Kg
% Movement
Electricity
925,851 KWh
179,041
934,274 KWh
198,374
-19,333
-10%
Gas
336,593 KWh
61,811
370,236 KWh
68,034
-6,223
-9%
Vehicle fuel
59,408 L
144,468
62,574 L
153,324
-8,856
-6%
Water
4,216 cubic metres
881
4,488 cubic metres
938
-57
-6%
Refrigerant gases
0
0
5.6
11,693
-11,693
-100%
Total emissions
386,201
432,363
-46,162
-11%
FTE Employees
653
626
Co2e per FTE
591kgs (0.591 metric tonnes)
690kgs (0.69 metric tonnes)
-99
-14%
Integrated Care 24
Directors' Report (Continued)
For the year ended 30 June 2023
Page 9
N.B. please note prior year CO2 per full time equivalent (FTE) for 2021/22 has been restated as headcount rather than FTE was used in the calculation last year in error. Based on FTE's the CO2 usage is estimated to be equivalent to 591Kg CO2e per FTE Employee based on 2022/23 in which we had an average of 653 FTE's.
The UK Government provides an annual document - Greenhouse Gas Factors for Company Reporting. This document enables organisations to convert energy use or waste figures into equivalent greenhouse gas emissions, thus enabling organisations to measure its impact on the environment and climate change. For this report we have used 2022 factors.
The level of electricity use has only decreased slightly (0.9%) but this has occurred as FTE staff numbers grew by 4%. The reduction in use is due to measures such as the introduction of energy efficient lighting in our offices. The main driver for change in electricity calculated CO2 levels is due to the production of electricity itself becoming less CO2 intensive.

Gas usage was down 9% in year, but no specific programmes delivered the change, and this was mainly driven by a milder winter in 2022/23.

Use of vehicle fuel fell mainly driven by the introduction of newer hybrid cars improving consumption.
A large amount of the companies air conditioning systems were replaced in 2021/22 this has reduced the leaks and the need to refill units this year reducing our refrigerant gas usage.
An environmental news-letter is distributed to all staff to raise awareness of energy usage, and we have particularly focused on our drivers, as vehicle fuel is a large source of CO2 emissions.  In order to reduce the carbon footprint of our Home Visiting services we are again investing in more hybrid cars this year and are keeping further options under review as technology improves in order that we can contribute to the NHS drive to carbon neutrality.
Auditor

The auditors, Moore Kingston Smith LLP, are deemed to be reappointed under section 487(2) of the Companies Act 2006.

Statement of directors' responsibilities

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 group and company, and of the surplus or deficit of the group for that period. In preparing these financial statements, the directors are required to:

 

 

The directors are responsible for keeping adequate accounting records that are sufficient to show and explain the group’s and company’s transactions and disclose with reasonable accuracy at any time the financial position of the group and 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 group and company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Integrated Care 24
Directors' Report (Continued)
For the year ended 30 June 2023
Page 10
Statement of disclosure to auditor

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 auditor of the company 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 auditor of the company is aware of that information.

On behalf of the board
A Catto
Director
13 December 2023
Integrated Care 24
Independent Auditor's Report
To the Members of Integrated Care 24
Page 11
Opinion

We have audited the financial statements of Integrated Care 24 (the 'parent company') and its subsidiaries (the 'group') for the year ended 30 June 2023 which comprise the Consolidated Statement of Total Comprehensive Income, the Group Balance Sheet, the Company Balance Sheet, the Group Statement of Changes in Equity, the Company Statement of Changes in Equity, the Consolidated Statement of Cash Flows and notes to the financial statements, including a summary of 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:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the group and parent 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 group's and parent 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.

Integrated Care 24
Independent Auditor's Report (Continued)
To the Members of Integrated Care 24
Page 12

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the group and the parent company and their environment obtained in the course of the audit, we have not identified material misstatements in the Strategic Report or the Directors' Report.

 

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

 

Responsibilities of directors

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 group's and parent 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 group or parent company or to cease operations, or have no realistic alternative but to do so.

Integrated Care 24
Independent Auditor's Report (Continued)
To the Members of Integrated Care 24
Page 13
Auditor's responsibilities for the audit of the financial statements

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.

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

 

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

 

Integrated Care 24
Independent Auditor's Report (Continued)
To the Members of Integrated Care 24
Page 14

Explanation as to what extent the audit was considered capable of detecting irregularities, including

fraud

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.

 

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the company.

 

Our approach was as follows:

Ÿ

 

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

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 for no purpose other than to draw to the attention of the company’s members those matters we are required to include in an auditor's report addressed to them. To the fullest extent permitted by law, we do not accept or assume responsibility to any party 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.

Guy Richardson (Senior Statutory Auditor)
for and on behalf of Moore Kingston Smith LLP
15 December 2023
Chartered Accountants
Statutory Auditor
6th Floor
9 Appold Street
London
EC2A 2AP
Integrated Care 24
Consolidated Statement of Total Comprehensive Income
For the year ended 30 June 2023
Page 15
2023
2022
Notes
£
£
Income
3
73,033,706
76,323,226
Cost of sales
(58,736,587)
(59,139,751)
Gross surplus
14,297,119
17,183,475
Administrative expenses
(10,020,345)
(9,918,356)
Other operating income
3
195,914
281,865
Operating surplus
4
4,472,688
7,546,984
Income from interests in associated undertakings
8
121,317
62,337
Other interest receivable and similar income
8
384,115
10,687
Interest payable and similar expenses
9
(134)
(28)
Surplus on ordinary activities before taxation
4,977,986
7,619,980
Tax on surplus on ordinary activities
10
(829,181)
(1,445,858)
Surplus on ordinary activities after taxation and total comprehensive income
4,148,805
6,174,122
Total comprehensive income for the year is all attributable to the members of the parent company. There were no amounts of other comprehensive income in the current or prior year.

The consolidated statement of total comprehensive income has been prepared on the basis that all operations are continuing operations.

 

 

Integrated Care 24
Group Balance Sheet
As at 30 June 2023
Page 16
2023
2022
Notes
£
£
£
£
Fixed assets
Goodwill
11
-
0
3,634
Other intangible assets
11
277,771
450,869
Total intangible assets
277,771
454,503
Tangible assets
12
2,494,632
1,846,996
Investments
13
159,629
163,312
2,932,032
2,464,811
Current assets
Stocks
16
104,168
95,445
Debtors
17
11,259,561
9,740,724
Cash at bank and in hand
16,675,307
15,260,873
28,039,036
25,097,042
Creditors: amounts falling due within one year
18
(9,310,957)
(9,779,633)
Net current assets
18,728,079
15,317,409
Total assets less current liabilities
21,660,111
17,782,220
Creditors: amounts falling due after more than one year
19
(129,162)
(280,811)
Provisions for liabilities
21
(969,904)
(1,089,169)
20,561,045
16,412,240
Capital and reserves
Merger reserve
1,043,841
1,043,841
Income and expenditure account
19,517,204
15,368,399
Shareholders' funds
20,561,045
16,412,240
The financial statements were approved by the board of directors and authorised for issue on 13 December 2023 and are signed on its behalf by:
A Catto
D B Baines
Chief Executive Officer
Director
Integrated Care 24
Company Balance Sheet
As at 30 June 2023
Page 17
2023
2022
Notes
£
£
£
£
Fixed assets
Intangible assets
11
262,346
430,078
Tangible assets
12
2,480,840
1,846,996
Investments
13
620
620
2,743,806
2,277,694
Current assets
Debtors
17
11,390,677
9,455,536
Cash at bank and in hand
16,044,940
14,202,113
27,435,617
23,657,649
Creditors: amounts falling due within one year
18
(9,364,295)
(9,225,552)
Net current assets
18,071,322
14,432,097
Total assets less current liabilities
20,815,128
16,709,791
Creditors: amounts falling due after more than one year
19
(129,162)
(280,811)
Provisions for liabilities
21
(969,904)
(1,089,169)
Net assets
19,716,062
15,339,811
Capital and reserves
Merger reserve
1,043,841
1,043,841
Income and expenditure account
18,672,221
14,295,970
Total equity
19,716,062
15,339,811

As permitted by s408 Companies Act 2006, the Company has not presented its own income and expenditure account and related notes. The Company’s surplus for the period was £4,376,251 (2022: £5,656,848 surplus).

The financial statements were approved by the board of directors and authorised for issue on 13 December 2023 and are signed on its behalf by:
A Catto
D B Baines
Chief Executive Officer
Director
Company Registration No. 03193182
Integrated Care 24
Group Statement of Changes in Equity
For the year ended 30 June 2023
Page 18
Merger reserve
Income and expenditure account
Total
£
£
£
Balance at 1 July 2021
1,043,841
9,194,277
10,238,118
Year ended 30 June 2022:
Surplus and total comprehensive income for the year
-
6,174,122
6,174,122
Balance at 30 June 2022
1,043,841
15,368,399
16,412,240
Year ended 30 June 2023:
Surplus and total comprehensive income for the year
-
4,148,805
4,148,805
Balance at 30 June 2023
1,043,841
19,517,204
20,561,045
Integrated Care 24
Company Statement of Changes in Equity
For the year ended 30 June 2023
Page 19
Merger reserve
Income and expenditure account
Total
£
£
£
Balance at 1 July 2021
1,043,841
8,639,123
9,682,964
Year ended 30 June 2022:
Surplus and total comprehensive income for the year
-
5,656,847
5,656,847
Balance at 30 June 2022
1,043,841
14,295,970
15,339,811
Year ended 30 June 2023:
Surplus and total comprehensive income for the year
-
4,376,251
4,376,251
Balance at 30 June 2023
1,043,841
18,672,221
19,716,062
Integrated Care 24
Consolidated Statement of Cash Flows
For the year ended 30 June 2023
Page 20
2023
2022
Notes
£
£
£
£
Cash flows from operating activities
Cash generated from operations
27
4,144,936
5,404,846
Interest paid
(134)
(28)
Income taxes paid
(1,729,295)
(1,201,295)
Net cash inflow from operating activities
2,415,507
4,203,523
Investing activities
Purchase of intangible assets
(38,303)
(27,887)
Purchase of tangible fixed assets
(1,380,983)
(796,909)
Proceeds on disposal of tangible fixed assets
33,505
37,628
Cash dividend from associate
125,000
-
Interest received
378,280
10,687
Net cash used in investing activities
(882,501)
(776,481)
Financing activities
Payment of finance leases obligations
(118,572)
(118,571)
Net cash used in financing activities
(118,572)
(118,571)
Net increase in cash and cash equivalents
1,414,434
3,308,471
Cash and cash equivalents at beginning of year
15,260,873
11,952,402
Cash and cash equivalents at end of year
16,675,307
15,260,873
Integrated Care 24
Notes to the Financial Statements
For the year ended 30 June 2023
Page 21
1
Accounting policies
Company information

Integrated Care 24 (“the Company”) is a company limited by guarantee which is domiciled and incorporated in England and Wales. The registered office is Kingston House, Orbital Park, Ashford, Kent, TN24 0GP.

 

The Group consists of the company and all its subsidiaries.

1.1
Accounting convention

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.

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 pound.

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

The company is a qualifying entity for the purposes of FRS 102, being a member of a group where the parent of that group prepares publicly available consolidated financial statements, including this company, which are intended to give a true and fair view of the assets, liabilities, financial position and surplus or deficit of the group. The company has therefore taken advantage of exemptions from the following disclosure requirements for parent company information presented within the consolidated financial statements:

 

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 22
1.2
Basis of consolidation

The consolidated financial statements incorporate those of the company and all of its subsidiaries (i.e. entities that the Group controls through its power to govern the financial and operating policies so as to obtain economic benefits). Subsidiaries acquired during the year are consolidated using the purchase method. Their results are incorporated from the date that control passes. All financial statements are made up to 30 June 2023.

 

All intra-group transactions, balances and unrealised gains on transactions between group companies are eliminated on consolidation.

 

The cost of a business combination is the fair value at the acquisition date of the assets given, equity instruments issued and liabilities incurred or assumed, plus costs directly attributable to the business combination. The excess of the cost of a business combination over the fair value of the identifiable assets, liabilities and contingent liabilities acquired is recognised as goodwill.

 

Provisional fair values recognised for business combinations in previous periods are adjusted retrospectively for final fair values determined in the 12 months following the acquisition date.

Entities in which the group holds an interest and which are jointly controlled by the group and one or more other venturers under a contractual arrangement are treated as joint ventures. Entities other than subsidiary undertakings or joint ventures, in which the group has a participating interest and over whose operating and financial policies the group exercises a significant influence, are treated as associates.

Investments in joint ventures and associates are carried in the group balance sheet at cost plus post-acquisition changes in the group’s share of the net assets of the entity, less any impairment in value. The carrying values of investments in joint ventures and associates include acquired goodwill.

 

If the group’s share of losses in a joint venture or associate equals or exceeds its investment in the joint venture or associate, the group does not recognise further losses unless it has incurred obligations to do so or has made payments on behalf of the joint venture or associate.

 

Unrealised gains arising from transactions with joint ventures and associates are eliminated to the extent of the group’s interest in the entity.

As permitted by s408 Companies Act 2006, the Company has not presented its own income and expenditure account and related notes. The Company’s surplus for the period was £4,376,251 (2022: £5,656,848 surplus).

1.3
Going concern

In the opinion of the directors the group is a going concern with sufficient liquidity to cope with the current and expected future trading environment. In addition, the group continues to perform satisfactorily, despite the challenging conditions created by the current economic environment, and has sufficient financial resources to meet operational requirements.

 

The directors have based this assessment on forecasts showing the group’s expected financial position over the next twelve months and considering the group’s cash reserves and net assets at June 2023. The company also has a number of contracts in place with Integrated Care Boards in four different counties which extend beyond this period.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 23
1.4
Income

Income represents amounts receivable for the provision of out of hours services and NHS 111 service and associated services net of VAT. Income is recognised in the period in which the services are performed in line with the underlying contract.

 

Income received in respect of government grants has been recognised on the accruals basis in line with the recognition criteria outlined in section 24 of FRS 102. Where the income relates to capital grants, the income is recognised over the useful life of the assets to which the funding relates and where the funding relates to non-capital grants, this is recognised in the period where the expenditure to which it relates is incurred.

1.5
Intangible fixed assets - goodwill

Acquired goodwill is written off in equal annual instalments over its estimated useful economic life of 10 years. Acquired goodwill is annually reviewed for impairment with identified impairments charged to the income and expenditure account.

1.6
Intangible fixed assets other than goodwill

Intangible assets acquired separately from a business are recognised at cost and are subsequently measured at cost less accumulated amortisation and accumulated impairment losses.

 

Intangible assets acquired on business combinations are recognised separately from goodwill at the acquisition date where it is probable that the expected future economic benefits that are attributable to the asset will flow to the entity and the fair value of the asset can be measured reliably; the intangible asset arises from contractual or other legal rights; and the intangible asset is separable from the entity.

Amortisation 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:

Software
5 years straight line
Development Costs
3 years straight line

Amortisation of intangible fixed assets is included in administrative expenses.

1.7
Tangible fixed assets

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:

Land and buildings Leasehold
Over the period of the lease
Fixtures, fittings & equipment
15% to 33% straight line
Motor vehicles
15% to 33% straight line
Medical equipment
33% straight line

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 recognised in the income and expenditure account.

Where assets are used exclusively for a particular contract, the asset will be depreciated over the duration of the contract. This may result in change in depreciation policy if contracts are extended.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 24
1.8
Fixed asset investments

Equity instruments are measured at fair value through surplus or deficit except for those equity investments that are not publicly traded and whose fair value cannot otherwise be measured reliably which are recognised at cost less impairment until a reliable measure of fair value becomes available.

In the parent company financial statements investments in subsidiaries, associates and jointly controlled entities are initially measured at cost and subsequently measured at cost less any accumulated impairment losses.

An associate is an entity, being neither a subsidiary nor a joint venture, in which the company holds a long-term interest and where the company has significant influence. The group considers that it has significant influence where it has the power to participate in the financial and operating decisions of the associate.

 

Investments in associates are initially recognised at the transaction price (including transaction costs) and are subsequently adjusted to reflect the group’s share of the surplus or deficit, other comprehensive income and equity of the associate using the equity method.

 

Any difference between the cost of acquisition and the share of the fair value of the net identifiable assets of the associate on acquisition is recognised as goodwill. Any unamortised balance of goodwill is included in the carrying value of the investment in associates.

 

Losses in excess of the carrying amount of an investment in an associate are recorded as a provision only when the company has incurred legal or constructive obligations or has made payments on behalf of the associate.

 

In the Company financial statements investments in associates are accounted for at cost less impairment.

1.9
Impairment of fixed assets

At each reporting period end date, the group reviews the carrying amounts of its tangible and intangible 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). Where it is not possible to estimate the recoverable amount of an individual asset, the company estimates the recoverable amount of the cash-generating unit to which the asset belongs.

 

The carrying amount of the investments accounted for using the equity method is tested for impairment as a single asset. Any goodwill included in the carrying amount of the investment is not tested separately for impairment.

Intangible assets with indefinite useful lives and intangible assets not yet available for use are tested for impairment annually, and whenever there is an indication that the asset may be impaired.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 25

Recoverable amount is the higher of fair value less costs to sell and value in use. If the recoverable amount of an asset (or cash-generating unit) is estimated to be less than its carrying amount, the carrying amount of the asset (or cash-generating unit) is reduced to its recoverable amount. An impairment loss is recognised immediately in surplus or deficit, unless the relevant asset is carried at a revalued amount, in which case the impairment loss is treated as a revaluation decrease.

 

Recognised impairment losses are reversed if, and only if, the reasons for the impairment loss have ceased to apply. Where an impairment loss subsequently reverses, the carrying amount of the asset (or cash-generating unit) is increased to the revised estimate of its recoverable amount, but so that the increased carrying amount does not exceed the carrying amount that would have been determined had no impairment loss been recognised for the asset (or cash-generating unit) in prior years. A reversal of an impairment loss is recognised immediately in surplus or deficit, unless the relevant asset is carried at a revalued amount, in which case the reversal of the impairment loss is treated as a revaluation increase.

1.10
Stocks

Stocks are stated at the lower of cost and estimated selling price less costs to complete and sell.

At each reporting date, an assessment is made for impairment. Any excess of the carrying amount of stocks over its estimated selling price less costs to complete and sell is recognised as an impairment loss in surplus or deficit. Reversals of impairment losses are also recognised in surplus or deficit.

1.11
Cash and cash equivalents

Cash and cash equivalents are basic financial assets and include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of 100 days or less, and bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities.

1.12
Financial instruments

The group has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ of FRS 102 to all of its financial instruments as Section 12 ‘Other Financial Instruments Issues’ is not relevant to the group.

 

Financial instruments are recognised in the group's balance sheet when the group becomes party to the contractual provisions of the instrument.

 

Financial assets and liabilities are offset and 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

Basic financial assets, which include debtors and cash and bank balances, are initially measured at transaction price including transaction costs and are subsequently carried at amortised cost using the effective interest method unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market rate of interest. Financial assets classified as receivable within one year are not amortised.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 26
Impairment of financial assets

Financial assets, other than those held at fair value through surplus or deficit, are assessed for indicators of impairment at each reporting end date.

 

Financial assets are impaired where there is objective evidence that, as a result of one or more events that occurred after the initial recognition of the financial asset, the estimated future cash flows have been affected. If an asset is impaired, the impairment loss is the difference between the carrying amount and the present value of the estimated cash flows discounted at the asset’s original effective interest rate. The impairment loss is recognised in surplus or deficit.

 

If there is a decrease in the impairment loss arising from an event occurring after the impairment was recognised, the impairment is reversed. The reversal is such that the current carrying amount does not exceed what the carrying amount would have been, had the impairment not previously been recognised. The impairment reversal is recognised in surplus or deficit.

Derecognition of financial assets

Financial assets are derecognised only when the contractual rights to the cash flows from the asset expire or are settled, or when the group transfers the financial asset and substantially all the risks and rewards of ownership to another entity, or if some significant risks and rewards of ownership are retained but control of the asset has transferred to another party that is able to sell the asset in its entirety to an unrelated third party.

Basic financial liabilities

Basic financial liabilities, including creditors, bank loans, loans from fellow group companies and preference shares that are classified as debt, 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 payments discounted at a market rate of interest. Financial liabilities classified as payable within one year are not amortised.

 

Debt instruments are subsequently carried at amortised cost, using the effective interest rate method.

 

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of business from suppliers. Amounts payable are classified as current liabilities if payment is due within one year or less. If not, they are presented as non-current liabilities. Trade creditors are recognised initially at transaction price and subsequently measured at amortised cost using the effective interest method.

Derecognition of financial liabilities

Financial liabilities are derecognised when the group's contractual obligations expire or are discharged or cancelled.

1.13
Taxation

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

Current tax

The tax currently payable is based on taxable surplus for the year. Taxable surplus differs from net surplus as reported in the income and expenditure account 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 group’s liability for current tax is calculated using tax rates that have been enacted or substantively enacted by the reporting end date.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 27
Deferred tax

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 surpluses. Such assets and liabilities are not recognised if the timing difference arises from goodwill or from the initial recognition of other assets and liabilities in a transaction that affects neither the tax surplus nor the accounting surplus.

 

The carrying amount of deferred tax assets is reviewed at each reporting end date and reduced to the extent that it is no longer probable that sufficient taxable surpluses will be available to allow all or part of the asset to be recovered. Deferred tax is calculated at the tax rates that are expected to apply in the period when the liability is settled or the asset is realised. Deferred tax is charged or credited in the income and expenditure account, except when it relates to items charged or credited directly to equity, in which case the deferred tax is also dealt with in equity. Deferred tax assets and liabilities are offset if, and only if, there is a legally enforceable right to offset current tax assets and liabilities and the deferred tax assets and liabilities relate to taxes levied by the same tax authority.

1.14
Provisions

Provisions are recognised when the group has a legal or constructive present obligation as a result of a past event, it is probable that the group will be required to settle that obligation and a reliable estimate can be made of the amount of the obligation.

 

The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at the reporting end date, taking into account the risks and uncertainties surrounding the obligation. Where the effect of the time value of money is material, the amount expected to be required to settle the obligation is recognised at present value. When a provision is measured at present value, the unwinding of the discount is recognised as a finance cost in surplus or deficit in the period in which it arises.

1.15
Employee benefits

The costs of short-term employee benefits are recognised as a liability and an expense, unless those costs are required to be recognised as part of the cost of stock or fixed assets.

 

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

 

Termination benefits are recognised immediately as an expense when the company is demonstrably committed to terminate the employment of an employee or to provide termination benefits.

1.16
Retirement benefits

Pension benefits for most employees of the company are provided by the NHS Pension Scheme, which is a statutory, unfunded, defined benefit scheme. The company’s liability is limited to the amount of contributions made to the scheme and liability for meeting pension payments sits solely with the scheme. For this reason the scheme is accounted for as if it were a defined contribution scheme. Accordingly company contributions are charged to surplus or deficit in the period to which they relate.

 

Employees that are not eligible to join the NHSPS are given the option to enrol in an alternative defined contribution scheme.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
1
Accounting policies
(Continued)
Page 28
1.17
Leases

Leases are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership to the lessees. All other leases are classified as operating leases.

 

Assets held under finance leases are recognised as assets at the lower of the asset's fair value at the date of inception and the present value of the minimum lease payments. The related liability is included in the balance sheet as a finance lease obligation. Lease payments are treated as consisting of capital and interest elements. The interest is charged to the income and expenditure account so as to produce a constant periodic rate of interest on the remaining balance of the liability.

Rentals payable under operating leases, including any lease incentives received, are charged to profit or loss on a straight line basis over the term of the relevant lease except where another more systematic basis is more representative of the time pattern in which economic benefits from the leased asset are consumed.

1.18
Merger Reserve

In a prior year the company merged with StourCare Community Interest Company and On Call Care Limited. The companies operated similar businesses to Integrated Care 24. The reserves were included in the merger reserve.

2
Judgements and key sources of estimation uncertainty

In the application of the group’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.

Key sources of estimation uncertainty

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.

Useful economic life of tangible fixed assets

The annual depreciation charge for tangible fixed assets is sensitive to changes in the estimated useful economic lives and residual values of the assets. The useful economic lives and residual values are re-assessed annually. They are amended when necessary to reflect current estimates, based on technological advancement, future investments, economic utilisation and the physical condition of the assets.

Useful economic life of intangible fixed assets

The annual amortisation charge for intangible assets is sensitive to changes in the estimated lives and residual values of the assets. The useful economic lives and residual values are re-assessed annually. Goodwill impairment reviews are also performed annually. These reviews require an estimation of the value in use of the cash generating units to which goodwill has been allocated. The value in use calculation requires the entity to estimate the future cash flows expected to arise for the cash generating unit and a suitable discount rate to calculate present value.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
2
Judgements and key sources of estimation uncertainty
(Continued)
Page 29
Provisions for liabilities

On an ongoing basis the group assesses provisions that are required for liabilities as a result of past events. Provisions comprise estimated costs of insurance claims against the group ongoing at the year end and estimated costs of restoring office premises to its original condition at the termination of a lease. These are estimated with reference to the group insurance policies and industry expected restoration rates respectively.

3
Income

An analysis of the group's income is as follows:

2023
2022
£
£
Primary income
Provision of Out-of-Hours services
32,720,981
32,116,946
Provision of 111 and CAS services
31,081,080
30,370,543
Pharmacy income
2,737,340
2,455,375
Provision of prison services
-
6,259,445
GP practice income
1,218,642
-
Other income from associated services
5,275,663
5,120,917
73,033,706
76,323,226
Other significant income
Interest income
384,115
10,687
Rental income
195,914
281,865
Income analysed by geographical market
2023
2022
£
£
United Kingdom
73,033,706
76,323,226
4
Operating surplus
2023
2022
£
£
Operating surplus for the year is stated after charging/(crediting):
Depreciation of owned tangible fixed assets
547,455
513,490
Depreciation of tangible fixed assets held under finance leases
168,814
168,814
Impairment of owned tangible fixed assets
5,470
-
Surplus on disposal of tangible fixed assets
(21,897)
(29,657)
Amortisation of intangible assets
215,035
245,819
Operating lease charges
1,495,723
1,516,656
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 30
5
Auditors' remuneration
2023
2022
Fees payable to the company's auditor and its associates:
£
£
For audit services
Audit of the financial statements of the group and company
29,000
28,800
Audit of the company's subsidiaries and associates
8,000
19,800
37,000
48,600
For other services
Accountancy services
11,000
12,120
Taxation compliance services
7,000
7,680
18,000
19,800
6
Employees

The average monthly number of persons (including directors) employed by the group during the year was:

2023
2022
Number
Number
Management
13
12
Operational
795
765
Administration
194
198
1,002
975

Their aggregate remuneration comprised:

2023
2022
£
£
Wages and salaries
24,909,931
23,975,508
Social security costs
2,350,154
2,198,733
Pension costs
2,575,196
2,255,529
29,835,281
28,429,770
The majority of employee costs, save for directors remuneration (see note 7), is expensed to cost of sales in the statement of comprehensive income. Also within cost of sales are non-employed sessional GP costs including pension contributions and agency staff costs which total £20,463,612 (2022: £20,978,105).
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 31
7
Directors' remuneration
2023
2022
£
£
Remuneration for qualifying services
1,159,163
1,086,956
Company pension contributions
128,764
138,161
Compensation for loss of office
-
119,112
1,287,927
1,344,229
The number of directors for whom retirement benefits are accruing amounts to 10 (2022: 9).
Remuneration disclosed above (excluding termination payments) includes the following amounts paid to the highest paid director:
Remuneration for qualifying services
166,648
159,542
Company pension contributions
23,245
22,223

The directors are the group's key management personnel.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 32
8
Interest receivable and similar income
2023
2022
£
£
Other interest receivable and similar income
Interest on bank deposits
384,115
10,687
Income from interest in associated undertakings
Share of profit from associate
121,317
62,337
Total interest and similar income
505,432
73,024
9
Interest payable and similar expenses
2023
2022
£
£
Interest on financial liabilities measured at amortised cost:
Other interest payable
134
28
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 33
10
Taxation
2023
2022
£
£
Current tax
UK corporation tax on surpluses for the current period
834,187
1,442,741
Adjustments in respect of prior periods
(147,447)
-
0
Total current tax
686,740
1,442,741
Deferred tax
Origination and reversal of timing differences
142,441
3,117
Total tax charge
829,181
1,445,858

The charge for the year can be reconciled to the surplus per the income and expenditure account as follows:

2023
2022
£
£
Surplus on ordinary activities before taxation
4,977,986
7,619,980
Expected tax charge based on the standard rate of corporation tax in the UK of 25.00% (2022: 19.00%)
1,244,497
1,447,796
Tax effect of expenses that are not deductible in determining taxable profit
(245)
9,012
Tax effect of income not taxable in determining taxable surplus
921
(13,612)
Tax effect of utilisation of tax losses not previously recognised
(44,768)
(41)
Unutilised tax losses carried forward
30,842
54,286
Adjustments in respect of prior years
(147,447)
-
0
Permanent capital allowances (in excess of)/less than depreciation
(190,731)
(98,575)
Surplus on disposal
(5,474)
(5,635)
Provisions
(17,537)
45,944
Deferred tax charge
142,441
3,117
Other differences
-
0
3,566
Effect of change in tax rates
(183,318)
-
Tax expense for the year
829,181
1,445,858
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 34
11
Intangible fixed assets
Group
Goodwill
Software
Development Costs
Total
£
£
£
£
Cost
At 1 July 2022
89,493
1,210,411
381,782
1,681,686
Additions
-
0
38,303
-
0
38,303
Disposals
-
0
(56,478)
-
0
(56,478)
At 30 June 2023
89,493
1,192,236
381,782
1,663,511
Amortisation and impairment
At 1 July 2022
85,859
759,542
381,782
1,227,183
Amortisation charged for the year
3,634
211,401
-
0
215,035
Disposals
-
0
(56,478)
-
0
(56,478)
At 30 June 2023
89,493
914,465
381,782
1,385,740
Carrying amount
At 30 June 2023
-
0
277,771
-
0
277,771
At 30 June 2022
3,634
450,869
-
0
454,503
Company
Software
Development Costs
Total
£
£
£
Cost
At 1 July 2022
1,184,254
381,782
1,566,036
Additions
38,303
-
0
38,303
Disposals
(56,478)
-
0
(56,478)
At 30 June 2023
1,166,079
381,782
1,547,861
Amortisation and impairment
At 1 July 2022
754,176
381,782
1,135,958
Amortisation charged for the year
206,035
-
0
206,035
Disposals
(56,478)
-
0
(56,478)
At 30 June 2023
903,733
381,782
1,285,515
Carrying amount
At 30 June 2023
262,346
-
0
262,346
At 30 June 2022
430,078
-
0
430,078

Development costs represent the development of the group's 111 and Out-of-Hours management and security software.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 35
12
Tangible fixed assets
Group
Land and buildings Leasehold
Fixtures, fittings & equipment
Motor vehicles
Medical equipment
Total
£
£
£
£
£
Cost
At 1 July 2022
1,261,628
5,492,562
1,164,400
142,466
8,061,056
Additions
148,929
1,309,311
18,669
-
0
1,476,909
Disposals
-
0
(392,213)
(95,645)
(26,367)
(514,225)
At 30 June 2023
1,410,557
6,409,660
1,087,424
116,099
9,023,740
Depreciation and impairment
At 1 July 2022
950,674
4,335,832
788,013
139,541
6,214,060
Depreciation charged in the year
111,718
508,699
93,902
1,950
716,269
Impairment losses
-
0
5,470
-
0
-
0
5,470
Eliminated in respect of disposals
-
0
(298,932)
(81,392)
(26,367)
(406,691)
At 30 June 2023
1,062,392
4,551,069
800,523
115,124
6,529,108
Carrying amount
At 30 June 2023
348,165
1,858,591
286,901
975
2,494,632
At 30 June 2022
310,954
1,156,730
376,387
2,925
1,846,996
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
12
Tangible fixed assets
(Continued)
Page 36
Company
Land and buildings Leasehold
Fixtures, fittings & equipment
Motor vehicles
Medical equipment
Total
£
£
£
£
£
Cost
At 1 July 2022
983,500
5,562,939
1,163,979
137,461
7,847,879
Additions
148,929
1,295,009
18,669
-
0
1,462,607
Disposals
-
0
(404,467)
(95,645)
(26,367)
(526,479)
At 30 June 2023
1,132,429
6,453,481
1,087,003
111,094
8,784,007
Depreciation and impairment
At 1 July 2022
672,546
4,406,209
787,592
134,536
6,000,883
Depreciation charged in the year
111,718
502,927
93,902
1,950
710,497
Eliminated in respect of disposals
-
0
(300,454)
(81,392)
(26,367)
(408,213)
At 30 June 2023
784,264
4,608,682
800,102
110,119
6,303,167
Carrying amount
At 30 June 2023
348,165
1,844,799
286,901
975
2,480,840
At 30 June 2022
310,954
1,156,730
376,387
2,925
1,846,996

The net carrying value of tangible fixed assets in both the group and the company includes the following in respect of assets held under finance leases or hire purchase contracts. The depreciation charge in respect of such assets amounted to £66,122 (2022: £139,723). Assets purchased in the period under finance lease or hire purchase contracts amounted to £nil (2022: £nil).

Group
Company
2023
2022
2023
2022
£
£
£
£
Fixtures, fittings & equipment
7,843
73,965
7,843
73,965
13
Fixed asset investments
Group
Company
2023
2022
2023
2022
Notes
£
£
£
£
Investments in subsidiaries
14
-
0
-
0
120
120
Investments in associates
15
159,629
163,312
500
500
159,629
163,312
620
620
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
13
Fixed asset investments
(Continued)
Page 37
Movements in fixed asset investments
Group
Shares
£
Cost or valuation
At 1 July 2022
163,312
Share of profit in year
121,317
Dividends received
(125,000)
At 30 June 2023
159,629
Carrying amount
At 30 June 2023
159,629
At 30 June 2022
163,312
Movements in fixed asset investments
Company
Shares
£
Cost or valuation
At 1 July 2022 and 30 June 2023
620
Carrying amount
At 30 June 2023
620
At 30 June 2022
620
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 38
14
Subsidiaries

Details of the company's subsidiaries at 30 June 2023 are as follows:

Name of undertaking
Country of
Class of
% Shares
Incorporation
shareholding
held
Brightdoc 24 Limited
England & Wales
Ordinary
100
Cleo Systems 24 Limited
England & Wales
Ordinary
100
Pharma Alert 24 Limited
England & Wales
Ordinary
100
Name of undertaking
Nature of business
Brightdoc 24 Limited
Supply of locum doctors
Cleo Systems 24 Limited
Development and integration of digital solutions for healthcare services
Pharma Alert 24 Limited
Operation of pharmacies

The companies above all have their registered office at Kingston House, The Long Barrow, Orbital Park, Ashford, Kent, TN24 0GP.

15
Associates

Details of the company's associates at 30 June 2023 are as follows:

Name of undertaking
Country of
Class of
% Shares
Incorporation
shareholding
Held
iDental Care 24 Limited
England & Wales
A Ordinary
50
Name of undertaking
Nature of business
iDental Care 24 Limited
Out of hours dental provider

iDental Care 24 Limited has its registered office at Kingston House, The Long Barrow, Orbital Park, Ashford, Kent, TN24 0GP.

16
Stocks
Group
Company
2023
2022
2023
2022
£
£
£
£
Finished goods and goods for resale
104,168
95,445
-
0
-
0
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 39
17
Debtors
Group
Company
2023
2022
2023
2022
Amounts falling due within one year:
£
£
£
£
Trade debtors
8,432,300
7,445,590
7,907,010
7,006,713
Corporation tax recoverable
25,466
-
0
25,466
-
0
Amounts owed by group undertakings
-
-
765,838
276,668
Other debtors
89,897
135,426
11,104
3,913
Prepayments and accrued income
2,711,898
2,159,708
2,681,259
2,145,934
11,259,561
9,740,724
11,390,677
9,433,228
Amounts falling due after more than one year:
Amounts owed by group undertakings
-
-
-
22,308
Total debtors
11,259,561
9,740,724
11,390,677
9,455,536
18
Creditors: amounts falling due within one year
Group
Company
2023
2022
2023
2022
Notes
£
£
£
£
Obligations under finance leases
20
29,643
118,572
29,643
118,572
Corporation tax payable
-
0
1,017,089
-
0
992,794
Other taxation and social security
1,729,120
2,194,174
1,657,758
2,165,522
Trade creditors
2,609,108
1,733,637
2,251,406
1,320,753
Amounts due to subsidiary undertakings
-
0
-
0
1,252,028
692,803
Other creditors
90,984
24,780
20,619
22,144
Accruals and deferred income
4,852,102
4,691,381
4,152,841
3,912,964
9,310,957
9,779,633
9,364,295
9,225,552
19
Creditors: amounts falling due after more than one year
Group
Company
2023
2022
2023
2022
£
£
£
£
Obligations under finance leases
20
-
0
29,643
-
0
29,643
Accruals and deferred income
129,162
251,168
129,162
251,168
129,162
280,811
129,162
280,811
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 40
20
Finance lease obligations
Group
Company
2023
2022
2023
2022
£
£
£
£
Future minimum lease payments due under finance leases:
Within one year
29,643
118,572
29,643
118,572
In two to five years
-
0
29,643
-
0
29,643
29,643
148,215
29,643
148,215
21
Provisions for liabilities
Group
Company
2023
2022
2023
2022
£
£
£
£
Other provisions
385,899
747,245
385,899
747,245
Dilapidations provisions
378,580
278,940
378,580
278,940
764,479
1,026,185
764,479
1,026,185
Movements on provisions:
Other provisions
Dilapidations provisions
Total
Group
£
£
£
Additional provisions in the year
(361,346)
99,640
(261,706)
Other provisions
Dilapidations provisions
Total
Company
£
£
£
Additional provisions in the year
(361,346)
99,640
(261,706)

Other provisions is comprised of the estimated costs of insurance claims against the group ongoing at the year end as well as the estimated cost of staff who will deal with these claims.

Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 41
22
Contingent liabilities

From April 2019, following the launch of the Clinical Negligence Scheme for General Practice (CNSGP), the company has not needed to fund its own clinical negligence insurance cover as this is provided by the new state-backed scheme.

 

The company does, however, have liability for claims brought after April 2019 for medical incidents occurring prior to this date. In September 2023 the company purchased clinical negligence cover for the 12 months to September 2024 for £424,108 to cover claims brought in this period relating to medical incidents prior to April 2019.

 

The company has also made a provision of £210,000 (2022: £210,000) for potential future claims made under the Human Rights Act relating to the termination of the Health and Justice Contract in the year. This provision is included within note 21. This is the best estimate of the Directors of any potential further liability relating to this contract based on the evidence they have available but note that there may be future claims which will require settlement for amounts beyond the provision already made within these financial statements.

23
Deferred taxation

Deferred tax assets and liabilities are offset where the group or company has a legally enforceable right to do so. The following is the analysis of the deferred tax balances (after offset) for financial reporting purposes:

Liabilities
Liabilities
2023
2022
Group
£
£
Accelerated capital allowances
322,133
146,778
Tax losses
-
(11,047)
Other timing differences
(116,708)
(72,747)
205,425
62,984
Liabilities
Liabilities
2023
2022
Company
£
£
Accelerated capital allowances
322,133
146,778
Tax losses
-
(11,047)
Other timing differences
(116,708)
(72,747)
205,425
62,984
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
23
Deferred taxation
(Continued)
Page 42
Group
Company
2023
2023
Movements in the year:
£
£
Liability at 1 July 2022
62,984
62,984
Charge to profit or loss
142,441
142,441
Liability at 30 June 2023
205,425
205,425
24
Retirement benefit schemes
2023
2022
£
£
Charge to surplus or deficit in respect of defined benefit schemes
2,500,148
2,346,209
Charge to surplus or deficit in respect of defined contribution schemes
75,048
42,055
Contributions payable to funds at the year end included in creditors
407,999
290,990

The NHS Pension Scheme, which is a defined benefit scheme, is available for all qualifying employees. As the company’s liability is limited to the amount of contributions made to the scheme, it is accounted for as if it were a defined contribution scheme.

25
Operating lease commitments
Lessee

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

Group
Company
2023
2022
2023
2022
£
£
£
£
Within one year
684,745
649,497
684,745
649,497
Between two and five years
845,026
1,186,644
845,026
1,186,644
1,529,771
1,836,141
1,529,771
1,836,141
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 43
26
Related party transactions

Group

The group has taken advantage of the exemption within FRS 102 Section 33.1A Related Party Disclosures to not disclose transactions with entities that are within the same group and included in the consolidated financial statements of the group.

 

Company

During the year the company charged a management fee of £12,226 (2022: £10,188) to its associate iDental Care 24 Limited. The outstanding balance at the year end was £95 (2022: £2,051).

 

27
Cash generated from operations
2023
2022
£
£
Surplus for the year after tax
4,148,805
6,174,122
Adjustments for:
Taxation charged
829,181
1,445,858
Finance costs
134
28
Investment income
(505,432)
(73,024)
Gain on disposal of tangible fixed assets
(21,897)
(29,657)
Amortisation and impairment of intangible assets
215,035
245,819
Depreciation and impairment of tangible fixed assets
721,739
682,304
(Decrease)/increase in provisions
(261,706)
543,985
Movements in working capital:
(Increase)/decrease in stocks
(8,723)
8,929
(Increase) in debtors
(1,487,536)
(2,445,238)
Increase/(decrease) in creditors
515,336
(1,148,280)
Cash generated from operations
4,144,936
5,404,846
28
Analysis of changes in net funds - group
1 July 2022
Cash flows
30 June 2023
£
£
£
Cash at bank and in hand
15,260,873
1,414,434
16,675,307
Obligations under finance leases
(148,215)
118,572
(29,643)
15,112,658
1,533,006
16,645,664
Integrated Care 24
Notes to the Financial Statements (Continued)
For the year ended 30 June 2023
Page 44
29
Subsidiary audit exemption

The company’s active subsidiaries Brightdoc 24 Limited and Pharma Alert 24 Limited are exempt from the requirements of the Companies Act 2006 relating to the audit of their individual accounts by virtue of section 479A of the Companies Act 2006.

 

The parent company has therefore guaranteed all existing liabilities of the above entities and this guarantee will remain in force until those liabilities are settled.

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