The Directors present their report and financial statements for the year ended 30 June 2024.
We are a not-for-profit social enterprise whose purpose is to enable health systems to improve patient experience of urgent care. We have no shareholders, and any surplus funds are re-invested into improving care delivery and social value.
IC24 provides integrated urgent care services across a population of some 6.3 million people in South and East England, including NHS 111, urgent primary care, and related healthcare services. In addition we provide General Medical Services (GMS) Primary care in Sussex and supply ICT systems to support other organisations through our CLEO systems subsidiary.
This report reflects on the organisation's performance, challenges, and key strategic initiatives for the year.
The financial year 2023/24 has been marked by both ongoing challenges and significant progress for IC24. While the healthcare sector continues to navigate the aftermath of the COVID-19 pandemic, with pressures on urgent and emergency care services, IC24 has remained agile in adapting to changing needs. This year has seen the ongoing evolution of our service offering, with expanded roles in primary care, digital health, and out-of-hours services. However, the principal activity of the social enterprise continues to be that of providing unscheduled urgent integrated care (NHS111 and urgent primary care). In addition, IC24 also provides in-hours primary care to patients in 3 practices in Brighton and our subsidiary, CLEO Systems, continues to show steady growth in the digital healthcare space, particularly with its electronic prescribing solution.
Our social enterprise owns 100% of the issued share capital of Brightdoc 24 Limited, which provides locum doctors to the organisation and 50% of the issued share capital of iDental Care 24 Ltd which provides out of hours dental care in Brighton.
In February 2024 IC24 sold its 100% shareholding in Pharma Alert 24 Limited, which operates a pharmacy in Hastings. During the year commissioners in both Norfolk and Waveney and Mid & South Essex expressed their intention to award IC24 new contracts which enables us to continue to invest and innovate to better support patients and partners. Norfolk awarded the new contract in August 2024 and discussions are progressing well with Mid and South Essex.
We continue to provide the unique, national NHS paediatric clinical assessment service (PCAS) which was initiated in August 2021 to support parents with unwell children. This continues to be an exemplar of providing senior opinion at an early stage in the patient pathway. This service contract was extended during the year and the service was provided for the whole of 2023/24.
In late 2023 NHS England took the decision to end the National Service Advisor resilience service, which meant sadly saying goodbye to some of the colleagues involved in February 2024 as we closed it down.
IC24 continued to operate several smaller contracts in Sussex, including a home visiting service, roving GP service, emergency department primary care service and overnight district nursing service. The latter two services were decommissioned during 2023/24 as Sussex commissioners sought to reduce their costs.
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 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).
For the year ending 30 June 2024, IC24 has faced a challenging financial environment, with high inflation and rising operational costs driven by increases in the national living wage not being fully covered by commissioners. We have had to work extra hard on improving productivity to ensure we remained financially stable. In addition we have invested more than £600k in Primary care in the three practices we acquired the contract to run in Brighton, to ensure we improved the service provision to patients and as part of our wider strategy.
Revenue for the year remained stable at £75 million, with an increase of £2 million compared to the previous year, primarily driven by the provision of the new care home support and the Covid Medicines Delivery Unit (CMDU) in Norfolk, expansion of our primary care services, the full year effect of our national resilience and Paediatric CAS contracts. Meanwhile, turnover growth has been limited by the loss of contracts such as Home Nursing and emergency GP’s in Sussex and the sale of the Pharma Alert pharmacy which sadly could not be made to cover its costs. In addition, 111 income was impacted by reductions in funding of the service by Essex commissioners as they try to reduce costs.
The surplus for the year after taxation was £1.0 million, down from £4.1 million in 2023, reflecting the pressures of increasing staffing and operational costs. Nevertheless, the Directors are confident that IC24 remains financially robust and well-positioned to meet future challenges.
Current Operating Position Including Key Performance Indicators
IC24 provides 111 services directly to Norfolk and Essex commissioners along with being part of a joint venture with South East Coast Ambulance Service (SECAmb) for Kent and Sussex. In total IC24 is responsible for 4.9% of total NHS 111 Call Volume: IC24 answered 926,780 111 calls in 2023/24, which represented a 5% increase over the prior year. In addition, our performance in terms of percentage of calls answered in sixty seconds, which struggled in 2022/23 (49.8% on average) improved significantly to 74.3% and has continued to improve in the early part of 2024/25. Nationally, demand into 111 has increased 11.6% in 2023/24 as rapid access to Primary and secondary care health provision has become harder to access.
In addition, IC24 ran the temporary National Call answering service until the end of February 2024. This service diverted simpler calls from National 111. We answered 327,723 calls during 2023/24 reducing pressure on National 111 by 1.7%.
We continue to provide the virtual Clinical Assessment Service (CAS) in Norfolk, Essex, and, along with our partner SECAmb in Kent. The number of patients we were able to advise in 2023/24 was 130,410 which would otherwise need to have been seen by other parts of the NHS such as GPs.
National Health Service England have also extended the Paediatric Clinical Assessment Service (PCAS) where we are the single national provider. This service answers calls from all 111 providers in relation to children by using specialist Paediatricians and Childrens Advanced Nurses Practitioners. Of the 35,002 calls received, 60% were resolved through self-care advice, avoiding unnecessary trips to A&E, GP’s and significantly improving patient outcomes.
This year we have focused on the operational effectiveness of our out of hours and home visiting service across Norfolk, Essex, Kent and Sussex. With the end of COVID we have seen a 33% increase in patient contacts via these services, mainly in base visits. We visited 35,807 patients at home and undertook 589,197 patient appointments in local bases and issued 128,636 prescriptions.
Our work is aimed at reducing the number of 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. During 2023/24 we clinically reviewed 46,823 of the 111 calls that initially indicated an emergency referral to hospital was required resulting in 26,177 patients appropriately diverted to a more suitable service, and thus reducing the load on hospital emergency services. In addition, we also reviewed 116,032 of the 111 calls that initially indicated an Ambulance was required to visit. This review resulted in 66,273 fewer patients requiring ambulance visits. These reviews are critical to ensure ambulances and hospitals are free to focus on the most appropriate patients.
IC24’s acquisition of the contract to run three GP practices in Sussex expanded our reach in primary care, enabling us to serve over 14,000 patients. This aligns with NHS strategic priorities, notably those outlined in the Fuller Report, which advocates for greater integration between urgent and primary care services to improve patient experience and clinical outcomes. We have worked with these practices to standardise their back office functions, provide remote consultations where effective and focus on improving their quality and range of services to patients. Whilst doing this the organisation has made a net investment of more than £0.6 million in staff and improving facilities to ensure patients receive a positive primary care service.
Another regional system collaboration initiative this year has been the launch of our Covid Medicines Delivery Unit (CMDU) in Norfolk. This service was mobilised to ensure clinically vulnerable patients who test positive for covid19 are triaged and assessed for eligibility of antiviral medication. These patients require detailed clinical assessment and prescribing. Bespoke training packages and pathways were developed for our clinicians. This centralised service has also enabled our system partners in primary care to signpost eligible patients into our service to support capacity.
CLEO Systems, a subsidiary of IC24, remains at the forefront of digital healthcare innovation. The development of the CLEO SOLO electronic prescribing system (EPS) has seen successful pilots in partnership with NHS Trusts, including Midlands Partnership NHS Foundation Trust. This EPS solution has recently been commissioned by NHS for 180 pharmacies across England. As part of our digital health strategy, CLEO is well-positioned to support the digital transformation of urgent and emergency care, with a growing pipeline of contracts in development.
Our People
By making IC24 a great place to work for our people, we can continue to deliver exceptional care to our patients. We know that a happy and engaged workforce delivers better patient outcomes.
We use our annual engagement survey and various specific questionnaires throughout the year to identify opportunities to make IC24 a better place to work. This year we invited colleagues to join our employee voice forum, Link 24 and we launched our Employee Alliance and regional Listening into Action sessions so that we could hear directly from our colleagues about what matters most to them. Hearing feedback directly from our workforce is vital for our continued organisational growth, which not only includes recruiting top talent but retaining and development our current workforce.
Well-being is one of eight factors in our annual engagement survey and our overall score of employee wellbeing has increased each year.
The health and wellbeing at work of our employees is our highest priority and we are always looking for ways we can enhance the support we provide to deliver a range of initiatives our people find helpful.
Supporting the mental health at work of our people has been a key area of this year which saw us partner with Able Futures who deliver a comprehensive mental health support service for employees. We have continued to invest in the Mind Health Journey and since we commenced this initiative, over 200 colleagues have registered to take part. We have also provided mental health training for Managers to support their teams and we incorporated wellbeing into our Leadership Development Programme.
Equality, diversity, and inclusion
Our four Colleague Resource Groups (CRG) continue to provide our employees with a voice to celebrate diversity, promote inclusivity, equity and diversity. Through our CRGs we provide a safe space to voice issues, promote allyship and provide education and support for people in the spaces of cultural inclusion, disability, gender equality and LGBTQ+.
In May we launched our annual inclusion and belonging survey which forms part of the NHS Workforce Race Equality Standard (WRES) and Workforce Disability Standard (WDES) campaigns which enables us to monitor our progress against indicators of workforce equality. We have seen a sustained increase in response rate over recent years from 18% of workforce in 2022 to 26% of workforce in 2023.
IC24 was proud to be recognised in several “Best Places to Work” lists, reflecting our focus on creating an inclusive and supportive work environment. We also continue to make significant progress in advancing our equality, diversity, and inclusion (EDI) agenda, with notable achievements such as the signing of the NHS England Sexual Safety in Healthcare Charter and progress towards becoming a Level 3 Disability Confident Leader.
Sustainability and environmental impact
At IC24 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. We are UKAS accredited to ISO 14001:2015 and undergo regular review by an external third-party to ensure our environmental credentials are continuously improved. As a major healthcare provider and supplier of healthcare services to the NHS, we have a Board approved Sustainable Development Management Action Plan in place.
By embracing sustainability and mitigating harmful practices, we are creating social value through the protection of the environment. Environmental considerations are about the contribution and extent to which we are minimising our negative impact, including supporting local activities that seek to protect the local environment from waste and pollutants. One practical example of this is the introduction of thirty four hybrid vehicles in our home visiting service to replace older diesel models.
IC24 faces several risks that could impact our ability to deliver on our mission. These include:
Financial Sustainability: Inflation and rising staff costs continue to be a challenge, as NHS contracts have not always kept pace with the increasing cost base. We are working closely with commissioners to manage these pressures and have workstreams to focus on, and deliver, efficiencies in our services to ensure that services remain financially sustainable.
Workforce Capacity: The ability to recruit and retain skilled staff, particularly clinical personnel, is an ongoing challenge. Our “Great Place to Work” strategy continues to be our primary mitigation, alongside investment in workforce development and flexible working arrangements.
Changing Healthcare Landscape: The reorganisation of the NHS into Integrated Care Systems (ICS) presents both risks and opportunities. The future of large-scale Integrated Urgent Care (IUC) contracts remains uncertain, but we continue to explore new partnerships to ensure our long-term viability as demonstrated by our joint ventures with SECAmb and, more recently with Gloucestershire Health and Care NHS Foundation Trust.
Digital Transformation: As CLEO Systems grows, the risk of managing significant expansion while maintaining high-quality customer support is a key focus. We are continuing to invest in infrastructure and governance to support this growth.
Conclusion and looking ahead
IC24 remains committed to its purpose of improving patient care and experience through the provision of high-quality, integrated urgent care services. Despite the ongoing challenges in the healthcare sector, we are confident that our strategic focus on primary care integration, digital health innovation, and workforce development will position us well for the future. Our focus on our core values of Patients, People, and Partners will ensure that we continue to meet the evolving needs of the NHS and the communities we serve. We will also continue to ensure efficiency and effectiveness are key to our future in order that we continue to run both a financially stable and environmentally responsible organisation.
On behalf of the board
The directors present their report and financial statements for the year ended 30 June 2024.
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.
The directors who held office during the year and up to the date of signature of the financial statements were as follows:
The results for the year are set out on page 15.
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.
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:
Likely consequences of any decision in the long term;
Interests of the group's employees;
Need to foster the group's business relationships with suppliers, partners and others;
Impact of the group's operations on the community and the environment;
Desirability of the group maintaining a reputation for high standards of business conduct;
Need to act fairly as between members of the group.
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:
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.
The auditors, Moore Kingston Smith LLP, are deemed to be reappointed under section 487(2) of the Companies Act 2006.
We have audited the financial statements of Integrated Care 24 (the 'parent company') and its subsidiaries (the 'group') for the year ended 30 June 2024 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).
Basis for 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
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 Strategic Report and the Directors' Report for the financial year for which the financial statements are prepared is consistent with the financial statements; and
the Strategic Report and the Directors' Report have been prepared in accordance with applicable legal requirements.
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.
As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:
Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.
Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purposes of expressing an opinion on the effectiveness of the company’s internal control.
Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the directors.
Conclude on the appropriateness of the directors’ use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the group's or the parent company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the group or the parent company to cease to continue as a going concern.
Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.
Obtain sufficient appropriate audit evidence regarding the financial information of the entities or business activities within the group to express an opinion on the consolidated financial statements. We are responsible for the direction, supervision and performance of the group audit. We remain solely responsible for our audit opinion.
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.
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:
We obtained an understanding of the legal and regulatory requirements applicable to the company and considered that the most significant are the Companies Act 2006, UK financial reporting standards as issued by the Financial Reporting Council, and UK taxation legislation.
We obtained an understanding of how the company complies with these requirements by discussions with management and those charged with governance.
We assessed the risk of material misstatement of the financial statements, including the risk of material misstatement due to fraud and how it might occur, by holding discussions with management and those charged with governance.
We inquired of management and those charged with governance as to any known instances of noncompliance or suspected non-compliance with laws and regulations.
Based on this understanding, we designed specific appropriate audit procedures to identify instances of non-compliance with laws and regulations. This included making enquiries of management and those charged with governance and obtaining additional corroborative evidence as required.
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.
The consolidated statement of total comprehensive income has been prepared on the basis that all operations are continuing operations.
As permitted by s408 Companies Act 2006, the company has not presented its own profit and loss account and related notes. The company’s profit for the year was £1,975,406 (2023 - £4,376,251 profit).
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, as listed on page 38.
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:
Section 4 ‘Statement of Financial Position’ – Reconciliation of the opening and closing number of shares;
Section 7 ‘Statement of Cash Flows’ – Presentation of a statement of cash flow and related notes and disclosures;
Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instrument Issues’ – Carrying amounts, interest income/expense and net gains/losses for each category of financial instrument; basis of determining fair values; details of collateral, loan defaults or breaches, details of hedges, hedging fair value changes recognised in surplus or deficit and in other comprehensive income;
Section 33 ‘Related Party Disclosures’ – Compensation for key management personnel.
As permitted by s408 Companies Act 2006, the company has not presented its own profit and loss account and related notes. The company’s profit for the year was £1,975,406 (2023 - £4,376,251 profit).
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.
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 from the date of signing these financial statements and considering the group’s cash reserves and net assets at June 2024. The company also has a number of contracts in place with Integrated Care Boards in four different counties which extend beyond this period.
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.
Amortisation of intangible fixed assets is included in administrative expenses.
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.
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.
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.
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.
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, 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.
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.
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, 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.
Financial liabilities are derecognised when the group's contractual obligations expire or are discharged or cancelled.
The tax expense represents the sum of the tax currently payable and deferred 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
An analysis of the group's income is as follows:
Pharmacy income relates to the income of Pharma Alert 24 Limited, the subsidiary that was sold during the year (see note 14).
The average monthly number of persons (including directors) employed by the group during the year was:
Their aggregate remuneration comprised:
The directors are the group's key management personnel.
The charge for the year can be reconciled to the surplus per the income and expenditure account as follows:
Development costs represent the development of the group's 111 and Out-of-Hours management and security software.
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 £7,843 (2023: £66,122). Assets purchased in the period under finance lease or hire purchase contracts amounted to £nil (2023: £nil).
Details of the company's subsidiaries at 30 June 2024 are as follows:
The companies above all have their registered office at Kingston House, The Long Barrow, Orbital Park, Ashford, Kent, TN24 0GP.
On 8 February 2024, the company disposed of its subsidiary, Pharma Alert 24 Limited.
Disposals |
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Net assets |
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| 100,795 | ||||||||||||||||||||||||||||||||||||||||||||||||
Gain on disposal |
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| 200,000 | ||||||||||||||||||||||||||||||||||||||||||||||||
Total consideration |
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| 300,795 | ||||||||||||||||||||||||||||||||||||||||||||||||
The consideration was satisfied by: |
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Cash Outstanding consideration due to be paid 2025 |
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| 200,000 100,795 | ||||||||||||||||||||||||||||||||||||||||||||||||
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Details of the company's associates at 30 June 2024 are as follows:
iDental Care 24 Limited has its registered office at Kingston House, The Long Barrow, Orbital Park, Ashford, Kent, TN24 0GP.
All stock in the prior year related to Pharma Alert 24 Limited, the subsidiary disposed of during the current year.
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.
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 2024 the company purchased clinical negligence cover for the 12 months to September 2025 for £381,800 to cover claims brought in this period relating to medical incidents prior to April 2019.
The company has also made a provision of £200,000 (2023: £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.
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:
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.
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
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 (2023: £12,226) to its associate iDental Care 24 Limited. The outstanding balance at the year end was £nil (2023: £95).
During the year £532,273 was invoiced in relation to GP practice services provided to Transforming Primary Care Limited, a company related by virtue of there being common directors. This amount was settled in full during the year and there were no amounts outstanding at the balance sheet date.
The company’s active subsidiary, Brightdoc 24 Limited is 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 entity and this guarantee will remain in force until those liabilities are settled.