Every charity must have a trustee body

Charity trustees are volunteers who, under the charity's governing document, are responsible for the overall control of the charity and ensuring that it is properly managed.  Their responsibilities include:

• ensuring the charity keeps proper books and records
• preparing annual accounts and, in many cases, an annual report of the charity's activities, including at least a summary of the financial accounts
• formally approving the charity's annual report and accounts
• subjecting the accounts to external scrutiny, if required by legislation or by the charity's governing document
• ensuring the charity does not spend money on things outside its remit

How do you ensure your staff/trustees are equipped to run an organisation funded by the public?

Charities operate by employing skilled full and part-time paid employees and taking on unpaid volunteers and trustees.  They are subject to laws and regulations governing the charity, charities in general and, where appropriate, employment law. 

At the EAAA, we are effectively running an advanced and highly specialist ‘not-for-profit’ organisation – ie an organisation which doesn’t operate to make a profit but to run a service for our community.  The work of the EAAA, of course, involves helicopters, skilled clinical staff, liaison with the NHS and other emergency services.  We work with both national and international trade bodies to maintain best practice and to ensure we operate at the cutting edge of the air ambulance sector internationally.

Operating the EAAA safely and efficiently – and to provide the level of service expected by the public – requires a team of professional full and part time staff, with experience of running organisations of this scale and complexity.  We recruit people to specific paid roles in the same exacting way as commercial businesses do.

As of May 2007, the EAAA employed the equivalent of 17 full time staff.  They include fundraisers, administrators and finance staff, including those who run our in-house lottery.  They are based in Norwich, Ipswich, Cambridge, Peterborough and Bedford.

We are supported, as are many not-for-profit organisations, by a band of dedicated and unpaid volunteers, who are managed by our staff.  As at May 2007, we had more than 110 volunteers.  They are a critical resource and play an essential role in helping us meet our tough financial targets.

Although by law trustees cannot be paid, they do not take their activities lightly as regulations governing their roles make them personally responsible.  As a result, charities and not-for-profit organisations often have to work hard to recruit trustees.  They look to their trustees to provide particular experience, either in their field of operation or perhaps to bring new skills to the charity, such as finance, marketing or fundraising.

The EAAA is fortunate to have a board of trustees of the highest calibre, all of whom are closely involved with the charity and none of whom have ever even claimed the expenses to which they are entitled.  Our trustees are:

Chairman Mr Andrew Egerton-Smith
Mr Ted Witton
Mr Patrick Peal
Mr David Barker MBE
The Rt Hon The Earl of Iveagh
Mr Richard King CBE 

How much income does the EAAA raise in a year?

We estimate that we need to raise around 8p per month from every man, woman and child in the area we serve to keep the air ambulance service flying.

In 2005/6 we were fortunate to receive a large, single and one off donation of £740,000 from an individual who did not want to be identified.

To spread our risk, we seek our funds from a variety of sources as do most not-for-profit organisations and charities.   We receive no National Lottery funding but do operate our own highly successful lottery, which generates an income of over £1m a year.  We also have two shops that generate around £40,000; our clothes collections which generate around £25,000 and each year we receive grants and legacies of around £240,000.

A breakdown of our sources of income is provided below:

Fundraising                   61%
Lottery                          24%
Legacies/in memorium     9%
Merchandise                   2%
Investment income           2%
Charity Shops                 1%
Other                              1%

Why do you prefer people to make regular gifts?

Of course, we welcome any and all gifts but long-term regular donations are particularly helpful because predictable income enables better planning – and the more we can plan and budget, the more effective and efficient we can be.  Regular gifts also mean lower support costs and cheaper bank charges so that more of the money we receive goes directly to support our work.

Securing new donors' support is also crucial to allow the charity to keep functioning but there is a cost involved in reaching new donors.  If people commit to giving regularly for a year or more, charities will recoup those costs.

How does the EAAA decide how to spend its income?

We work closely with our colleagues at the East of England Ambulance NHS Trust and with the NHS Strategic Health Authority to identify likely future requirements of the EAAA service.  Our management team prepares plans and budgets to meet these demands, which require the approval of the trustees.

In addition to running the helicopters, the charity has numerous other costs to cover, including medical equipment, training, flight helmets and suits, radios and even more mundane items such as refrigerators and washing machines.   In addition, we have to cover salaries and overheads to run the charity itself.

A sum equivalent to one year’s operation is also held in reserve to ensure that we can keep the helicopters flying even in the event of a sustained turn down in fundraising.  This amounts to around £3 million.

How much of my donation goes on fundraising/administration?

The information below shows how much we spend on fundraising and other forms of support, which are essential to our survival.

Helicopter operation and medical equipment 76.8%
Fundraising                                               12.2%
Lottery running costs/prize money                 8.4%
Buying merchandise                                     1.3%
Governance (audits, legal, etc)                       0.7%
Charity shop costs                                        0.5%

What level of administration costs is appropriate?

Every not-for-profit organisation operates in a different environment and performs different activities, so the level of support costs varies.  What we all have in common is that we seek to minimise support costs.

In our case, we regularly benchmark our costs, income and reserve levels against other air ambulance charities and similar sized regional not-for-profit organisations to ensure that our cost levels are comparable.

How much of my donation is spent on your CEO/directors' salaries?

Not-for-profit organisations have the same need for professionalism and effective management structures as a business or public sector organisation.  In order to attract the requisite calibre of senior staff, it is necessary to pay them at a level commensurate with the responsibility.  Having said this, CEOs and directors of charities are not generally paid at the same level as their peers in the commercial sector and this certainly applies to the EAAA.

We also have the intricacies of negotiations and dealings with the NHS, as well as with aircraft operators and statutory bodies such as the Civil Aviation Authority. The aviation industry is one of the most regulated industries in the world and we require very high levels of management expertise to work within this environment. 

We don't set our directors' salaries as a percentage of income. Our directors' salaries are part of our support costs.  You can check this information in our annual report, which is published as part of the charity's financial reporting obligations.

Why do you have reserves?

Our monthly total running costs are £250,000 and our trustees have set a policy that we should have one year’s funding in reserves to ensure that temporary downturns in funding do not jeopardise our 365 day a year service.  There is a precedent for this with one of our fellow air ambulance charities stating that they had to ground two helicopters for part of 2006 due to the Tsunami appeal diverting funds away from them.

In addition to this, we also earmark reserves to fund initiatives to further improve the service we offer. These initiatives (eg helipads at hospitals, training to further improve clinician standards) may not have commenced for various reasons although funding is allocated.

What are the EAAA’s key achievements over the last 12 months?

During 2006, the air ambulance attended nearly 600 road traffic accidents, as well as medical emergencies such as falls from scaffolding and ladders, equestrian and sporting injuries (where we are often called because access by a land ambulance is difficult), chest pains and cardiac arrests, burns, drowning and industrial incidents.

Also during the year, we acquired a state of the art air ambulance, a Eurocopter BK117, one of the most widely used helicopters for air ambulance work in the world.  The BK117 has greater room internally allowing clinicians to carry out more procedures than were possible previously.  It also means we have room to take another walking wounded patient to hospital or convey the parent of an injured child or other family member.

During 2006 we successfully tested a dedicated tasking desk in partnership with the NHS.  The aim was to ensure that the air ambulance could be more accurately targeted to the most appropriate type of incident or accident.  The trial was a success and it is likely to become a permanent fixture in 2007/8.

We’re working to make things even better

We’re constantly looking at ways to improve the service.  For instance, our clinicians now benefit from extra training and have access to additional drugs, equipment and resources over and above those on board a land ambulance.

We have also enrolled more doctors and now have eight doctors working on a rota.  Overall, our objective is to have teams of doctors and paramedics working together to bring different skills to the aid of the patient.

The NHS pays the salaries of the paramedics while the doctors, until recently, served on the helicopter on a voluntary basis.  The East of England Ambulance NHS Trust has now agreed to pay them at the same rate as paramedics.  This is a considerably lower sum than they would normally earn and we are indebted to them for the support they give to the charity.

Ideally we would like to have doctors trained in anaesthesia and other advanced clinical interventions on board for all shifts but, at around £100,000 per doctor, it is not affordable at this stage, since we would require five to fully man two helicopters.

Our replacement helicopters are larger than our original workhorse, the Bolkow B105 helicopter (which we have kept as a back up) allowing our clinicians to carry out procedures not previously possible.

We have invested in our fundraising and in-house lottery. For every £1 invested in fundraising we manage to generate over £4.  We do this by attending events and buying and selling merchandise, such as Christmas cards and pin badges.

We've worked in co-operation and partnership with other organisations

We work closely with our colleagues at the East of England Ambulance NHS Trust, the region’s hospitals, corporate sponsors and the media.

One of our key partners is MAGPAS, the emergency medical charity, whose volunteer doctors and paramedics provide medical treatment at the scene of serious incidents in Cambridgeshire and Peterborough.  Its emergency teams are based at RAF Wyton and are generally car-based, though they also, on occasion, use the use the police air support unit helicopter to get to the patients quickly.

MAGPAS also runs the Community First Responder Scheme (CFRS).  Through this scheme, it trains volunteers from every community in Cambridgeshire so that they can begin life-saving treatments in the minutes before a regular ambulance arrives.  Over 250 volunteers are involved in the scheme.

We can point to specific examples of our work

Kieran Seymour would not be here today were it not for the EAAA.  It rescued him in August 2005 after an horrific road accident at Ipswich which left his grandmother dead and his grandfather lost both legs.  His younger brother, Ethan, was also injured.  Kieran’s injuries were judged so serious that only very rapid medical attention could save him.  Fortunately the air ambulance was available to whisk him to Ipswich Hospital and within minutes of the accident, he was receiving the life-saving attention he needed. 

There are countless other examples of people whose lives have been saved – or recovery dramatically improved – thanks to the intervention of the air ambulance.  We have a library of case studies of which we are justifiably proud.

We have achieved specific targets

When the charity was first established in 2001, we could only afford to fly the air ambulance one day a week.  We knew that this was not good enough for the people of the region and it was our initial target to increase it to five days a week and ultimately 365 days a year.  We have now met this target and are now setting ourselves similar targets to provide seven day coverage in Bedfordshire, a county into which we are extending our service.

We've raised awareness of the issues

As a charity, we’re well aware of the importance of constantly proving the value of the service the air ambulance provides.  We work with all the regional media to keep them informed of the work we’re doing, to take them up with the air ambulance as observers and to give them access to patients of the air ambulance who are happy to talk about their experience.

In addition we campaign on key issues, particularly the provision of more regional hospital helipads.  For instance, we ran a highly successful appeal with the Lynn News to raise funds to build a new state of the art helipad at the Queen Elizabeth Hospital in the town. It is hoped that this provision will soon be available for the citizens of Kings Lynn and West Norfolk.

With our colleagues at the famous annual Chariots of Fire Cambridge university road race, we raised significant funds towards the cost of a helipad at Addenbrooke’s Hospital.  Construction should be completed by Autumn 2007.

Why doesn’t the air ambulance receive any public funding?

The East of England Ambulance NHS Trust pays the salaries of paramedics and supplies equipment and consumables as found on a land ambulance.  Many parish councils around the region have contributed but, other than this, the charity receives no public funds so this question should really be directed at national and local government.

We believe that all the UK’s air ambulances, and particularly ours, play a crucial role in the emergency cover service in their region.  Rapid medical attention provided by airborne crews have saved countless lives and ensured a better recovery for many others.

The NHS is already under great pressure to deliver higher quality standards of patient care while reducing its running costs. With around 20 helicopter air ambulances operating in England and Wales, at an average of £800,000 to £1.2m pa for each one, this would mean that around £16m to £24m would need to be found from NHS funds each year.

Charities have a long history of expert innovation in meeting the needs of particular groups in society. Government has seen the usefulness of helping to fund this innovation and taking up the improvements found.  Perhaps in the future the NHS might be more financially able to support the air ambulance service.

Wouldn't you be more effective and efficient if you merged with all the other charities that work in your area?

We are conscious of the need to consider any possible risks of duplication of effort.   Many charities are set up to meet perceived specific and local needs.  The EAAA is a good example.  With our poor road network, isolated rural communities, physical locations (marshes, drainage ditches, coastline, Broads, Fens etc) and large distances from one hospital to another, an air ambulance was essential for the region.   So, a group of like minded individuals got together and launched the charity to meet these needs.  By November 2006 the helicopter had flown over 6,000 missions.

Collaboration is important though and we already work closely with other regional emergency care groups.  For instance, we work with our colleagues in BASICS (British Association for Immediate Care) schemes operating in the region, including MAGPAS (Mid Anglia General Practitioners and Accident Service), NARS (Norfolk Accident and Rescue Service) and SARS (Suffolk Accident and Rescue Service). We also have strong links with both the Red Cross and St Johns Ambulance. We provide complementary services and share some training and best practice resources. 

As a result of the recent merger of the three former NHS ambulance trusts in the East of England region to form the new East of England Ambulance NHS Trust, we are working more closely with our colleagues at the Essex Air Ambulance.

As a result of this closer working, it was identified that the counties of Bedfordshire and Hertfordshire had no dedicated air ambulance cover. The NHS suggested that each charity should consider extending their services into an additional county and following extensive consultation with our supporters, some 93% said they supported such a move.

As a result, we have secured a second aircraft which will be on operational duty on the Cambridgeshire/Bedfordshire border to cover those two counties, with the existing helicopter serving Norfolk and Suffolk.  In this way we will have two helicopters serving four counties as opposed to one helicopter serving three.  This will result in an improved level of service for everyone in all four counties.   Initially this will be a five day per week service until such time as funds from Bedfordshire grow to move up to seven days per week. 

Why do you have your office in towns where the cost of office space must be higher than elsewhere?

A charity is only as good as the people it can get to work for it and we have to balance the cost of location with our need for a strong skill base to cover the range of specialist professional requirements for our work.  That being said, thanks to the generous help of some of our supporters, our office accommodation represents very good value.