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Restor ing the heart of healthcare

Annual Report and Financial Statements, 2014/15 Year ended 30th June 2015

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This year’s highlights

New journal launchedThe Developing Mental Health journal has been launched and is about to publish its 3rd edition (publishing every other month). Each edition usually includes one or two main articles around a theme, a highlighted article from recent literature and a practical tool. Occasionally there will be larger themed editions.

PRIME in AfricaIt has been exciting to see African PRIME tutors spreading PRIME teaching to neighbouring countries. Teaching delivered in Uganda was enthusiastically received by a WHO consultant charged with amassing principles of teaching humanity in healthcare who said, “at last I have found an organisation that actually does this”.

Annual ConferenceThe Annual Conference that took place in Lichfield in March was truly international with people from 17 countries taking part and many of them contributing extremely well received reports on their work and the role that PRIME had played where they came from.

Chair’s introductionThe blessing of this last year is evident in the on-going steady and stable development of PRIME’s international vision. The rate of this development continues as in earlier years. Within any short period it may seem quite slow, as we anticipated so many years ago, but this annual report allows us to marvel at the progress, and to be encouraged by the wonderful feedback received from many

hundreds of participants across the world. We are seeing much more than just a change of attitude in the way our colleagues perceive their work – we are seeing their spirits enlivened and hearts touched. This in turn then transforms their interaction with their patients.

As always the impressive statistics of our programmes can only be a relatively sterile reflection of this deeper fruit. We seek to be a facilitating, encouraging charity – visits overseas are the catalysts for ongoing local initiatives. We could never measure the fruit of renewed consultations in our participants’ work. We are delighted when our colleagues abroad lead local conferences – the feedback from one such in Africa was extraordinary. Equally we are delighted when asked to teach teachers and influence the core curriculum of a medical or nursing school, perceiving the potential fruit for the future, yet having to hold that in faith, not in statistics.

Thus we are witnessing the gradual growth of an international community of independent groups. There is a sense of federation. We in the UK seek to release any image of being the sole providers and wish to develop our resources further to serve others. The manuals are already used widely but the future may involve developing distance learning online.

Every building relies on the security of its foundations. We have invested over many years in relationships, and in the robustness of the vision. However the practical outworking is equally robustly supported by an amazingly efficient and dynamic office team. Many are the uninvited messages of thanks and appreciation. The quality of reports, personal encouragement and support for individual tutors, and the meticulous understanding of management detail are outstanding.This professional core secures the work of our voluntary charity. The number of hours donated at home, and the number of hours volunteered by those who after much preparation travel across the

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3Chair’s Introduction

6Trustees’ Report

9A Summary of the Year

19A Snapshot of our Finances

20Financial Review

22Independent Examiner’s Report

24Statement of Financial Activities

25Balance Sheet

26Notes to the Accounts

world are like the grains of sand on a beach – uncountable. The inclusion in these accounts of ‘Gifts in Kind’ gives some indication of the scale of this generosity. It is this tithing of time, professional skill, and loving generosity that is the key to unlock so much undeserved blessing. We thank the Lord for these people.

Another year passes. Another year to give thanks for the international family of PRIME. Another year to 'stand still’ and watch the unfolding of the Lord’s plan with his provision. Another year to live this modern mystery of the practical and transforming leadership of the Lord at the core of our professional calling. There is deep awareness of the privilege of walking on a highway with our God.

John Caroe

PRIME Chair

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Trustees Dr John Caroe (Chair)Mr John Caladine (Treasurer)Dr David ButlerMrs Gillian CaroeMr Steve FouchDr John GeaterDr Michael Sheldon

Chief Executive Prof Richard Vincent

Secretary Mr John Caladine

Charity number 1111521

Company number 5492101

Principal address Innovation Centre, Highfield DriveSt Leonards on Sea. East Sussex

TN38 9UH

Registered office Innovation Centre, Highfield Drive

St Leonards on Sea. East Sussex

TN38 9UH

Independent Examiner D A Hargreaves FCA

Sellens French, 91-97 Bohemia Road

St Leonards on Sea. East Sussex

TN37 6RJ

Bankers CAF Bank Limited 25 Kings Hill Avenue

Kings Hill, West Malling

Kent

ME19 4JQ

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Trustees’ ReportThe trustees present their report and accounts for the year ended 30 June 2015.The accounts have been prepared in accordance with the accounting policies set out in note 1 to the accounts and comply with the charity's Memorandum and Articles of Association, the Companies Act 2006 and the Statement of Recommended Practice, "Accounting and Reporting by Charities", issued in March 2005.

Structure, governance and managementThe charity is a company limited by guarantee, incorporated on 27 June 2005 and registered as a charity on 30 September 2005. The company was established under a Memorandum of Association, which established the objects and powers of the charitable company and is governed under its Articles of Association. In the event of the company being wound up members are required to contribute an amount not exceeding £10. After incorporation the charitable company was gifted the reserves of the unincorporated charity Partnership in International Medical Education registered charity number 1088777, in accordance with its charitable objectives.

The trustees, who are also the directors for the purpose of company law, and who served during the year were:

The directors of the company are also charity trustees for the purpose of charity law and, under the company's Articles, are known as the Trustee Board. Under the requirements of the Memorandum and Articles of Association the Trustee Board is elected to serve for a period of three years after which they must be re-elected at the next Annual General Meeting. One third of the trustees retire by rotation each year and are available for re-election.

New trustees are encouraged to familiarise themselves with the charity and the context within which it operates including the following areas:

• Obligations of the Trustee Board.

• Foundation documents that set out the operational framework for the charity including the Memorandum and Articles.

• Resourcing and the current financial position set out in the latest published accounts.

• Future plans and objectives.

The Trustee Board of seven members meets at least three times a year and is responsible for the strategic direction and policy of the charity. In planning and overseeing the activities for the

Dr John Caroe (Chair) Mr Steve FouchMr John Caladine (Treasurer) Dr John GeaterDr David Butler Dr Michael SheldonMrs Gillian Caroe

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year the Trustee Board keep in mind the Charity Commission guidance on public benefit. At present the Committee has members from professional backgrounds relevant to the work of the charity. A scheme of delegation is in place for the day-to-day operational management of the charity, individual supervision of new volunteers and also ensuring that the volunteers continue to develop their skills and working practices in line with good practice.

Related partiesPRIME has close relationships with the Christian Medical Fellowship which nominates a member of the Trustee Board, currently Mr Steve Fouch, who has provided considerable wisdom and support.

As well as informal links with national and regional organisations and groups for delivering particular programmes, PRIME has formed a number of more formal relationships with certain other secular and professional organisations by way of a series of Memoranda of Understanding.

Risk managementThe greatest identified risk is that of PRIME tutors travelling to work in potentially unstable countries. All tutors are required to sign a legal document prior to representing PRIME where they declare their own responsibility for their safety and any risks involved and agree that no claim will be made against PRIME. They also declare that they will only offer clinical advice or treatment to patients in their own capacity; they will not claim any remuneration; they will endeavour to reflect the Christian ethos of PRIME at all times and do nothing to bring the Christian faith or PRIME into disrepute.

The Trustee Board conducts regular reviews of the internal and travel-related risks to which the charity is exposed. Where appropriate, systems or procedures have been established to mitigate the risk the charity faces. Internal control risks are minimised by the implementation of procedures for authorisation of all transactions and projects. Procedures have been developed to ensure compliance with health and safety of staff, volunteers and clients, and these will be periodically reviewed to ensure that they continue to meet the needs of the charity.

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Objectives and activitiesThe charity’s objects are the relief of sickness for the benefit of all people through health and medical education in partnership with appropriate organisations throughout the world.

We remain passionate to see excellence in healthcare available to people everywhere. We do this through educational activities that, as well as increasing evidence-based knowledge and improving clinical skills also seek to:

• Restore the heart of healthcare - medicine that is based on a heart-felt and active care for patients not just an intellectual understanding of the illness and healing process.

• Restore the humanity to healthcare – “Medicine is more than the sum of our knowledge about disease. Medicine concerns the experiences, feelings, and interpretations of human beings in often extraordinary moments of fear, anxiety, and doubt... The values that doctors embrace set a standard for what patients expect from their medical practitioners.”1 Around the world patients are crying out for healthcare provision that recognises the whole person and reflects the best of humanity: integrity, compassion and altruism.

• Change the emphasis of medical mission – from the practical provision of medical treatment to sustainable education that empowers and equips national healthcare workers to provide the highest standards of healthcare long after PRIME has left.

The activities currently carried out for public benefit by the charity can be broadly categorised as for the advancement of health and medical education and the relief of those in need.1 Royal College of Physicians. Doctors in Society: medical professionalism in a changing world. Report of a Working Party of the Royal College of Physicians of London. London: RCP, 2005.

How we workPRIME works in partnership with local organisations and groups to provide training and consultancy programmes that build on local knowledge and experience and are tailored to reflect local needs and contexts.

PRIME services are provided regardless of age, creed, disability, gender, race, religion or sexual orientation.

All PRIME programmes seek not only to teach whole person care, but wherever possible to impart teaching methods to achieve a sustainable effect. Conferences are designed to be equally fruitful, in networking and developing new contacts for future development.

We continue to seek qualified volunteer tutors. All PRIME tutors are volunteers and for the most part cover their own locum and international travel costs. The Trustees are very grateful to all our tutors without whom PRIME would be unable to deliver our ever-expanding teaching programmes.

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A Summary of the YearOver the financial year PRIME tutors delivered 70 separate programmes in 27 different countries across Africa, Asia, North America, Australia and Europe. This involved over 79 different tutors serving overseas for a total of over 200 days providing teaching and training to well over 3,000 individuals. Indirectly, we believe that this training will improve the care provided to the thousands of patients each of those individuals will treat, as well as the hundreds of healthcare students they will teach in the course of their careers. Our tutors and partners continue to work extremely hard and many have travelled with great courage into demanding situations.

The organisation is evolving into a horizontally-connected international network of like-minded people taking their own initiatives within their culture and calling. The original core group seek to maintain a central facilitating hub whilst moving to become a resourcing and encouraging group rather than a dominant leading team.

PRIME remains totally committed to its foundational Christian calling, and we are very aware and grateful for the ongoing blessings that we have all witnessed.

In Memory ofPRIME’s achievements rest on the hard work and dedication of so many people around the world. Sadly this year we have lost some of these talented individuals and it seems only right to pay tribute to them for their contributions, some over many, many years.

The death of David Chaput de Saintonge, whilst expected, leaves an enormous hole in PRIME and in many of our lives. We thank God for the 15 years he served with PRIME where his contribution to the materials and methods that form the basis of our work was huge and the lives he touched numbering in the thousands. He played an incredible part in allowing the vision to become a reality. He will be sorely missed – but his presence lives on in so many ways in the on-going teaching of PRIME, the manuals and materials he created and in the inspiration he has been to so many.

We also lost two of our key national partners. Dr Olivet Buck, family doctor and educator in Freetown, Sierra Leone who died during the recent Ebola outbreak while caring for her patients and Eva Kalvinska, Head of Spiritual Care in the giant Motol Hospital, Prague who died in a road accident.

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Review of the Year’s ActivityAlbaniaPRIME activities in Albania were largely focused around World Mental Health week, which also coincided with the 50th anniversary celebrations of one of our partners. Two teaching events on ‘Institutionalisation: treatment and support of psychiatric patients in long term hospital care’ were offered to psychiatrists, doctors, nurses and other mental health workers. The first of a planned series of psycho-educational leaflets has been published. The series will be produced in conjunction with local psychologists to provide some effective and informative material for patients, carers and the general public. Work continues with the other titles in the series. A PRIME team has also delivered various mental health teaching to healthcare professionals, social workers and church leaders. PRIME teams have also been involved with some further palliative care teaching and some discussions are taking place about a PRIME conference in the near future.

ArmeniaOur previous programmes having drawn to a close we continue to discuss various possibilities for future activity in Armenia with various partners including the Ministry of Health, medical schools and others. At the present time the development of further three-year primary and palliative care training programmes look to be the priority.

AustraliaPRIME Australia held their annual tutor training event in July 2014, joined this year by colleagues from China, the UK and the USA. PRIME Australia is leading several programmes including China, India, Papua New Guinea and Malaysia, which are included later in this report.

AzerbaijanWe are exploring a possible PRIME conference to teach mental health skills to primary care workers with broad agreement from the Ministry of Health.

BelgiumPRIME has been in touch with a new group being established for Christians in healthcare based on PRIME principles. A PRIME tutor from Portugal was a keynote speaker at the foundation conference.

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BosniaAlthough PRIME have not been actively involved in Bosnia during the year we continue to support our partners there.

ChinaProgress in developing links with China has continued at a steady pace. No overall lead for this work has emerged, though we are aware of much useful and dedicated work in progress there through various friends. There is huge opportunity to assist in family doctor training in the years to come, but we have not yet reached the point of having concrete tasks requested by our Chinese friends.

EthiopiaA PRIME team taught a week’s course to the healthcare teachers at a new medical school. The course was a success and a return visit to give some further teaching at a more advanced level is likely, including mentoring, ward-based teaching and assessing specialist nurses. During the visit the team had discussions with a specialist nursing school hoping to run a course teaching their nurse instructors and an evangelical theological college to run a teaching the teachers course on various topics. PRIME tutors are also involved in discussions with various medical schools looking to develop their family medicine training and residency programmes.

GeorgiaA PRIME team participated in the first Christian Medical Association of Georgia conference, which was attended by delegates from various healthcare professions and locations in Georgia. New partnerships are developing for future teaching on palliative care and end of life care. A senior palliative care consultant and a neurologist from Georgia attended the PRIME annual conference and were also able to engage with an additional programme at a local hospice and a primary care clinic while they were in the UK. Plans are now developing to establish and support a palliative care service outside the capital.

GermanyA small PRIME team attended an international conference on the Christian responses to health and development. It was a good opportunity to meet with some significant international leaders, many of whom PRIME had no contact with previously. The conference ended with a strong call to the World Council of Churches to raise health to a much higher profile in their agenda. A team will be attending the next of this series of conferences in October 2015 which is intended to mark the start of the development of a European medical missions network.

GhanaNine PRIME tutors helped lead a five-day practical multi-professionals conference at the Central University College in Greater Accra. The meeting overall was judged to be very successful with a strong local lead emerging to

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“Fantastic, loved it. Can’t wait for the next one!”

Delegate, Georgia

develop PRIME throughout Ghana. Some of team remained to lead a separate tutor-training programme, which was enthusiastically taken up by the attending faculty staff with whom we left a comprehensive collection of PRIME resources.

IndiaPRIME tutors from both Australia and the UK continue to support the contact teaching phases of Masters in Medical Education in multiple centres across India as well as supporting and assisting Christian Medical College in updating its family medicine teaching materials. A PRIME team will be leading a new programme of palliative care teaching in November 2015 in two centres initially, though we hope that this may expand further.

KenyaA team of PRIME tutors from Kenya and the USA represented PRIME at the East Africa Health Professional Educators Association inaugural meeting in Uganda and the 6th Biennial Africa Church Health Associations Platform conference in Nairobi. Delegates at the Uganda conference included a World Health Organisation technical officer who expressed interest in working with the team to explore how spiritual care can be incorporated in the WHO guidelines. Kenyan tutors also conducted a leadership training conference in Nairobi and two of our Kenyan colleagues were able to attend and contribute at our annual conference. PRIME input is planned for the GMHC Africa Conference in September 2015.

MalaysiaA team from PRIME Australia led a special teaching the teachers conference, which was very well received and we hope will be the start of PRIME activities in the wider region. Delegates included individuals from the Philippines, Malaysia and Brunei.

Middle EastOne of our partners in the Middle East is looking to translate the ‘Whole Person Medicine’ handbook and slides into Arabic, which will be a great step forward in assisting our teaching in the region. Conflict and insecurity in the area has delayed some events from taking place as scheduled but teams have been able to visit the region to conduct palliative care training and to explore possible future teaching opportunities. Plans are developing for further palliative and primary care training in the region.

Some of our PRIME tutors, partners and friends are continuing to live and work in very difficult situations in unsettled and war torn areas. We had hoped to be able to welcome again a small team from the region to our annual conference but they were not granted visas. They were

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“It was most helpful. The topic today has really brought a turn around in my life.” Delegate, Ghana

however able to share with us an excellent and informative presentation on compassion in healthcare from an Islamic perspective.

MozambiqueWe hope that some of our friends and partners from Mozambique will be able to attend the forthcoming conference for Portuguese speaking health professionals in Lisbon, Portugal.

NepalA PRIME team has delivered a mental health training programme in Kathmandu and continues to support KOSHISH, a local mental health NGO working at the front line of mental health provision there. The team also visited a transit centre in Kathmandu and supported KOSHISH as trainers in mental health to primary health workers in Tanahun district. A professor of psychiatry from Nepal who is well known to PRIME attended the annual PRIME conference and gave a spotlight story. While in the UK we were able to arrange for him to spend time with two mental health authorities.

NetherlandsA team of senior PRIME personnel ran a PRIME stream as part of the pre-conference programme of the ICMDA World Congress. Their teaching was well received by delegates. PRIME personnel also led afternoon seminars within the main conference programme for juniors and students. The conference also provided an opportunity to further extend our ongoing work due to the rich networking with many of our partners across the world as well as new contacts offering possible future developments.

NigeriaPRIME’s Nigerian tutors delivered a symposium on whole person medicine to over 90 healthcare professionals with a virtual contribution from our CEO by video. They also delivered an introduction to whole person medicine at a major teaching hospital at an event attended by key officials. We were able to welcome several of our Nigerian tutors and friends to our annual conference and especially pleased that one of our longstanding Nigerian tutors was able to join part of the teaching programme whilst others were able to contribute spotlight stories. Teams of Nigerian and UK tutors are working together to plan further whole person medicine and training the trainers events at multiple locations in summer 2015 as well as a conference for health professionals and

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“PRIME should continue the good work. This is what the world needs.”

Delegate, Nigeria

pastors on assisting the mental health care of prisoners.

Papua New GuineaTeams from PRIME Australia continue to contribute to the development of a hospital chaplaincy training programme, which has been running over the past three years. A PRIME tutor spent eight weeks in-country developing and delivering mental health training to healthcare professionals and community leaders. PRIME connections in Papua New Guinea have also been helpful in work towards the third edition of the ‘Health Care Manual for Community Health Workers’ that is long awaited.

PolandA team of local PRIME tutors continues to deliver communication skills workshops as well as a weekend course for students. PRIME CEO, Richard Vincent was invited to speak at the 40th Anniversary celebrations of Poznan University of Medical Sciences and an international day conference on Physiotherapy, both in his continuing role as Visiting Professor. A further conference for up to 100 delegates has been outlined for 2015.

PortugalThe Portuguese CMF is organising the first-ever Portuguese-speaking conference for Christian health professionals, in partnership with ICMDA and CMF Brazil in October 2015. PRIME tutors are involved in the organising committee and the programme will include PRIME teaching sessions. It is hoped that some Christian doctors and medical students from Angola, Brazil and Mozambique will attend the conference with some sponsorship from ICMDA.

RomaniaPRIME’s long-standing partnerships in Romania continue with events often attracting many hundreds of delegates. Teaching during the year has included ‘the patient's journey with cancer’, ‘the doctor as a teacher of patients’, ‘a positive aspect of dying’ and ‘teaching small groups of students’. Teaching has been enthusiastically received and feedback has been excellent. Our

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relationships with several medical schools also continue and this year we have taught family medicine topics which were underrepresented on the curriculum. We have also been able to develop links with the Romanian Association of Physicians and Surgeons as a result of recent PRIME events.

RussiaPRIME tutors have delivered several seminars introducing whole person care at events organised by our various partners. We hope to develop a three-year programme to support the development and outreach of regional Christian medical groups, train trainers and develop a group of Russian-speaking PRIME tutors to do this work. We also retain contact with our partners at Moniki University and others and are exploring plans for a five-day training course in the near future.

RwandaA team of PRIME tutors from Kenya and the USA represented PRIME at the East Africa Health Professional Educators Association conference in Rwanda. The programme included a keynote presentation and a workshop.

Sierra LeoneFurther PRIME activity in Sierra Leone has been curtailed due to the outbreak of Ebola in that country. One of our key partners, Dr Olivet Buck, died during the epidemic whilst caring for her patients. Her death was both a tragedy that shocked many of us and a considerable setback to the work of PRIME in Sierra Leone. We look forward to a time when the country has recovered and we are able to re-engage with our highly dedicated and committed partners.

South AfricaPRIME was asked to speak at the national CMF conference and we were able to provide a video presentation from our CEO. We are developing plans for a major tutor training event in 2016.

South AmericaThe PRIME event at Panama ICMDA proposed for June 2015 did not go ahead. A key South American leader was able to attend our annual conference so as to have a better idea of the vision and ethos of PRIME and to assist in the teaching – the advantage being that they will teach in Spanish. They believe that people from all countries in the region will attend the congress and be able to cascade PRIME teaching widely. Following discussions the key people in South America have agreed to hold a PRIME seminar in Peru in Autumn 2016 with the aim of introducing the PRIME vision to Christian Medical Associations in the South American continent. 

SpainA PRIME representative attended the NCFI European Conference in Madrid.

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“We were challenged to use our medical knowledge

through teaching, to implement Christian values in medical

education.” Delegate, South America

SwazilandA PRIME tutor visited Mbabane to assess the potential for PRIME to train tutors in whole person care. The visit was focused on discussing the logistics of setting up the School of Medicine in Swaziland and PRIME’s role is not confirmed at this stage.

UgandaA PRIME team from the UK continues to deliver whole person care conferences in Gulu and Kisoro to pastors, church leaders, community health workers, leaders, and both private and government clinical schools. This programme looks likely to expand further to Kagando. Meanwhile a team from PRIME Australia are working in Kitgum with a focus on emergency medicine and first aid. This year there has been some overlap between these two projects. As well as these ongoing projects PRIME is developing plans to contribute to the 5th HCFI Conference along with a training the trainers programme for regional healthcare leaders.

UkraineThe recent troubles in Ukraine have continued to disrupt various events including a palliative care training event and a course for medical educators of overseas medical students with the Crimea State Medical University. In July PRIME senior tutors were able to meet a team of Ukrainian Health Care professionals in London to discuss palliative care services and provision and to arrange a visit for the team to the St Christopher’s Hospice. A PRIME team were able to attend and contribute at the 5th Annual Christian Conference for Young Medical Professionals which attracts delegates from many different countries, cultures and faiths.

United KingdomThere is a slow growth of regional groups as well as a growing number of PRIME tutors who would like to develop our work in the UK more substantially. PRIME held popular special interest events for mental health and palliative care professionals and has also been actively supporting chaplaincy training for the spiritual care team at Guy’s and St Thomas’ Hospitals. This was the first time doctors had taken part in this training and we hope that it represents a step forward in helping gain better integration of spiritual and medical care in our hospitals. PRIME tutors attended a conference in Edinburgh on 19th June, the International Palliative Care Day hosted by the Academy of Global Health, University of Edinburgh. This increasing opportunity was highlighted in this conference

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“It will be good if this is spread all over the

country.” Clinical Officer, Uganda

“This is wonderful it so accords with my heart.”

A Jewish Rabbi, UK

with speakers from the Academy of Global Health, Cairdeas and PRIME. PRIME seminars have also been included in various other organisations’ events including the Christian Medical Fellowship, GP Vocational Training Schemes in the West Midlands, Faith in Healthcare in East Sussex and an international conference on physician health run by the British Medical Association.

United States of AmericaPRIME’s contribution to the Global Missions Health Conference in Kentucky in November comprised speaking at two breakout sessions and running two PRIME workshops: Exploring Whole Person Medicine and Teaching Whole Person Medicine. These events offered a rich exploration of whole person medicine with a group of experienced, mature Christian pioneers and teachers. We were well received, and it seems that even for this impressive group PRIME presents a novel and worthwhile approach. We look forward to seeing how PRIME’s work may develop as a result of our US visits, particularly though local initiatives.

ZimbabweA PRIME team was invited to give a whole person medicine taster to third year medical students. The university has indicated a desire that all students of the medical school should have PRIME teaching at the start of clinical training and again, just before qualification. Several items of literature were left with faculty members and there was some discussion about future events.

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“I liked the interaction between the students

and the tutors. It helped us to reflect

what we feel and understand about the

subject. The role plays we did helped with

retaining a vivid memory of what we learnt.” Delegate,

Zimbabwe

New opportunities being exploredDeveloping Mental HealthDeveloping Mental Health is a free resource designed and prepared for all healthcare professionals who have an interest in and concern for mental health care – psychiatrists, clinical psychologists, general physicians, mental health nurses, general nurses, occupational therapists, pharmacists, physiotherapists, dieticians, community health workers, social workers, administrators, chaplains and interested faith and community leaders.

We are aware of a greater sense of responsibility towards mental health care amongst health care professionals...and our hope and prayer is that Developing Mental Health will contribute to both the training and the practice of mental health care in many thousands of communities worldwide. Over time we hope to build an international network for mental health professionals working in developing countries to reduce unnecessary suffering in thousands of communities.

NursingAs part of our commitment to engage other health professionals an initial Skype meeting has taken place to discuss strategy. Nursing is now specifically represented on both the PRIME Executive Committee and Trustee Board. It was agreed that the next step would be to review PRIME materials, in particular the ‘Whole Person Medicine’ manual, to make them more acceptable and appropriate for nursing and other allied health professions. PRIME was represented at the NCFI European Regional Conference in Spain. Plans for PRIME input at the NCFI Quadrennial International Congress in the Philippines continue to develop.

Values Added programmeFollowing a comprehensive review of the programme the Values Added working group decided to expand the audience to include all healthcare professionals and to make the programme available for online study. An online learning zone has been developed and we hope to launch the new format in the coming months. Meanwhile work has been ongoing on developing the materials for module three.

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A snapshot of our financesThe principal funding source for the charity continues to be voluntary donations from individuals and organisations. During the year we were also grateful to have been awarded grants from the Brian Mitchell Charitable Settlement, GEM, MSM and the University of Nigeria to support various initiatives.

Income - £729,634

Expenditure - £722,601

All financial figures taken from the PRIME annual accounts for the financial year ended 30th June 2015.

We are entirely reliant on our volunteer tutors and financial support from individuals, groups and charitable trusts. If you are one of our wonderful supporters, thank you. Donations are used to maintain and improve our high levels of education and to allow PRIME to fulfil the many varied opportunities and invitations we receive from our partners around the world.

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Gifts in Kind - £542,344Individual Donations - £99,816Organisations - £39,509Restricted Income - £26,511Conferences - £19,222Book & DVD Sales - £1,975Investment Income - £210Misc Income - £47

Charitable Activities - £620,422Support Costs - £97,072Governance - £4,457Cost of generating income - £650

Financial reviewOur entirely voluntary teams of tutors allow PRIME to deliver our programmes at minimal cost. Once again this year the value in kind of their generosity is significant. Our challenge each year is to raise sufficient income to provide the core support services necessary to carry out these programmes against a background of limited resources and uncertainty of funding.

Nevertheless the charity has, with the aid of sound financial management and the support of both the Trustee Board and volunteers, raised significant financial income for the period July 2014 to June 2015. We are very grateful to all our faithful donors, both individuals and organisations. The accounts for the charity show a surplus of income over expenditure on unrestricted funds of £12,684. This produced a net increase in unrestricted fund reserves to £49,375 as at 30 June 2015.

Principal funding sourcesAn audit of donations during the financial year shows that we are dependent on a small number of individual donors (122, of which 55 donate regularly) and limited, mainly one-off donations from seven charitable organisations and local churches.

During the period from July 2014 to June 2015 PRIME received into restricted funds grants and donations totalling £26,511 for the following projects: Africa Fund (£50), AV/IT Fund (£4,735), Nepal Mental Health Fund (£3,900), Resource Fund (£580), Uganda TEAMS Project Fund (£2,409) the general Support Fund (£14,737) and to the Tom Garrett Memorial Fund (£100).

Reserves policyIt is the policy of the charity that unrestricted funds which have not been designated for a specific use should be maintained at a level equivalent to between three and six months expenditure. The trustees consider that reserves at this level will ensure that, in the event of a significant drop in funding, they will be able to continue the charity’s current activities while consideration is given to ways in which additional funds may be raised. This level of reserves has been maintained throughout the year.

Investment policyAside from retaining a prudent amount in reserves each year most of the charity’s funds are to be spent in the short term so there are few funds for long-term investment. Having considered the options available, the Trustee Board has continued to invest the majority of its reserves in a high interest-bearing deposit account with CAF.

Plans for future periodsThe charity plans continuing the activities outlined above in the forthcoming years subject to satisfactory funding arrangements.

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Statement of trustees' responsibilitiesThe trustees, who are also the directors of PRIME Partnerships in International Medical Education for the purpose of company law, are responsible for preparing the Trustees' Report and the accounts in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the trustees to prepare accounts for each financial year which give a true and fair view of the state of affairs of the charity and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that year.

In preparing these accounts, the trustees are required to:

• select suitable accounting policies and then apply them consistently;

• observe the methods and principles in the Charities SORP;

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

• prepare the accounts on the going concern basis unless it is inappropriate to presume that the charity will continue in operation.

The trustees are responsible for keeping adequate accounting records that disclose with reasonable accuracy at any time the financial position of the charity and enable them to ensure that the accounts comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

This report has been prepared in accordance with the special provisions relating to the small companies within Part 15 of the Companies Act 2006.On behalf of the board of trustees

Dr John Caroe

ChairmanDated: 3rd November 2015

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Independent Examiner’s ReportTo the trustees of PRIME Partnerships in International Medical EducationI report on the accounts of the charity for the year ended 30 June 2015, which are set out on pages 24 to 34.

Respective responsibilities of trustees and examinerThe trustees who are also the directors of PRIME Partnerships in International Medical Education for the purposes of company law, are responsible for the preparation of the accounts. The trustees consider that an audit is not required for this year under section 144(2) of the Charities Act 2011, the 2011 Act, and that an independent examination is needed. The charity's gross income exceeded £250,000 and I am qualified to undertake the examination being a Chartered Accountant.

Having satisfied myself that the charity is not subject to audit under company law and is eligible for independent examination, it is my responsibility to:

i) examine the accounts under section 145 of the 2011 Act;

ii) to follow the procedures laid down in the general Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act; and

iii) to state whether particular matters have come to my attention.

Basis of independent examiner's reportMy examination was carried out in accordance with the general directions given by the Charity Commission. An examination includes a review of the accounting records kept by the charity and a comparison of the accounts presented with those records. It also includes consideration of any unusual items or disclosures in the accounts, and seeking explanations from you as trustees concerning any such matters. The procedures undertaken do not provide all the evidence that would be required in an audit and consequently no opinion is given as to whether the accounts present a ‘true and fair view’ and the report is limited to those matters set out in the statement below.

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Independent examiner's statementIn connection with my examination, no matter has come to my attention:

a) which gives me reasonable cause to believe that in any material respect the requirements:i) to keep accounting records in accordance with section 386 of the Companies Act

2006; andii) to prepare accounts which accord with the accounting records, comply with the

accounting requirements of section 396 of the Companies Act 2006 and with the methods and principles of the Statement of Recommended Practice: Accounting and Reporting by Charities;

have not been met; or

b) to which, in my opinion, attention should be drawn in order to enable a proper understanding of the accounts to be reached.

Sellens French

D A Hargreaves FCASellens FrenchChartered Accountants91-97 Bohemia RoadSt Leonards on SeaEast SussexTN37 6RJ

Dated: .........................

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Statement of Financial ActivitiesIncluding Income and Expenditure AccountFor the year ending 30th June 2015

The Statement of Financial Activities also complies with the requirements for an income and expenditure account under the Companies Act 2006.

Notes Unrestricted Funds (£)

Restricted Funds (£)

Total 2015 (£)

Total 2014 (£)

Incoming Resources

Voluntary Income 681,669 26,511 708,180 599,450

Incoming resources from charitable activities 21,244 - 21,244 13,450

Investment Income 210 - 210 320

Total incoming resources 3 703,123 26,511 729,634 613,220

Resources Expended

Cost of generating funds 650 - 650 1,143

Direct charitable activities 595,813 24,609 620,422 520,586

Support costs 95,390 1,682 97,072 86,260

Governance costs 4,457 - 4,457 3,012

Total resources expended 5 696,310 26,291 722,601 611,001

Net incoming resources before transfers 6,813 220 7,033 2,219

Gross transfers between funds 11 5,871 (5,871) - -

Net income/(expenditure) for the year /Net movement in funds

12,684 (5,651) 7,033 2,219

Fund balances at 1 July 2014 36,691 25,108 61,799 59,580

Fund balances at 30 June 2015 11 49,375 19,457 68,832 61,799

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Balance SheetAs at June 2015

The company is entitled to the exemption from the audit requirement contained in section 477 of the Companies Act 2006, for the year ended 30 June 2015. Members have not required the company to obtain an audit, since no member of the company has deposited a notice, pursuant to section 476, requiring an audit of these accounts under the requirements of the Companies Act 2006.The directors acknowledge their responsibilities for ensuring that the company keeps accounting records which comply with section 386 of the Act and for preparing accounts which give a true and fair view of the state of affairs of the company as at the end of the financial year and of its incoming resources and application of resources, including its income and expenditure, for the financial year in accordance with the requirements of sections 394 and 395 and which otherwise comply with the requirements of the Companies Act 2006 relating to accounts, so far as applicable to the company.These accounts have been prepared in accordance with the special provisions relating to small companies within Part 15 of the Companies Act 2006.The accounts were approved by the Board on 3rd November 2015.

2015 2014

Notes £ £ £ £

Fixed assets

Tangible assets 8 5,493 3,684

Current assets

Stocks 1,754 1,185

Debtors 9 6,169 7,772

Cash at bank and in hand 63,889 55,230

71,812 64,187

Creditors: amounts falling due within one year

10 (8,473) (6,072)

Net current assets 63,339 58,115

Total assets less current liabilities 68,832 61,799

Income Funds

Restricted funds 11 19,457 25,108

Unrestricted funds 11 49,375 36,691

68,832 61,799

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Dr John Caroe Mr John Caladine FCCA

Chair Treasurer

Notes to the Accounts1 Accounting policies1.1 Basis of preparation The accounts have been prepared under the historical cost convention.The accounts have been prepared in accordance with applicable accounting standards, the Statement of Recommended Practice, "Accounting and Reporting by Charities", issued in March 2005 and the Companies Act 2006. 1.2 Incoming resourcesAll incoming resources are included on the Statement of Financial Activities when the charity is legally entitled to the income and the amount can be quantified with reasonable accuracy.Voluntary income is received by way of grants, donations and gifts and is included in full in the Statement of Financial Activities when receivable. Grants, where entitlement is not conditional on the delivery of a specific performance by the charity, are recognised when the charity becomes unconditionally entitled to the grant.Donated services and facilities are included at the value to the charity where this can be quantified. Income from investments is included in the year in which it is receivable.1.3 Resources expendedExpenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources.Costs of generating funds comprise the costs associated with attracting voluntary income.Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries.Support costs comprise the core office facilities necessary to support the charity’s activities.Governance costs include those incurred in the governance of the charity and its assets and are primarily associated with financing and with its constitutional and statutory requirements.1.4 Tangible fixed assets and depreciationTangible fixed assets are stated at cost, less depreciation. Depreciation is provided at rates calculated to write off the cost less estimated residual value of each asset over its expected useful life, as follows:

Fixtures, fittings and equipment 25% straight lineComputer equipment 33% straight line

Fixtures and equipment costing below £500 are not capitalised but written off to the Statement of Financial Activities.1.5 StockStock is valued at the lower of cost and net realisable value, after making due allowance for obsolete and slow moving items.1.6 TaxationIt is considered that the charity is exempt from corporation tax on its charitable activities.1.7 Hire purchase and leasing commitmentsRentals paid under operating leases are charged to the Statement of Financial Activities on a straight line basis over the period of the lease. 1.8 Unrestricted fundsUnrestricted funds include donations and other incoming resources receivable or generated for the objects of the Charity without further specified purpose and are available as general funds. 1.9 Restricted fundsRestricted funds are to be used for specific purposes laid down by the donor. Expenditure which meets these criteria is charged to the fund together with the appropriate management and support costs.

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2 FundsUnrestricted fundsThe general fund is the umbrella fund encompassing all the activities of the charity.

Designated fundsFuture development fundThis represents a gift to the charity which is unrestricted to be allocated to find ways of projecting the work of the charity to produce new sources of income.

Restricted fundsThe Restricted funds of the charity where monies have been given for specific purposes are :-

Africa development fundFunds put aside by PRIME trustees to support development programmes in Africa.Albania fundGrant awarded for the specific purpose of supporting palliative care development in Albania.Armenia fundFunds donated for the specific purpose of supporting PRIME's disaster medicine programme in Armenia.Armenia St Sarkis fundGrant awarded for the specific purpose of supporting palliative care development in Armenia. The St Sarkis Trust subsequently gave permission for these funds to be used for any PRIME activities in Armenia.AV/IT fundGrant awarded for the specific purpose of upgrading and expanding PRIME’s audio visual and IT equipment.Church leader fundGrant awarded for the specific purpose of supporting church leader development programmes.Developing Mental Health fundGrant awarded for the specific purpose of supporting the development of a mental health periodical to replace the Developing Mental Health Journal.Ethiopia distance learning fundGrant awarded for the specific purpose of developing a distance learning programme and materials for use in Ethiopia.Nepal mental health fundFunds donated to support the KOSHISH mental health project in Kathmandu, Nepal.Resource fundFunds donated to enable PRIME to distribute PRIME materials, text books and DVDs free of charge to individuals and organisations unable to fund the purchase of these materials. This fund includes the remainder of the David Chaput de Saintonge support fund by kind permission of the donors.Support fundFunds donated for the specific purpose of supporting individuals from less wealthy countries to attend PRIME conference or teaching programmes who would otherwise be unable to attend and to provide general financial support for conference and training programmes.Syria fundFunds donated to support a PRIME partner living and working in Syria.Tom Garrett memorial fundFunds donated in memory of Dr Tom Garrett for the specific purpose of supporting PRIME’s work in the particular areas of Africa in which Tom worked, primarily in West Africa.Uganda TEAMS project fundGrants awarded to support the PRIME project in Gulu, Uganda in association with TEAMS.

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3 Incoming resourcesUnrestricted

funds£

Restricted funds

£

Total2015

£

Total2014

£Voluntary incomeRegular donations and gifts 36,825 22,913 59,738 52,349Other donations and gifts 19,509 3,598 23,107 38,036

Grants receivable 30,000 - 30,000 10,000Donation of reimbursed expenses 33,203 - 33,203 19,232Gifts in kind (see note 4) 542,344 - 542,344 464,997

Gift aid recoverable 19,788 - 19,788 14,836

681,669 26,511 708,180 599,450

Incoming resources from charitable activities

Annual conferences 18,462 - 18,462 8,901Other events income 760 - 760 1,467Books and DVD sales 1,975 - 1,975 2,656

Miscellaneous income 47 - 47 426

21,244 - 21,244 13,450

Investment incomeInterest recieved 210 - 210 320

Total incoming resources 703,123 26,511 729,634 613,220

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4 Gifts in kind

Teaching is calculated using the Royal College of General Practitioners teaching rate of £500 per day for 595 days of teaching. Travel preparation and other on the ground costs are not included.Accommodation, local travel and meals are valued at EU per diem rates. Travel, flights and other costs charged by PRIME teachers are shown under Teaching / Education programme of activities, of which £33,203 has been gifted back to PRIME as shown in note 3.Voluntary staff time represents the notional equivalent salary which would have been paid to the voluntary services of our volunteer Chief Executive Officer and volunteer Finance Officer. They have been valued at industry averages for these roles.Professional services represents the notional cost of accounting services provided free of charge.There were also unknown further expenses incurred by PRIME tutors for which claims were never made.

2015 2014

£ £

Teaching 331,350 273,000

Accommodation, local travel and meals 172,882 191,997

Voluntary staff time 34,430 -

Professional services 3,682 -

542,344 464,997

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5 Resources expendedUnrestricted

funds£

Restricted funds

£

Total2015

£

Total2014

£Cost of generating funds

Fundraising charges 650 - 650 1,143

650 - 650 1,143

Direct charitable activities

Teaching / Education programme of activities 32,771 24,609 57,380 46,221

Annual conference 16,532 - 16,532 6,970

Books and DVD courses 2,436 - 2,436 1,646

Other day courses UK 1,730 - 1,730 752

Donated services (see note 4) 542,344 - 542,344 464,997

595,813 24,609 620,422 520,586

Support costs

Salaries 79,694 - 79,694 68,197

Rent and rates 8,500 - 8,500 8,682

Office consumables 2,650 - 2,650 2,706

Insurance 859 - 859 1,075

Computer and internet costs 937 - 937 1,261

Telephone 1,024 - 1,024 713

Travel costs non-teaching 386 - 386 2,535

Depreciation of office equipment 459 1,682 2,141 550

Executive Committee meeting costs 387 - 387 396

Subscriptions 254 - 254 145

Recruitment 240 - 240 -

95,390 1,682 97,072 86,260

Governance costs

Independent Examination (2014 Audit Fee) 1,340 - 1,340 2,280

Bookkeeping and payroll 384 - 384 40

Bank charges 357 - 357 85

Trustee meeting costs 2,376 - 2,376 607

4,457 - 4,457 3,012

Total resources expended 696,310 26,291 722,601 611,001

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6 Trustees and related party transactionsNone of the trustees (or any persons connected with them) received any remuneration during the year, but were reimbursed expenses of £4,150 travelling expenses (2014: £3,429) to cover mainly travel costs incurred whilst undertaking duties on behalf of the charity.

7 EmployeesNumber of employeesThe average monthly number of employees during the year was:

The trust is grateful for the 82 volunteer staff who provided help in so many various ways.There were no employees whose annual remuneration was £60,000 or more.

2015 2014

Number Number

Support staff 3 1.5

Direct charitable work 1 1

4 2.5

Employment costs 2015 2014

£ £

Wages and salaries 76,914 62,749

Social security costs 2,780 5,448

79,694 68,197

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8. Tangible fixed assets

Fixtures fittings and equipment

£

Cost

At 1 July 2014 11,780

Additions 3,950

At 30 June 2015 15,730

Depreciation

At 1 July 2014 8,096

Charge for the year 2,141

At 30 June 2015 10,237

Net book value

At 30 June 2015 5,493

At 30 June 2014 3,684

9 Debtors2015 2014

£ £

Gift aid debtor 3,832 6,501

Other debtors - 199

Prepayments 2,337 1,072

6,169 7,772

10 Creditors: amounts falling due within one year2015 2014

£ £

Taxes and social security costs 1,493 1,698

Directors loan account 1,500 1,500

Other creditors 4,080 75

Accruals 1,400 2,799

8,473 6,072

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11 Movement in fundsThe income funds of the charity include restricted funds comprising the following unexpended balances of donations and grants held on trust for specific purposes:

Transfers from Restricted Funds to the General Fund represent agreed administration and management charges.

Balance at1 July 2014

£

Incoming resources

£

Resources expended

£Transfers

£Balance at

30 June 2015£

Unrestricted funds

General fund 36,691 655,011 (658,198) 5,871 39,375

Designated funds

Future development fund - 10,000 - - 10,000

Restricted fundsAfrica development fund 598 50 - - 648

Albania fund 163 - - - 163

Armenia fund 505 - - - 505

Armenia St Sarkis fund 5,093 - (1,781) - 3,312

AV/IT fund 5,114 4,735 (2,789) (1,420) 5,640

Church leader fund 500 - (355) - 145

Developing Mental Health fund 2,000 - (265) - 1,735

Ethiopia distance learning fund 7,627 - (1,496) - 6,131

Nepal mental health fund - 3,900 (3,900) - -

Resource fund 546 580 (462) - 664

Support fund 113 14,737 (10,285) (4,421) 144

Syria fund 300 - - 300

Tom Garrett Memorial fund 2,549 100 (2,549) (30) 70

Uganda TEAMS project fund - 2,409 (2,409) - -

25,108 26,511 (26,291) (5,871) 19,457

Total funds 61,799 729,634 (722,601) - 68,832

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12 Analysis of net assets between fundsUnrestricted

funds£

Restricted funds

£

Total£

Funds balances at 30 June 2015 are represented by:

Tangible fixed assets 399 5,094 5,493

Current assets 57,449 14,363 71,812

Creditors: amounts falling due within one year (8,473) - (8,473)

49,375 19,457 68,832

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PRIME PARTNERSHIPS IN INTERNATIONAL MEDICAL EDUCATION Innovation Centre, Highfield Drive. St Leonards on Sea, East Sussex TN38 9UH United Kingdom

Telephone: 0044 (0) 1424 858258 Email: admin@prime-international.org Website: www.prime-international.org

UK Registered Charity Number: 1111521 UK Company Registration Number: 05492101

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