Chair’s Report 2023

Introduction

The Trustees of Duchy Health Charity have worked exceptionally hard and with great enthusiasm to fulfil their remit. Every Board member has given their time willingly and shown admirable creativity in trying to address issues and problem solve. As Chair, it continues to be my privilege to lead the Board but acknowledge the overwhelming sense of partnership amongst Trustees and, indeed followership, as appropriate.

Trustees who have already or will be standing down are: James Robinson, Tim Guy, Mary Vyvyan and Graham Murdoch. All have given magnificent service to the Charity and can point to ways in which health and wellbeing of the people of Cornwall has been improved as a result of what they have done.

Our President, Michael Galsworthy CVO CBE DL has worked tirelessly as President and previously, as Chair to further the activities of the Charity, raise its profile and enable it to punch way above its weight across Cornwall and nationally. Through gentle encouragement, clarity of thinking and a relentless sense of purpose, Michael has guided the Board for many years. He has also given the Charity opportunities to tell its story at, for example, the College of Medicine and Goldsmiths. We are very grateful and will miss his wise words and dry sense of humour.

It gives me great pleasure to submit this report on the recent activities of the Duchy Health Charity (DHC). It is true to say that Duchy Health has, post pandemic, reflected upon its activities, reassessed its impact upon Cornwall and considered whether it needed to change its direction of travel.

As a result, the DHC has re-invigorated its efforts to:

• Prevent disease and illness by encouraging health and wellbeing;
• Work in partnership with other organisations and institutions across Cornwall;
• Facilitate change in health and wellbeing across Cornwall.

Since its inception, DHC has awarded over £9 million. In the year up to the end of March 2023, it had awarded over £200 thousand.

For five years now, DHC has brought ideas of social prescribing to Cornwall, firstly through a series of conferences and latterly through supporting direct work in schools.

As an example of collaborative working, Duchy Health Charity worked with Cornwall Community Foundation to award grants to support people through the cost-of-living crisis in particular. This recognised the importance of housing and heating in the prevention of ill-health. Very small grants went to individuals for heating, food and clothing; larger ones went to organisations such as the Samaritans and Barnado’s.

A significant change to the working of the Charity this year has been the appointment of an Administrator. This has been most successful as our chosen candidate is skilled, resourceful and conscientious. In terms of Governance and the day-to-day work, the Charity has never been in such a strong position.

This report will cover the Charity’s organisational health; the changes of personnel and, most importantly, the activities of the Charity to fulfil its purpose as noted above. It covers the period between October 2022 and October 2023 which is the interval between the Charity’s AGMs and does, therefore, relate to parts of two financial years.

Activities

Grants

The Grants Committee is the focus for the Charity’s work; it is Chaired very efficiently and with great expertise by Sally-Jane Coode. The largest award for a number of years has been given for a new school-based Integrated Health Centre (IHC) for Humphry Davy School (HDS), Penzance. It was decided, on the basis of data, that a grant of £365k be given for this purpose (see below).

The total awarded in the financial year 2022-2023 was £204k. So far in the financial year 2023-24, excluding the award to HDS, the Charity has awarded £134,233 to organisations and charities such as:

• CHAOS Cornwall £30,000
• Bosence Farm Community £20,000
• Trelya £20,000
• Brook Young People £15,000
• Age UK Cornwall £7,550
• Cornwall Accessible Activities Programme £5,000

Social Prescribing

The national scheme for social prescribing was rolled out through GP practices and most GPs or Primary Care Networks, appointed a person to set up non-medical routes to improving health and well-being. However, most were appointed to work with adults; few have addressed the issue of social prescribing for children and young people. Arguably, children and young people should be the focus in order to prevent ill-health in later life; in the main, this is the approach that Duchy Health Charity has taken although there is an intent to focus upon intergenerational work when the opportunity arises.

Working with the CHAOS (Community Helping all of Society) Group, DHC decided to support a person to work as a young people’s social prescriber in two secondary schools in Cornwall. This has been very successful and is to be extended over the next five years. In each school, the social prescriber has a caseload of approximately 25 students. They work with the student, their families and the schools to establish a programme of support which includes introductions to activities such as boxing, cold water swimming and sound baths but maybe as simple as taking them for a haircut! This project is part of national research being run by Dr Michael Dixon.

DHC has recently decided to extend social prescribing for children and young people over the next 5 years, linking it where possible to the Integrated Health Centres already in 6, soon to be 7, secondary schools.

The first issue to be addressed was the definition of what a social prescriber does or should do. It became clear that while there are some basic ‘threads’, the role principally becomes what is the most appropriate programme for the student, paying due attention to retaining ‘professional’ boundaries.

The lessons learned over the last year have been shared regularly with the DHC Board and the impressive changes that have resulted are informing a strategy for future provision.

Integrated Health and Wellbeing Centre at Humphry Davy School, Penzance

It will be remembered that Duchy Health Charity funded the development of three Integrated Health Centres (IHCs) on secondary school sites in 2009/10. These three IHCs were rigorously evaluated, and the report was widely shared in peer reviewed papers and published. As a result, three more were developed, funded by the NHS. Again they were evaluated, and the results published after being peer reviewed.

A feature of all six IHCs to date is that they have developed to reflect the needs of their community. The services they deliver are as a result of discussion with the schools’ students as well as the community itself.

DHC took the decision two years ago that they wished to support another centre. The choice of where it should be related to the needs of the school and community as indicated by the data (levels of deprivation for example); the ability of the school to do the work needed at the school level (engagement with the students, staffing and resource implications etc) and an overwhelming enthusiasm of the school to support an IHC.

Having asked advice of the secondary headteachers and Cornwall Council and considered all the data available, the Board decided to offer an IHC to Humphry Davy School. The Board also held a large meeting of all interested services, including Public Health, Primary Care and representatives of the school’s Governing Body and Cornwall Council. Further discussions were held with elected councillors. DHC is making links with organisations such as Barnado’s to further the project’s reach and sustainability within the community (see Buddy scheme below).

At the time of writing, the DHC Board has voted to spend £365k to establish the centre at Humphry Day School. The school has undertaken to support the resource costs – staffing and running costs for example. As with the previous development of IHCs, the Board is planning to evaluate the implementation and first three years, at least, of the IHC at Humphry Davy.

The centre at Humphry Davy is expected to open in January 2024.

It is of note that there has been a new centre on a school site in Gateshead, NHS funded, which is modelled upon our initiatives in Cornwall. We took part in a number of meetings over winter 2022/23 to enable the plans to be developed, using our experience.

The Buddy Scheme

Related to the IHC above, Trustees have developed an idea for students and children to become a Buddy for other students. The definition of what such a role may be and how it will work are to be decided through the implementation discussions to be led by Barnado’s working with the students. If a model can be developed that is sustainable and easily managed, it will be expanded to other schools and organisations.

Awards

For a number of years, Duchy Health Charity has given funding to local University and Further Education College students to recognise special achievement; and to support students who may need additional financial assistance to help them maintain their studies but who are not eligible for the University bursary schemes, by way of an ‘enablement award – the Mary Grigg Award – named after a former Trustee.

For various reasons the granting of these awards has not been easy and as a result the Trustees are reviewing the awards criteria and how they might be administered in the future.

Mermaid

The Mermaid Centre which is the largest centre for breast cancer in the South West has been supported by the Duchy Health Charity over many years. Our current President’s family was instrumental in raising funds to set it up for example. Over recent years and at the request of Mermaid’s Trustees, DHC has taken over the Trusteeship of the funds that remained and is managing them to achieve the original intention of providing a suitable building to support the work that Mermaid undertakes. Sadly, Mermaid will not move to become part of the planned Women’s and Children’s hospital which is scheduled to open in 2028.

Unfortunately and despite a series of meetings with Royal Cornwall Hospital Trust, it has not proved possible to arrive at an agreed plan for Mermaid’s development as yet. DHC Trustees (Finance Committee) decided to invest the funds until such time as plans emerge.

Partnership with Cornwall Community Foundation (CCF)

As the cost-of-living crisis emerged nationally, it became clear to DHC Trustees that there would be greater potential for making a significant change across Cornwall by collaborating with CCF. After discussions with CCF about how this could be achieved and what we were to focus upon, Trustees donated £50k to CCF. Reports on how this was spent were provided. We hope to continue this relationship.

Organisational health of Duchy Health Charity

After a period of reflection following external review which was reported last year, this year (2022-2023) has been concerned with development and implementation. The list below gives a brief outline of the work undertaken and achieved to improve governance and compliance:

• All meetings are available as hybrid (a mix of face to face and online);
• Development of a new, interactive website with website traffic analysis;
• Safeguarding training for all Board members and Safeguarding lead appointed;
• Virtual Governance and information noticeboard for Trustees launched;
• Terms of Reference developed and agreed for all sub-groups and Grant committee;
• Stimulation of creative ideas and open-ended discussion within small groups of Trustees, feeding into the committee structure and the Board;
• Introduction of the Charity Excellence Framework which identifies governance priorities for the Board;
• Outline risk matrix developed;
• Cyber security risk assessment conducted (LOW), followed by identification of priorities;
• Reviewed and update policies: safeguarding, data protection and privacy; investment.
  
  

Additionally, the Board has worked to raise the profile of the Charity through joining networking organisations National Council of Voluntary Organisations (NCVO); Cornwall Voluntary Sector Forum (Cornwall VSF) and present at the Transformation Cornwall Meet the Funders event (Truro) and the Rotary Club (Penzance).

The Grants Committee is the focal point of our activity. This year the Committee, under its Chair Sally-Jane Coode, has worked hard to:

• Develop the grant awarding criteria to support the efficiency and effectiveness of the awards;
• Improve processes for the recording and communication of all grants;
• Improve awareness of the impact of grant awards through the introduction of a project reporting template;
• Ensure that bids for funding are dealt with at an appropriate level, by email at the lower levels, and give timely advice and/or feedback.
  
  

Trustees

The Board has had an informal policy for succession planning over many years. Like many Charities, we have found it difficult to recruit new Trustees, especially since Covid. However we are delighted that recently, we have been successful in recruiting four new Trustees and a new President.

From our Board meeting of 30 October 2023, our new Trustees will be:

• Professor Tony Woolf, retired consultant rheumatologist;
• Ms Olivia Miller, solicitor at Stephen Scown and specialist in Charity law;
• Mrs Gaynor Coley, experienced Trustee of a number of Charities and ex MD of the Eden Project;
• Ms Jenny Taylor, Public Health Consultant, Cornwall.

Our new President will be Katharine, Lady Falmouth who has great experience of charitable work, particularly related to many aspects of health and wellbeing. She worked hard with Cornwall Foundation NHS Trust to raise £500k towards the Level 4 provision for mental health (Sowenna) for children and young people. She has also been involved in Promoting Effective Parenting – an organisation which no longer exists; Children’s Hospice South West (CHSW) and the Cornwall Women’s Centre.