Key achievements - information

• publishing a range of 25 leaflets, including 7 bi-lingual versions of our most widely-read leaflet, all printed in clear typeface and also available in large print;
• completing a project to research the need for materials in additional languages; producing a bilingual Polish/English leaflet as a result, with information in Chinese and Somali to be considered at a later stage;
• publication and promotion of two versions of our most widely -read leaflet, one for people with learning disabilities or reading difficulties and one for profoundly deaf people, especially those whose first language is British Sign Language;
• making all leaflets available on our website, free to read and download;
• over 61,000 leaflets sent by request to hospitals, health centres and individuals – a seven percent increase on the previous year
• recording a further 2,300 visits per month to the leaflet pages on our website; we are now aware that a flaw in the system caused these figures to be under-reported and this has been corrected for 2008/09.
• continuing development of The Miscarriage Association website, recording an average of 16,477 visits per month – an increase of five percent on the previous year.

Key achievements - awareness

• maintaining a high public profile for the charity and for the subject of pregnancy loss, with 72 requests from the broadcast and printed media for expert comment, background information and case studies;
• completion of a short film Acknowledging Pregnancy Loss, supported by the Media Trust, for public launch in April 2008;
• one of four national charities chosen by artist Charlotte Latham to be part of and benefit from an interactive art exhibition Make Your Mark With Art, resulting in the artwork Hands of Hope;
• collaborative work with other baby-loss charities to raise awareness of pregnancy and baby loss through the UK–wide Babyloss Awareness Week;
• an excellent internet profile, with links from other websites, so that we feature highly on the largest search engines.

Key achievements - good practice

• presenting our research on risk factors for miscarriage to the European Society for Human Reproduction and Embryology’s winter symposium in Brussels; and running tailored training sessions for two NHS hospitals on caring for patients with pregnancy loss;
• producing a tutorial on Breaking Bad News for the Royal College of Obstetrics and Gynaecology’s on-line training and tutorial system, in collaboration with Judith Schott;
• acting as advisors on five research proposals; advising on three guidance documents from the National Institute for Clinical Excellence and two patient information leaflets; and providing input for two sets of professional guidelines and the Healthcare Commission review of maternity and pregnancy care;
• working with the Royal College of Nursing and the Institute of Cemetery and Crematorium Management to revise and update guidelines on the sensitive disposal of fetal remains;
• producing a distance learning pack for service users who want to represent the patient perspective on pregnancy loss in local NHS Trusts;
• active links with other pregnancy/maternity charities, the Association of Early Pregnancy Units and the Royal Colleges of Nursing and of Obstetricians and Gynaecologists.

Key achievements - organisation

• regular review of the charity’s accessibility for people with disabilities;
• a rolling programme to monitor and evaluate the charity’s services, responsive to user feedback and implementing recommended changes where possible;
• increasing Board membership from seven to nine Trustees through a positive recruitment campaign;
• starting the process of registering the charity with the Office of the Scottish Charity Regulator to allow continuing work in Scotland; registration was completed in August 2008 .

• maintaining a high-quality helpline service five days a week;
• further development of volunteer recruitment, training and support, with a continuing emphasis on distance learning;
• publishing and promoting two new leaflets: one for people who are considering stopping their attempts to have a baby and another, for employers, on miscarriage and the workplace;
• continuing to assess and, where possible, address gaps in accessibility of services, for reasons of language, culture, disability or other special needs;
• researching additional ways of increasing access to services, such as text messaging and other internet facilities and forums;
• continuing work with the Royal College of Nursing and the Institute of Cemetery and Crematorium Management to revise and then launch joint national guidelines on the sensitive disposal of fetal remains;
• a complete review and updating of the charity’s image, including printed and online text and design;
• a project to raise the profile of pregnancy loss and the charity’s services with professionals working in primary care;
• drafting a plan to develop targeted in-house training in hospitals and in primary care;
• collaborative work with the relevant professional organisations, government departments, hospitals and charities to improve care for couples who experience pregnancy loss;
• collaboration with other charities to raise awareness of pregnancy and baby loss.

The Miscarriage Association’s accounts have been prepared in accordance with the Statement of Recommended Practice for Charity Accounting issued by the Charity Commissioners (revised 2005).

This necessitates the following practice: -

• income has been defined in terms of Restricted Funds, received for specific purposes, and General Funds, which may be freely used for the purpose of The Association. There is a further subdivision between income from generated funds, including grants and donations; income from activities to generate funds, such as fundraising events; and income from activities to further the charity’s objects, such as leaflet sales and conferences.
• expenditure is categorised into the cost of generating funds, charitable expenditure in furtherance of the charity’s objects, and governance costs. These are further subdivided to distinguish between the costs of direct activity and the support costs relating to those activities.
• the Association had 29 branches (i.e. support groups) during the year. Branch income and expenditure are incorporated in The Association’s accounts but it should be noted that these funds are held by and for the use of those branches alone and are classed as Restricted Funds. Fourteen branches held no funds at all during the year. Donations from branches to The Association’s General Fund are entirely at the discretion of those branches .

The Miscarriage Association continued its policy of managing its resources wisely in the year ended 31 March 2008, enabling it to maintain a high level of service provision and to make provision for the future.

Although we have seen a small drop in total income and a slight increase in overall expenditure, we achieved a surplus of general (unrestricted) funds for the year. This has enabled us to increase our General Reserve Fund and to designate some of these Reserves for specific projects over the next three years.

During the year we noted changes in both income and expenditure levels and trends compared with 2006/07. We achieved a 27% increase in income from sales of leaflets to hospitals and clinics, despite NHS financial constraints and also noted increased income from members’ donations. Income from fundraising activities, particularly the London Marathon, remained steady and as ever, all such activities carried the added benefit of raising the charity’s profile. Income from government grants and from external donations by individuals, companies and trusts dropped by 40%. This may reflect the difficult economic climate and changing government priorities as well as increasing competition for charitable funds.

We continued to maximise the value of all our funds by proactive management of a mix of instant access and high interest savings accounts, resulting in increased investment income. The combination of earned, investment and fundraising income constituted 71% of The Miscarriage Association’s general (unrestricted) income for the year and these are clearly key areas to focus on for future growth.

While general (unrestricted) income decreased by 5%, we maintained general (unrestricted) expenditure at 2006/07 levels without compromising the quality of our services. This was achieved by tight control on spending, including not filling a part -time administrative post. This careful management resulted in the surplus of general funds for the year.

Restricted income for three new projects was expended during the year, and we also completed another four projects, using restricted funds carried forward from the previous year and resulting in the overall deficit in project funding. Branch income was significantly higher than in previous years, partly due to local fundraising activity. This was offset in part by increased branch expenditure, especially the costs of fundraising. Branch funds, incorporated into these accounts, are held and used by those branches alone.

As always the generously donated services of all of our volunteers enable us to keep the costs of providing direct charitable support relatively low – an estimated saving of 43% of service provision and support costs. We greatly appreciate the financial and moral support prov provided by our donors, members and friends. We are fortunate too in the dedication of staff and Trustees who manage the Association’s limited resources with great care.

The Miscarriage Association continues to develop its services in response to both continuing and changing needs for support and information in the sensitive area of pregnancy loss. We need to be equally responsive to changing and more challenging financial climates. We have done well to build up our general fund reserve to protect The Micarriage Association from a significant drop in income but this is not a sustainable option for maintaining and developing our services in the long term. We need to continue to work hard to increase earned, investment and fundraising income in order to ensure a healthy future.

The directors of The Miscarriage Association are referred to in the company’s Memorandum and Articles of Association and in this report as its Trustees. The Board of Trustees must comprise no fewer than four and no more than twelve people, all of whom must be members of The Miscarriage Association. Members of the Board of Trustees are elected at the Annual General Meeting and may serve for a period of up to three years. At the Annual General Meeting at least one third of the Trustees must retire although they may seek re-election.

The Board of Trustees met five times and held four telephone conferences in the year ended 31 March 2008. Members of the Board of Trustees during the period to the date of this report were as listed below:

B Hepworth-Jones (Chair)
A de Verteuil (Vice Chair)
S McPherson (Vice Chair)
P Kerry (Hon Treasurer)
K Addison (Appointed October 2007)
B Boyle (Appointed January 2008)
S Gillham (Appointed October 2007)
C Hobro (Appointed February 2008)
C Moulder (Appointed May 2008)
A Walton
C Williams-Racz (Resigned January 2008)
P Wright (Resigned October 2007)

No Trustee held any beneficial interest in the charity during the period under review.

The Trustees conduct an annual risk assessment for The Miscarriage Association, reviewing potential areas of risk and, where appropriate, developing and/or strengthening policies and systems to mitigate against risks. Areas reviewed included financial, strategic, operational, environmental and
regulatory.

During the year, volunteers continued to make a significant contribution to the work of The Miscarriage Association. A UK-wide network of 102 support volunteers, with personal experience of pregnancy loss, provided telephone support and ran support groups. Sixty of these volunteers provided specialist support for those with a particular experience of loss, such as late miscarriage, ectopic pregnancy, or loss after fertility treatment, and 24 provided support via an out of hours service when the helpline was not staffed. A team of nine regional co-ordinators trained, selected and mentored new and established support volunteers. Fifty-two volunteers attended training days and/or completed distance-learning packs during the year .

Other volunteers provided media interviews, reviewed books for the newsletter, provided the user perspective to health and social care professionals, fundraised, edited the newsletter and managed the website. All Trustees are, by definition, volunteers. The Miscarriage Association estimates that the value of support volunteers and regional co-ordinators in 2007/08 (based on the median national wage) was £55,425.

The Miscarriage Association continued to raise funds from a mix of sources, though with notable differences from the previous year. Government funding, donations and grants from companies and trusts made up only 29% of income, reflecting the difficult economic climate and changing government priorities as well as increasing competition for static or decreasing charitable funds. Overall income was down by seven per cent.

On the other hand, our drive to increase more sustainable funding saw positive results. We succeeded in increasing earned income from fees, sales and bank interest by 13%, so that it comprised 38% of total income during the year. Fundraising activities, notably the London Marathon, continued to be a sound source of funds, generating 27% of overall income. We will work to increase income from these sources in future years.

We actively encouraged tax-effective giving, whether through payroll giving schemes or through donations and sponsorship. The resulting Gift Aid revenue increased by £4,500 on the previous year and constituted 7% of overall income.

A resolution to re-appoint Mazars LLP as auditors will be proposed at the forthcoming annual general meeting.

Approved by the Trustees on 6 September 2008
and signed on their behalf by

Chair: B Hepworth-Jones