The Annual Report presents the key activities, statistics and achievements of both Services during a challenging year that was significantly impacted by the Covid-19 pandemic. For people with disabilities, the Covid crisis, its restrictions and the subsequent disruptions to healthcare services, proved particularly difficult. They faced many traumatising and life changing experiences and were among the worst affected groups in Irish society. The pandemic impacted on NAS services too, particularly during the first lockdown. Face-to-face meetings were limited with many service providers focused on the safety of their residents and therefore unable to engage properly with NAS advocates. It was also a demanding period for the Patient Advocacy Service, provided by NAS and commissioned by the Department of Health. The Service provides support to people who wish to make a complaint to the HSE about their care in a HSE-funded public acute hospital or HSE-operated nursing home. The impact of the Covid virus meant that some hospital patients were unable to communicate with their loved ones, families were unable to visit, and medical procedures were delayed. Both Services also dealt with the challenges of working from home throughout most of 2020. The pandemic meant it was impossible for staff to continue to work in their offices. Despite these issues, NAS and the Patient Advocacy Service responded adeptly and effectively to the crisis, adapting their Services and way of working, and embracing new technologies such as video calls and text messaging. They continued to operate as normal throughout the pandemic, providing high quality, professional advocacy support to people across Ireland and supporting them to have their voices heard. In 2020, NAS provided advocacy support in over 3,750 pieces of work, continuing the trend which has seen our casework increase by over 50% since 2015. The Patient Advocacy Service also provided support in over 530 cases in 2020, its first full year of operation.