2023-09-30-accounts

The British Association of Plastic, Reconstructive and Aesthetic Surgeons Trustees Annual Report and Financial Statements for the year ended 30 September 2023

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Table of Contents

Table of Contents
President’s foreword	3
About BAPRAS	5
Our achievements	6
Overview of the progress made against plans	7
In summary	8
Our activities	10
Events and training	11
Special Interest and Advisory Groups	16
Total educated at BAPRAS events	17
BAPRAS education	18
Grants and bursaries	21
Infuencing policy	23
Support for other organisations	25
2022 Membership Plans for the future Financial review Statement of trustees responsibility Independent auditors report Statements of fnancial activities	27 29 30 35 37 44
2023 Reference and administration detail 58

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Presidents’ foreword

The trustees present their report and the audited financial statements for the year ended 30 September 2023. Reference and administrative information set out on page 54 forms part of this report. The financial statements comply with current statutory requirements, the memorandum and articles of association and the Statement of Recommended Practice - Accounting and Reporting by Charities: SORP applicable to charities preparing their accounts in accordance with FRS 102.

This trustees’ annual report includes a directors’ report as required by company law. In 2022 and 2023, much emphasis has been placed on supporting our membership and the return to ‘normal’ following the COVID pandemic. We have returned to plans to reinvigorate our annual congress, and were pleased for all our events to return to an ‘in person’ setting, kicking off with a successful congress in Nottingham in late 2022, which was attended by 437 delegates. For future years, a planned injection of additional sponsorship from industry supporters will, we are sure, see the number of plastic surgery consultants and trainees attending congress rise even further, enabling us to better educate the plastic surgery community with the latest information, research and guidance.

We continued to develop the work of our Special Interest and Advisory Groups, which now number seventeen, covering a wide range of areas of sub-specialty interest. We will continue to convene additional groups as the need arises, and the groups have been supporting all areas of BAPRAS’ work in education, research and policy influencing. We were also delighted that our open access journal, JPRAS Open, received its first impact factor this year and look forward to seeing the title continue to grow in stature.

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Our National Teaching Programme saw the commencement of its second series in Spring of 2023, which again has been well attended. Alongside eLPRAS, which continues to grow, with an ever- increasing amount of new content becoming available, our educational offering for healthcare professionals at all stages of their career continues to thrive.

In response to members’ requests, a mentoring scheme was launched in late 2022, which has paired seven experienced consultant mentors with mentees in their first few years of consultant practice. We will be expanding the scheme next year to include trainees approaching the exit exam and hope the scheme will go from strength to strength. In addition, supporting our members has been high on the agenda: as well as dedicated time being given at congress and in webinars throughout the year, to combating issues around bullying and harassment, we have also produced a suite of website resources to support anyone struggling and to encourage conversations around how we can support each other.

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Ruth Waters, President, 2022

Maniram Ragbir, President, 2023

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About BAPRAS

Charitable Purposes

BAPRAS has been established to fulfil the following purposes:

To relieve sickness and to protect and preserve public health by the promotion and development of plastic surgery

To advance education in the field of plastic surgery.

Public Benefit

In accordance with our charitable objectives, BAPRAS strives to improve patient care and to improve the quality of medical and surgical care for the benefit of patients within the specialty of plastic, reconstructive and aesthetic surgery. The Charity’s ultimate beneficiaries are therefore patients, and benefits to patients are provided through continuing dissemination of information in relation to the specialty by the Association

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Our achievements

In order to fulfil our charitable purposes, our principle activities surround the provision of education opportunities and information for anyone with an interest in plastic surgery.

These activities include a range of plastic surgery events and training courses for medical professionals at all stages of their careers; publication of our peer-reviewed journal, JPRAS; an e-learning offering, e-LPRAS; provision of grants and bursaries for further study or to fund research in plastic surgery; dissemination of information and guidance on plastic surgery for members of the public; and provision of assistance and guidance around standard setting, consensus building and best practice

In providing these activities, in 2022/2023, we have helped to educate more than 8,635 healthcare professionals, leading to improved care for patients, and to inform 35,095 members of the public via our website, and provision of printed guidance.

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6287
Accessed
eLPRAS
1007
1311 Attended a
34260 Attended a National BAPRAS Event835
Accessed the patient Teaching Received a
information hub Programme Webinar printed patient information guide
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Overview of the progress made against plans

How we measure our success

The Trustees monitor a range of measures to determine our success in meeting our charitable objectives.

These measures include:

• Level of membership as a percentage of total consultants and trainees in the NHS workforce

• Growth in attendance at our meetings and educational events

•Numbers of abstract submissions for our annual congress

•Impact factors of JPRAS and JPRAS Open

•Number of members of the public that have received support via our patient information hub or by receiving a physical copy of one of our patient information guides

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In summary

Membership

Our membership has declined slightly compared to previous years.

This is mainly due to decreasing numbers of reapplication in the Student/ Foundation and Junior categories.

A previously seen decline in Full and Trainee members has halted and we expect this to reverse in the next reporting period.

Events

We have seen our events return fully to an in-person setting following the end of the COVID pandemic. Pre-pandemic, we had begun to put plans in place to evaluate and reinvigorate our event portfolio. While some events continue to thrive, such as our annual congress and student day, others, including our Advanced Educational Courses have not seen number return to pre-COVID levels and will be reviewed in detail to make sure they are still appropriate.

Numbers of abstract submissions for Congress is consistent with pre-COVID years.

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JPRAS & JPRAS Open

JPRAS Open recorded its’ first Impact Factor in 2023.

While JPRAS’ impact factor has decreased in this period, this is consistent with other surgical journals, many of which experienced a larger than usual uplift in IF in the previous year, owing to the increased amount of submissions and publications seen during the COVID pandemic.

Public Education

39,095 members of the public utilised BAPRAS’ patient information hub or received a copy of one of our patient information guides.

While we haven’t collated this information in the past, this provides a baseline for improvement for future years.

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Our activities

The trustees review the aims, objectives and activities of the charity each year.

This report looks at what the charity has achieved and the outcomes of its work in the reporting period. The trustees report the success of each key activity and the benefits the charity has brought to those groups of people that it is set up to help. The review also helps the trustees ensure the charity’s aims, objectives and activities remained focused on its stated purposes.

In 2023, BAPRAS has been investigating the setup of a trading subsidiary, which, in future years will handle the funds received for our event exhibitions and sponsorships. This is due to commence trading in early 2024.

The trustees have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the charity’s aims and objectives and in planning its future activities. In particular, the trustees consider how planned activities will contribute to the aims and objectives that have been set.

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Events & training

Annual Congress

Following the COVID pandemic, 2022 saw our return to restriction-free congress, reverting back to the usual format of three days of faceto-face programming, which took place between 30 November and 2 December 2022 at the East Midlands Conference Centre in Nottingham. We aimed to grow our delegate numbers, abstract submissions and support from industry back to pre-COVID levels, which was achieved.

The event was subtitled ‘Together’ and aimed to showcase BAPRAS’ support for members as we move post-COVID, with sessions on how to better support colleagues alongside guest presentations and free papers, as well as introducing innovative content, such as practical masterclasses around microsurgery, and a cadaveric training day. We were pleased to partner with PLASTA again, to provide a dedicated pre-conference for surgeons in training from undergraduate level upwards, as well as a specific nurses’ study day on the Friday of the congress.

While BAPRAS has not opted to create hybrid meetings, we have taken the opportunity to record larger proportions of congress, with videos of eponymous lectures being made available to members post-event, and plans to grow this further to provide additional event content in the future.

437 113

302

22

Delegates Free papers 185 % & posters increase from presented* 2021 109% increase from 2021

Abstract submissions received* 187% increase from 2021

Industry support 22% increase from 2021

*No poster abstract submissions were collected in 2021

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delegates Advanced Educational Courses 73 We commenced series 5 of our long-running Advanced Educational Courses in Plastic Surgery series, with courses on lower limb reconstruction and hand surgery advances in October 2022 and April 2023 respectively. Aimed at trainees in the latter years of their training and consultants refreshing their knowledge on the latest advances in plastic surgery, 78

Aimed at trainees in the latter years of their training and consultants refreshing their knowledge on the latest advances in plastic surgery, as well as trainees and consultants in interface specialties, each series runs for eight courses on a range of subspecialty topics.

Following several years as an online only offering during COVID, this year we aimed to reinstate the course series as fully in-person events. While delegate numbers are lower than pre-COVID they are slowly growing again and we will continue to monitor attendance levels at these courses.

Delegate numbers

Course	5.1	73	154	Series	4	equivalent
Course	5.2	78	n/a	Series	4	equivalent

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delegates120

Students Day

BAPRAS’ long-running study day for medical students was held in February 2023 in York and attracted 120 delegates. The students spent the day learning about the variety of subspecialisms available within plastic surgery, as well as being taught practical surgical techniques from a team of specialist trainees.

The event was the first one to be run since pre-COVID, and attracted a higher than usual cohort of attendees (delegate numbers are usually around 100 for this event). With BAPRAS’ workforce planning survey identifying future issues in attracting medical students into surgery, we are pleased that the event remains well attended and well received by attendees.

Celtic Meeting

delegates67

BAPRAS continues to organise, on behalf of plastic surgeons within Scotland, a two-day regional meeting held at the Dunkeld Hydro.

The meeting traditionally attracted around 100 delegates. This number has been lower post-COVID (67 delegates registered in 2023) and consultation is ongoing with consultants and trainees in the region to ensure that the meeting fits the needs of those in the region.

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Regional Meetings

An aim for 2022 was to collaborate and engage more with members and non-members in the different regions that make up our Board of Trustees.

As well as supporting the Celtic Meeting (aimed at those working in Scotland, Wales and Northern and the Republic of Ireland), there was a BAPRAS presence at the North East and East of England regional meetings, with plans also being made to attend the East Midlands meeting in November 2023.

Our President also visited the plastic surgery unit in Belfast.

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delegates Collaborative events 79 This year we have run a number of collaborative events. Firstly we introduced of a series of meetings run in collaboration with PRASIS. The first two webinars in the series ran in July and September 2023 and focused on pensions and cyber insurance. This was part of our commitment to supporting members in all areas of their professional practice. 63

We also co-hosted a congress in Amsterdam in partnership with the Dutch Association of Plastic Surgeons (NVPC).

We plan for further partnered meetings in 2024 with selected Education Partners, as well as a meeting in collaboration with the Caribbean Association of Plastic, Reconstructive and Aesthetic Surgery.

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79 63
Attendees at Attendees at
collaborative Amsterdam
webinars Congress
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Special Interest and Advisory Groups

64% of full members belong to a SIAG

Since 2021, BAPRAS has involved its’ Special Interest and Advisory Groups (SIAGs) in increasing amounts of the organisation’s work. There are now seventeen SIAGs covering a range of areas of subspecialty interest, with plans to increase this further in 2023/4 to cover additional areas of the curriculum.

Our SIAGs are involved in guideline writing, provision of educational content for surgeons (with involvement in congresses, advanced courses and eLPRAS), and act as a network for surgeons to share queries, and ask for advice from other professionals. In 2024, we intend to also involve the SIAGs in reinvigorating our patient information guides.

We also organised two webinars and two in-person events for our skin cancer, breast, lymphoedema and head and neck SIAGs, to give opportunities to share knowledge, educate colleagues on best practice, and set consensuses. These were attended collectively by 90 people

367 of our full members belong to at least one SIAG ( 64% of our full members)

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Total educated at

422

1007

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BAPRAS education

6287 users

eLPRAS

Since 2010, BAPRAS has supported the development of an online e-learning programme to support both the curriculum for plastic surgery trainees and consultant revalidation. Development of the e-learning in plastic reconstructive and aesthetic surgery project (eLPRAS) has been sponsored by BAPRAS and hosted by e-Learning for Healthcare (e-LfH), under the auspices of Health Education England (HEE).

In September 2021, it was decided to re-align the management of the project, to bring control closer to BAPRAS, with oversight by the Education Committee. Work is ongoing to reinvigorate the project, using funding obtained from eIntegrity. The project has no finite end date, but will continue to be run by BAPRAS, in collaboration with a team of external instructional designers.

Between October 2022 and September 2023, 8653 new sessions of educational content were launched (2021-2022: 8565). There are plans to grow this further in 2023, with support from the Special Interest and Advisory Groups to assist with writing content.

6287 users accessed eLPRAS in 2022/3. This was a slight decrease on the previous year (2021-2022: 6309) but plans are in place in 2023/4 to extend access to those BAPRAS members working outside of the NHS, as well as to provide more easily accessible linkages with JPRAS and the National Teaching Programme to help drive up access.

We have also been pleased to extend our provision to provide free of charge access to a number of surgeons from low and middle income countries. So far 33 people have been given access on this basis, with additional offering being planned via BFIRST, with whom we partner closely regarding training in LMICs

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National Teaching Programme

In June 2021, BAPRAS commenced a series of fortnightly national teaching webinars, covering the full breadth of the plastic surgery curriculum and delivered to all UK trainees free of charge. Trainees in low and middle income countries (LMIC) have also been given the opportunity to access resources and videos from the series free of charge, with a fee being levied on trainees from high and upper middle income countries (HUMC).

The series ran through 2022 and was renewed in April 2023 for a second series. While average numbers of attendees has dipped slightly, this was expected as many of the cohort attending the courses in the first year are still undertaking plastic surgery specialist training (though many have re-attended courses in the second series to consolidate their learning).

92 82 Average Average attendance per attendance per webinar webinar 2021- 2022 2022- 2023

Registrations from outside the UK

2021- 2022

17 55 HUMC LMIC

2022- 2023

48 197 HUMC LMIC

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JPRAS

The Journal of Plastic, Reconstructive and Aesthetic Surgery (JPRAS) is owned by the Association and published by Elsevier Science. The Editor, Professor Andrew Hart is supported by the Committee of Management for JPRAS, which represents the Association, and an Editorial Board with an international faculty. The entire back archive of JPRAS (formerly BJPS) can be viewed online. BAPRAS also produces an open access journal, JPRAS Open (Editor, Dr Daniel Kalbermatten). All members of BAPRAS receive full access to JPRAS as a benefit of their membership subscription.

In early 2023, JPRAS Open received its first impact factor of 1.4 .

JPRAS’s current impact factor is 2.7 . This is a slight drop from 2021/2022 (3.0), a period when many journals saw a growth in their impact factor owing to the increased number of articles that were published over the pandemic.

The number of papers submitted to the Journal in 2022/2023 was 1,122 (2021/2022: 1,368). This was a return to ‘usual’ numbers, following a significant increase in 2020/21. It is noted that many journals saw a similar pattern in submission numbers over this period. We are currently in the processes of renegotiating contracts with the publishers, and will be working in 2024 to reduce publication times and improve access via the BAPRAS members’ portal.

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Grants and £98,568 bursaries

BAPRAS funds bursaries, grants and fellowships in nine different categories for education and research purposes. Grants awarded to individuals totalled £99,851in 2022/23 (£98,568 in 2021/22). These were provided to 30 people (2021/22: 20).

BAPRAS also provided grants to BFIRST (£40,000) and PLASTA (£15,000) to enable both organisations to carry out their work supporting surgeons in low and middle income countries, and trainees in plastic surgery respectively.

This year, an additional bursary focused on developing leadership skills has been introduced. There are plans to develop an offering to promote innovation within the specialty following a change to the remit of our Research Committee to also include this area.

Full details of the grants that we have awarded this year, along with further reports can be found on our website (https://www.bapras. org.uk/professionals/training-and-education/prizes-grants-andfellowships)

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Grant making policy

BAPRAS’ Education, and Research and Innovation Committees review applications for the Association’s range of existing bursaries, prizes, grants and fellowships, and recommends awardees to Council.

The committees also develop new awards as a need becomes apparent. The range of BAPRAS bursaries are advertised on the Association’s website, on social media and via relevant stakeholder groups.

Applications can be made by completion of an online form. Applications are accepted from individuals, not organisations. BAPRAS educational grants are only available to its members, though applications are accepted from non-members for research grants.

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Influencing policy

BAPRAS runs two data gathering projects aimed at gathering statistics relevant to future developments of the specialty.

Flap registry

The UK National Flap Registry was established to collect information about all major free and pedicled flap operations carried out in the UK and since 2016 has collected data on 10,914 procedures. There were 1239 procedures logged between January - December 2023 and 930 procedures during the same period in 2022. The UKNFR is used by 276 surgeons across 131 hospitals sites.

A dedicated report on data from 2020-2023 is planned in 2024.

Workforce planning survey

The twelfth annual workforce planning survey was conducted and results released in mid-2023. The survey provides important workforce data on plastic surgery consultants, specialty doctors and trainees practicing in the UK and Ireland, allowing us to establish patterns and highlight potential problems which may affect the provision of plastic surgery services in the future.

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2855 patients assisted monthly

Information Provision

BAPRAS provides dedicated information to help educate members of the public, providing support for ensuring safe, considered elective surgical procedures, as well as guidance and information for those undergoing non-elective surgery.

We provide this via five printed patient information guides and a dedicated section of our website which also includes a further thirtythree online guides, as well as information on cosmetic surgery abroad, considerations for surgery and selection of a surgeon.

In 2022/3, our patient information pages were visited by an average of 2855 people monthly and we distributed copies of 835 printed patient information guides free of charge to hospitals, clinics and individuals that requested them. Numbers of printed guideline requests are decreasing, and we will review which guides we should continue to produce in hard copy in 2023/4.

In the coming year, we intend on reviewing, updating and introducing additional guides which will be available via our website, with a view to making our patient information hub a ‘one stop shop’ for any patient or potential patient considering plastic surgery both in the NHS and the private sector.

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Support for other or anisations g

BFIRST

Formed from BAPRAS’ Overseas Service and Training Committee, the British Foundation for International Reconstructive Surgery and Training trains surgeons working in the poorest countries in the world enabling services to be developed to manage locally-occurring surgical problems.

BAPRAS provided £40,000 of funding plus administrative support to the organisation to ensure their work can continue to grow.

PLASTA

BAPRAS provides support for specialist trainees, foundation and core doctors via financial support for the Plastic Surgery Trainees Association (PLASTA). As well as £15,000 of funding, BAPRAS also provided administrative and technical support for PLASTA’s annual congress. Members of PLASTA’s exec committee are invited to BAPRAS’s committees and council to represent trainee views. We also continue to work closely with PRASSA, the UK’s national student-led association for those at undergraduate level with an interest in plastic surgery, supporting their work via our undergraduate study day.

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Other bodies with BAPRAS representation

BAPRAS is represented in the following external organisations and boards:

• Armed Forces

• British Association of Aesthetic Plastic Surgeons

• BAD Therapy and Guidelines Subcommittee

• British Society for Surgery of the Hand

• Burns Informatics Group

• Cosmetic Practice Standards Authority

• European Board of Plastic, Reconstructive and Aesthetic Surgery

• European Society of Plastic, Reconstructive and Aesthetic Surgery

• Federation of Surgical Specialty Associations

• International Collaboration of Breast Device Registry Activities

• International Confederation of Plastic Surgery Societies

• Outpatients Transformation Clinical Forum

• PRASEAG

• Royal College of Surgeons of Edinburgh Surgical Specialty Board

• Royal College of Surgeons of England Council

• RCS Invited Review Mechanism

• RCS Cancer Services Committee

• RCS Training Interface Groups for Cleft, Head and Neck, Major Trauma, Mohs and Breast

• Scar Free Foundation Research Council

• UEMS

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Membership

The membership on 30 September 2023 totalled 1249 (2022: 1305).

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1305 1249
2021 - 2022 2022 - 2023
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While numbers have declined in the Student and Foundation and Junior categories, small increases have been seen in our Full and Trainee categories.

We intend to move to an online direct debit signup service to make this more accessible to those in the more junior categories, to assist with retention, and will continue to offer large discounts for those members registering for educational events. It is also hoped that numbers of nurses and SAS doctors seeking membership of BAPRAS will rise as we continue to work on ways to better support medical professionals in these roles. A specific nurse category was introduced in early 2023 which is just starting to attract member applications. We also intend to continue to support regional meetings, with a view to meeting potential trainee and full members with more regularity.

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Membership Category September 2023 September 2022
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Membership Category	September 2023	September 2022
Full	575	566
Trainee	200	199
Junior	80	114
Student & Foundation	66	97
Associate	29	27
Affiliate	7	6
Interspecialty	16	16
Overseas	76	76
Honorary	84	85
Senior	116	119

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The above figures amount to 66% of the NHS workforce for Full Members (65% in 2022), and 58% of the NHS workforce for Trainee members (57% in 2022). While our membership growth has slowed in recent years, it still represents a significant portion of the NHS workforce.

Supporting our members

An area of particular emphasis for 2022/3 has been to ensure that our members feel supported in the workplace. With increasing reports of sexual misconduct and bullying in surgical settings and the increasing pressures on surgeons and trainees within the NHS, BAPRAS feels that attitudes and culture need to change and members need to feel supported in order to undertake their jobs to the best of their abilities.

We have launched a suite of resources focusing on supporting surgeons, which is available via our website and have dedicated time both within our annual congress, and in standalone webinar sessions to tackling issues around bullying and harassment.

In 2022, we also launched a mentoring scheme, initially aimed at paring surgeons with more than 10 years’ experience with a new consultant, up to three years on from qualifying.

The scheme has trained 19 mentors, and has paired four mentees. In 2024, we will be expanding the scheme to also include trainees approaching the end of their training.

We also ran our first ‘Wellbeing Weekend’. This was an opportunity for members of all levels to connect, building bridges between those who may not work together, and allowing networking in a relaxed setting away from work or educational events. The event was well received by the 50 delegates that attended. We are planning to run this event again in 2025.

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Plans for the future

Strategic review

A review of BAPRAS’ strategic direction was undertaken in 2018. It was agreed that the resulting strategic plan would be utilised until the end of 2023, and following initial discussions with Trustees, time will be given in 2024 to adapting the current plan to ensure it is fit for purpose and to set goals for the next five years. It is anticipated that all members of Council and all members of staff will be involved in this process.

Supporting members

Further emphasis will be placed on supporting members in the workplace. Following the successful commencement of our mentorship programme for early years consultants, we will be expanding this provision to include trainees approaching the completion of specialist training, and providing enhanced resources and education to support surgeons experiencing bullying in the workplace, and to empower bystanders to speak out.

Event Portfolio

A more detailed review of events for which attendance numbers have not returned to pre-COVID levels will be undertaken and recommendations made by the Education Committee as to how changes can be made to ensure their continuing success.

JPRAS

With our current publishers contract reaching a conclusion in late 2024, discussions are ongoing to renegotiate this. Plans are also in place to initiate a review of the Journal’s strategic direction, to provide a dedicated member of secretariat staff to connect the relationship between the publishers, editorial board, and secretariat office, and a plan to reduce article processing times, working with an increased panel of reviewers to initiate this.

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Financial review

During the year, the Association generated £1,385,668 (2022: £1,172,419) of income and spent £1,444,740 (2022: £1,062,442) disseminating information as it relates to any, and all of the fields that pertain to the Association’s charitable objectives.

Subscription income from members contributed £354,010 (2022: £361,495) and the Journal of Plastic, Reconstructive and Aesthetic Surgeons contributed £503,248 (2022: £457,707) towards the operational costs of the Association.

The Carpue Keegan fund received a top up of some £57,525 which has been invested along with the legacy received previously.

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Investments

The Trustees have wide ranging powers to invest the funds of the Association as they see fit, and in practice, they receive advice from the Association’s investment managers on appropriate investments. The Association’s investment portfolio continues to be managed by Cazenove Capital Management Limited, with an increase in cash holdings in view of the current economic changes.

At 30 September 2023 BAPRAS’ investment portfolio totalled £2.64m (2022: £2.61m)

Our investment policy

The Trustees’ investment strategy, and the instructions given to the Association’s investment managers was to aim to increase the value to the investment portfolio until it achieved a valuation of £2 million. This has been achieved and the Trustees are considering the most efficient ways to draw down funds. It is expected that conversations will be resumed in 2024 and Trustees will once again review the Association’s planned future activities and funding requirements with a view to drawing income from the investment portfolio whilst maintaining the capital value in real terms.

Following the receipt of a bequest, which has been used to set up the Carpue Keegan fund, a separate investment portfolio has been set up. This is currently performing at below inflation and so to safeguard the future of the funds it has been decided to delay awarding the Carpue Keegan Fellowship which would be funded by this portfolio.

Any short-term surplus cash funds are still to be held in high interestbearing deposit accounts.

Reserves and going concern

At 30 September 2023, the ‘total charity funds’ amounted to £2.85m (2022: £2.87m).

Free reserves at the end of September 2023 totalled £2.33m (2022: £2.40m).

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Our reserve policy

The Trustees have determined a suitable target for the level of free reserves at two years cost of total expenditure which is in the region of some £2.8m.

Following confirmation that income from JPRAS is less likely to decrease when the contract is renewed in 2025, discussions will be undertaken in 2024 regarding how additional funds may be utilised should they become available. It is likely that a proportion of existing ‘free reserves’ will be held on a long-term basis to generate a regular income stream in perpetuity with the balance of ‘free reserves’ being spent in a systematic and controlled manner on appropriate projects.

Risks

The Trustees believe that BAPRAS does not need to expose itself to a high level of risk in order to achieve its present aims and goals. Therefore, a policy is followed to ensure that only risks that are, or can be mitigated to, medium risk level are accepted by the Trustees and the Association. This overall assessment of risk may change at a later date depending upon initiatives being considered at the time.

The Head of Operations reviews and updates the risk review monthly, in collaboration with all committees of the Association, and overseen by the Honorary Treasurer. Results are presented for scrutiny by the Officers and thereafter, by Council. Any significant changes in the Association’s risk profile will be highlighted to the membership at the Annual General Meeting.

The highest risks are considered to be:

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Risk Management controls
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Risk	Management controls
Members joining an increasing range of subspecialty organisations	A review of membership categories and benefts was undertaken in 2023; work will continue in 2024 to attend events of other Associations and regional training meetings to promote member benefts and activities
Negative publicity	A dedicated company has been employed to handle crisis communications should the need arise
Loss of staff (and changes to BAPRAS Collection staffng arrangements)	Overlapping roles have been introduced to ensure no role is siloed to one person. A review of the staffng arrangements for the collection is being undertaken following the resignation of the staff member responsible for this area
Rent increase	A review of the current rental market was undertaken and it was ascertained that while rent was rising, it still represented good value compared to what was available commercially.
Inability to recruit new trustees to replace those who demit.	A review of job descriptions and advertising methods will take place, along with discussions at Training Programme Director level to ensure protected time is available for those wishing to become involved at Trustee level

Risk regarding the security of journal funding, which was high in previous years’ reports has been downgraded this year following the commencement of a tendering process for a journal publisher. This revenue stream has been assured until at least 2030, and so is no longer a concern in the immediate future. We have already started to look to alternative funding streams, such as increasing our event sponsorship revenue in order to safeguard the Association further should there be any issues around journal income post 2030.

Opportunity has also been taken to ensure better linkages between our members, the secretariat office and the publishing office by the instigation of a recruitment process for an in-house journal manager.

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Fundraising

BAPRAS does not undertake any specific fundraising activities. We are funded via membership fees, attendance fees for our programme of educational activities, publication of our journal, sponsorship by industry and revenue from our investments.

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Statement of trustees responsibility

The trustees (who are also directors of BAPRAS for the purposes of company law) are responsible for preparing the trustees’ annual report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and group and of the incoming resources and application of resources, including the income and expenditure, of the charitable company or group for that period. In preparing these financial statements, 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

• State whether applicable UK Accounting Standards and statements of recommended practice have been followed, subject to any material departures disclosed and explained in the financial statements

• Prepare the financial statements 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 charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

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In so far as the trustees are aware:

• There is no relevant audit information of which the charitable company’s auditor is unaware

• The trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Members of the charity guarantee to contribute an amount not exceeding £1 to the assets of the charity in the event of winding up. The total number of such guarantees at 30 September 2023 was 1249 (2022: 1305). The trustees are members of the charity but this entitles them only to voting rights. The trustees have no beneficial interest in the charity

The trustees’ annual report has been prepared in accordance with the provisions applicable to companies subject to the small companies’ regime.

The trustees' annual report has been approved by the Trustees on 7 March 2024 and signed on their behalf by Maniram Ragbir.

Maniram Ragbir BAPRAS President

page 36

Independent auditors re ort p

Independent auditor’s report to the members of The British Association of Plastic Reconstructive and Aesthetic Surgeons

Opinion

We have audited the financial statements of The British Association of Plastic Reconstructive and Aesthetic Surgeons (the ‘charitable company’) for the year ended 30 September 2023 which comprise the statement of financial activities, balance sheet, statement of cash flows and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

• Give a true and fair view of the state of the charitable company’s affairs as at 30 September 2023 and of its incoming resources and application of resources, including its income and expenditure for the year then ended

• Have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice

• Have been prepared in accordance with the requirements of the Companies Act 2006

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under

page 37

those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees' use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on The British Association of Plastic Reconstructive and Aesthetic Surgeons’ ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other Information

The other information comprises the information included in the trustees’ annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material

page 38

inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit: • The information given in the trustees’ annual report, for the financial year for which the financial statements are prepared is consistent with the financial statements; and

• The trustees’ annual report has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the trustees’ annual report. We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

• Adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; or

• The financial statements are not in agreement with the accounting records and returns; or

• Certain disclosures of trustees’ remuneration specified by law are not made; or

page 39

• We have not received all the information and explanations we require for our audit; or

• The directors were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies’ exemptions in preparing the trustees’ annual report and from the requirement to prepare a strategic report.

Responsibilities of trustees

As explained more fully in the statement of trustees’ responsibilities set out in the trustees’ annual report, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered

40 page

material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud are set out below.

Capability of the audit in detecting irregularities

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, our procedures included the following:

• We enquired of management, which included obtaining and reviewing supporting documentation, concerning the charity’s policies and procedures relating to:

• Identifying, evaluating, and complying with laws and regulations and whether they were aware of any instances of non-compliance;

• Detecting and responding to the risks of fraud and whether they have knowledge of any actual, suspected, or alleged fraud;

• The internal controls established to mitigate risks related to fraud or non-compliance with laws and regulations.

• We inspected the minutes of meetings of those charged with governance.

• We obtained an understanding of the legal and regulatory framework that the charity operates in, focusing on those laws and regulations that had a material effect on the financial statements or that had a fundamental effect on the operations of the charity from our professional and sector experience.

• We communicated applicable laws and regulations throughout the audit team and remained alert to any indications of noncompliance throughout the audit.

41 page

• We reviewed any reports made to regulators.

• We reviewed the financial statement disclosures and tested these to supporting documentation to assess compliance with applicable laws and regulations.

• We performed analytical procedures to identify anyunusual or unexpected relationships that may indicate risks of material misstatement due to fraud.

• In addressing the risk of fraud through management override of controls, we tested the appropriateness of journal entries and other adjustments, assessed whether the judgements made in making accounting estimates are indicative of a potential bias and tested significant transactions that are unusual or those outside the normal course of business.

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Use of our report

This report is made solely to the charitable company's members as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest

42 page

extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members as a body, for our audit work, for this report, or for the opinions we have formed.

Joanna Pittman (Senior statutory auditor) 13 March 2024

for and on behalf of Sayer Vincent LLP, Statutory Auditor 110 Golden Lane, LONDON, EC1Y 0TL

43 page

Statements of financial activities li page 4

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Statement of financial activities (incorporating an income and expenditure account)

For the year ended 30 September 2023

	Restricted £ - 15,802 5,521	Endowment £ 57,525 - -	2023 Total £ 57,525 1,294,405 33,738	Unrestricted £ 12,000 1,061,915 87,389	Unrestricted £ 12,000 1,061,915 87,389	Unrestricted £ 12,000 1,061,915 87,389	Unrestricted £ 12,000 1,061,915 87,389
1,306,820	21,323	57,525	1,385,668	1,161,304	11,115	-	1,172,419
1,421,519	23,221	-	1,444,740	1,050,392	12,050	-	1,062,442
1,421,519	23,221	-	1,444,740	1,050,392	12,050	-	1,062,442
38,065 (114,699)	- (1,898)	57,525 9,429	47,494 (59,072)	(186,371) 110,912	- (935)	- 11,713	(174,658) 109,977
(76,634) (1,898)	(1,898) 1,898	66,954 -	(11,578) -	(75,459) (935)	(935) 935	11,713 -	(64,681) -
(78,532)	-	66,954	(11,578)	(76,394)	-	11,713	(64,681)
(78,532) 2,404,520	- -	66,954 460,691	(11,578) 2,865,211	(76,394) 2,480,914	- -	11,713 448,978	(64,681) 2,929,892

All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in note 17 to the financial statements.

page 45

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Balance sheet

Balance sheet	Balance sheet
As at 30 September 2023			Company no. 02657454
Note £ Fixed assets: 11 12 Current assets: 13 173,661 350,508 524,169 Liabilities: 14 (313,784) 17 2,325,988 Total unrestricted funds The funds of the charity: Creditors: amounts falling due within one year Net current assets Total charity funds Investments Cash at bank and in hand Tangible assets Restricted income funds Unrestricted income funds: General fund Endowment funds Total net assets Debtors		2023 £ 121 2,643,127	£ 175,011 391,701	2022 £ 161 2,610,870
		2,643,248 210,385		2,611,031 254,180
	524,169 (313,784)		566,712 (312,532)
	2,325,988		2,404,520
		2,853,633		2,865,211
		- 527,645 2,325,988		- 460,691 2,404,520
		2,853,633		2,865,211

Approved by the trustees on 7 March 2024 and signed on their behalf by

M Ragbir President

page 46

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Statement of cash flows

For the year ended 30 September 2023

For the year ended 30 September 2023
Cash flows from operating activities Net expenditure for the reporting period (as per the statement of financial activities) Depreciation charges (Gains) / losses on investments Dividends, interest and rent from investments Decrease/(increase) in debtors Increase in creditors Net cash provided by / (used in) operating activities Cash and cash equivalents at the beginning of the year Net cash provided by / (used in) investing activities Cash flows from investing activities: Dividends, interest and rents from investments Proceeds from sale of investments Purchase of investments Cash and cash equivalents at the end of the year Change in cash and cash equivalents in the year	£ £ (11,578) 40 (47,494) (33,738) 1,350 1,252 (90,168) 33,738 75,000 (59,763) 48,975 (41,193) 391,701 350,508 2023		£ £ (64,681) 54 174,658 (93,504) (75,134) 8,739 (49,868) 93,504 918,029 (1,412,592) (401,059) (450,927) 842,627 391,701 2022
		(90,168) 48,975		(49,868) (401,059)
		(41,193) 391,701		(450,927) 842,627
		350,508		391,701

page 47

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

1 Accounting policies

a) Statutory information

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) is a charitable company limited by guarantee and is incorporated in England and Wales.

The registered office address is the Secretariat offices of the Association at The Royal College of Surgeons of England, 3843 Lincoln's Inn Fields, London WC2A 3PE.

b) Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) - (Charities SORP FRS 102), The Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy or note.

In applying the financial reporting framework, the trustees have made a number of subjective judgements, for example in respect of significant accounting estimates. Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances. The nature of the estimation means the actual outcomes could differ from those estimates. Any significant estimates and judgements affecting these financial statements are detailed within the relevant accounting policy below.

c) Public benefit entity

The charity meets the definition of a public benefit entity under FRS 102.

d) Going concern

The trustees consider that there are no material uncertainties about the charity's ability to continue as a going concern.

The trustees do not consider that there are any sources of estimation uncertainty at the reporting date that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next reporting period.

e) Income

Income is recognised when the charity has entitlement to the funds, any performance conditions attached to the income have been met, it is probable that the income will be received and that the amount can be measured reliably. Income streams such as subscription income and journal income fall into this category.

For legacies, entitlement is taken as the earlier of the date on which either: the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executor(s) to the charity that a distribution will be made, or when a distribution is received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is a treated as a contingent asset and disclosed if

Income from government and other grants, whether ‘capital’ grants or ‘revenue’ grants, is recognised when the charity has entitlement to the funds, any performance conditions attached to the grants have been met, it is probable that the income will be received and the amount can be measured reliably and is not deferred.

Income received in advance of the provision of a specified service is deferred until the criteria for income recognition are met. The journal income is received by calendar year so the income for the last three months are deferred into the subsequent year.

f) Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the charity; this is normally upon notification of the interest paid or payable by the bank.

1 Accounting policies (continued)

g) Fund accounting

Restricted funds are to be used for specific purposes as laid down by the donor. Expenditure which meets these criteria is charged to the fund.

page 48

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

Endowment funds comprise the Carpue/Keegan Fellowship Fund. The capital is invested in perpetuity; the income from this is available to fund travelling bursaries.

Unrestricted funds are donations and other incoming resources received or generated for the charitable purposes.

h) Expenditure and irrecoverable VAT

Expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party, it is probable that settlement will be required and the amount of the obligation can be measured reliably. Expenditure is classified under the following activity headings:

Expenditure on charitable activities includes the costs of delivering scientific meetings, advanced educational courses and exhibitions all undertaken to further the purposes of the charity and their associated support costs

Irrecoverable VAT is charged as a cost against the activity for which the expenditure was incurred.

i) Allocation of support costs

Resources expended are allocated to the particular activity where the cost relates directly to that activity. However, the cost of overall direction and administration of each activity, comprising the salary and overhead costs of the central function, is apportioned in full to the charitable activity of disseminating information on the speciality.

Governance costs are the costs associated with the governance arrangements of the charity. These costs are associated with constitutional and statutory requirements and include any costs associated with the strategic management of the charity’s activities.

j) Grants payable policy

Grants payable are charged to the statement of financial activities in the year in which the offer is conveyed to the recipient.

k) Operating leases

Rental charges are charged on a straight line basis over the term of the lease.

l) Tangible fixed assets

Items of equipment are capitalised where the purchase price exceeds £2,000. Depreciation costs are allocated to activities on the basis of the use of the related assets in those activities. Assets are reviewed for impairment if circumstances indicate their carrying value may exceed their net realisable value and value in use.

Depreciation is provided at rates calculated to write down the cost of each asset to its estimated residual value over its expected useful life. The depreciation rates in use are as follows:

Presidential badge and chain 25% reducing balance

m) Listed investments

Investments are a form of basic financial instrument and are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date using the closing quoted market price. Any change in fair value will be recognised in the statement of financial activities. Investment gains and losses, whether realised or unrealised, are combined and shown in the heading “Net gains/(losses) on investments” in the statement of financial activities. The charity does not acquire put options, derivatives or other complex financial instruments.

n) Debtors

Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

o) Short term deposits

Short term deposits includes cash balances that are invested in accounts with a maturity date of between 3 and 12 months.

p) Cash at bank and in hand

Cash at bank and cash in hand includes cash and short term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

q) Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

r) Pensions

The charity is a participating employer in the Superannuation Arrangements of the University of London (SAUL). Additional information on the accounting of this pension can be found in note 18. This pension scheme is accounted for as if it is a defined contribution pension scheme.

s) Financial instruments

The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

2a Income from donations and legacies

The endowment funds comprise the Carpue/Keegan Fellowship Fund which is a legacy bequeathed to the charity in June 2021. This was topped up by £57k was received during the year. The capital is invested in perpetuity; the income from this is available to fund travelling bursaries. An educational grant of £12k was received from Motiva to fund four plastic surgeons for attendance at a meeting in Thailand.

2b Income from charitable activities

Unrestricted £ 354,010 503,248 273,792 - 6,000 438 141,115	£ - - - 3,802 - 12,000 - Restricted	2023 Total £ 354,010 503,248 273,792 3,802 6,000 12,438 141,115	Unrestricted £ 361,495 457,707 109,054 - 9,000 1,301 123,358	£ - - - 5,000 - - - Restricted	2022 Total £ 361,495 457,707 109,054 5,000 9,000 1,301 123,358
1,278,603	15,802	1,294,405	1,061,915	5,000	1,066,915
Unrestricted £ 6,079 22,138	£ - 5,521 Restricted	2023 Total £ 6,079 27,659	Unrestricted £ 671 86,718	£ - 6,115 Restricted	2022 Total £ 671 92,833

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

4a Analysis of expenditure (current year)

4b Analysis of expenditure (prior year)

	Charitable activity					Charitable activity
	Disseminating information on the specialty	Governance costs	Support costs	2023 Total		Disseminating information on the specialty	Governance costs	Support costs	2022 Total
	£	£	£	£		£	£	£	£
Staff costs (Note 7)	-	26,538	504,215	530,753	Staff costs (Note 7)	-	26,220	498,139	524,359
Membership costs	18,705	-	-	18,705	Membership costs	9,933	-	-	9,933
Journal expenditure	103,371	-	-	103,371	Journal expenditure	104,398	-	-	104,398
BFIRST funding	40,000	-	-	40,000	BFIRST funding	40,000	-	-	40,000
Grants, bursaries, awards and prizes Research grants	47,727 52,124	- -	- -	47,727 52,124	Grants, bursaries, awards and prizes Research grants	46,917 51,652	- -	- -	46,917 51,652
Costs of meetings, courses and other events	336,379	-	-	336,379	Costs of meetings, courses and other events	99,064	-	-	99,064
e-Learning project costs	5,700	-	-	5,700	e-Learning project costs	5,935	-	-	5,935
Public education and communication costs	49,438	-	-	49,438	Public education and communication costs	36,248	-	-	36,248
PLASTA contribution	15,000	-	-	15,000	PLASTA contribution	15,000	-	-	15,000
Other charitable activities	12,100	-	-	12,100	Other charitable activities	-	-	-	-
Other direct costs	16,544	-	-	16,544	Other direct costs	8,346	-	-	8,346
Operating lease rentals, land and buildings:	-	2,307	43,830	46,137	Operating lease rentals, land and buildings:	-	1,193	22,671	23,864
Other office costs	-	4,916	67,992	72,908	Other office costs	-	1,978	37,577	39,555
Investment management fees	-	-	25,420	25,420	Investment management fees	-	-	-	-
Irrecoverable VAT	-	-	35,725	35,725	Irrecoverable VAT	-	-	14,253	14,253
Legal and professional fees	-	-	21,834	21,834	Legal and professional fees	-	-	27,364	27,364
Audit fees	-	13,335	-	13,335	Audit fees	-	11,000	-	11,000
Accounting and advisory	-	1,500	-	1,500	Accounting and advisory	-	4,500	-	4,500
Depreciation - owned assets	-	-	40	40	Depreciation - owned assets	-	-	54	54
	697,088	48,596	699,056	1,444,740		417,493	44,891	600,058	1,062,442
Support costs	699,056	-	(699,056)	-	Support costs	600,058	-	(600,058)	-
Governance costs	48,596	(48,596)	-	-	Governance costs	44,891	(44,891)	-	-
Total expenditure 2023	1,444,740	-	-	1,444,740	Total expenditure 2022	1,062,442	-	-	1,062,442

50

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

• 5a Grant making (current year)

Grant making (current year)
PLASTA funding Research grants At the end of the year Cost BFIRST funding Grants, bursaries, awards and prizes	Grants to institutions £ 40,000 15,000 - -	Grants to individuals £ - - 47,727 52,124	Support costs £ - - - - -	2023 £ 40,000 15,000 47,727 52,124	2022 £ 40,000 15,000 46,916 51,652
	55,000	99,851		154,851	153,568

BAPRAS awards an annual grant of £40,000 to BFIRST which helps train surgeons working in poor countries to enable them to undertake reconstructive plastic surgery. BAPRAS also awards an annual grant of £15,000 to PLASTA which help educate plastic surgeons and develop their skill set.

Other grants, bursaries, awards and prizes have been made to individuals and all in furtherance of the charity's charitable objects.

5b Grant making (prior year)

Grant making (prior year)
PLASTA funding Cost BFIRST funding Grants, bursaries, awards and prizes Research grants At the end of the year	Grants to institutions £ 40,000 15,000 - -	Grants to individuals £ - - 46,916 51,652	Support costs £ - - - - -	2022 £ 40,000 15,000 46,916 51,652	2021 £ 40,000 15,000 30,159 41,662
	55,000	98,568		153,568	126,821

6 Net income / (expenditure) for the year

This is stated after charging / (crediting):

This is stated after charging / (crediting):
	2023	2022
	£	£
Depreciation	40	54
Auditor's remuneration (excluding VAT):
Audit	12,650	11,000
Other services provided	1,500	4,500

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

7 Analysis of staff costs, trustee remuneration and expenses, and the cost of key management personnel

Staff costs were as follows:

Staff costs were as follows:
Other pension costs Healthcare provision Recruitment and other staff costs Social security costs Salaries and wages	2023 £ 400,846 42,906 74,764 7,108 5,129	2022 £ 405,699 38,597 62,327 6,193 11,543
	530,753	524,359

No employee earned more than £60,000 during the year (2022: nil).

The total employee benefits (including medical insurance, pension contributions and employer's national insurance) of the key management personnel were £128,592 (2022: £120,659).

The charity trustees were neither paid nor received any other benefits from employment with the charity in the year (2022: £nil). With exception of the payments disclosed in note 9, no charity trustee received payment for professional or other services supplied to the charity (2022: £nil).

Trustees' expenses represents the payment or reimbursement of travel and subsistence costs totalling £11,022 (2022: £5,054) incurred by 8 (2022: 11) members relating to attendance at meetings.

8 Staff numbers

The average number of employees (head count based on number of staff employed) during the year was 11 (2022: 12).

9 Related party transactions

Joe O'Donoghue is no longer a Trustee of BAPRAS and no longer works in the capacity of JPRAS Editor. For 2023 his remuneration was £nil (2022: £10,248).

Paolo Matteucci, a Trustee received a pump priming research grant of £19,624.

M Ragbir is also trustee of BFIRST. In the year BAPRAS gave a grant of £40,000 (2022:£40,000) to BFIRST.

10 Taxation

The charity is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.

page 52

The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

For the year ended 30 September 2023
11 12 13 Depreciation Tangible fixed assets Other debtors Prepayments and accrued income Trade debtors Debtors: amounts falling due within one year Investments comprise: Disposal proceeds Fair value at the end of the year At the end of the year At the end of the year Cost At the start of the year UK Common investment funds Listed investments All of the above assets are used for charitable purposes. Net book value At the end of the year At the start of the year Charge for the year At the start of the year Additions at cost Net gain / (loss) on change in fair value Fair value at the start of the year	£ 7,905 Presidential badge and chain	Total £ 7,905
	7,905	7,905
	7,744 40	7,744 40
	7,784	7,784
	121	121
	161	161
	2023 £ 2,610,870 59,763 (75,000) 47,494	2022 £ 2,290,965 1,412,592 (918,029) (174,658)
	2,643,127	2,610,870
	2023 £ 2,643,127	2022 £ 2,610,870
	2,643,127	2,610,870
	2023 £ 39,394 5,885 128,382	2022 £ 57,605 5,762 111,644
	173,661	175,011

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

14 Creditors: amounts falling due within one year

Creditors: amounts falling due within one year
Other creditors Taxation and social security Accruals Deferred income (note 15) Trade creditors	2023 £ 73,894 29,468 1,682 49,730 159,010	2022 £ 46,726 22,437 1,658 31,395 210,316
	313,784	312,532

15 Deferred income

Deferred income comprises income received in advance of events and royalty income that relates to the next reporting period.

reporting period.	reporting period.
Balance at the beginning of the year Amount released to income in the year Amount deferred in the year Balance at the end of the year General unrestricted £ 121 2,115,482 210,385 2,325,988 General unrestricted £ 161 2,150,179 254,180 2,404,520 Investments Net current assets Net assets at 30 September 2021 Tangible fixed assets Analysis of net assets between funds (current year) Net assets at 30 September 2022 Analysis of net assets between funds (prior year) Tangible fixed assets Investments Net current assets		Restricted £ - - - - Restricted £ - - - -	2023 £ 210,316 (180,316) 129,010	2022 £ 149,867 (95,867) 156,316
			159,010	210,316
			Endowment funds £ - 527,645 -	Total funds £ 121 2,643,127 210,385
	2,325,988		527,645	2,853,633
	General unrestricted £ 161 2,150,179 254,180		Endowment funds £ - 460,691 -	Total funds £ 161 2,610,870 254,180
	2,404,520		460,691	2,865,211

16a Analysis of net assets between funds (current year)

16b Analysis of net assets between funds (prior year)

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

For the year ended 30 September 2023
17a Total restricted funds General fund Unrestricted funds: Carpue/Keegan Fellowship Fund Restricted funds: e-Learning Fund Endowment funds: Carpue/Keegan bursary Educational Grant Movements in funds (current year) Total funds Total unrestricted funds	At 1 October 2022 £ 460,691	Income & gains £ 66,954	Expenditure & losses £ - (5,700) (5,521) (12,000) (23,221) (1,383,454) (1,383,454) (1,406,675)	Transfers £ -	At 30 September 2023 £ 527,645
	- - -	3,802 5,521 12,000		1,898 - -	- - -
	-	21,323		1,898	-
	2,404,520	1,306,820		(1,898)	2,325,988
	2,404,520	1,306,820		(1,898)	2,325,988
	2,865,211	1,395,097		-	2,853,633

The narrative to explain the purpose of each fund is given at the foot of the note below.

17b Movements in funds (prior year)

Movements in funds (prior year)
Total restricted funds Endowment funds: Carpue/Keegan endowment fund Carpue/Keegan bursary Restricted funds: Total unrestricted funds Total funds e-Learning Fund Unrestricted funds: General Fund	At 1 October 2021 £ 448,978	Income & gains £ 11,713	Expenditure & losses £ - (5,935) (6,115) (12,050) (1,236,763) (1,236,763) (1,248,813)	Transfers £ -	At 30 September 2022 £ 460,691
	- -	5,000 6,115		935 -	- -
	-	11,115		935	-
	2,480,914	1,161,304		(935)	2,404,520
	2,480,914	1,161,304		(935)	2,404,520
	2,929,892	1,184,132		-	2,865,211

Purposes of restricted funds

The e-Learning Fund was set up in 2008/2009 following the receipt of funding from the Department of Health to cover the costs incurred by the Charity in working in partnership with the Department of Health on its e- Learning for Healthcare programme. For 2023, the Charity funded £1,898 (2022: £935) of this expenditure itself by a transfer from the General Fund.

The Motiva educational grant provided accredited UK Plastic Surgeons the opportunity to attend the VII World symposium on Ergonomic Implants in Bangkok, Thailand on November 3-5 2022.

The Endowment funds comprise the Carpue/Keegan Fellowship Fund which is a legacy bequeathed to the charity in June 2022. The capital is invested in perpetuity; the income from this is available to fund travelling bursaries.

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

18 Pension Commitments

General description of the pension scheme

The Charity is a participating employer in the Superannuation Arrangements of the University of London ("SAUL"), which is a centralised, funded, defined benefit scheme within the United Kingdom and is contractedout of the Second State Pension (prior to April 2016). SAUL is an independently-managed pension scheme for the non-academic staff of over 50 colleges and institutions with links to higher education.

Pension benefits accrued within SAUL currently build up on a Career Average Revalued Earnings ("CARE") basis. Following a consultation with Members, the SAUL Final Salary Section closed from the 31 March 2016 and all Members now build up benefits on a CARE basis.

The Charity is not expected to be liable to SAUL for any other current participating employer's obligations under the Rules of SAUL, but in the event of an insolvency of any participating employer within SAUL, an amount of any pension shortfall (which cannot otherwise be recovered) in respect of that employer, may be spread across the remaining participating employers and reflected in the next actuarial valuation.

Funding policy

SAUL's statutory funding objective is to have sufficient and appropriate assets to meet the costs incurred in paying SAUL's benefits as they fall due (the "Technical Provisions"). SAUL adopts assumptions which, taken as a whole, are intended to be sufficiently prudent for pensions and benefits already in payment to continue to be paid and for the commitments, which arise from Members' accrued pension rights, to be met.

The Technical Provisions assumptions include appropriate margins to allow for the possibility of events turning out worse than expected. However, the funding method and assumptions do not completely remove the risk that the Technical Provisions could be insufficient to provide benefits in the future.

A formal actuarial valuation of SAUL is carried out every three years by a professionally qualified and independent actuary. The last actuarial valuation was carried out with an effective date of 31 March 2020. Informal reviews of SAUL's position, reflecting changes in market conditions, cash flow information and new accrual of benefits, are carried out between formal valuations.

The actuarial valuation applies to SAUL as a whole and does not identify surpluses or deficits applicable to individual employers. On 31 March 2020, 94% of funds needed to pay the pensions were already built up in SAUL. This is partly because the pandemic had a short term negative effect on SAUL's investments at that date. This grew to 109% at 30 April 2021.

The cost of future benefits being built up is 35% of Members' salaries compared to a combined contribution from Members and Employers of 22%. This means the shortfall, known as a 'contribution strain' has increased to 13%. Some decisions have been made to make sure SAUL is sustainable for the future. Three changes are to be made to SAUL, one of which was an increase in Employers' contributions to 19% from April 2022 and then to 21% from January 2023.

19 Operating lease commitments payable as a lessee

The charity's total future minimum lease payments under non-cancellable operating leases is as follows for each of the following periods

each of the following periods
Less than one year One to five years	2023 2022 £ £ 37,816 33,020 63,027 88,053 100,843 121,073 Property
	100,843	121,073

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The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS)

Notes to the financial statements

For the year ended 30 September 2023

• 20 Legal status of the charity

The charity is a company limited by guarantee and has no share capital.

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Reference and administration detail

The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) is a charitable company limited by guarantee, incorporated on 21 October 1991 and registered as a charity on 28 October 1991.

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.

All trustees give their time voluntarily and receive no benefits from the charity. Any expenses reclaimed from the charity are set out in note 7 to the accounts.

Company Number: 02657454. Country of Incorporation: United Kingdom Charity Number: 1005353 Country of Registration: England and Wales

Registered office and operational address:

British Association of Plastic, Reconstructive and Aesthetic Surgeons, at the Royal College of Surgeons of England, 38-43 Lincoln’s Inn Fields, London WC2A 3PE

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Trustees

Trustees, who also served as directors under company law, who served during the year and up to the date of this report were as follows:

For period 1 October 2022- 31 December 2022	For period 1 January 2023 – 31 December 2023	For period 1 January 2023 - 7 March 2024	Position
Ms Ruth Waters	Mr Maniram Ragbir	Mr Maniram Ragbir	President
Mr Maniram Ragbir	Ms Ruth Waters	Mr Paul McArthur	Deputy President
Mr Umraz Khan	Mr Umraz Khan	Miss Reena Agarwal	Honorary Secretary, Company Secretary
Mr Simon Wood	Mr Simon Wood	Mr Simon Wood	Honorary Treasurer
Mr Mike Moses	Mr Mike Moses	Professor Peter Dziewuski (from 10 January2024)	Council Member- East of England
Miss Reena Agarwal	Mr Graham Offer	Mr Graham Offer	Council Member- East Midlands
Mr Shehan P Hettiaratchy	Ms Catherine Milroy	Ms Catherine Milroy	Council Member- London
Mr Keith P Allison	Ms Aenone Harper-Machin	Ms Aenone Harper-Machin	Non-regional Council Member
Mr Peter Kalu	Mr Peter Kalu	Mr Dean Boyce	Non-regional Council Member

59 page

Mr Alastair Brown	Mr Alastair Brown	Mr Brendan Fogarty	Council Member- Northern Ireland
Mr Omar Ahmed	Mr Omar Ahmed	Mr Omar Ahmed	Council Member- North East
Mr Milind Dalal	Mr Paul McArthur	Mr Jeyaram Srinivasan (from 8 February2024)	Council Member- North West
Mr Kaz Rahman	Mr Kaz Rahman	Mr Kaz Rahman	Council Member- Scotland
Professor Henk Giele	Professor Henk Giele	Professor Henk Giele	Council Member- South Central
Mr Christopher Macdonald	Mr Christopher Macdonald	Mr Christopher Macdonald	Council Member- South East Coast
Mr Duncan N Mackenzie	Mr Duncan N Mackenzie	Ms Rachel Clancy	Council Member- South West
Mr Peter J Drew	Mr Nicholas Wilson Jones	Mr Nicholas Wilson Jones	Council Member- Wales
Mr Shivram Singh	Mr Shivram Singh	Ms Yvonne Wilson	Council Member- West Midlands
Mr Paolo L Matteucci	Mr Paolo L Matteucci	Mr Paolo Matteucci	Council Member- Yorkshire & Humber

60 page

Key Management Personnel

Mrs Gemma Adlington- Head of Operations Mrs Mobolaji Olusina- Head of Finance

Bankers

National Westminster Bank PLC PO Box 2021 10 Marylebone High Street London, W1A 1FH

Lloyds TSB Bank PLC Southampton Row Branch Victoria House Southampton Row London, WC2B 5HR

Solicitors

Harper James Floor 5, Cavendish House 39-41 Waterloo Street Birmingham B2 5PP

Auditor

Sayer Vincent LLP 110 Golden Lane London EC1Y 0TL

Investment Advisor

CCLA Investment Management Ltd 80 Cheapside London EC2Y 6DZ

HR Advisor

Persona People Management Downslea North Fawley Oxon, OX12 9NJ

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