Company Registered Number: 02685083 Charity Registered Number {England & Wales): 1009671 NATIONAL ECZEMA SOCIETY (A Company Llmlted by Guarantee) UNAUDITED TRUSTEES. REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021 llllllllll •I48c￿QI08• A13 #240 1 COMPANIES H¢￿SE NATIONAL ECZEMA SOCIETY IA Company Llmited by Guarantee) CONTENTS Page Reference and Administrati¥• Details of th• Charity. its Truste•s and Advis•rs Trustees. Report 2-11 Statwn¢nt of Trustee5' Re5pon5ibilitie5 12 Independent Exarnlnevs Report 13-14 Con$¢lidated Statement of Financial Pxtivities 15 Cons¢lidated Balance Sheet 16-17 Charity Balancè Shggt 18-19 Consolldated Statement of Cash Flows 20 Notss to the Flnanclal Statements 21-46 NATIONAL ECZEMA SOCIETY IA Company Llmlted by Guarantee} REFERENCE AND ADMINISTRATIVE DEfAILS OF THE CHARrrY. rrs TRUSTEES AND ADVISERS FOR THE YEAR ENDED 31 DECEMBER 2021 Truste¢$ Edwa￿ Dawes QC. Chair {resign8d 19 May 2022) Ellen WIn￿nI. Chair Stephen Pugh, Treasurer (appointed to Chair 19 May 2022. resigned as Treasurer 19 May20221 Catherine Escott m￿de Johnston Hannah Kuntik (appointed 16 Marth 2022) Or Simon Lovegrove {apptynted 16 March 2022) Professor Cdia Mo55 OBE Bharat Pa￿a (appointed 16 March 2022) James Pilayanukul lapp)inled to Treasurer 19 May 2022) Hedwig Vollers (appointed 16 March 2022) Suzanne Watson Company re9islered number 02685083 Charity reglstered numb•r 1009671 Rfjglslergd offi¢• 11 Murray Street L￿￿On NW1 9RE Chl•f execu￿¥• offl¢er & Andrew PrcKI Company secretary Independent Examiner MHA Maclntyre Hudson Chartered AcCO￿Lints 6th Floor 2 London Wall Place London EC2Y SAU Principal Bankers CAF Bank Ltd National Westminster Bank plc BardayE Bank plc Status and Goveming Document National Eczema Soaety is a dwritsble company, limited by guarantsg. It was ir￿0[pOrated on 6 February 1992 and ￿gIStered as a clwnty on 10 March 1992. It is govemed by its Artides of A5soLiatiOn. Subsidiary Companies Eczema Trading Linwted Page 1 NATIONAL ECZEMA SOCIErY {A Company Limited by Guarantee TRUSTEES, REPORT FOR THE YEAR ENDED 31 DECEMBER 2021 The trustees present their amual report tcgelhet with the finanaal statements of the Group and the Charity for Ihe year 1 January 2021 to 31 December 2021. The trustees confirm that the Annual Report and financial statements of the company wmply wilh the current statutory requirements, the requirements of the companys goveming document and the provisions of the Statement of Recommended Pradice ISORPI. ap￿1¢able to charities preparing their accounts in aecordance with the Financi81 Reports"ng StarKlard applicable in the UK arKI Republic of Ireland IFRS 102). Since the Charity and the Group qualifies as small under section 383. the Sirategic report required of medium and large companies under The Companies Acl 2006 (Strategic Report and Directorfs Report) Regulations 2013 is not required. Pvrpos• and alms National Eczema Society was ests￿l$hed in 197510 support people wih eczema and their faM￿leS and lo work on their behaw. We rernain dedicated to these founding principles and today we continue to help people across the UK with evideno-based information and advbce about eczema and its management. We deliver this in various ways through our website. weknnars. instnr¢tional videos. social media channels, publi01￿nS and nUr￿sUppOrted Helpline. We also provwje a cdlective votce for pe¢)ple with eczema. to infom researth and influence heallh Wicy lo improve eczema care, and raise greater awareness and understandiro of the ￿rKI1￿¢)n amor¥J people affected by eczema and the WKJer public. The prevalence of eczema has increased over recent decades. arKI around one n five children arKI one in ten adults are now impacted by this lrfe-challengin9 condition in the UK. While the reasons for the increase are not fully understoc*J. il does mean Ihe charity's services are needed more than ever. Our SLrpport has been especially valuable for many dvring the Coronavns pandemic. when aecess lo healthcare was more dI￿￿ulL for many. There is as yel no cure for ￿Zema and. unless you have the ndilion. it can be hard to imagine the daity challenge ol INing with relenuess itchiThJ and inflamed. painful skin. Many heallhcare professionals have limited demialology training and timely access lo specialist dem)alology heatthcare for pe¢Jple vmh eczema can often be drffiujll. National Eczema Society aims lo provide the infomwbon and support needed for people to self-manage their eczema effectively. lo become experts in their own care. learn from the experiences of others. and provide the reassurance of knowng they are not on their own. Ensurlng our work delivers our charitable aims We review our activities each year and monitor the impact of our work lo ensure we continue lo fulfil our purpose of supporting peop￿ affected by ec28ma. Among othèr ways, w8 assess the Society's performance and ach￿vements through the number of peO￿e we have helped wilh information and advice, and the quality and consistency of the resources we provide. We consider how planned aCtiV￿"e$ wll ¢ontn"bute to the aims and objectives we have sel, and in doing this we have referred lo the Charty Commissw)n'$ general guidance on public benefit We have had regard to the legislative and regU￿try requirements for disckssing how our charitable obiectives have provided such benefit. and wnpiied ¥￿1h the duty set out in section 4 of the Charities Act 2011. 2021 Activlty and achSevem•nts- dellverlThg publi¢ benefit l our charitable activities focus on supp)rting people affecled by eczema and championing their needs. and further our charrtable purposes for the publ￿ benefit. Here we pyesenl a summary of the Society's work over the year. Page 2 NATIONAL ECZEMA SOCIETY {A Company Llmltèd by Guarants•l TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Impact of Coronavlrus pandemlc The Society's plans ffi 2021 reflected the oryoing impact oflhe Coronavirus pandemic and importan of effective ￿rnOte working and serV￿e delNery. Once again. great credit and thanks are due to the staff team, trustees. volunteers and suppliers who worked so hard over the year to maintain the Sou'ety's services and operatK)ns in thallenging circumstarw. The Society now operates 8 hybr￿ we*king model. first introduced at the stsrt of the pandemi¢, and this will continue. Like many organisations. we moved to virtual meetings in response to the pandemic and held our second AGM. in September 2021. using the vhleoconferenctng pkttorm Zoom. Trustee Board meetings are now hybrid. wilh t￿th in peTSM and vith•al attentjance supported. We took the difficult d￿l$lOn not to organise any face-to-face events again during 2021. rellecling the ongoing challenges of Covid restrict￿$. The Swevs Helpline, websf(e and wcial media communications continued operating as usual throughout the year. Coronavirus also affected some of our fundraising activity. nolabty thallenge events and community fvndraising. We are graleful to our members and supporters fc￿ being so generous with Ihesr donatK)ns durirvj the year. at a time of conlinued uncertsinty. D•llvorlng Inlomiatlon and advlc• for peopl• living with e¢zema The Society continue5 to provKle a V•ide range of high quality. evidenc&based information and advice about eczema and its managomgnt for people with the condrfion arwj thgir famil￿$. Our eczema Helpline is at the heart of the Society's work. enabling the charity io provide the perstThlised independent adw¢e and reassurance needed by people strugglin9 lo ¢ope with eczema vtherever they live in the UK. We receive around 1.600 lelephone, email and message enquiries a year from pa￿nts of Children with eczema and aduks living with Ihe condition. These cover o wide range of questions absyJt eczema symptoms and trealmenls. from the latest biologic drug5 to eczem3-friendly clothing. We offer a demiatology nurse call4*ack service for Peop￿ who have more ccmmplex enquiries. and around 40¥0 of Callers are helped by one of our experienced dermatdogy nurse advisers. Our Helpline is available free of tharge to anyone affected by eczema in the UK who needs our supporL Aongside our Helpline. the Soctety [￿OduceS a wide range of patient inf0m)at￿l booklets and factsheels about eczema management and treatment, available online and in print. We distribule prinled copies at events the charity Organ￿e5 and altends. and we prowde(l over 12.000 copies of our printed publications to healthcare professh)nals ¢Juring the year. for onward distribution to patients in h05pilal demiatology dinics and other healthcare settings. National Eczema Swety fadsheets ard bcK)klets are updated regularfy on a rolling ￿VIeW cyde and ¢he¢ked by heallhcare professKJnals to ensure the infom)ation is accurate and uptO&date. We updated and reprinted a number of publications over the year. including our Itching and Scratching bc¥)klet. Paste Bandages anil Wet Wraps b¢￿klet and ChildhoctyJ Atoptc Eczema gukye. We continue to raise awarenes5 of local volunleer4ed pat*nt Sup￿1 groups. ty providing information and a presence for these groups on the Society's websrte. Unfortunately. because of ongoing Covid restridions, the infomiation tslk planned by the sOc￿ty.$ Wesl Surrey and North-East Hampshire Support Group had to be postponed again. where Dr George Monuieff was due to speak about the causes ol eczema arKI latest thinkiThJ on eczema eare. Page 3 NATIONAL ECZEPIA SOCIETY (A Company Limited by Guarantee) TRUSTEES. REPORT (CONTINUED} FOR THE YEAR ENDED 31 DECEMBER 2021 We publish all our eczema Informati￿ on the Society's website, wh￿h received over 1.3 million visits during the year. antj we promote health advice messages through ijur sock41 media charbnels. media engagement and other extemal communications. This year we launthed 8 series of popular webinars for people affecled by eczema and their families, on various eczema management topbcs, and ordings olthese are available lo view (M) the Society's Y¢)uTub8 pagg. NES m•mb•rshlp sch•me National Eczema SOc￿ty is a membership organisation and we are very grateful lo our 2,300 members who 5UPPOrt the Society through their annual membeF5hip fee and addilN)nal donations. Members receive our quarterly magazine Exchange. which features exp¢rt information and news about eczema. Mambers are also encouraged to attend Ihe &xiety's Annual General Me8ting and contribute their ideas on the running of the charity. As in previous years. support for our tharity extends far beyond our membership and we remain grateful to all our domrs. and to those members who continue lo support us financially even though they no h)n9er have any Perso￿ need of our help. Representing patient views As a national patient organisalion for people eczema. Ihe &xiety plays a leading role in providing collective voice to champion the needs of those affeded ty the condition. We seek lo improve health outeomes for people ￿￿th eczema by influencing health policy and participating in groups like the All Party Parliamentary Group ￿ Skin (APPGS) and working with professional bodies like the British Association of Dermatologists. As a ￿￿mber of Ihe steering group. we contrsbuled lo the major NHS England Dermatology Outpatient Transfomwtion Programme. which developed a range of new guidanee lo help dermatology heahhcare providers meet the challenges of responding to the disruption to servi¢es ¢aused by Covid_ This covered are85 like leledem)atology and wailing lists. We also worked to raise awareness of the need for better understanding and representation in dermatolo9y for people with skin of colour. Reflecting the growng patient interest and awareness of the effects of topral steroid medication, and concerns abcwJl t¢)pul steroid withdrawal. the Socyety worked with the British Association of Dermatologists to develop a Po￿11)n statement on topical 51eroid withdrawal. Among other things, in the ststemenl we sought to darify the various terms LFsed to describe topical stgfoid wthdrawal and the different reactkjns peOe mwJht experience when stopping using topical steroid Ireatrnents. Topical steroid withdrawal is complex and research into the causes, symptoms and treatsnents is limited. Nattonal Ec2ema Soo'ety wants to see more ￿searCh in this area. One of the challenges is that the symptoms people experience when stopping using twcal slerohds can appear similar lo those of poorly controlled eczema. These symptorrts can be very painfvl and distressing. The Society is emphasising the importance of using lopical steroid treatments safely and effectively, and among other things is calling for clearer labelling of topical sleroKls to show lhe￿ polerrylstrervJth. We continued lo grow our organisaknon81 eaparjty lo supw)rt patient invofvement in shaping research. NES is approached regularty by researchers seeking patient views and lo leam from patient experiences. It is so encouraging to see such a range of research underway and new treatments in the pipeline, following a IcM)g peri￿1 when e¢2ema was largely overlooked. The Society is actively supporting eczema research by participating in study steering groups. providing patient perspectives for research tlla15, and working with universities and companies that a￿ assessing and devebping new drug treatments. We do this to help ensure eczema researth has the greatest chance of suc(*ss in finding new treatrnents and ultimatety a cure. Page 4 NATIONAL ECZEMA SOCIETY IA Company Limited by Guarantee) TRUSTEES, REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 We also provide a patient perspective lo dinical 9uideline devek)pment. Ihe assessment of new treatrnents. and policy wnsullati¢)ns. We contributed to the assessment by the National Institute of Health and Care Excellence (NICE) and the Scottish Medicines consorbum ISMCI of a new eczema drug Car￿ baricitinib. which was apwoved for use by the NHS in 2021. This inlended for aduts with moderate to Seve￿ eczema. Bariciknnib is a type of drug known as a Janus kinase IJAKI inhibitor and it wort¢s in a drfferent vrdy lo other immunosuppressant and b￿91¢ drugs ¢urrenUy used to treat eczema. As eczema affects people in different ways. it 15 important that we have a range of treatment options to help ensure people c8n awss a treatrnent that works effectivety for them. During the year, we contributed a patient persWe and evidence io olher NICE and SMC ￿vIews, induding assessment of several other new drugs for eczema. induding a new ts'obgic treatment called tralokinumab and hyo JAK-inhititcf drugs ialled upadacitsnib and abrocifinib. 11 is disappointing that efforts to press NHS England and NHS Irrprovemenl to darify their prescribing guidance on om(Jlients for people with eczema has not yet been fulty realised. The current guidance Is confusing and does not make it suffi¢ienUy clear Ihat GPS can - and should - tXes￿lbe leave-on emollients for people wrth lon*lem inllammatory condibons. including eczema. We wll continue working with other dermatology organisations. led by the Dermatology Council of England and British Association of Demialologists, lo press forthe agreed ￿￿"￿¢a￿.0n guidance to Oe issued lo prescribers and commis5*)ner5. In olher inlluencing aclivity. thè Soci8ty continues to work with the Medipnes and Healthcare Products Regulatory Agency IMHRAI to suppori the Agency's communution Programme to raise awareness of ffire risks of emollients. Emoll*nt pa<*a9ing now comes with ffi￿ waming labels. Emollients are not fiammable in themselves. or when Ihey are on the skin. Hcrwever. if bedding, ¢bthing or dressings containing dried emollient resKJue catches fre