Endometriosis UK Annual Report for year ended 31 March 2022 ## **Endometriosis UK** **Annual report and financial statements for the year ended 31 March 2022** **Company no. 2912853** **Charity no. 1035810 OSCR no. SC051651** 1 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Contents** ## **For the year ended 31 March 2022** This Trustee and Directors’ report provides an overview of performance in relation to our key objectives and of future plans. It includes key performance data and the stories of some of those Endometriosis UK has helped, in addition to financial summaries and analysis. ||Page| |---|---| |Reference and administrative information|3| |Trustees’ annual report|5| |Independent auditor’s report|26| |Statement of financial activities (incorporating an income and expenditure account)|30| |Balance sheet|31| |Statement of cash flows|32| |Notes to the Financial Statements|33| 2 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Reference and administrative information** ## **For the year ended 31 March 2022** Endometriosis UK is a company limited by guarantee and a registered charity. Company number 2912853 Country of incorporation United Kingdom Country of registration England & Wales Charity Number 1035810 Country of registration Scotland Charity Number SC051651 Registered office and operational address 10 – 18 Union Street, London SE1 1SZ **Trustees** Trustees, who are also directors under company law, who served during the year and up to the date of this report were as follows: Liz Campbell Chair Tracey Hammonds Treasurer Sanchia Alasia Sarah Atkinson Anna Cooper Andy Glyde Andrew Horne Sera Miller Dr Veena Rao Cassia Rowland Arvind Vashisht Endometriosis UK has a skills-based Board of Trustees and trustees are recruited in order to ensure that the board has the right mix of skills and knowledge to provide effective governance. The Board of Trustees has a range of skills and experience including voluntary sector management, fundraising, financial management, primary and secondary health care and of living with endometriosis. Trustees are elected each year at the Annual General Meeting. The higher of three or one third of trustees are asked to retire each year and may offer themselves for re-election. **Company Secretary** Emma Cox, CEO Endometriosis UK **Key management personnel** Emma Cox **Bankers** CAF Bank Limited PO Box 289 Kings Hill West Malling Kent ME19 4TA **Solicitors** Bates Wells and Braithwaite 10 Queen Street Place London EC4R 1BE 3 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Auditor** Sayer Vincent LLP Chartered Accountants and Statutory Auditor Invicta House 108-114 Golden Lane London EC1Y 0TL ## **Medical Advisory Panel** Arvind Vashisht, Consultant Gynaecologist, University College London Hospital Kirana Arambage, Consultant Gynaecologist, John Radcliffe Hospital, Oxford Professor Christian Becker, Senior Clinical Research Fellow, John Radcliffe Hospital, Oxford Professor Andrew Horne, Professor of Gynaecology and Reproductive Sciences, Edinburgh University Shaheen Khazali, Consultant Gynaecologist, Ashford & St Peter’s NHS Foundation Trust Dr Uma Marthi, General Practitioner with special interest in women’s health, Rochdale Dr Veena Rao, General Practitioner with special interest in women’s health, Cumbria Fevzi Shakir, Consultant Gynaecologist, Royal Free Hospital Dr Katy Vincent, Associate Professor, Senior Fellow in Pain in Women, John Radcliffe Hospital, Oxford The Trustees present their report and the audited financial statements for the year ended 31 March 2022. Reference and administrative information set out on pages 3 and 4 forms part of this report. The financial statements comply with current statutory requirements, the memorandum and articles of association, the requirements of a directors’ report as required under company law, and the Statement of Recommended Practice – Accounting and Reporting by Charities: SORP applicable to charities preparing their accounts in accordance with FRS102. 4 Endometriosis UK Annual Report for year ended 31 March 2022 ## **About endometriosis** Endometriosis is a gynaecological condition where tissue similar to the lining of the womb (the endometrium) grows in other areas of the body, most commonly within the pelvic cavity. This tissue responds to the hormonal cycle in the same way as the lining of the womb, but unlike the lining of the womb there is no way for it to exit the body. It remains within the body where the bleeding forms lesions, cysts and scar tissue (adhesions). An estimated 1.5 million women and those assigned female at birth in the UK have endometriosis - that’s 1 in 10 from puberty to menopause who suffer from this disease, although the impact may be felt for life. We do not know the percentage severely disabled by it. We currently do not know what causes the disease and there is no cure. Endometriosis can result in inflammation, scar tissue, severe pain, painful sexual intercourse, infertility, bowel and digestive problems, bladder problems and a wide range of other symptoms. None of the symptoms are exclusive to endometriosis and diagnosis can take a long time often with multiple visits to healthcare practitioners. Currently surgery with biopsy is the only way of diagnosing it definitively. Endometriosis UK's own patient surveys have found that on average it takes 8 years from first symptoms to being diagnosed (March 2020). This figure has not changed in a decade, and is still unacceptably long. Additionally, there is a general lack of awareness about endometriosis: fewer than 50% of people asked in a survey (March 2020) were aware of the condition and even fewer knew what it was. There is no wholly satisfactory drug therapy and often the treatment is surgery, although for many this has to be repeated. The repercussions of endometriosis can be enormous: it can affect every aspect of life, from work, ability to conceive, to relationships and overall quality of life. Since the condition is hard to see and problematic to diagnose, it can feel very isolating - coping with persistent pain, infertility and other unpleasant symptoms can also lead to depression. Endometriosis can also have a huge effect on partners, family members and personal relationships, and all those affected may need support. This is evident from the number of partners and family members who contact the charity. Although in the past it was considered a disease of the over 30’s, increasing numbers are reporting that they are experiencing troublesome symptoms as early as their first period and sometimes even before this. There is no evidence to suggest that this is due to an increase in occurrence of endometriosis, but rather is due to the realisation at an earlier age that severe period pain is not normal. Hence help is being sought at an earlier age - something for which the charity's campaigns over many years should take credit. However, without improved diagnosis and treatment the negative outcomes of persistent pain, debilitating symptoms and potential infertility still remain. 5 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Foreword** We’re proud to share with you our annual report to highlight what you have helped us achieve this year, and to set out our plans for the future. It is thanks to our incredible volunteers, medical advisors, fundraisers, partners and supporters that we are able to be here for people when they need us, and drive real change for all those affected by endometriosis in the UK. Covid 19 continued to have a significant impact on the endometriosis community. Many found themselves still waiting for appointments or surgery cancelled, with little support from the NHS due to pandemic pressures. With no appointments, others were not able to get a diagnosis nor access the treatment they need. Waiting lists continued to rise, with gynaecology waiting lists increasing by the highest percent of all medical areas. We have taken all opportunities to raise our concerns with governments, NHS, healthcare practitioner organisations and decision makers. We have continued to ensure we are at the heart of conversations around how endometriosis care can be improved and delivered across the UK, lobbying parliamentarians in England, Northern Ireland, Scotland and Wales to ensure that governments, the NHS and society recognise the significant impact endometriosis may have on all aspects of life. We worked hard to fill in the gaps where we could, working with our Medical Advisory Panel and healthcare practitioners to provide information and guidance, and deliver virtual support services. Our Support Group leaders supported virtual meetings, and started to return to face to face meetings when appropriate. We delivered a webinar programme in partnerships with specialist endometriosis centres across the UK, expanded our helpline and launched a new web chat service. We have been very proud of the amazing work done by volunteers in our support network, working hard to increase our helpline support, and Support Groups moving to balancing virtual and face to face meetings. Our volunteer network has grown significantly, and thanks to our team of over 180 trained volunteers, Endometriosis UK continues to be there for those with endometriosis when they need it most. March saw the launch of a new webchat service, developed following research that identified the need. Our dedicated Medical Advisory Panel, despite being on the frontline of dealing with Covid 19 and the backlog from the pandemic, found the time to help us update guidance and provide the information that was most needed, especially for those whose surgery, appointment or treatments were delayed or cancelled, along with the newly diagnosed. We hosted webinars, made videos, and organised online panels and discussions to provide our community with information on managing their symptoms, and insights into how endometriosis care may resume. In August 2021, the Scottish Government launched its first Women’s Health Plan. We were very pleased to see that many of our messages had been taken on board, including commitments to drive down diagnosis times, improve endometriosis care, fund research, improve healthcare practitioner knowledge and develop menstrual health education in schools. We look forward to continuing to work with the Scottish Government to make the plan a reality. In March 2022, the Welsh Government funded the appointment of Endometriosis Specialist Nurses in each of the 7 health boards, aiming to improve diagnosis, access to treatment and awareness. We await the publication of the Women’s Health Plan for England, and have continued to lobby for improved care, targets to reduce diagnoses time and investment in research throughout the delay in publishing, as well as supporting debates in Parliament to raise the profile of endometriosis. In October 2021, we were deeply shocked and saddened by the death of Sir David Amess. Sir David was founder and chair of the All Party Parliamentary Group (APPG) on Endometriosis, and a great supporter of the endometriosis community and Endometriosis UK. He will be sorely missed. We are grateful to those MPs who ensured the continuation of the APPG at a difficult time, especially Emma Hardy MP and Hannah Bardell MP for becoming joint chairs. We were once again overwhelmed by the support for our _Walk for Endo_ and _1 in 10 Challenge._ Fundraising events and their success have enabled us to increase our work to raise awareness of endometriosis and increase our campaigning. 6 Endometriosis UK Annual Report foryear ended 31 March 2022 We have welcomed new staff who have immediately had a positive impact on our support network including launching our new webchat service and our first dedicated staff member in Scot5and, our fundraising and our policy campaigning. In the year ahead, further investment will result in increase and improvement of our information provision and awareness raisin8. We dropped Awareness Month in March thi5 year- instead we had Action Monthl Awareness is important, but we want to see actions too, and we promoted a range ol actions including campaigning for MPS to update and improve the guidelines on endometriosis,. for healthcare practitioners to learn more about endometri0s15: and lobbying for more money to be invested in endometriosis research. Our survey work showed that there has been arb increase in awareness about endometriosis but it IS Still low especially for men, with only 31% of men175% of women) able to identify endometriosis as a gynaecological condition from a list of optlons, demonstrating how much more we need to do. Durlng the year we launched a new logo and brand for the charity. responding to all the feedback from volunteers and supporters. We heard loud and clear that the endometrlosis community wanted the charity to look stron& determlned to achieve change. and to be there to support and advocote for everyone with endometri05i5. We believe our new look delivers thls. There remains much work for us as a charlty to do, and we have bold and ambitlous plans for the future wlth a new 5-year strategic plan launched during the year. Strengthening our ambitlons and resolve to ensure everyone living Wlth endometriosis has a prompt diagnosis. the best care and the support they need. The Board sub committee on Oiverslty and Inclusion is overseeing our programme of work to improve our awarene55 of diversity and inclusion and ensure all of our work meets the highest standards in this regard. There is still much to do but we are commltted to ensuring we are an open, fair and equal organisation in all that we do and importantly that all voices are heard and reflerted in our policy and our campalgns. Wlth the Impact of the pandemic still being felt In the NHS and the cost of livlng crlsls, we know there are challenglng tlmes ahead, and our commitment to support those with endometriosis remains strong. The need for our charity and the work we do Is greater now more than ever before. and we are determined to be here to deliver more for the endometriosis community. We would like to thank everyone who has helped us in the past year, our Board, our Advisors, osjr funder5 and our wonderful staff and volunteer team. Endometriosis UK Annual Report for year ended 31 March 2022 ## **Tribute to Sir David Amess MP, Chair of the APPG on Endometriosis** Everyone at Endometriosis UK, and so many people in the endometriosis community, were devastated by the tragic death of Sir David Amess, MP for Southend West, on October 15, 2021. Sir David had been Chair of the All-Party Parliamentary Group (APPG) on Endometriosis ever since he launched it in 2018, working tirelessly to raise awareness and improve services for those with the condition. He had first become interested in endometriosis after a constituent approached him in 2016 describing her experiences struggling to get a diagnosis and appropriate treatment to deal with the condition. Sir David, who had served on the Health Select Committee from 1998 to 2008, decided he had to do something about it. In Sir David’s time as chair, the APPG on Endometriosis undertook a far-reaching inquiry on the state of endometriosis in the UK leading to the publication in October 2020 of a ground-breaking report with many recommendations on how to improve care and support. The APPG also held a number of public events, often led by Sir David himself, to raise awareness of the condition, the most recent taking place virtually, in a Covid 19 compliant manner, during Endometriosis Awareness Month in March 2021. Most recently, he had successfully expanded the group’s members to include a number of fellow MPs from different parties. **Emma Cox, CEO of Endometriosis UK, said:** “Sir David Amess worked tirelessly to raise awareness of endometriosis, and to improve services for those living with the condition. His support was key to ensuring increased public awareness and understanding of the condition.” “Long before his senseless, tragic death, many individuals and families affected by endometriosis had expressed their gratitude to Sir David for making them feel that they were being listened to and believed – many of them have otherwise been ignored or misunderstood. We will never forget his achievements and support.” Sir David Amess was born in Plaistow, East London in 1958. He was first elected as MP for Basildon in 1983. He was subsequently the MP for Southend West from 1997, most recently re-elected in 2019. He received a knighthood for political and public service in 2015. 8 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Objectives and activities** ## **Purposes and aims** 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. 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. ## **Achievements and performance** The charity's key activities and who it tries to help are described below. All its charitable activities are undertaken to further Endometriosis UK’s charitable purposes for the public benefit, and focus on: - Support for everyone living with endometriosis - Information and supporting research - Raising awareness and campaigning - Resourcing the organisation so we can deliver more The following outcomes for the next 5 years have been agreed: - Reducing diagnosis time - Improving access to high quality treatment - Ensuring everyone with endometriosis has the support they need 9 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Key achievements** Despite the continuation of the challenges posed by Covid 19 in 2021/2022, we achieved several long-term objectives, focused on supporting those with endometriosis, reducing diagnosis times, and improving access to treatments. We have highlighted a few of these below, with more details of our activities on following pages. ## **Support for people living with endometriosis** Offering support for those living with endometriosis is at the heart of everything we do. We continue to be there for people with endometriosis, with our fantastic team of over 181 trained volunteers providing direct support through our Support Groups, telephone Helpline, Health Unlocked online forum. In addition, we launched our new webchat support service and trained a cohort of new volunteers to facilitate this service. We have built on the success of our previous years’ webinar programme, working in partnership with BSGE centres across the UK. We were pleased to be invited by the Scottish Government to take part in the development of the first Women’s Health Plan for Scotland, and delighted to see that the published plan included many of our requirements, including commitments to drive down diagnosis times, improve endometriosis care, fund research, improve healthcare practitioner knowledge and develop menstrual health education in schools. Our report, commissioned by the Scottish Government, _Analysis of Endometriosis Service Provision in Scotland_ , identified the provision of, gaps in, and barriers to, care for endometriosis in Scotland which also fed into the Women’s Health Plan. The Scottish Government also provided funding for Endometriosis UK to deliver information and awareness events for the newly diagnosed, recognising the difficulties of accessing care due to the pandemic. We look forward to continuing to work with the Scottish Government on the implementation of the Plan. ## **Information & research** Access to accurate information is essential for those with endometriosis. The Covid 19 pandemic has continued to impact on those with endometriosis, with appointments delayed or cancelled and long waiting times. Worryingly, gynaecology waiting times have increased by a greater percent than any other area, and has meant our information provision is more important than ever. Through expanding our partnerships with endometriosis specialists and centres, we increased our webinar, support and information provision to ensure that those impacted by backlogs in treatment received up to date information We know that research is at the core of improving the lives of those with endometriosis. We are involved in a wide range of research activities, aiming to ensure the views of those with endometriosis are always considered in research. We worked with Verity, the PCOS charity, to support a debate in the UK Parliament on increasing research funding for endometriosis and PCOS, as well as being a partner in clinical trials, helping with PPI (public and patient involvement) to ensure input from patients, reviewing patient materials and helping to recruit study participants. ## **Awareness and Campaigning** Our policy and campaigns work in 2021 included campaigning for endometriosis services to be restarted and reduce waiting times, responding to public consultations on health, involvement in the Women’s Health Plan in Scotland, engaging with parliamentarians and governments across the UK including continuing to support the All Party Parliamentary Group on Endometriosis, and a public campaign to update and improve the NICE guidelines on endometriosis. We were pleased to launch our logo and brand, following a number of consultations, workshops and surveys. The response to these changes was overwhelmingly positive and we’re excited that our brand now reflects who we are as an organisation. 10 Endometriosis UK Annual Report for year ended 31 March 2022 We renamed this years’ Awareness Month as Action Month. This change reflected our commitment to being proactive in calling for improvements in the experience of those living with endometriosis, and was really well received by the community. Action Month posed the opportunity to _do something_ , rather than be passive, and we were certainly busy throughout the month with a number of campaign actions, media opportunities, presentations and awareness activities taking place. Action Month exhibited the creativity and enthusiasm of the endometriosis community, with a raft of events and activities, including the 9[th] World Wide Endo March being held. ## **Resourcing** Our team of 181 trained volunteers deliver our direct support services. We have continued to facilitate virtual training for volunteers, and have continued volunteer recruitment through the year. Our staff team grew over the last year, with new roles to increase and diversify the work we do, improving capacity and expertise within different project areas. New appointments were a Scottish Development Coordinator enabling us to better support volunteers and lead on projects throughout Scotland; a Head of Resources to lead our Governance, HR and Facilities work and lead on new projects; an Executive Assistant to the CEO & Office Manager to support the CEO, manage the office, and coordinate activities across the team; and an Administration Assistant to support finance and fundraising administration. We appointed a Specialist Advisor (part time) who started in May 2022, an Endometriosis Specialist Nurse, to develop our information provision and provide clinical expertise to support our volunteers. During the year, we also appointed two Kickstart positions, 6-month posts, a scheme funded by the Government to create jobs for 16 to 24 year olds on Universal Credit. We were delighted to receive grants from several funders for our work in Scotland, the Health and Social Care Alliance, the National Lottery Community Fund, and the Scottish Government, which helped us provide resources for Support Groups, training for volunteers, and deliver information and awareness raising activities for those recently diagnosed with endometriosis in Scotland. 11 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Support for those living with endometriosis** Our volunteer-led support services continue to be a core part of how we support the endometriosis community. Despite the ongoing challenges of living with the Covid 19 pandemic in accessing support and treatment, we have continued to diversify the support for those living with endometriosis. A key achievement this year has been the launch of our new webchat service, facilitated by a team of newly trained volunteers. Our new Scottish Development Coordinator role enables us to better support volunteers throughout Scotland and lead on projects specific to that nation. We look forward to seeing the impact of the role in improving the lives of those with endometriosis in Scotland. We have continued to recruit and train volunteers virtually, with 56 new volunteers trained over the year, increasing our total number of active volunteers to 181. This has meant a substantial increase in our capacity to support those in the endometriosis community through our services. ## **Highlights** - 276 group meetings took place, most held online. We have supported groups to begin resuming face to face meetings, social events and wellbeing walks and activities - 700 calls were answered by our Helpline - 585,848 website sessions, with a total of over 1.8 million views - 6821 registered for our webinars led by medical experts, and were viewed by over 15,000 via YouTube and Facebook - Held two virtual _Living with Endometriosis_ events with Homerton Hospital in London, and Edinburgh and Aberdeen hospitals in Scotland - Increased the support offered via Health Unlocked, our online moderated forum, with 6,078 new members signed up, making the total number of members 59,992 - Celebrated our Black volunteers during Black History Month ## **Future Plans** - Identify areas for new support groups - Continue to develop a programme of webinars and _Living with Endometriosis_ information events, virtual and face to face, in partnership with BSGE Centres across the UK - Ensure our support groups are sustainable through the recruitment and training of new volunteers to lead together with existing group leaders - Continue to build and strengthen our new webchat service to develop the support we offer - Delivering our Diversity and Inclusion Research Project, and offer new support and information provision for everyone with endometriosis. We recognise every journey is different and will continue to work in all areas where endometriosis is impacting on lives. - “The presentation was very well delivered. I found “The presentation was very well delivered. | found the information both interesting and useful.” the information both interesting and useful.” "I just wanted to say a big thank you for offering the bowel endometriosis webinar. It was so interesting and I "| just wanted to say a big thank you for offering the bowel endometriosis webinar. It was so interesting and | appreciated the time the doctors took out of their busy schedules to share their knowledge. They both appreciated the time the doctors took out of their busy schedules to share their knowledge. They both expressed passion and care for the topic, and came across so comprehensively. Thank you to Endometriosis expressed passion and care for the topic, and came across so comprehensively. Thank you to Endometriosis UK for taking the time, and allowing us to have free access to such valuable information. Endometriosis UK UK for taking the time, and allowing us to have free access to such valuable information. Endometriosis UK make such a difference to us endometriosis sufferers, so I am extremely grateful for everything you do." make such a difference to us endometriosis sufferers, so | am extremely grateful for everything you do." **A big THANK YOU to all of our amazing volunteers!** 12 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Testimonials from those with endometriosis we have supported** ## **Comments on our Helpline** “I spoke to the most lovely person on Monday on the helpline. She was really kind and knowledgeable. Thank you for all you’re doing as the charity at this moment” “I called this morning and spoke to a really lovely lady. It's really what I needed, been having the worse couple of days. Made me feel so much better that I could talk to someone who understood! Thank you” “Thank you so much for listening. That’s all I needed, a safe space to offload and know I am not crazy. I feel so much better and able to carry on advocating for myself for a while longer.” ## **Feedback for online support groups and webinars** “Went to the support meeting tonight and I’ve never ever experienced that level of help. I’m beyond grateful! Thank you!” “The last one was so super helpful! I have made so many changes and I am so grateful to you.” “One of the attendees unmuted herself specially to tell everyone how much our support services have helped her, particularly the Helpline, which she described as “a miracle” and told everyone how our Helpline volunteers have supported her numerous times, helping her feel understood and navigate the challenges of the disease”. ## **Examples of feedback from people we have supported** “I just wanted to say a huge thank you for the support you provide, particularly through your website. I was finally diagnosed with endometriosis yesterday after years of talking to dismissive GPs and not being believed about how bad my symptoms were. From the start of this process I used your resources such as the symptoms grid and then right up to the laparoscopy with what to expect. Without your info, I would have felt clueless going into it so THANK YOU!” “I am lucky to have only had a few bad years in my late 40s with endometriosis, but my 21 year old daughter has had it since she was 16. So I wanted to support your ongoing support for her, and all the other women suffering. Your charity does such a good job and I wish you all the best in these strange and difficult times.” “Endometriosis UK helped me at when I was at my lowest. I was able to get diagnosed through the GP, to find access to a specialist centre and the treatment I needed. I am so grateful” “My whole life has been a fight with endometriosis and sharing my story gives me that little bit of hope. Thank you Endometriosis UK” 13 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Information & research** ## **Highlights** Our Endometriosis Friendly Employer Scheme continued to grow, with 90 members at the end of March. These workplaces have taken action through the _Endometriosis Friendly Employer_ scheme, to ensure employees with endometriosis and menstrual health conditions are supported and enabled to thrive at work. During 2021 HSBC, Southeastern Railway and NHS Digital were amongst those that pledged to be _Endometriosis Friendly Employers_ , and we were pleased to hear about the important progress made by organisations who joined in prior years, including Severn Trent Water and many UK police forces. During our Action Month in March in particular, we presented at a number of Lunch and Learn and Wellbeing sessions for employers, providing information about endometriosis, the impact it can have on an individuals work life and how employers can provide support in the workplace. Through the _Endometriosis Friendly Employer_ scheme, organisations have begun to make great progress for employees with endometriosis; by holding events to raise awareness of the disease and the impact it can have, developing guidance and policies to better-support those with endometriosis at work, working with Endometriosis UK to deliver training for staff and nominating workplace Endometriosis Champions to increase awareness and signpost. Behind the scenes, our information was reviewed as part of the regular review process. We worked with a team of MSc students to assess the usability of our website and improvements that could be made, and started developing a new site to deliver these. We are pleased to be involved in a range of research projects. Research into endometriosis is vital to find out more about the disease. Only through research will we find out more about the cause of endometriosis, how to better treat and manage it, the support people might need and, one day, a cure. We have partnered with university researchers and clinical trials teams to aid recruitment and participation in a number of research projects aimed at improving the lives of those living with endometriosis, including the following clinical trials: DIAMOND: Deep infiltrating endometriosis: management by medical treatment versus early surgery ESPriT2: The effectiveness of laparoscopic treatment of isolated superficial peritoneal endometriosis for managing chronic pelvic pain in women: a randomised controlled feasibility trial REGAL: Recurrence of Endometriosis: A randomised controlled trial of clinical and cost-effectiveness of Gonadotrophin Releasing Hormone Analogues with add-back hormone replacement therapy versus repeat Laparoscopic surgery ADVANTAGE – Advanced Discovery of Visceral Analgesics via Neuroimmune Targets and the Genetics of Extreme Human Phenotype - The ADVANTAGE consortium aims to improve how we treat people with visceral pain from a variety of diseases, such as endometriosis; focusing on their pain rather than just their underlying disease. We are a member of the Patient and Charities Advisory Board of the consortium. In November, MPs attended a debate in Westminster Hall to discuss research into endometriosis and polycystic ovary disease (PCOS). Working with Verity, the charity for PCOS, our campaigning meant almost 6000 people wrote to their local MPs to ask them to attend, with each of the UK’s 650 MPs being contacted about the issue. ## **Future plans** - Work with the research community on projects to learn more about endometriosis, its treatment and management, focussing on the needs of those with the disease. - Continue to push for increased funding into research. - Develop our online resources to provide the information the endometriosis community needs. - Expand the _Endometriosis Friendly Employer_ scheme. 14 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Awareness & Campaigning** ## **Highlights** A key area for our awareness, campaigning and policy work over the year has been to raise the issue of long waiting times those with endometriosis are facing. The pandemic put significant pressure on the NHS resulting in growing waiting lists, and worryingly gynaecology waiting lists have increase by the highest percentage of all areas of care. We have been campaigning so that those with endometriosis are given due priority and receive the care and treatment they need. Our activities have included lobbying governments and NHS trusts across the UK, raising with journalists and working with organisations such as the Royal College of Obstetrics and Gynaecology. We were involved in the development of the Women’s Health Plan in Scotland which included commitments to drive down diagnosis time and improve care. Following several years of campaigning, along with other charities, the Welsh Government agreed menstrual wellbeing education would be included in the new Welsh RSE code and we successfully persuaded the Welsh Senedd Health and Social Care Committee to make Women’s Health one of their priorities. Our Scottish Parliament and Welsh Senedd election outreach campaign encouraged MSPs and MSs to be Endometriosis Champions. In England, endometriosis was identified as a priority area for action in the Vision for the Women’s Health Strategy. To ensure the voice of the endometriosis community was heard in shaping policy, we responded to a number of key government consultations, and have been involved in a number of initiatives with other organisations to further campaign for those with endometriosis, for example the Menstrual Health Coalition and the Association of Fertility Patient Organisations, as well as a coalition of over 40 charities in Wales which developed a Quality Statement for women and girl’s health. We continue to be the Secretariat to the UK Parliament All Party Parliamentary Group (APPG) on Endometriosis. Key campaigning highlights included: - The 2021 Scottish National Party Manifesto included a commitment to reduce waiting times for diagnosing endometriosis from over 8 years to less than 12 months by the end of the parliament - Scottish Government’s Women’s Health Plan has a priority to “improve access for women to appropriate support, speedy diagnosis and best treatment for endometriosis” - Producing a report for the Scottish Government - _Analysis of Endometriosis Service Provision in Scotland_ – to feed into the Women’s Health Plan - Over 6,000 people participated in our “write to your MP” campaign on research funding for endometriosis and PCOS, run jointly with the charity Verity - Virtual parliamentary events in all four UK parliaments for Endometriosis Action Month 2022 - Our Scottish Parliament election outreach campaign reached over 600 candidates - Our Welsh Senedd elections outreach campaign reached over 200 candidates ## **Media work** During the year, Endometriosis UK has raised public awareness and understanding of the disease through a wide range of media coverage, including: - Several BBC online news stories, as well as appearances by staff and volunteers on a range of BBC national and local broadcast outlets. - An ITV Regional News package broadcast and online during Action Month, featuring our Chief Executive, several volunteers and the Paralympic medallist Charlotte Henshaw - A range of national newspaper coverage including a feature in the Daily Mail's Good Health, Mail on Sunday, the Scottish Sun, Metro, along with local, regional and specialist newspapers including the Liverpool Echo, News Letter (Belfast), MyLondon, Glasgow Times and Hertfordshire Mercury 15 Endometriosis UK Annual Report for year ended 31 March 2022 - Articles on the Endometriosis Friendly Employer scheme appeared online in Cosmopolitan, Tyler, HR Magazine, Employee Benefits and Civil Society News - 130,000 followers on social media, an increase of 18% in the last year. In Action Month in March, our social media for the month reached over 723,000 people. ## **Awareness Activities** This year saw the 9[th] Worldwide EndoMarch taking place, with five of our support groups taking part in the global virtual event as well as some marches able to resume as in person events - Aberdeen, London, Merseyside Mid Wales, Oxford and North Highlands. A big thank you to the volunteer teams for all your work to raise awareness. Following a wealth of input from volunteers and supporters, through focus groups and surveys, we developed a new logo and brand identify for the charity. We’re really grateful to everyone who took part in the process – all feedback received helped improve our understanding of what Endometriosis UK means to our audiences. We heard loud and clear that the endometriosis community want the charity to look strong, determined to achieve change, and to be there to support and advocate for everyone with endometriosis. Central to the new brand is highlighting the ‘End’ in endometriosis, to reflect our desire to end so much about the current challenges those with endometriosis face and the detrimental impact on lives endometriosis can have: to end the taboos, end the ignorance, end the isolation and end the pain it can cause. We’re pleased that the new logo has received overwhelmingly positive feedback since its launch in November. During Endometriosis Action Month, we tried new ways to help raise awareness, including digital billboards and having our logo lit up on buildings, provided to Endometriosis UK free of charge. ## **Future plans** - Increase public awareness through a programme of annual campaigns. - Continue to campaign to get good quality menstrual wellbeing education implemented in schools. - Proactively working with journalists to raise awareness. - Continue to work with the APPG on Endometriosis - Ensure those with endometriosis have a louder voice and are heard. - 16 Endometriosis UK Annual Report for ye3r ended 31 March 2022 END PAIN It takes women wlth endometrlosls more than elght years to be dlagnosed- we need to end thelr paln NEWS DME cost0f￿￿Trg Warinukfaine corOna￿T￿5 Climate UK Wortd Bu51ne55 PolitlE5 Teih LoraIN￿5 REgivn5 BTr5t Endometriosis: 'There's a fire inside my uterus, Vicky Cbapmun Mirror METRO _ Antta Nn•ka TV presenter's 14 years of agony with debilitating condition affecting one in 10 women Women NTrlth endometriosis are spending too long in pain MiirL'miirnendrc￿IK￿kLnXlIUIalM￿I ihcc(Indili(In. hutt￿>￿an} fceliBnnrcd hi. dneii)r%i)reoinpoll￿l ￿)411￿￿rIn%llOjlt R05ie Lon8man Endorn•trfD4SP4tI ILOOKEAST IJ¢ ¢¢l¢gropb 17 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Resourcing** ## **Highlights** We launched our new 5-year strategic plan, strengthening our ambitions and resolve to ensure everyone living with endometriosis has a prompt diagnosis, the best care and the support they need. Our Chair and CEO held virtual drop-in sessions for volunteers to discuss the charity’s strategy and ambitions. We continued to work remotely in line with government guidance at different points throughout the year. Having closed our previous office, in September we moved into new office accommodation within the Royal College of Obstetricians and Gynaecology (RCOG) allowing for hybrid working. Our staff team grew further this year, with four new permanent roles, and during the year we also hosted two six-month Kickstarter placements, entry-level roles funded by the Government. We recruited a Specialist Advisor role at the end of the financial year, who started in May. As new staff settle in, we look forward to being able to deliver more for the endometriosis community in the year ahead. We continued to see success through our fundraising, despite the ongoing concerns around Covid 19 and resultant large waiting lists, and cost of living challenges; ensuring in person events were safely managed in line with guidance. ## **Income** **Expenditure** **----- Start of picture text -----**
Fundraising - 44%
Donations - 43%
Grants - 9%
Helpline & Support Services - 60%
Information Services - 14%
Raising Funds - 19%
Research - 7%
**----- End of picture text -----**
## **Future plans** - Continue to implement our new 5 year strategic plan - Continued investment in volunteer training, support and development - Review our membership offer and grow our membership - Develop relationships with Charitable Trusts & Companies to secure new funding - Increase online donations via the website and social media 18 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Supporters** Supporters across the UK were integral to our work in 2022 with 1,217 supporters signing up for our Walk for Endo and 1in10 fundraising challenges, and we were delighted to see many new participants as well as those coming back to support us. Over 350 individuals, workplaces and groups separately took on challenges, organised events and found creative ways to fundraise for our work. As Covid 19 restrictions eased, we were pleased to be able to cheer on our supporters at challenge events once again, including the Asics 10k and Brighton and London Marathons, and look forward to seeing more of our supporters take on challenges at events in the future. ## **Future plans** - Expand participation in events and ways to engage with and support us - Develop exciting new events, including virtual events - Attract more members and supporters - Secure high profile ambassadors - Identify more corporate partners **----- Start of picture text -----**
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19 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Beneficiaries of our services** Our beneficiaries include all those with or impacted by endometriosis. Endometriosis UK is committed to supporting and advocating for everyone affected by endometriosis regardless of race, gender, sex, gender identity, class, sexual orientation or disability and ensuring diversity. Everyone affected by endometriosis needs to be acknowledged, and we know that we must do more to identify the needs of all those affected by endometriosis, develop, maintain, and evaluate our work to meet those needs and advocate for necessary change and ensure all voices are heard. We know that there are additional complexities in accessing healthcare and support for those from Black, Asian and minority ethnic communities, and for the LGBTQ+ community. From survey work undertaken in 2019 and 2020, we identified that we were not reaching these communities as we would like, and are taking steps to actively ensure we drive change for those from under-represented groups. The Board have established a Diversity & Inclusion Group to take this work forward, and having undertaken training for all our volunteers, trustees and staff, we are working to ensure we understand the needs of all those with endometriosis including those from under-represented groups, which will inform our priorities. We have engaged a research agency to partner with us to address this area of development and are excited to progress this work further in coming months. ## **Financial review** The Trustee Board oversees the charity’s finances. To support the Board, a Finance Committee meets regularly, chaired by our Treasurer. For the financial year 2021/22 we significantly increased our expenditure so we could deliver more, and generated a surplus of £288,430. We were able to both raise expenditure and achieve a surplus as a result of careful management of costs, plus an amazing level of fundraising from our supporters. Planned investment was undertaken as the financial situation over the year became more certain, with expenditure regularly reviewed and carefully monitored. Investments included developing a new Web Chat service and improving our Helpline; increased support and activity in Scotland including the appointment of our first staff member in Scotland; undertaking a rebrand; growing our Diversity & Inclusion activities; increasing our administrative and finance processing staff capacity and moving to a new office. Our new home is within the Royal College of Obstetricians and Gynaecologists building, as part of a hub for small, women’s health charities. Further expansion of our work is planned over the next year, including development of our information provision, expanding our support network, and increasing our campaigning and awareness work. The Trustees are keen to secure diverse income streams to ensure that we can achieve our objectives – we have ambitious plans for a small charity. Through both managing costs and developing our fundraising, the trustees carefully monitored finances over the year to ensure the year ended with unrestricted reserves that comfortably met our reviewed reserves policy. The Trustees, and Finance Committee working closely with the CEO, will continue to look for opportunities to develop further fundraising opportunities along with how best to spend our income to deliver the most for those with endometriosis. The charity has delivered a surplus for this and the prior three years as we grew reserves to enable a period of growth going forward. This placed us in a good position to survive the impact of Covid 19, and has allowed our growth, even during the pandemic. The Board undertook a review of resources prior to launching the new strategic plan, alongside an operational plan to deliver our ambitious strategy. 20 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Principal risks and uncertainties** The charity reviewed risk during 2021-22, covering the key aspects of our work including finance, governance and management, operational and external factors. Material risks were identified, reviewed and mitigated by the trustees and this will continue in the year ahead. A detailed Covid 19 risk assessment had been produced at the onset of the pandemic, and this was reviewed by the Board regularly. As we moved to ‘living with Covid 19’ this was integrated into the risk register, and the risk statement reviewed and updated, and the risk register reviewed on a regular basis by staff and trustees. Given the uncertainty of the situation, a range of 5-year scenarios and financial modelling was undertaken to enable the Trustees to plan how to manage the charity, monitor progress and mitigate against the impact of Covid 19 and other risks. Expenditure continues to be carefully monitored given uncertainty about fundraising income in the challenging economic climate. Our key risks, and our mitigations for these are: - Not meeting the needs of the endometriosis community. We must be a reliable source of valuable information, and proactively campaigning for changes needed to improve the care and treatment, including those currently undiagnosed. Throughout the year we focused on new ways of providing supporting through the pandemic, planned and launched campaigns to improve access to treatment and care, and worked with healthcare practitioners and partners to provide current information. - Impact of pandemic and downturn in the economy; not meeting income targets and having insufficient funds to deliver services and achieve objectives. Without growing our income, it will be more difficult to deliver our ambitious strategy. Key to our income is the engagement and mobilisation of the endometriosis community and developing new ways to generate income. We are focusing on activities that will accelerate our progress at this critical time, and looking to diversify our income sources for example through grants. - Information technology – risk our systems fail to meet our operation need. IT systems are crucial to our work, and as a small charity our IT support is via external providers. We reviewed all our providers, identified and implemented new software to support our work, and started the upgrade of our website. ## **Reserves policy and going concern** Our reserves policy is to hold unrestricted reserves equivalent to at least 6 months’ operating costs. We hold financial reserves for practical reasons, including: - Ensuring we can go on funding our vital work should our income fall below target. Having reserves should give us time to adjust expenditure without causing undue disruption to our projects and those we support. - Providing working capital to meet upfront expenditure during the year before income is received. - To provide resource for investment, eg developing services and ensuring we maximise our reach. Free reserves level at March 2022 were £906,177, 19 months total operating costs for the financial year 21/22, however with expansion of our work, commitments to further expenditure including designated funds, and development work for the financial year 2022/23, this equates to 11 months of operating costs for the current financial year. £51,763 of restricted funds was carried forward. We started the year in a good financial position, having worked hard over the prior 4 years to build reserves in order to expand our activities. Initially, planned expansion of activities and appointment of new staff 2021/22 were delayed and expenditure minimised whilst we ascertained the impact of the pandemic, and we cautiously expanded to ensure sustainability . The reserves level achieved is based on meeting our reserves policy over the next two years as the charity grows. We received a great response to our new fundraising plans and the move for a lot of the year to virtual events and activities, and would like to thank all the fundraisers and donors who were so generous over the year. 21 Endometriosis UK Annual Report for year ended 31 March 2022 This has helped us invest in new areas of work to support the endometriosis community, and to plan for further activities and support in the year head. At the year end, the charity has unrestricted reserves totalling £1,139,959. Staff and Trustees reviewed the reserves policy in March 2022 and continue to carefully monitor the cash flow position and reserves. Having sufficient reserves allows us to plan for and deliver future projects, with a focus on decreasing diagnosis times, raising awareness and supporting those with endometriosis. It also enables us to leverage further income, for example some funders are happier to part fund activities where the organisation has already raised some money. Having sufficient reserves allows us to make the most of opportunities. ## **Structure, governance and management** Endometriosis UK is a charitable company limited by guarantee, incorporated on 25th March 1994 and registered as a charity on 29th March 1994. 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. In March 2021, we registered with OSCR- the Scottish Charity Regulator. All trustees give their time voluntarily and receive no benefits from the charity. Any expenses reclaimed from the charity are set out in note 6 to the accounts. ## **Trustee induction and training** The recruitment of Trustees is led by an audit of the skills held by the members of the Board, who are appointed by an open recruitment process using both search and advertisement as appropriate, against an agreed person profile and job specification. Shortlisted candidates are interviewed by a Nominations Committee of the Board who make a recommendation to the Board. The AGM of the Charity confirms all appointments. New Trustees undergo a formal induction process covering, governance, risk management, financial systems and agreed procedures. The Board hold an annual away day to consider strategy and review the performance of the Board. Diversity and Inclusion training was undertaken by Board members, and opportunities for training and knowledge development are raised with the Board, for example the training offered by our auditors. With two trustees reaching their six-year term of office in 2023, we will be recruiting for new trustees in 2023, and encourage all those interested to consider applying – please look out on social media and our website for further information in due course. ## **Risk Management** The Trustees have a Risk Policy and a Risk Register. Each Board Meeting assesses whether new risks have emerged or whether any of the identified risks have changed in severity. The whole register is reviewed at the September Board meeting. Trustees consider that the formulated plans to deal with such risks are appropriate at present. ## **Statement of responsibilities of the trustees** The trustees (who are also directors of Endometriosis UK 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). 22 Endometriosis UK Annual Report for year ended 31 March 2022 The law applicable to charities in England and Wales 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 of the incoming resources and application of resources, including the income and expenditure, of the charitable company 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, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006 (as amended). They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. 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 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 31 March 2022 was 998 (2021: 1,071). The trustees are members of the charity but this entitles them only to voting rights. The trustees have no beneficial interest in the charity. ## **Auditor** Sayer Vincent LLP was re-appointed as the charitable company's auditor during the year and has expressed its willingness to continue in that capacity. The Directors annual report has been prepared in accordance with the special provisions applicable to companies subject to the small companies' regime. The trustees’ annual report has been approved by the trustees on 12 September 2022 and signed on their behalf by 23 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Acknowledgements** We could not do the work we do without the time and knowledge kindly offered to us by our volunteers, fundraisers, speakers, health experts and medical advisors. Without them we would not be able to reach and support the people we do. We would like to thank them all for their on-going support and generosity. All those volunteers who have given up their time to support people affected by endometriosis - through the Helpline, Support Groups, Webchat, Health Unlocked - receive a special vote of thanks. Huge thanks as well to everyone involved in running an event and everyone who baked cakes or ran or walked or gave up chocolate (or sponsored others for doing so) or were involved in other fundraising projects to raise money to support the charity. And a very heartfelt thank you to those who told their stories to the media to raise awareness, which can be such a hard and emotional thing to do yet is vital in raising awareness and helping others. As always, all of our work will be a team effort. Our staff, volunteers, members, trustees, those with endometriosis in our wider community, their friends and family, healthcare professionals, researchers – all of those who work so tirelessly as part of Team Endo are making a huge difference where it is so desperately needed. We are grateful to those organisations who have provided expertise and support to help us raise awareness very generously free of charge, with special thanks to the team at Come the Glorious Day, and to Clear Channel for supplying our first digital billboards. As well as our funders below, we would like to thank each and every person who has made a donation this year or encouraged other people to donate. We would also like to thank our small and dedicated staff team. The National Lottery Community Fund The Health and Social Care Alliance, Scotland The Scottish Government Time Of The Month Cecil Pilkington Charitable Trust Endometriosis UK is committed to fundraising in an honest and transparent way. All staff, volunteers, contractors and partner organisations fundraising for Endometriosis UK are required to adhere to our high standards of ethical fundraising and comply with the code of the Fundraising Regulator. As well as hundreds of community fundraising supporters generously giving their time to raise money for the charity, Endometriosis UK has commercial participator agreements in place with TOTM and WUKA, who fundraised through perproduct donations during the year. The charity established commercial participator agreements with all sole traders and businesses known to be fundraising for Endometriosis UK, and monitored the activities of those fundraising by reviewing proposed messaging and products, and social media monitoring. There were no known failures to comply with the code of the Fundraising Regulator, and no complaints were received regarding staff, volunteers or individuals fundraising for Endometriosis UK. All staff and volunteers are required to adhere to Endometriosis UK’s safeguarding policy, which aims to protect vulnerable people across all aspects of our work, including fundraising. 24 Endometriosis UK Annual Report for year ended 31 March 2022 ## **About Us** ## **Meet the Endometriosis UK governance and staff team** ## **How to get involved** The more people working together the stronger we are and the louder our voice. We have a range of ways you can get involved, for more information please check out our website: www.endometriosis-uk.org/get-involved If you would like to hear what we are up to throughout the year, sign up for our regular e-update. ## **Contact** Endometriosis UK 10 -18 Union Street, London SE1 1SZ Tel: 020 7222 2781 Helpline: 0808 808 2227 www.endometriosis-uk.org/contact-us Twitter @EndometriosisUK Instagram endometriosis.uk Facebook www.facebook.com/endometriosis.uk.org 25 Endometriosis UK Annual Report for year ended 31 March 2022 ## **Independent auditor’s report to the members of Endometriosis UK** ## **Opinion** We have audited the financial statements of Endometriosis UK (the ‘charitable company’) for the year ended 31 March 2022 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 31 March 2022 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, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006 (as amended) ## **Basis for opinion** We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under 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 Endometriosis UK's 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. 26 Endometriosis UK Annual Report for year ended 31 March 2022 If we identify such material 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 and the Charities Accounts (Scotland) Regulations 2006 (as amended) require 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 - 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** We have been appointed as auditor under section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and under the Companies Act 2006 and report in accordance with regulations made under those Acts. 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. 27 Endometriosis UK Annual Report for year ended 31 March 2022 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 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 noncompliance 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 non-compliance throughout the audit. - 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 any unusual 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. 28 Endometriosis UK Annual Report for year ended 31 March 2022 ## **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 and section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005. 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 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. Fleur Holden (Senior statutory auditor) ## 25 October 2022 for and on behalf of Sayer Vincent LLP, Statutory Auditor Invicta House, 108-114 Golden Lane, LONDON, EC1Y 0TL Sayer Vincent LLP is eligible to act as auditor in terms of section 1212 of the Companies Act 2006 29 Endometriosis UK Annual Report for ye3r ended 31 March 2022 ststern*nt of flnw*lal xttthtlts lincorp)iating an income and expenditur* atcountl F¢r th• •nd•d Yl 2022 2022 Trtal Unrestritted 2021 Total Unrestritted Restricted Restrirted Note Inc•rne frorn: Grant5 and donations Orher trading activitie5 396.101 383,372 127 9.694 79,576 475.677 383.3n 127 9.694 406,545 366,889 143 20,511 78.279 484,824 366,889 143 20,511 Other T￿11 Incomè 789,294 79.576 86&870 794,088 78,279 872,367 Evpendltyre w: Raising funds Charitable activitles Helpline and support servlces Information servicès Research 125.707 125.707 84,429 84,429 267.714 132,398 15.008 39,613 307.327 132.398 I S.008 83,736 97,707 78.279 162.01 S 97,707 11,971 Tottl eX￿ndliurl 540.827 39,613 580840 277,843 78.279 356.122 N¢t Income forth• 248.467 39,963 28V30 516,246 Sl 6.246 TTan5fer5 between funds Ntt movtmtnt In fvnds 248.467 39,963 2M450 S16,246 516,246 R•ronclllatton of funds: Total funds broughr forward Totsl fund5 rarrled fThrd 891.492 11,800 903.292 375,246 11.800 387,046 1,139,959 51,763 1.191.722 891,492 11.800 903,292 All of the abth* fesults are derlved from cantlnuin9 acri￿rIes. Théit wefe no other rer us* on particular axeas of charit￿5 WDrk. Oui lunding from Takeda is io Upda￿ Lfving wlth Endometrsosls booklet. whlch Is ￿ing ur￿led and wlll be publkshed in 2022. Scottk5h Government Pr￿KIed a grant for the lollrrt¥ing progrnmmes: • IMp￿￿[￿g the mental I￿lIbeing of ihose wilh endomeirlos15 • Impmvtllg the Support for people with care need5 • Improving the qualiTr of healthcare expersence The Health and Social CaTÈ Allianc• in Scotland prcmded a grant to sypport • LauTrchini w Suppcrt Grrwr6 th ScoflaThJ • D*elopinE mlofmation rnater415 • Supp￿'bn&I￿ re5UrnptsL￿ ol ta[&t￿late 5￿POrt Group fflee¢ry5 • Delryenng volunteer trairy The National LottEry Community Fund prowded A grant to supp)rt EXPandb￿ and ￿rengthen1r* Support Groups in kotI￿d trea51nÉ the awareness and a¥ailalx"lrtyof our Helplin?, Web(hat ar￿ reswr£e5 Scrrtland-bastd statl mèmbÈT to thE abo¥e 45 Endometriosis UK Annual Report for ye3r ended 31 March 2022 22 1 S Mmm•nu In fvnds (￿mIN•d) I￿￿05• of d•s1W*￿ fvnds To fund the set up. development and support for a new Webchar seThlce. plus expanslon of our Helpllne. This Is In addiiion io ihe Alliance Projeci and Scoitlsh Government 9rants, allowlng us to recrult a full time staff member and undenake addltlonal acU¥llles In Scotalnd. We had Identlfled ihat we had less ￿ach wlthin certain communEtes. noiably those from black. Aslan and mlnoflty ethin£ and LGBTQ+ commufiity. Additlonal funding was allocated. over and above what was already In the budget, to underiake research and dellvei Improved reach. Thè charlty's total futvre minlmum lèase paymènts under non-cancÈllable tspÈratlng lÈasès Is as follows for each ol the followlng period5 Propertv 2022 Olher 2021 2022 2021 Less than one yea¥ One to flve years Ovei five years 6.175 4,320 172 6.175 4.320 172 17 Lopl strtU5 af the chvlty The charliy 15 a iompany limited by 9uarantte and has no share capltal. The Ilablllty of each member In the e¥ent of wlnding up is limlted to £ l. 46