2023-12-31-accounts

Report of the trustees and financial statements

For the year ending 31 December 2023 for RICE – The Research Institute for the Care of Older People

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Contents

Trustee Report

Reference and administrative details................................................... 3 Welcome from the Chair...................................................................... 5 Our purpose........................................................................................ 7 Our impact over the years.................................................................... 12 Our impact in 2023.............................................................................. 16 Our future plans.................................................................................. 24 Financial review.................................................................................. 26 Structure, governance and management.............................................. 30 Trustee’s responsibilities in relation to the financial statements............ 33 Independent Auditor’s Report to the Members of RICE - The Research Institute for the Care of Older People.................................................... 34

Financial Statements

Statement of financial activities.......................................................... 39 Balance sheet..................................................................................... 40 Cash flow statement........................................................................... 41 Analysis of changes in Net Debt........................................................... 42 Accounting Policies............................................................................. 43 Notes to the Financial Statements....................................................... 47

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 3

Reference and administrative details

As at 31 December 2023:

RICE is a registered charity in England and Wales. Registered charity number: 1042559. RICE is a registered company limited by guarantee. Registered company number: 02979617.

RICE is used as a shorthand name to refer to the charitable company instead of the full name RICE – The Research Institute for the Care of Older People

principle address and registered office:

The RICE Centre Royal United Hospitals Combe Park, Bath BA1 3NG

Patron

Lady Pratchett

President

Professor Roy Jones

Vice Presidents

Sir Tony Robinson Professor Gordon Wilcock Dr Bruno Bubna-Kasteliz Rt Hon John Jolliffe

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 4

Trustees

The following, who are also Directors of the company, serve on the Board of Trustees:

Dr Mark Kingston (Chair) Ben Jones (Resigned 15.09.2023) Dr Robin Fackrell Sarah James Dr Lindsey Sinclair (Appointed 23.02.2023) James Scott (Appointed 23.02.2023) Nicola Moorey (Appointed 23.02.2023) Rob Appleyard (Appointed 02.11.2023) Amy Clarke (Appointed 02.11.2023) Belinda Bowling (Appointed 02.11.2023)

Key management personnel

Melissa Hillier, Chief Executive Officer Dr Tomas Welsh, Research & Medical Director

Solicitors

Stone King LLP 13 Queen Square, Bath BA1 2HJ

principle Bankers

Barclays Bank 4-5 Southgate, Bath BA1 1AQ

Auditors

Sumer AuditCo Limited County Gate, County Way Trowbridge BA14 7FJ

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 5

Welcome from the

Chair

I am pleased to present our Annual Report and Financial Statements for 2023, which has been a year of hard work and of consolidation. As I predicted in my introduction to last year’s annual report, 2023 has been a year of considerable pressures, with the cost-of-living crisis not only affecting our staff, but also our operating costs and charitable income. Despite this pressure, RICE remains a going concern and continues to have a committed and dedicated staff team and, over the last year, we have also re-built a very strong Board of Trustees who bring a formidable array of skills and experience to RICE.

I mentioned in my last introduction that we had renewed our vision and purpose. In 2023 we have taken this a stage further and have undertaken the process to develop a new brand for RICE as a leading charity in the health sector. This new brand will enable us to position ourselves more favourably in an increasingly competitive fundraising environment, whilst retaining our distinctive and eminent position in the field of dementia and associated research. I hope that the new brand will launch and also bear fruit in 2024.

2023 has been a very successful year in maintaining RICE’s profile as a cutting-edge, health research charity. Nine papers, which is a significant number for an organisation of our size, have been published this year under Dr Tomas Welsh’s name, either alone or in collaboration with others, and in journals that

are regarded as amongst the most prestigious. Alongside our academic work, we continue to participate in commercial drug trials. We are regarded by the pharmaceutical industry as one of the most reliable and professional organisations undertaking this research.

Earlier in the year, we were successful in obtaining a sizeable grant from the Big Lottery Community Fund to increase and enhance our non-medical support to patients with dementia.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 6

We are delighted that work on this important project is well underway. The project is providing postdiagnosis support to patients and families across Bath and North East Somerset, and we have an expanded and wide variety of events and activities arranged for 2024, including continuing to recruit more volunteers to help support RICE’s work.

RICE is commissioned to provide the NHS memory assessment service for Bath and North East Somerset. The service assesses and diagnoses those with memory problems and our service was rated as outstanding overall by the Care Quality Commission in 2021. The service will be re-commissioned during 2024 as part of a wider re-tendering process for community health services in the area. RICE is determined to continue to provide the highest-quality memory assessment service to Bath residents and beyond, and we will be making every effort to secure the contract to continue to deliver the service from April 2025 onwards.

Finally, I would like to pay tribute to our staff, trustees and volunteers for all their efforts, hard work and enthusiasm, and to our Patron, President and Vice Presidents for their support. To all those who contribute to RICE through donations and legacies and to our patients and to their families, without whom we would have no cause to exist, I would also like to say a personal thank you. It is a huge commitment that our patients and their loved ones make, and this is invaluable to the work of RICE.

Dr Mark Kingston, Chair of the Board of Trustees

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 7

Our purpose

RICE’s charitable objects as set out in its Articles of Association are:

“To relieve sickness and to promote and advance medical knowledge in particular without limitation by reference to all aspects of the care of older people and to undertake research in relation thereto and to publish the useful results of such research.”

RICE’s purpose is to lead and collaborate on essential research to improve the health and find effective treatment for those impacted by dementia and other conditions of older age. RICE’s main focus has historically been on Alzheimer’s disease and other forms of dementia.

However, we’ve extended our research to look at other conditions of older age, such as Parkinson’s Disease and falls prevention, as these are often conditions of co-morbidity with dementia and are an issue for many of the patients we support.

Registered charity in England and Wales No. 1042559 Company number: 02979617

Our vision

RICE’s vision is a world where people affected by dementia and other related disorders have a range of effective treatment options available to them, enabled by our world class research, services and support.

Our Mission

1

2

3

4

Putting our patients, their families and carers, at the heart of our work

Respecting and recognising diversity

Collaborating on all aspects of our activities

Challenging, learning and applying knowledge

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 9

Why RICE is needed

We all hope to live full and long lives and to stay healthy. Improvements in standards of living and in the diagnosis and treatment of many diseases mean that people are living for longer, but, as a result, are developing multiple and complex diseases in their later years. As we age, many of us will develop conditions which cause progressive problems with memory, thinking, planning, perception, and physical health, which will greatly impact on the quality of our day-to-day life and that of our family and loved ones.

Thirty-eight years ago, in 1985, RICE began its work in direct response to the urgent need to improve care for and the quality of life of older people, and to find better treatment options. Alzheimer’s disease and other dementias were identified as important conditions in need of improvement. There are 944,000 people estimated to be living with some form of dementia in the UK, and this is predicted to rise to 1.1 million by 2030 and 1.6 million by 2050.[1] Currently, there is no cure.

The dementias are devastating diseases which involve more than just memory problems. The conditions often cause disorientation, confusion, anxiety and agitation as well as other problems such as language and visual difficulties. People become increasingly frail, and the majority also have, or will develop, other health conditions that create additional ill health and complications. People living with dementia can also experience social isolation and financial difficulties due to the disease.

The impact of dementia goes far beyond the person living with the disease, impacting on family and friends who are forced to watch their loved one deteriorate. Caring for someone with dementia can be traumatic, exhausting, stressful and emotionally draining, as well as financially costly, particularly when care is taken on by an older family member who may have to give up their work and social activities.

Dementia is projected to be the costliest health condition by 2030. The estimated cost of dementia in the UK was £25 billion in 2021 and is expected to rise to £47 billion by 2050. [2]

[2] https://dementiastatistics.org/statistics/the-economic-impact-of-dementia/ (last accessed 17/01/2024)

[1]https://dementiastatistics.org/about-dementia/ (last accessed 17/01/2024)

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 10

Despite this, dementia research receives less funding than other health conditions and new and improved treatments have been slow to develop – no new dementia drug treatments have been licensed in the UK since 2002. Drug treatments that are available are mainly for Alzheimer’s disease and of limited efficacy and there are no specific treatments whatsoever for several other types of dementia.

People living with dementia are affected by other health conditions. Living with two or more long-term health conditions is called multimorbidity. Multimorbidity is associated with low quality of life and often results in a person requiring intensive support from health and care services. Most people living with dementia are affected by multimorbidity, yet services are mostly designed to treat a single disease rather than treat multiple, complex conditions.[3] Research suggests that people living with dementia may be affected by around five other health problems such as falls, osteoarthritis, diabetes, stroke, osteoporosis and heart failure.[4] Treating these conditions becomes more complicated when a person also has a cognitive impairment caused by dementia or Parkinson’s disease. There is an urgent need to better understand multimorbidity, how it interacts with dementia and impacts on patients and their families, and how services can better treat multiple, complex conditions in older age.[5]

Parkinson’s disease is the fastest growing neurological condition in the world. There are around 153,000 people currently living with Parkinson’s disease in the UK, and this is expected to rise to 172,000 by 2030.[6] Currently, there is no cure.

Parkinson’s disease is a destructive disease, causing progressive damage to the brain. This damage causes a variety of physical, psychological and cognitive changes including body tremors, problems with movement and balance, as well as depression, anxiety, and memory problems.

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542764/ (last accessed 17/01/2024) [4] https://pubmed.ncbi.nlm.nih.gov/31109906/ (last accessed 17/01/2024) [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542764/ (last accessed 17/01/2024) [6] https://www.parkinsons.org.uk/about-us/reporting-parkinsons-information-journalists (last accessed 17/01/2024) Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 11

People living with Parkinson’s disease also experience a deterioration in their quality of life as the disease progresses. Parkinson’s disease can also cause dementia and the person is increasingly likely to suffer from falls.[7]

People living with dementia or with Parkinson’s disease are more likely to suffer from a fall. 60% of people living with Parkinson’s disease[8] and 66% of people living with dementia[9] are affected by a fall every year. Falls cause several issues. They can lead to serious injury or death or result in a person losing their independence as the fear of falling results in inactivity, loss of strength and frailty, which can then cause more falls and contribute to general ill health.

The health problems associated with dementia, Parkinson’s disease and falls are all related, and the numbers of people living with these diseases and with more than one of these conditions is going to increase as the population ages. To improve all our lives in older age and to reduce the burden of cost to society, we need to understand much more about Alzheimer’s disease and other dementias, Parkinson’s disease and fall prevention, and how they affect and are affected by each other, by other health conditions and by personal situations. Finding better care and treatment options, and prevention strategies will help to reduce the impact of these illnesses and enable older people and their families to live as well and as independently as possible.

Public benefit

Trustees have paid due regard to the Charity Commissions’ guidance on public benefit. The Trustees are confident that RICE’s purpose and objectives are in accordance with the regulations on public benefit.

[7] https://pubmed.ncbi.nlm.nih.gov/22133477/ (last accessed 17/01/2024) [8] https://chiefpd.blogs.bristol.ac.uk/about-the-trial/ (last accessed 17/01/2024) [9] https://pubmed.ncbi.nlm.nih.gov/19436724/ (last accessed 17/01/2024)

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 12

Our impact over the

years

Our pioneering memory clinic

RICE established one of the first memory clinic services in the UK in 1987 – a service which has since been widely replicated and is now considered standard and best practice by the NHS. RICE now runs the NHS memory assessment service in Bath and North East Somerset on behalf of the Bath and North East Somerset, Swindon and Wiltshire Integrated Care Board through a sub-contract with the HCRG Care Group. To date, we have assessed, diagnosed, treated, and advised many thousands of people with memory problems and their families.

If someone has a concern about a person’s memory or thinking processes, they can be referred to our memory clinic by their GP or another health specialist or they can self-refer as a private patient. At the memory clinic, they will undergo assessments and meet with our multi-disciplinary clinical team. Following the assessments, they may receive a diagnosis and treatment from our clinicians. Support and advice are available to help people deal with the news and impact of such a significant diagnosis and help and advice is also available for people where dementia does not seem to be the problem.

In 2021 we had our first comprehensive inspection since registering with the Care Quality Commission. We were delighted to be rated as outstanding overall.[10] The inspector said that RICE delivers “an exceptional, innovative service”. They were impressed that our patients were treated as experts in their own condition and were offered a rounded service of diagnosis, care and information, and research opportunities all under one roof. RICE was applauded by the commission as being an exemplar service for dementia, with skilled leaders and staff, and a service that other organisations could learn from.

Over the years we have worked hard to provide highquality services and to create an environment which puts our patients’ needs first. Our purpose-built centre in Bath is specifically designed to be a low stimulus space for our patients to visit, and the length of our appointments ensure that our patients have the time to be heard and to process what is happening. These are important factors given the impairment in memory and thinking they may have and the increasing isolation they may be feeling.

[10]https://www.cqc.org.uk/location/1-686182980 (last accessed 17/01/2024)

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 13

Our post-diagnosis support

In addition to the initial support we provide to people and their families after a memory problem or dementia has been diagnosed, we provide additional post-diagnosis support to help people to live as well as they can with their diagnosis and to support the people caring for them.

Our support programmes are funded by generous donations from trusts and foundations and members of the public. They include:

Carers courses:

A one day programme for people looking after relatives or friends with dementia. The programme provides information on simple coping strategies to help manage stress, reduce isolation, and address financial concerns as well as support available from other services.

Cognitive stimulation therapy:

A seven week programme for people with mild to moderate dementia. The programme aims to stimulate memory in an interactive and engaging way, and attendees are taught activities and strategies to help their memory.

Living well with dementia:

A 10 week programme for people newly diagnosed with dementia. The programme provides a place for people to talk about their diagnosis and to learn about what they can do to help their memory and to live as well as possible with their diagnosis.

We’re in the process of launching a range of other post-diagnosis support services as a result of funding secured from the Big Lottery Community Fund.

We work with other support services for people living with dementia and their carers to ensure that our patients and their families are aware of and can access other local services. This includes the local Alzheimer’s Society Dementia Support Workers, the Carers’ Centre Bath & North East Somerset, and Curo’s Independent Living Service. They often take part in our support programmes and attend our clinic to offer immediate information to patients and carers. This collaboration is beneficial for our patients and their carers and makes a difference to them.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 14

Our pioneering research

Patients and their families who are keen to be involved in research and contribute to increasing knowledge about dementia and health conditions in older age, are easily able to as a result of RICE’s unique position in both providing clinical support and undertaking research activities. Patients and their families have told us that being part of our research projects gives them more opportunities to socialise and to be better informed about their condition, how it is progressing, and how it can best be managed. It also helps them to feel that they are contributing to potential improvements in healthcare.

RICE staff combine their clinical work through the memory clinic with direct involvement in research within the RICE centre. This means most patients taking part in our research will not only be familiar with the building but also with our staff; this relatively unique situation is reassuring for patients and makes us ideally placed to carry out clinical research. Additionally, by supporting and treating our patients and their families, RICE staff are more easily able to identify research projects that may benefit our patients psychologically and socially and hopefully have a real impact on their health and the quality of their lives.

By combining our clinical and research expertise we are able to ensure that research informs and is informed by clinical practice and enable patients and their loved ones to contribute to research into relevant questions that can potentially improve both treatment and care options not only for themselves but for all of us as we get older. It is this combination of research with diagnostic and support services that makes RICE unique and a remarkably impactful organisation.

We are one of the oldest centres for finding treatment for people with Alzheimer’s disease and other types of dementia. For more than 38 years, RICE has made a significant contribution to global research into Alzheimer’s disease, dementias and other related conditions.

Since 1985, we have undertaken trials of more than 50 potential drug treatments working with global pharmaceutical companies and other researchers. Of these, four are currently licensed in the UK for treatment of Alzheimer’s disease and all were evaluated from the very earliest clinical trials in their development by RICE. Our clinical trial research has looked at potential drug treatments for mild cognitive impairment, a condition that sometimes leads to dementia, vascular dementia and Parkinson’s disease. We have also carried out research with patients and healthy people that aims to increase knowledge about genetics and the hereditary aspects of dementia.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 15

RICE has also been involved in large-scale collaborative research projects investigating non-drug treatments, such as better ways of assessing quality of life for people with dementia and how to improve the quality of life of people living with dementia and their carers. We have helped services to identify better ways of supporting those who have dementia.

For example, we have been part of projects to develop a better understanding of the benefits of cognitive rehabilitation therapy and the factors which influence a person’s ability to live well with dementia. Through this work RICE has been able to contribute and collaborate with others to help further our collective understanding of what it’s like living with dementia and how we can support people to live fuller, happier and healthier lives.

Collaborating with others - locally, nationally and internationally

A key part of our work has included working with other organisations caring for older people and researching older people’s health. We’ve worked with clinicians and researchers from the Royal United Hospitals and the local universities of Bath, Bristol and West of England as well as further afield, to develop and undertake innovative research into the health problems of older age.

Over the years our staff have been recognised for the quality of their clinical and research work. Our Research & Medical Director, Dr Tomas Welsh, holds appointments at the University of Bristol where he is an Honorary Senior Lecturer and Deputy Lead for Complex Medicine of Older People.

He is also Co-chair of the British Geriatrics Society Dementia and Delirium and Brain Health Specialist Interest Group and Co-chair of the European Geriatric Medicine Society Dementia Specialist Interest Group. Dr Welsh has been invited to comment on the Scottish Intercollegiate Guideline Network draft guidelines on dementia, is an associate editor at the Age and Ageing medical journal and is Secretary to the Geriatric Medicine Board at the Royal College of Physicians.

We communicate and share our research findings not just with other clinicians and scientists but with the wider public too. Over the years our researchers have regularly presented at national and international academic and clinical conferences, written chapters for clinical books, and published articles in academic journals such as Age and Ageing, Aging & Mental Health, Alzheimer’s & Dementia, Cortex, Journal of Alzheimer’s Disease, International Journal of Geriatric Psychiatry, Journal of Psychopharmacology, Lancet, Lancet Neurology, Neuropsychologia, New England Journal of Medicine and the Proceedings of the National Academy of Science. In total RICE staff have authored or co-authored more than 200 publications.

Registered charity in England and Wales No. 1042559 Company number: 02979617

Our impact in 2023

In 2023, we have continued to lead and collaborate on essential research and service delivery to improve the health of and find effective treatment for people impacted by dementia and other related conditions.

Our main objectives for the year were to:

• Deliver high quality memory clinic services for Bath and North East Somerset which put patients and their carers at the heart of the service

• Deliver and expand our post-diagnosis support offer for people and their families affected by dementia

• Continue our clinical trials and research activities with a focus on Alzheimer’s disease and dementia, Parkinson’s disease, and falls prevention

• Contribute to clinical and research knowledge and increase awareness of RICE

We describe below the main activities undertaken to meet these objectives and the people we have worked with. All our charitable activities have focused on reducing the impact of health problems in older age and have been undertaken to further RICE’s purpose and for public benefit.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 17

We delivered high quality memory clinic services for Bath and North East Somerset which put patients and their carers at the heart of the service.

In 2023 there were 1,929 patient contacts with our memory clinic, of which 513 were patients being assessed for the first time and 1,416 were receiving either follow-up care or medication reviews. Based on data collected between January and December 2023 on 834 of our patients, 43% identified as male, 57% as female, 83% as white, 2% as Black, Asian or mixed ethnicity, and 15% declined to report their ethnicity. 9% of the 834 patients were in their 40s, 50s or 60s, 31% in their 70s and 60% were in their 80s, 90s or 100s.

Demand for our memory clinic services remained high and challenging in 2023. This is in part indicative of the national increase in rates of dementia in the population and in part the ongoing impact, postcovid. Thanks to generous funding from Bath and North East Somerset Council, we were able to continue to fund much needed additional doctor capacity for three months at the start of the year to help ensure that our face-to-face appointments were run in a covid-secure manner. We also completed the creation of additional covid-secure clinic rooms in our building to ensure that we can continue to operate safely into the future and to help meet demand for appointments.

As part of providing our memory clinic services, we have continued to host medical students as part of their medical training and to host specialist doctors in training to help them to develop their skills in dementia care. We have also continued to work with the colleagues from the Alzheimer’s Society, Age UK Bath and North East Somerset, Curo and the Avon and Wiltshire Mental Health Partnership NHS Trust to ensure our patients receive the right support for them. We have also connected with colleagues providing audiology services and specialist speech and language therapists with the aim of increasing our referrals to them and ensuring our patients are supported with all their healthcare needs.

Registered charity in England and Wales No. 1042559 Company number: 02979617

Every year we ask our patients what they think about our memory clinic, and in 2023 they told us:

"I am very thankful for the work that you do and for the confidence you have given me."

"Staff put you at ease and were very good at explaining all about the process of appointment."

"I would like to sincerely thank all involved for their time, compassion and professionalism shown to Mother and I."

We delivered and expanded our post-diagnosis support offer for people and their families affected by dementia.

In 2023, RICE ran several support programmes which were funded by a generous donation from the Contain Outbreak Management Fund from Bath and North East Somerset Council.

We ran three cognitive stimulation therapy programmes which were attended by a total of 19 people. Attendees reported feeling brighter in their mood and improvements to their confidence as a result of attending the programme. They also greatly benefited from meeting and socialising with others:

“It is helpful to be together with people [who] are the same as myself – we can laugh about things together.”

Cognitive Stimulation Therapy Attendee, 2023

“[It is] a well-constructed course delivered by people who care and understand the dementia journey that people are on.”

Carer of Cognitive Stimulation Therapy Attendee, 2023

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 19

We ran two living well with dementia programmes which were attended by a total of 9 people with dementia and 8 of their carers. Attendees enjoyed meeting and sharing with others in a similar situation to themselves. They also reported feeling better about their diagnosis:

“… by the end of the 10 weeks I felt more in control of how I feel about the dementia I have.”

Living Well with Dementia Attendee, 2023

“I have been scared by my diagnosis, but I am now feeling a lot more positive.”

Living Well with Dementia Attendee, 2023

We ran four, one day programmes for carers which were attended by a total of 50 people. Attendees reported finding the course very informative and helpful in supporting their informal roles as carers:

“Dealing with the problems of looking after someone with Alzheimer's is not easy and it is very reassuring to know there is help, advice and support available.”

Carers Day Attendee, 2023

“Very informative and useful advice given and guidance given where [to] get help.”

Carers Day Attendee, 2023

We also trained our staff to deliver the strategies for relatives programme which is an eight week programme supporting carers and relatives of people with dementia to develop their skills, manage stress and communicate more effectively. We will be delivering this alongside our other programmes next year.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 20

As well as providing our support programmes we provided one-to-one psychological support to our patients and carers to help them to adjust to their dementia diagnosis and manage the feelings and stress that receiving a diagnosis causes. 16 patients and their carers were provided with psychological support. Three carers also received listening support to help them to express their feelings and identify their needs.

Thanks to a three-year grant secured from the Big Lottery’s Communities Fund in 2023, we have put in place much needed infrastructure to be able to expand the post-diagnosis support we can offer to people with dementia and to their carers. This has involved recruiting to new staff roles, developing a volunteering and community engagement programme, and conducting research to understand more about what post-diagnosis support people want. Our new support programmes and seasonal events will start with a gusto in 2024 kicking off with our new ten week Chat, Make and Move programme which uses activities designed to boost participants wellbeing.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 21

We continued with our clinical trials and research activities with a focus on Alzheimer’s disease and dementia, Parkinson’s disease, and falls prevention.

During the year around 50 of our patients were supported by our staff to take part in our clinical trials and other research projects. Based on data collected on these patients, 64% identified as male, 36% as female, and 100% as white. 85% resided in Bath and North East Somerset, 2% in Somerset, 9% in Wiltshire, and 4% came from further afield. 26% of the 50 patients were in their 60s, 40% in their 70s, 30% were in their 80s and 4% were in their 90s. 26% of the patients had been diagnosed with Alzheimer’s disease, 43% with mild cognitive impairment, 4% with mixed dementia, and 27% with other.

----- Start of picture text -----
Alzheimer's Disease
Aged 60-69
26%
26% Other
27%
Aged 80+
34%
Mixed dementia
4%
Aged 70-79 Mild Cognitive Impairment
40% 43%
----- End of picture text -----

RICE also has an active pool of 125 healthy volunteers whom we support to get involved in our research as well as other institutions’ research projects. In 2023, the healthy volunteers were involved in a number of university-based projects such as the use of online museums by older adults and the use of small amounts of exercise and tai chi as a means of supporting healthy ageing.

In 2023, RICE was involved in six clinical trials. The trials included the ongoing Biogen Embark trial, Evoke and Evoke plus trials, Janssen Autonomy trial and the Postgraduate trial which was sadly discontinued early in the year due to the drug being trialled not achieving the expected results. We participated in a new trial in 2023, the ImmunoBrain Phase 1 trial, which is exploring whether escalating doses of a drug known as IBC-Ab002, is safe and effective in people with early Alzheimer’s disease. At the end of 2023 we were also in the process of setting up three new drug trials with Biogen, Janssen and Lilly.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 22

The Biogen Embark trial is investigating further the potential benefits of the drug aducanumab, following on from a research study carried out previously at RICE and other centres around the world. The Evoke and Evoke plus trials are looking at whether the drug Semaglutide, already licensed to treat Type 2 diabetes, is effective in treating memory loss in patients with mild Alzheimer’s disease and mild cognitive impairment. The Janssen Autonomy trial is exploring whether a new compound called JNJ63733657 is safe and effective for treating early Alzheimer’s disease and mild dementia due to Alzheimer’s disease.

In 2023 we continued to collaborate with the Royal United Hospitals on two new Covid-19 trials. Trial visits for participants took place in the RICE Centre and our staff worked with hospital staff to perform the visits. Covid continues to be a threat to the health of older people and RICE is proud to be involved in these trials which are helping to reduce the risks of Covid and the wider impact it has had on older people, particularly those with dementia. The trials included: testing a new Covid-19 vaccine developed by Moderna which may protect people from getting sick if they come into contact with the covid virus, and a trial run by the Bristol Trials Centre to understand the impact of administering patients with the shingles vaccine at the same time as administering Covid-19 and flu boosters in preparation for the 2023/2024 flu season.

In 2023, RICE was involved in five other research projects. The ongoing projects included AFRI, SIPA-2, Top Hat, and two new projects, MySmile and CareCoach. The AFRI study is trialling the use of air filters in care homes to reduce infection. SIPA-2 is looking at medicines management in people with sensory impairment in collaboration with the University of Strathclyde. As part of this project, we provided advice on the development of an online educational course on medication management for people with sensory impairment which is now available on Future Learn. The Top Hat project led by University College London and in collaboration with doctors at the Royal United Hospitals, is looking at whether ondansetron, an anti-sickness medication usually used for people having cancer treatment, can effectively treat visual hallucinations in people with Parkinson’s disease.

The MySmile project, led by researchers at the Bristol dental and medical schools, is investigating whether improving oral health can help to slow memory loss. During 2023, RICE recruited patients for the study on behalf of the dental and medical schools. The CareCoach project, led by the University of Exeter, tested the impact of a package of online resources and tips to help carers of people with dementia to have the information and skills that they need to manage and support the day-to-day care of their loved one. Our staff were trained to act as coaches to the carers.

In 2023, RICE continued to participate in the National Institute for Health Research Clinical Research Network’s Research Site Initiative scheme. The scheme supports organisations to establish and maintain their research capacity. In the second year of the scheme, RICE had to recruit to four research projects which met the scheme’s requirements. We’re pleased to have achieved this target and hope to participate in the scheme again in 2024.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 23

We also continued with our new RICE PhD fellowship. The studentship is partly funded from a generous donation from the Medlock Charitable Trust. The second year of the fellowship has progressed well. The PhD project being researched will examine the links between dementia and psychological distress, and, for the first time, use ‘Big Data’ from the Clinical Practice Research Datalink. The data set that will be used includes information from around 60 million people. The PhD project is strengthening our links with researchers at the University of Bath and helping to build our capacity for future research projects.

We contributed to clinical and research knowledge and increased awareness of RICE.

RICE continues to work collaboratively with a wide range of universities and international teams on our research programme. In 2023, we continued to work closely with Parkinson’s disease researchers in several exciting areas. This included work with Dr Emily Henderson from the University of Bristol on the redesign of Parkinson’s disease services. We also housed Dr Matthew Smith from the University of Bristol in the RICE Centre. Matthew has been undertaking research on the use of an electronic device to help manage incontinence in patients with Parkinson’s disease. We’re delighted that his PhD research has been, almost, successfully completed. We’ve also built a new relationship with Rare Dementia Support based at the UCL Dementia research Centre, and hope that in 2024 we will work together on some exciting new initiatives.

RICE publishes and presents its research findings and shares the knowledge that we gain in our activities so that we can contribute to the growth in knowledge of older people’s health and healthy ageing. We use our findings and expertise to influence health and care policy and to deliver improvements in how health and care services are provided. In 2023, we published nine papers and we were invited to deliver a number of talks at national and international conferences. Our staff also continued to provide teaching on dementia and polypharmacy to University of Bristol Medical Students and on the medicine of Older People to University of Bath pharmacists and to local GPs on topics related to dementia and older people’s health.

As well as sharing our knowledge with scientists, health and care professionals, and commissioners and service providers, we share our knowledge with our funders, supporters and the wider public. Our website continued to grow in its impact and attracted 5,700 new visitors in 2023 and our social medial channels also saw a growth of over 13%. We also re-started our regular newsletters and sent them out by post and email to over 450 supporters. We set up a new Lived Experience Advisory Panel which merged with and built on our patient involvement group and will ensure that those affected by dementia are consulted on all our work and research activities.

Registered charity in England and Wales No. 1042559 Company number: 02979617

Our future plans

2023 has been another year of change and development for us. We have reviewed our look and feel as an organisation so that we are better placed to reach as many people as possible who are impacted by dementia. We have spoken to those who know us well, our patients and their families, funders, doctors, researchers, and supporters as well as local residents to understand how well we are known, and what we are known for and how well our brand reflects our work. We are very grateful to the Big Lottery Community Fund whose generous support has helped us to carry out this market research. We will be continuing with this work in 2024 when we hope to launch an updated look and feel for RICE.

We have expanded our post-diagnosis support services and will continue to do so in 2024, where we hope to hold more workshops, groups, and drop-in sessions both in our centre as well as offering activities in the community and in partnership with other organisations. We will also continue to focus in 2024 on gathering further insight on what people with dementia and their carers need to help reduce isolation and confusion and to increase their opportunities for connection and support. This will ensure that our expanding post-diagnosis support services meet their needs.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 25

We will also continue to build our clinical and research capacity and to be involved in new areas of research in 2024. In early 2024, we will be recruiting to three new trials. The Biogen Envision trial is being conducted to verify the clinical benefit of aducanumab as part of the approval process required for the US Food and Drug Administration. The trial will test the safety and effectiveness of the drug on patients with mild Alzheimer’s disease and mild cognitive impairment. We will also setup and recruit to the Janssen Retain which is investigating the use of a new drug to help people showing early signs of memory loss in people who haven’t had a dementia diagnosis, and to the Lilly Trailblazer trial, which is also investigating the use of new drugs designed to help people showing early signs of memory loss but who may or may not have a dementia diagnosis already.

RICE will also be involved in three new research projects which will start in 2024. Maintain is led by the University of Exeter and is initially a small study exploring the feasibility of improving the strength and balance of patients with dementia who have had a fall and whether by doing this it could help to keep them independent. iACT4Carers is exploring the benefit of online coaching sessions for carers and we will be recruiting patients to the study which is led by the University of East Anglia. We’ve developed a new project with the local hospice, Dorothy House to look at managing distress in care home residents with dementia. This project secured funding in 2023 and will go ahead in 2024.

As part of a wider recommissioning process for all community services across Bath and North East Somerset, Swindon and Wiltshire our memory assessment service will be recommissioned from April 2025. We will work hard to ensure that the recommissioned service meets the high standard that we currently deliver, and we will work closely with other charities working with older people, as well as our NHS colleagues to help ensure people with dementia and their families are appropriately supported.

With the growing number of people in the UK impacted by Alzheimer’s disease and dementia, Parkinson’s disease, and falls it is vital that our research and services continue to evolve and to develop.

RICE will therefore continue in 2024 with our main objectives to:

• Deliver high quality memory clinic services for Bath and North East Somerset which put patients and their carers at the heart of the service

• Deliver and expand our post-diagnosis support offer for people and their families affected by dementia

• Continue our clinical trials and research activities with a focus on Alzheimer’s disease and dementia, Parkinson’s disease, and falls prevention

Contribute to clinical and research knowledge and increase awareness of RICE

We will also continue to invest in improvements to our internal processes and building stable and sustainable foundations from which we plan to grow and develop in future years.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 26

Financial Review

In 2023 RICE ended the year with a surplus of £83,120 (2022 – deficit of £116,584), and with total funds of £1,994,973 (2022 - £1,911,853). The surplus can be broken down into a figure of £104,271surplus on unrestricted funds (2022 - £111,271 deficit) and £21,151 deficit on restricted funds (2022 - £5,313 deficit). The surplus is a result of RICE receiving a number of generous legacy donations during the year.

Total funds increased to £1,994,973 from £1,911,853 due to the surplus. Fixed assets totalled £1,201,185 with most of that value being in our purpose built, specialist Centre for which a significant depreciation charge is made in the accounts every year. Net current assets increased by £110,677 to £793,788 split between restricted funds of £121,150 and unrestricted funds of £672,638. £76,217 of these unrestricted funds has been designated by Trustees for specific research and educational activity and will be spent over the next two years. Additionally, a further £278,782 was designated by Trustees for particular activities at their first board meeting in February 2024. See the post year end note 18 for more details.

Total income in 2023 was £1,128,776 (2022 - £828,056). This increase was due to a number of generous legacy donations and a large grant from the Big Lottery’s Community Fund to develop post-diagnosis support for patients and carers. RICE continued to receive income from four main income sources which include its agreements to deliver clinical trials and research projects, the memory clinic service for Bath and North East Somerset, all of which are our charitable activities, and income from fundraising. Overall, income from charitable activities increased by £34,123 to £638,628.

Total expenditure in 2023 was £1,045,656 (2022 - £944,640). The main reason for the increased expenditure was an increase in staffing which was required to expand our charitable activities and to develop our capacity to deliver and grow our services. Staff costs represented 68% of total costs in 2023 (2022 – 66%). Overhead costs continued to be tightly controlled.

2024 is likely to be a difficult year financially for RICE. Trustees are planning for a large deficit year as further investments are needed to increase our capacity further. This increase in capacity should result in an increase in income so that our expenditure is covered in future years, and our target is that RICE will achieve a balanced financial position from 2025.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 27

Fundraising

We are immensely grateful to everyone who generously supported RICE through donating, running for RICE in the Bath Half Marathon or taking part in a community or challenge event, telling their stories or volunteering with us.

In 2023 we raised 43% of our income through fundraising. This represents an increase in fundraising income of 120% from 2022 and is the result of generous legacy donations and a large grant from the Big Lottery’s Community Fund. The amounts received from fundraising are presented in the accounts as donations and legacies, and fundraising activities.

In 2023, most of our fundraising income came from Trusts and Foundations. Trusts including McLay Dementia Trust, St Monica Trust and Bath Boules have generously supported our Living with Dementia, Carers Courses and our new Chat, Make and Move activities courses. We received donations from Harford Charitable Trust, the Joseph Matthews Trust and Blevins Franks to help support our clinical services and patient support activities. We also received generous donations towards our research work from the Discworld Foundation, Medlock Charitable Trust and Dementia Research UK and contributions towards core costs from the Annett Trust, Ray Harris Trust and Smith Charitable Trust.

We are immensely grateful to our committed givers who provide regular and adhoc donations to RICE which contribute to much needed core funds. We were also fortunate to receive gifts given in memory or in wills from supporters who had sadly passed way. We are incredibly grateful for these donations which have helped to cover our core costs and to support our charitable activities.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 28

In 2024 our fundraising activities and efforts will look at new ways of bringing in income with the ambition of increasing the income we have available to fund our charitable activities.

Fundraising standards information

All our fundraising activities are carried out in-house by trained and experienced staff employed directly by RICE. Our Head of Fundraising and Communications oversees all our fundraising activity and is accountable to our Chief Executive Officer and the Board of Trustees. We monitor and support any volunteers who do fundraising on our behalf and provide them with guidance on GDPR and good fundraising practice. We do not engage any third-party professional or commercial fundraisers.

RICE fundraising activities are guided by an internal ethical fundraising policy which sets out our approach to fundraising and our interactions with vulnerable people. The policy aligns with and follows closely the Code of Fundraising Practice, which we also use and comply with. RICE is a voluntary member of the Fundraising Regulator and updates its approach to fundraising when new guidance from the regulator is published. In 2023, we received no complaints about our fundraising activities.

Reserves

Trustees hold restricted reserves as required to meet RICE’s funding agreements and commitments. Trustees review each year the amount and the purposes of unrestricted reserves held alongside setting the operational budget for the year ahead.

At 31 December 2023, RICE had restricted funds of £1,309,193 and unrestricted reserves of £685,780. £13,142 of the unrestricted reserves is tied up in fixed assets, and £76,217 has been designated by Trustees for specific activities. A further £241,422 was designated by Trustees for particular activities at their first board meeting in February 2024. See the post year end note 18 for more details. It means that during 2024, RICE has approximately £354,999 of unrestricted reserves available for general use, which would cover approximately three months running costs and staff redundancy liabilities if required. This is consistent with RICE’s reserves policy which aims to set aside £355,000 of unrestricted reserves to cover staff redundancy liabilities and three months running costs.

Going Concern

RICE anticipates that our research programme, service delivery, and fundraising will bring in income needed to cover the majority of our operating costs for the next 12 months, and that there are enough reserves that can and will be used to support any shortfall in income. Having carefully assessed internal and external factors, the Trustees believe that RICE has adequate resources available to continue to operate as a going concern for the foreseeable future.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 29

Risk Management

Trustees are responsible for identifying, managing and mitigating risks to the charity. To enable this, RICE has an internal risk management policy and a risk register which reviews risks by their likelihood and severity, identifies controls and actions to manage them appropriately and allocates a risk owner who is responsible for ensuring controls are in place and appropriate actions are taken. Trustees review key risks on a six-monthly basis or more often if circumstances require.

Principle risk and uncertainties

During 2023 measures were prioritised to mitigate those risks scored as high. The highest risks currently relate to financial challenges and uncertainties, and the potential loss of the memory assessment service contract due to future re-commissioning. Trustees have mitigated these as best as possible by focusing on improving the financial return from our clinical trials, prioritising development of our private patient income, focusing fundraising on those activities which are likely to bring in most income to cover core costs, and by starting early the planning and engagement activities required around the recommissioning. These risks will continue to be monitored closely by Trustees in 2024.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 30

Structure, governance and management

Structure

RICE is a registered charity in England and Wales (1042559) and a registered company limited by guarantee (02979617). We’re governed as defined by our Articles of Association which were agreed on 17/10/1994 and amended on 23/12/2015, 09/11/2017 and 24/08/2023. Trustees are the members of the charity.

Trustees

RICE is governed by a Board of Trustees who elect a Chair from amongst themselves. The board is collectively responsible for governance of RICE, for developing our strategic direction, and they have oversight of all activities. They ensure we operate in line with our charitable objects and for public benefit, and that we meet our financial and legal obligations, and both manage and mitigate risk. The board meets four times a year.

There is a Remuneration Committee which usually meets once a year and is chaired by the Chair of the board. All Trustees are involved in the committee which agrees any pay awards due and any changes to agreed pay and pension structures. There is also a Finance and Audit Committee which meets four times a year to ensure trustees have detailed oversight of RICE’s finances, financial risk management and finance systems, policies and processes. Trustees also hold an annual strategic day which provides an opportunity for Trustees and the whole team at RICE to review progress against the strategy and discuss future plans and activities.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 31

RICE’s Articles allow for a minimum of three and a maximum of 12 Trustees. By the end of 2023 there were nine Trustees appointed to the board. Trustees are appointed for a term of three years and can serve a maximum of three terms. Trustees have all been appointed based on their personal and professional expertise. Together the Trustees act independently of any other connections they have, and do not hold their trusteeships as representatives of other organisations or interests. This means Trustees can act within the best interests of RICE and its beneficiaries. They bring a breadth and depth of leadership experience related to our charitable objects, governance needs and research credentials.

Prospective Trustees are identified through recommendation and/or personal introduction, and specifically for their knowledge in the areas of expertise sought at the time. They’re invited to meet with the Chair and Chief Executive Officer and to observe a meeting of the board and meet Trustees as part of their recruitment process. All Trustees are required to undergo Disclosure and Barring Service (DBS) checks and must meet eligibility criteria to serve as a charity trustee. Every trustee is asked to sign a declaration of eligibility and a declaration of interests on appointment and thereafter. Trustees must ensure that any conflicts of interest are notified to the board as soon as practically possible and any related party transactions are disclosed as needed.

Once appointed all Trustees receive a copy of the RICE trustee handbook, which is updated regularly, and a tailored induction to RICE and its operations. Trustees receive regular updates on changes and developments in charity regulation and practice throughout the year either at their meetings or via our internal bulletin.

Organisational structure and key management personnel remuneration

The board has delegated authority for dayto-day operational management of RICE to the Chief Executive Officer. The Chief Executive Officer is assisted by the Research & Medical Director and a senior management team who lead on day-to-day operational decision-making. The Chair of the Board of Trustees is responsible for the appraisal and performance management of the Chief Executive Officer. Staff are employed at RICE based on the specific skills that they can bring to their role. For RICE to operate successfully, we need a range of skills and we need to pay appropriately to ensure we can recruit people with the right skills. Registered charity in England and Wales No. 1042559 Company number: 02979617[ay]

We also need to retain staff in a competitive market both in the charity and the health and care sector and so staff pay scales are set with these factors in mind. All clinical staff pay is aligned to NHS agenda for change salaries. Pay awards are agreed yearly by the remuneration committee in line with NHS awards and subject to funds being available. All charity staff pay is set based on an internal pay structure developed using benchmarking and comparisons with other charities of our size and type. Pay awards are agreed yearly by the remuneration committee and tend to match any NHS awards also made. These awards are also subject to funds being available.

Volunteers

Our work would not be possible without the volunteers who support us and get involved in our activities: from patients volunteering in research projects, to volunteers helping to run research and getting involved in our clinics, to those volunteers supporting our fundraising efforts and helping to fundraise by running their own fundraising events. Their contributions are incredibly valuable to us, and we thank them all for the time and commitment they have given and continue to give us. In 2023, over 50 patients and their families volunteered to be part of a research project, one doctor and four psychologists volunteered in our memory clinic, and ten volunteers were recruited to support our patient-related activities and to provide office and admin support.

Related party transactions

The only related party transactions in the year were with the Royal United Hospitals (RUH). See note 8 for more details about the relationship between RICE and the RUH and the transactions which occurred.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 33

Trustee’s responsibilities in relation to the financial

statements

Company law requires the Trustees to prepare financial statements that give a true and fair view of the state of affairs of the charity at the end of the financial year and of its surplus or deficit for the financial year. In doing so the Trustees are required to:

• Select suitable accounting policies and then apply them consistently

• Make sound judgements and estimates that are reasonable and prudent

• Prepare the financial statements on the going-concern basis unless it is inappropriate to presume that the charity will continue in business

The Trustees are responsible for maintaining proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and enables them to ensure that the financial statements comply with the Companies Act 2006. The Trustees are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In accordance with company law, as the company’s directors, we certify that:

• So far as we’re aware, there’s no relevant audit information of which the company’s auditors are unaware

• As the directors of the company we’ve taken all the steps that we ought to have taken in order to make ourselves aware of any relevant audit information and to establish that the charity’s auditors are aware of this information

Sumer AuditCo Limited have acted as the Company’s auditors during the year.

On behalf of the Board of Trustees,

Dr Mark Kingston, Chair

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 34

Report of the Independent Auditor’s to the Members of RICE – The Research Institute for the Care of Older People

Opinion

We have audited the financial statements of RICE-The Research Institute For The Care Of Older People (the 'charitable company') for the year ended 31 December 2023 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (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 December 2023 and of its incoming resources and application of resources, including its result, for the year then ended;

• have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

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

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditors' 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.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 35

Conclusions relating to going concern

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company'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 trustees are responsible for the other information. The other information comprises the information included in the Annual Report, other than the financial statements and our Report of the Independent Auditors thereon.

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.

In connection with our audit of the financial statements, 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 audit or otherwise appears to be materially misstated. 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 Report of the Trustees for the financial year for which the financial statements are prepared is consistent with the financial statements; and

• the Report of the Trustees has been prepared in accordance with applicable legal requirements.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 36

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 Report of the Trustees.

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:

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

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

• certain disclosures of trustees' remuneration specified by law are not made; or

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

• the trustees were not entitled to take advantage of the small companies exemption from the requirement to prepare a Strategic Report or in preparing the Report of the Trustees.

Responsibilities of trustees

As explained more fully in the Statement of Trustees' Responsibilities, 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.

Our responsibilities for the audit of the financial statements

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

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 37

The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

Based on our understanding of the charity and the provision of research and support services, we identified that the principle risks of non-compliance with laws and regulations related to safeguarding, health and safety, employment law, Companies Act 2006 and Charity Law, and we considered the extent to which non-compliance might have a material effect on the financial statements of the charity. We also considered those laws and regulations that have a direct impact on the preparation of the financial statements such as the Companies Act 2006 and the Charities Statement of Recommended Practice.

We evaluated management's incentives and opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls) and determined that the principle risks were related to revenue recognition, management override, and potential lack of segregation of duties. Audit procedures performed by the audit engagement team included:

• discussions with management and trustees, including consideration of known or suspected instances of non-compliance with laws and regulations and fraud;

• understanding and review of management's internal controls designed to prevent and detect irregularities, and fraud;

• review of the minutes of the Trustees meetings;

• review of tax compliance;

• designing audit procedures to incorporate unpredictability;

• performing analytical procedures to identify any unusual or unexpected relationships that might indicate risks of material misstatement due to fraud;

• review of the financial statements disclosures and testing to supporting documentation to assess compliance with relevant laws and regulations discussed above;

• enquiring of management about actual and potential litigation and claims;

• testing transactions entered into outside of the normal course of the charity's business; and

• identifying and testing journal entries, in particular any journal entries with fraud characteristics such as journals with round numbers.

There are inherent limitations in the audit procedures described above and the further removed noncompliance with laws and regulations is from the events and the transactions reflected in the financial statements, the less likely we would become aware of it. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 38

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at www.frc.org.uk/auditorsresponsibilities. This description forms part of our Report of the Independent Auditors.

Use of our report

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an auditors' 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.

James Gare FCA DChA (Senior Statutory Auditor) for and on behalf of Sumer Audit Co. Statutory Auditors County Gate County Way Trowbridge BA14 7FJ

Date: 28/05/2024

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 39

Statement of financial

activities

(incorporating the income and expenditure account) for the year ended 31 December 2023

The notes on pages 47 to 57 form part of these accounts.

Registered charity in England and Wales No. 1042559 Company number: 02979617

Balance Sheet

at 31st December 2023

The Financial Statements and notes set out on pages 47 to 57 have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies and were approved by Trustees on 14 May 2024 and were signed on behalf of the Trustees by:

Dr Mark Kingston, Chair Company registered number: 2979617

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 41

Cash flow statement

for the year ended 31 December 2023

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 42

Analysis in changes of Net Debt

for the year ended 31 December 2023

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 43

Accounting Policies

for the year ended 31 December 2023

RICE is a company limited by guarantee (02979617) and registered as a charity in England & Wales (1042559). RICE’s registered address is: The RICE Centre, Royal United Hospital, Combe Park, Bath, BA1 3NG. RICE’s functional and presentation currency is the pound sterling. Amounts include in the financial statements are rounded to the nearest whole pound.

The principle accounting policies adopted by the Charity in drawing up its Financial Statements are as follows:

a) Basis of accounting

The Financial Statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019) – (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006. The financial statements of the charitable company, which is a public benefit under FRS102, are prepared on a going concern basis under the historical cost convention. There are no significant areas of judgements or key sources of

estimation uncertainty.

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Going concern

RICE anticipates that our research programme, service delivery, and fundraising will bring in income needed to cover the majority of our operating costs for the next 12 months, and that there are enough reserves that can and will be used to support any shortfall in income. As part of a wider

recommissioning process for all community services across Bath and North East Somerset, Swindon and Wiltshire our memory assessment service will be recommissioned from April 2025. RICE will be making every effort to secure the contract to continue to deliver the service. However, Trustees are already planning for the possibility of having to make up a shortfall in income in 2025 if the contract can’t be secured. The shortfall in income will be met by expanding our current research activities, private clinical services, and our post-diagnosis support offer. Having carefully assessed internal and external factors, and the impact of the recommissioning process, the Trustees believe that RICE has adequate resources available to continue to operate as a going concern for the foreseeable future.

b) Income

• All income is recognised in the Statement of Financial Activities once the charitable company has entitlement to the funds, it is probably that the income will be received and the amount can be measured reliably

• For donations to be recognised the charity will have been notified of the amounts and the settlement date in writing. If there are conditions attached to the donation and this requires a level of performance before entitlement can be obtained then income is deferred until those conditions are fully met or the fulfilment of those conditions is within the control of the charity and it is probable that they will be fulfilled

For legacies, entitlement is taken as the earlier of:

• the date on which the charity is aware that probate has been granted;

• the estate has been finalised and notification has been made by the executor(s) to the Trust that a distribution will be made; or

• when a distribution is received from the estate

Receipt of a legacy, in whole or in part, is only considered probably when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is treated as a contingent asset and disclosed if material

• Grants and fees for contracts and agreements are recognised in full in the SOFA in the year in which they are receivable

• When donors specify that donations or grants are for a restricted purpose, this income is included in restricted funds when receivable

Registered charity in England and Wales No. 1042559 Company number: 02979617

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• Income from clinical trials is recognised based on the date of the patient visit and has been accrued where appropriate into the SOFA to reflect this

• Income which was received in 2023 but relates to 2024 has been deferred or included in funds for 2023 as appropriate

• Investment income is accounted for in the period in which the charity is entitled to receipt The value of services provided by volunteers has not been included

• Income from donated Royalties is received yearly and included when the charity is advised that a payment will be made and is entitled to it, and the amount can be measured reliably

c) Expenditure

• Liabilities are recognised as expenditure as soon as there is a legal or constructive obligation committing the charitable company to that expenditure, it is probably that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources. Expenditure includes Irrecoverable VAT

Rent payable under operating leases are charged to the SOFA as incurred over the term of the lease

d) Fixed assets, depreciation and amortisation

Fixed assets are capitalised when their value is over £1,000. They’re initially recorded at cost.

Depreciation and amortisation is calculated to write down the cost of fixed assets over their expected useful lives, on the following basis:

• Leasehold land and buildings – 2%-2.5% straight line

• Research equipment – 25% straight line

• Office equipment – 25% straight line

• Website – 25% straight line

• Trademark – 10% straight line

e) Pension costs

The charitable company operates a defined contribution pension scheme. Contributions payable to the charitable company’s pension scheme are charged to the Statement of Financial Activities in the period to which they relate.

f) Funds

Funds held by the charity are:

• Unrestricted general funds – these are funds which can be used in accordance with the charitable purposes at the discretion of the Trustees

Registered charity in England and Wales No. 1042559 Company number: 02979617

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• Designated funds – these are a portion of the unrestricted funds that have been set aside for a particular purpose by the Trustees

• Restricted funds – these are funds that can only be used for particular restricted purposes within the purposes of the charity. Restrictions arise when specified by the donor or funder or when funds are secured for restricted purposes

A further explanation of the nature and purpose of each fund is included in the Notes to the Financial Statements (see note 14).

h) Financial instruments

The charity has minimal exposure to customer credit risk, liquidity risk and market risk. Please refer to the risk section of the Trustees annual report for information on how risks are managed. The charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method. The charity does not have any non basic financial instruments.

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

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

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

i) Corporation tax

The charitable company is exempt from corporation tax on its charitable activities.

Registered charity in England and Wales No. 1042559 Company number: 02979617

RICE ANNUAL REPORT AND ACCOUNTS 2023 PAGE 47

Notes to the Financial

Statements

For the year ended 31 December 2023

Registered charity in England and Wales No. 1042559 Company number: 02979617

Notes to Financial Statements [continued]

Direct expenditure has been allocated to the appropriate activity. Indirect staff costs and general support costs have been apportioned to activities in proportion to the number of staff in each area of activity. General support costs for the year ended 31 December 2023 are made up as follows:

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

The Trustees neither received nor waived any remuneration or benefits during the year (2022 - £0). No expenses were reimbursed to the Trustees during the year (2022 - £0).

The only related party transactions in the year were with the Royal United Hospitals (RUH). Whilst the RUH and RICE work closely together due to our similar interests in improving the health of older people, the two organisations operate completely separately of each other. One of RICE’s Trustees is employed by the RUH, but in their role as Trustee they act independently and only in RICE’s best interest. RICE and RUH also share a staff member who holds a joint employment contract with both parties, but in their role at RICE act independently and only in RICE’s best interest. In 2023, RICE paid £119,240 to RUH and RUH paid £29,941 to RICE. These transactions can be broken down as follows:

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

As a result of RICE’s investment in relocating to a new site in 2008, there is a significant annual depreciation charge on property restricted assets that is included in the Statement of Financial Activities each year as resources expended on restricted funds. Additionally, in 2019, RICE completed its attic conversion work which resulted in additional depreciation charges on property restricted assets and which is being accounted for in the same way as the existing property restricted asset. The total property depreciation charge amounted to £35,704 in the year ended 31 December 2023 (2022 - £35,608). The annual depreciation charge reduces the value of the restricted fund asset in the Balance Sheet as in note d) of the Accounting Policies.

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

Notes to Financial Statements [continued]

Registered charity in England and Wales No. 1042559 Company number: 02979617

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Notes to Financial Statements [continued]

In February 2024, at their first board meeting of the year, Trustees decided to designate an additional £241,422 of the £596,421 of unrestricted net assets available for the following purposes: to develop a new healthy brain clinic, as an emergency fund for fixed asset renewal and repairs, and to fund a large, planned for, deficit budget for 2024. Following these designations the amount of unrestricted reserves available for general use is £354,999, which would cover approximately three months running costs and staff redundancy liabilities if required.

Registered charity in England and Wales No. 1042559 Company number: 02979617