**Company Registered Number: 02988368 Charity Registered Number: 1042574**
## **INTERNATIONAL HEADACHE SOCIETY**
**(A Company Limited by Guarantee)**
**TRUSTEES' REPORT AND FINANCIAL STATEMENTS**
**FOR THE YEAR ENDED 31 DECEMBER 2023**
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **CONTENTS**
||Page|
|---|---|
|**Reference and Administrative Details of the Charitable Company, its Trustees and**|1 - 2|
|**Advisers**||
|**Trustees' Report**|3 - 16|
|**Trustees' Responsibilities Statement**|17|
|**Independent Auditor's Report on the Financial Statements**|18 - 21|
|**Consolidated Statement of Financial Activities**|22|
|**Consolidated Balance Sheet**|23 - 24|
|**Charitable Company Balance Sheet**|25 - 26|
|**Consolidated Statement of Cash Flows**|27|
|**Notes to the Financial Statements**|28 - 46|
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITABLE COMPANY, ITS TRUSTEES AND ADVISERS**
**FOR THE YEAR ENDED 31 DECEMBER 2023**
|**Trustees**|F Ahmed, Honorary Treasurer|
|---|---|
||M Ashina, Past president until 15 September 2023 (resigned 15 September 2023)|
||R Burstein, President-elect until 15 September 2023, President from 15 September|
||2023|
||A Carmine Belin|
||G Coppola (resigned 15 September 2023)|
||A Antreou (appointed 15 September 2023)|
||S Ashina (appointed 15 September 2023)|
||J Hoffmann (resigned 1 May 2024)|
||M Valença (appointed 15 September 2023)|
||M F Prieto Peres, President-elect (appointed 15 September 2023)|
||A Özge|
||C Tassorelli, President until 15 September 2023, Past-President from 15|
||September 2023|
||M Chu (resigned 15 September 2023)|
||M Goicochea (resigned 15 September 2023)|
||A Charway-Felli (resigned 15 September 2023)|
||A H E Mohammed (resigned 15 September 2023)|
||T Monteith (resigned 15 September 2023)|
||P Pozo-Rosich, Secretary|
||O Daniel (appointed 5 October 2023)|
||L Mechtler (appointed 10 December 2023)|
||M Velez (appointed 5 October 2023)|
|**Company registered**||
|**number**|02988368|
|**Charity registered**||
|**number**|1042574|
|**Registered office**|6th Floor|
||2 London Wall Place|
||London, United Kingdom|
||EC2Y 5AU|
|**Independent auditor**|MHA|
||Statutory Auditor|
||Building 4, Foundation Park|
||Roxborough Way|
||Maidenhead|
||SL6 3UD|
Page 1
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITABLE COMPANY, ITS TRUSTEES AND ADVISERS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023**
|**Bankers**|Santander UK plc|
|---|---|
||1st Floor|
||Market Place|
||Derby|
||DE1 3PY|
||Close Brothers Limited|
||10 Crown Place|
||London|
||EC2A 4FT|
|**Solicitors**|Penningtons Manches Cooper LLP|
||Clarendon House|
||Clarendon Road|
||Cambridge|
||CB2 8FH|
|**Investment Managers**|Schroder Unit Trust Limited|
||31 Gresham Street|
||London|
||EC2V 7QA|
||Eskmuir Asset Management Ltd|
||8 Queen Anne Street|
||London|
||W1G 9LD|
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
## Trustees
The Trustees, who act as directors of the company, who have served since 1 January 2023, are as follows:
|F Ahmed (Honorary Treasurer)|J Hoffmann (resigned 1 May 2024)|
|---|---|
|Anna Antreou (appointed 15 September 2023)|L Mechtler (appointed 10 December 2023)|
|M Ashina (Past-President) (resigned 15
September 2023)|A H E Mohammed (resigned 15 September 2023)|
|S Ashina (appointed 15 September 2023)|T Monteith (resigned 15 September 2023)|
|R Burstein (was President-elect) (President from 15
September 2023)|A Özge|
|A Carmine Belin|M F Prieto Peres (appointed 15 September
2023) (President-elect)|
|A Charway-Felli (resigned 15 September 2023)|P Pozo-Rosich (Honorary Secretary)|
|M K Chu (resigned 15 September 2023)|C Tassorelli (Past-President)|
|G Coppola (resigned 15 September 2023)|M K Velez (appointed 5 October 2023)|
|O Daniel (appointed 5 October 2023)|M Valença (appointed 15 September 2023)|
|M T Goicochea (resigned 15 September 2023)||
Trustees benefit from indemnity insurance to cover the liability of the Trustees which by virtue of any rule of law would otherwise attach to them in respect of any negligence, default or breach of trust or breach of duty of which they may be guilty in relation to the Charity. The cost of this insurance in the year has been included within total insurance costs.
## Structure, governance and management
In common with all limited liability companies, the Society has a board of directors who take overall responsibility. A new Memorandum and Articles of Association was adopted in September 2008 which created a Board of Trustees, who became the directors of the Society. The Articles were updated in September 2023 with a change to voting eligibility.
The day-to-day running of the Society is the responsibility of the Board of Trustees with the assistance of a selfemployed Executive Director (appointed June 2023), a self-employed Administrative Manager, and outsourced accountancy services support from MHA. In addition, there are 14 advisory Standing Committees and Special Interest Groups.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
The constitution allows for the members in general meeting to elect Honorary life members; seven were elected in 1997 (Eero Hokkanen, James W Lance (since deceased), Frank Clifford Rose (since deceased), Federigo Sicuteri (since deceased), Ottar Sjaastad (since deceased), Dieter Soyka (since deceased), Marcia Wilkinson (since deceased)) and a further four in 2002 (John Desmond Carroll (since deceased), Karl Ekbom (since deceased), Lee Kudrow, Edgard Rafaelli Jnr (since deceased)). From 2005, it was agreed that all PastPresidents of the Society should be elected as Honorary life members following their leaving the Board of Trustees (including retrospectively) and a further seven were elected at this time (Marie-Germaine Bousser, Michel D Ferrari, Ninan T Mathew (since deceased), Jes Olesen, Jean Schoenen, Peer Tfelt-Hansen, K Michael Welch). In 2009 a further two Past-Presidents (Michael A Moskowitz, Fumihiko Sakai) and two recipients of the IHS Recognition for Service Award (Peter J Goadsby, Timothy J Steiner) were elected. In 2011 the PastPresident (Hans-Christoph Diener) and a recipient of the IHS Recognition for Service Award (E Anne MacGregor) were elected. In 2013 two recipients of the IHS Recognition for Service Award (Giuseppe Nappi, K Ravishankar) were elected. In 2017 the Past-President (Alan Rapoport) was elected. In 2019 the Past-President (David Dodick) was elected. In 2021 the Past-President (Lars Edvinsson), two recipients of the IHS Recognition for Service Award (Allan Purdy, Vincenzo Guidetti) and two Honorary Life Members (Patrick Humphrey, Pramod Saxena) were elected. In 2023 the Past-President (Messoud Ashina) and two Honorary Life Members (Rigmor Jensen, Stephen Silberstein) were elected.
IHS offers Junior membership at a reduced rate to Residents and Trainees alternatively within three years of obtaining medical doctorate or academic post graduate degree or specialist certification, whichever was obtained latest, up to 15 years following MD qualification, or within six years of obtaining latest academic degree for other academic groups, up to 15 years following primary qualification. IHS also offers membership at a reduced rate to eligible members from upper-middle income countries. Standard members (which includes Honorary, Junior and Upper-middle income country members) are entitled to vote at IHS meetings.
National scientific societies sharing the aims of the IHS can become Affiliate Member Societies of IHS. The representatives of the Affiliate Member Societies join the Advisory Council.
IHS offers free of charge Associate membership to assist those professionally interested in headache disorders who are residents of low- and lower-middle income countries. Associate membership is also offered to those eligible for junior membership from upper-middle income countries.
## Induction and training of Trustees
Following elections at the Annual General Meeting, a ‘Trustees’ Pack’ is given to new Trustees which includes the Society’s Articles and Bylaws as well as Charity Commission Guides on being a Trustee of a UK registered charity. In view of the worldwide location of Trustees it is complex to organise formal face to face training for new Trustees.
## Risk management
In June 2004 the Society adopted a formal risk management policy and structure for assessing risk and this was updated in January 2012. The Society supports a systematic approach to risk management that ensures that the risks associated with every activity are assessed, ranked and prioritised. A risk map is produced which is reviewed by the Board of Trustees annually. The Board of Trustees are confident that this ensures that any exposure to risk is identified and that procedures are in place to manage that risk.
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## **INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
The Trustees consider the principal risks and associated mitigation strategies to be:
- The loss of trustees – the Society implements succession planning including overlapping terms of Board members to minimise knowledge loss in these circumstances
- Conflicts of interest – the Society has a clear policy on disclosure of conflicts of interest and procedures in place to ensure that decisions are not influenced by individuals with associated conflicts
- Compliance with legislation and regulations – the Society allocates key compliance procedures across the Board of Trustees to ensure compliance is adhered to as required
- Dependence on income sources – the Society retains adequate reserves to cover potential shortfalls in funding.
## Public Benefit
The Trustees confirm that they have referred to the information contained in the Charity Commission’s general guidance on public benefit when reviewing the Society’s aims and objectives, and in planning activities and strategy for the year ahead.
Through its activities, most notably the journals, the International Congress, the International Classification of Headache Disorders, clinical trial guidelines, worldwide education and the Online Learning and Education Centre, the Society disseminates vital research and educates physicians and headache specialists throughout the world in order that they are better able to understand and treat headache sufferers.
## **Objectives and Principal Activities**
The Society’s activities, summarised below, ensure that it fulfils its charitable purpose and that they are for the public benefit across the world.
## Objectives
The objects are to relieve sickness and to protect and preserve health in the United Kingdom and elsewhere in the world, including in any one or more of the individual countries of the world. The Society achieves this, in particular, by promoting research into the causes, mechanisms, consequences, diagnosis, prevention, treatment and other aspects of headache and by disseminating the useful results of such research, by advancing the education and raising the awareness of the public of the subjects of headache, its science and management, and by such other ways as the charity through its trustees may from time to time decide.
The income and property of the Society are applied solely towards the promotion of its objects.
## Aims and Activities
In 2023 the Society aimed to continue its work in promoting headache research and dissemination of knowledge.
The 21st Congress of the International Headache Society (IHC) was held in Seoul, Republic of Korea in September. An International Headache Academy (iHEAD) was held in Seoul prior to IHC and a Master School was held in Mexico. The Online Learning and Education Centre on the website was updated with new online educational content and a new CME-accredited course was added. IHS collaborated with the European World Organization of Family Doctors (WONCA) to develop an online course designed for primary care physicians. Four headache awareness campaigns were run online on cluster headache, migraine, tension-type headache and medication-overuse headache. One IHS Fellowship, two Headache Trainee Programmes, three Short-stay Scholarships and one Allied Specialties Scholarship were awarded. Three Junior Research Grants, two Child and Adolescent Seed Funding Grants, and two Secondary Headache Research Grants were awarded. Visiting Professor programmes were held in Sri Lanka, Vietnam and Laos. IHS supported a speaker to attend the annual European Academy of Neurology Sub-Saharan Regional Teaching Course in Tanzania.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
Two IHS Guidelines documents were published in Cephalalgia and two more plus practice recommendation guidelines, migraine treatment guidelines in collaboration with the Italian Headache Society, and guidelines on real-world data studies in headache are ongoing with expected publication in 2024. IHS also published Grading of Recommendations, Assessment Development and Evaluation (GRADE) tables of monoclonal antibodies targeting CGRP in migraine prevention. All IHS guidelines are published in Cephalalgia.
Cephalalgia and Cephalalgia Reports, the IHS scientific journals, continued publication. Cephalalgia changed from a subscription journal to an open-access title; this will ensure that scientific research is freely available and enable researchers with limited access or funds to access the most up to date advances in the field of headache research and medicine. Two IHS Corporate Roundtable meetings were held and brought together key stakeholders to ensure the future of headache medicine and patient access to new medications.
## Activities
Every other year the Society, through its subsidiary company, holds an International Headache Congress, at which developments and research in the field of headache is discussed. In 2022 the first Regional Headache Conference was held, also through the subsidiary company. The Society also publishes a professionally acclaimed journal, Cephalalgia, a companion title, Cephalalgia Reports, and hosts an extensive Online Learning and Education Centre on the IHS website. Educating the next generation of headache specialists (iHEAD) and teaching in regions where headache specialists are few (Visiting Professor programme, IHS Master Schools, IHS Regional Outreach ProgrammE) are key objectives, as is raising awareness of headache and migraine worldwide and reducing the associated stigma.
## Professional Collaborations
The Society works closely with its Affiliate Member Societies (national societies). In 2023 there were 53 Affiliate Member Societies worldwide. Some of the Affiliate Member Societies offer membership of IHS through their society; these include:
- the American Headache Society
- the Australian and New Zealand Headache Society
- the Brazilian Headache Society
- the British Association for the Study of Headache
- the Danish Headache Society
- the Dutch Headache Society
- the German Migraine and Headache Society
- the Italian Headache Society
- the Italian Neurological Association for Research on Headache
- the Japanese Headache Society
- the Korean Headache Society
- the Latin-American Headache Society.
IHS (via the IHS Trading Company) hosts the biennial International Headache Congress which is organised in consultation with the national society of the hosting country. Recent congresses have been held in Seoul, Republic of Korea (2023), virtually – joint congress with the European Headache Federation (2021), Dublin, Ireland (2019), Vancouver, Canada (2017), Valencia, Spain (2015), Boston, USA (2013), and Berlin, Germany (2011).
The next congress will be in São Paolo, Brazil, in 2025. IHS will also hold a smaller IHS | Science conference in Berlin, Germany, in 2024.
IHS also collaborates with the World Health Organization on the International Classification of Headache Disorders (ICD-11), with the International Association for the Study of Pain and the World Federation of Neurology, and with European World Organization of Family Doctors (WONCA) on education of primary care physicians. IHS is a member of OneNeurology.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
## Fundraising
The Society carries out its fundraising both internally and externally. It does not use professional fundraisers or commercial participators.
Corporate sponsorships provide the only fundraising income for the Society and this is done through Trustee interactions with corporate companies who are contacted in the course of a regular professional relationship or though the Professional Conference Organiser in respect of the International Headache Congresses. The Society is not subject to any undertaking to be bound by any voluntary scheme for regulating fundraising or any voluntary standard of fundraising in respect of its activities.
The Society does not raise funds from the public. No complaints have been received in respect of the Society’s fundraising activities during the financial year.
## **Strategic Report**
## Achievements and performance
Dr Patricia Pozo Rosich reports to the Society as honorary secretary.
This report covers the activities of IHS for the year ended 31 December 2023.
In January 2023 Cephalalgia switched to an open-access title, enabling published scientific research in Cephalalgia to be freely available and remove barriers to ensure clinicians and researchers with limited access or funds can keep up to date with advances and developments in the field of headache research and medicine. It is also beneficial to authors who receive higher exposure for their research. As expected with the switch to open access the impact factor and journal ranking has decreased, however, it is expected this will recover over the coming years. The 2022 impact factor was 4.9; Cephalalgia is ranked 46 of 212 clinical neurology journals, and 78 of 272 neuroscience journals. Professor Arne May retired at the end of 2023; he was succeeded by Professor Simona Sacco who took over in January 2024. Wendy Krank continues as Managing Editor and the journal is published by SAGE Publications Ltd.
Several special collections and papers were published in Cephalalgia during 2023:
- Migraine genetics (Special Collection)
- New migraine drugs (Special Collection) – Editorial by Francesca Puledda, Cristina Tassorelli and Hans-Christoph Diener
- Other primary headaches (Special Collection) – Editorial by Mi Ji Lee and Kuan-Po Peng
- Cluster headache and other TACs (Special Collection) – Editorial by Stefan Evers and Roberto de Icco
- • Harassment in the headache field: a global web-based cross-sectional survey – Irene de Boer on behalf of the IHS Women’s Leadership Forum
- Cephalalgia – The early history – Stefan Evers
- Crossing the Rubicon? The future impact of artificial intelligence on headache medicine – Kuan-Po Peng and Arne May.
The abstracts from the 21[st ] International Headache Congress (IHC) 2023 were also published in the journal.
Cephalalgia Reports, the open-access silhouette title to Cephalalgia providing an international forum for original research papers, review articles, clinical perspectives, case reports, technical reports and short communications now has over 150 published articles. The journal is listed in the Directory of Open Access Journals and Scopus and has applied for PubMed listing.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
Membership numbers have been increasing over the past years culminating in the highest ever number of members in 2023 – 2,150 (65% through their Affiliate Society) – the first time the society has had over 2,000 members; in 2023 IHS welcomed 493 new members. Members who did not renew were actively followed up throughout the year and a membership campaign was begun in the autumn and carried through to early 2024. IHS continues to offer free of charge Associate Membership to specialists living in low and lower-middle income countries, and also to those eligible for Junior membership from upper-middle income countries. There was one new Affiliate Member Society in 2023 – IHS currently has 53 Affiliate Member Societies representing 52 countries.
The elections for the elected members of the Board of Trustees were successful; 46% of IHS members voted. Mario Peres was elected as President-elect, and Anna Andreou, Sait Ashina and Marcelo Valença as Elected Trustees. Subsequently the Board Co-opted three new Trustees: Oved Daniel, Laszlo Mechtler and Maria Karina Velez. Current elected Trustees Andrea Carmine Belin, Jan Hoffmann and Aynur Özge started their second term; Jan Hoffmann resigned in May 2024 due to a change in position to work with a commercial company. Messoud Ashina, Gianluca Coppola, Augustina Charway-Felli, Maria-Teresa Goicochea, Amr Hassan, Min Kyung Chu, and Tesha Monteith retired from the Board following the Annual General Meeting and we thank them for their work on behalf of the society.
The Memorandum of Understanding with the IHS Global Patient Advocacy Coalition (IHS-GPAC) was not renewed.
The European Corporate Roundtable brings together industry partners, IHS representatives, patient advocates and a European Medicines Agency representative. The main purpose of the Corporate Roundtable is to hold a dialogue between all stakeholders to enhance the efficiency of drug development in the European Union and evaluate/minimise barriers to access to new drugs and devices for appropriate patients. The Corporate Roundtable met in June and December to discuss guidelines on real-world evidence studies, clinical trial guidelines, global outreach, practice recommendations, clinical trials dashboard, online training course for trial conduction, and journal submissions.
The Standing Committees and Special Interest Groups (SIGs) continued to be active on behalf of the Society.
There were new Committee Chair appointments as terms ended and re-appointments for a second term: Peter Goadsby was re-appointed Chair of the Classification Committee; Gisela Terwindt was re-appointed Chair of the Clinical Trials Committee; Jr-Wei Wu succeed Anna Andreou as Co-Chair of the Communications Committee; Henrik Schytz was re-appointed Chair of the Education Committee; Mo Levin continues as Acting Chair of the Ethics Committee; Cristina Tassorelli succeeded Messoud Ashina as Chair of the Leadership, Development and Nominations Committee; following his election as President-elect, Mario Peres has stepped down as Chair of the Membership Committee and Co-Chairs Gianluca Coppola and Teshamae Monteith appointed; Messoud Ashina succeeded Hans-Christoph Diener and Shuu-Jiun Wang as Chair of the Science and Research Committee; Stefan Evers and Mona Nada were appointed as Co-Chairs of the Cluster Headache Special Interest Group; and Irene de Boer succeeded Francesca Puledda as Chair of the Juniors Group.
The Clinical Trials Committee published one Guideline document: ‘Guidelines of the International Headache Society for Controlled Clinical Trials in Idiopathic Intracranial Hypertension’. An experience-based update to the ‘Guidelines for controlled trials of preventive treatment of migraine in children and adolescents, 1st edition’ was published. IHS also published Grading of Recommendations, Assessment Development and Evaluation (GRADE) tables of monoclonal antibodies targeting CGRP in migraine prevention; the tables are evidence based and independently assessed, and it is envisioned that the tables will provide support for author groups writing national or regional treatment or management guidelines for migraine prevention.
A Clinical Trials Dashboard was developed in collaboration with the Neurological Institute C Mondino Foundation, Italy, and hosted on the IHS website. The dashboard allows easy, fast and precise research of all information regarding studies in headache worldwide.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
The Communications Committee continued to heighten IHS’ profile in social media. Under the guidance of the two Communications Committee Co-Chairs, IHS enhanced its online profile through the social media channels and the Society is now increasingly active, highlighting Society new and general headache medicine advancements on a daily basis, giving IHS a strong online presence. The Committee also took over management of the Cephalalgia and Cephalalgia Reports channels. Four awareness campaigns were held on tension-type headache, cluster headache (on 21 March, to co-incide with Cluster Headache Awareness Day, the spring equinox), medication-overuse headache, and migraine. Each campaign includes three videos on ‘What is’, ‘How to diagnose’ and ‘How to treat’ the disorders, with videos in many different languages.
The IHS Education Committee sent Visiting Professors to Sri Lanka, Vietnam and Laos. A Master School was held in Mexico in collaboration with the Mexican Headache Society, AMCEMIG. The Committee also continued to add to the collection of videos and podcasts in the website Online Learning and Education Centre, and hold webinars on different headache subjects during the year. The first IHS Learning Institute course, on migraine, was launched; the course is Continuing Medical Education (CME)-accredited by the European Accreditation Council for Continuing Education (EACCME). During IHC 2023 interviews were held on various topics with leading experts in the field and uploaded to the IHS YouTube channel.
The eighth International Headache Academy (iHEAD) was held in Seoul in September, immediately prior to the IHC 2023; 93 delegates attended from 30 different countries. iHEAD aims to advance headache education and facilitate mentorship for the next generation of headache specialists and key opinion leaders in the region. Delegates are carefully selected by the Scientific Steering Committee collaborating with the IHS Juniors Group and regional headache societies. The educational content is directed by the Scientific Steering Committee, which develops a comprehensive agenda combining the latest research in headache care with instruction in practical approaches to research, clinic-based medicine and professional development. iHEAD targets a dual need: 1) to attract young physicians to pursue a career in headache medicine; and 2) to raise the level of education on headache across the different countries. Attendees are given the education and skills necessary to return to their countries of origin and develop and improve the practice of headache medicine locally. A research project identified during iHEAD 2022 is currently in progress, and four review papers for submission to Cephalalgia are being written by iHEAD 2023 faculty in collaboration with delegates.
One IHS Fellowship was awarded in 2023, to a researcher from New Zealand to study with Dr Jan Hoffmann in the UK. Three past Fellows presented their research during IHC 2023.
Two Headache Trainee programmes and three Short-stay Scholarships enabled young physicians from lowerincome countries to spend up to 12 weeks and 8 weeks, respectively, in leading headache centres. The aim of these programmes is to increase transnational mobility of young researchers living in lower-income countries by providing grants for short, goal-directed stays in headache centres and research institutions.
One Allied Specialties Scholarships, for allied healthcare professionals (e.g. nurses, therapists) to visit a major headache centre for clinical training was awarded; a physiotherapist from Italy will visit a centre in Queensland, Australia.
IHS offered 65 travel grants to young researchers and physicians from around the world to attend IHC 2023.
Three Junior research grants for scientific projects were awarded, one based in Germany, one in Australia and one in China; the projects were reviewed and selected by the Juniors Group. Two secondary headache research grants were awarded to researchers from Nepal and India. Two seed funding grants for projects focusing on child and adolescent headache were awarded to researchers from Italy and the USA.
Two awards were offered to recognise promising early- and mid-career basic, clinical or translational scientists whose research has contributed to the headache field.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
The Juniors Group continued their virtual mentoring programme to promote global mentorship, collaborations, and support within the Society. Mentors and mentees were paired based on either clinical, research, advocacy interests or career paths. Following the year of mentorship two mentees will visit their mentor’s headache centre for a short visit to finalise their coaching. The Juniors Group also continued work on the international medications project to understand the availability of different headache medications around the world. Currently data has been collected from 66 different countries. Preliminary results were presented in a poster at IHC 2023 and the results will be published in Cephalalgia.
The Asian Regional Consortium for Headache (ARCH) now has 17 national headache societies and the group will work to set up national headache societies where none currently exist. There is an internet-based communication platform on the ARCH website and mobile apps are in development to assist members in connecting with each other.
The Women’s’ Leadership Forum has published two groundbreaking and impactful publications.
IHS supported a speaker to attend the annual European Academy of Neurology (EAN) Sub-Saharan Regional Teaching Course in Tanzania. The Society continued to collaborate with the International Association for the Study of Pain (IASP) holding a joint session at the IHC 2023 in Seoul, with two speakers from IASP. A collaboration with several stakeholders including the American Headache Society, National Institute for Neurological Diseases and Stroke (NINDs), national and international scientists and clinicians, and patient organisations continues to identify headache research priorities, the aim to identify three priority areas for headache research in the short term (three to five years) and longer term to unify the headache field towards reaching goals. A special session held at IHC 2023 presented the project and was attended by the NINDs programme director.
The Society became a member of OneNeurology, an initiative conceived by the European Federation of Neurological Associations and the EAN that has led to a wide partnership involving numerous international disease-specific organisations and regional umbrellas with the aim to ensure recognition and support for the wide range of neurological disorders. This will be achieved with multiple initiatives, from capacity building to awareness raising.
Through the diverse in-person/virtual educational events and other initiatives IHS reached healthcare professionals worldwide to educate on headache medicine and research. The online learning centre, with much free access content, reaches people interested in headache worldwide and includes a CME-accredited education course on migraine, and the headache awareness campaigns which have a global remit for anyone interested in headache, from all medical disciplines, primary care and headache patients. In total 14 grants were awarded either for in-person clinical visits or for scientific research. The positive impact of the various IHS grants has been recognised through a survey of past grant recipients, the results of which were published in Cephalalgia (Puledda F, et al. A history of International Headache Society grants and their impact on headache careers. Cephalalgia 2022;42(11-12):1288-1293. doi:10.1177/03331024221107384), and IHS continues to retain contact with past grant recipients to keep informed of their careers.
Four congresses/courses were offered the opportunity to run under the auspices of IHS during 2022:
- The Global Migraine and Pain Society Spring Symposia, İstanbul, Turkey, 29-30 April 2023
- Corso di alta formazione in terapie avanzate delle cefalee-2 modules, Roma, Italy, May/November 2023
- The 2nd International Egyptian Headache Congress and 7th MENA Headache Congress, Cairo, Egypt, 18-19 May 2023
- The Global Migraine and Pain Society Autumn Symposia, Headache Scales in Clinical Practice-1, İstanbul, Turkey, 21-22 October 2023.
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**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
IHS also offered endorsement to a grant proposal:
- Grant proposal by Dr Schwedt to PCORI for a study on comparative effectiveness study of three oral medications used for migraine prevention.
IHS continued collaborating with producers of a television documentary on headache: ‘Headed for the future’. The documentary will highlight the progress within the field of headache disorders and science with the message that headache science will lead to improved quality of life for patients. The target audience will be the general public, health policy makers and healthcare professionals. The three episodes will involve interviews with leading scientists, headache specialists, patient advocates and patients enrolled in clinical trials throughout the world. During 2023 the episodes were finalised and release is expected during 2024.
The highlight of the year was the 21st IHC held in Seoul, Republic of Korea, in September, the first IHC in Asia since 2005. Over 1,600 delegates attended the congress either in person (>1,100) or virtually, and enjoyed an incredibly diverse and rich programme covering all topics of headache medicine through teaching courses, plenary sessions, debates, lunchtime and parallel sessions, and satellite symposia. Oral presentations from submitted abstracts highlighted the recent exciting developments in headache medicine and almost 500 posters were displayed, the best of which were selected for presentation as e-posters. During the IHC the Juniors Group held their Headache Science Excellence Tournament, a competitive tournament providing an opportunity for young scientists to present their data during a short talk and discussion.
Following the congress an online webinar was held showcasing the highlights of the congress and in 2024 all the recorded presentations were made available for IHS members on the website. Posters were uploaded to the website IHC poster library.
IHS Trading Company Ltd. organises the bi-ennial IHC on behalf of the charity – surplus funds are gift-aided to the charity following the event through a Deed of Covenant.
A new Executive Director, Eric Liebler, was engaged to work with and support the Board in the day-to-day management of the Society, fulfil defined strategies and seek new ones for the society going forward.
Carol Taylor continues to provide administrative assistance to the Society with assistance from Chelsea Thomas, and Intermarketing Agency supports the website. MHA are engaged for accountancy services.
I am grateful to the Trustees, Standing Committees and Special Interest Groups and Affiliate Societies for their activities on behalf of IHS throughout 2023.
## **Financial review**
## Investment policy
The Trustees consider social, environmental and ethical considerations when investing. The Society held significant cash reserves as at 31 December 2011 of £1.4m and a decision was made by the Board in early 2012 to invest £500k in specialist quoted charity investments with J P Morgan to generate higher revenue in capital returns.
In September 2016 the J P Morgan products were no longer available and were sold for £643k. In November 2016 £600k was reinvested in four Schroder Unit Trust Funds. In 2023 one of the funds was discontinued and the IHS funds returned to the society’s bank account.
In 2017 it was recommended and subsequently agreed by the Board to invest £250k in the Diversified Property Fund for Charities (DPFC) managed by Eskmuir Asset Management Ltd. This was concluded in August 2017. A further £250k was invested in the DPFC in September 2018.
Page 11
**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
Any significant surplus cash held by the Society is placed on bank deposit. The Trustees consider this gives a reasonable return at very low risk and allows the flexibility to have easy access to funds at short notice should demands be made on the Society in order for it to achieve its charitable objectives.
The Trustees consider that the investment performance was satisfactory and investment objectives had been met.
## Reserves policy
At 31 December 2023 the group's total funds were £2,999,356 (2022: £3,089,613) of which £2,919,487 (2022: £2,900,726) were unrestricted and £79,869 (2022: £188,887) were restricted.
At 31 December 2023 IHS Trading’s total funds were £(200,400) (2022: (102,998)) this fund is in deficit.
Certain of the group's income arises only in alternate years. In addition, grants and donations received can vary significantly from year to year. At this stage in the group's development the Trustees consider it appropriate to maintain a general reserve in the region of two to three times the expected annual expenditure (£1.5m to £2.3m) which is in line with similar not for profit international organisations. Should the group's income fall unexpectedly, this general reserve would be used to enable it to plan and execute in good order either a reduction in its activities or an improvement in its income stream. The Trustees acknowledge that the current level of reserves is high and the Treasurer will take steps to address the situation in the post-COVID-19 period as the Society’s activities continue to increase.
## Financial activities and affairs
As shown in the statement of financial activities on page 22, the group had total income of £894,676 in 2023 (2022: £1,035,786) and net decrease in funds for the year before tax of £90,257 (2022: net increase of £92,406 before tax).
The group’s income was made up from several sources. Royalty income from the Society’s journal Cephalalgia totalled £145,147 (2022: £373,276) and membership fees reached £150,067 (2022: £142,826). There was income from its trading subsidiary of £58,395 (2022: £99,057).
In addition, the company received investment income from its investments and bank deposits totalled £150,148 (2022: £75,977).
The group had total expenditure of £923,486 in 2023 (2022: £852,678). Of the total expenditure in 2023 £109,018 (2022: £92,447) was restricted.
The group’s expenditure included governance costs of £105,716 (2022: £89,359), grants and expenditure made in furtherance of the charity’s objectives of £133,513 (2022: £148,723), educational development costs including the Open Learning centre and two Master Course (Copenhagen) totalled £202,432 (2022: £211,263), costs of its journal, Cephalalgia, of £16,605 (2022: £64,047), committee expenses of £nil (2022: £1,100) and support costs of £271,632 (2022: £202,714).
## Going concern and consideration
The Trustees have assessed the use of going concern and have considered possible events or conditions that might cast significant doubt on the ability of the Group to continue as a going concern. The Trustees have made this assessment for a period of at least one year from the date of the approval of these financial statements. The Trustees have concluded that there is a reasonable expectation that the Group has adequate resources to continue in operational existence for the foreseeable future. The Group therefore continues to adopt the going concern basis in preparing these financial statements. The Trustees are not aware of any post balance sheet events which would have a material impact on these financial statements.
Page 12
**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
## Grants and donations
All of the Society’s resources are dedicated to the achievement of its objectives. There are occasions where it is appropriate to make grants (and to provide support) to individuals and institutions towards the costs of activities and events undertaken for reasons complementary to the Society’s objectives. In addition, there are cases where other institutions working on a similar agenda are better placed to achieve the Society’s objectives. In those cases, the Society may choose to donate some of its financial resources thereto. The Board of Trustees considers all grants and donations in detail prior to giving approval (or otherwise).
## **Plans for future periods**
IHS will continue work to strengthen existing partnerships and establish new strategic relationships which will allow the Society to extend its educational reach and influence regional, national, and global policy makers that will facilitate drug development, remove barriers to care, and improve access to new and emerging therapies.
IHS will work to make headache medicine available in low- and middle-income countries throughout the world. It is recognised that in these countries most headache sufferers cannot seek medical advice from a doctor, but instead see community healthcare workers who do not have knowledge of headache medicine and no access to therapies on the World Headache Organization (WHO) list of essential medications. IHS will develop tools for educating community healthcare workers in using diagnostic tools they can understand and applying therapeutic tools (i.e. medications) available to the communities they serve. The initiative will begin with pilot projects in Kenya and the Philippines.
Following a request from WHO, IHS will collaborate with Lifting the Burden (LTB), European Headache Federation (EHF) and DREAM to make recommendations to WHO for addition of drugs for the treatment of headache to the WHO list of essential medications. The proposal will be submitted to WHO later in 2024.
The WHO has also asked LTB to propose a world headache week – this will be the third week of March which includes 21 March, Cluster Headache day. IHS will collaborate with LTB, EHF and the European Migraine and Headache Alliance to develop a campaign to support the world week.
A Global Burden of Disease (GBD) Task Force will be formed to work with collaborators with the leaders of the GBD, the largest and most comprehensive effort to quantify health loss across places and over time, so health systems can be improved and disparities eliminated providing a global population health map and keeping track of it. It is important that all headache disorders are categorised in the GBD and a strong group of experts from partner organisations will join the task force to ensure that all headache disorders are included.
IHS will organise a second Regional Outreach ProgrammE of IHS (ROPE-IHS) in collaboration with the DREAM (Disease Relief through Excellent and Advanced Means) programme in Malawi. The initial survey in Malawi highlighted the lack of proper training in neurology and headache. Following the first ROPE-IHS, the after-course survey showed a great improvement in their knowledge of neurology, pain, and primary and secondary headache. The aim of the second event is to create a self-sustainable educational programme – the training will be expanded to reach more clinical officers, and there will be further collaboration with two local HCPs who will be trained as IHS ambassadors and part of the faculty of the training event.
Through the ROPE-IHS and Visiting Professor programmes IHS will continue to reach areas where there is little or no headache education or infrastructure. Specific local healthcare professional needs will be carefully considered when designing the programmes to determine the best modalities to reach out to these countries in order to foster improvement. These activities will continue to focus on Africa, Central and South America, and Asia.
Page 13
**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
IHS will continue to seek representation in lower income countries through the Affiliate Member Societies and fund educational activities and content. Associate Membership will be actively promoted through the Affiliate Societies at their meetings and courses to further highlight the work of the Society and increase knowledge and headache research in these regions. IHS will also promote membership to national general neurology societies, in particular those countries to which free of charge membership is offered, and help to establish headache societies in lower-income countries
IHS is represented throughout Asia with the Asian Regional Committee for Headache (ARCH), and will continue to support activities in this region and try to promote headache research among general neurologists.
IHS will continue to expand its partnership with the International Association for the Study of Pain (IASP) and representatives from IHS will join the IASP World Congress on Pain in the Netherlands for a joint IHS-IASP symposium.
In May IHS will host the first IHS | Science meeting – this will be a unique, intimate meeting which will highlight some of the most significant scientific and clinical advances underway. This scientific meeting will bring together world experts and new leaders to present and discuss the latest developments in basic and clinical headache science. We expect a robust exchange of ideas and discussions surrounding how these advances will affect our community and the patients we treat. The limited number of delegates will facilitate maximal opportunity for learning and opportunities to network and collaborate.
Work will begin on the 22[nd ] IHC to be held in São Paulo, Brazil, in September 2025 and the location for the 23[rd ] IHC will be discussed.
The Clinical Trials committee will publish guidelines on post-traumatic headache. IHS will work with the Italian Headache Society to finalise the joint evidence-based guidelines for migraine prevention and treatment which will be submitted to Cephalalgia. Work will also continue on real world data studies in headache.
The Society will also finalise global practice recommendations for the acute and preventive treatment of migraine, an initiative aimed at providing a general framework of migraine treatment that is suitable for use both in countries where all anti-migraine drugs are available, as well as in those where only the drugs of the WHO’s list of essential medicines are accessible. Importantly, IHS plans to use these practice recommendations for fostering optimisation and harmonisation of migraine treatment across countries and improve the availability of antimigraine drugs in regions with limited access. The initiative is perfectly in line with the Intersectoral Global Action Plan 2022–2031 launched by the WHO in May 2022 for improving access to both services and support for neurological conditions all over the world.
The Classification Committee has begun to discuss the update and publication of the International Classification of Headache Disorders, 4[th ] edition, and this will continue in 2024.
In 2024 IHS will continue focus on online educational activities with further webinars, educational videos and podcasts being released in the Online Learning and Education Centre, and thee more Continuing Medical Education (CME)-accredited Learning Institute courses on cluster headache, spontaneous intracranial hypotension and primary care. In collaboration with the Education Committee, the Child and Adolescent Committee will organise a webinar series on the understanding and management of headache disorders in children and adolescents. Work will start on new initiatives to produce animated videos to highlight primary and secondary headache disorders and also online clinical case presentations.
A Visual Aura Table will be published where, for the first time, headache researchers show the full spectrum of aura visual disturbances in a standardised way. The aura table has been tested in a large, multicentre international population among 215 migraine with aura patients and the results published in Cephalalgia. The Table will be freely available and downloadable. IHS endorses its use to describe migraine aura better and more accurately, both clinically and in research settings. The goal is that the table will be used for the benefit of patients and healthcare professionals around the world.
Page 14
**INTERNATIONAL HEADACHE SOCIETY (A company limited by guarantee)**
## **TRUSTEES’ REPORT FOR THE YEAR ENDED 31 DECEMBER 2023**
Four Visiting Professors meetings will be available – IHS will identify the locations for these and the visiting speakers. The 10[th ] International Headache Academy will be held in May in Berlin, immediately prior to IHS 2024 | Science.
In collaboration with the World Organization of Family Doctors (WONCA) Europe IHS will develop an online course similar to the Learning Institute designed for primary care physicians, with the aim of increasing awareness of headaches and related disorders among family physicians. The course will consist of three modules, each based on a case study, with pre- and post-learning test questions, allowing participants to assess their learning. Following the launch a webinar will be held to promote the course with speakers from IHS and WONCA Europe.
The Headache Trainee and Short-Stay Scholarships programmes will be open to facilitate attendance of physicians from lower-income countries to visit specialised headache institutions abroad and actively increase knowledge on headache disorders and specialised headache management.
The Juniors Group will offer three Junior Research Grants, for basic or clinical research, to support innovative and impactful research from young investigators, promote the career of young investigators in the field of headache, and increase the knowledge base of headache disorders These grants will be restricted to research in low and lower-middle income countries.
The Child and Adolescent Committee will offer seed funding to initiate projects that study headaches in children and adolescents in low and lower-middle income countries.
Two awards will be offered to recognise promising early- and mid-career basic, clinical or translational scientists whose research has contributed to the headache field. The award winners will deliver a short presentation of their research at the IHC in September 2025.
The Society will continue to closely interact with its international Affiliate Member Societies, encouraging their members to join IHS at a preferential rate through their national society and gathering educational materials for the Online Learning and Education Centre in multiple languages.
The Communications Committee will continue to forge relationships with doctors and researchers all over the world, and actively promote IHS activities through social media platforms. In collaboration with the Education Committee, the Committee will continue to support different headache disorders awareness campaigns.
To facilitate collaboration between headache specialists worldwide, Exchange Groups will be initiated. This new initiative will aid to further enhance engagement and ensure that the needs of the growing international headache community are fully met. The Exchange Groups will provide members access to opportunities including enhanced connections, professional growth, networking, collaboration, and leadership development.
A new Regional Committee will be established to replace the dissolved Linguistic SIGs. A Regional Committee will be impactful than the Linguistic SIGs and follow the path of ARCH – now with 17 member countries. The Committee will facilitate close liaison with local countries with similar economies and needs and liaison with larger headache centres in neighbouring countries. IHS has identified nine possible regions, including higher- and lower-income areas.
The newly formed Cluster Headache Special Interest Group will identify projects. Cluster Headache remains undiagnosed and under-treated and greater visibility is needed for this debilitating condition.
IHS will continue to collaborate with the American Headache Society and National Institute for Neurological Diseases and Stroke to identify three priority areas for headache research in the short (three to five years) and longer term (six to 10 years) with the aim to unify the headache field towards reaching goals and to cite priorities when proposing new research projects.
Page 15
INTERNATIONAL HEADACHE SOCIETY
{A company limited by guarantee)
TRUSTEES, REPORT
FOR THE YEAR ENDED 31 DECEMBER 2023
Due to the ongoing conflict between Russia and Ukraine. IHS will continue to not accept any new member
applications or grant applications, or hold any activities in Russia or Belarus until further notice. The Society will
be ready to help Ukrainian doctors and researchers through scientificldinical initiatives. projects and educational
opportunities when the conflict is over.
IHS is engaged in many activities which are important for the headache world bul they are not well known and
deseNe beller recognition. IHS wll strengthen its public relations Ihrough engagement of a professional company
lo ensure that the work oflhe society is promoted.
other matters
Statement of disclosure to the audito
As far as the Trustees are aware. there is no relevant audit information of which the group and charitable
company's auditors are unaware. All of the Trustees have taken all steps that they ought to as directors in order
lo make themselves aware of any relevant audit informalion and to eslablish that the company's audltors are
aware of thal information.
ara
ion of the re
This report has been prepared taking advantage of the small companies. exemption of section 415A of the Companies
Act 2006 and taking advantage of the small companies. exemptions in preparing the Directors, report and from Ihe
requirement to prepare a strategic report.
Auditor
The auditors, MHA, have indicated their willingness to continue in office.
This report was approved and aulhorised for issue by the Trustees and signed on Its behalf by:
JSvrshh
F Ahmèd
Treasurer
R Bursteln
Presldent
Date:
9-9-2024
Page 16
INTERNATIONAL HEADACHE SOCIETY
(A Company Limited by Guarantee)
STATEMENT OF TRUSTEES, RESPONSIBILITIES
FOR THE YEAR ENDED 31 DECEMBER 2023
The Trustees (who are also the Directors of the Charitable Company for the purpose5 of company law) are
responsible for preparing the Trustees, Report and the financial statements in accordance with applicable law and
United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounling Practice).
Company law requires the Trustees to prepare financial statements for each financial year. Under company law,
the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view
of the state of affairs of the Group and the Charitable Company and of their incoming resources and application
of resources, including their income and expendilure, 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 of Ihe Charilies SORP (FRS 102).,
make judgements and accounting estimates that are reasonable and prudent",
state whether applicable UK Accounting Standards (FRS 102> 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
Group will continue in business.
The Trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the
Group and the Charitable Company's Iransactions and disclose with reasonable accuracy al any time the financial
position of Ihe Group and the Charitable Company and enable them to ensure Ihal the financial statements comply
with the Companies Act 2006. They are also responsible for safeguarding the assets of the Group and 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 ofwhich the Group and Charity's auditor is unaware., and
the Trustees have taken all steps that they ought to have taken to make themselves aware of any relevant
audit information and to establish thal the auditor is aware of that information.
Approved by order of the Members of the Board of Trustees and signed on its behalf by:
FAh
ed
Treasurer
R Burstein
PresKlent
Date".
9-9-2024
Page 17
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF INTERNATIONAL HEADACHE SOCIETY**
## **Opinion**
We have audited the financial statements of International Headache Society (the 'parent charitable company') and its subsidiaries (the 'group') for the year ended 31 December 2023 which comprise the Consolidated Statement of Financial Activities, the Consolidated Balance Sheet, the Charitable Company Balance Sheet, the Consolidated Statement of Cash Flows and the related notes, 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, including Financial Reporting Standard 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 Group's and of the parent charitable company's affairs as at 31 December 2023 and of the Group's 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; and
- have been prepared in accordance with the requirements of the Companies Act 2006 and the Charities Act 2011.
## **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 Group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including the Financial Reporting Council's Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.
## **Conclusions relating to going concern**
In auditing the financial statements, we have concluded that the Trustees' use of the going concern basis of accounting in the preparation of the financial statements is appropriate.
Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Group's or the parent 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.
Page 18
**(A Company Limited by Guarantee)**
## **INTERNATIONAL HEADACHE SOCIETY**
## **INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF INTERNATIONAL HEADACHE SOCIETY (CONTINUED)**
## **Other information**
The other information comprises the information included in the Annual Report other than the financial statements and our Auditor's Report thereon. The Trustees are responsible for the other information contained within the Annual Report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material 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.
## **Opinion 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' Report for the financial year for which the financial statements are prepared is consistent with the financial statements.
- the Trustees' Report has been prepared in accordance with applicable legal requirements.
## **Matters on which we are required to report by exception**
In the light of our 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' Report.
We have nothing to report in respect of the following matters in relation to which Companies Act 2006 requires us to report to you if, in our opinion:
- the parent charitable company has not kept adequate and sufficient accounting records, or returns adequate for our audit have not been received from branches not visited by us; or
- the parent charitable company 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 prepare the financial statements in accordance with the small companies regime and take advantage of the small companies' exemptions in preparing the Trustees' Report and from the requirement to prepare a Strategic Report.
Page 19
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF INTERNATIONAL HEADACHE SOCIETY (CONTINUED)**
## **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 Group's and the parent 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 Group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.
## **Auditor's responsibilities for the audit of the financial statements**
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an Auditor's Report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered 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 is detailed below:
- Obtaining an understanding of the legal and regulatory frameworks that the entity operates in, focusing on those laws and regulations that had a direct effect on the financial statements;
- Enquiry of management and those charged with governance to identify any instances of known or suspected instances of fraud;
- Enquiry of management and those charged with governance around actual and potential litigation and claims;
- Enquiry of management about any instances of non-compliance with laws and regulations;
- Reviewing the control systems in place and testing the effectiveness of the controls;
- Performing audit work over the risk of management override of controls, including testing of journal entries and other adjustments for appropriateness;
- Evaluating the business rationale of significant transactions outside the normal course of business;
- Reviewing accounting estimates for bias;
- Reviewing minutes of meetings of those charged with governance; and
- Reviewing financial statement disclosures and testing to supporting documentation to assess compliance with applicable laws and regulations.
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.
Page 20
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF INTERNATIONAL HEADACHE SOCIETY (CONTINUED)**
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 Auditor's Report.
## **Use of our report**
This report is made solely to the charitable company's Members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006, and to the charitable company's Trustees, as a body, Part 4 of the Charities (Accounts and Reports) Regulations 2008. 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 its Members, as a body, for our audit work, for this report, or for the opinions we have formed.
## **Bianca Silva BA, ACA, DChA (Senior Statutory Auditor)**
for and on behalf of **MHA**
Statutory Auditor Maidenhead, United Kingdom
Date: 26 September 2024
MHA is the trading name of MacIntyre Hudson LLP, a limited liability partnership in England and Wales (registered number OC312313).
Page 21
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2023**
|**Note**
**Income from:**
Charitable activities
4
Other trading activities
5
Investments
6
Gain on foreign exchange
**Total income**
**Expenditure on:**
Raising funds
7
Charitable activities
8,9
**Total expenditure**
**Net income/(expenditure) before net**
**losses on investments**
Net losses on investments
**Net movement in funds**
**Reconciliation of funds:**
Total funds brought forward
Net movement in funds
**Total funds carried forward**|**Unrestricted**
**funds**
**2023**
**£**
**686,133**
**58,395**
**150,148**
**-**
**894,676**
**113,987**
**700,481**
**814,468**
**80,208**
**(61,447)**
**18,761**
**2,900,726**
**18,761**
**2,919,487**|**Restricted**
**funds**
**2023**
**£**
**-**
**-**
**-**
**-**
**-**
**-**
**109,018**
**109,018**
**(109,018)**
**-**
**(109,018)**
**188,887**
**(109,018)**
**79,869**|**Total**
**funds**
**2023**
**£**
**686,133**
**58,395**
**150,148**
**-**
**894,676**
**113,987**
**809,499**
**923,486**
**(28,810)**
**(61,447)**
**(90,257)**
**3,089,613**
**(90,257)**
**2,999,356**|Total
funds
2022
£
859,554
99,057
75,977
1,198
1,035,786
96,055
756,623
852,678
183,108
(90,702)
92,406
2,997,207
92,406
3,089,613|
|---|---|---|---|---|
The Consolidated Statement of Financial Activities includes all gains and losses recognised in the year.
The Trustees have taken the option not to disclose the unconsolidated Statement of Financial Activities. The notes on pages 28 to 46 form part of these financial statements.
Page 22
## **INTERNATIONAL HEADACHE SOCIETY (A Company Limited by Guarantee) REGISTERED NUMBER: 02988368**
## **CONSOLIDATED BALANCE SHEET AS AT 31 DECEMBER 2023**
|**Fixed assets**
**Note**
Tangible assets
12
Investments
13
**Current assets**
Debtors: Amounts falling due within one year
14
Cash at bank and in hand
19
Creditors: Amounts falling due within one year
15
**Net current assets**
**Total net assets**
**Charity funds**
Restricted funds
16
Unrestricted funds
General fund
16
Non-charitable trading fund
16
Total unrestricted funds
16
**Total funds**||**2023**
**£**
**354,654**
**1,943,579**
**2,298,233**
**(276,118)**
**3,119,887**
**(200,400)**|**2023**
**£**
**354,654**
**1,943,579**
**2,298,233**
**(276,118)**
**3,119,887**
**(200,400)**|**2023**
**£**
**-**
**977,241**|
|2022
£
422,419
1,806,496
2,228,915
(289,353)
3,003,724
(102,998)|2022
£
422,419
1,806,496
2,228,915
(289,353)
3,003,724
(102,998)|2022
£
-
1,150,051
1,150,051
1,939,562
3,089,613
188,887
2,900,726
3,089,613|
|---|---|---|---|---|---|---|---|---|
|||||**977,241**
**2,022,115**|||||
|||**3,119,887**
**(200,400)**||||3,003,724
(102,998)|||
|||||**2,999,356**|||||
|||||**79,869**
**2,919,487**|||||
||||||||||
|||||**2,999,356**|||||
Page 23
INTERNATIONAL HEADACHE SOCIETY
(A Company Limited by Guarantee
REGISTERED NUMBER: 02988368
CONSOLIDATED BALANCE SHEET (CONTINUED)
AS AT 31 DECEMBER 2023
The Trustees acknowledge their responsibilities for complying with the requirements of the Companies Act 2006
with respect to accounting records and preparation of financial statements.
The financial statements have been prepared in accordance with the provisions applicable to entities subject to
the small companies regime.
The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by-
_, i3vrs+eih
R Bursteln
President
Treasurer
Oate.. 9-9-2024
The notes on pages 28 to 46 form part of these financial statements.
Page 24
## **INTERNATIONAL HEADACHE SOCIETY (A Company Limited by Guarantee) REGISTERED NUMBER: 02988368**
**CHARITABLE COMPANY BALANCE SHEET AS AT 31 DECEMBER 2023**
|**Note**
**Fixed assets**
Tangible assets
12
Investments
13
**Current assets**
Debtors: Amounts falling due within one year
14
Cash at bank and in hand
19
Creditors: Amounts falling due within one
year
15
**Net current assets**
**Total net assets**
**Charity funds**
Restricted funds
16
Unrestricted funds
General funds
16
Total unrestricted funds
16
**Total funds**|**513,974**
**1,879,579**
**2,393,553**
**(171,039)**
**3,119,887**|**2023**
**£**
**-**
**977,242**
**977,242**
**2,222,514**
**3,199,756**
**79,869**
**3,119,887**
**3,199,756**|543,409
1,659,734
2,203,143
(160,584)
3,003,724|2022
£
-
1,150,052
1,150,052
2,042,559
3,192,611
188,887
3,003,724
3,192,611|
|---|---|---|---|---|
The Charitable Company's net movement in funds for the year was £7,145 (2022 - £314,844).
Page 25
INTERNATIONAL HEADACHE SOCIETY
IA Company Limited by Guarantee)
REGISTERED NUMBER: 02988368
CHARITABLE COMPANY BALANCE SHEET (CONTINUED)
AS AT 31 DECEMBER 2023
The Trustees acknowledge their responsibilities for complying with the requirements of the Act with respect to
accounting records and preparation of financial statements.
The financial statements have been prepared in accordance with the provisions applicable to entities subject to
the small companies regime.
The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by..
, J3urs4¥ih
F Ahmed
Treasurer
R Bursteln
President
9-9-2024
Date
The notes on pages 28 to 46 form part of these financial statements.
Page 26
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **CONSOLIDATED STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2023**
|**Note**
**Cash flows from operating activities**
Net cash provided by/(used in) operating activities
18
**Cash flows from investing activities**
Investment income
6
**Net cash provided by investing activities**
**Change in cash and cash equivalents in the year**
Cash and cash equivalents at the beginning of the year
**Cash and cash equivalents at the end of the year**
19
The notes on pages 28 to 46 form part of these financial statements|**2023**
**£**
2022
£
**(13,065)**
368,208
**150,148**
75,977
**150,148**
**75,977**
**137,083**
**444,185**
**1,806,496**
1,362,311
**1,943,579**
1,806,496|
|---|---|
Page 27
**INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **1. General information**
The International Headache Society is a charitable company limited by guarantee and is registered with the Charity Commission (Charity Registered Number: 1042574) and the Registrar of Companies (Company Registration Number: 02988368) England and Wales.
The address of the registered office is given in the Group and Charity information on page 1 of these financial statements.
The nature of the Group and Charity's operations and principal activities are detailed within the Trustees Report.
The significant accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all years presented unless otherwise stated.
## **2. Accounting policies**
## **2.1 Basis of preparation of financial statements**
The financial statements have been prepared in accordance with the Charities SORP (FRS 102) - 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), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.
International Headache Society meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy. The financial statements have been presented in sterling, which is also the functional currency of the Group and are rounded to the nearest pound.
The Consolidated Statement of Financial Activities (SOFA) and Consolidated Balance Sheet consolidate the financial statements of the Charitable Company and its subsidiary undertaking. The results of the subsidiary are consolidated on a line by line basis.
The Charitable Company has taken advantage of the exemption allowed under section 408 of the Companies Act 2006 and has not presented its own Statement of Financial Activities in these financial statements.
## **2.2 Going concern**
The Trustees have assessed the use of going concern and have considered possible events or conditions that might cast significant doubt on the ability of the Group and Charity to continue as a going concern. The Trustees have made this assessment for a period of at least one year from the date of the approval of these financial statements. The Trustees have concluded that there is a reasonable expectation that the Group and Charity has adequate resources to continue in operational existence for the foreseeable future. The Group and Charity therefore continues to adopt the going concern basis in preparing its financial statements.
Page 28
**INTERNATIONAL HEADACHE SOCIETY**
**(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **2. Accounting policies (continued)**
## **2.3 Income**
All income is recognised once the Charitable Company has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.
Grants are included in the Consolidated Statement of Financial Activities on a receivable basis. The balance of income received for specific purposes but not expended during the period is shown in the relevant funds on the Balance Sheet. Where income is received in advance of entitlement of receipt, its recognition is deferred and included in creditors as deferred income. Where entitlement occurs before income is received, the income is accrued.
Income tax recoverable in relation to investment income is recognised at the time the investment income is receivable.
Other income is recognised in the period in which it is receivable and to the extent the goods have been provided or on completion of the service.
## **2.4 Expenditure**
Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use.
Expenditure on charitable activities is incurred on directly undertaking the activities which further the Group's objectives, as well as any associated support costs.
Grants payable are charged in the year when the offer is made except in those cases where the offer is conditional, such grants being recognised as expenditure when the conditions attaching are fulfilled. Grants offered subject to conditions which have not been met at the year end are noted as a commitment, but not accrued as expenditure.
All expenditure is inclusive of irrecoverable VAT.
## **2.5 International Headache Congress (IHC)**
The 21st IHC was held in Seoul, South Korea, in September 2023.
Page 29
**INTERNATIONAL HEADACHE SOCIETY**
**(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **2. Accounting policies (continued)**
## **2.6 Tangible fixed assets and depreciation**
Tangible fixed assets costing £250 or more are capitalised and recognised when future economic benefits are probable and the cost or value of the asset can be measured reliably.
Tangible fixed assets are initially recognised at cost. After recognition, under the cost model, tangible fixed assets are measured at cost less accumulated depreciation and any accumulated impairment losses. All costs incurred to bring a tangible fixed asset into its intended working condition should be included in the measurement of cost.
Depreciation is charged so as to allocate the cost of tangible fixed assets less their residual value over their estimated useful lives, on a reducing balance basis.
Depreciation is provided on the following basis:
Furniture and equipment - 25%
## **2.7 Foreign currencies**
Monetary assets and liabilities denominated in foreign currencies are translated into sterling at rates of exchange ruling at the reporting date.
Transactions in foreign currencies are translated into sterling at the rate ruling on the date of the transaction.
Exchange gains and losses are recognised in the Consolidated Statement of Financial Activities.
## **2.8 Fund accounting**
General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Group and which have not been designated for other purposes.
Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Group for particular purposes. The costs of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements.
Investment income, gains and losses are allocated to the appropriate fund.
## **2.9 Investments**
Fixed asset investments are a form of financial instrument and are initially recognised at their transaction cost and subsequently measured at fair value at the Balance Sheet date, unless the value cannot be measured reliably in which case it is measured at cost less impairment. Investment gains and losses, whether realised or unrealised, are combined and presented as ‘Gains/(Losses) on investments’ in the Consolidated Statement of Financial Activities.
Investments in subsidiaries are valued at cost less provision for impairment.
Page 30
**INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **2. Accounting policies (continued)**
## **2.10 Taxation**
The Charitable Company is considered to pass the tests set out in Paragraph 1 Schedule 6 of the Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes. Accordingly, the Charitable Company is potentially exempt from taxation in respect of income or capital gains received within categories covered by Chapter 3 Part 11 of the Corporation Tax Act 2010 or Section 256 of the Taxation of Chargeable Gains Act 1992, to the extent that such income or gains are applied exclusively to charitable purposes.
## **2.11 Debtors**
Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
## **2.12 Liabilities**
Liabilities are recognised when there is an obligation at the Balance Sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably.
Liabilities are recognised at the amount that the Charitable Company anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.
## **2.13 Financial instruments**
The Group 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.
## **3. Judgements and key sources of estimation uncertainty**
No significant judgements or estimates have been made by management in preparing these financial statements other than in the consideration of useful lives of tangible fixed assets. The Trustees consider that the useful lives of assets are fairly stated.
Critical accounting estimates and assumptions:
The Charitable Company makes estimates and assumptions concerning the future. The resulting accounting estimates and assumptions will, by definition, seldom equal the related actual results. The estimates and assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year are discussed below.
Page 31
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **4. Income from charitable activities**
|Membership fees receivable from individuals
Income from journal
iHEAD International Headache Academy
Other income
Sponsorship
Membership fees receivable from individuals
Income from journal
iHEAD International Headache Academy
Other income
Sponsorship|**Unrestricted**
**funds**
**2023**
**£**
150,067
145,147
186,906
15,492
188,521
686,133
Unrestricted
funds
2022
£
142,826
373,276
67,842
14,973
260,637
859,554|**Total**
**funds**
**2023**
**£**
**150,067**
**145,147**
**186,906**
**15,492**
**188,521**
**686,133**
Total
funds
2022
£
142,826
373,276
67,842
14,973
260,637
859,554|
|---|---|---|
Page 32
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **5. Income from other trading activities**
|Income received by trading subsidiary
Income received by trading subsidiary|**Unrestricted**
**funds**
**2023**
**£**
58,395
Unrestricted
funds
2022
£
99,057|**Total**
**funds**
**2023**
**£**
**58,395**
Total
funds
2022
£
99,057|
|---|---|---|
**6. Investment income**
|Dividend income
Bank interest receivable
Dividend income
Bank interest receivable|**Unrestricted**
**funds**
**2023**
**£**
69,199
80,949
150,148
Unrestricted
funds
2022
£
55,092
20,885
75,977|**Total**
**funds**
**2023**
**£**
**69,199**
**80,949**
**150,148**
Total
funds
2022
£
55,092
20,885
75,977|
|---|---|---|
Page 33
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **7. Expenditure on raising funds**
|Expenditure incurred by trading subsidiary
Expenditure incurred by trading subsidiary|**Unrestricted**
**funds**
**2023**
**£**
113,987
Unrestricted
funds
2022
£
96,055|**Total**
**funds**
**2023**
**£**
**113,987**
Total
funds
2022
£
96,055|
|---|---|---|
## **8. Analysis of expenditure on charitable activities - by fund**
|Charitable Activities
Charitable Activities|**Unrestricted**
**funds**
**2023**
**£**
700,481
Unrestricted
funds
2022
£
664,176|**Restricted**
**funds**
**2023**
**£**
109,018
Restricted
funds
2022
£
92,447|**Total**
**2023**
**£**
**809,499**
Total
2022
£
756,623|
|---|---|---|---|
Page 34
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **9. Analysis of expenditure on charitable activities - by type**
|Charitable Activities
Charitable Activities|**Activities**
**undertaken**
**directly**
**2023**
**£**
406,045
Activities
undertaken
directly
2022
£
405,186|**Grant**
**funding to**
**individuals**
**2023**
**£**
131,822
Grant
funding to
individuals
2022
£
148,723|**Support**
**costs**
**2023**
**£**
271,632
Support
costs
2022
£
202,714|**Total**
**funds**
**2023**
**£**
**809,499**
Total
funds
2022
£
756,623|
|---|---|---|---|---|
## **Analysis of support costs**
|Administrator's fees and financial support
Membership administration
Travel and meetings expenses
Website running costs
Communication/Stationary costs
Bank and credit card charges
Sundry expenses
Governance costs
Executive directors fees|**Total**
**funds**
**2023**
**£**
**104,438**
**1,598**
**9,237**
**18,692**
**1,688**
**1,673**
**322**
**89,160**
**44,824**
**271,632**|Total
funds
2022
£
101,446
4,716
4,148
11,544
1,802
2,746
864
75,448
-
202,714|
|---|---|---|
Page 35
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **10. Governance costs**
|Auditor's remuneration - Audit services
Auditor's remuneration - Non-audit services
Prior year (over)/ under accrual of audit fees
Legal, professional and consultancy
Travel and meeting expenses|**2023**
**£**
**21,250**
**36,636**
**(1,325)**
**16,600**
**32,555**
**105,716**|2022
£
14,300
39,271
(250)
17,963
18,075
89,359|
|---|---|---|
Included within governance costs are £16,556 (2022 - £13,911) of governance cost incurred by the trading subsidiary (Note 7).
## **11. Trustees' remuneration and expenses**
No staff are directly employed by the Charity.
During the year, no Trustees received any remuneration or other benefits (2022 - £NIL).
During the year ended 31 December 2023, there were expenses reimbursed or paid directly to Trustees of £20,188 (2022 - £14,189). The expenses reimbursed related to travel costs.
Page 36
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
|**12.**
**Tangible fixed assets**
**Group and Charitable Company**
**Cost**
At 1 January 2023
At 31 December 2023
**Depreciation**
At 1 January 2023
At 31 December 2023
**Net book value**
At 31 December 2023
At 31 December 2022
**13.**
**Fixed asset investments**
**Group**
**Cost or valuation**
At 1 January 2023
Disposals
Revaluations
At 31 December 2023
**Net book value**
At 31 December 2023
At 31 December 2022|**Furniture and**
**equipment**
**£**
**283**
**283**
**283**
**283**
**-**
-
**Listed**
**investments**
**£**
**1,150,051**
**(111,343)**
**(61,467)**
**977,241**
**977,241**
1,150,051|
|---|---|
|||
|||
|||
|||
|||
|||
Page 37
**(A Company Limited by Guarantee)**
## **INTERNATIONAL HEADACHE SOCIETY**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **13. Fixed asset investments (continued)**
|**Charitable Company**
**Cost or valuation**
At 1 January 2023
Disposals
Revaluations
At 31 December 2023
**Net book value**
At 31 December 2023
At 31 December 2022|**Investments**
**in**
**subsidiary**
**companies**
**£**
**1**
**-**
**-**
**1**
**1**
1|**Listed**
**investments**
**£**
**1,150,051**
**(111,343)**
**(61,467)**
**977,241**
**977,241**
1,150,051|**Total**
**£**
**1,150,052**
**(111,343)**
**(61,467)**
**977,242**
**977,242**
1,150,052|
|---|---|---|---|
The investment in subsidiary company represents 100% of the issued share capital of I. H. S. Trading Company Ltd, a company registered in England and Wales, company registration number : 04008927.
The details of the subsidiary and its activity in the year have been included below.
## **Principal subsidiaries**
The Society has one wholly owned subsidiary company, I. H. S. Trading Company Ltd. Company number is 04008927. Registered office address is; 6th Floor, 2 London Wall Place, London, EC2Y 5AU. That company was incorporated on 1 June 2000 and commenced its activity, the organization of conferences, on 1 January 2001. The Society has owned all of the company's share capital since it was incorporated. The company gifts its taxable profits, where applicable, to the Society. A summary of the company's trading results is shown below. Audited accounts for the company have been filed with the Registrar of Companies.
The following was a subsidiary undertaking of the Charitable Company:
|**Name**|**Company**|**Holding**|**Included in**|
|---|---|---|---|
||**number**||**consolidation**|
|I.H.S Trading Company Ltd|04008927|100%|Yes|
Page 38
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **13. Fixed asset investments (continued)**
The financial results of the subsidiary for the year were:
|**Name**
**Income**
**£**
**Expenditure**
**£**
**Profit/(Loss)**
**/ Surplus/**
**(Deficit) for**
**the year**
**£**
I.H.S Trading Company Ltd
**58,395**
**(155,797)**
**(97,402)**
**14.**
**Debtors**
**Group**
Group
**Charitable**
**Company**
**2023**
2022
**2023**
**£**
£
**£**
**Due within one year**
Trade debtors
**-**
27,787
**-**
Amounts owed by group undertakings
**-**
-
**285,881**
Corporation tax recoverable
**7,344**
7,344
**-**
Prepayments and Accrued income
**347,310**
362,749
**214,750**
VAT recoverable
**-**
24,539
**13,343**
**354,654**
422,419
**513,974**|**Net assets**
**£**
**(200,399)**
Charitable
Company
2022
£
-
250,970
-
278,749
13,690
543,409|
|---|---|
Page 39
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **15. Creditors: Amounts falling due within one year**
|Membership fees received in advance
Trade creditors
Other taxation and social security
Accruals
Grants payable|**Group**
**2023**
**£**
**20,377**
**85,354**
**5,294**
**152,525**
**12,568**
**276,118**|Group
2022
£
24,128
136,449
-
78,776
50,000
289,353|**Charitable**
**Company**
**2023**
**£**
**20,377**
**37,854**
**-**
**100,240**
**12,568**
**171,039**|Charitable
Company
2022
£
24,128
51,479
-
34,977
50,000|
|---|---|---|---|---|
|||||160,584|
Page 40
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **16. Statement of funds**
## **Statement of funds - current year**
|**Unrestricted funds**
General fund
Non - charitable trading fund
**Restricted funds**
Chronic Migraine Guidelines
fund
Core Curriculum fund
Online Education fund
IASP/HIS Joint Meeting fund
Headed for the future
**Total of funds**|**Balance at 1**
**January**
**2023**
**£**
**Income**
**£**
**3,003,724**
**836,281**
**(102,998)**
**58,395**
**2,900,726**
**894,676**
**28,153**
**-**
**9,001**
**-**
**40,530**
**-**
**690**
**-**
**110,513**
**-**
**188,887**
**-**
**3,089,613**
**894,676**|**Expenditure**
**£**
**(658,671)**
**(155,797)**
**(814,468)**
**-**
**-**
**(34,020)**
**-**
**(74,998)**
**(109,018)**
**(923,486)**|**Gains/**
**(Losses)**
**£**
**(61,447)**
**-**
**(61,447)**
**-**
**-**
**-**
**-**
**-**
**-**
**(61,447)**|**Balance at**
**31**
**December**
**2023**
**£**
**3,119,887**
**(200,400)**
**2,919,487**
**28,153**
**9,001**
**6,510**
**690**
**35,515**
**79,869**
**2,999,356**|
|---|---|---|---|---|
Page 41
**INTERNATIONAL HEADACHE SOCIETY (A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **16. Statement of funds (continued)**
## **Designated funds**
Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes.
The Contingency fund was designated fund that had been set up by the Society to provide for future unforeseen expenditure. The fund was not utilised in 2022 and the Trustees have decided the the designation is no longer required. This has been transferred back to the general funds
## **General funds**
During the year the trading subsidiary, IHS Trading made a gift aid payment of £nil (2022 - £184,862) to IHS. As distribution this was recognised as a transfer in the year.
## **Restricted funds**
The Society’s restricted funds are the Chronic Migraine Guidelines fund, representing grants received towards the costs of creating guidelines for controlled trials of prophylactic treatment of chronic migraine in adults, the Core Curriculum fund, representing a grant received towards the cost of developing a core curriculum of education for neurologists and an Online Education fund, funded by Pfizer and Allergan. The IASP/IHS joint meeting fund is restricted to use on IASP and IHS meetings.
These restricted funds are historical with no movement year on year. The Board has approved application to the Charity Commision to request approval to release restrictions on these funds.
A restricted fund, Headed for the future, represents grant funding received from Lundbeck for a collaboration with IHS in creating a television documentary on headache, which is managed for IHS by Gospel PR.
Page 42
## **INTERNATIONAL HEADACHE SOCIETY (A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **16. Statement of funds (continued)**
## **Statement of funds - prior year**
|Balance at
1 January
2022
Income
£
£
**Unrestricted funds**
**Designated funds**
Contingency fund
65,000
-
**General funds**
General fund
2,531,433
936,729
Non - charitable
trading fund
119,440
99,057
2,650,873 1,035,786
**Total Unrestricted**
**funds**
2,715,873
1,035,786
**Restricted**
**funds**
Chronic Migraine
Guidelines fund
28,153
-
Core Curriculum
fund
9,001
-
Online Education
fund
40,530
-
IASP/HIS Joint
Meeting fund
690
-
Headed for the
future
202,960
-
281,334
-
**Total of funds**
2,997,207
1,035,786|Balance at
1 January
2022
Income
£
£
**Unrestricted funds**
**Designated funds**
Contingency fund
65,000
-
**General funds**
General fund
2,531,433
936,729
Non - charitable
trading fund
119,440
99,057
2,650,873 1,035,786
**Total Unrestricted**
**funds**
2,715,873
1,035,786
**Restricted**
**funds**
Chronic Migraine
Guidelines fund
28,153
-
Core Curriculum
fund
9,001
-
Online Education
fund
40,530
-
IASP/HIS Joint
Meeting fund
690
-
Headed for the
future
202,960
-
281,334
-
**Total of funds**
2,997,207
1,035,786|Expenditure
£
-
(623,598)
(136,633)
(760,231)
(760,231)
-
-
-
-
(92,447)
(92,447)
(852,678)|Expenditure
£
-
(623,598)
(136,633)
(760,231)
(760,231)
-
-
-
-
(92,447)
(92,447)
(852,678)|Transfers
in/out
£
(65,000)
249,862
(184,862)
65,000
-
-
-
-
-
-
-
-|Gains/
(Losses)
£
-
(90,702)
-
(90,702)
(90,702)
-
-
-
-
-
-
(90,702)|Balance at
31
December
2022
£
-
3,003,724
(102,998)
2,900,726
2,900,726
28,153
9,001
40,530
690
110,513
188,887
3,089,613|
|---|---|---|---|---|---|---|
|||-
-
-
-
(92,447)
(92,447)
(852,678)|||||
||||||||
||||||||
Page 43
## **INTERNATIONAL HEADACHE SOCIETY**
## **(A Company Limited by Guarantee)**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **17. Analysis of net assets between funds**
## **Analysis of net assets between funds - current year**
|Fixed asset investments
Current assets
Creditors due within one year
**Total**
**Analysis of net assets between funds - prior year**
Fixed asset investments
Current assets
Creditors due within one year
**Ttl**|**Unrestricted**
**funds**
**2023**
**£**
977,241
2,218,364
(276,118)
2,919,487
Unrestricted
funds
2022
£
1,150,051
2,040,028
(289,353)
2,900,726|**Restricted**
**funds**
**2023**
**£**
-
79,869
-
79,869
Restricted
funds
2022
£
-
188,887
-
188,887|**Total**
**funds**
**2023**
**£**
**977,241**
**2,298,233**
**(276,118)**
**2,999,356**
Total
funds
2022
£
1,150,051
2,228,915
(289,353)
3,089,613|
|---|---|---|---|
## **Total**
Page 44
**(A Company Limited by Guarantee)**
## **INTERNATIONAL HEADACHE SOCIETY**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **18. Reconciliation of net movement in funds to net cash flow from operating activities**
|Net income/expenditure for the year (as per Statement
Activities)
**Adjustments for:**
Losses/ (gains) on investments
Investment income
Decrease/ (increase) in debtors
Increase/(decrease) in creditors
**Net cash provided by/(used in) operating activities**
**19.**
**Analysis of cash and cash equivalents**
Cash in hand
**Total cash and cash equivalents**
**20.**
**Analysis of changes in net debt**
Cash at bank and in hand|of Financial
**At 1**
**January**
**2023**
**£**
**1,806,496**
**1,806,496**|**Group**
**2023**
**£**
**(90,257)**
**172,810**
**(150,148)**
**67,765**
**(13,235)**
**(13,065)**
**Group**
**2023**
**£**
**1,943,579**
**1,943,579**
**Cash flows**
**£**
**137,083**
**137,083**|Group
2022
£
92,406
90,702
(75,977)
135,399
125,678
368,208
Group
2022
£
1,806,496
1,806,496
**At 31**
**December**
**2023**
**£**
**1,943,579**
**1,943,579**|
|---|---|---|---|
Page 45
**INTERNATIONAL HEADACHE SOCIETY**
**(A Company Limited by Guarantee)**
**NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023**
## **21. Members' liability**
Each member of the charitable company undertakes to contribute to the assets of the company in the event of it being wound up while he/she is a member, or within one year after he/she ceases to be a member, such amount as may be required, not exceeding £1 for the debts and liabilities contracted before he/she ceases to be a member.
## **22. Related party transactions**
The Charity has one wholly owned subsidiary company, I.H.S. Trading Company Ltd (IHS Trading).
The Charity charged IHS Trading £41,775 _(2022 - £40,578)_ during the year ended 31 December 2023 representing an allocation of costs relating to finance and costs incurred in administering the company.
During the year, the Charity loaned £nil _(2022 - £50,000)_ to the I.H.S Trading Company Ltd (IHST), for the purpose of setting up for the Congress.
During the year ended 31 December 2023, IHS Trading made a gift of £nil _(2022 - £184,862)_ and a repayments of £6,864 _(2022: £nil)_ . As at 31 December 2023 IHS Trading owed the parent company £285,881 _(2022 - £250,970)._
Page 46