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2021-03-31-accounts

Charity Reglstratlon No. 1044906 Company Reglstratlon No. 02992437 IEngland and Wales} ORTHOPAEDIC INSTITUTE LTD ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021

ORTHOPAEDIC INSTITUTE LTD LEGAL AND ADMINISTRATIVE INFORMATION Trustees Mr E R Evans, Chairman Dr B AA5hton Mrs V Edwards Mr R Freeman Profwmasry Mrs L Ossèllon Mr R Lumby MrJ S Bratt Prof. S Roberts DrGER Th￿as Charlty number 1044906 Company number 02992437 Règlstered offSce Arthritis Research Centre RJAH Hospital Oswestry Shropshire SY10 7AG Audltor Wenn Townsènd 30 Sl Giles Oxford OX13LE Sollcltors Hatch8rs Soliciiors LLP Thornes Hall Castle Street Shrewsbury Shropshire SY1 1DA Inveslment advlsors Barclays Wealth ndsorcourt 2nd Floor 1-3 Windsor Place Cardiff CF103BX

ORTHOPAEDIC INSTITUTE LTD CONTENTS Page Trust@es report Stat8ment of Trustses responsibilities Indèp8ndenl audllorfs report Slatémenl of financi81 acllvities 10-11 Balance sheet 12 Notes lo the financial statements 13-30

ORTHOPAEDIC INSTITUTE LTD TRUSTEES REPORT (INCLUDING DIRECTORS. REPORT) FOR THE YEAR ENDED 31 MARCH 2021 The Trustees present their report and the audited financial slalemenls ofthe charity for the year ended 31 March 2021. The trustees have adopted the provisions of the St818m8nl of Recommended Practice ISORP)'Accounling and Reporting by Charltles" in preparing the annual report and financial statements of the charity. ObJèctlve8 and 8¢tlvlt The oblects ofthe Charity are to promole by all available means the study of disease and particularly disorders ofthe locomotor system and allied subjects, and generally lo Improve the slandard of knowledge ofthe means of Prevention. diagnosis and methods of Irealmenl and cure of such disorders, and lo initiat8, encourage, Support and carry oul research and investigation into the cause5 of such disorders and the possibilllies of prevention and allevialion or cure. The Charity's main objectives for the year continuo lo be funding and facllitaling medical r8séarch and leaching at the RJAH Orthopaedic Hospital NHS Foundation Trust, Osweslry. Shropshire. The strategies lo achieve the objectives of the Charity are: To encourage researchers to submit projects lo the Inslilule for fundlng. coupled with persuading smaller research departments to be more forthcoming in this respect. To continue the organisalion and running of trainillg courses, together with a variety of specialised teaching and training cour8es open lo doctors in ggr)eral and medical st8ff throughout this country and overseas. To conllnue wllh our support for the very $uec8ssful Research Days wh8re patients. donors, schools and members of the public are Invlled to come along to view the iesearch work that is being carrlèd out and to ensure the ongoing trend of allracting high profile Professors. Consultants and Clinicians lo allend this annualevent. Th8se two days enhanc8 the profile of the Hospital and improves its national and International reputatlon. To promote In tho I￿al press and on our updated website our achievements more comprehensively. To endeavour lo promote the Institute wlth the legal professlon, to enGourage future legacies and donations. Fundralslng standards Informatlon The Charity raises funds from the public through evénts and marketlng. The Charity employs ? fundraisw who manages the fundraising campaigns. Any significant fvndraising activities are approved by the Trustees the Trustees monitor the performance of events through attendance. To the dale of this report, no complalnts have been received in connection with the Charity's fvndraising activities. The Charity do&s not solicit or place l￿du8 prossure on Ihe general public for don81ions. Any marketing is via emai18 to a consented donor li$L within the hospilal staff network or through the website. social média and local press. Publlc bÈn8llt statamont The Trusl88s hav8 paid due Tegard to the Charity Commission guldance on publlc benefit and consider th18 when deciding whlch acllvilies the Charity Should undertake. All of the Charity's aclivilies focus on medical research and teaching and are undarlaken to further our charitable purposes for the public benefit.

ORTHOPAEDIC INSTITUTE LTD TRUSTEES REPORT (INCLUDING DIRECTORS, REPORT) {CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Achlevomgnts and pertormance Each yearthe Charity produces an extensive annual report, which fully explains th8 projects receiving funding and the progress in the year. Copies of this report are available from th8 r@gistered office. Brief descriptions of the malor funds supporting thèse projects are recorded in the notes lo the accounts. Circulating our Annual Report enables us lo keep in close contact vAlh OUT funders. We seek medical research funding for varfous innovative projects over a 213 year Ilme span to provide conlinuity to our research staff. Thé Trustees wish to thank all of ils donors for the support over the last twelve months lo enable the research projects to continue despite the challenges of the COVID-19 outbreak. During the year the Orthopaedlc Instllule provided fundlng for six new research projec15 Wlth over thirty projects ongoing at the year end. Local profile also enables the fundraiser lo Ilalse closely with local charitable organisations. This initiative continues to bring in funds frjr the work of the Charity. Patients are very supportive of the Hospital and the Instit￿e. During the year we were able to hold 6 onllne courses and webinars. generating income of £13,108 (2020 - £210,244). With a change in our course administrator in Nov8mb8r 2020. the focus of the role moved to being able lo attract course d818gates through soclal media and onliné presence and ensuring wa could successfully deliver courses and webinars virtually. The courses included anatomy and surgical exposureg, two GP study days, fool and 8nk18 and the FRCS lumour and stalislics webinar. The fixed asset inve8lments held by the Charity at the 31 March 2021 had a market value of £1,514,605 {2020 £1,242,832}. The income slraam from the inv8slmenls for the year Including bank interest was £41,103 {2020- £50,114). The Trustees ar8 satisfied with the management of Ihe investment porifcAio against the objeelives detsi18d wllhin the financial revlew. Flnanclal revlow The Charlty has generaled a nel surplus this year of £305,12712020.- deficit of £235,402), which includès an unrealised ggin on the investment portfolio of £275,46912020'. loss of £196,672). Further details of income and fund balances are presented elsewhere within this report. It18 the policy of thé Charlly that unreslrfcled funds whiGh have not been designated for a specific use should be Maintalned al a level equivalent lo be￿een three and six month's expenditure. The Ttustees consider that reserves al this level will ensure that, in the event ol a significant dTOP in funding, they will be able to continue the Charity's current activities while consideration is given to ways in which gdditional fund8 may be raised. Thls level of reserves has been maintained throughout the year. Given the long-teim nature of the research prqects undertak6n by the Charity tha Trustees designate unr&stricted funds lo individual prciects soon after they are rèeeived. Thls allows for long term planning and security for the research staff. As a result of this policy significant balances are retained as de8ignated for particular research projects. The Charfty has the poliw of retainlng a low level of unrestricted undesignated funds lo meet adminlstralion costs and provlde a small reserve for slartlng new projects or appeals. The Trustees have the policy that this balance should exceed £10,000 lo cover approximately three months adminislralion expenses. The unrestrict8d general fund fluGluates throughout the year ag unrestrict8d income is received and held as such until il is allocated to specif5¢ projeds. The Trustees pollcy is that the unrestricted general fund should not 8xceed £80.000 and this is monitored al the quarterly comm1tt6e meetings. At the year-end. unreslricled undesignalèd reserves excludir￿j gains on investments tolalled £80,000.

ORTHOPAEDIC INSTITUTE LTD TRUSTEES REPORT (INCLUDING DIRECTORS, REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 The main source of the Charlly's income is generated from charili8s, grant making bodies, individual donors and surpluses on courses. The reputation of the Hospital has ellabled the Institute lo forge long standing personal connections wlth the decision makers 2nd this has enabled personal ¢ontacl when support is sought. In addition, the Charity has received three generous legacies during the year, for which il is v@ry grateful and will help lo fund research projects. Funds are either received in respons8 to applications made by the research team8 for specific projects in which case the incom8 is used to 8UPPOrt those projects or for income received wher8 no specific applicatlon has b88n made the research teans apply for grants from these r8serves. The investment objectives ar8.. The creation of a sulficienl financial return to enable th8 Charity to carry out It8 purposes effectively andwithout Interruption. and The malnl8nance and, if p08slble, enhancement ofthe Inve81ment funds whilst they are Invested. To obtain a reasonable balance between capital growth and income so that the Charity Gan meet future aswell as ¢urrenl needs. To avoid investments that are unduly risky. The Trustees. policy Is lo invest In an appropriate mix of real assels. i.e. equities. fixed interest and monetary asseis. Trustees recogniso that the relurr)s on 6quilie8, whi18 expected lo be greater over the longer-18rm than those of fixed interest and monetary assets, are lik81y lo be more volallle. Investment in a mix of asset classes should nevertheless provid8 th& levels of Telurn required and mitigate volatility for the Trust to aGhieve its objectives. The Trustee8 have delegated th8ir investment powers to an appointed Investment manager. The investment manager is responsible for carrying out all day-104Jay investment decisions including a¢quisltlon and re81isalion of investments. Tho investment manager is required lo exercise the power to give effect lo th8 principles as contained in this statement and, in particular, must have regard to the need for div8rsificalion and suitability of inve51menis selected. Due to changing investment pra¢lic8, the investment manager Is appointed on a discretionary basis. Vvhilsl the Trust@8s are not involved in the day-to-day operation of the inv8stment portfolio arbd cannot directly influ8nc@ allainment of a performance target, they will assess performance on an annual basis. Measurable targets have been developed for the investment manager consislenl wlth the achievement of the objectives sel out abovè and an acceptabl8 level of risk with no holding in a sing18 equity or poo1￿j vehicle having a value that is mor8 than 7Vh of the lolal equty portfolio. The Trustee5 do [￿t wlsh lo participala in any undeNritlng arrangement or hold direct investments quoted on AIM or OFEX markets. The appoinlmenl of the investment manager will be reviawed from time lo tlme by the Trustees, based upon the results of their monilorlng of performance, investment process and the man8g8¢s compllance wllh the requirements of ihe Truste8 Act 2000 and guidance of the Charity Commissloners. The investment manager will meet the Trustees (or a designated bo(ty of trusleesl al least once a year lo review performanee over the preceding period and to discuss and agree the strat&gy to be adopted. Although generally the interesls of a trust's beneficiaries are best served by seeking to obtain 8 sound financial return from a suitably div8rse portfolio of investments, the invaslment manager will hav& the regard lonot investing in thos8 assets which could be delrimenlal to the ebjeclives 8nd alms of the Trust. The Trust does not have an ethlcal investmenl policy. The investment powers of the Tru8t068 have been formally vested In the Charlly's independent stockbrokers, Barclays Wealth.

ORTHOPAEDIC INSTITUTE LTD TRUSTEES REPORT {INCLUDING DIRECTORS. REPORT) {CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 The Trustees have conducted their ¢)wn review of the major risks to which the Charity is exposed and systems have been established lo mitigate those risks. External rlsks to funding hav8 led to the engagement of a fundraiser to ov8rs8e appeals made by the Charity and report lo the Tru8tees on fundraising progress each quarter. Internal risks are minimised by the implem&ntalion of prOc￿Ur@S for aulhorisation of all transactions and projects and lo ensure ¢onsislenl quality of delivery foi all operational aspects of Ihe charitable company. These procedures are periodically revi8W8d lo ensure that they still meet the needs of the Charity. Long term alms and objectlves The Institute inlend5 to continue to be supportive of the Trust Board at the Robert Jones and Agnes Hunt Orthop8edic Hospital NHS Foundation Trust and lo work alongside the Trust lo asslst with funding of medle8J research pro1￿1$. We intend to continue developing our fundraising base by approaching newly fomed charities and seelfing to acquire new connections. Wa will encourage res8archers to submit projects for funding. Liaison with local solicitors is vital to maintain the receipt of18gacies which asslsl considerablywhen funding research projects. We will continue to support teaching and Irainlng and runnlng of courses for the medical profession. Cours8S are vltal not only in 811racting the delegates and generaling income but also lo promote th@ Robert Jones an Agnes Hunt OrlhopaediG Hospital NHS Foundation Trust and retain our staThJard as a Centre of Excellence wllh national and international repulatlon. Structure, governance and management The Charity is a company limited by guarantee and therefore has no share capital. Each member is liable. upon winding up, lo an amount not exceeding £1. The Charity was incorporated on 21 st November 1994 to take over and continue the administration of the pre existing Charity The Institute of Orlhopa6dics. The company was eslabllshed under 8 hAemorandum ofA8socialion, which established thè objects and powers of the charitsble company and Is governed under its Articles ofAss(Kiation. The Trustees, who are also the directors for the purwse of company law, and who sèrved durlng the year and up lo the dale of this r8POrt were.. Mr E R Evans Chairman Dr B AAshlon Mrs V Edwards Mr R Freeman Profw Masry Mrs L osselton Mr R Lumby Mr J S Brall Prof. S Roberts Dr G E R Thomas (appoint￿ 28 OctO￿r 20201 The Twstees retiring by rotation are.. Mr E R Evans, Mr J S Brattand Prof S Roberts As sel out In the Articles of Assoclation the members of Ihg Orthopoedic Inslllute Limited ￿c￿ln3te the Chair of the Trust8es. Each year one thlrd of the Trustees rellre by rotation and may offer themselves for re- elaclion. When a vacancy exists the new Trustee will be of similar standing to the retiring Truslèe. AIS members are circulated wllh invitations to nominat8 Trustees prior to the Annual General Maetlng advising them of thè retiring Trustees and requesting nomination8 for the Annual General Meeting.

ORTHOPAEDIC INSTITUTE LTD

TRUSTEES REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED)

FOR THE YEAR ENDED 31 MARCH 2021

The paid administrators of the Charity have been delegated by the Trustees as being responsible for day to day management.

The Charity collaborates very closely with the medical department at Keele University in carrying out many research projects.

The Charity operates within the environs of the Robert Jones & Agnes Hunt Orthopaedic NHS Foundation Hospital. The NHS Trust engages the staff undertaking research projects, teaching and administration. The Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust recharges their salary costs to the Charity.

Implications of COVID-19

COVID-19 has had a significant impact on the charity during the year and continuing after the year end. With the hospital's resources beingfocused on fighting the virus, research and training activities have been significantly reduced. Our face to face courses were cancelled or postponed and we look to how we can provide future training with reduced delegate numbers and also to online course provision where possible.

In addition our previously successful fundraising events over the Summer and Autumn of 2020 have had to be postponed. Our team have been able to work throughout the lockdown period, focusing on generating new income streams for the charity as well as strengthening our existing resources such as our website. Our research work has and will continue with 36 projects in progress currently and we look to the future when we can meet in person with our clinicians, researchers, patients, delegates, volunteers and donors again.

As well as our current income streams being reduced significantly, our long term financial investments have also been affected adversely by the general economy and the impact of COVID-19. Our investments are held for their longer term value as well as providing ongoing income to support our charitable activities. We continue to monitor our investments performance and risk profile with our financial advisors.

Disclosure of information to the auditors

In so far as the trustees are aware:

there is no relevant audit information of which the charitable company's auditors are 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 that the auditors are aware of that information.

This report has been prepared having taken advantage of the small companies exemption in the Companies Act 2006.

••,�man"'"" •�=••PO=-'"'

Mr ER Evans Chairman & Trustee

8th September 2021

- 5 -

ORTHOPAEDIC INSTITUTE LTD STATEMENT OF TRUSTEES RESPONSIBILITIES FOR THE YEAR ENDED 31 MARCH 2021 The Trustees Iwho are also the directors of Orlhopaedlc Institute Ltd for the purpose of company law). are responslble for preparing theTrustees' Annual Report and the financial statements in accordance vrfth applicablé law and United Kingdom A￿oUntIng Standards {Unit8d Kingdom Generally Accepted Accountlng Practice). Company Law requires the Trustee8 to prepare flnancial slalemenls for each finaneial year which give a tru8 and fair view of the stale of affairs of the Charlly and of tho incoming resources and application of resources, including the income and expenditure, of the charitable company for that year. In preparfng these financial stalemenls, the Trus188s are required lo.. set￿1 suitable accounting policies ar)d then apply them consistently. observe the methods and principles in the Charities SORP 2019 IFRS 102)., make judgements and estimate8 that are reasonablè and prudent,. and prepare the financial 8lalemenls on the going Goncem basis unless il is inappropriate to presume that the Charity wlll continue In operation. The Trustees are responsible for k88plng adequate accounting records that disclose with re8sonable accuracy at any time the financial position of the Charity and enable them lo ensur8 that the financial statements comply with the Cornpanies Act 2006. They are alse responsible for safeguarding the assets of the Charity and hence for tsking reasonable steps for the prevention and detection of fraud and other irregularili8s.

ORTHOPAEDIC INSTITUTE LTD INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF THE ORTHOPAEDIC INSTITUTE L TD FOR THE YEAR ENDED 31 MARCH 2021 Oplnlon Wè have 8udi18d Ihe ffinancial 8latemenl8 of Orthopaedic Instllute Ltd Ilh& 'charitable company'i for the y&ar ond8d 31st March 2021 whiGh comprise the Slalemenl of Financial Actfvllies, Ihe Balance Sheet, and notes lo tho financial stalgtnenls, indu(ling a summary tsf significant accounting policiès. The ffinancial reporting Iramewoik that ha5 been applied in Ihelr preparallon is applicable law and United KirwJdorn A¢¢ounling Standards. including Financial Reportlng Standard 102 Tha FFnanel&lRèportin9 Standardapplicable in th8 LIKandRepubliG oflreland (Uniled KirwJdom Generally Aceèplèd Aceounbng Praetic81. In our op￿lOn the fln8ndal $talements'. give a true and far view of the slate of thè eharltablè company's affalrs as al 3151 March 2021, and of Ils Incomlng re5ourGes and application of resources, indudlng hs incom& and expenditure, for the year Ihen ended,. havè bèèn properly prepa￿ in accordance with United Kkngdom Generally A¢￿pted Aceountlng Pra¢ll¢e: and have been prepared in accordance with the requirements oflhe Companies Act 2006. B#81s for oplnlon We ct)nduGled our audit In accordance with Inlemational st￿dards on Auditing IUKI IISA8 IUKI} arKI app4iGablo law. Our responsibilities under those standards are lurlhèr dèscribèd in the Auditorfs responsibilities for Ihe audit of final￿181 Statements section of our report. We are Independent of lh¢ Gharitable company in accordance with the elhic81 requiieman(s that ale relevanl to our audit of the ffinanclal slalements in the UK, includlng the FRC'S Ethical Slandard, and WÈ hav8 fulfillèd our olh&r ethical responsibilities in accordance wtth these requirements. We believe that the audil evidence wo have obtained 1$ 5u(ficlenl and appropriate to provide 8 b88is for our opinion. ConcluBlons relatlng to going concern In auditing the financial slalements. we h8v8 cOncl￿ed that the IN8teas' use of th¢ gc4ng ¢on¢em basis of accounliThJ in the weparalion of the financ1818talem8nts is appropriate. Based on the work we have perfoTmèd, ￿ hava not id￿tir1ed any material uncertainties relating lo events or conditions that, in(fividually or coilectively, may cast significanl dwbton Ihe charitable companWs ability lo Ixjnfinuè as a going concem for 8 period ofat least ￿efve montrs frorn WI￿￿ the finanoal statemenls are authorised for issuè. Our resptsniibilitiès and the re$ponslbllilles of the Iruslees with respèct to going coneem are described In the relev8nl sections of Ihis rgport. Other inforniatlon The truslees are responsible for the other inlonnation. The other information comprises the ￿fOll￿ation induded in the twstees, annual rewrt, other than th& financial statements and our audilorfs reFKTrrt Ihereon. Our opinlon on the financial statements does not eovèr thè othar information and, except to Ihe extent othe￿18¢ exp1kil￿ stated in our report. we do not express any forrn of assuianG¢ GonGlusion Ihereon. In cwnèctlon with our audft ol the financial 81atements, our Tesponsiblllty Is to read the other inforrnation and, in doSng so. cons1dar wh&ther the other information is materially inconsistent with the linancial statements or our knowledge oblain¢d in the audit QT otherwise appears to be maleiially migslalèd.11 we id8ntify such material inconsislencies or apparent material misslalements, WB are required to detèrminè ￿￿ther there is a material rnisslatemenl in the financial $lalements or 8 material misstal6menlolthe other informa￿0￿. If. based on the work we have performed, we c0ncludethatthe￿ is 8 m8tÈrial misstatèmènt of this other informallon. we are required lo report that facl. We have nothing to report In Ihis ￿gard. Opinlons on other matters prescrlbed by the companigs Aci 2006 In our opinion. based on the work ￿derlake￿ in IhB course of the aud the information given in thetrustees, reporf lincorporating thè dlrÈclors' report) forlhe flnanclal yearforwhich thefirlan￿9l slalements are prepared is consistent with the financlal slaletnents., alld the direthis, r¢pgrt has been prepared in accordance wlth applicablè I￿al requirements. P4Jatt•r9 on which we are requlred to rgport by èxceptlon In the light of our kno￿edge and und8rslandlng of the charitable company and ils environment obtained in the course ol the audit, we have not Iderfffied Materi￿ misslaternenls in the diieclm, report.

ORTHOPAEDIC INSTITUTE LTD INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF THE ORTHOPAEDIC INSTITUTE L TD (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 We have nothing lo roport in respecl ol the followng matters in rÈlatlon lo which Ihe Companies Act 2006 and the Charities Act 2011 requires us lo ioport lo you If, in our opinion.. adequate sccounting records have not been kopl, or relurns &Jequale for our audlt hav8 not been received from branchés not visited by us- or the finanGial statements are not in xgrèÈmènt with th& accounting record8 and relums., or certain disclosures ol directors. remuneration stKryfied by law are not made,. or we have received all the inf0m￿li0n and expl8nalion5 w¢ requSre for our audit., or the InJslg85 weie enlltled lo prepare the finanelal st8tèm8nts in accordance with tho small companies, regime and take advantage of the small companies. exemptions in praparing the directors, report and from thè ￿quIrement to prepare a 3lraleglc report. Rè&ponslbllltl•s of tru8tee8 As explained MO￿ fully in the Iruslees, res￿nSIbilit￿S stalement set outon page 6. the Itustees (who are also the directorl of the d)arltable company for IhÈ purposés ol company lawl are re8ponsible forthe preparation of the financial statements and for ￿Ing satisfied that they give a Iiu¢ and lair view. and for such intèrnal control as the trustees deterTThne is necÈg88ry to •nable the preparation of financial stslemenls that are free trom malèrlal mksstatoment, whether due lo fraud ttr èrror. In pr¢parlng the financial statemènts, the Irustses are responsible lor as8e8singtheeharltable companys ability lo continua as a ￿Ing concern, disclosing, as applicablg, mattors r¢Laled lo going concern arKI uslng th• going concern basls of ac¢ountlng unless the truste&% either intend lo liquidole the charitable company or lo cease operation$. or have no reali51

lkrnalThie but to do so.

AudS10rf¥ responslbSlltles forthe audit of thè flnanclal statements Ourobjecbves are to obtain reasonabl8 assuranGg aboulwhetherthe financial slatemènts as awhole arefree from material mls8tat@m8nt. whether du8 lo fraud or error, and to issue an aLhYilorfs rèport that indudes our opinicfi. Reasonable assurance is a high level of assurance, but 1$ not a guarantee that an audil condusled in accordance wilh ISAS IUKI ￿11 always d¢le¢t a material nwsslatemenl when it èxlsts. Misstslements can arise from ftaud or error and are con8Édered material W. Individually or in thè aggrèg8t8, thèy c￿jId reasonably be expected lo inflLJence tha 8eowmic d￿lS1o¢18 of users taken on the basis of these financial slalgm¢nls. A further description of our responslbllities for the audit of the financlal slalements Is located on the Financial RÈportir CounGil's website at.. wvM.frc.org.uklaudltorsrÈsponsibilities. Thi8 description forrn8 ol our auditorfs report. Irragularili85, including fraud, are instsn¢es of non-compliance with lawg and r8gulBtions. We deslgn procedure8 in lin¢ with our responsibilities, outlined above. lo detect material misslatÈménts in resped of irregularities. including fiaud. The spgcific procedures for this engauement and the extent to which these arg Gapablp of delectSng ir￿Ular1ties, induding fraud15 detailed below.. Enquiry of management. those charged with governance and Ihe enlity's soli¢iloTS art)und actU818nd pot8ntial litlgatson and clalms., Enquiry of Èntity staff in tax and Com￿lance furKtion¥ to identfy any instan¢e8 of n0rrtompl1an￿ ￿th laws and règulations.. Revvawin9 tllinut¢s of meetings of those ¢h8rgèd vAth gov8mance.' Reviewing Inancial stalement di8¢108ur68 8nil lesling to supporting documenl81ion to 8ss&ss compliance applicable laws and mgulalKJn5', Perfoimlng audit work over the rf5k of management gverride of controls, including tÈ$ting of joumal entries and olher adjustments for approprHleness, evaluating the business ralk)nale of signthcanl transaGlions gutside the n￿Mal course of lyJsine¥s and ￿vIewIng accounting èslimatèg for bias. Because of the inhoienl limilatk)ns ol an audit, there is a risk th8twè wlll not detect all irregularities, induding those leading lo & material misstalement in the finan¢ial ststem8nts or non-compliancg with rogulalion. This risk increases the more that compliance wrfh a law or ￿guLatiOn is removed from the events and transactions reflected in the financial slalements, as we will ba lèss likely lo become aware of inslawE8 of non<ompliance. The risk is also greater r¢gard1ng i1[egu￿rit￿S occurring due to fraud r8lh&r than error. as fraud i￿o￿e8 inlenlion81 conc8alment. forgery, collusion, omi55ion or rnisrèprÉs8ntation.

ORTHOPAEDIC INSTITUTE LTD

INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF THE ORTHOPAEDIC INSTITUTE LTD (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021

Use of our report

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company's members as a body, for our audit work, for this report, or for the opinions we have formed.

Lee Baker FCA (Senior Statutory Auditor) For and on behalf of Wenn Townsend Chartered Accountants and Statutory Auditor 30 St Giles

Oxford OX1 3LE

8th September 2021

Wenn Townsend is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006

ORTHOPAEDIC INSTITUTE LTD STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 MARCH 2021 Unrestrlcted Deslgnatod funds funds Restrlcted funds Total 2021 2021 2021 2021 Note8 Donations and legacies Charitsble activitl&s Investments 222,428 32,670 41,103 42.289 264.717 32.670 41.103 Total Income 296.201 42,289 338,490 Ralslng funds Charltable a¢livilies 59,707 202.679 59,707 249,365 46,686 Total resources expense8 262,386 46,686 309,072 N8t gain on investments 11 275,709 275,709 Nèt Ineomlnglloutgolngl rfrsources beforo transfers Gross transfers btheen funds 309.524 (4,39n 305,127 {303,691) 305,825 (2,1341 Nèt Incomel(expendlturel for thg year., Net movement In futKIs 5,833 305.825 {6,5311 305,127 Fund balanc8S at 1 April 2020 74,167 1.958.056 1,207.119 3,239.342 Fund balances at 31 March 2021 80.000 2,263,881 1.200.588 3,544,469 The statement offinancial activities includes all gains and losses recognlsed in the year. All income and expenditure derive from conlinulng aclivltles. The slalement of finan¢ial actlvities also complies wilh the requirements for an incom8 and 8XP8nditure arLount under the CompaniesAGI 2006. 10-

ORTHOPAEDIC INSTITUTE LTD STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITUREACCOUNT FOR THE YEAR ENDED 31 MARCH 2021 Unre5trlcted Deslgnated Restrl¢ted funds funds funds Totsl 2020 2020 2020 2020 Notas Donations and legacies Charitable activities Investments 119,785 224.256 50,114 8,403 8,005 128.188 232.261 50,114 Total Income 394.155 18,408 410.563 Raising funds Charitable ￿tIVitIeS 143,230 270.454 6,192 29,760 149.422 300,214 Totsl resources expendèd 413,684 35,952 449.e36 Net (lossllgain on Investments 11 (196,329) (196,329) Not loutgolngylncomlng ra8ourc88 boforo transfers (215,858) 119,5441 (235.402) Gr08s Iranslers between funds 210,025 {210,0251 Not Incomellèxpendlture for tho yaar: Net movement In funds 15,8331 1210,0251 (19,544) {235.4021 Fund balances al 1 April 2019 80.000 2,168,081 1.226.663 3.474,744 Fund balancesat31 March 2020 74.167 1.958,056 1,207.119 3,239,342

ORTHOPAEDIC INSTITUTE LTD

BALANCE SHEET AS AT 31 MARCH 2021

Fixed assets
Tangible assets
Investments
Current assets
Debtors
Cash at bank and in hand
Creditors: amounts falling due
Note
12
13
15
within one year
17
Net current assets
Total assets less current liabilities
Net assets
Income funds
Restricted funds
Unrestricted funds:
Designated funds
Unrestricted funds
Total unrestricted funds
20
2021
£
£
1,285,193
1,607,141
2,892,334
6,756
691,017
697,773
(45,638)
652,135
3,544,469
3,544,469
1,200,588
2,263,881
80,000
2,343,881
3,544,469
2020
£
£
1,322,993
1,335,368
2,658,361
2,977
707,294
710,271
(129,290)
580,981
3,239,342
3,239,342
1,207,119
1,958,056
74,167
2,032,223
3,239,342
2020
£
£
1,322,993
1,335,368
2,658,361
2,977
707,294
710,271
(129,290)
580,981
3,239,342
3,239,342
1,207,119
1,958,056
74,167
2,032,223
3,239,342
3,239,342
3,239,342
1,207,119
1,958,056
74,167
2,032,223
3,239,342

The financial statements were approved by the Trustees on 8th September 2021

Mr ER Evans fJ1l Chairman and Trustee

Company Registration No. 02992437

The notes on pages 13 to 30 form part of these financial statements

ORTHOPAEDIC INSTITUTE LTD NOTESTO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2021 Accountlng pollcl&8 Charlty Informatlon Orthopaedi¢ Inslltute Ltd is a private charitabl8 company limited by guarantee incorporated in England and Wales. The registered officg is Arthritis Research Centre. RJAH Hospital, Osweslry, Shropshlre, SYIO 7AG. The registered number is 02992437. In the evonl ofthe charity being wound up. the liability In respect of the gu8ranlee is Ilmlied to £1 per member. 1.1 Accountlng conventlon The charity conslitules a publlc ben8fi1 onlity as defined by FRS 102. The financial statements h8V8 b88n prepared in accordance wth Accounting and Reporting by Charities.. Statement of Recommended Practice applicable to charities preparing Ihelr accounts in accordan¢e wlth the Financial Reporting Standard appllcable in the UK and Republic of Ireland issued in October 2019, the Finan￿al Reporting Standard applicable in the United Kingdom and Republlc of Ireland (FRS 1021. the Charities Act 2011, the Companies Act 2006 and UK Generally Accepted Accounting Practice. Th8 financial statements are prepared in stedlng. which is the functional Currency of the Charity. Monetary amount8 in these financial statements are rounded to the nearest £. The accounts have been prepared under the historical cost convention. modified lo includé thé r8valualionof certain financial instruments at fairvalue. The principal accounting policies adopted are set out below. 1.2 Golng concern At the time of approving the financial stal8menls, the Trustees have 8 reasonable expectation that the Charity has 8dequ8t8 resources lo continue in operational existence for the foreseeable future. Thus the TrLJslees continue lo adopt the golng concern basis of acwunling In preparing the financial 51atemenls. The Trustees have considered the ongoing Covid-19 scenario and concluded that il will have continu8 10 impaclon the new financial year. The course provision has changed significantly over the last 18 months. Legacy in¢ome and donations have enabled th8 charity lo continue to support research and education over the year, despite the significant decline in course incorne. The charity continues to adapt lo meet the needs of its m@mb&rs, course attendees. and requirements of the NHS Trust. Steps have been taken to ensure IheTe are appropriate business and strategic plans in place to manage tho ongoing Ghanges. The p08itlon Is under constant revlaw. 1.3 Charltable funds Unrestricted funds are available for use at the discretlon of the Tru51ees In furtherance of their charitable objectives. Designated funds Gompris? unrestricted funds that havè bèen set aside by th8 trust8es for particular purpose8. The aim and use of each d8signat8d fund is sel out in the notes to the fina￿la1 Statements. Restricted funds are subject lo speeific conditions by donors as to how they may be used. The purposes and usés of the restricted funds are set out in the notes lo the financlal statement8. 1.4 In¢ome recognltlon All incoming resources are included in the Statement of Finan¢io1 Adivities (SOFA) when the charity is 18galty enlided lo the income after any performance conditions hav8 b88n mel, the amount can be measured reliably and it Is probable that the i[￿0￿8 ￿11 b8 recelved. For donations to be recognlsed th& charity wll have be8n notified of the amounts and the setuement dale in writing.11 there are conditions attached to the donation and this requires a levèl of performance befor8 8nli118menl can be oblained then income is delerred until thos8 condthons are fully met or the fulfilmenl of those conditions is within the control of the charlty and il is probable that they will be fulfilled. 13-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Accountlng pollcles (contlnuèdl Income recognltlon Icontlnuedl No amount is included in th8 ffinancial slatements forvolunteer time in line ￿th the SORP. Further detsil is given in the Trustees. Annual Retxyt. For legacies. entitlement is th6 éarlier of the charlty being notif￿d of an Impending distribution or the legacy being ieceived. Al this point ￿cOme is recognised. On occaslon legacies will be notified lo the charity however it is not possible lo m8asure the amount expected to be dislribuled. On these occasions, the legaGy is treated as a contingent asset and disclosed. Income from trading aclivilie5 includès income e8med from fundraising events and trading acliviti8S to rais8 funds for the ch81ily. IrKome is received in &xch8nge for supplying goods and services in order to raise fvnd5 ?nd is recogni8ed when entiU8m8nl has occurred. Invastmenl income is earned through hdding assets for investment purposes such as shares. 11 includes dividends and interest. Investment income is included when the amount can k measured r81iably. Int8r8St Income is recogllised using the effe¢ts've Interest method and divid8nd income is recognised as the charity's right lo receive payment is 8Stabllshed. 1.5 Expendfture recognlllon All expendllure is a¢counled for on an accruals basls and has been Classified urKler headings that aggr8gate all costs rel8led lo the category. Expenditure is recognised wh8re there is a legal or constructive obligation to make payments lo third parti8s, il is probable Ihatlhe setuemenlwill be required and the amount of the obligation can be measured reliably.11 is calègorisad under the following headings.. Costs of raising funds includes of wsts offundralsing and events. costs of runnlng courses and educational events and Investment management fees., Expenditure on charitable activiti?s includes research salaries and related èxpenditure, costs of PTomoling further education and training and depTecialion of the leasehold pr8mises'. and Other expenditure represents those items not falling into Ihe c8tsgories above. Irrecoverable VAT is charged as an expen58 against the acllvlty which expenditure ar08e. Researoh proposals are apwaised by the Research Panel and presonled lo the members for support. On approval. bjnds are allocal8d lo i￿1VidUal research projects and costs are spent as they arise over the course of the project. On complelK)n any surplus is reallocated to the relevant fund from which is W8S Drlglnally allocated.. any cost overrun must return lo the Research Panel for appraisal before approval by the mernbers. Grants payable to thlrd parties are within the charitable objectives. Where uncondillonal grants are off8red, Ihls is accrued as soon as the reapienl is notified of the grant. as this gives rls8 to a reasonable expectation that the recipient will receive the grants. Where grants are conditlonal relating lo performance then the grant Is only accrued when any unfulfilled conditions are oulslde of the control of the Charity. 1.6 Support costs allocatlon Support costs are those that assist thè work of the charity bul do not directly Tepresenl charitable 8Ctivifj88 and Include office costs, governance costs, administrative payroll costs. They are Incurrad diraclly in support of expendiiure on the objects oflhe charity. Where support costs Cannot be dlredy attributed to particular headi￿5 they have b8an allocated lo ¢o$t of raising funds and expenditur8 on charitable acllvitles on a basis consistent with use of th8 resources. Fund-raising costs are those incurred In seeking voluntsry contribullon8 and do not include tre costs of dlsseminating information in support of the charitable aclivilies. The analysis of these costs is irKluded In note 8. 14-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 AcGountlng pollcles {contlnued} 1.7 Tanglble flxed as$ets Tangible fixed assets are initially measured at cost and subsequently measured at cost orvaluation, nel of depreclatlon and any impairment losses. Depreciallon is provided al the followlng annual rates in order to write off 8ach asset over it8 estimated useful life-_ Long leasehold Overthe period ofthe lease With the exceptlon of the long leasehold property the Charlty operatos a poliGy of charging all expenditur8 on capital items lo the Statement of Financlal Aclivlties in the year in which11 Is occurred. 1.8 Flxed asset Invgstments Llsted inv8slments are included In the Balance Sh8et al marketvalue. Unlisted investments 9re Included at cost as an approximation of marf<el valu8 unless there is specific evidence lo the contrary. 1.9 ImpaltTnent of flxed a55ets Al eaeh reporting end date, th8 Charity reviews the carrying amounts of ils tangible 8S5els to detemiine whether thera is any indication that those assets have suffered an impairrllenl loss. If any such Indi￿119n exlsts, the recoverable amount of the asset Is 8stimated in order lo detemiine the extent of th& impairment 108s lif any). 1.10 stocks The Charity holds stock of speciallsl publications for use on courses held for extemal sales. Al the y&sr end itwas not posslble to measure the nel r8alisable value of this stock with certainty to pemil ils inclusion in ihe financial statements. This is largely due to the high volume of stock held whlch h8s an Indeleminate usefLJI Ilf8. 1.11 Cash and cash gqulvalents Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-lèrm liquid investments with origlnal maturities of three months or less, and bank overdrafts. Bank overdrafts are shown within borrowings In current liabilities. 1.12 Flnanclal Instrumgnts The Charity has olected to apply the provisions of Section 11 'Basic Financial Instruments. and Section 12 'Olher Financial Instruments Issues, of FRS 102 to all of its financial Instruments. Financlal instruments are recognised in the Charity's balance sheet wh8n the Charity becomes party lo the conliaclual provisions of the instrument. Financial assets and liabilili&s are offset. with the net amounts presented In the financial statements. when there is a legally enforceable right lo sel off the recognised amounts and there is an inlentlon to sellle on a el basis or to realise the asset and settle the liability simultaneously- Baslc financialassots Basic financial assets. which include debtors, loan notes and cash and bank balanc88, are initially measured al transaction price Including transaction costs and are subsequently carried al amortised cost using the effective interest method unless the arrangement conslilutes a financing Iransaclion, where the transaction is measured al the present value ol the futUTe receipts discounted al a market rate of in18r&st. Flnancial assets classified as recelvable within one year are not amortised. 15-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Accountlng poll¢les Icontlnuedl Flnanclal Instrumtsnts Icontlnuedl Baslc flnancialliabfflitles Basic financial liabilities. including cradilors and bank loans are initially recogni$6d al transactior) price unless the arrangement conslilules a financing Iransaclion, wher8 the debt inslrum8nl is measured al the present value of the future payments discounted at a market rale of inler6St. Financial liabilities classified as payable within one year are not amortised. Debt instrum8nts are subsequently carried al amorlised cost, using the effectlve Snleresl rale method. Trade credittsrs ar8 obligallons to pay for goods or services that have been acquir8d in the ordinary course of operations from suppllers. Amounts payable are classified as current liabilities if payment is due within one year Of less. If not, they aro pras&nted as non-¢urr8nt liabilities. Trade ciedllors are recognised initially at Iransaclion price and subsequently m8asured at amortised cost using the effective Interest method. D8r8cognltlon of Ilnancial liabllltles Flnancial liabilities are derecognised when the Charity's contractual obligatlons expire or are discharged or an¢elled. 1.13 Employw benefits The cost of any unused holiday enlillemenl18 recognised in the period in which the employee's services 8re received. Termination benefits are recognised immediately as an expense when th8 Charity is demon8trably committed to lem)inate the employment of an employee or to provide lerminalion benefits. 1.14 Retlremont boneflts Payments to defined contribution retirement benefil schemes are charged as an expense 8s they fall due. 1.15 Taxatlon The Charity is exempl from corporation lax on Ils eharilable activities. 1.16 Debtors Trade and other debtors are recognised al the settlement amount due. Prepayments are valued at the amount prepaid. 1.17 Credltors Creditors and provisions are recognlsed where the Charity has a present obligation resulting from a past event that will probably result in th8 transfer of fund5 to a thlrd party and the amount due to S8ttle thè obllgation can be measured or estimated reliably. Creditors and provisions are nomially recognised at their selllement amount. 16-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 AIARCH 2021 Crltlcal accountlng estlmates and judgements In the application of th& Charll*s accounting pollcles, the Truslees are required lo mak8 judgem8nts, eslimales and assumplions about Ihe carrying amount of assets and liabilities that are not readily apparenl from other si)urces. The eslimales and aS￿elated assumptions are based on hi5101ical experience and other factors that are ¢or)sidèr8é to be ￿leVant. Actual r8sulls may differ from these estimates. The estimates and u[￿erlYIng assumptions arè rèviawed on an ongoing basis. Revision8 to accounllng eslimales are recognised in the parlod in which the estimate is revised where the revision affects only that pericd, or in Ihe pèriod of the revision and fLJtur8 periods where the revlsion affects both current and future perlods. Donatlons and legaclos Unrestrlcted R8Strlcted funds funds Total Total 2021 2021 2021 2020 Donation8 and gifts Legacies 11,859 210.569 42,289 54,148 210,5fj9 44,443 83.745 222,428 42,289 264,717 128,188 Forthe yearended 31 March 2020 119,785 8,403 128.188 17-

¢£J(

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS ICONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Investments Unrestrlctèd Funds 2021 Unrestricted funds 2020 I￿Ome from listed investm8nls Interest rec8ivable 40,173 930 47,832 2.282 41.103 50,114 Ralslng funds 2021 2020 Fundralsin and ubliBi Staging fundraising &venls and related G051s Stsff costs 2.705 26.600 12,366 27,122 Fundraising and PL￿11¢Ity 29,305 39,488 Courses and eduCat￿nal events Course expenses Stsff costs 504 25,543 78.e81 27,122 Course costs 26,047 105.803 Investmènt mana eme 4,355 4.131 59,707 149.422 19-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Charltsble actlvltles 2021 2020 Depreciation and imparment Research and laboratory equipment Education, Irainlng and prizes Research salaries. fees and exp&nsÈs 37,800 95.225 3e8 92,833 37.800 97,911 10.232 136.369 226,226 282.312 Share of govemanc8 costs (see note 8> 23,139 17.902 249,365 300,214 Support costs Support Governance Costs costs 2021 2020 Sub-contractor costs Printing, stslionery and m1scellane￿S Auditors. remuneration 6.194 11,845 5,100 6.194 11.845 5.1CN) 7.778 5,144 4.980 23,139 23.139 17,902 Analysed between Charitable adivilies 23,139 23,139 17,902 Govemance costs Includes p8ymenls to the auditors of £5.10012020- £4.9801 foT audlt fees. -20-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 Employ6os 2021 2020 The av8rage monthly number of employees during th& year was.. Employment costs 2021 2020 Wages and salaries Social security costs Other p8nsion costs 50.688 469 986 51,400 1,712 1.132 52,143 54.244 Other employment services raquired by the Charity wer8 supplied by employees of RJAH Orthopaedic Hospital NHS Foundation Trust in r8specl of research. education and adminislrallon duties and invoiced to The Institute by th8 Hospital. A part-time b¢)ok-ke8par and part-tlme admlnlstrator are engaged by The Inslilule and are both self- employed. There were no employees whos8 annual r￿UneratIOn was £60,000 or more. fjo Trustoes None of the Trustees (or any persons connected with them) received any remunérallon, beneflts or expenses from the Charity during the year. 11 Net galnslllossesl on Investments Unrestricted Unrestrlcted funds funds 2021 2020 Realised gain 240 343 Unrealised gainl(lossl 275,469 1196,6721 Net gainllloss) on investments 275,709 1196,3291 21-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 12 Tanglble flxed assets Short leasehokl Cost At 1 April 2020 1,979.993 Al 31 March 2021 1,979,993 Dépreclatlon and Impalrm9nt At 1 April 2020 Depreciation charged in the year 857,000 37,800 Al 31 March 2021 6S4,800 Carrylng amount At31 March2021 1,285, 193 At 31 March 2020 1,322,993 The leasehold propèrty is the Leopold Muller Arthritis Res88rch C8ntre. This bullding was constructed on land h&ld on a 60 year lease that 8tarted on 28th March 1995. No depreciation was charged dullng the first 8 years of the lea80. The leasehold interest which now covers both Ihe land and the building is now being amortised so as to write off the cost of conslructson of the building overthe rem8ining p8rfod of the lease. The RJAH Orthopaedic Hospital NHS Foundation Tru81 have undertaken lo provide cover on the bulldlng equivalent lo that normally provided by a comprehensive insurance pollcy. 13 Flxod asset Investments Llsted Investmènts 5% Loan stoGk Total Cost or valuatlon At 1 April 2020 Disposals Valuation changes 1,242.832 13,6961 275,469 92,53e 1.335.368 (3,6961 275.469 At 31 March 2021 1.514,605 92,536 1,607.141 Carrylng amount At 31 March 2021 1,514,605 92.536 1,607.141 Al 3 March 2020 1,242,832 92,536 1,335,368

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 13 Flxed asset Invéstm6nts {Contlnued) Flxed asset Investments revalued Costs of Investmer)Is held al 31 March 2021 £1,307.86112020- £1,311,552). 5V. loan stock Telales to loan notes to Ashfleld 2018 Limited received on the sale of its shares in Arklow Engineerfng Limited. Whilst the Charity ha5 a legal obligation to receive these funds in 2023, al th8 date of signing these financial statements the Trustees do not have certainty as to whether this will be recoverable. No provlslon has been m￿e against the value of the108n stock. 14 Flnanclal Instruments 2021 2020 Carylng amount of Ilnanclal assets Debt instruments measured al amoilised cost Equity Instruments measured at cost less impairment 790.309 1.307.861 802,807 1,322,993 Carrying amount of flnanclal IlabSlltles Measured at amortised cost 27,536 98,184 Flnanelal assets measur8d al amortised ¢08t consists of trade débtors, ether deblor5, loan stock and cash at bank and in hand. Financi#l liabilities measured 81 amortised cost consists of trade creditOTS and accruals. In relation to Ihe equity instruments measured at fair value. income of £40,173 {2020- £47,832) has bean recogni8ed in th8 y8ar. The fair value adjustment for the year was a gain of £275,469 (2020 a loss of £1￿.6721. 15 Debtors 2021 2020 Amounts lalllng due wlthln one year.. Trade debtors 6,096 Other debtors 2.977 6.75e 2.977 16 Analysls of Invastmants at market value 2021 2020 UK Equities Unlisted Loan Stock 1,514,605 92,536 1,242,832 92.536 1.607.141 1,335,368

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 17 Credltors: amounts falllng due wlthln onè year 2021 2020 othertaxation and social seourily Trade credilot5 Other creditors Deferred income Accru81s 1.273 6.399 78 16,751 21,137 1,120 91.754 157 29,826 6,433 45,638 129,290 18 Deferrèd Income Deferred income represents course fees paid durlng the year which ralat8 to courses held in the following year and amounts received in tha year ended 31 March 2021 for fundraising events to lake place after 31 March 2021. The amount deferred al the year-end will be released in the year ended 31 March 2022 as te relevant coursas are provided lo the delegates and the ftjndraising ev8nts lake place. 2021 2020 Deferred Income as 1 April Amounts releas8d in the year 29,826 113.0931 63.225 163.2251 Blfwd deferred income remaining 16.733 Delerred Income at 31 March 16.751 29.826 19 R8tlrom8nt beneflt schemes Deflned contrlbutlon schemes The Charity operates a define(I contribution pension scheme for all qualifying employees. The asséts of the scheme are held geparatety from those of th8 Charity in an independently administered fund. The charge lo prorrt or Ios8 in respect of defined conlribulitsn schemes was £98612020- £1,132). -24-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 20 Movement In funds The income funds of the charity include restricted funds comprising the followlng unexpended balanc8s of donations and grants held on trust for specific purposes- 2021 Balance at 1 Aprtl 2020 In¢omlng rèsources Resources expended Transfers Galns and BalanGè at 31 Ios505 Mar¢h 2021 Unrestrlcted fund5 Unrestricl8d Designated 74,167 1,958,056 296,201 1262,386) 1303.6911 305.825 275,709 80.000 2,263,881 2,032,223 296,201 (262.3861 146,6861 2.134 275,709 2.343,881 Restricted 1,207,119 42,289 (2,134) 1.200.588 3,239,342 338,490 1309.0721 275,709 3,544,469 A det8iled analysis of the movement in funds is given in note 22. 2020 Balanco at 1 Ap￿1 2019 Incomlng sources R•sourc•s èxpended Tr￿s1￿r$ Galn¥ and Balaneo at 31 lo$$•s Mareh 2020 Unrestrlcted funds Unieslricled D8signated 80,ODO 2.168.081 394.156 1413,684) 210.025 1196,330) 1210,0251 74,167 1,958.056 2.248.081 394,156 {413,684) 1196,330) 2,032,223 1.207.119 Reslricled 1,226,663 16,408 {35.9521 3,474,744 410.564 1449.6361 1196.3301 3.239,342

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED> FOR THE YEAR ENDED 31 MARCH 2021 21 Analysls of net assets between funds Unrestrlcted Deslgnated Rostrlcted funds funds funds 2021 2021 2021 Total 2021 Fund balances al 31 March 2021 are represented by: Tangible assets Investments Current assetsllliabililies) 473,819 1.607,141 182,921 811.374 1,285,193 1,607,141 652.135 80.000 389,214 80,000 2.263,881 1,200,588 3,544,469 Unrestrlcted Dgslgnated Re5trlcted funds funds funds 2020 2020 2020 Total 2020 Fund balances al 31 March 2020 are represented by.. Tangible ass8ts Investments Current asse1511liabililiesl 487.756 1,335.368 134,932 835,237 1,322,993 1,335,368 580,981 74,167 371.882 74.167 1,958,OS6 1,207.119 3,239.342 -26-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 22 Analysls of funds Total fund balancg to 01104120 Total fund balanco t¢ 31103121 Costs Incomè Transfors General purposes General purp05es- designated Course {ExplInc￿1rI OrtlK)paeiJic development fuMI Pioles8orial suspÈnse fund Anatomy fund lincorporaling Henry Freede Fundl Arthroplasty fund ArthToplasty fvn¢J- restricted Research fund (Tony Smith) Research fund ITony Smilhl- restricted RJP Upper Limb fund CIND fund CIND fund- reslricled ENT course fijnd ENT wurse fund- restr￿ted Fool & Anklè résèarch fund INMI H8nd 8urg6ry res & trg fund Hip unil Iformety JRR & DI Histopalhology research fuTh Upper Limb (Hand & Wrist} fund Limb reconstruction fund (ABI Fund Generation fund Iprevlously London Maralhonl Fund Goneialion fund {previously London Maralhonl reslrided Medical photography Micro surg&ry fund Mugeular dyslrophy fund OSCAR fund Oncology fund Oncolooy fund- reStr￿ted orthotlc rès8arch fund Osc811 fund Paediatri55 fund P8ediatrlcs ftJnd- restricted Club Foot fund (replaces Paediatric Neurology) cl￿ Foot fund (replaces Paediatric Nouro109yI restricted Phamacy fund (replaces Pathology Mus8uml Postgraduate lund Publlshlng fund IJBR + VCPI Radiology fund Radiography fund Registrars day fund IS-JI Research fund (Arthritis & Rheum*>logvl Rèsearch fund (Arthritis & RheumaiologyI- r¢stiided Ros6arch fund (General) Legacy income R¢8earch fund {Generaf)- restrictèd Research fund {JBRI Rosearch fund IJB Y<l- r8slriclgd Research lund IS Wvhilel Rosearch fund IS w￿lle1- reslricl8d Charfes Salt research fund Radiology Research fuThY Radiology Research fuwvJ- Ipsttided Spinal injurles fund Splnal injuries fvnd- réstrictèd Spinal injuTlèS Staff fund 74,167 167,3721 119,840 146.634) 51,509 112.259) 1.371 1.205 6.724 3.001 80.OCKJ 51,509 115.8621 {3701 28,121 141 69,1 62,139 83,171 216,863 41,108 70.338 63.343 66.346 223.OS4 41,108 2.310 147 13.799 28,43e 4,126 11.285 4.441 84.816 12.185 2.046 254 8.010 38,534 2.189 123,5601 1,200 47 147 13,536 15.488 4,126 10.986 4,441 82.372 13.334 2.007 249 S.699 34.367 2.082 262 380 1121 12,580 299 loo 232 2.145 18 39 (1,4001 310 17751 2,27e 107 3.426 4.814 5.OS2 1.061 3.565 61,212 3.426 17,3921 10,186 98 21 69 1,202 5,160 1,082 3.634 59,534 780 7,841 7,827 3,383 3.772 88 13,5911 713 7,6￿2 27.297 3,247 3,772 65 149 529 136 (20,CWI 24 1.148 357 744 47.822 85.70D 925 12.540 6.993 2.134 315.973 75.([ 244.085 25.637 20,340 4.995 160 34,247 127 110 92,855 3,608 4,709 1.148 363 14 927 1.661 18 243 14.8891 {2,1341 174,602 1193.500} {20 440 49,169 87,3&2 943 12,332 2,103 15101 59 191,4731 4,212 118,5 42,289 403,315 (2,4831 114,6601 120,340} 283.891 110.9771 100 5,094 160 34,911 131 110 94,725 3,608 4.800 1.870 91 1,839,938 1269,820) 330,712 17.e861 1,893,144 .27-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS {CONTINUEDI FOR THE YEAR ENDED 31 MARCH 2021 22 Analysls of fund5 {contlnued) Total fund balance to 01104120 Total fund balane• to 31103r21 Costs Income Transfers 1.839.938 (269,8201 330,712 17.686) 1.893.144 Spinal stLJdiÈs céntre Spinal studie8 centre- reslrf¢ted Spinal $ludlès research projects IBCI Spinal studies research proléets IBCI- rÈstrict8d Sports injury research futyj Teaching fund IR Banerjee) Teaching fund IR Banerjee)- reslrKted Lloyd Griffiths prize Lloyd Griffilhs prize- re$lrf¢ted WG Davies prize WG Davies prizè- rèstricted Division of nursitvJ studies Division of nursing slLJdlès- ￿StriCted J Rowland Hughes price J Rowland Hughes pri¢e- ￿striCted Dr W M Park fflemorlal fund Dr W M Park me￿rIal fund- i¢$lricted Friday PM fund Aneslhetisys fund Rheum8tology Educational fund {Dr A Askari) Rheumatology Edueatlon81 fund- rostr￿ted GP Study Day fund Veterans Centre fund Veierans Centre fund- restricted Dr B Tins fund Dr B Tins fund- reslrided SAS Doctors ConferenGe lund BicinfomialScs 47,075 11,041 3.967 7.725 36,426 5.914 1.535 1.407 418 2,4Sg 3,645 4,336 1,1C* 1.127 48,201 11,041 7.311 7,725 37,132 6,258 1,535 1.410 418 {463} 3,600 227 706 144 200 (321 35 119 3.645 4,441 1,106 388 153 2,393 209 1.234 5,543 8.786 3,264 18.381 10.357 1.813 5,866 11,589 3,540 3,190 105 (101 10 153 2,343 49 1,197 5,438 8,263 3,264 15,927 6,296 1.813 4,718 11.689 3,473 3.129 14 23 105 223 300 19271 3.380 157 3,904 1.148 67 61 Sul>total 2.035,203 1271.2f21 338,730 2.102.661 LMA Research cantre LMA Research centre- reslrietèd Unrealised gains 4e7,756 835.237 1118,854} {13,93 {23,8631 473.819 811.374 156.615 275.469 T￿al 3.239,342 13fJ9.072) 614,199 3,544.469 Summary Reslrlcted funds Designated fvnd Unr6slricled fLmds 1,207,119 1,958.056 74.167 146.6861 42,289 12,134) 1,200,588 305.825 2.263.881 1303.6911 80,000 1262.386) 571,910 Total 3,239.342 1309.072) 614.199 3.544,469 -28-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 22 Analysls of funds {Contlnuedl orfundg wlth balances roat8rthan £25 000 Anatomy Fund Incorporatlng tho Henry Freede Anatomy Fund Finances teaching and research work under the discretion of Dr D.C.Jafftay. Arthroplasty Fund For research arKJ trainlng by Arthroplasty Unll. Charles Salt R&search Fund Used for various projects including'O$teoporo818 in Men. research. Centr8 for Inherltsd Neuromuscular Disease ICINDI Fund Fund is for finding new treatments for inherited neuromuscular disèas8. Foot & Ankle Research Fund This funds rès6arch and training activities into feel and ankles. Llmb Reconstructlon Fund Used for research by MrA Bing into limb reconslructlon. L.M.A.RC This fund rppresenls the monies given to build the Leowld Muller Arthritis Research Centre which housesthe work of thé charlty. The main source of funds was a bequest of £1.25 million from the Leopold Mullei Foundatlon. The orthopaedlc Institute ￿Mited fvold5 this building on a 60 year lease ihat eommenced on 28th March 1995. Oneology Fund This funds research into c8ncèr$. orthopaedlc Dèvelopmont Fund Orthopaedic Developmont Fund will sUPPOrt tha new Professor. Professorlal Suspgnse Thls furbd is for the charity's academic wofessorial successor to seek lund selected research projectsbefore external funding is sought. Publishlng Fund This fvnd 15 for the publishing of books for courses under thejLwisdiolion of the Profe880r and Dr VPullicino. Radlology Fund This fund is used Radiologists. education. training and r8search. Research Fund (Generall Funds varlous approved reSe?￿h projects wlhin the RJAH NHS Trust. Splnal Inlurles Fund Funds research into management of splnal injurie8. Splnal Stud1￿ Centre Funds held for use In the Spinal Injurles Cenlre. Sport Injurlas Re58arch Funds raised for tha supp)rt of research Into Sports Injuries. -29-

ORTHOPAEDIC INSTITUTE LTD NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2021 22 Analysls of funds {Contlnued) atsrlal Transfers The reasons for m2lerial transfers between dlfferenl classes of funds are sel out below. Goneral fund- allocation of interest and dividends 8CTOSS funds and transfer to general designated fund following designation lo research and training. Course fund - alltxalion of course profits to funds. Orthopaedic Developm8nt fund - receipt of cour8e profits and provision of funds lo research granls. Research fund Ig8n8ral}- funds allocated for specific research projects & reallc¢alion of legacy funds to the g&naral fund to be allocated lo future research prolects & education Unrestrfctgd Funds Included in unre81ricled funds are (lesign8t8d funds, during the year transfer8 are made between these designated fund8 at the Trustees, discretion. 23 Flnanclal commltments. guarantses and contlngent Ilabllltles The Trustees have approved on-golng research commitments over the next two year8 lotalllng £512.361 {2020'. £418,116). This represents the allocation of fund8 to research projects to be spent by the Charity as ¢951$ arise over the cour8e of the re8earch. 24 Rèlated party tran5actlons Remuneratlon of key managément personnel K8y management personnel are the Trustees. No remuneratlon is paid lo key management personnel. Transactlons wlth rèlatèd partles During the year the Charity entered into the following transactions with relat8d parties-. Th8 Charlty operates within the environs of the RJAH Orthopaedic Hospital NHS Found8tion Trust. Du8 10 Ihis a significant t)umber of transactions are undeTlaken b8tw8&n the two entities, the transactions are within the normal a¢livitl8s of the Charlly and are conducted on an aTm's length basls. Due lo the volume of such transactions it is not practical to separately identify the total amount arising during the year. Thé staff undertaking research projects, teaching and administration gre engaged by the NHS Trust. Their salary costs are recharged by the RJAH OrthopaediG Ho$pllal NHS Foundation Trust to the Ch8rily on monthly basis. During the year the Charity made purchases of £138,371 {2020.' £206,580) from RJAH Orthopaedic Hospital NHS Foundation Trust for goods and seNieès and contribution Io shared project costs. Al the y8ar end £5,663 (2020.. £85,495) was owed to the RJAH Orthopaedic Hospital NHS Foundatlon Trust for goods and services. Durlng the year the Charity made recharges of expenditure of £4,04512020'. £6.171> to RJAH Orthopaedic Hospital NHS Foundation Trust. No guarantees have been given or reeeivéd. -30-