Registered number: 03153785 Charity number: 1066532 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) TRUSTEES. REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) CONTENTS Page Reference and administrative details of the Charity, its Trustees and advisers Trustees. report 3-12 Trustees. responsibilities statement 13 Independent auditorfs report on the financial statements Consolidated statement of financial activities 14-17 18 Consolidated balance sheet 19 Charity balance sheet Consolidated statement of cash flows 20 21 Notes to the financial statements 22-42 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS FOR THE YEAR ENDED 31 DECEMBER 2023 Trustees Paul Rosen. Chaimian (resigned 10 September 2023) John Bateson Roberto Bellucci. Chai￿an (appointed 10 September 2023) José Guell Till Staffeldt Company registered number 03153785 Charity registered number 1066532 Registered office 5th Floor 10 Finsbury Square London EC2A 1AF Company secretary Oliver Findl (Resigned 0710212024) Independent auditor Crowe U.K. LLP Fourth Floor St James House St James Square Cheltenham GL50 3PR Bankers Bank of Ireland 28 Main Street Blackrock Co Dublin Ireland Allied Irish Bank PO Box 1121 Dublin 4 Ireland Solicitors Fox Williams LLP 10 Finsbury Square London EC2A 1AF United Kingdom BDB Pitmans LLP One Bartholomew Close London EC1A 7BL United Kingdom Page 1 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 Investment Bankers Ruffer LLP 80 Wictoria Street London SW1E 5JL United Kingdom Rathbone Investment Management Limited 8 Finsbury Circus London EC2M 7AZ United Kingdom Page 2 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES, REPORT FOR THE YEAR ENDED 31 DECEMBER 2023 The directors present their report and the audited consolidated financial statements of the group for the year ended 31 December 2023. The directors have adopted the provisions of the Statement of Recommended Practice {SORP) "Accounting and Reporting by Charities (FRS 102}° in preparing the annual report and consolidated financial statements of the group. Objectives and activities of the society The European Society of Cataract and Refractive Surgeons (ESCRS) vrfas incorporated on 1 February 1996 under the Companies Act 1985 as a Company Limited by Guarantee and not having a Share Capital. The charitable company is registered with the Charity Commission in the UK- Number 1066532. The objects for which the charitable company is established are (i) to promote education and research in the field of implant and refraclive surgery and promote the study and practice of ophthalmology and research relating thereto and the dissemination of the useful results thereof and (li) to promote experimental work in the field of intraocular lens implantation and refractive surgery and the dissemination of the useful results thereof. ESCRS has one wholly owned subsidiary, ESCRS Trading Limited, whose principal activities include arranging and hosting the annual meetings of ESCRS and publishing the society's magazine, EuroTimes. ESCRS Trading Limited is limited by shares and all its profits are transferred to the charity under the UK Gift Aid rules. Details of the extemal advisors engaged by the charity are listed on the Reference and Administrative Information pages. Public benefit The directors have referred to the guidan￿ contained in the Charity Commission's general guidan￿ on public benefit when reviewng the society's aims and objectives and in planning its future activities. In particular, the directors consider how planned ackn'vities will contribute to the aims and objectives that have been set. The purpose of ESCRS is to ensure the best possible outcomes and quality of life for cataract and refractive surgery patients. Through ESCRS'S aims of improving education and standards in ophthalmology across Europe, patients with cataract and refractive conditions and the wder public are our main beneficiaries. The provision of education, the fvnding of original research and registries for benchmarking surgical outcomes ontributes to the development of the field of ophthalmology, the education of its practitioners, and ultimately to better patient care. Structure, govemance and management The goveming documents of the charitable company are its Articles of Association, supported by Bye-Laws. The directors (Trustees) have overall responsibility for the proper management of the charitable company's business and regulat1y review the goveming documents with a view to ensuring they are in line wth the latest Charity Commission guidance. The general management of the charitable company is vested in a Council of Management I'council,) which has been established to assist the directors by organising the day-tr>day operations of the society- The Council consists of the directors of the charitable company. the President of the society, the Treasurer, the Secretary, the Immediate Past President, the European Editor of the Joumal of Catsract and Refractive Surgery ('JCRS'), 10 ordinary members and co-opted members from time to time. The 10 ordinary members of Council are elected by the members of the society for a period of four years and may be re*lected for a further period of four years only. No more than one ordinary member of the Council may be from the same country. Only ordinary members are elected and entitled to vote. Page 3 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 The Council of Management elects an Executive consisting of the President, the Secretary and the Treasurer, to ensure the decisions of the Council are implemented. To be elected President. a candidate must be a full member of the society. but not ne￿sSarilY a member of the Council. He or she is appointed by the Council for a period of years, which term shall not be renewable. A o-thirds majority ofthe voting members ofthe Council is required for appointment as President. The Secretary is the executive officer of the society and monitors implementation of the decisions of the Council. At the AGM in September 2023, the bye-law in relation to the maximum tenure of the Secretary was revised, the Secretary is elected every two years from amongst the elected members of the Council and can now stand for re-election only once, provided they are an elected member at the time of the vote. The Treasurer monitors implementation of the financial decisions ofthe Council. At the AGM in September 2023, the bye-law in relation to the maximum tenure of the Treasurer was revised., the Treasurer is elected every years from amongst the elected members of the Council and can now stand for re-election only once, provided they are an elected member at the time of the vote. The European Editor of the Joumal of Cataract and Refractive Surgery is proposed by the Executive, in consultation with the existing editor, and approved by the Council. At the AGM in September 2023, the bye-law in relation to the tenure of the Editor was revised. The initial term of office is now four years, with the possibility of extending the term for up to four more years thereafter, subject to certain conditions. The society fvnctions through a number of stsnding committees as shovm below.. Finance Committee- chaired by the Treasurer" General Purposes Committee- chaired by the Secretary- Publications Committee- chaired by the European Editor of the JCRS- Programme Committee- chaired by the President., Education Committee- chaired by the immediate past-President- Research Committee- chaired by an elected Council member. The composition of each committee is govemed by the Bye-Laws. All members of Council and Committees give their time voluntarily and their contribution is crucial to the ongoing success of the society and its ability to meet its charitable objectives. The society employs a Managing Director, Tom Ogilvie-Graham, and a Finance Director, Gillian Burgess, and retains the services of an external professional association management and conference organisation company which provides it with a full range of bespoke services including board support, financial management, membership, congress, event. publishing, online and education services. The Trustees set the pay and remuneration of key management personnel, through the annual performance appraisal process. The Trustees then infomi the Finance Committee. Directors of the charitable company The number of directors, who are the Trustees of the charity, shall not be less than three but shall not be more than five. The non-medical Trustee positions are advertised, applicants are inteNiewed by a nominations ommittee and a recommendation made to the Council who then approve or reject the applicants. Nominations for medical trustees also require approval by the Council. All Trustees are given an induction and ongoing training on their responsibilities and other matters as required. Page 4 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 Those who served as directors during the financial year and up to the date of this report are listed below.. Roberto Bellucci {Chaimian from 10 September 2023) Paul Rosen (Chairman until 10 September 20231 John Bateson Jose Guell Till Staffeldt The directors work wth and oversee the Council of Management, which is elected by the membership. The directors do not retire by rotation. In general. a director must rekn're when he or she has served for a maximum term of 8 years. The secretsry who served during the financial year was Oliver Findl - resigned 7th February 2024. Strate icRe ort Princi al risks and uncertainties Annual congress The main source of income to the society is rts annual congress. A key risk to the society is a failed or significantly diminished annual congress and the resultant loss of income that would arise. This includes the risk to an annual congress from an act of terrorism or. as transpired in 2020 and 2021, from a pandemic. There is also the risk that changes in conditions occur, over time, which reduce the attractiveness and relevance of a large annual meeting developed around a scientific programme, for delegates or industry supporters. The directors mitigate these risks by taking out insurance for each conference where possible against insurable risks. by continuing to evolve the format of the meeting in response to feedback and innovations in the marketplace, and by maintaining sufficient reserves at all times to ensure the society could continue its operations uninterrupted for a period of at least 15 months while corrective action is taken and alternative revenue sources could be developed. Outsourced seNice provider The society outsources the day-towday operation of its activities, including the organisation of the annual ongress, to a third-party service provider. There is a risk, therefore, that supplier failure or poor performance could impact on the society's operations or its income. The directors mitigate this risk by utilising a robust process for supplier selection, including a detailed assessment of financial viability, and by ongoing, detsiled monitoring of supplier performance, overseen by the society's Managing Director and Finance Director. Achievements and erfomiance The main activities of the society during 2023. were as follows. (a) Membership Membership of the ESCRS is open to ophthalmologists and to ophthalmologists-in-training. At the end of 2023 there were 7,021 {2022'. 6,313) members in total, 1,959 {2022.' 2,260) of whom were trainee ophthalmologists. 23 European national societies offer group membership of ESCRS and the Society values the close collaboration with these organisations. Membership is free for trainee ophthalmologists for up to five years. As a member they can access ESCRS iLearn and ESCRS On Demand. key education reSoUr￿s, and the peer-reviewed scientific journal of the society, the Journal of Cataract & Refractive Surgery. They also pay a nominal registration fee to attend the ESCRS meetings and are eligible to apply for various grants and bursaries. The aim of providing free membership for trainees is to invest in the future of this subspecialty of ophthalmology by ensuring that the education resources and the annual meetings are available to as many ophthalmologists as possible. Page 5 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 (b} Meetings ESCRS Meetings The two ESCRS scientific meetings held each year are the highlight of the society's calendar. The 27th ESCRS Winter Meeting took place in Vilamoura, Portugal as an in-person event in March 2023 and was attended by over 1.300 delegates. The society held the 41st Annual Congress of ESCRS as a hybrid (in-person and virtual) meeting in Vienna in September 2023. The meeting was an enomious success and retained its position reached in 2022, as the largest ophthalmic conference in the world conceming visiting doctors. A total of over 15,100 delegates altended in Vienna and a further 520 joined virtually. Industry was again very well represented, wth 270 industry partners participating in the exhibition. Sustainability continued to be a particular focus, with all possible reductions in carbon emissions being made and unavoidable emissions offset through the purchase of carbon credits across three certified offsetting projects, meaning that the Vienna meeting was carbon neutral. Delegates were given the option to add a Contribution to their registration fee towards carbon offsetting, with over 20 % of delegates choosing to do so, while a mandatory offsetting fee was introduced for all exhibitor badges purchased by industry. ESCRS will continue to build on these initiatives for future meetings. The second ESCRS iNovation Day ran in 2023., This is a one-day meeting held immediately before the Annual Congress, which brings together clinical and business experts from across Europe and further afield. The meeting focuses on the most urgent clinical needs and barriers to success in anterior segment care and how the latest technology innovations may address those within the next 5 to 10 years. ESCRS Participation in Other Meetings Each year the ESCRS supports and participates in several national society meetings by funding expert ophthalmologists from the society to attend these meetings thereby bringing international expertise and teaching to ophthalmologists who might not be able to travel to attend the ESCRS meetings. ESCRS also collaborates the other regional cataract and refractive societies around the world through participation in joint symposia and other sessions. The sharing of research results and new developments among the world leaders has an invaluable role in the global advancement of cataract and refractive surgery. ESCRS was pleased to send senior representstives to the meetings of the American Society of Cataract & Refractive Surgery (ASCRSI, the American Academy of Ophthalmology {AAO), the Asia-Pacific Association of Cataract & Refractive Surgeons (APACRS). the European Society of Ophthalmology (SOE) and the College of Ophthalmology in Eastem, Central and Southem Africa (COECSA), during the year, in addition to a number of other national society meetings (c) Publications The EuroTimes magazine, which indudes the latest news and developments in the world of ophthalmology, is published by the society and circulated free of charge to over 23,500 ophthalmologists worldwide. 10 issues were published in 2022. The Journal of Cataract & Refractive Surgery, which is published jointly wth ASCRS, is circulated free of charge to members of the ESCRS and contains peer-reviewed articles on the latest research in the field. 12 issues were published in 2023. Page 6 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 (dl Education The society makes available a broad range of educational resources, in support of its charitable objects. Many of these are free for all ophthalmologists to access. including the ESCRS Education Portal and the ESCRS Player. These provide a wide variety of expert-led content, including articles, podcasts and videos. Landmark articles published in peer-reviewed scientific ophthalmology joumals, selected by the ESCRS Publications Committee, are made available free of charge, alongside a selection of Online Case Reports from the Journal of Cataract & Refractive Surgery, which provide an excellent opportunity to see how scientific and medical kno￿edge is 'put into practice.. There have been over 460,000 page views in total on the ESCRS Player since it began, with 831 videos now available. An annual survey is conducted at the ESCRS meetings, as part of the Independent Medical Education (IME) programme, to establish key educational needs amongst ophthalmologists. Educational programmes, funded by unrestricted educational granls from supporting companies. are then designed in response to the needs identified, with a programme typicalty including a symposium at an ESCRS meeting, EuroTimes supplements, and creation of online resources (videos and podcasts). These are free for all ophthalmologists to access on the ESCRS Education Forum. Members of the society have access to additional educational reSoUr￿s. induding ESCRS On Demand. an extensive library of presentations and videos from ESCRS meetings, which expands each year with content from the most recent Winter Meeting and Congress. Members can also aC￿sS ESCRS iLearn an &learning platform offering courses which attract CME credits. The ESCRS IOL calculator, launched in 2022, is also made available free of charge for all ophthalmologists to access., it is a web application for IOL power calculations, which collates results from multiple modern formulas simultaneously. through a real time integration. The calculator has proved extremely popular and further investment was made in 2023 to further enhance its functionalty. The calculator was used to make 700,000 calculations in 2023, by 33,000 users. With the support of its Young Ophthalmologists for Sustainability group, the society has developed a web-based tool called SIDICS, {Sustainability Index for Disposables in Cataract Surgery), for evaluating the sustainability of customised cataract packs used by hospitals and surgical centres. This tool is free to access and allows users to see how the packs which they order compare wth the ESCRS benchmark recommendation and where there is potential for C02 savings, wth a view to driving improvement over time. In 2023 the society launched ￿ ESCRS Masterclass programmes in Complex Cataract and Minimally Invasive Glaucoma Surgery {MIGSI, supported by industry partners, wth 100 leamers tsking part in a series of mentor guided didactic workshops, live webinars and in-person sessions at the Annual Congress, with the goal being to improve practice pattems and clinical outcomes and to significantly increase the number of patients treated in the specialisations concemed. The ESCRS Moving Simulator programme also launched in mid-2023, allowng affiliated national societies in need of this highly useful training equipment to apply to use a surgical simulator owned by the society, for period of 6-8 weeks at a time, to provide training locally using a bespoke ESCRS GU￿1cUlum. Over 140 people completed the curriculum in 2023. Work continued throughout 2023 on the development of two Clinical Guidelines (Cataract and Refractive), which are expected to be published in 2024. available for all ophthalmologists to access. (el Clinical and Scientific Research ESCRS provides funding for research projects through a number of Awards, wth calls for applications normally issued annually. In 2023, the Research Committee refreshed its operating policy and guidance for the clinical research funded by ESCRS, to continue to ensure for the fvture that the investment in research provides a benefit to the society's membership. the wder ophthalmic community and patients. Page 7 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 In 2023, the first Digital Research Awards were made, the award having been introduced in 2022. Two awards were made to institutions which proposed projects wth complementary goals, therefore it was decided to fund both. These are OCT-KC. An open access dataset of high-resolution corneal optical coherence tomography images in eady keratoconus) led by Moorfields Eye Hospital and EUKOR (European Keratoconus Outcomes Registry ) led by University of Coimbra Six new Systematic Research Awards were made in 2023,. this is a smaller award wth a maximum value of 10,000. In addition, the ETCF trial (European Prospective Multi-centre Trial comparing Triple-DMEK with Cataract Surgery in Patients wth Cataract and Fuchs endothelial comeal dystrophy), a Clinical Research Award made in 2022 for a value of é728k, led by the University of Cologne, was initiated during 2023. Research projects which were ongoing or reached completion in 2023 were: the META-COR Study {METAgenomics guided treatment of CORneal infections- an interventional blinded randomized clinical trial., the MYOPRED Study (Influence of posterior vitreous detachment on retinal detachment after lens surgery in myopic eyes),. the NECSUS Study {NEuroadaptstion after Cataract and refractive Surgery Study)., the MEROV Study (Monofocal Extended Range of Vision)- the EPICAT Study (Effectiveness of Periocular drug Injection in CATaract surgery)- the CAMERA study {Innovative ocular surface grading camera), the ANTISEPSIS study {Pr Operative Antisepsis and treatment of blepharitis wth Povidone-lodine 10h) and the IOLExcg study (Clinical study on the functional and morphological course of patients wth intraocular lens opacification). The Toric IOL study wll now start in 2024, following a change in the lead organisation to the University of Maastricht One new Pioneer Research Awards commenced during 2023 entitled -Development and Validation of a Novel Machine Leaming-Based Intraocular Lens Power Fomiula for Cataract Surgery Combined with Endothelial Keratoplasty.. (fj Surgical outcomes registries The society manages and funds three important surgical outcomes registries, The European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO), the European Cornea and Cell Transplantation Registry (ECCTR) and the European Registry of Childhood Cataract. Together, these Registries contain data for more than 4 million surgeries and represent one of the richest ophthalmology datasets in Europe. Use of the Registries is available to ESCRS members free of charge. In 2023, the Registries Steering Committee focused on integrated of new data sources, with a focus on country- level registries and surgical data from individual clinics, wth an increase in the number of cases entered through the website interface. In addition, the Registries Steering Committee set out an ambitious agenda and joined forces wth the three Task Forces (Global, Industry & PROMS) that were estsblished and the first meeting of the ECCTR (European Comea & Cell Transplantation Registry} consortium took place to plan upcoming publications and identify new data sources, including a new Spanish registy that will join ECCTR in 2024. (g) Grants and bursaries In 2023, ESCRS made available a number of bursaries for trainee doctors to attend the two ESCRS conferences, in addition to 26 ObSe￿erShIp grants for trainee doctors to spend a period observing clinical practice at a European centre of expertise. The Peter Barry Fellowship is awarded annually and offers a grant of 60,000 for a trainee to spend a year abroad gaining clinical or research experience at a ￿ntre of ex￿llenCe anywhere in the world. Page 8 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 (h) Direct donations ESCRS makes direct donations each year to selected charities. 2023 was the first year of three major projects funded by ESCRS which wll run from 2023 to 2025.. a project to build capacity and improve cataract surgical services in Malawi, wth Blantyre Institute for Community Outreach (BICO)., an Eyes of the World project to deliver equitable access to, and sustainable improvement in. eye care seryices in the Inhambane province of Mozambique- and a campaign for treating cataract for the most vulnerable population in Palestine, wth St John Eye Hospital. Total funding of É900k over 3 years (divided into three annual tranches. with the second and third tranches being dependent on satisfactory perfomiance) has been granted for these projects, of which E300k was paid in 2023 Smaller donations were made to the Ridley Eye Foundation, to fund a High-Altitude Cataract Camp in Nepal and to the Diocese of Wau in South Sudan. The society also sent representatives to the College of Ophthalmology in Eastem, Central and Southem Africa (COECSA) meeting in 2023, to provide support with its wet lab training programme. (i) Fundraising The charity had no fundraising activities during 2023 vknich require disclosure under S162A of the Charities Act 2011. ti) Support for Ukraine The society continues to be deeply disturbed by the ongoing invasion of Ukraine and has taken steps to provide support to colleagues in Ukraine. The society established a restricted fund in 2022, to which members and sister societies can make financial donations. which are directed exclusively towards ophthalmology-related relief efforts in Ukraine and in support of Ukrainian doctors and patients outside of Ukraine. At 31 December 2023, restricted donations to date totalled É111 k. The society also designated É1 Ook of funds from its own reserves in 2022 for the same purpose and has coordinated donations of ophthalmological supplies and equipment with a total value of.over É2.5m from industry partners, which have been transported to clinics across Ukraine. ESCRS provided free registration to its Vienna Congress for 676 Ukrainian attendees, and a number were given travel bursaries in addition. The society also waived the membership fee for 2023 for Ukrainian colleagues. The society is extremely grateful to all those who have supported these efforts and reiterates its full support for Ukrainian colleagues, who are often continuing to serve their patients under the most challenging of circumstances. Future Developments Notwithstanding the time taken for in-person meetings to recover fully to pre-pandemic levels, the directors do not envisage any substantial changes to the nature of the charity's activities and, through its work, are confident in the charity's ability to continue to make meaningful impacts on the lives of pats'ents across the world. The 28th ESCRS Winter Meeting was held in Frankfurt. Germany in February 2024 and the 42nd Annual Congress is planned to be held as a hybrid event in Barcelona, Spain in September 2024. Industry support for the Bar￿Iona Congress is very strong, with bookings received to date making it the largest ESCRS exhibition ever, and the society will again hold the iNovation Day, immediately before the Bar￿Iona Congress, which wll bring together doctors and industry executives to discuss innovations in ophthalmology. The society continues to build on the significant sustainability measures already implemented. to reduce or offset the carbon footprint of its meetings and wll expand on this in 2023 to focus on diversity, equality and inclusion. In February 2024, the services agreement with the companys outsource provider, MCI, was extended for a further period. In March 2024, following a tender process, the directors appointed Cazenove as the new investment manager for the society. Further detail on the prO￿sS is provided in the "Investments. section of this report. Page 9 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES. REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 Financial review The group made a deficit on unrestricted activities before investment gains of É194k in 202312022= É203k). The overall result in 2023 after investment gains was a surplus of E67k (2022= deficit of £1,759k). The group's principal source of funding is the revenue generated by its annual congress, in particular the exhibition revenues generated by industry participation and delegate registration fees. The surplus generated by the annual congress supports the society's investment in education and research programmes, and charitable donations. The resources available to the group and those expended during the year are set out in the Statement of Financial Activities. Income from unrestricted activities increased to É18,193k in 2023 (2022.. É13,540k), as the annual congress, which was staged as a hybrid (in-person and virtual) meeting in Vienna, continued to recover towards pr pandemic levels of participation During 2023, the group designated E631k to its designated Research reserve, to cover funding agreed for new Research projects, including the new Digital Research Award, wth kn projects awarded in the year. É300k was released from the designated Charity reserve back to General reserves, as the charitable giving strategy was fijrther refined. The group uses the followng financial key perfomiance indicators to assess its position= 2019 2020 2021 2022 2023 'ooo 'ooo 'ooo Income 17,638 1,828 24.027 4,791 14.7161 19,619 7,716 12,7111 18,087 13,647 12031 14,437 18,208 11941 15,465 Surpluslldeficrtl before investment gainslllossesl General reserves al 31 December Nofwithstanding the impact of the cu￿ent geopolitical uncertainty. the ESCRS group has adequate reserves and remains in a stable financial position. This will ensure the continued funding of educational initiatives, high-quality research projects and support for charitable projects in the developing wotld. Reserves Policy The reserves policy takes into consideration the major risks that could affect ESCRS in the future and principally the threat posed to the income of the society through a failed (or diminished) annual congress whether due to a pandemic, competitive factors, an act of God, acts of terror. or the potential withdrawal over time of funding from orporate supporters due to legislative and regulatory changes. The reserves policy is designed to allow ESCRS to continue njnning its activities UnInte￿UPted for at least a 15- month period, regardless of the level of income received, during which projects would be re-evaluated depending on the circumstances and the need to. and success in, generating new revenue streams. Allowing a 15-month period helps to minimise the risk of compromising the core objectives and activities of ESCRS. On this basis, the directors consider that the required level of readily usable reserves at 31 December 2023 should remain at É12.8m. This compares to a total unrestn'cted general reseNe as shown in the audited accounts of É15.4m. There was therefore a surplus above the reserve requirement of E2.6m at 31 December 2023. The directors are aware of the surplus and actively keep it under consideration. Page 10 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) ## TRUSTEES’ REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 ## Investments The society has an Investment Policy Statement which sets oul the investment aims and objectives and closely reflects the reserves policy of the society. The investments are currently divided into two portfolios. Portfolio A provides the reserve fund for ESCRS in the event of a failed annual congress, the main source of income to the society. It is to be managed on a conservative low risk basis with the principal objective of maintaining the real capital value of the funds and to generate a minimum total return in excess of inflation plus 2.5% over rolling three-year periods. Portfolia B is to be managed on a low to medium risk basis and provide income which is to be factored into the short-term spending plans of the society. The overall return on the society's investments in 2023, net of fees, was -2.2% (2022: +7.7%). The directors review and benchmark the investment performance of the fund managers on an ongoing basis. During 2023, the directors reviewed the Investment Policy of the society and issued a tender for the provision of investment management services to the society. The existing investment managers were invited to tender, in addition to several other managers, selected by the trustees through a shortlisting process. The process concluded in March 2024, with the appointment of Cazenove as the new investment manager. ## Going concern and future business success The directors have reviewed the activities of the group and its available resources in the context of considering going concern. 2023 saw the main revenue generating activity of the society, the Annual Congress, return close to pre-pandemic levels of attendance by exhibitors and delegates alike. The group also continues to manage costs carefully; and in early 2024 agreed an extension to the agreement with its outsourced services provider which provides certainty over ongoing fixed costs for several years. Management has prepared a forecast for 2024 and 2025 and closely monitors the society's income, costs and cashflow requirements. The directors also closely monitor reserves levels, in line with the Reserves policy, and consider that the Society has adequate. On this basis the directors are confident that the group will continue in operational existence and that the financial statements should continue to be drawn up on a going concern basis. ## Indemnity insurance The group purchased and maintained, throughout the financial year, Directors’ and Officers’ Liability Insurance in respect of the directors. ## Statement as to disclosure to our auditor The trustees in office at the date of approval of this Trustees’ Annual Report confirm that, so far as they are each aware, there is no relevant audit information of which the charity's auditor is unaware and each trustee has taken all the steps they ought to have taken as a trustee to make themselves aware of any relevant audit information and to establish that the charity's auditor is aware of that information. The group accounts are prepared in accordance with section 398 of the Companies Act 2006, section 138 of the Charities Act 2011, and with the special provisions of part 15 of the Companies Act relating to small companies. The constitute the annual accounts required by the Companies Act 2006 and are for circulation to the members of the company. The auditors, Crowe U.K. LLP, (Chartered Certified Accountants and Statutory Auditors) have indicated their willingness to continue in office in accordance with the provisions of Section 485 of the Companies Act 2006. Page 11 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2023 Small group exemption This report has been prepared in accordance with the Statement of Recommended Practice — Accounting and Reporting by Charities and in accordance with the special provisions of the Companies Act 2006 relating to a small group. Approved by order of the members of the board of Trustees and signed on their behalf by: TrusteeRoberto Bellucci fpiersOn 0 Viethenee Cree Date: 4 September 2024 Page 12 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (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 Charity for the purposes of company law) are responsible for preparing the Trustees' report including the Strategic report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the Trustees to prepare financial statements for each financial period. 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 Charity and of their incoming resources and application of resources, including their income and expenditure, 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 the Charities 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 ta any material departures disclosed and explained in the financial statements; - a 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 Charity's transactions and disclose with reasonable accuracy at any time the financial position of the Group and the Charity and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the Group and the Charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. Approved by order of the members of the board of Trustees and signed on its behalf by: ## (Lrbeta NOLL Roberto Bellucci Trustee Date: 4 September 2024 Page 13 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) ## INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS ## Opinion We have audited the financial statements of European Society of Cataract and Refractive Surgeons (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 Charity balance sheet, the Consolidated statement of cash flaws 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 incaming 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 theCompanies Act 2006. ## Basis for opinion We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described jn the Aucitor'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 14 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS ## (A company limited by guarantee) ## INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (CONTINUED) ## Other information The other information comprises the information included in the Annual report other than the financial statements and our Auditor's repart 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 infarmation given in the Trustees’ Report including the Strategic Report for the financial year for which the financial statements are prepared is consistent with the financial statements. - « the Trustees' Report and the Strategic Report have 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 ofthe audit, we have not identified material misstatements in the Trustees' Report including the Strategic 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. Page 15 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (CONTINUED) ## Responsibilities of trustees As explained more fully in the Trustees’ responsibilities statement, 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 quarantee 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: A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at: www.fre.org.uk/auditorsresponsibilities. This description forms part of our Auditor's report. ## Extent to which the audit was considered capable of detecting irregularities, including fraud Irregularities, including fraud, are instances of non-compliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive ta those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion. We obtained an understanding of the legal and regulatory frameworks within which the charitable company and group operates, facusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, the Charities Act 2011 together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items. In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s and the group's ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company and the group for fraud. The laws and regulations we considered in this context were General Data Protection Regulation (GDPR) and Tax legislation. Page 16 ## **EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS** ## **(A company limited by guarantee)** ## **INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (CONTINUED)** Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the Trustees and other management and inspection of regulatory and legal correspondence, if any. We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the timing of recognition of Independent Medical Education income, congress income from exhibition and sponsorship, publishing income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management, and the Trustees about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, designing audit procedures to test the timing of income, reviewing the calculations of provisions, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission and reading minutes of meetings of those charged with governance. Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non-compliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non­ compliance and cannot be expected to detect non-compliance with all laws and regulations. ## **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 its members, as a body, for our audit work, for this report, or for the opinions we have formed. ## **Tara Westcott (Senior statutory auditor)** for and on behalf of ## **Crowe U.K. LLP** Statutory Auditor Fourth Floor St James House St James Square Cheltenham GL50 3PR Date: 19 September 20?4 Page 17 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) ## CONSOLIDATED STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2023 |||Restricted|Unrestricted|Total|Total| |---|---|---|---|---|---| |||funds|funds|funds|funds| |||2023|2023|2023|2022| ||Note|€|€|€|€| |Income from:|||||| |Charitable activities|4|-|17,900,058|17,900,058|13,279,645| |Fundraising activities|5|14,408|-|14,408|107,180| |Investments|6|-|282,671|282,671|255,945| |Other income|7|-|10,548|10,548|4,595| |Total income||14,408|18,193,277|18,207,685|13,647 365| |Expenditure on:|||||| |Raising funds|8|-|146,755|146,755|146,653| |Charitable activities|9|24,125|18,240,737|18,264,862|73,622,119| |Total expenditure||24,125|18,387,492|18,411,617|13,768,772| |Net expenditure before net|||||| |gains/(losses) on investments||(9,717)|(194,215)|(203,932)|(121,407)| |Net gains/(losses) on investments||-|271,094|271,094|(1,637,337)| |Net movement in funds||(9,717)|76,879|67,162|(1,758,744)| |Reconciliation offunds:|||||| |Total funds broughtforward||83,029|18,768,901|18,851,930|20,610,674| |Net movement infunds||(9,717)|76,879|67,162|(1,758,744)| |Totalfundscarriedforward||73,312|18,845,780|18,919,092|18,851,930| Results of the charitable campany for the year was a loss of €3,263,835 (2022: €4,702,038) The Consolidated Statement of Financial Activities includes all gains and losses recognised in the year. The notes on pages 22 to 42 form part of these financial statements. Page 18 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) REGISTERED NUMBER: 03153785 ## CONSOLIDATED BALANCE SHEET AS AT 31 DECEMBER 2023 ||||2023||2022| |---|---|---|---|---|---| ||Note||€||€| |Fixed assets|||||| |Tangible assets|14||194,385||-| |Investments|15||18,478,463||78,071,453| ||||18,672,848||18,071,453| |Current assets|||||| |Debtors|16|2,269,356||2,186,240|| |Cash at bank and in hand||4,055,736||3,939,522|| |Current liabilities||6,325,092||6,125,762|| |Creditors: amounts falling due within one|||||| |year|4G|(5,453,914)||(4,101,386)|| |Net current assets|||871,178||2,024,376| |Total assets less current liabilities|||19,544,026||20,095,829| |Creditors: amounts falling due after more|||||| |than one year|18||(214,916)||(160,488)| |Provisions for liabilities|20||(410,018)||(1,083,411)| |Total net assets|||18,919,092||718,857,930| |Charity funds|||||| |Restricted funds|21||73,312||83,029| |Unrestricted funds|21||18,845,780||718,768,907| |Totalfunds|||18,919,092||18,851,930| The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by: ## Roberto Bellucci wGrto Pelee c-! Trustee ## Date: 4 September 2024 The notes on pages 22 to 42 form part of these financial statements. Page 19 ## EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS (A company limited by guarantee) REGISTERED NUMBER: 03153785 CHARITY BALANCE SHEET AS AT 31 DECEMBER 2023 |||||2023||2022| |---|---|---|---|---|---|---| |||Note||€||€| |Fixed assets||||||| |Tangible assets||14||-||-| |Investments||15||18,478,463||18,071,453| |||||18,478,463||18,071,453| |Current assets||||||| |Debtors||16|187,566||1,494,123|| |Cash at bank and in hand|||1,035,096||760,190|| |Current liabilities|||1,222,662||2,254,313|| |Creditars: amounts falling due within one||||||| |year||17|(3,647,009)||(1,657,225)|| |Net current liabilities|/assets|||(2,424,347)||597,088| |Total assets less current liabilities||||16,054,116||718,668,541| |Creditors: amounts falling due after more||||||| |than one year||18||(214,916)||(160,488)| |Provisions for liabilities||20||(151,041)||(571,267)| |Total net assets||||15,688,159||17,936,786| |Charity funds||||||| |Restricted funds||21||73,312||83,029| |Unrestricted funds||21||15,614,847||17,853,757| |Totalfunds||||15,688,159||17,936,786| The Charity's net movement in funds for the year was €(2,248,.627) (2022 - €(4,702,038)). The Trustees acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and preparation offinancial statements. The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by: ## Roberto Bellucci , ' Date: 4 September 2024 Trustee The notes on pages 22 to 42 form part of these financial statements. Page 20 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) CONSOLIDATED STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2023 2023 2022 Cash flows from operating activities Net cash used in operating activities Note 24 324.492 1,238, 896 Cash flows from investing activities Purchase of tangible fixed assets Purchase of investments (208,270) (3, 354) Net cash used in investing activities (208,270) (3,354) Cash flows from financing activities Net cash provided by financing activities Change in cash and cash equivalents in the year Cash and cash equivalents at the beginnin9 ofthe year 116.222 1,235,542 3,938,884 2, 703, 342 Cash and cash equivalents at the end of the year- Note 25 4,055,106 3, 938, 884 Page 21 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 General infomiation The European Society of Cataract and Refractive Surgeons {No. 03153785) is a company limited by guarantee incorporated in the United Kingdom. The registered office of the company is 5th Floor 10 Finsbury Square. London, EC2A 1AF. United Kingdom which is also the principal place of business of the company. The financial statements have been presented in Euro which is also the functional currency of the company. Accounting policies 2.1 Basis of preparation of financial statements The financial statements have been prepared in accordance with the Charities SORP (FRS 1021 Accounting and Reporting by Charities= Statement of Recommended Practice applicable to charities preparing their accounts in accordance the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006. The European Society of Catsract and Refractive Surgeons 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 ststed in the relevant accounting policy. The Consolidated statement of financial activities (SOFA) and Consolidated balance sheet consolidate the financial statements of the Charity and its subsidiary undertaking. The results of the subsidiary are consolidated on a line by line basis. The Charity has taken advantage of the exemption allowed under section 408 of the Companies Act 2006 and has not presented its own Ststement of financial activities in these financial statements. 2.2 Going concern The Group is profitable and has substantial cash resources. Management has prepared a forecast for 2024 and 2025 and closely monitors its income. cost and cashflow requirements. The directors also closely monitor reserves levels, in line wth the Reserves policy and consider that the Society has adequate reserves. On this basis the directors are confident that the group will continue in operational existence and that the financial ststements should continue to be drawn up on a going concem basis. 2.3 Income Income comprises membership income. congress income, publishing income, fundraising income and other income. Income is included in the Statement of Financial Activities when the group is legally entitled to it. its financial value can be quantified with reasonable certainty and there is reasonable certainty of its ultimate receipt. Income received in advance for membership is accounted for as deferred income until eamed. All other income is accounted for on an accruals basis. Income tax recoverable in relation to investment income is recognised at the time the investment income is receivable. Page 22 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Accounting policies Icontinued) 2.4 Expenditure Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third paty. 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 raising funds includes all expenditure incurred by the Group to raise funds for its charitable purposes and includes investment managers fees. Expenditure on charitsble 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 vthich 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 Tangible fixed assets and depreciation Tangible fixed assets are capitalised and recognised when ftjture 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 impaimient 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 tsngible fixed assets less their residual value over their estimated useful lives. Depreciation is provided on the follobwng bases.. Purchase lease 21 years Leasehold improvements 15 years Fixtures, fittings and equipment 5 - 10 years 2.6 Invesljnents Fixed asset investments are a fO￿n 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 vthich case it is measured at cost less impairment. Investment gains and losses, whether realised or unrealised, are combined and presented as 'Gainsl{Losses) on investments, in the Consolidated statement of financial activities. Page 23 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Accounting policies Icontinued) 2.7 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. 2.8 Cash at bank and in hand Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account. 2.9 Liabilities Liabilities and provisions are recognised vthen 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 wll be required in settlement, and the amount of the settlement can be estimated reliably. Liabilities are recognised at the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or setvices it must provide. Provisions are measured at the best estimate of the amounts required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the pre-tax discount rate that reflects the risks specific to the liability. The unwnding of the discount is recognised in the Consolidated statement of financial activities as a finance cost. 2.10 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. 2.11 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. Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes. The aim and use of each designated fund is set out in the notes to the financial statements. Restricted funds are funds which are to be used in accordance spectfic 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 fvnd is set out in the notes to the financial statements. Investment income, gains and losses are allocated to the appropriate fund. Page 24 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Critical accounting estimates and areas of judgement Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of fvture events that are believed to be reasonable under the circumstances. The Group makes estimates and assumptions conceming 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 addressed below. Provision has been made for doubtful debts at the end of the financial year. This requires management to consider the recoverability of debtor balances and. wth regard to those where recovery is considered doubtful, estimate the risk of doubtful debts becoming irrecoverable based on their knowledge and experience. Provision has also been made for potential lease dilapidations and onerous lease liabilities, using assumptions made with inpLrt from specialist professional advisors. Page 25 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Income from charitable activities Unrestricted funds 2023 Total funds 2023 Membership Congress income Publishing other income 494,392 494,392 15,755,102 15,755,102 1.035,002 1,035,002 585,762 585,762 29,800 29,800 Royalty income 17,900,058 17,900,058 Unrestricted runds 2022 Total funds 2022 Membership Congress Income Publishing Royalty income 373,20T 373,20T 11,928,376 11,928,376 919,036 919,036 59,026 59,026 13,279,645 13,279,645 Page 26 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Income from fundraising activities Restricted funds 2023 Total funds 2023 Fundraising 14,408 14,408 Restricted runds 2022 Total runds 2022 Fundraising 107, 180 107, 180 Investment income Unrestricted funds 2023 Total funds 2023 Income from listed investments 282,671 282,671 Unrestricted runds 2022 Total runds 2022 Income from listed investrnents 255, 945 255, 945 Page 27 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Other incoming resources Unrestricted funds 2023 Total funds 2023 Other income 10,548 10,548 Unrestncted funds 2022 Total funds 2022 Other income 4, 595 4, 595 Investment management costs Unrestricted funds 2023 Total funds 2023 Investment management fees 146,755 146,755 Unrestncted funds 2022 Total funds 2022 Investment management fees 146,653 146,653 Page 28 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 Analysis of expenditure on charitable activities Summary by fund type Restricted Unrestricted funds funds 2023 2023 Total 2023 Congress costs Publications and other 11,345,585 11.345,585 1,588,304 1,588,304 420,569 420,569 1,597,640 1.597,640 2,891,661 2,891,661 396,978 421,103 Membership costs Research costs Education costs Donations 24.125 24,125 18,240,737 18,264,862 Restricted Unrestricted runds runds 2022 2022 Total 2022 Congress costs Publications and other 7, 936, 678 1, 820, 029 140, 729 1,699,014 1,815, 744 184, 202 7,936,678 1, 820, 029 140, 729 1,699,014 1,815, 744 209, 925 Membership costs Research costs Education costs Donations 25, 723 25, 723 13,596,396 13,622, 119 Page 29 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 10. Analysis of expenditure by activities Activities undertaken directly 2023 Grant funding of activities 2023 Support costs 2023 Total funds 2023 Congress costs Publications and other Membership costs Research costs 11.135.997 1,559,025 142,871 1.299.535 2,093,054 421.103 209,588 11,345,585 29,279 1.588,304 277,698 420,569 298,105 1,597,640 738,782 2.891,661 421,103 Education costs Donations 59,825 16,651,585 59,825 1,553,452 18,264,862 Activities undertaken directly 2022 Grant funding of actwities 2022 Support costs 2022 Total runds 2022 Congress costs Publications and other 7,377. 114 1,657,622 98,437 1, 188,421 1,246,948 209.925 559, 564 162,407 42, 292 510,593 526, 796 7,936,678 1, 820, 029 140, 729 1,699,014 1,815, 744 209, 925 Membership costs Research costs Education costs 42,000 Donations 11, 778,467 42, 000 1,801,652 13,622, 119 Page 30 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 11. Auditor's remuneration 2023 2022 Fees payable to the Charity's auditor for the audit of the Charity's annual accounts 28.653 27, IOT Fees payable to the Charity's auditor in respect of: All taxation advisory Se￿iceS not included above Preparation of consolidated and entity accounts of subsidiary 10,046 4,145 3, 850 12. staff costs Group 2023 Group 2022 Charity 2023 Charity 2022 Wages and salaries Social security costs 330,882 29,106 338, 666 16,083 330,882 29,106 338, 666 16,083 359,988 354, 749 359,988 354, 749 The average number of persons employed by the Charity during the year was as follows.. Group 2023 No. Group 2022 No. Charity 2023 No. Charily 2022 No. Administration and Management The number of employees whose employee benefits (excluding employer pension costs) exceeded 60,000 was.. Group 2023 No. Group 2022 No. In the band É120.001- É130,000 In the band É150.001- E160,000 In the band É190,001- É200,000 In the band É200.001- Q10,000 Page 31 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 13. Trustees, remuneration and expenses During the year, no Trustees received any remuneration or other benefits (2022 - ÉNIL). During the year ended 31 December 2023. Trustee expenses were incurred at É16,524 (2022 - É13,839). 14. Tangible fixed assets Group and Charity Leasehold Fixtures, improvemen Fittings and Equipment Purchase lease Total Cost At 1 January 2023 Additions 261.282 52.587 447,956 208,270 761,825 208,270 At 31 December 2023 261.282 52,587 656,226 970,095 Depreciation At 1 January 2023 Charge for the year 261.282 52,587 447,956 13,885 761,825 13,885 At 31 December 2023 261.282 52,587 461,841 775,710 Net book value At 31 December 2023 194,385 194,385 At 31 December 2022 Page 32 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 15. Fixed asset investments Listed investments Group and Charity Valuation At 1 January 2023 Investment income 18.071,453 282,671 271,094 (146,755) Revaluations Fees and charges At 31 December 2023 18,478,463 16. Debtors Group 2023 Group 2022 Charity 2023 Charity 2022 Due within one year Trade debtors 668,547 1,291,935 8,700 98, 500 1.218,844 Amounts owed by group undertakings other debtors 2,875 890,690 707,244 Prepayments and accrued income Tax recoverable 704,351 189, 954 178,866 176, 779 2,269,356 2, 186, 240 187,566 1,494, 123 Page 33 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 17. Creditors: Amounts falling due within one year Group 2023 Group 2022 Charity 2023 Charity 2022 Bank overdrafts Trade creditors Amounts owed to group undertakings Other taxation and social security Accruals and deferred income 630 2,598,537 638 1,865,960 630 534,475 1.504,525 129.659 1.477,720 638 517,931 25,755 2,828,992 17,435 2,217,353 17,435 1,121,221 5,453,914 4, 101,386 3,647,009 1,657,225 Group 2023 Group 2022 Charity 2023 Charity 2022 Deferred income at 1 January Resources deferred during the year Amounts released from previous periods 907,559 995,543 {747,070 463, 524 806, 032 (361,997) 476,626 394,750 (316,078) 353, 008 375, 100 (251, 482) 1,156,032 90T, 559 555,298 476, 626 Deferred income relates to membership fees and grant income which are received in advance of specific onditions being met. The income is shovffl as deferred until those condition5 are fully satisfied. 18. Creditors: Amounts falling due after more than one year Group 2023 G￿up 2022 Charity 2023 Charity 2022 Accruals and deferred income 214,916 160,488 214,916 160, 488 Page 34 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 19. Financial instruments Group 2023 Group 2022 Charity 2023 Charity 2022 Financial assets Financial assets measured at fair value through income and expenditure 18,478,463 18,071,453 18,478,463 18.071,453 20. Provisions Group Provision At 1 January 2023 Amounts released 1.083,411 (673,393) 410,018 Charity Provision At 1 January 2023 Amounts released 571,267 (420,226) 151,041 The provision has been made for potential lease dilapidations and onerous lease payments using assumptions made with input from specialist professional advisors. Page 35 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 21. Statement of funds Statement of funds - current year Balance at 31 Gainsl December (Lossesl 2023 Balance at 1 January 2023 Transfers inlloutl Income Expenditure Unrestricted funds Designated funds Research Fund Charity Fund Ukraine Fund 2,609,181 1,650,000 72,988 {909,724) {359,136 113,717 631,429 (300,864) 2.330,886 990,000 59,271 4,332,169 11,282,577 330,565 3,380,157 General funds General Funds- all funds 14.436,732 18.193,277 (17.104.915I (330.565) 271.094 15,465,623 Total Unrestricted funds 18,768,901 18.193,277 (18.387,492 271,094 18,845,780 Restricted funds Endophthalmitis study Fundraising Appeal 1,572 1,572 81,457 14,408 124,125 71,740 83.029 14,408 (24,125) 73,312 Total of funds 18,851,930 18,207,685 {18,411,617) 271,094 18.919,092 Page 36 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 21. Statement of funds Icontinued Restricted funding relates to monies given for an Endophthalmitis study and donated in support of ophthalmology-related relief for Ukraine and charitable projects supported by ESCRS. The Designated Research Fund relates to amounts committed to approved research grants but not yet spent. The Designated Charity Fund contains funds designated for expenditure on charitable donations to be made in accordance with the Society's discretionary grant policy. The Designated Fundraising Fund contains funds designated for provision of ophthalmology-related relief to Ukraine. Page 37 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 21. Statement of funds Icontinued Statement of funds - prior year Balance at 31 De￿fflber 2022 Balance at l January 2022 Transfers in/out Gains/ (Losses) Income Expenditure Unrestricted funds Designated funds Research Fund Charity Fund Ukraine Fund 2,292, 777 229, 134 (669, 157) (131,467) (27.012) 985, 561 1,552,333 100.000 2,609, 181 1, 650, 000 72, 988 2,521,911 (827, 636) 2, 637,894 4,332, 169 General funds General Funds- all funds 18,087, 791 13,540. 185 (12.915.413) (2.637,894) (1,637,33T) 14,436, 732 Total Unrestricted funds 20,609. 102 13,540. 185 (13. 743,049) (1,637,33T) 18,768,901 Restricted funds Endophthalmitis study Fundraising Appeal 1.572 1,572 107, 180 (25, 723) 81,457 1,572 107, 180 (25, 723) 83, 029 Total of funds 20,610,674 13,647,365 (13, 768, 772) (1,637,337) 18,851,930 Page 38 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 22. Analysis of net assets between funds Analysis of net assets bet￿n funds - current year Restricted Unrestricted funds funds 2023 2023 Total funds 2023 Tangible fixed assets Fixed asset investments Current assets 194,385 194,385 18,478,463 18.478,463 6,251,780 6,325,092 (5,453,914} (5,453,914) {214,916} (214,916) (410,018} (410,018) 73,312 Creditors due within one year Creditors due in more than one year Provisions for liabilities and charges Total 73,312 18,845,780 18,919,092 Analysis of net assets bet￿￿n funds - prior year Restricted Unrestricted funds funds 2022 2022 Total funds 2022 Fixed asset investments 18,071,453 18,071,453 6, 042, 733 6,125, 762 (4, 101, 386) (4, 101, 386) (160,488) (160,488) (1,083,411) (1,083,411) Current assets Creditors due within one year Creditors due in more than one year Provisions for liabilities and charges 83,029 Total 83,029 18, 768,901 18,851,930 Page 39 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 23. Reconciliation of net movement in funds to net cash flow from operating activities Group 2023 Group 2022 Net income l (expenditure) for the year (as per Statement of Financial Activities) 67,162 (1.758, 744) Adjustments for: Depreciation charges (Gains)ILosses on investments Dividends and interests from investments 13,885 (271,094) 1,637,337 (282,670) (255, 945) 183,118) (1,018, 120) 1,406,965 2,217,473 (673,393) 270, 242 146,755 146,653 Decreasel(Increase) in debtors Increase in creditors (Decrease) l increase in provisions Fees I charges on investment Net cash provided by operating activities 324,492 1,238, 896 24. Analysis of cash and cash equivalents Group 2023 Group 2022 Cash at bank and in hand 4.055,736 (630) 3.939, 522 (638) Overdraft Total cash and cash equivalents 4,055,106 3,938, 884 25. Analysis of changes in net debt At1 January 2023 Cash flows At31 December 2023 Cash at bank and in hand Bank overdrafts repayable on demand 3,939,522 (638) 116,214 4.055,736 (630) 3,938,884 116,222 4,055,106 Page 40 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 26. Operating lease commilments At 31 December 2023 the Group and the Charty had commitments to make future minimum lease payments under non-cancellable operating leases as follows.. Group 2023 Group 2022 Charity 2023 Charity 2022 Not later than 1 year Later than 1 year and not laterthan 5 years 149,650 224,475 149, 650 55,371 83, 056 55,371 149,650 374, 125 55,371 138,427 27. Related party transactions The Society has research funding agreements in place wth sponsor institutions in relation to research projects where the Principal Investigator is a related paty.. A research funding agreement wth the Vienna Institute for Research in Ocular Surgery, with a total value of £628,293, was approved in 2016 for the MYOPRED project, whose Principal Investigator is Oliver Findl, the Chair of the Education committee of the chantable company. At 31 December 2023, the remaining funding available under the agreement was £52.574131 December 2022.. £112,072). A research fvnding agreement wth the University of Maastricht was approved in 2023 for the Toric-IOL study, wth a total value of £1,429,245, replacing an agreement with University of Oxford, which was terminated by mutual agreement. The Co-chief Investigator is Paul Rosen, a trustee of the charitable company. At 31 December 2023, the remaining funding available under the agreement was E1,208,569 (31 December 2022.. É1,277,642). A research funding agreement Moorfields Eye Hospital, wth a total value of É283,178, was approved in 2023 for the OCT-KC project. whose Principal Investigator is Bruce Allan, an elected member of the Council of the Society- At 31 December 2023, the remaining funding available under the agreement was 223,178. The Society has consultancy agreements in place with certain related parties under which honoraria are paid for their consultancy services in relation to the Independent Medical Education programme. In 2023, payments totalling É50,330 were made in connection v￿th these consultancy agreements (31 December 2022. É27,700). Page 41 EUROPEAN SOCIETY OF CATARACT AND REFRACTIVE SURGEONS {A company limited by guarantee) NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023 28. Subsidiary ESCRS Tradin Limited The above entity is registered at 5th Floor 10 Finsbury Square, London, EC2A 1AF, United Kingdom, and is consolidated as European Society for Catsract and Refractive Surgeons holds 100 % of the shares. The financial results for the year were: 2023 2022 Income Expenditure Profit Net assets 17.375.866 (14.044,8681 3,330,998 3,230,933 12,852,003 { 9,908,710) 2,943,293 915.144 Amounts owed to European Society for Cataract and Refractive Surgeons are included as a creditor (2022.. debtor) in these accounts were é1,504,525 (2022.. E1,218,8441. Page 42