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2021-03-31-accounts

TIIE ROYAL ORTHOPAEDIC HOSPITAL CHARITABLE FUND THE ROYAL ORTHOPAEDIC HOSPITAL CHARITY ANNUAL REPORT 202012021 www.rohcharity.org Charity Registration Number: 1078046

Contents

Chair’s Statement ........................................................................................................................................... 2 Charity Manager’s Welcome .......................................................................................................................... 3 Legal, reference and administrative details .................................................................................................... 4 About us .......................................................................................................................................................... 4 Aims and objectives ........................................................................................................................................ 4 Achievements ................................................................................................................................................. 5 Creating a clear strategy ............................................................................................................................. 5 A surge of community support ................................................................................................................... 5 Engagement ................................................................................................................................................ 5 Website re-configuration ............................................................................................................................ 5 Marketing .................................................................................................................................................... 5 Activities.......................................................................................................................................................... 6 Public benefit .............................................................................................................................................. 6 How support has made a difference ............................................................................................................... 6 Providing immediate support in response to the COVID-19 pandemic...................................................... 6 Patient entertainment ............................................................................................................................ 6 Supportive equipment ............................................................................................................................ 6 Prioritising wellbeing .............................................................................................................................. 7 Supporting the wider community ........................................................................................................... 7 Additional improvement projects completed ............................................................................................ 7 Improving the environment for patients ................................................................................................ 7 Investing in the Children & Young People’s Pathway ............................................................................. 8 Research developments.............................................................................................................................. 8 The use of Affinity Selection Systems for intraoperative cell salvage. ................................................... 8 The generation of a biological glue for bone regenerative medicine. .................................................... 8 Staff welfare and amenities ........................................................................................................................ 9 Investment in learning ............................................................................................................................ 9 Looking to the future ...................................................................................................................................... 9 Current appeals.........................................................................................................................................10 Financial Review ...........................................................................................................................................11 Investments ..............................................................................................................................................11 Income ......................................................................................................................................................11 Expenditure ...............................................................................................................................................11 Compliance ...................................................................................................................................................12 Principal Address ......................................................................................................................................13 Principal professional advisors .................................................................................................................13 Principal officers and related parties ........................................................................................................14 Charitable Funds Committee ....................................................................................................................14

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Principal Charitable Funds advisor (to the board) ....................................................................................15 Delegated officers .....................................................................................................................................16 Structure, governance and management .....................................................................................................17 Related parties ..........................................................................................................................................18 Reserve Policy ...........................................................................................................................................18 Audit Dispensation ....................................................................................................................................18 Risk Considerations ...................................................................................................................................18 Going Concern ..........................................................................................................................................19 Statement of trustees’ responsibilities .....................................................................................................19 Declaration ....................................................................................................................................................19 Independent Examiner’s Report to the Trustees of The Royal Orthopaedic Hospital Charitable Fund .......20 Responsibilities and basis of report ...............................................................................................................20 Independent examiner's statement ..............................................................................................................20 Financial statements .....................................................................................................................................21

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Chair’s Statement

The Trustees present The Royal Orthopaedic Hospital (ROH) NHS Foundation Trust Charitable Funds’ Annual Report with Financial Statements for the year ended 31st March 2021.

Welcome to the 2020/21 Annual Report and Financial Statements for the Royal Orthopaedic Hospital NHS Foundation Trust (ROH) Charitable Fund, a life changing year for us all. Since the Charity was founded in 1997, it has supported the Trust, its visitors and staff immeasurably. Charitable giving has been and always will be at the hospital’s heart - ever since its inception in 1817.

We are proud to have been able to support the Trust throughout this time of need, by providing vital enhancements to both staff and patients throughout the COVID-19 pandemic. Over 2020/21 we saw an outpouring of support for both the ROH and the NHS in general which has amplified the way in which NHS charities can support their hospital staff, patients and visitors.

As a result of many successful grant applications, we are proud to have been provided with £181,000 from NHS Charities Together to support various largescale projects. All grant applications communicated the need to prioritise the wellbeing of staff and patients over the COVID-19 pandemic and beyond. With these funds, we have supported the Trust in a range of ways and also plan to over the next few years. You can read about these examples on pages 6 -9 of this report.

Staff have particularly engaged with the Charity team this year, seeking support with new ideas, research developments and capital projects. Sharing the outcome of initiatives through articles, photos and videos have enabled our community to engage and we are reaping the rewards.

We have taken a particular focus on research throughout 2020/21, through funding new and exciting research initiatives, maintaining the on-site Regenerative Medicine Laboratory and working strategically with our key partners.

The decision was made to invest in personnel to support and grow the Charity into what we hope will be a much larger supportive arm to the Trust. We created two new positions bringing the Charity to a team two full time and one part time members of staff. We welcomed Ali Gray – Charity Manager in June 2020 and Tammy Foo – Fundraising Officer in March 2021. This has enabled the Charity to have a much more strategic and aligned approach to the Trust. You can read more about the team structure and their goals within this report.

We are so grateful for the support we have received this year from online followers, donors, fundraisers or partners; we could not have made the impact the ROH deserves without your drive and support. Our donations range from a few pounds to hundreds of thousands of pounds – all are underpinned by a real passion and reason to give. We are so grateful that we get to share these stories and use donations to make a difference across the organisation. I offer our sincere thanks to everyone who has contributed so generously to support the fund.

Professor D Gourevitch Chairman of The Royal Orthopaedic Hospital Charitable Funds Committee

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Charity Manager’s Welcome

Having joined The Royal Orthopaedic Hospital Charity in quarter one of 2020/2021 as Charity Manager, it was a challenging time to start a new role during a pandemic. It is however a great feeling to work for the ROH, a specialist Trust, with passionate staff, students, volunteers and supporters. I see this role as twofold: firstly, to capitalise on our relatively unique standing in the charity sector, raising money for the NHS as a rare specialist hospital and then secondly, to use that great foundation as the catalyst for heightening our profile and ultimately, increasing our funds.

We continue to strive to make patients feel supported throughout their journey with us and I feel delighted to be working for such a prestigious charity. In times of austerity, fundraising can feel like an awkward conversation to have but in reality, the truth is that ‘many hands make light work’. I deliberately use this cliché because it captures the very essence of how volunteering and fundraising activity can take place. A little bit of time and money, donated by many people, can equate to a huge difference!

COVID-19 has been a time of reflection. Our community has recognised the amazing work of our NHS and the overwhelming feeling of support has boosted many of us during this time. Fundraising provides valuable support for improvement, which allows us as a specialist orthopaedic hospital to set ambitious targets for the future. Our patients tell us that they have a positive experience here, but we know there is always more that we can do. We work together as a unit, respecting each other’s expertise, in the knowledge that our collective experience will keep us at the forefront of orthopaedic care.

During a difficult year, the Charity came together with the community to support each other through challenges across our healthcare system. Our priority was being open with each other about the needs of both our patients and staff. This unprecedented time during the pandemic particularly highlighted the importance of wellbeing and creating opportunities for us to constantly evolve the services we provide to the ROH community. It has been reassuring and comforting to know that with the right support, our patients and staff will thrive.

ROH Charity is a crucial factor in how far we are able to advance our clinical expertise, and ultimately, improve our offer to patients. The Charity is delighted to have supported many initiatives over 2020/2021 which are all based on one premise; to improve our patient experience. As a Charity, we are constantly working with passionate colleagues, patients, and members of the public to raise funds for this pioneering institution.

ROH is one of the largest specialist orthopaedic units in Europe. Here at ROH we pride ourselves on providing a specialist and trusted place for patients and a professional working environment for our staff, to deliver the appreciated added extras in terms of health facilities and comfort.

We are hugely proud of what was achieved during 2020/21 and excited to build upon our strong foundations. The next few years will be transformational for ROH Charity and I am looking forward to being part of it.

Ali Gray - Charity Manager of The Royal Orthopaedic Hospital Charitable Fund

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Legal, reference and administrative details

The Royal Orthopaedic Hospital NHS Trust Charity was formed on 18 March 1997 under the Trustees of the Birmingham Health Authority General Charity, who delegated the responsibility of expending funds to the Executive and Non-Executive Directors of The Royal Orthopaedic Hospital NHS Trust. On the 12 October 1999 this was amended under a Supplemental Deed by The Royal Orthopaedic Hospital NHS Trust’s solicitors, Wragge & Co., to transfer total responsibility to the Directors of The Royal Orthopaedic Hospital NHS Trust as Trustees.

The Charity was registered on the “Central Register of Charities” on 4 November 1999 under the registration number 1078046. The Trust was formerly known as The Royal Orthopaedic Hospital NHS Trust. The Trust was granted Foundation Trust status on 1 February 2007. On 16 October 2007 the Trust executed a Supplemental Deed under which the charity’s name was amended to The Royal Orthopaedic Hospital NHS Foundation Trust Charity.

The annual report and financial statements relate to the funds administered for the public benefit by The Royal Orthopaedic Hospital NHS Foundation Trust.

About us

The Royal Orthopaedic Hospital Charitable Fund exists to support NHS patients, their families and carers, as well as provide specialist training, equipment and knowledge to staff at The Royal Orthopaedic Hospital NHS Foundation Trust.

The Trust is our Corporate Trustee with the hospital Board acting on its behalf. The Charitable Funds Committee supports key decisions, which is made up of designated Board members and external stakeholders as detailed in the Principal Officer’s section below.

Aims and objectives

The objects of The Royal Orthopaedic Hospital Charitable Fund as defined in the Charity Commission registration document are as follows:

“The Trustees shall hold the trust fund upon trust to apply the income, and at their discretion, so far as may be permissible, the capital for any charitable purposes relating to the National Health Service wholly or mainly for the services provided by The Royal Orthopaedic Hospital”.

The main objectives of the Charity are to support the Royal Orthopaedic Hospital by:

The Trustees have a policy that funds are spent in line with donors’ wishes. During the year the funds of the Charity were used to support a range of charitable and health related activities. These funds have been deemed to benefit both patients and staff of the Trust, and by extension the wider public.

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Achievements

Over the last year the ROH Charity has been involved in many meaningful projects in order to grow our Charity and enhance our support within the Trust despite many key events being cancelled and/or postponed due to the coronavirus pandemic.

Creating a clear strategy

Many NHS Trusts across the UK have an established strategy to generate charitable funds, in order to enhance NHS services. Over 2020/21 newly appointed Charity Manager – Ali Gray, prioritised working with key stakeholders both internally and externally to create a Charity Strategy that aligns with the Trust’s 5 year plan. This will identify key principles and enablers for the Charity to follow, which will deliver an increase in fundraising income.

Ordinarily the Charity strategy would be a five year plan but this strategy runs alongside the general Trust strategy and therefore ties in to the last remaining three years.

A surge of community support

Over 2020/21 a large increase in gifts-in-kind were received in response to the COVID-19 pandemic, gifted by members of the community, corporates and major donors. These were calculated to be worth approximately £36,960 (2019/20 £2494) and were given to support both patients and staff within the hospital. Gifts received ranged from hot takeaway meals, to PPE and hand sanitiser.

The connections made through this outpouring of generosity will be vital to support new projects and appeals going in the future.

Engagement

COVID-19 has highlighted the positive impact NHS Charities can have on the Trusts in which they support. Education around the Charity is key for all staff and volunteers within the hospital and is a priority going forward. Trust departments are more engaged than ever after more regular communication has occurred both internally and externally throughout the COVID-19 pandemic.

Website re-configuration

A full review of the ROH Charity website was completed taking into consideration Trustee and user feedback in early 2020. This vital piece of work was completed in order to streamline the donor journey throughout the site.

A donation button was made live in order to direct individuals to give via our website. This gives the donor and/or fundraiser an easier journey around our website as well as enables us to set up bespoke donation platforms which are tailored to each appeal and/or event.

A full review of content took place and relevant departments were contacted to be involved in sharing the impact charitable funding has had on their department, patients and teams.

Marketing

After a review of both internal and external marketing at the Trust, investment was made in 10 contactless donation points in key areas of the hospital. These were implemented in March 2021 and will therefore see the impact of these donations in the 2021/22 report.

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This initiative was executed to support the reduction in cash being used at the Trust as well as help the Charity to generate a larger digital presence. A full brand review is currently taking place and a rebrand is expected to happen in 2021/22.

Activities

Public benefit

The Trustees have reviewed the activities of the Charity against the public benefit principles outlined in guidance issued by the Charities Commission, and believe that these meet the public benefit charitable aims. The Charity meets this requirement through The Royal Orthopaedic Hospital NHS Foundation Trust who provides services to the public.

How support has made a difference

Providing immediate support in response to the COVID-19 pandemic

The COVID-19 pandemic meant that NHS hospitals including the ROH had to adapt to a new way of working to suit government guidance as well as maintain the safety of all staff, patients and all visitors.

The ROH Charity has been honoured to be able to help support the Trust throughout this time by providing enhanced support in various forms throughout the year:

Patient entertainment

Improving patient experience remains our biggest intention and self-isolation has become a main problem which we were keen to address. With visiting restrictions in place throughout the pandemic, patients across the country including those at the ROH were experiencing feelings of loneliness and isolation whilst in hospital. To support this issue, all inpatient areas were provided with iPads for staff to utilise with patients who are unable to contact loved ones. This proved to help patients feel more positive about their hospital stay, feel less anxious and help families feel more at ease. Apps are used on the devices to help support patients with communication, distraction and patient education.

“The nurses who looked after my Grandad were incredible, they sat with him constantly and help to show him photos of our family to make him feel more comforted. They let me say goodbye by videocalling me during his last hours, I cannot thank them enough” Patient relative, July 2020.

These have proven really helpful to both staff and patients on our wards. So much so, an additional £100,000 has been successfully awarded by NHS Charities Together, to implement a new bedside entertainment system for all inpatients in 2021/22.

Supportive equipment

Additional equipment has been sourced to enhance care for patients experiencing distress, anxiety, memory loss and confusion. This includes communication aids, sensory equipment, puzzles and games to help with distraction as well as music players including music from all eras.

“There has been a lovely example of a HCA playing 1940s music and the patients all started singing and clapping, which is a good morale boost and gets them moving”, Staff Nurse

This equipment has been able to help soothe patients, create active discussion and alleviate worry.

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Prioritising wellbeing

NHS healthcare staff including those at the ROH have had immense pressure on their shoulders over the last year. In recognition of this, all staff were provided with wellbeing packs to help support them. These included luxury chocolate, hot drink sachets, mental health information and vouchers for our in-house café.

Support was also provided over the Christmas break to all staff members which included mindfulness practice booklets, gifts and an advent calendar guide to keeping colleagues well.

A further £33,000 was received in December 2020 after another successful grant application, in order to support additional wellbeing facilities across the hospital. This included bespoke outdoor spaces for reflection, an in-house wellbeing room for staff to utilise at times of crisis and additional ‘Mental Health First Aid’ training programmes. These projects plan to be implemented in September 2021.

Supporting the wider community

£85,000 was also received in 2020/21 and ring-fenced for a largescale Musculoskeletal project supporting community, social prescribing and partnership working.

The number of people treated for musculoskeletal (MSK) conditions is increasing. Lower back and neck pain are the greatest causes, of years lost to disability, with chronic joint pain or osteoarthritis affecting over 8.75 million people in the UK. Associated with their physical condition, these patients are also facing challenges with mental health, long-term health conditions and isolation. This has been further exacerbated by the impact of COVID-19. Many patients will face longer waits for treatment and intervention, and undoubtedly this will affect their quality of life.

The new project launching in 2021/22, will provide clear access to self-help and management tools/techniques, streamline pathways throughout the West Midlands as well as support social prescribing throughout the region.

A special mention should be made to NHS Charities Together as well as all those who donated towards their Urgent COVID-19 Appeal. Without grant funding from this amazing membership organisation, the ROH Charity would not have been able to support the Trust in this way.

Additional improvement projects completed

Improving the environment for patients

Patients feel more comfortable in a more vibrant and less clinical environment. In 2020, phase two of the Ward 4 build at the ROH was completed and the ROH Charity was involved with funding key items to help support patients to feel more comfortable, confident and at home. This involved sourcing wall art, smart TVs and dementia clocks for the ward. Wall art can help distract from the clinical environment, create conversation and be more welcoming to patients on the ward. Smart TVs were also provided to side rooms for patients to enjoy a range of entertainment whilst staying at the Trust.

This is something we plan to continue across the Trust in order to offer a more supportive hospital experience.

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Investing in the Children & Young People’s Pathway

£30,000 was donated to the Trust to support the renovation of the Children and Young People’s Outpatients department, (CYPOPD), which now offers an interactive and supportive space for young patients and their families.

The new design flowing through the department, offers a distraction to both patients and any accompanying young people from their treatment. Entertainment units were purchased featuring interactive games for patients up to 17-years-old and offer a more inclusive, ‘clutter- free’ environment. A renewed sensory facility has also been installed and a reflection room added to the space. The reflection room is a calming space where patients and families can sit and reflect upon an appointment and be used as a safe space to discuss any issues with staff.

Research developments

A significant amount of funds was invested in the upkeep of the Dubrowsky Regenerative Medicine Laboratory over 2020/21. This enabled key research projects to start utilising the laboratory using partners at Aston University.

Here are some examples of how the laboratory is advancing research for orthopaedic patients:

The use of Affinity Selection Systems for intraoperative cell salvage.

The use of red blood cell salvage, has become commonplace in surgery, and orthopaedics specifically. This recycles the patient’s own red blood cells back to the patient during surgery. The technique reduces and, in some cases, negates the need entirely for blood transfusions, as well as reduces the risk of infection for the patient.

This project supports the use of new technology that would allow the identification and removal of cancer cells through an active filtration process. This would then lead to the development of a new primary cancer, red cell salvage system, which would be transformative in the care of this patient group.

The Dubrowsky Regenerative Medicine Laboratory is being used to develop the filtration system along with testing that filtration system with human blood, both from healthy volunteers and those with cancer cells.

The generation of a biological glue for bone regenerative medicine.

Osteoarthritis is where an inflammatory and deteriorating process occurs inside a joint leading to the loss of cartilage, exposure of the underlying bone and intense pain. This loss of cartilage means that patients present with pain, stiffness and loss of function.

Early in the osteoarthritic process, tearing and breakdown of the cartilage is seen and this is a precursor to a more aggressive loss of joint cartilage.

The aim of this research project is to develop a biological glue that could be used to seal early tearing and defects in the intra-articular cartilage, in a similar fashion to the mending of pot holes in a road and preventing the replacement of the entire road surface.

The Regenerative Medicine Laboratory will be used to develop the glue and test its efficacy, using tissues donated from patients having surgery at the ROH, under the ethics of the Research Tissue Bank.

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A research strategy has been implemented meaning a more streamlined process for staff, students and researchers to apply for funding for their new ideas. This will enable more research projects to take place in the future and ensure donations received supporting research are utilised appropriately.

Staff welfare and amenities

Investment in learning

Investment in learning was set up in December 2013 with the key aim to support the personal and professional development of staff at the Trust. Charitable funding was allocated to support apprenticeship qualifications, customer care training, developing technical skills and professional qualifications for career progression. The allocation continues to support the professional and personal development of staff. Despite many training events cancelled, over £12,000 of investment was made in staff training 2020/21. This included:

Over the five years since the introduction of investment in learning initiative, the Trust has been able to support the personal and professional development of a high number of staff members, from a range of specialities and backgrounds.

Looking to the future

The charity’s expenditure plans from 2021/22 to 2022/23 include improvements to patient care by enhancing facilities, staff training, research and the purchase of medical equipment by following the Charity and Trust strategy.

Strategic priorities for the next three years are:

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Current appeals

Over 2020/21 departments within the Trust have continued to come forward with ideas for new appeals in which the public could support. The Trust and Charity have worked together autonomously to develop key meaningful appeals that have a positive impact on the Trust and those who visit.

The public are currently able to support the following appeals:

Children and Young People’s Appeal, supporting patients aged 0 –25 and their loved ones www.rohcharity.org/impact/CYP

This appeal enables the public to give direct support to Children and Young People’s services at the ROH. This enables the purchase of additional equipment, the up-keep of sensory, reflection and play spaces within the Trust and also helps us to develop new improvement projects to support young patients and their families.

Research & Development Appeal | Supporting research & development at ROH

www.rohcharity.org/impact/eureka

Supporting orthopaedic research is one of our main charity objectives and has been since its inception. The NHS is constantly changing, finding new cures and caring techniques. This is all done to ensure our patients are diagnosed quickly and have the very best chance of recovery. The Trust has a long history of conducting very important and influential research, which has helped shape the way orthopaedic conditions and injuries are treated today. The public have an opportunity to support enable further research at the ROH through this appeal.

Invest In Our Best | The Thank you Appeal, supporting staff at the ROH www.rohcharity.org/impact/invest

This appeal allows staff to gain access to additional training in the latest treatments and courses. It helps grow the skills on offer in the Trust and provides all those ‘extra bits’ of funding which help make the Royal Orthopaedic Hospital so special. It also helps to fund the annual celebratory awards which publicly thank our hard-working staff for the special care and service they provide.

Knowledge Hub Appeal | Supporting the healthcare professionals of our future

www.rohcharity.org/impact/hubappeal

The Knowledge Hub is an important space and one which has a huge impact on the care that surgeons, doctors and nurses offer to local people. This appeal supports the upkeep of the newly renovated Knowledge Hub which holds all staff and student training throughout the year. This space promotes inclusivity, innovation and learning for the healthcare professionals of our present and future. Individuals are able to sponsor a seat in our lecture theatre to support this incredible centre.

Cancer Care Family Fund | Supporting oncology patients visiting The Royal Orthopaedic Hospital www.rohcharity.org/ourwork/current-appeals/ccff/

The Cancer Care Family Fund has been developed to give added support to oncology patients visiting the Trust. The appeal provides inpatients with welcome packs on arrival for surgery, which include items for distraction, added things to take their mind off their stay, as well as information about the ward and their care team. The appeal also provides financial support to patients who are in need. This requires a thorough review process to evaluate which patients are eligible for this support.

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Financial Review

The net assets of the Charitable Funds as at 31 March 2021 were £2,213,000 (2019/20 £1,612,000). Fund balances increased in year by £601,000 due to donations and legacies of £635,000, dividend income of £38,000, a gain on investment of £157,000 and offset by in year expenditure of (£229,000).

As a result of the COVID-19 pandemic, the Charity did not produce an expenditure plan for 2020/21. This was because all fundraising event plans were put on hold and activity on clinical areas was affected. All expenditure will continue to be assessed via the Charity’s governance polices.

Investments

The investment and performance review produced by Cazenove, the Charity’s investment advisors, showed a positive return on total investments of 24.2% for the year ended 31 March 2021, compared to a negative return of (8.6%) in 2019/20. The total portfolio has increased from £796,000 at the beginning of the year to £953,000 at the end of 31 March 2021.

Income

The main flow of income is received from members of the public, in total income amounted to £673,000 (2019/20 £302,000), which comprises donations of £584,000 (2019/20 £72,000), dividend income on investment totalling £38,000 (2019/20 £42,000) and legacies of £51,000 (2019/20 £188,000).

Material donations and legacies received during the year include:

Donations from
individuals		 Legacies Income from
fundraising events
General Fund 286 50 5
MSK Early Intervention
Project		 87
Covid-19 Fund 181
554 50 5

Expenditure

The total expenditure for the year to 31st March 2021 was £229,000 (2019/20 £430,000), which comprises of grants of £146,000 (2019/20 £383,000) and support costs of £72,000 (2019/20 £38,000).

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Material expenditure during the year includes:

£
Salary Recharge - A Gray 57,015
Accessable 3 year 26,273
#109 CYP Unit 17,334
2020/21 Management Fee 15,200
#094 Bladder Scanner 7,620
Regenerative Med Lab 7,604
#065 Hoverjack 6,965
#075 Covid staff meal vouchers 6,810
Provision of Nightingale Frontline 5,000
2020/21 Audit Fee 4,800

Material expenditure during 2019/20 included:

----- Start of picture text -----
£
Regenerative Med Lab 324,012
Staff Awards 12,368
Investment in learning 9,698
Automatic Calendar Clocks (white) 5,639
Singing Medicine Project 5,000
Grande Manual Recliner 3,715
Christmas Ball 3,124
Overseas Nurses-accommodation 2,691
Printed Custom Wall Mural 2,454
Hearing loss equipment 2,179
----- End of picture text -----

Compliance

The financial statements have been prepared in accordance with the accounting policies set out in note 1 to the accounts and comply with the Charity’s trust deed, which is the governing document, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland.

The Charity is a subsidiary of The Royal Orthopaedic hospital NHS Foundation Trust (ROH). The principal activities of the ROH is the provision of healthcare. The executive and non-executive directors of the ROH exercise control of the Charity as corporate Trustees. Details of the Trustees can be found on page 11. The consolidated accounts for the ROH and the Charity can be found at www.roh.nhs.uk or requested via the email address below.

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Principal Address

Registered Office Mrs Joanne Williams The Royal Orthopaedic Hospital NHS Foundation Trust The Woodlands Bristol Road South Northfield Birmingham B31 2AP

Email Address ROH.Charitablefunds@nhs.net

Website: www.rohcharity.org

Principal professional advisors

Bankers National Westminster Bank PLC Birmingham City Office 103 Colmore Row Birmingham B3 3NS

Investment Advisers Cazenove Capital Management 12 Moorgate London EC2R 6DA

Independent Examiner Deloitte LLP 1 City Square Leeds United Kingdom LS1 2AL

Solicitors Mills & Reeve LLP 78-84 Colmore Row Birmingham B3 2AB

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Principal officers and related parties

Trustee details

The members of The Royal Orthopaedic Hospital NHS Foundation Trust Board, detailed below are the Trustees of the Charitable Funds. Board Members as Trustees are governed by the law applicable to Trusts, principally the Trustees Act 2000.

Trustee Name

Office

The Trust Board reviews the skills, composition and balance of the Board. The joint Nominations & Remuneration Committee of the Council of Governors discuss the skill-set required and the time commitment and recommend the process of appointment. The Non-Executive and Executive Directors of The Royal Orthopaedic Hospital NHS Foundation Trust Board, on appointment become Trustees of the associated Charity.

Charitable Funds Committee

The Charitable Funds Committee is constituted as a standing Committee of the Trust Board. The Trust Board is the corporate trustee and as such cannot delegate responsibility for the charity’s overall priorities, strategy, budget and reporting responsibilities.

On behalf of all members of the Trust Board (being the Trustees in law under the terms of the Charities Acts) the Committee will:

  1. Seek assurance on the adequacy of the arrangements for the safeguarding of those assets donated or bequeathed, in cash or other form, to the Trust's Charitable Funds.

  2. Seek assurance that as far as is practicable, that the expressed or intended wishes of donors or benefactors are met in the deployment of funds.

  3. Seek assurance on the robustness of the banking, accounting and audit arrangements in respect of charitable funds.

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  1. Seek assurance on the appropriateness of the appointment of Investment Brokers to provide professional advice on the investment of charitable funds.

  2. Seek assurance on the adequacy of the investment strategy for the Charitable funds.

  3. Seek assurance on the robustness of the management of funds through the consideration of regular reports on income to and expenditure from the Trust's Charitable Funds, prior to submission and to review the regular investment reports supplied by the Trust's brokers.

  4. Consider and approve the Annual Charitable Funds accounts and the Annual Report to the Charities Commission.

  5. Seek assurance that the Trust is complying with Standing Orders, Standing Financial Instructions and operating procedures in so far as these cover the use of charitable funds within the Trust

  6. Seek assurance that the Trust is complying with the relevant legislation and formal Department of Health guidance on charitable funds.

  7. In accordance with the Scheme of Delegated Authority and authorisation limits, (see Standing Orders and Standing Financial Instructions) to consider all business cases involving the use of Charitable Funds prior to any required consideration by the Trust Board.

  8. Seek assurance on any additional matter referred to the Committee from the Board.

Principal Charitable Funds advisor (to the board)

The Director of Finance and Performance reviews the training needs of the trust board as agent for the corporate trustee. He is responsible for ensuring that the funds are managed appropriately and with due regard to their purpose and requirements.

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Delegated officers

Funds Held on Trust (Charitable and Non-Charitable Funds)

Funds Held on Trust (Charitable and Non-Charitable Funds) Funds Held on Trust (Charitable and Non-Charitable Funds) Funds Held on Trust (Charitable and Non-Charitable Funds)
Responsibility Executive lead Operational lead
a) Management
Funds held on trust are managed
appropriately		 Executive Director of
Finance &
Performance
(supported by the
Charitable Trustees)		 Deputy Director of Finance
b) Maintenance of authorised
signatory list of nominated fund holders		 Executive Director of
Finance &
Performance		 Deputy Director of Finance
c) Expenditure Limits Executive Director of
Finance &
Performance		 Refer to‘Financial Limits’table
below
d) Developing systems for receiving
donations		 Executive Director of
Finance &
Performance		 Deputy Director of Finance
e) Dealing with legacies Executive Director of
Finance &
Performance		 Deputy Director of
Finance/Financial Accounts Team/
Fundraising Officer
f) Appeals
1. Fundraising Appeals
2. Preparation and monitoring of
budget
3. Reporting progress and
performance against budget		 1. Charitable Funds
Committee
2. Executive Director
of Finance &
Performance
3. Executive Director
of Finance &
Performance		 1. Fundraising Officer
2. Fundraising Officer with
advice from Financial
Accounts Team
3. Fundraising Officer with
advice from Financial
Accounts Team
g) Operation of Bank Accounts
1. Managing banking arrangements
and operation of bank accounts
2. Opening bank accounts		 1. Executive Director
of Finance &
Performance
2. Executive Director
of Finance &
Performance		 1. Deputy Director of
Finance/Financial Accounts
Team
2. Executive Director of Finance
& Performance
h) Investments
1. Nominating deposit taker
2. Placing transactions in accordance with
the Charitable Funds Investment Policy		 1. Charitable Funds
sub-committee
2. Executive Director
of Finance &
Performance		 1. Executive Director of Finance
& Performance
2. Deputy Director of
Finance/Financial Accounts
Team

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Financial Limits(Subject to specific funding earmarked in budget)
Includes:
1. CHARITABLE FUNDS
1.1 General Funds
Charitable Funds Committee
Over £5,000
Chief Executive or Executive Director of Finance &
Performance and relevant Fund holder
From £501 to £5,000
All named officers to
approve
Named Fund Managers
Up to £500
1.2 Specific Funds
Charitable Funds Committee
Over £5,000
Chief Executive or Executive Director of Finance &
Performance and relevant Fund holder
From £501 to £5,000
Ratification of all approvals
Named Fund Managers
Up to £500
BOTH named officers to
approve

Structure, governance and management

The business of the Trust is conducted through a series of quarterly Trustees’ meetings, where Trustees oversee the day-to-day administration of funds, ensuring that the funds continue to support a wide range of activities benefitting both patients and staff. Trustees are responsible for controlling expenditure and also for the investment and reserve policies with any associated decisions.

The day-to-day running of the Charity is delegated to the key management personnel in the form of Executive Director of Finance and Performance being a member of the Trust Board and a Trustee of the Charity. His responsibilities include ensuring the systems of control are robust, all legal or managerial changes are implemented and that the other Trustees and Fund Managers are advised on a regular basis of the fund balances.

The accounting records and the day-to-day administration of the funds are dealt with by the Finance Department, which is located at The Royal Orthopaedic Hospital NHS Foundation Trust, Bristol Road South, Birmingham B31 2AP, which was licensed as a Foundation Trust from 1st February 2007.

This year, work undertaken includes the provision of detailed information regarding expenditure to the Trustees. Items exceeding a value of £100 are narrated in quarterly reports to the Trustees to ensure that the Charity continues to use its funds for charitable purposes. The Trustees continued to receive investment advice from Cazenove Capital Management during the year, previously known as Schroder and Co. Schroder and Co acquired Cazenove and merged the private bank and charities sections of the business, branding them both as Cazenove Capital Management. The banking facilities and the solicitor as appointed remained unchanged during the year. The independent examiner is Deloitte LLP.

Fund managers have Standing Financial Instructions and internal procedures for administering the Charity, which remain unchanged. Fund Managers and Trustees are made aware of any new legal obligations where appropriate during the year.

There are 31 funds in total, of which 30 are restricted funds for wards and specific departments and one general fund which is unrestricted.

Charitable funds vested in the Trust are operated through a special purpose charity with subsidiary earmarked accounts.

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Related parties

The Charity receives services from and provides goods to the associated NHS Foundation Trust. Trustees’ serve as Executive and Non-Executive Directors on the Trust Board. Business is conducted carefully to ensure funds are expended in the most appropriate manner and that the expenditure policy is consistent with the preferred wishes of the donor.

Reserve Policy

The Trustees require each fund holder to identify their plans to expend funds. An expenditure plan is completed annually and enables the Trustees to monitor fund movements. To ensure that there is no buildup of unnecessary reserves, this practice continues year on year. The Trustees also inform fund holders when their plans are insufficient to expend their resources. The Charity does not hold any funds that are in deficit.

The Royal Orthopaedic Hospital Foundation NHS Trust Charity has a reserves policy to ensure sufficient unrestricted funds that are freely available for its annual operating purposes not subject to commitments and planned expenditure. The purpose of this level of reserves is to ensure a minimum level of liquidity in order to continue to operate as a charity and have sufficient funds to meet the charity objects.

Reserves do not include endowment funds, restricted funds and designated funds.

Current
Year		 Previous
Year		 Increase /
(Decrease)
Unrestricted Funds(Reserves) 608,361 324,763 283,598
Restricted / Designated Funds: 1,605,289 1,264,545 340,744
Endowment Funds 0 23,030 (23,030)
Total Funds 2,213,650 1,612,338 601,312
Ratio ofReservesto Annual Operating Expenditure 2.6:1 5.3:1

Audit Dispensation

The Charity’s income and assets are above the independent examination threshold required by the Charities Commission for England and Wales and therefore the Annual Report and Accounts for the year ended 31 March 2021 have been subject to an independent examination carried out by Deloitte LLP.

Risk Considerations

The Trustees have assessed the risks to the Charity and are satisfied that there are policies and procedures in place to mitigate these risks. A risk register is in place that outlines the key risks that are faced by the Charity and measures that are in place to reduce or mitigate the risk. The two main risks faced by the Charity is that it is exposed to volatility in investments which could lead to a loss of income and the fund restrictions make the utilisation of funds in a timely manner difficult to achieve. The Trustees have decided to accept and retain these risks but measures are in place such as working closely with investment brokers to manage the risk.

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Going Concern

The Trustees have assessed the Charity and consider it to be a going concern being at least 12 months from the approval of the financial statements. Grants made by the Charity are its discretion and there are no material commitments as at 31 March 2021. The Investments are uncommitted and available to cover operational costs if required.

All income and expenditure relate to continuing operations and the statement of financial activities includes all gains and losses recognised in the year to 31st March 2021.

Statement of trustees’ responsibilities

The Trustees are responsible for preparing the Trustees' Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice), including FRS 102 "The Financial Reporting Standard applicable in the UK and Republic of Ireland".

The law applicable to charities in England and Wales requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the Charity and of the incoming resources and application of resources of the Charity for that year. In preparing these financial statements, the Trustees are required to:

The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the Charity and enable them to ensure that the financial statements comply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the trust deed. They are also responsible for safeguarding the assets of the Charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. ‘The Trustees are responsible for the maintenance and integrity of the Charity and financial information included on the Charity's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Declaration

DECLARATION

The Trustees have approved the trustees’ report above.

Signature Date __28/01/2022_____ Full name Steve Washbourne Position Interim Director of The Royal Orthopaedic Hospital NHS Foundation Trust, and Trustee

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Independent Examiner’s Report to the Trustees of The Royal Orthopaedic Hospital Charitable Fund

I report to the trustees on my examination of the accounts of The Royal Orthopaedic Hospital Charitable Fund (“the Charity”) for the year ended 31 March 2021 which comprise the income and expenditure account, the balance sheet and the related notes 1 to 18.

This report is made solely to the charity’s trustees, as a body, in accordance with section 145 of the Charities Act 2011 and regulations made under section 154 of that Act. My work has been undertaken so that I might state to the charity’s trustees those matters I am required to state to them in an independent examiner’s report and for no other purpose. To the fullest extent permitted by law, I do not accept or assume responsibility to anyone other than the charity and the charity’s trustees as a body, for my work, for this report, or for the opinions I have formed.

Responsibilities and basis of report

As the charity's trustees you are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011 (“the 2011 Act”). You are satisfied that your charity is not required by charity law to be audited and have chosen instead to have an independent examination.

I report in respect of my examination of your charity’s accounts as carried out under section 145 of the 2011 Act. In carrying out my examination I have followed the applicable Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act.

Independent examiner's statement

Since the charity’s gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Association of Chartered Certified Accountants, which is one of the listed bodies.

I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:

  1. accounting records were not kept in respect of the Trust as required by section 130 of the 2011 Act; or

  2. the accounts do not accord with those records; or

  3. the accounts do not comply the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 other than any requirement that the accounts give a ‘true and fair view’ which is not a matter considered as part of an independent examination.

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Sarah Anderson, ACCA

for and on behalf of Deloitte LLP

Leeds, United Kingdom

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Financial statements

STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 MARCH 2021

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BALANCE SHEET AS AT 31 MARCH 2021

The notes on pages 22 to 33 form part of these accounts.

These financial statements of The Royal Orthopaedic Hospital NHS Foundation Trust Charitable Funds registered number 1078046 were approved by the Board of Trustees and authorised for issue.

Signed: Date: 28/01/2022

Mr S Washbourne - Interim Director of Finance and Performance, and Trustee

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CASHFLOW STATEMENT FOR THE YEAR ENDED 31 MARCH 2021

The notes on pages 22 to 33 form part of these accounts.

Notes to the accounts

1 Accounting Policies

1.1 Basis of preparation

The financial statements are prepared under the historical cost convention, in accordance with the Statement of Recommended Practice “Accounting and Reporting by Charities (SORP 2019)” applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), effective 1 January 2019; and the Charities Act 2011.

The accounts are prepared on the basis that the Charity has taken the small charity exemption and has not produced the accounts in line with activity based reporting.

1.2 Income

Income is recognised when the Charity has entitlement to the funds, any performance conditions attached to the item(s) of income have been met, it is probable that the income will be received and the amount can be measured reliably.

Donations are recognised when the Trust has been notified in writing of both the amount and settlement date. In the event that a donation is subject to conditions that require a level of performance before the Charity is entitled to the funds, the income is deferred and not recognised until either those conditions are fully met, or the fulfilment of those conditions is wholly within the control of the Charity and it is probable that those conditions will be fulfilled in the reporting period.

1.3 Income from legacies

Legacy gifts are recognised on a case by case basis following the granting of probate when the administrator/executor for the estate has communicated in writing both the amount and settlement date. In the event that the gift is in the form of an asset other than cash or a financial

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asset traded on a recognised stock exchange, recognition is subject to the value of the gift being reliably measurable with a degree of reasonable accuracy and the title to the asset having been transferred to the Charity.

1.4 Expenditure

The funds held on trust accounts are prepared in accordance with the accruals concept. All expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party.

1.4.1 Investment management costs

Investment management costs are the fees charged by Cazenove for the management of the investment portfolio and are apportioned on the basis of fund values. The costs incurred by the charity can be found in note 5.2 of these accounts.

1.4.2 Grants payable

Grants payable are payments made to third parties (including NHS bodies) in the furtherance of the fund’s charitable objectives. They are accounted for on an accruals basis where the conditions for their payment have been met or where a third party has a reasonable expectation that they will receive the grant.

1.4.3 Support Costs – Management, administrative and governance costs

The administration fee represents an agreed estimate of the cost of the provision of The Royal Orthopaedic NHS Foundation Trust's staff for the day-to-day administration of the Charity and the production of the Charity's financial statements.

Governance costs comprise costs incurred in the governance of the charity and are apportioned on the basis of fund values each month. Costs incurred are as follows:

31-Mar-21 31-Mar-20
£000 £000
Independent examination fee 5 5

1.5 Structure of funds

Where there is a legal restriction on the purpose to which a fund may be put, the fund is classified in the accounts as a restricted fund. Funds where the capital is held to generate income for charitable purposes and cannot itself be spent are accounted for as endowment funds. Other funds are classified as unrestricted funds. Funds which are not legally restricted but which the Trustees have chosen to earmark for set purposes are classified funds held in unrestricted reserves. The major funds held within these categories are disclosed on notes 11.1 to 11.6.

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1.6 Transfers between funds

Transfers between funds are approved by the Trust Board through the Charitable Funds Committee. There have been £30k material transfers during the year to 31 March 2021 (2019/20 £nil). £23k of this relates to a transfer from the Endowment and £7k between funds. The Trustees were asked to approve the transfer of the £23,000 held as endowments in the charity accounts to the general fund in order to utilise the funds more effectively.

1.7 Investment fixed assets

Investment fixed assets are shown at market value.

1.8 Investment current assets

1.9 Realised gains and losses

All gains and losses are taken to the Statement of Financial Activities as they arise. Realised gains and losses on investments are calculated as the difference between sales proceeds and opening market value (or date of purchase if later). Unrealised gains and losses are calculated as the difference between market value at the year end and opening market value (or date of purchase if later).

1.10 Investment income and expenditure

All income and expenditure from investments is allocated quarterly to the relevant funds pro rata based on the value of each fund.

1.11 Irrecoverable VAT

Any VAT that is irrecoverable is charged to the relevant funds as expenditure.

1.12 Pooling scheme

An official pooling scheme is operated for all investments for all funds administered on behalf of The Royal Orthopaedic Hospital General Charity.

The Scheme was registered with the Charity Commission on 4[th] November 1999.

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1.13 Going concern

After making enquiries, the Trustees have a reasonable expectation that The Royal Orthopaedic Hospital NHS Foundation Trust Charitable Fund has adequate resources to continue in operational existence for the foreseeable future. For this reason, they continue to adopt the going concern basis in preparing the accounts.

1.14 Debtors

Amounts that are owed to the charity for goods and services or amounts the charity has paid in advance are measured by their recoverable amounts.

1.15 Cash at bank and in hand

Cash equivalents are short-term, highly liquid investments that are readily convertible to known amounts of cash and that are subject to an insignificant risk of changes in value.

1.16 Creditors

A liability is recognised for the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as an advance payment for goods or services it must provide. Liabilities must be measured at their settlement amount except for certain types of financial liabilities.

1.17 Gifts in kind

Gifts in kind, such as food and care packages are not accounted for when they are accepted and immediately distributed unless a single donation is material. Gifts of tangible assets such as microwaves and fridges are recognised as a donation at fair value (market price) on receipt and charitable expenditure when they are distributed. Where gifts in kind are held before being distributed to beneficiaries, they are recognised at fair value as stock until they are distributed.

1.18 Accounting judgements and estimates

The Trustee is required to make judgements, estimates and assumptions about the carrying amounts of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an on-going basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

The Trustee does not consider there are any critical judgements or sources of estimation uncertainty requiring disclosure beyond the accounting policies listed above.

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2 Income

3 Analysis of expenditure

3.1 Total expenditure by type of fund

3.2 Charitable activities by grants payable

There were no non-audit services provided in the current or prior year.

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The above grants have all met the objects of the particular fund by which they were financed.

3.4 Expenditure on charitable activities

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8.2 Market Value at 31 March
8.3 Analysis of gross income from investments
9 Analysis of Debtors

Note : The debtor balances for 19/20 years relate to unrestricted funds.

10 Analysis of Creditors

11 Analysis of Funds
11.1 Endowment Funds

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The above listed endowments funds are expendable endowments.

11.2 Details of Endowment Funds

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Name of fund

Description of the nature and purpose of each fund

Sutcliffe Stephens

Nurse Prize

For the benefit of staff and patients

11.3 Restricted Funds

31-Mar-19
Income
Expenditure
Transfers
Gains/(Losses)
31-Mar-20
2019/20 Funds
Material funds £000
£000
£000
£000
£000
£000
Mr Dubrowsky
Hip Research
League of Friends
Oncology
Orthopaedic R&T		 1,241
17
(348)
0
(39)
871
124
1
(2)
0
(6)
117
52
1
(1)
0
(3)
49
60
1
(1)
0
(3)
57
33
9
(6)
0
(2)
34
33
1
(1)
0
(2)
31
24
11
0
0
(7)
28
16
0
0
0
(1)
15
9
0
0
0
(1)
8
11
0
0
0
(2)
9
9
0
0
0
0
9
7
0
0
0
0
7
6
0
0
0
0
6
7
4
0
0
0
11
17
5
(9)
0
(1)
12
MRI
Ward 11
Spinal Surgery
Mr Thomas
Stephens
Sutcliffe
Mr Jeys
Chapel Furnishings

Ward 3
Other Funds
Total
1,649
50
(368)
0
(67)
1,264

11.4 Details of material funds – restricted funds

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11.5 Details of material funds - unrestricted fund

Name of fund

Description of the nature and purpose of each fund

General Fund

General purpose

11.6 Transfers between funds

There have been £30k transfers during the year to 31 March 2021 (2019/20 £nil)

There are no contingent gains or losses during the year ending 31 March 2021 (2019/20 £nil).

The Charity had no legal or constructive obligations as at 31 March 2021 (2019/20 £nil).

There was no remuneration or expenses payable to Trustees and connected persons and key management personnel (2019/20 £nil).

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During the year none of the Trustees or members of the key management staff or parties related to them has undertaken any material transactions with The Royal Orthopaedic Hospital NHS Foundation Trust Charitable Fund.

Board members (and any other staff) take decisions both on Charity and Investment matters but endeavour to keep interests of the Charity and the associated Trust separate and discrete and do not seek to benefit personally from such decisions. Note 8 to the accounts presents the current investment position for the Charity. Declarations of personal interest have been made in both capacities and are available to be inspected by the public.

The Charitable Trust has made revenue payments of £42,534 (2019/20 £21,278) to The Royal Orthopaedic Hospital NHS Foundation Trust where the Trustees (whose names are listed on page 3) are also members of the Trust.

The only related party transactions which have occurred to 31 March 2021 have been between the Charity and The Royal Orthopaedic Hospital NHS Foundation Trust.

17 Cashflow Statement

18 Post Balance Sheet Events

There have been no events post balance sheet at the date of this report.

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THE ROYAL OH7HQPAEDIC 1105PITAL CHARITABLE FUND @fundROH www.rohcharity.org Charity Registration Number. 1078046