2023-12-31-accounts

St. lohn of Jerusalem Eye Hospital Company No: 3867950 Charity No: 1080185 ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2023

	Page
Legal and Administrative Information	1
	2
Statement of Trustees Responsibilities	9
Independent Auditors Report	10
Statement of Financial Activities	13
Income and Expenditure Account	13
Balance Sheet	14
Notes to the Financial Statements	15

Registered and Principal Office

4 Charterhouse Mews London EC1M 6BB United Kingdom

Bankers

National Westminster Bank Plc 134 Aldersgate Street London EC1A 4JB United Kingdom

Bankers in the occupied Palestinian territories Bank of Palestine PLC Hebron Road P.O. Box 765 Bethlehem

Independent Auditors

PricewaterhouseCoopers LLP 1 Embankment Place London WC2N 6RH United Kingdom

1

St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

The Trustees present the along with audited financial statements of St. John of Jerusalem Eye Hospital (the Company or SJJEH) for the year ended 31 December 2023. The financial statements have been prepared in accordance with the Statement of Recommended Practice: Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the UK Companies Act 2006.

St. John of Jerusalem Eye Hospital was formally incorporated as a private company limited by guarantee in October 1999 under the UK Companies House registration number 3867950. Its Memorandum and Articles of Association govern the Company. It is registered as a UK charity having the Charity Number 1080185.

The Charity operations are centralised in the Occupied Palestinian Territories where it runs Day Hospitals in Hebron and Gaza, and a Clinic in Anabta.

The Company's objects are the relief of sickness and the preservation and protection of health, in particular, but not exclusively, by maintenance and development of St. John Eye Hospital in the Occupied Palestinian Territories (oPt) or elsewhere and the clinical, teaching and research activities connected therewith.

The sole member of the Company, since 31 March 2011, is St. John of Jerusalem Eye Hospital Group, (the Group) which appoints the Board of Directors/Trustees of the Company (the Board). The Board manages the business and affairs of the Company and usually meets three times a year with at least one meeting in Jerusalem. At its meetings, the Board reviews the performance of the Company and, in particular, the performance of the hospitals in Gaza and Hebron, and the clinic in Anabta. The Board also considers and approves the operational and capital budgets. The Steering Committee meets three times a year between the three Board meetings to maintain momentum on Board matters between meetings.

The Board is aware of the codification of and takes these duties into account in consideration of SJJEH's activities.

New Trustees are selected in consultation with the Board to maintain an appropriate balance of skills, experience and diversity. Trustees are appointed for a term of three years and may be reappointed for two further terms of three years and are not normally eligible for a further reappointment. An induction programme is in place for new directors.

The Board appoints the Chief Executive who reports to the Chairman and is accountable to the Board. The Chief Executive is Dr. Ahmad Ma ali, appointed from May 2019.

2

St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

The Trustees, who are also the directors for the purpose of UK company law, during the year and at the date of this report, are listed below:

• Non-trustees are appointed to these committees for their expertise .

Each committee has terms of reference, which were updated in 2023.

• Sir Andrew Cash (Chairman)

• Mr. C. Hoult (Treasurer and Company Secretary)

• Miss. H. Dodds (Forsyth)

• Mr. P. Hackwood

• Mrs. A. Bhatia

• Ms. I. Levin

• Dr. M. A. Abu-Ramadan (reappointed January 2024; resigned 1 April 2024)

• Dr D.H. Verity

• Mr. J. Ingham Clark

• Mr. J Macaskill

• Mr. T. Jones

• Mr. D.E.I Pyott

• Ms D. Corner

• Dr. I Khammash (resigned October 2023)

• Mr. J von Einem (appointed June 2023)

• H Von Bose (resigned June 2023)

The Board currently has the following Committees:

• Steering Committee

• Finance Committee*

• Investment Committee*

• Audit Committee*

• Fundraising, Marketing & Communication Committee*

• Strategy and Planning Committee

• Clinical Governance Committee

• Honours and Awards Committee*

• Payroll and Remuneration Committee

• Human Resources Committee

• Guild Liaison*

• Digital and IT Committee

3

St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

loss provision covering the building, medical and other equipment of £1,362k as at 31 December 2023.

In partnership with the likes of Christian Blind Mission (CBM), Fred Hollows Foundation and the Federal Ministry of Economic Cooperation and Development (Germany) (BMZ), we managed to sustain our services in Gaza up until October 7[th] , 2023 when Hamas militants attacked southern parts of Israel. The Israeli military responded with massive air strikes on almost all of the Gaza Strip which was later followed by a land incursion on northern and southern parts of it.

Our staff were given clear orders by the Israeli Authorities to evacuate the Hospital on the second day of the war and, since then, the Hospital has not been functional and the war continuous. Additionally, our staff and their families were also instructed to move to the southern part of the Strip where it was deemed safer.

Although the hospital building was not directly struck, however, and as a result of the hostilities, it has sustained some considerable collateral damages.

As it has remained to be one of the few standing buildings in the neighbourhood, it is believed that the building still has an intrinsic value. Also, displaced refugees have moved to the hospital to utilise it as a safe shelter. Our staff have not been able to return to the Hospital to carry out a proper assessment of the damages to the building, furniture and equipment. However, based on unofficial reports and photos received, much of the furniture and equipment have either been damaged or removed. As a result, and after taking professional advice, the Trustees have recorded an impairment

Up till October 2023, our Gaza Hospital saw almost 30,600 patients, and performed over 2,000 major operations. Our Gaza Mobile Outreach Programme has a screening element in isolated communities and homes. This programme in Gaza saw over 3,500 patients during 2023.

The clinic continues to operate on two floors within the Red Crescent Society leased premises.

In 2023, our Anabta clinic witnessed another decrease in the number of patients treated which was over 11,300 outpatients at our Anabta Clinic.

Our Anabta Clinic is accessible for the 1 million residents in Anabta and surrounding Nablus, Tulkarem and Jenin. Those living in the area number amongst the poorest in the oPt. Many of its residents are refugees from a particularly high prevalence of diabetic retinopathy in this area of the West Bank. 25 major operation was undertaken at the clinic during the year.

4

St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

Our Hebron Hospital is a vital source of eye care in an area that is particularly affected by the movement restrictions in the West Bank. The hospital provides sight-saving treatments such as cataract and laser eye surgery to treat diabetic retinopathy, and serves the 640,000 people who live in and around Hebron, including the semi-nomadic Bedouins.

Our Hospital treated over 13,000 patients in 2023, including performing almost 600 major operations.

The cost of the ongoing operations of the Company in Gaza and the West Bank amounted to £3.9m (2022, £2.8m) including an impairment loss provision of £1.4m, while total patient and voluntary income amounted to £3.7m (2022, £3.6m). The overall net movement in funds was a deficit of £696k (2022, £0.8m surplus) including exchange losses of £501k. The principal component of operating costs (excluding the impairment loss) relates to personnel; 55% (2022, 53%). The Company remains heavily dependent on voluntary income which, in the main, is obtained as a result of the fundraising efforts of other Group companies.

Reserves

At 31 December 2023, reserves totalled £4,519k including restricted funds of £920k leaving £3,599k unrestricted (comprising £2,592k in tangible fixed assets and £1,007k in net current assets). The Trustees review annually the need for reserves in line with the guidance issued by the Charity Commission. In undertaking this review, the Trustees take into account general reserves available elsewhere in the Group. The Trustees recognise the need to maintain, as the circumstances allow, the level of general reserves within the Company to ensure that it

can continue to run efficiently with adequate working capital. This is intended to be achieved through a renewed focus on cost-cutting, revenue generation, the introduction of new sources of revenue, and enhanced fundraising activities to ensure financial resilience and sustainability for the future. Thus, unrestricted reserves need to be maintained to equate to at least nine months running costs (equivalent to £1.1m).

Principal Risks & Uncertainties

A comprehensive risk management policy is in place along with a risk register of all clinical, operational, financial, external, political and governance risks. The risk register is continuously reviewed by the relevant committees with particular focus on residual risks.

A key risk which SJJEH faces continues to be financial, in particular by the impact, most recently, of the unstable political situation within the Occupied Palestinian Territories. The position has been exacerbated by Brexit and the impact of the continuing reduction in value of Sterling against the Israeli Shekel, by changes to the statutory level of minimum wages and the increased levels of inflation. SJJEH relies heavily on voluntary income received mainly from donors in the Middle East, Europe, the United Kingdom and the United States. In the current global financial situation, it remains a great challenge to continue to attract core funding from existing and new sources. The fundraising strategy includes a focus on endowment and legacy giving in order to mitigate this risk as well as a focus on major gifts for core costs.

Liquidity is a recurring issue, especially with the prolonged payment pattern of the Palestinian Authority for its working capital needs. SJJEH therefore sets aside a portion of the investment

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St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

portfolio as a cash deposit, in order to ensure meeting the working capital needs.

International currency exchange movements are an additional risk. It should be recognised that exchange gains do not represent realisable income which are capable of being utilised by SJJEH, as they largely reflect the translation into Sterling of the Israeli Shekel value of the Hospital premises.

Operationally, patient and staff access to Jerusalem is crucial to the continuation of our ability to provide eye care services in the occupied Palestinian territories. Working in a volatile region has inherent risks. Gaza has its own risks. As is currently experienced and since October 7[th] 2023, the situation could escalate at any time as instability and strife continues to affect the neighbouring countries, a particular current concern.

that SJJEH can maintain sufficient liquidity over the period to December 2025 maintaining a balance between supporting the activity that is crucial to delivering the objects of the charity, whilst ensuring the long-term financial sustainability of SJJEH.

Further details of the above are set out in Note 1 to the Financial Statements.

Having assessed the combination of all these various matters, and a written agreement from the Group to provide such financial support as is required to enable the Company to fulfil all of its obligations as they fall due, the Board of Trustees have a reasonable current expectation that SJJEH has adequate resources to continue in operational existence for the period to December 2025, being a period of at least 12 months from the date of approval of the financial statements. For these reasons, the Board of Trustees have adopted the going concern basis of accounting in the preparation of the financial statements.

Going concern

Fundraising Statement

The Trustees must satisfy themselves as to a minimum period of 12 months from the date of approval of the financial statements.

The Trustees have produced detailed, yet forecast and projected activity, the related financial budgets, cash flows and liquidity for the period to December 2025.

The Trustees have also considered in their assessment of going concern the impact of a challenging, yet reasonably plausible, downside liquidity position. Under this scenario, SJJEH projects to have sufficient liquidity through the period to December 2025.

Nevertheless, the Trustees have sought to identify certain mitigating actions that could be implemented, in order to provide additional liquidity or reduce cash outflows, so as to ensure

SJJEH as a charity with income over £1m is required to make a statement regarding its fundraising activities in accordance with the Charities Act 2016. Fundraising activities are carried out on behalf of SJJEH by our own inhouse fundraising staff and by volunteer fundraisers.

We do not consider volunteer fundraisers to be acting as legal representatives for the charity as we have not formally contracted them to fundraise on our behalf. Our small team of inhouse fundraising staff are fully trained on fundraising regulations and have been made aware of relevant policy procedures. We ensure that we protect vulnerable persons from unreasonable intrusion into their privacy, persistent approaches or undue pressure to give by using a personal approach to fundraising. We do not use professional fundraisers or commercial participators in any of our activities

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St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

and we are registered with the Fundraising Regulator. No complaints were received by SJJEH in relation to its fundraising during the relevant period and, after due enquiry, we are not aware of any breaches of the regulations of the Fundraising Regulator committed by SJJEH.

Remuneration policy

All roles within the Company are evaluated in order to determine where it fits on our pay scale. The salaries within the scale are determined by the market rates for an equivalent position. In exceptional cases, where the market information supports it, salaries may be above the top of the band. Each year, the payroll budget is reviewed, based on legislative, statutory and market changes, using a range of sources and taking account of affordability.

Nablus Hospital

Due to the continuous decline in the number of patients within our Anabta Clinic, the Board has approved a plan of relocating the Anabta Clinic and the establishment of a new day hospital in Nablus City. The total cost for this project is estimated at circa £3million including the cost to purchase the property. The project is to be funded by The Priory in the USA of The Order of St John, Mr. David Pyott, The Australian Department of Foreign Affairs and Trade (DFAT), and the Group's general reserves estimated at £1.2million. The project is expected to be completed by the end of 2024.

Management consult with the finance, payroll and renumeration, and HR committees of the Board, and a pay review proposal is submitted to the Board who makes the decision on the proposal.

Gaza Hospital

Management has developed an Emergency Medical Response Plan which comprises the following phases:

• Phase one (3-6 months): Primary eye care and basic public health interventions

• Phase two (6-9 months) : Medical intervention phase- focuses on treatment of eye complications related to diabetes mainly.

Great emphasis continues to be placed covering risk management - clinically, operationally and financially.

The Clinical Governance Committee continues its regular review of all medical and nursing policies and protocols in addition to instigating and reviewing clinical audits and investigating clinical complications and 'near misses'.

The Board engages independent firms of accountants to carry out internal audit programmes on the financial controls in operation within the C s activities.

• Phase three (12 months): Rehabilitation of the Hospital and the provision of surgical services.

This Plan will be actioned as soon as it is possible and safe to recommence operations in Gaza. There is no guarantee as to if or when this can take place.

Finance

Unfortunately, we are operating in a politically volatile time and this has severely impacted our finances in the past few years. The unrest within the region and the shift in the international focus

7

St. John of Jerusalem Eye Hospital Trustees Report For the year ended 31 December 2023

has affected the level of donations received by the Hospital.

The Trustees have given due regard to the Charity Commission's General Guidance on public benefit when planning the charity's activities.

Our Annual Report sets out our activities, achievements and performance during the year, which are directly related to the objects and purposes for which SJJEH exists. SJJEH achieves its principal objectives through the delivery of services to members of the public in the West Bank and Gaza without regard for any distinction by race, class or religion.

• the exemption from charge when the relevant authority does not finance the treatment and the patient is unable to pay all or part themselves;

• the teaching and training activities at the Hospitals which enhance the quality of service delivered and also increase the pool of qualified ophthalmologists, specialist nurses and allied healthcare professionals within the region;

• the research activities into endemic diseases affecting the Palestinian population; and our services enhance education and employment prospects and contribute to economic growth.

The Trustees Report on pages 2 to 8 was approved by the Trustees and signed on their behalf by:

The Public Benefit from SJJEH activities is:

Sir Andrew Cash

• the provision and development of clinical and surgical ophthalmic services to patients at the Hebron & Gaza Hospitals and the clinic in Anabta;

Chairman, Board of Trustees, St. John of Jerusalem Eye Hospital Company No. 3867950 Date: 13.08.2024

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St. John of Jerusalem Eye Hospital Statement of Trustees Responsibilities For the year ended 31 December 2023

The Trustees (who are also directors of St. John of Jerusalem Eye Hospital for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and regulation.

Company law requires the Trustees to prepare financial statements for each financial year. Under that law the Trustees have prepared the financial statements in accordance with United Kingdom Accounting Standards, comprising FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland”, and applicable law (United Kingdom Generally Accepted Accounting Practice).

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 the affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company 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 in the Statement of Recommended Practice: Accounting and Reporting by Charities;

make judgments and estimates that are reasonable and prudent;

° state whether FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland has been followed, subject to any material departures disclosed and explained in the financial statements; and

prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.

transactions and disclose with reasonable accuracy at any time the financial position of the charitable company 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 charitable company 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 charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

In so far as the Trustees are aware at the time of approving our Trustees’ Annual Report: (a) there is no relevant audit information of which the company’s auditors are unaware; and (b) the Trustees have taken all the steps that they ought to have taken as Trustees in order to make themselves aware of any relevant audit information and to establish that the company’s auditors are aware of that information.

The Trustees’ (Directors’ ) report has been prepared in accordance with the special provisions relating to small companies within Part 15 of the Companies Act 2006. The Trustees , Report on pages 2 to 8 was approved by the Trustees and signed on their behalf by:

Sir Andrew Cash

Chairman, Board of Trustees, St. John of Jerusalem Eye Hospital Company No. 3867950 Date: 13.08.2024

The Trustees are responsible for keeping adequate accounting records that are sufficient

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Independent A Report to the Members of St. John of Jerusalem Eye Hospital

Opinion

give a true and fair view of the state of the affairs as at 31 December 2023 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended;

have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards, including Reporting Standard applicable in the UK and

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

We have audited the financial statements, included within the Annual Report and Financial Statements, which comprise: the balance sheet as at 31 December 2023; the statement of financial activities and the income and expenditure account for the year then ended; and the notes to the financial statements, which include a description of the significant accounting policies.

Basis for opinion

We conducted our audit in accordance with under ISAs (UK) are further described in the financial statements section of our report. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Independence

We remained independent of the company in accordance with the ethical requirements that are relevant to our audit of the financial statements in and we have fulfilled our other ethical responsibilities in accordance with these requirements.

Conclusions relating to going concern

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 a period of at least twelve months from the date on

which the financial statements are authorised for issue.

In auditing the financial statements, we have basis of accounting in the preparation of the financial statements is appropriate.

However, because not all future events or conditions can be predicted, this conclusion is not a guarantee concern.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Reporting on other information

The other information comprises all of the information in the Annual Report and Financial Statements other than the financial statements and responsible for the other information. Our opinion on the financial statements does not cover the other information and, accordingly, we do not express an audit opinion or, except to the extent otherwise explicitly stated in this report, any form of assurance thereon.

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit, or otherwise appears to be materially misstated. If we identify an apparent material inconsistency or material misstatement, we are required to perform procedures to conclude whether there is a material misstatement of the financial statements or a material misstatement of the other information. 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 based on these responsibilities.

considered whether the disclosures required by the Companies Act 2006 and Charities Act 2011 have been included.

Based on our work undertaken in the course of the audit, the Companies Act 2006 requires us also to report certain opinions and matters as described below.

Report

In our opinion, based on work undertaken in the course of the audit, the information given in the

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Independent A Report to the Members of St. John of Jerusalem Eye Hospital

2023 is consistent with the financial statements and has been prepared in accordance with applicable legal requirements.

In light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we did not identify any material

Responsibilities for the financial statements and the audit

Responsibilities of the trustees for the financial statements

Responsibilities, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements in accordance with the applicable framework and for being satisfied that they give a true and fair view. The trustees are also responsible for such internal control as they 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 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 company or to cease operations, or have no realistic alternative but to do so.

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 includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of noncompliance 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.

Based on our understanding of the company and the environment in which it operates, we identified that the principal risks of non-compliance with laws and regulations related to the Companies Act 2006 and the Charities Act 2011 and relevant regulations made or having an effect thereunder, and we considered the extent to which non-compliance might have a material effect on the financial statements. We also considered the direct impact of these laws and regulations on the financial statements. We evaluated ma opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to posting of inappropriate journal entries to conceal misappropriation of assets or manipulate financial results. Audit procedures performed by the engagement team included:

Testing journal entries where we identified particular fraud risk criteria.

Obtaining independent confirmations of cash balances at the year end.

Testing estimates and judgements made in the preparation of the financial statements for indicators of bias.

Reviewing meeting minutes, and significant contracts and agreements.

Holding discussions with the trustees and management to identify significant or unusual transactions and known or suspected instances of fraud or non-compliance with laws and regulations.

Assessing financial statement disclosures, and agreeing these to supporting evidence, for compliance with applicable laws and regulations.

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

A further description of our responsibilities for the audit of the financial statements is located on the website at: www.frc.org.uk/auditorsresponsibilities. This

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IndependentAuditor5' Report to the Members of St. John of Jerusalem Eye Hospital Use of this report This report, including the opinions, has been prepared for and only for the companls members as a body in accordance with Chapter 3 of Part 16 of the Companies Act 2006 and for no other purpose. We do not, in giving these opinions, accept or assume r&8poThsil)ility for any other purpose or to any other person to whom this report is shown or into whose hands it may comc save where expressly agreed by our prior consent in writing. Other required reporting Under the Companies Act 2006 we are required to report to you if, in our opinion: we havc not obtained all the inforniation and explanations we require for our audit" or adequate accounting records have not been kept by the company, or returns adequate for our audit have not been re￿iVed from branches not visited by us. or Certain disclosures trustees. remuneration qpecified by law are not made. or the company financial statements are not in agreement with the accounting records and returns. We have no exceptions to report arising from this responsibllity. Entitlement to exemptions Under the Companies Act 2006 we are required to report to you if, in our opinion, the trustees were nol entitled to.. take advantage of the small companies, exemption in preparing the Annual Report,. and take advantage of the small companies exemption from preparing a Strategic Report, We have no exceptions to report arising from this responsibility. Andrew Lowe (Senior Statutory Auditor) For and on behalf of Pricewaterhousecoopers LLP Chartered Accountants and Statutory Auditors London Date: 131sl1+ 12

St. John of Jerusalem Eye Hospital Statement of Financial Activities For the year ended 31 December 2023

----- Start of picture text -----
Unrestricted Restricted Total Total
Funds Funds Funds Funds
2023 2023 2023 2022
Notes £'000 £'000 £'000 £'000
Income
Income from donations and legacies 3 37 2,208 2,245 1,586
Income from charitable activities 4 1,486 - 1,486 2,060
Total income 1,523 2,208 3,731 3,646
Expenditure
Expenditure on charitable activities (2,609) (1,300) (3,909) (2,738)
-
Other expenditure (17) (17) (17)
Total expenditure 5 (2,626) (1,300) (3,926) (2,755)
Net (expenditure) / income (1,103) 908 (195) 891
Transfers between funds 10,11 178 (178) - -
-
Exchange (losses) on overseas activities (501) (501) (89)
Net Movement in Funds (1,426) 730 (696) 802
Fund balances brought forward at 1 January 5,025 190 5,215 4,413
Fund balances carried forward at 31 December 12 3,599 920 4,519 5,215
----- End of picture text -----

All gains and losses recognised in the year are included in the Statement of Financial Activities. All of the above results are derived from continuing activities.

Income and Expenditure Account for the year ended 31 December 2023

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |£'000|£'000| |Income|3,731|3,646| |Expenditure|(3,926)|(2,755)| |Net (expenditure) / income|(195)|891|

----- End of picture text -----

The income and expenditure account excludes the exchange losses and gains on overseas operations shown in the Statement of Financial Activities.

The accounting policies and the notes on pages 15 to 23 form part of these financial statements.

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St. John of Jerusalem Eye Hospital Company 3867950 Balance Sheet as at 31 December 2023

Note	2023	2022
	£'000 £'000
Fixed Assets Tangible assets 7		2,592 2,529
Total Fixed Assets		2,592 2,529
Current Assets Stocks Debtors 8 Cash at bank and in hand		- 71 2,704 2,994 2,500 1,769
Total Current Assets Creditors: Amounts falling due within one year 9 Net Current Assets		5,204 4,834 (3,277) (2,148) 1,927 2,686
Total Assets Less Current Liabilities		4,519 5,215
Net Assets		4,519 5,215
The Funds of the Charity Restricted income funds 10 Unrestricted income funds 11		920 190 3,599 5,025
Total Charity Funds 12		4,519 5,215

The accounting policies and the notes on pages 15 to 23 form part of these financial statements.

The financial statements on pages 13 to 23 were approved by the Trustees and signed on their behalf by:

Sir Andrew Cash Chairman, Board of Trustees

Christopher Hoult Treasurer

Date:

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St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

1 Principal accounting policies

a Basis of preparation

The financial statements of St. John of Jerusalem Eye Hospital ( the "Charity" or the "Company") have been prepared on the going concern basis, under the historical cost convention, with items recognised at cost or transaction value unless otherwise stated in the relevant note(s) to these financial statements. The financial statements have been prepared in accordance with the Statement of Recommended Practice: Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102) and the Companies Act 2006.

The Company's objects are the relief of sickness and the preservation and protection of health, in particular, but not exclusively, by maintenance and development of St. John Eye Hospital in the Occupied Palestinian Territories or elsewhere and the clinical, teaching and research activities connected therewith.

The ultimate parent undertaking and controlling party is St. John of Jerusalem Eye Hospital Group (the "Group"), a company incorporated in the United Kingdom under registration number 7355619. It is registered as a charity under the number 1139527 and has a registered Office at 4 Charterhouse Mews, London, EC1M 6BB. St. John of Jerusalem Eye Hospital Group is the parent undertaking of the largest group of undertakings to consolidate these financial statements at 31 December 2023. The consolidated financial statements of St. John of Jerusalem Eye Hospital Group are available from 4 Charterhouse Mews, London, EC1M 6BB.

Going Concern

BACKGROUND

In assessing the going concern position of the Charity, the Trustees have produced detailed, yet adaptable, business plans that consider the forecast and projected activities, the related financial budgets, cash flows and liquidity for the period to December 2025, which is a period of at least 12 months from the date of approval of the financial statements.

This assessment period was selected as it aligns to the financial year end, is consistent with its budgeting process and timelines and is a period of at least 12 months from the date of approval of the financial statements.

Based on the cash flow projections, the Trustees have adopted the going concern basis of accounting in preparing these financial statements.

KEY ASSUMPTIONS

The business and financial plans incorporate the following key assumptions:

Demand for services from patients and the capacity and supply of patient services by the Charity is budgeted for 60% of normal levels of activity due to the current unstable political situation in the region. Gaza is assumed to be out of commission during 2024.

SENSITIVITY ANALYSIS

The Trustees have considered the impact on forecast and projected activities, budgets, cash flows and liquidity of a challenging, yet reasonably plausible, downside scenario (sensitivity analysis) such that the key assumptions are not met, or able to be met, in whole or in part. This comprises:

Under this scenario, the Charity projects to have sufficient liquidity through the period to December 2025, without needing to implement mitigating actions.

Nevertheless, the Trustees have sought to identify certain mitigating actions that could be implemented, in order to provide additional liquidity or reduce cash outflows, so as to ensure that the Charity can maintain sufficient liquidity over the period to December 2025.

CONCLUSIONS

Having assessed the combination of all these various matters, and a written agreement from the Group to provide such financial support as is required to enable the Company to fulfil all of its obligations as they fall due, the Trustee Board has a reasonable current expectation that the Charity has adequate resources to continue in operational existence for the period to December 2025, being a period of at least 12 months from the date of approval of the financial statements.

For these reasons, the Trustee Board has adopted the going concern basis of accounting in the preparation of these financial statements. Accordingly, these financial statements do not include any adjustments to the carrying amount or classification of assets and liabilities that would result if the Charity were unable to continue as a going concern.

15

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

b Foreign currencies

The Charity's functional and presentational currency is pounds sterling. Transactions in foreign currencies are recorded at the exchange rate ruling at the date of the transaction. Monetary assets and liabilities at the year end are translated at the rate ruling at the balance sheet date. Results of overseas operations are translated at the average rate for the period and their assets and liabilities at the balance sheet rate. All exchange differences are dealt with in the Statement of Financial Activities. Exchange differences on the translation of the assets and liabilities of overseas operations are included as other recognised gains and losses. All other exchange differences are included as incoming resources or resources expended as appropriate. The exchange rate of the Pounds Sterling to the Israeli Shekel at 2023 year-end was 4.6209 (2022, 4.2376), while the average rate for 2023 was 4.5856 (2022, 4.15).

c Income recognition

Donations and other income are recognised in the financial statements on a receivable basis. Grants are recognised when the entitlement to the grant is confirmed. Legacies are recognised when the entitlement arises, being the earlier of the Charity being notified of the impending distribution or the legacy being received.Donations in kind are recorded as income when the resources are received and recorded at fair value. Income from charitable activities is accounted for when earned i.e. the service is provided to patients. Subsidies and exemptions in respect of medical services provided without charge are shown as a deduction from gross income.

d Volunteers

The value of services rendered by medical volunteers is not recognised in these financial statements

e Resources expended and basis of allocation of costs

Resources expended are accounted for on an accruals basis and have been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with use of resources. The irrecoverable value added tax is included with the item of expense to which it relates.

f Expenditure on charitable activities

These represent the costs of providing the medical and training services of the hospital and its clinics including both direct expenditure and the associated support costs.

g Governance costs

These comprise costs attributable to the overall management of the Charity's affairs and compliance with constitutional and statutory requirements.

h Cash flow statement exemption

The Charity has taken advantage of the exemption in FRS 102 from preparing a statement of cash flows, on the basis that it is a qualifying entity.

i Rentals

The costs in respect of rentals are charged to the Statement of Financial Activities on a straight line basis over the contract period.

j Liquid resources

Liquid resources are cash, time deposits, and certificates of deposit, in addition to cash at bank and in hand held in current accounts with UK and Palestinian Banks.

16

1 Principal accounting policies (continued)

k Pension and other end of service costs

The amount charged in the Statement of Financial Activities in respect of pension costs is the contributions payable in the year on an accruals basis in respect of defined contribution and money purchase pension arrangements. Other end of service benefits are accrued as earned on an undiscounted basis.

l Taxation

The Charity is entitled to certain tax exemptions on income and gains from investments, and surpluses on any trading activities carried on in furtherance of its primary objectives, if these gains and surpluses are applied solely for charitable purposes.

m Tangible assets and depreciation

Cost of tangible assets includes the original purchase price of the asset and the costs attributable to bringing the asset to its working condition for its intended use.

Donated fixed assets are brought into account at an estimate of their market value at the time of acquisition and, thereafter, depreciated on the bases set out below. The costs of minor additions to fixed assets under £500 are expensed in the year in which they are incurred. Impairment reviews are carried out if there is an indication that the recoverable amount of an asset is below its net book value.

Depreciation on fixed assets is provided at rates estimated to write off the cost, less estimated residual value of each asset, over its expected useful life on a straight line basis, as follows:

Buildings	- 2.5% per annum
Building improvements	- 10% per annum
Medical equipment	- 15% per annum
Motor vehicles	- 20% per annum
Other equipment	- 20% per annum
Fixtures and fittings	- 6% per annum
Computer equipment	- 33% per annum
The carrying values and	estimated useful lives of assets are regularly reviewed for impairment and, where deemed appropriate, are
written down.

On disposal of an item of tangible assets, the difference between the disposal proceeds and its carrying amount is recognised in other hospital income in note 4.

n Funds

Restricted funds are funds which are subject to specific conditions imposed by the donors. Unrestricted funds are generally available for the Charity to carry out its charitable objectives.

General reserves are unrestricted funds available to be used at the discretion of the Board of Trustees for the furtherance of the charitable objectives of the Charity and which have not been designated for any other purpose.

Transfers between funds represent tangible assets purchased with restricted donations and used for hospital operations.

o Stocks

Stocks comprise hospital medical stores and supplies stated at the lower of cost or net realisable value using the FIFO method.

p Estimates and assumptions

The preparation of the financial statements in conformity with generally accepted accounting principles requires the use of estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of income and expenditure during the reporting period. Although these amounts are based on Trustees' best estimates of the amount, events or actions may mean that actual results ultimately differ from those estimates, and these differences may be material. The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the change takes place 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.

Exchange rates are fundamental to the uncertainties. Mainly the impact of subsequent adverse movements between the exchange rates of the reporting and the operative currencies which would potentially affect, to some extent, the operating capability notwithstanding the enhanced but unrealisable balance sheet value of non UK fixed assets.

The Charity provides against receivables by making judgements based on experience regarding the level of provision required to account for potentially uncollectible receivables.

17

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

As at 31 December 2023, the Company has accounted for an impairment loss provision of £1,362k covering the hospital building, medical and other equipment and inventory in the Gaza branch. The war in Gaza started on the 7th October 2023, when Hamas militants attacked southern parts of Israel. The Israeli military responded with massive air strikes on almost all parts of the Gaza Strip which was later followed by a land incursion on northern and southern parts of the Strip. Gaza staff were given clear orders by the Israeli authorities to evacuate the hospital on the second day of the war and, since then, the hospital has not been functional and the war continues. Although the hospital building was not directly struck, it has sustained some considerable collateral damage as a result of the hostilities. Gaza staff have not yet been able to return to the hospital to carry out a proper assessment of the damage to the building, furniture and equipment. However, based on reports and photos received, much of the furniture and equipment and inventory have either been damaged or removed. Accordingly, the Company has recorded a full 100% impairment loss provision against the net book value of these assets. As the building has remained to be one of the few standing buildings in the neighbourhood, the Trustees believe that the building still has an intrinsic value. However, it is clear, and after taking professional advice, based on a value in use basis assessment that an impairment loss provision should be recorded, and this has been accounted for at 90% of the net book value of the asset.

2 Legal status of the Charity

The Charity is a company limited by guarantee and has no share capital (Company No.3867950 and Charity No. 1080185) and has a registered Office at 4 Charterhouse Mews, London, EC1M 6BB. The liability of each member in the event of winding up is limited to £10.

The Company owns two £1 shares being all the issued shares in The St. John of Jerusalem Eye Hospital (Palestine) Limited (company number: 6365210), which has not traded since incorporation.

3	Income from donations and legacies	Unrestricted	Restricted 2023 Unrestricted	Restricted	2022
		£'000	£'000 £'000 £'000	£'000	£'000
	Donations Donations in kind	23 14	2,208 2,231 1 - 14 56	1,529 -	1,530 56
		37	2,208 2,245 57	1,529	1,586

18

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

----- Start of picture text -----
Income from charitable activities 2023 2022
£'000 £'000
Total Total
Outpatient income 885 1,162
Surgical income 922 1,402
Less: Patient Relief (325) (506)
Net Patient Related Income 1,482 2,058
Other Hospital income 4 2
1,486 2,060
----- End of picture text -----

4 Income from charitable activities

Patient Relief represents subsidies and exemptions to cover the value of medical services rendered when payment is waived by the Company where funding is not available from the relevant authorities and where the patients are unable to pay any balance owing. All of the above income comprises unrestricted funds.

5 Total expenditure a Resources expended

----- Start of picture text -----
|||||||| |---|---|---|---|---|---|---| |Costs of|Costs of| |charitable|charitable|Governance|Governance| |activities|activities|Costs|Costs|Total|Total| |2023|2022|2023|2022|2023|2022| |£'000|£'000|£'000|£'000|£'000|£'000| |Personnel costs (note 6)|1,406|1,465|-|-|1,406|1,465| |Medical costs|651|748|-|-|651|748| |Establishment costs|128|153|-|-|128|153| |Depreciation (note 7)|234|324|-|-|234|324| |Impairment|1,362|-|-|-|1,362|-| |Office expenses|27|26|-|-|27|26| |Travel and subsistence|16|19|-|-|16|19| |Auditors' remuneration|8|-|17|17|25|17| |Other professional fees|68|70|-|-|68|70| |Other costs|29|47|-|-|29|47| |Finance costs|4|3|-|-|4|3| |-|-| |Foreign exchange differences|(24)|(117)|(24)|(117)| |3,909|2,738|17|17|3,926|2,755| |Support costs included above|139|66|-|-|139|66|

----- End of picture text -----

Total resources expended in 2022 of £2,755,000 comprise £1,659,000 for unrestricted funds and £1,096,000 for restricted funds. The impairment loss comprises of £1,284k against tangible fixed assets in Gaza and £78k against the inventory balance prior the war.

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |Support costs comprise:|£'000|£'000| |Personnel costs|45|45| |Establishment costs|64|77| |Depreciation|23|32| |Office expenses|27|26| |Finance costs|4|3| |Foreign exchange differences|(24)|(117)| |139|66|

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19

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

5 Total resources expended (continued)

----- Start of picture text -----
||||| |---|---|---|---| |2023|2022| |b|Auditors' remuneration (excluding value added tax):|£|£| |External Audit|14,263|14,287| |-| |Other services provided by external auditors|7,231| |21,494|14,287|

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6 Employee information

a Staff numbers

The average monthly number of employees, including part time staff calculated on a full-time equivalent basis, analysed by function was:

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |Number|Number| |Medical and nursing|57|58| |Support services|16|13| |Administration|5|4| |78|75| |Staff costs| |2023|2022| |£'000|£'000| |Wages and salaries|1,346|1,406| |Pension costs|59|60| |Other related costs - net|1|(1)| |1,406|1,465|

----- End of picture text -----

b Staff costs

c Emoluments of employees

The number of employees whose emoluments (salaries and benefits in kind) fell within the following bands were:

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |Number|Number| |£60,001 - £70,000|1|-|

----- End of picture text -----

d Remuneration received by key management personnel

This represents salaries and other benefits received by senior management personnel within their course of employment in managing the daily operations of the Charity. The amount received by 3 staff members (2022: 3) amounted to £144,000 (2022: £148,000).

20

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

----- Start of picture text -----
7 Tangible assets
Buildings & Medical Other
Improvements Equipment Assets Total
Cost £'000 £'000 £'000 £'000
Balance at 1st January 2023 2,376 3,891 552 6,819
Additions 1,573 222 13 1,808
Exchange differences (209) (324) (46) (579)
Balance at 31st December 2023 3,740 3,789 519 8,048
Accumulated Depreciation
Balance at 1st January 2023 462 3,418 410 4,290
Charge for the year 59 146 29 234
Impairment 837 371 76 1,284
Exchange differences (38) (281) (33) (352)
Balance at 31st December 2023 1,320 3,654 482 5,456
Net Book Value
At 31st December 2023 2,420 135 37 2,592
At 31st December 2022 1,914 473 142 2,529
----- End of picture text -----

Other Assets comprise furniture and fixtures, vehicles, and office equipment. The impairment loss of £1,284 k against tangible fixed assets includes 89% loss provision against the building, and 100% loss provision against medical and other equipment.

8 Debtors

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |Amounts falling due within one year|£'000|£'000| |Trade debtors|307|80| |Prepayments and accrued income|20|19| |Intercompany balance|2,377|2,895| |2,704|2,994|

----- End of picture text -----

Intercompany balance includes cash advances and transfers to the Israeli entity (Amuta) from the Charity.

9 Creditors

----- Start of picture text -----
|||| |---|---|---| |Amounts falling due within one year|2023|2022| |£'000|£'000| |Trade creditors|1,302|162| |Taxation and social security|4|4| |Accruals|352|387| |Retirement benefits|1,619|1,594| |Holiday pay accrual|-|1| |3,277|2,148|

----- End of picture text -----

Accrued retirement benefits mainly represent amounts payable in line with relevant law when staff leave the employment of the Company. Such amounts are accrued when earned, based on current monthly salaries and periods of service. Also included in the balance are provident schemes.

21

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

10 Restricted income funds

----- Start of picture text -----
Purchase of
At 1st Incoming Costs of Tangible At 31
January Resources charitable Fixed December
2023 activities Assets 2023
£'000 £'000 £'000 £'000 £'000
QFFD Fund - 668 (255) (178) 235
Johanniter (JIA) Fund - 187 (15) - 172
ESCRS Fund 70 89 (159) - -
IMC / USAID Fund - 53 (53) - -
BMZ Fund 117 421 (538) - -
Orcam Fund - 6 (6) - -
Fred Hollows Foundation Fund - 269 (269) - -
USA Priory Fund - 513 - - 513
Gaza Emergency Appeal Fund - 1 (1) - -
Poor Patient Fund 3 1 (4) - -
190 2,208 (1,300) (178) 920
----- End of picture text -----

----- Start of picture text -----
||||||| |---|---|---|---|---|---| |Purchase of| |At 1st|Incoming|Costs of|Tangible|At 31| |January|Resources|charitable|Fixed|December| |2022|activities|Assets|2022| |£'000|£'000|£'000|£'000|£'000| |Arab Fund|-|83|(83)|-|-| |Johanniter International Assistance -JIA Fund|-|434|(434)|-|-| |ESCRS Fund|-|70|-|-|70| |Capital Funds|-|246|-|(246)|-| |IMC / USAID Fund|-|109|(109)|-|-| |BMZ Fund|-|583|(466)|-|117| |SOA|-|3|(3)|-|-| |Poor Patient Fund|3|1|(1)|-|3| |3|1,529|(1,096)|(246)|190| |Qatar Fund For Development (QFFD) contributed towards performing surgeries in Gaza Hospital including the purchase of medical supplies| |and equipment needed for operations.| |Johanniter International Assistance -JIA Fund contributed towards the purchase of medical supplies and equipment.| |ESCRS Fund: The European Society of Cataract and Refractive Surgeons contributed towards the performance of cataract surgeries.| |IMC /USAID Fund contributed towards expanding the level of operations within the Gaza branch especially for needy patients| |BMZ Fund project contributed towards expanding the level of operations within the Gaza branch through the introduction of a Diabetic Retinopathy|

----- End of picture text -----

Qatar Fund For Development (QFFD) contributed towards performing surgeries in Gaza Hospital including the purchase of medical supplies and equipment needed for operations.

ESCRS Fund: The European Society of Cataract and Refractive Surgeons contributed towards the performance of cataract surgeries. IMC /USAID Fund contributed towards expanding the level of operations within the Gaza branch especially for needy patients BMZ Fund project contributed towards expanding the level of operations within the Gaza branch through the introduction of a Diabetic Retinopathy screening and epidemiological research components,

Poor Patient Fund contributed towards the treatment costs of needy patients.

Fred Hollows Foundation Fund: contributed towards expanding the level of services within Gaza.

USA Priory Fund: contributed towards establishing and equipping a new hospital in Nablus. Orcam Fund contributed towards assisting visually impaired patients.

Gaza Emergency Appeal Fund contributed towards ensuring the continuity of services within the charity.

11 Unrestricted income funds

----- Start of picture text -----
|||| |---|---|---| |2023|2022| |£'000|£'000| |Opening balance|5,025|4,410| |Net movement in funds excluding transfers|(1,604)|369| |Transfer from restricted funds|178|246| |Total Unrestricted Funds|3,599|5,025|

----- End of picture text -----

Transfers represent amounts released from restricted funds for the purchase of tangible assets. Unrestricted Funds includes designated fixed asset funds of £2,592k (2022: £2,529k)

12 Total charity funds

----- Start of picture text -----
|||||||| |---|---|---|---|---|---|---| |Unrestricted|Unrestricted|Restricted|Restricted|Total|Total| |Funds|Funds|Funds|Funds|Funds|Funds| |Analysis by type of asset and liability|2023|2022|2023|2022|2023|2022| |£'000|£'000|£'000|£'000|£'000|£'000| |Tangible assets|2,592|2,529|-|-|2,592|2,529| |Net current assets|1,007|2,496|920|190|1,927|2,686| |3,599|5,025|920|190|4,519|5,215|

----- End of picture text -----

22

St. John of Jerusalem Eye Hospital Notes to the Financial Statements For the year ended 31 December 2023

13 Trustees' remuneration

The Trustees receive no remuneration.

All expenses incurred by the Trustees were paid by the parent charitable company.

14 Financial Instruments

The Company has taken advantage of the exemption which is available under FRS 102 1.12 ( c), (relating to sections 11 and 12 of the standard) as a wholly owned subsidiary not to disclose the following:

• . Categories of financial instruments

• . Items of income, expenses, gains or losses relating to financial instruments, and

• . Exposure to and management of financial risks

• . Full disclosure in relation to financial instruments is available in the consolidated financial statements of St. John of Jerusalem Eye Hospital Group.

15 Related parties transactions

The sole member of the Company, since 31 March 2011, is St. John of Jerusalem Eye Hospital Group, which appoints the Board of Directors/Trustees of the Company.

During the year, the Chairman of the Charity, Sir Andrew Cash, was also the chairman for St. John of Jerusalem Eye Hospital Group.

The Company owns two £1 shares being all the issued shares in The St. John of Jerusalem Eye Hospital (Palestine) Limited (company number: 6365210), which has not traded since incorporation.

16 Contractual & designated obligations

In 2023, the Board approved the plan of relocating the Anabta Clinic and the establishment of a new day hospital in Nablus City. The total cost for this project is estimated at circa £3m including the cost to purchase the property. The project is funded by The Priory in the USA of the Order of St John,Mr. David Pyott, The Australian Department of Foreign Affairs and Trade (DFAT), and the Group's general reserves estimated at £1.2m.The project is currently due to be completed by the end of 2024.

23