2020-09-30-accounts

ORCHID CANCER APPEAL annual report and fi nancial statements 2019–2020

Orchid Cancer Appeal

Registered Of fi ce 60 Gray’s Inn Road

About Orchid Cancer Appeal

Orchid Cancer Appeal, known as Orchid, is a small, in fl uential charity, solely dedicated to improving the lives of men of all ages who are at risk of, or affected by male cancer.

For over 20 years we have been working to save men’s lives from prostate, testicular and penile cancer through a range of support services, education and awareness campaigns, and a world-class research programme.

Registered of fi ce 60 Gray’s Inn Road London WC1X 8AQ

Tel [phone] www.orchid-cancer.co.uk

Registered in England with the Charity Commission No.1080540

Company Limited by Guarantee Registered in England No. 3963360

London WC1X 8AQ Board of Trustees Mr R Lane CBE Chair (deceased 8 February 2020) Mr CS Osborne Chair (appointed 10 March 2020) Mr W Cohen Treasurer (appointed 1 January 2020) Mr K Cook Treasurer (resigned 3 March 2020) Mr D Badenoch Mr PG Bracher Mr S Harris Mr M Kibblewhite (appointed 10 March 2020) Professor RTD Oliver Mr P Norman Mr S Seymour Mr N Watkin Chief Executive Miss RI Porta (resigned 23 April 2020) Mr A Orhan (appointed interim Chief Executive 24 April 2020 and as Chief Executive 8 January 2021) Auditor Moore Kingston Smith LLP Devonshire House 60 Goswell Road London EC1M 7AD

Accountants JS2 Limited 1 Crown Square Woking Surrey GU21 6HR

Legal advisors Farrer & Co 66 Lincoln’s Inn Fields London WC2A 3LH

Bankers HSBC Plc

Report designed by Andrassy Media

20 Electric Parade George Lane South Woodford London E18 2LX

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Annual report and nancial statements 2019-2020

Contents

Welcome from our Chair 4 CEO’s letter 5 The year in review 6 The year in numbers 10 Fundraising 12 Our impact 16 Prostate cancer 18 Testicular cancer 22 Penile cancer 26 Research 30 The year ahead 32 Governance 36 Objects, operating context and activities 36 Structure, Governance and Management 37 Financial review 40 Formal statements 41 Auditor’s Report 45 Statement of fi nancial activities 45 Balance sheet 46 Statement of cash ows 47 fl Notes to the fi nancial statements 48

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Orchid Cancer Appeal

Welcome from our Chair

With the advent of the COVID-19 pandemic, and changes in senior personnel, this year was one of rapid, and unexpected change for Orchid to work through.

In February 2020, the whole organisation was deeply saddened by the sudden passing of our Chair, Robert Lane CBE. Robert had been with Orchid for twelve years, the last six as Chair, leading the organisation with his characteristic warmth and strength.

In March, I was asked to step into the role of Chair and Orchid were delighted to welcome back Mark Kibblewhite as a Trustee. The Board of Trustees came together to identify and explore new avenues and existing areas of business to help in our fi ght to help educate men and save lives, and I would like to thank them for their dedication and leadership this year.

Shortly after the UK entered full lockdown due to the pandemic, our CEO Rebecca Porta left for a new position after nine years of service to the organisation. This led the Board to appoint Ali Orhan as interim CEO from April 2020. Ali had been working with Orchid since 2017 and we felt his extensive knowledge of public health – with specialisms in cancer and sexual health – together with his senior management experience was exactly what Orchid required.

The Trustees worked closely with the new CEO to restructure Orchid and make the necessary changes to secure our future going forward. I would like to thank all our wonderful staff, volunteers, grant givers and supporters for their enduring support to Orchid at this time.

Colin Osborne MBE

4 WELCOME FROM OUR CHAIR

Annual report and nancial statements 2019-2020

CEO’s letter

In April 2020, I was honoured to be appointed as the interim CEO at Orchid. I knew at the time it would be a huge challenge as the UK was in full lockdown due to the pandemic.

In the COVID-19 environment there were critical decisions to be made and actions to be taken from a very basic level of operation such as reassessing contracts with service providers, to ensuring the safety of staff and supporters by changing the way we did business, to making strategic fundraising decisions and applying for vital grants to ensure Orchid’s survival.

I am pleased to say that the whole of the organisation responded to this testing time with creativity and positivity and there were many highlights including:

• Changing the London Marathon into a virtual marathon team, raising £10,000

• Rapidly adapting our outreach work in communities to be COVID-19 safe, so that information packs were in sealed packs and letter box drops were carried out to avoid any virus transmission

• Progressing on a substantial National Lottery Community Fund grant application which gives us optimism for next year.

In addition, I am extremely proud to say that Orchid’s short fi lm on prostate cancer and its impact, Uncle Mike, won awards at Thundr Short Film Showcase in August 2020, as well as numerous mentions and commendations at other international fi lm festivals such as the Baltimore International Black Film Festival, London City Film Awards and the Edinburgh Independent Film Awards. This is a testament to the quality of the fi lm and the story, and enables Orchid’s messages to reach an international audience.

Reaching wider and more diverse audiences is something that I am passionate about, and I will be working tirelessly to make sure Orchid’s information and support becomes more inclusive and reaches new audiences. Not only will this help to promote our brand and protect more men, but it will also bring in new supporters and funders to perpetuate our work.

I would like to thank the Board of Trustees, staff and volunteers for their support and understanding as we navigated numerous challenges and demands whilst still keeping to our mission and plans

Ali Orhan, CEO

CEO’S LETTER 5

Orchid Cancer Appeal

The year in review

This page, left to right: Our Dare A Dad sponsorship campaign was one innovative response to fundraising activity moving online; One in Four was a creative way of raising prostate cancer awareness from the preCOVID-19 part of the year; while Each One Teach One – a virtual way of offering support, prompted by the pandemic – proved very popular with men

For almost the fi rst six months of the year, Orchid responded to low levels of male cancer awareness by reaching out into the heart of local communities to educate people about the signs, symptoms and risk factors of testicular, penile and prostate cancer.

We gave talks in workplaces and in prison, had information stands in libraries and at community events, showed fi lms to community groups with question-and-answer sessions, and delivered Male Cancer Roadshows in locations such as Bristol, Luton and Blackburn. We particularly targeted men in areas of deprivation where men are often less likely to engage with traditional health services.

When the COVID-19 pandemic hit, Orchid’s immediate response was to pause community outreach in line with Government guidance. At

the same time, we realised that our colleagues in the NHS may not be available to answer as many patient queries as normal regarding male cancer concerns, so we increased the hours of our freephone National Male Cancer Helpline. As we had expected, calls did increase, both in number and duration. The complexity of calls to the Helpline also increased at this point as it became dif fi cult for some people to access healthcare services.

We were concerned by reports of people not presenting to healthcare professionals with potential cancer symptoms, and our Nurse led services were reviewed and adapted in light of the changing external landscape so we could reach men safely with male cancer messages and offer support.

The peer support groups which Orchid help

6 THE YEAR IN REVIEW

Annual report and nancial statements 2019-2020

Above: We launched our award-winning short fi lm Uncle Mike which tells the story of a young man and his mentor, and the impact of prostate cancer on their relationship Above right: Check.Check.Check. was our social media-based campaign for Male Cancer Awareness Week

to facilitate moved to meet virtually. This proved popular with those attending, and the fi rst online penile cancer forum delivered via Zoom attracted men from as far a fi eld as Nottingham, Birmingham, London and Scotland.

Our social media activity also increased. Our annual Male Cancer Awareness Week in September was at the height of the pandemic, so the decision to deliver a predominantly digital campaign proved timely. The campaign delivered a series of daily messages via social media about seeking medical advice if potential male cancer symptoms were present, with a call to action for men to “Check.Check.Check.”

Unable to give talks and presentations face to face, we developed a presentation about each of the male-speci fi c cancers which could be delivered virtually. As our staff worked from home for much

of the second part of the year and were not always able to respond as quickly as we would like to requests for information, we also improved the information found on our website. This included making sure that all of our information was easily downloadable to avoid any delay for people who wanted our specialist information.

Working in partnership has remained a key objective despite COVID-19, and we have continued to work with other groups to improve patient outcomes. We were particularly delighted to be invited to take part in the European Reference Network (eUROGEN) and European Patient Advocacy Groups (ePAG) meetings, to improve the patient pathway for men with penile cancer across Europe. This has included the recruitment and empowerment of two men with penile cancer, who have been supported by Orchid to become patient

THE YEAR IN REVIEW 7

Orchid Cancer Appeal

Above, left to right: We launched Active Surveillance, our fi lm describing the bene fi ts of this treatment involving regular blood tests, physical examinations and MRI biopsies; an emergency grant from National Lottery Community Fund was a much needed boost for the charity as the pandemic started to take its toll.

representatives for ePAG in an ongoing programme which includes Orchid Nurse Rob Cornes.

A documentary about Orchid supporter Richard Stamp's experience of living with penile cancer aired on Channel 5 in August 2020, with a potential viewing audience of 6 million. The documentary, in which both Orchid and our Nurse Rob Cornes were represented, did so much to raise the pro fi le of penile cancer. A subsequent interview on ITV’s This Morning had a potential audience of 500,000, while a youtube clip of this video has been viewed by over 30,000 people. There was also coverage in the national press.

Alongside our Nurse-led services, Orchid continues to support world-class research. During 2019-20 we were pleased to support the work of the Orchid Research Tissue Bank and the Circulating Tumour Cells project, and more on this work can be found on page 30 of this report.

Orchid has also continued to work closely with the St Bartholomew's Testicular Cancer Support Group with Orchid Nurse Rob Cornes helping facilitate virtual online meetings.

8 THE YEAR IN REVIEW

Annual report and nancial statements 2019-2020

‘Contacting the Orchid helpline was the most important call of my life’

Orchid Cancer Appeal

The year in numbers

With the challenges of the Coronavirus pandemic Orchid needed to fi nd new and innovative ways of connecting with men. Consequently, many of the most signi fi cant numbers during the year have been a result of the organisation’s online activities... Orchid launched two new fi lms 125% during the reported year: Active Increase in Instagram followers Surveillance and Uncle Mike Total reach of Male Cancer Awareness Week campaign 2020 334,027[2] 5,451 prostate 3,081 testis 639 penile 48,281 Number of patient samples stored at Resources disseminated the Orchid Tissue Bank and shared

10 THE YEAR IN NUMBERS

Annual report and nancial statements 2019-2020

Number of Circulating Tumour Cells at the Orchid Tissue Bank 1,270 260,778 350 Facebook reach (number of unique accounts that Number of individuals who signed up have seen any of Orchid’s posts) to Hands On Payroll Giving

91,814

Number of impressions on Twitter (number of people who saw Orchid’s tweets)

National Male Cancer Helpline: number of helpline hours provided

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THE YEAR IN NUMBERS 11
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Orchid Cancer Appeal

As a result of the pandemic, fundraising in all areas became increasingly competitive. We were therefore delighted to receive a grant from the National Lottery Community Fund’s COVID-19 emergency funding programme, as well as grants from other supporters including Janssen, to help us through a dif fi cult time.

Fundraising

Throughout the period our fundraising team remained resilient and continued to build relationships with existing and potential supporters

Orchid worked tirelessly throughout the year to save the lives of men from prostate, testicular or penile cancer, and we could not have done this without our supporters. We really appreciate every donation or grant given in what has been a challenging year and would like to thank everyone who has supported us.

There had been a promising start to the year in all areas of fundraising. However, the COVID-19 pandemic brought new and unknown challenges for our small fundraising team, including the postponement and cancellation of both externally organised events and Orchid’s own established fundraising events. Furthermore, there was a change in the giving criteria for some Charitable Trusts as a number supported only causes directly COVID-19 related, and others postponed meetings whilst giving was reviewed.

Fundraising in all areas became increasingly competitive. We were therefore delighted to receive a grant from the National Lottery Community Fund’s COVID-19 emergency funding programme, as well as grants from other supporters including Janssen, to help us through a dif fi cult time. Throughout the period our fundraising team remained resilient and continued to build relationships with existing and potential supporters.

Some of the priorities for the year were further developing areas such as payroll giving which produces long term sustainable income, working with funders to seek permission to delay the start of projects or to seek permission to deliver activities differently, and carefully stewarding those who had signed up to or were interested in postponed or cancelled events

12 FUNDRAiSING

Annual report and nancial statements 2019-2020

which resulted in strong teams for the virtual London Marathon as well as for future events. We truly are indebted to the many supporters, friends and volunteers who have supported Orchid during this testing year.

Orchid recognises the importance of listening to and putting supporters at the centre of everything that we do. We are registered with the Fundraising Regulator and adhere to the Code of Fundraising Practice when carrying out our activities. Our staff are committed to following codes of good practice and standards developed by the fundraising community through the work of the Chartered Institute of Fundraising and other professional bodies.

to the Senior Management team and the Board of Trustees. As part of our supporter care programme, we have agreed policies and procedures in place and written agreements with external agencies that we engage to help us or who raise funds for the Charity.

We ensure that anyone engaged to work for us is trained in and respects our aims and objectives and carries out their activities with the same high standards and care we would ourselves. During the year we received one complaint in relation to our fundraising activities which was addressed in line with our policy. We remain committed to improving our practice, learning from supporter feedback.

Above: social media campaigns like Orchid’s Virtual Challenges sought innovative ways to fundraise when existing channels were interrupted by COVID-19

Orchid operates a clear and stringent complaints handling procedure that is reported

FUNDRAISING 13

Orthid CancÈrAppÈal 14

volunteers who have supported Orchid during this testing year

Orchid Cancer Appeal

Our impact

Orchid is dedicated to improving the lives of men of all ages who are at risk of, or affected by male cancer. We work to save men’s lives from prostate, testicular and penile cancer through a range of support services, education and awareness campaigns, and a world-class research programme:

Prostate cancer

Low awareness levels of this most common cancer in men in UK 18

Testicular cancer

Potentially most treatable cancer affects younger men 22

Penile cancer

Exceptionally rare but often psychologically damaging 26 Research Our onging investment in future generations of men 30

16 OUR IMPACT

Annual report and nancial statements 2019-2020

OUR IMPACT 17

Orchid Cancer Appeal

Our impact: Prostate cancer

Prostate cancer is the most common cancer in men in the UK. Around 49,000 men will be diagnosed each year while 11,500 will die from the disease. Survival at 10 years is high at around 68%.

Although there Prostate cancer is the most common cancer in men in the UK. Around 49,000 men will be are over 95 diagnosed each year while 11,500 will die from prostate cancer the disease. Survival at 10 years is high at support groups around 68%. in the UK, the One of the biggest changes over the last few black community years has been the utilisation of a treatment remains under called active surveillance. As more men are represented diagnosed with early prostate cancer which may remain indolent for some time, sometimes for years, there is a greater bene fi t from close monitoring of patients with regular PSA (prostate-speci fi c antigen) blood tests, physical examinations and MRI guided biopsies. This means that treatment, which will inevitably have an effect on sexual function and continence, can be avoided until such time that there is obvious progression of disease. Research has also indicated that even some men with more severe disease may also bene fi t from active surveillance and this is likely to become one of the biggest treatment options for men in the next 10 years. Research also shows that it may take some men 6-months or more to adjust to the fact that their cancer does not require immediate treatment, and initial

support for these men is essential to help them come to terms with their treatment. As more accurate biomarkers evolve, identifying men who will have signi fi cant or non-signi fi cant disease, surveillance is likely to become much more widely used.

One of the greatest challenges around prostate cancer remains the unequal risk of prostate cancer among black African and black Caribbean men who are twice as likely to develop prostate cancer than Caucasian men. Creating awareness in this community and helping support black men diagnosed with prostate cancer is crucial. Although there are over 95 prostate cancer support groups in the UK, the black community remains underrepresented.

18 OUR IMPACT: PROSTATE CANCER

Annual report and nancial statements 2019-2020

Successful completion of a three-year prostate cancer project delivered in targeted London Boroughs

January 2020 saw the end of the successful three-year ‘Changing lives: engaging with Black African and Black Caribbean men at risk of, or affected by, prostate cancer’ project which had been funded by the Big Lottery Fund (now the National Lottery Community Fund) in partnership with the charity Cancer Black Care.

The project had been developed in response to low levels of awareness amongst black African and black Caribbean men about prostate cancer and their increased risk which meant many were presenting late to healthcare professionals with possible signs and symptoms. One in four black men will develop prostate cancer in their lifetime, compared to a risk of one in eight among other men.

Using culturally appropriate print and fi lm resources developed as part of the project, Orchid reached out to the black community in seven London boroughs to increase awareness and understanding of prostate cancer. We also encouraged black men to discuss their prostate cancer risk with healthcare professionals, as well as empowering them with the necessary information to seek help for any potential signs and symptoms as soon as possible. Treatment is more likely to be successful if a cancer is diagnosed at an early stage.

The project also provided support opportunities for black

men living with and beyond a diagnosis of prostate cancer to increase their con fi dence about engaging with treatment and aftercare, and to reduce the isolation many men may feel through the provision of peer support opportunities. In addition, the project team offered specialist training and support to healthcare professionals to increase their con fi dence and competence to discuss prostate cancer with black men at risk and post-diagnosis and to provide appropriate support.

Throughout the project, our team carried out outreach activities working with community groups, faith groups, barber shops and in other targeted locations. Over the three years of the project, more than 1,600 culturally appropriate posters, 42,000 prostate cancer z-cards and 26,000 Helpline cards were distributed in the target boroughs.

Independent evaluation shows the success of the project. Through the ‘Changing Lives’ project Orchid engaged with over 8,000 black men at risk of prostate cancer, over 200 black men who were living with prostate cancer, and over 400 healthcare professionals.

Orchid is keen to share the project learnings, and the full evaluation report showing the outcomes is available to download via the Orchid website.

OUR IMPACT: PROSTATE CANCER 19

Orchid Cancer Appeal

20 OUR IMPACT: PROSTATE CANCER

Annual report and nancial statements 2019-2020

et ‘To me, the lea fl was saying, don’t leave it too late! I had no idea about the signs. I showed it to my friends and they didn’t know either’

OUR IMPACT: PROSTATE CANCER 21

Orchid Cancer Appeal

Our impact: Testicular cancer

Testicular cancer is rare with around 2,300-2,400 men being diagnosed each year in the UK. Around 60 men will die each year from testicular cancer although it remains potentially the most treatable and curable type of cancer with over 90% of men surviving 10 years.

Testicular cancer Testicular cancer is rare with around 2,300-2,400 tends to affect a men being diagnosed each year in the UK. Around 60 men will die each year from testicular younger age cancer although it remains potentially the most group than most treatable and curable type of cancer with over other cancers, 90% of men surviving 10 years. with nearly Testicular cancer tends to affect a younger age 50% of men group than most other cancers, with nearly 50% diagnosed under of men diagnosed under the age of 35, and 80% the age of 35 of men diagnosed between the ages of 15-45. This means that testicular cancer will often affect men at a stage of their life where they may be starting a family or career, or just consolidating their place in life. Treatment occurs quickly with men often being diagnosed and treated within a few weeks. As well as surgery to remove the affected testicle, treatment may also involve chemotherapy. In addition to temporary side effects chemotherapy can increase the risk of cardiovascular disease in later life.

either peer support or psychological support. Orchid has consistently supported the biggest testicular cancer support group in the UK, which is co-ordinated by the specialist nurse team at St Bartholomew’s in London, both physically and virtually. In addition, the creation of Orchid’s telephone counselling service will allow men to access psychological support without the necessity of waiting for extended periods of time. Orchid also continues to work with the Testicular Cancer Network to improve the resources available to those affected by testicular cancer throughout the UK.

Challenges around testicular cancer involve supporting men in adjustment to life following treatment. Many men will only realise the full implication of their cancer journey when treatment ends and may not be able to access

22 OUR IMPACT: TESTICULAR CANCER

Annual report and nancial statements 2019-2020

‘Your Privates’ microsite: a one stop shop for information about testicular cancer

Since the launch of Orchid’s ‘Your Privates’ microsite in 2013, men and their loved ones have regularly accessed this unique resource to fi nd out about the signs and symptoms of testicular cancer, its diagnosis, what life is like after testicular cancer, and where they can seek support if they need it. People have also used the site to contact an Orchid Nurse to get answers to their testicular health questions and concerns.

During the year 2,900 people accessed the ‘Your Privates’ site, an increase of 2.5% on the previous year. The videos embedded in the site were particularly popular with over 33,000 views of the video showing how to carry out testicular selfexamination, and 15,000 views of ‘what’s not testicular cancer’ which we know can help allay men’s fears. Feedback about these videos includes: “Best calm explanation video” and “Thanks for this! The last thing saved me! I had this cyst on the

top of my balls that was exactly how you explained it, and I was so scared it was testicular cancer (I’m 14) thanks for clarifying!”

With an early diagnosis for testicular cancer being so important, Orchid also knows we must reach out to those at risk. We particularly want to increase young people’s understanding of testicular cancer and their con fi dence in seeking help and support if they need it. We continued work on resources to be used in schools through the development of a teachers’ lesson plan, activities, and a summary video to be delivered during personal, social, health and economic education (PSHE) lessons. The resources outline possible risk factors, signs and symptoms, and highlight the importance of selfexamination, and are now an important part of the microsite. We are delighted to report that the lesson plan has recently been both accredited and promoted by the PSHE Association.

OUR IMPACT: TESTICULAR CANCER 23

24 24 SECTIONOUR IMPACT: TESTICULAR CANCER

Annual report and nancial statements 2019-2020

‘You’ve saved me! I had this cyst on the top of my balls that was exactly as you explained it, and I had been so scared it was testicular cancer (I’m 14). Thanks for clarifying!’

OUR IMPACT: TESTICULAR CANCER 25

Orchid Cancer Appeal

Our impact: Penile cancer

Most men will never meet another man affected by penile cancer due to its rarity therefore missing out on invaluable peer support

Penile cancer is exceptionally rare in the UK with around 670 men being diagnosed each year. Around 170 men will lose their lives to the disease although 68% of men will survive 10 years following their diagnosis.

Out of all the male speci fi c cancers penile cancer has the potential to cause the most physically and psychologically damaging side effects, as all curative treatment will involve some form of surgery to the penis itself. This can be minimally invasive but may also involve partial or total amputation of the penis resulting in a radical change in body image and sexuality.

Due to its intimate nature around 15-50% of men will delay seeking treatment. Delaying penile cancer treatment can lead to disease progression of the primary tumour such that organ-sparing surgery may no longer be feasible. In addition, 20-25% of penile cancer may be misdiagnosed with men being referred to dermatologists and sexual health clinics. Treatment is performed at specialist regional treatment centres in the UK with dedicated teams performing penile sparing surgery.

The main challenges for Orchid around penile cancer are creating awareness of the disease - many people do not realise penile cancer exists, and the isolation which men may feel following treatment. Most men will never meet another man affected by penile cancer due to its rarity therefore missing out on invaluable peer support.

In addition, there is an unmet need to support these men psychologically. When men realise that they may need psychological help such as counselling there is often a severe delay in referral. Orchid has therefore focused on the development of a telephone counselling service to support men and wherever possible has created events to offer peer support, as well as supporting and encouraging allied healthcare professionals in the creation of regional support groups.

26 OUR IMPACT: PENILE CANCER

Annual report and nancial statements 2019-2020

Putting penile cancer on the agenda in Scotland

With 83 cases a year, there is a higher incidence of penile cancer in Scotland in comparison to the rest of the UK, and those affected by penile cancer in Scotland are also being diagnosed at a younger age. A penile cancer diagnosis can be psychologically devastating, and treatment can be challenging especially if the diagnosis has been made at a late stage.

Orchid has signi fi cant experience of educating people about the signs and symptoms of penile cancer, as well as understanding the complex issues involved in supporting penile cancer patients. Whilst we do not as yet know why Scotland has a higher incidence proportionally than the rest of the UK, we do know that many people have not heard of penile cancer, let alone know what potential symptoms might be. Orchid therefore identi fi ed the need to develop a project to put penile cancer on the agenda in Scotland.

With the support of two retired Nurses, delivery of the Penile Cancer Support Service began with a series of Penile Cancer Information Roadshows run in non-medical settings in targeted locations across the country, using Scotland speci fi c resources developed for the project. Our team engaged local people in penile cancer conversations, and the

retired Nurses also gave talks to healthcare professionals and patient groups.

We were delighted to recruit to the post of Penile Cancer Information Manager – Scotland in December 2019. Based in Glasgow and sharing Orchid’s literature and knowledge, they have been leading and developing the project to raise awareness of signs and symptoms amongst the Scottish population, and to encourage those with concerns to seek immediate help.

They have also been providing support to those living with a diagnosis, working with the Orchid Male Cancer Nurse and referring patients to the Orchid National Male Cancer Helpline for specialist information when needed. Collaborative working and a fl exible approach during the COVID-19 pandemic have been key to the success of the project, and the Information Manager has been working to introduce Orchid’s specialist penile cancer materials and services to healthcare professionals across the country. Our Information Manager also sits on the Cross-Party Group on Cancer and had the opportunity to contribute to the development of Scotland’s Cancer Recovery Plan.

OUR IMPACT: PENILE CANCER 27

Orchid’s research programme is investing in the wellbeing of

Annual report and nancial statements 2019-2020

RESEARCH 29

Orchid Cancer Appeal

Our impact: Research

Orchid’s research programme is an investment in the wellbeing of current and future generations of men. If we understand the three male-speci fi c cancers, how they work and how to treat them, we can offer a better and brighter outlook for our loved ones, their children and grandchildren.

The Orchid Research Tissue Bank – Professor Daniel Berney

The Circulating Tumour Cell project - Professor Yong-Jie Lu

Despite the impact of COVID-19, it was a productive year with important research fi ndings and publications in leading international journals.

While the development of new drugs and therapies prolongs patients’ survival period, advanced cancers are still rarely cured, yet cancers diagnosed at early stage are mostly curable. Detection of cancer at an early stage is still challenging for many cancer types, including prostate cancer. Currently cancer diagnosis is based on tissue biopsy.

Professor Lu’s team have been investigating a blood test in prostate cancer detection for several years using a platform, Parsortix made by ANGLE plc, to ef fi ciently detect cancer cells spread into the blood circulation. Their research shows the detection of cancer cells in the blood and their gene expression predict the prostate cancer tissue biopsy outcome with high accuracy, which not only distinguishes cancer from benign, but also indolent from aggressive

cancers. This has the potential to change the paradigm of prostate cancer diagnosis and guide the treatment of cancer patients by monitoring cancer aggressiveness and progression by a blood test. The team now want to perform a multiple centre validation study, a critical step to move this prostate cancer blood test into clinical use.

They have also started to investigate the potential of using other materials/products that cancer cells release into the blood circulation. They have detected in peripheral blood certain prostate cancer cell released molecules, which are used by cancer cells to communicate with other body cells for cancer growth and metastasis, and their appearance is associated with the development of hormone therapy resistance of prostate cancer. These cancer cell molecules may also have potential in prostate cancer early detection, which is in their future research plan.

Not all prostate cancers diagnosed at early stage are life threatening, so while the aim is to treat aggressive prostate cancer ef fi ciently to cure the cancer, reducing side effects of treatment such as impotence and incontinence by avoiding unnecessary therapies for

30 RESEARCH

Annual report and nancial statements 2019-2020

Adapted from Xu et al. Clin Cancer Res. 2017; 23:5112-5122 (https://clincancerres.aacrjournals.org/content/23/17/5112)

non-signi fi cant prostate cancer is equally important. Currently, cancer pathology grade, clinical stage and blood PSA level have been used to decide who requires treatment and who can be safely ‘observed’ with routine follow up. Further molecular biomarkers are required to improve the treatment strati fi cation, which is long-term research focus.

The research team have also been actively involved in the application of arti fi cial intelligence in assisting pathological grade of prostate cancer. Arti fi cial intelligence assisted pathological grading saves pathologist time in cancer diagnosis and reduces human errors/variation in cancer grading such as individual grading variation. Therefore, arti fi cial intelligence assisted pathological grading has the potential to resolve the pathological diagnosis of cancers. As an international leading pathologist in urological cancers, Professor Berney has published papers in improving pathological diagnosis standards and promoting diagnostic communications.

The genetic changes in cancer cells determines cancer development, behaviour and the treatment responses. Therefore, the team has continued collaboration work with the international

consortiums in prostate cancer genetic risk and somatic genetic abnormality studies, which led to high pro fi le publications in the top scienti fi c journal Nature and its sister journals. These fi ndings are landmarks for understanding of human cancer genetics alterations and will promote the development of new approaches in cancer diagnosis and treatment.

For testis cancer the team are researching the appropriate and re fi ned targeting of chemotherapy, to make sure it is administered to those men who need it and sparing the toxic side effects for those who do not. It is hoped a suite of papers about testis cancers with pathological review jointly with the University of Denmark will become a mainstay of pathological information to guide treatment for both localised and advanced germ cell tumours.

For penile cancer, the team have reviewed the current stage of research and their understanding of the molecular pathogenesis of penile carcinoma.

A full list of publications for the period is available on request.

Above: Circulating tumour cells (CTCs) detected in the blood of prostate cancer patients. In panel A, CTCs were visualised using a cell painting method called immuno fl uorescence staining, which stains speci fi c proteins in cells. The proteins speci fi c to cancer cells are VIM (yellow) and CK (green), while the protein CD45 (red) is speci fi c to blood cells. Cell nuclei were stained using a dye called DAPI. Photos of each colour can be taken separately as well as all together (merged). In this image three types of CTCs (arrowed) can be seen, 1. painted green (top row arrowed); 2. both green and yellow (middle row) and 3. yellow (bottom row), while blood cells were painted red. In panel B, on the same CTC the scientists detected the genetic changes using a method called fl uorescence in-situ hybridisation (FISH), proving that the cell is cancerous.

RESEARCH 31

Orchid Cancer Appeal

The year ahead

The reporting year ended with Male Cancer Awareness Week where we reached 334,027 people via our digital ‘Check.Check.Check.’ campaign, complemented by the taking of COVID-19 safe male cancer information packs to 10,000 households in targeted areas.

outlines possible risk factors, signs and symptoms, and highlights the importance of self-examination, and we are planning to work further with the PSHE Association to promote this new resource. We will continue to review all our male cancer materials, and to develop new materials as necessary.

Raising awareness of male cancer risk factors, signs and symptoms remained a priority as we entered the new fi nancial year. Still unable to work face to face in the community and deliver Male Cancer Information Roadshows, talks and presentations, we are developing an alternative programme of increased social media activity to reach men in targeted locations, as well as offering virtual male cancer talks. We will continue to review our activities and use the learnings from COVID-19 to inform the development of plans to return to working in the community when it is safe to do so. In addition, we are increasing the promotion of our Nurse-led services via GP practices and e-bulletins to healthcare professionals.

We will also be developing and expanding our Health at Work programme, working with Wellbeing Teams within businesses to empower employees with the information they need to know about male cancer and when and where to seek help if needed.

The evaluation of our ‘Changing Lives’ project highlighted the need for more work in the heart of communities to help overcome the barriers to engaging with prostate cancer, and we will work to secure funding to do this.

We will seek accreditation from PSHE Association for our new testicular cancer lesson plan for use in schools. This

With access to GPs dif fi cult in many areas, yet an ongoing need for men to discuss potential male cancer symptoms, we plan to develop a check card to help men prepare for appointments. This resource will enable men to give a clear and concise account of what they are experiencing and will support men to feel comfortable when sharing intimate details which will make their fi rst appointment more effective.

Funded with a grant from Janssen we will be launching a new fi lm ‘Living with prostate cancer’ in the year ahead to encourage men and loved ones to talk about the impact of this cancer. We will also be developing a fi lm on living with advanced prostate cancer. The project will offer those living with advanced prostate cancer practical solutions to improve their quality of life.

Supporting men living with male cancer (and their loved ones) will remain a priority for Orchid in the coming year. The hours of the National Male Cancer Helpline were increased due to the COVID-19 pandemic, and we are planning to pilot an out-of-hours service with the aim of being there for more men who need us.

The embarrassment men with male cancers may feel about using public toilets can be a barrier to leaving home, and to help overcome this we are exploring the possibility of providing radar keys for men with penile cancer in Scotland as

32 THE YEAR AHEAD

Annual report and nancial statements 2019-2020

part of the Penile Cancer Support Service. Having a radar key would enable men to access the privacy of locked disabled toilets. We will explore the offer of radar keys more widely.

The peer support opportunities which we facilitate will continue to be delivered virtually or online as appropriate. We will be launching a unique telephone counselling service for men affected by testicular and penile cancer. This will allow up to 30 men, over twelve months, access to a professional counsellor who can offer up to six free counselling sessions. The telephone service can be utilised by men anywhere within the UK and is being co-ordinated with the guidance of Dr Peter Branney, senior psychologist at the University of Bradford. It will be evaluated, and the information obtained will be used to create a bespoke service for the future.

We evaluate all our activities to measure success and impact, and we will carry out independent evaluation of the Penile Cancer Support Service in Scotland in the coming year.

We will continue to invest in world class male cancer research to bene fi t the well-being of current and future generations of men. The focus of our research in the year ahead will be the Orchid Research Tissue Bank incorporating the Circulating Tumour Cell project. This project is led by Professors Dan Berney and Yong-Jie Lu.

mechanisms of prostate cancer development, progression and response to therapies and develop biomarkers for the diagnosis, prognosis and treatment response prediction of prostate cancer as well as testicular and penile cancers.

Securing funding for our plans is a priority. As a small charity we were able to adapt to the COVID-19 environment and develop a fl exible approach to delivering services to meet the needs of men. We were also able to adapt our fundraising to the changing landscape. Having reviewed our income streams and stabilised, our fundraising strategy now focusses on developing and re-growing our income. We will continue to offer the best possible support to our corporate partners, the Charitable Trusts and Foundations who give to us, and the individuals and community groups who support us with donations and fundraise on our behalf. Alongside that, our fundraising plans also include exploring new opportunities and developing areas where we will secure the best return on investment.

Orchid is grateful to everyone who has supported us in the last year, and those who will support us in the coming year. Our work would not be possible without you.

Collection and validation of tissue from male cancers from high quality clinical trials and cohorts will advance our understanding of male cancers, creating better prognostic and predictive targets for treatment and diagnosis, and the project will also increase understanding of the molecular

THE YEAR AHEAD 33

Orthid CancÈrAppÈal 34 THEYEARAHEAD

Our Health at Work programme will empower employees

Orchid Cancer Appeal

Governance

Objects, operating context and activities

Orchid’s aim is to provide greater knowledge and c awareness about male speci fi c cancers by funding scienti fi and medical research into the prevention, diagnosis and treatment of these diseases, raising awareness, delivering Nurse-led services and providing information about them to people throughout the UK

Objects

Over 50,000 people in the UK are diagnosed with prostate, testicular or penile cancer every year and sadly these numbers are increasing. Orchid’s aim is to provide greater knowledge and awareness about male speci fi c cancers by funding integrated scienti fi c and medical research into the prevention, diagnosis and treatment of these diseases, raising awareness, delivering Nurse-led services and providing eye-catching, easy to understand information about them to people throughout the UK, thereby helping to ensure a better quality of life for those affected.

Operating context and activities

Orchid's aim is to offer the best possible care and support for men and their families through awareness and education programmes, to promote better understanding of the signs and symptoms of these cancers, to encourage an early diagnosis and improved outcomes and to ensure the best possible care through our in fl uence at a local and national level. Through funding world class research, our aim is to improve our understanding of male cancers, how they work, possible causes and to identify new treatments and enhance care. Support and information delivered by our Nurse Specialists and Community Engagement Team enables people interested in or affected by male cancers to have the best possible outcome.

36 GOVERNANCE

Annual report and nancial statements 2019-2020

Structure, governance and management

Duly registered as a Charity, Orchid is incorporated as a company, limited by guarantee, and governed by its Memorandum and Articles of Association.

Trustees are recruited on the recommendation of incumbent members of the Board, commensurate with the Chair’s aim to maintain a balanced composition. Applications from individuals seeking to become a Trustee will be considered as and when appropriate by the Board. The Board meet four times during the year and, at the Annual General Meeting, as required by the constitution, one third of the Trustees (or the nearest number thereto) retire from of fi ce in rotation, in order of longevity of appointment and are eligible to be reappointed. During the Coronavirus pandemic Trustees met virtually.

Trustee training and induction

On appointment, Trustees receive a comprehensive induction programme which includes a meeting with the lead programme researchers and visit to the research programmes. In the absence of in-house provision, or an otherwise formalised programme of training, the Chief Executive advises Trustees of opportunities that will increase their general understanding of voluntary sector, healthcare and/or medical research issues.

Structure, delegation and decision-making

The decision-making process operates as follows:

• At the strategic level, the Board of Trustees regularly reviews Orchid’s direction in the wider context of medical charities, requiring the Chief Executive to identify relevant key issues and present options for its consideration. Due governance remains a key requirement.

• The Finance Committee is responsible for the fi nancial oversight of the Charity including budgeting, fi nancial planning and monitoring as well as fi nancial reporting and the creation and monitoring of internal controls and accounting policies. It presents a report to the Board at each of its meetings. As at 30 September 2020, it comprised the Honorary Treasurer, Mr W Cohen, Mr C Osborne, Mr S Seymour and Mr S Harris.

• To improve ef fi ciency, Sub-Committees have been reviewed, and the Fundraising Sub-Committee meets as required.

• At the operational level, the Board delegates the day-today running of the Charity to the Chief Executive, requiring him to deliver every aspect of governance, planning and performance in accordance with the agreed strategic direction. The Board is kept appraised of personnel, awareness, research programme and budgetary issues.

Public bene t

The Trustees con fi rm that they have complied with the duty in section 17 of the Charities Act 2011 to have due regard to the Charity Commission's general guidance on public bene fi t including (PB2 Public Bene fi t: Running a Charity).

Key management personnel and remuneration policy

Orchid is committed to attracting and retaining talented staff. Staff are kept fully informed of the organisation’s strategy and objectives, and individual performance is reviewed throughout the year. Learning and development remain a priority. Temporary and volunteer personnel are engaged for speci fi c tasks to ensure a balanced approach to managing administration, awareness campaigns, support services and fundraising.

GOVERNANCE 37

Orchid Cancer Appeal

The key management personnel comprise the Trustees and the Chief Executive. Trustees do not receive remuneration. The salary of the Chief Executive is set by the Chairman of the Board of Trustees in consultation with the Finance Committee and Board of Trustees following an annual review of performance. The Charity uses Royal College of Nursing (RCN) bands, NHS pay scales and Charity Salary Surveys for benchmarking salaries of all other members of staff. Annual salary increases for staff are discussed and where applicable approved by the Finance Committee and Board of Trustees.

Research Programme: Peer Review

Given the importance of expert independent peer review in validating applications for new research grants and the veri fi cation of outcomes, the Scienti fi c Advisory Board (SAB) provides the Board of Trustees with the necessary degree of objectivity as to the quality, value for money and ef fi ciency of research that the Charity currently funds or may consider funding.

Internal control and risk management

Orchid is committed to active management of risk. Risk management is incorporated into governance and management structures, planning processes and all aspects of service delivery. Orchid produces a risk register which identi fi es risk and allocates responsibility for managing areas of risk to named individuals.

Governance and compliance Operational Financial Environmental/external Research Quality assurance

Each identi fi ed risk is assessed in terms of likelihood and impact and then weighted giving a gross risk rating. Actions to minimise each risk are identi fi ed and responsibility for monitoring these is given to named individuals. The strength of each risk management strategy is given a numeric rating enabling the net risk to be calculated.

The Chief Executive is responsible to the Board for the management and implementation of the risk management strategy and reports to the Board on progress towards mitigating each risk. Risk is reviewed quarterly by staff and not less than annually by the Finance Committee and Board of Trustees. They direct the Chief Executive as to the priorities and action to be taken to mitigate or remove them.

Several other policies, therefore, deal with risk management and risk assessment e.g. Health and Safety Policy, Safeguarding etc. All policies are reviewed regularly and updated in line with changes in legislation, regulation and best practice. New policies are introduced as required.

Speci fi c risks which, if materialised, would have had a signi fi cant impact on the Charity have been identi fi ed. These are shown in the table on the next page.

Following Charity Commission recommendations the risk register identi fi es risks under the following headings:

38 GOVERNANCE

Annual report and nancial statements 2019-2020

Governance and compliance

Ability to maintain a Board of Trustees with all the skills required to ensure that all aspects of governance are adhered to.

Mitigation

• An ongoing review of the composition of the Board of Trustees to ensure that all key functions, including medical, legal and fi nancial, are covered by suitably quali fi ed professionals

• Training and support for Board of Trustees and Finance Committee

• Dedicated specialist resource applied in key areas e.g. health and safety, HR and legal

Operational

Attracting, developing and retaining talented staff in a competitive employment market

Mitigation

• Annual salary review to include benchmarking of compensation and bene ts

• Staff development, training and succession planning programmes

• Communication programme to ensure staff are involved in the development of and progress towards Orchid’s strategy and annual workplan

Financial

Economic pressures, impact of COVID-19, competition, fundraising regulatory environment and consumer behaviour changes leading to a signi fi cant fall in income

Mitigation

• Annual budgeting and ongoing management, reporting and monitoring of fi nancial performance

• Diversi cation of income streams

• Ongoing consideration of market and consumer trends and regulations including GDPR

• Ensuring that key management personnel and advisers are of a calibre to ensure that the Charity is aware of and compliant with regulatory and similar requirements

Environmental/external

Changes in government policy or budgets, Charity sector regulations, or reform of the NHS or changes to the research environment that negatively impact on Orchid’s work

Mitigation

• Key personnel monitor public policy and the regulatory environment on an ongoing basis to ensure potential risks can be proactively managed

• Chief Executive and Nurse Specialists attend key events and forums to help shape agenda

• Chief Executive and the Board of Trustees routinely scrutinise alignment with, and progress of, Orchid’s strategy

Research

Orchid’s Research Programme fails to deliver results

Mitigation

• Scrutiny and approval of research funding applications by an expert committee, Orchid Scienti fi c Advisory Board

• Annual review of progress

Quality assurance

Patients, their families, health and social professionals, educators and other interested parties given inaccurate, poor quality information leading to reputational damage

Mitigation

• Services developed, delivered and evaluated in line with agreed protocol and standards

• Nurse Specialists are members of the Royal College of Nursing (RCN)

• All information materials and content regularly reviewed and updated

• High-quality training for staff

GOVERNANCE 39

Orchid Cancer Appeal

Financial review

Results for the year

Income for the year ended 30 September 2020 totalled £401,181 (2019: £846,169). After total expenditure of £756,577 (2019: £918,939), the year's activities show a net de fi cit of £355,396 (2019: de fi cit of £72,770). Total reserves at the end of the year amounted to £583,006 (2019: £938,402).

Reserves policy

Designated reserves are funds that have been earmarked by the Trustees for future expenditure on the objectives of the Charity, and at the end of the year the Trustees had designated £53,281 towards future research grant awards. In addition £121,808 has been designated to help fund the costs of increased organisational capacity with the Charity and a further £83,658 designated to help fund speci fi c awareness activities.

Free reserves are distinct from funds that have been earmarked or ‘designated’ for future expenditure on the objectives of the Charity, but for which legal liability has not yet been accepted. They must be maintained at a level which ensure the Charity’s core activity of funding research and awareness during a period of sustained unforeseen dif fi culty and a proportion must be in a readily realisable form. The calculation of the required level of reserves is an integral part of the Charity’s planning, budgeting and forecast cycle. It should take into account:

• risks associated with each income and expenditure stream differing from that budgeted

• planned activity level

• organisational commitments.

The available free reserves net of tangible fi xed assets are £139,396 (2019: £334,804). It is the Charity’s policy to maintain free reserves of approximately 3-4 months of operating costs. At current levels of expenditure this equates to £152,000-£203,000.

Formal statements

Statement of Trustees’ responsibilities

The Trustees, who are also directors of Orchid Cancer Appeal for the purposes of company law, are responsible for preparing the Trustees’ Report and the fi nancial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice.)

Company law requires Trustees to prepare fi nancial statements for each fi nancial year which 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 fi nancial statements, the Trustees are required to:

• select suitable accounting policies and then apply them consistently;

• observe the methods and principles in the Charities SORP;

• make judgements and estimates that are reasonable and prudent;

• state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the fi nancial statements;

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

The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the fi nancial position of the charitable company and enable them to ensure that the fi nancial 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.

40 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

The Trustees are responsible for the maintenance and integrity of the Charity and fi nancial information included on the Charity’s website. Legislation in the United Kingdom governing the preparation and dissemination of fi nancial statements may differ from legislation in other jurisdictions.

Auditor’s information

So far as each of the directors at the time the Trustees’ report is approved is aware:

a) there is no relevant information of which the auditors are unaware; and

b) they have taken all relevant steps they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information.

The auditor, Moore Kingston Smith LLP, has been authorised for appointment in accordance with Section 485 of the Companies Act 2006.

Moore Kingston Smith LLP has indicated its willingness to continue in of fi ce and in accordance with the provisions of the Companies Act, it is proposed that it will be reappointed auditor for the ensuing year.

The fi nancial statements have been prepared in accordance with the provisions of the Companies Act 2006 Part 15 relating to small companies, the 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 FRS 102 Charities SORP) and the Memorandum and Articles

Signed on behalf of the Trustees

C S Osborne Chairman of Trustees 15 June 2021

FINANCIAL REVIEW 41

Orchid Cancer Appeal

Independent Auditor’s Report to the Members of Orchid Cancer Appeal

Opinion

We have audited the fi nancial statements of Orchid Cancer Appeal (‘the company’) for the year ended 30 September 2020 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the fi nancial statements, including a summary of signi fi cant accounting policies. The fi nancial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 ‘The Financial Reporting Standard Applicable in the UK and Ireland’ (United Kingdom Generally Accepted Accounting Practice).

In our opinion the fi nancial statements:

• give a true and fair view of the state of the charitable company’s affairs as at 30 September 2020 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; and

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

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs(UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s Responsibilities for the audit of fi nancial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the fi nancial statements in the UK, including the FRC’s Ethical Standard, and we have ful fi lled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is suf fi cient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

We have nothing to report in respect of the following matters in relation to which the ISAs (UK) require us to report to you where:

• the trustees have not disclosed in the fi nancial statements any identi fi ed material uncertainties that may cast signi fi cant doubt about the company’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from the date when the fi nancial statements are authorised for issue.

Other information

The other information comprises the information included in the annual report, other than the fi nancial statements and our auditor’s report thereon. The trustees are responsible for the other information. Our opinion on the fi nancial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

In connection with our audit of the fi nancial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the fi nancial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the fi nancial 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 in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

• the information given in the trustees’ annual report for the fi nancial year for which the fi nancial statements are prepared is consistent with the fi nancial statements; and

• the trustees’ annual report has been prepared in accordance with applicable legal requirements.

• the trustees’ use of the going concern basis of accounting in the preparation of the fi nancial statements is not appropriate; or

42 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identi fi ed material misstatements in the trustees’ annual report.

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:

• adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; or

• the fi nancial statements are not in agreement with the accounting records and returns; or

• certain disclosures of trustees’ remuneration speci fi ed by law are not made; or

• we have not received all the information and explanations we require for our audit, or

• the trustees were not entitled to prepare the fi nancial statements in accordance with the small companies regime and take advantage of the small companies exemption in preparing the Strategic Report.

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 19, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the fi nancial statements and for being satis fi ed that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of fi nancial statements that are free from material misstatement, whether due to fraud or error.

In preparing the fi nancial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the nancial statements

Our objectives are to obtain reasonable assurance about whether the fi nancial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in aggregate, they could reasonably be expected to in fl uence the economic decisions of users taken on the basis of these nancial statements.

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

• Identify and assess the risks of material misstatement of the fi nancial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is suf fi cient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.

• Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purposes of expressing an opinion on the effectiveness of the charitable company’s internal control.

• Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the trustees.

• Conclude on the appropriateness of the trustees’ use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast signi fi cant doubt on the charitable company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the fi nancial statements or, if such disclosures are inadequate, to modify our opinion.

FINANCIAL REVIEW 43

Orchid Cancer Appeal

Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.

• Evaluate the overall presentation, structure and content of the fi nancial statements, including the disclosures, and whether the fi nancial statements represent the underlying transactions and events in a manner that achieves fair presentation.

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and signi fi cant audit fi ndings, including any signi fi cant de fi ciencies in internal control that we identify during our audit.

Use of this report

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

James Saunders FCCA DChA

for and on behalf of Moore Kingston Smith LLP, Statutory Auditor Devonshire House 60 Goswell Road London EC1M 7AD

16 June 2021

44 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

Statement of nancial activities

(incorporating an income and expenditure account) For the year ended 30 September 2020

Year ended Year ended Unrestricted Restricted 30 September 30 September Note Total Total 2020 2019 £ £ £ £ Income from: Donations and Legacies 2 241,513 109,315 350,828 650,135 Charitable Activities 4 - 47,571 47,571 185,526 Trading Activities 534 - 534 527 Investments 2,248 - 2,248 9,981 Total income 244,295 156,886 401,181 846,169 Expenditure on: Raising funds Fundraising (donations and grants) 5 187,210 - 187,210 247,885 Charitable Activities Education and Awareness 5 240,237 186,234 426,471 594,359 Research 5 129,146 13,750 142,896 76,695 Total expenditure 556,593 199,984 756,577 918,939 Net income / (expenditure) and net movement in funds 5,6 (312,298) (43,098) (355,396 ) (72,770) Reconciliation of funds Total funds brought forward adjusted 706,427 231,975 938,402 870,730 Prior Year Adjustment - - - 140,442 Total funds brought forward as restated 706,427 231,975 938,402 1,011,172 Total funds carried forward 394,129 188,877 583,006 938,402

All of the above results are derived from continuing activities. There were no other recognised gains or losses other than those stated above. Movements in funds are disclosed in Note 13 to the nancial statements.

FINANCIAL REVIEW 45

Orchid Cancer Appeal

Balance sheet

As at 30 September 2020

30 September 30 September 2020 2019 Note £ £ £ £ Fixed Assets Tangible Assets 10 366 - Current Assets Cash at bank and in hand 727,441 84,979 Investments – cash deposits - 973,744 Debtors 11 136,586 187,046 864,027 1,245,769 CREDITORS Amounts due within one year 12 (281,387) (307,367) Net Current Assets 582,640 938,402 Total Assets less Current Liabilities 13 583,006 938,402 NET ASSETS 583,006 938,402 Represented by: 14 General Unrestricted Funds 135,382 334,804 Designated Funds 258,747 371,623 394,129 706,427 Restricted funds 188,877 231,975 583,006 938,402

The company is limited by guarantee.

The fi nancial statements have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies.

Mr C S Osborne

Company number 3963360

46 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

Statement of cash ows

For the year ended 30 September 2020

2020 2019 £ £ £ £ Cash fl ows from operating activities: Net expenditure for the year (355,396) (72,770) Adjustments for: Depreciation charges 729 - Interest (2,248) (9,981) Drecrease/(increase) in debtors 50,460 (57,457) (Decrease) in creditors (25,980) (75,553) Net cash provided by operating activities (332,435) (215,761) Cash fl ows from investing activities: Interest 2,248 9,981 Disposal of fi xed assets (1,091) - Disposals of investments 912,297 143,440 Net cash used in investing activities 913,454 153,421 Change in cash and cash equivalents in the year 581,019 (62,340) Cash and cash equivalents at the beginning of the year 146,422 208,762 Cash and cash equivalents at the end of the year 727,441 146,422 Analysis of cash and cash equivalents Cash at bank and in hand 727,441 84,979 Notice deposits of less than 3 months - 61,443 727,441 146,422

FINANCIAL REVIEW 47

Orchid Cancer Appeal

Notes to the nancial statements

1. Accounting policies

Basis of Preparation

These fi nancial statements have been prepared under the historical cost convention and in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). The Charity is a public bene fi t entity for the purposes of FRS 102 and therefore has also prepared the fi nancial statements in accordance with the 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 FRS 102 Charities SORP) and the Charities Act 2011.

Going concern

The trustees have assessed whether the use of the going concern assumption is appropriate in preparing these fi nancial statements. The trustees have made this assessment in respect to a period of one year from the date of approval of these fi nancial statements and have considered the impact of the coronavirus pandemic on the charity’s operations. In particular the trustees have considered the charity’s forecasts and projections and have taken account of pressures on donation income. After making enquiries the trustees have concluded there is a degree of uncertainty around donation income for 2020/21; however, there is a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future.

The charity has secured a 3-year project funded by The National Lottery Community Fund: Overcoming the Barrier to Engaging with Prostate Cancer. The aim is to work in targeted locations across England and focus on supporting individuals from identi fi ed communities to overcome barriers to engaging with prostate cancer. This will enable Orchid to continue its valued work. Many fundraising events have been postponed from 2020 and as a result Orchid has an all-time high number of runners signed up for events in the Summer of 2021. Whilst there is still some risk around fundraising events being held in the Summer, Orchid is hopeful that the relaxation of COVID-19 restrictions will enable these events to take place. The National Lottery project along with continued support from loyal donors will enable Orchid to continue to as a going concern.

The trustees con fi rm that there are no material uncertainties about the ability of the charity to continue as a going concern. The charity, therefore, continues to adopt the going concern basis in preparing its fi nancial statements.

Functional currency

The functional currency is considered to be in pounds sterling because that is the currency of the primary economic environment in which the Charity operates. The fi nancial statements are also presented in pounds sterling, rounded to the nearest £1.

Taxation

The Charity has suffered no tax charge as it is not subject to UK Corporation tax on its charitable activities.

Depreciation

Depreciation is provided at the following annual rates so as to write off the cost of each asset over its useful life. Assets with a purchase consideration in excess of £1,000 are capitalised. Computer and Of fi ce Equipment - 33 1/3% on written down value.

Funds accounting

General funds are unrestricted funds available for use at the discretion of the Trustees in furtherance of the general activities of the Charity and which have not been designated for other purposes.

Designated funds comprise funds which have been set aside at the discretion of the Trustees for speci fi c purposes.

Restricted funds are funds subject to speci fi c restrictions imposed by donors or by the nature of the appeal. The purpose and use of the Charity’s restricted funds is set out in the notes to the nancial statements.

Income

Income becoming available to the Charity is recognised when there is entitlement to the income, probability of receipt and amounts can be measured reliably as per FRS102 SORP.

Gifts in kind are valued and brought in as income and the appropriate expenditure, when the items are used/ distributed. The values attributable to gifts in kind are an

48 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

estimate of the gross value to the organisation, where quanti fi able. Where this intangible income relates to project activities, it is included as an activity in furtherance of the Charity's objects.

Expenditure

Cost of raising funds includes costs associated with the fund-raising events in furtherance of the Charity’s objects.

Charitable expenditure includes costs associated with particular activities in furtherance of the Charity’s objects.

Governance costs are those incurred in connection with the management of the Charity’s assets, organisational administration, and compliance with constitutional and statutory requirements and are included within support costs.

Charitable expenditure comprises direct expenditure including direct staff costs attributable to the activity. Support costs which cannot be directly attributed to an activity have been allocated to activities on a basis consistent with use of the resources.

Grants payable are charged when the offer is conveyed to the recipient except in those cases where the offer is conditional, such grants being recognised as expenditure when the conditions attaching are ful fi lled. Grants offered subject to conditions which have not been met at the balance sheet date are noted as a commitment, but not accrued as expenditure.

Financial instruments

The charitable company has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ of FRS 102 to all of its fi nancial instruments. Financial instruments are recognised in the Charity's balance sheet when the Charity becomes party to the contractual provisions of the instrument. Financial assets and liabilities are offset, with the net amounts presented in the fi nancial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously. With the exceptions of prepayments, deferred income and amounts owed to or from HMRC. All other debtor and creditor balances are considered to be basic nancial instruments under FRS 102.

Debtors

Short term debtors are measured at transaction price, less any impairment. Loans receivable are measured initially at fair value, net of transaction costs, and are measured subsequently at amortised cost using the effective interest method, less any impairment.

Cash and cash equivalents

Cash and cash equivalents in the balance sheet comprise cash at banks and in hand and term deposits with an original maturity date of three months or less. For the purpose of the statement of cash fl ows, cash and cash equivalents consist of cash and cash equivalents as de fi ned above.

Creditors

Short term trade creditors are measured at the transaction price. Other fi nancial liabilities, including bank loans, are measured initially at fair value, net of transaction costs, and are measured subsequently at amortised cost using the effective interest method. Deferred income represents grants, contract funding and training fees relating to future periods.

Pension scheme

The Charity operates a de fi ned contribution stakeholder pension scheme. The amount charged to the statement of fi nancial activities in respect of pension costs is the Charity's contributions payable in the year. The assets of the scheme are held separately from the Charity. There was no outstanding liability owed to the scheme at the end of the current or prior years.

Employee bene fi ts

The cost of short-term employee bene fi ts are recognised as a liability and an expense. The cost of any material unused holiday entitlement is recognised in the period in which the employee’s services are received.

Critical accounting estimates and areas of judgement

In the view of the Trustees in applying the accounting policies adopted, no judgements were required that have signi fi cant effect on the amounts recognised in the fi nancial statements nor do any estimates or assumptions carry a signi fi cant risk of material adjustment in the next fi nancial year.

FINANCIAL REVIEW 49

Orchid Cancer Appeal

Notes to the nancial statements

2. Donations

Current year Year ended Year ended 30 September 30 September 2020 2019 Restricted Unrestricted Total Total £ £ £ £ Individuals 16,200 69,301 85,501 56,468 Legacies - 17,000 17,000 - Corporates 5,000 17,434 22,434 120,076 Trusts and Foundations 88,115 11,250 99,365 161,065 Fundraising Events - 114,545 114,545 312,526 Total 109,315 229,530 338,845 650,135 Prior year Year ended 30 September 2019 Restricted Unrestricted Total £ £ £ Individuals - 56,468 56,468 - Legacies - - Corporates 29,000 91,076 120,076 Trusts and Foundations 151,515 9,550 161,065 Fundraising Events - 312,526 312,526 Total 180,515 469,620 650,135

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Annual report and nancial statements 2019-2020

Notes to the nancial statements

3. Fundraising events

Current year Year ended Year ended 30 September 30 September 2020 2019 Restricted Unrestricted Total Total £ £ £ £ Cycling events - 3,249 3,249 9,478 Running events - 39,017 39,017 117,694 Third party organised events - 64,346 64,346 159,279 Trek - - - - Other - 7,933 7,933 26,075 Total - 114,545 114,545 312,526 Prior year Year ended 30 September 2019 Restricted Unrestricted Total £ £ £ Cycling events - 9,478 9,478 Running events - 117,694 117,694 Third party organised events - 159,279 159,279 Trek - - - Other - 26,075 26,075 Total - 312,526 312,526

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Orchid Cancer Appeal

Notes to the nancial statements

4. Charitable activities

Current year Year ended Year ended 30 September 30 September 2020 2019 Restricted Unrestricted Total Total £ £ £ £ Grants - National Lottery Community Fund Covid 19 Emergency Funding 47,571 - 47,571 - Big Lottery Reaching Communities Fund - - - 132,526 North East London Cancer Network - - - 50,000 Other - - - 3,000 Total 47,571 - 47,571 185,526 Prior year Year ended 30 September 2019 Restricted Unrestricted Total £ £ £ Grants - Big Lottery Reaching Communities Fund 132,526 - 132,526 North East London Cancer Network 50,000 - 50,000 Other 3,000 - 3,000 Total 185,526 - 185,526

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Annual report and nancial statements 2019-2020

Notes to the nancial statements

5. Total expenditure

Year ended Year ended 30 September 30 September 2020 2019 Cost of Education and raising funds awareness Research Total Total £ £ £ £ £ Grants - - 112,876 112,876 41,454 Staff costs 118,013 199,116 22,014 339,143 373,753 Fundraising expenses 26,277 - - 26,277 107,362 Information materials - 72,185 - 72,185 131,634 Direct costs - 79,807 79,807 93,154 144,290 351,108 134,890 630,288 747,357 Support costs Depreciation 247 436 46 729 - Other 35,735 62,932 6,666 105,333 151,090 Governance - staff costs 3,033 5,118 566 8,717 11,060 Governance - audit fees 3,905 6,877 728 11,510 9,432 42,920 75,363 8,006 126,289 171,582 Total expenditure 187,210 426,471 142,896 756,578 918,939 Prior year 247,885 594,359 76,695 918,939

FINANCIAL REVIEW 53

Orchid Cancer Appeal

Notes to the nancial statements

6. Grants awarded

Year ended Year ended 30 September 30 September 2020 2019 £ £ Grant commitments brought forward 199,002 249,616 Institutional grants for medical research awarded during year: Orchid Study and Travel awards (2019: 1 individual) - 970 Barts and London School of Medicine 112,876 83,843 Write off - (43,360) Payments made during period/year (106,463) (92,067) Grant commitments carried forward 205,415 199,002 Payable less than one year 205,415 199,002 - - Payable two to fi ve years

Notes to the nancial statements

7. Net expenditure for the year

This is stated after charging: Year ended Year ended 30 September 30 September 2020 2019 £ £ Depreciation 729 - Auditor’s remuneration: Audit 9,592 9,432 Prior year under accrual Trustees’ remuneration Nil Nil Trustees’ expenses Nil Nil

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Annual report and nancial statements 2019-2020

Notes to the nancial statements

8. Staff costs and numbers

Staff cost were as follows: Year ended Year ended 30 September 30 September 2020 2019 £ £ Salaries and wages 241,235 222,273 Social security costs 20,787 21,968 Pension contributions 2,442 2,174 264,464 246,415 Consultants’ costs 83,397 138,398 347,861 384,813

During the year ended 30 September 2020 no employee earned more than £60,000; one employee earned £80,000-£89,999. The pension contribution paid in respect of this employee totalled £Nil (2019: £2,014)

The key management personnel of the Charity comprise the Trustees and the Chief Executive.

The charity trustees do not receive remuneration. The total remuneration of the chief executive was £80,177 (year ended 30 September 2019: £92,476). This includes amounts payable to a staff member covering the position in the absence of a permanent Chief Executive.

The average number of employees during the year was 5.8 (2019: 4.6)

The average number of employees during the year on a headcount basis was as follows:

FTE 2020 FTE 2019 No. No. Fundraising 1.3 0.8 Education and awareness 4.2 3.5 Grant support 0.3 0.3 5.8 4.6

FINANCIAL REVIEW 55

Orchid Cancer Appeal

Notes to the nancial statements

9. Taxation

The charitable company is exempt from corporation tax as all its income is charitable and is applied for charitable purposes.

Notes to the nancial statements

10. Tangible fi xed assets

Computer and 30 September 30 September of fi ce equipment 2020 2019 Total Total Total £ £ £ Cost At the start of the period 2,674 2,674 25,678 Additions 2,187 2,187 - Disposals (1,637) (1,637) (23,003) At the end of the period 3,224 3,224 2,674 Depreciation At the start of the period 2,674 2,674 25,678 Charge for the period 729 729 Disposals (545) (545) (23,003) At the end of the period 2,858 2,858 2,674 Net book value At the end of the period 366 366 - At the start of the period - - -

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Annual report and nancial statements 2019-2020

Notes to the nancial statements

11. Debtors

Year ended Year ended 30 September 30 September 2020 2019 £ £ Prepayments 83,777 35,060 Other debtors and accrued income 52,809 151,986 136,586 187,046

Notes to the nancial statements

12. Creditors: amounts due within one year

Year ended Year ended 30 September 30 September 2020 2019 £ £ Grants payable 205,415 199,002 Trade and other creditors 34,691 61,885 Taxation and Social Security 5,530 6,311 Accruals 35,754 40,169 281,390 307,367

FINANCIAL REVIEW 57

Orchid Cancer Appeal

Notes to the nancial statements

13. Movements in funds

Current year Brought forward Income Expenditure Carried forward £ £ £ £ Unrestricted General 334,804 244,295 (443,717) 135,382 Designated – Research 166,157 - (112,876) 53,281 Designated – Development 121,808 - - 121,808 Designated – Awareness 83,658 - - 83,658 Total unrestricted 706,427 244,295 (556,593) 394,129 Restricted - Testicular Cancer Counselling 16,247 - (16,247) - Big Lottery Reaching Communities Fund 51,469 - (51,469) Male Cancer Nurse Information Specialist 76,706 - (19,732) 52,870 The Innovation Research Project 16,200 - 16,200 Penile Cancer Peer Support 4,492 5,000 (4,492) 5,000 Education and Awareness - 33,250 (22,000) 11,250 Student Study and Travel Scholarships 6,729 - - 6,729 Roadshows 30,926 33,415 (26,814) 37,527 - Tissue Bank - 13,750 (13,750) Young Person’s Testicular Cancer Project 10,369 - - 10,369 National Lottery Community Fund – Covid 19 Emergency - 47,571 (10,243) 37,328 City of London Corporation - 7,500 - 7,500 - Services - 200 (200) - North East London Cancer Network 35,037 - (35,037) Total restricted 231,975 156,886 (199,984) 188,877 Total funds 938,402 401,181 (756,577) 583,006

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Annual report and nancial statements 2019-2020

Notes to the nancial statements

13. Movements in funds (continued)

Prior year Brought forward Income Expenditure Carried forward £ £ £ £ Unrestricted General 303,777 480,128 (449,101) 334,804 Designated – Research 250,000 - (83,843) 166,157 Designated – Development 121,808 - - 121,808 Designated – Awareness 83,658 - - 83,658 Total unrestricted 759,243 480,128 (532,944) 706,427 Restricted Testicular Cancer Awareness - - - - Testicular Cancer Counselling 19,226 - (2,979) 16,247 Big Lottery Reaching Communities Fund 69,664 135,526 (153,721) 51,469 Male Cancer Nurse Information Specialist 88,499 3,000 (14,793) 76,706 Awareness 242 19,750 (19,992) Penile Cancer Peer Support 9,960 5,000 (10,468) 4,492 Prostate Cancer Nurse 10,000 - (10,000) - Student Study and Travel Scholarships 7,700 - (971) 6,729 Roadshows 25,057 81,815 (75,946) 30,926 Tissue Bank - 38,950 (38,950) - Young Person’s Testicular Cancer Project 12,381 - (2,012) 10,369 Prostate Cancer Awareness 9,200 29,000 (38,200) - Services - 3,000 (3,000) - North East London Cancer Network - 50,000 (14,963) 35,037 Total restricted 251,929 366,041 (385,995) 231,975 Total funds 1,011,172 846,169 (918,939) 938,402

General funds are unrestricted funds available for use at the Trustees’ discretion in furtherance of the general activities of the charity and which have not been designated for other purpose.

Designated Research funds represent monies set aside at the Trustees’ discretion to be used to help fund the costs of future research programmes.

Designated Development funds represent monies set aside at the Trustees’ discretion to be used to help fund the costs related to increasing the organisational capacity of the charity.

Designated Awareness funds represent monies set aside at the Trustees’ discretion to be used to help fund speci fi c awareness activities.

FINANCIAL REVIEW 59

Orchid Cancer Appeal

Notes to the nancial statements

14. Analysis of net assets between funds

Current year Total funds at Unrestricted Restricted 30 September funds funds 2020 £ £ £ Fixed assets 367 367 Current assets 952,583 250,590 1,203,173 Creditors due within one year (281,390) (281,390) Net assets at 30 September 2020 671,560 250,590 922,150 Total funds at Prior year analysis of net assets between funds Unrestricted Restricted 30 Septembe r funds funds 2020 £ £ £ Fixed assets - - Current assets 1,013,794 231,975 1,245,769 Creditors due within one year (307,367) (307,367) Net assets at 30 September 2019 706,427 231,975 938,402

Notes to the nancial statements

15. Related party transactions

There were no related party transactions during the year (Year to 30 September 2019: none)

60 FINANCIAL REVIEW

Annual report and nancial statements 2019-2020

Notes to the nancial statements

16. Financial commitments

For the year ended 30 September 2020, the charity was committed to making the following future payments under non cancellable operating leases:

Year ended Year ended 30 September 30 September 2020 2019 £ £ Land and buildings - - Expiring within one year 14,184 18,300 14,184 18,300

FINANCIAL REVIEW 61

ORCHID FIGHTING MALE CANCER