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2022-03-31-accounts

COBALT HEALTH ANNUAL REPORT 2021/22

www.cobalthealth.co.uk

Charity Registration Number: 1090790 Company Number: 04366596

CONTENTS

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Chair’s statement 4
About us, our vision and values 5
Trustees’ strategic report 6
Our objectives and values 7
Coronavirus impact and response 8
Diagnosis – achievements, impact and the future 9
Research – achievements and impact 15
The Institute of Translational Medicine Imaging Centre update 16
Research - the future 17
Education - achievements, impact and the future 18
Fundraising report 20
Financial overview 23
Grant making policies, risk management 26
Structure, governance and management 27
Statement of trustees’ responsibilities 28
Independent auditors' report to the members of Cobalt Health 29
Statement of financial activities 32
Balance sheet 33
Cash flow statement 34
Notes to the financial statements 35
Trustees and advisers 54
Glossary 55
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Front cover image: Prime Minister Rishi Sunak visits a Cobalt mobile CT and integrated patient support unit, supporting the NHS with their lung health check programme, 28th October 2022.

Cobalt Health Annual Report 2021/22 – P.3

CHAIR'S STATEMENT

The trustees are pleased to report on another strong year for Cobalt, one that saw the transition from supporting our colleagues in the NHS during the COVID-19 pandemic to restarting key services, including working with a number of leading NHS trusts to provide critical diagnostic and screening services. We are especially proud of our sector-leading involvement in the provision of lung health checks. Our work is directly improving the lives and life expectancy of people in communities in the UK where these services are most required.

The increased activity, delivered through the commitment of the whole team, has resulted in similarly heightened surpluses over the last 2 years providing the Charity with strong reserves that make Cobalt’s finances robust and secure.

Whilst the expectation is that 2022/23 will be a more normal year in terms of income and surplus, and the future will be more challenging, our reserves allow Cobalt to continue to invest in state-of-the art diagnostic equipment, maintaining our aim to be early adopters in the UK. In 2021/22, Cobalt invested £5m in new medical equipment, with another £3.6m committed at the year end, including the exciting introduction of Cobalt’s first mobile PET/CT* scanner.

Our reserves will allow us to deliver on our ambitions to increase our research funding and grow our education offer, including funding our second Cobalt research fellow in a new partnership with the Royal Brompton Hospital.

Cobalt has grown its staff complement in line with the increase in the demand for its services over the last two years. We will continue to invest in our people to ensure we can continue to provide a high-quality service to more patients. This heightened resilience gives us a firm basis from which to go forward and develop further.

As always, the trustees are very grateful to all our staff, supporters and volunteers for their commitment to Cobalt and our ongoing objectives. It has been particularly heartening to see our fundraising events restart and the volunteers back working with us.

I would like to add my personal thanks to my fellow trustees for their continued support and advice. Their commitment to Cobalt’s vision has enabled the Charity to continue to grow and develop, increasing the impact Cobalt is having on patient outcomes.

Neil Holbrook

Chair of the board of trustees

P.4 – Cobalt Health Annual Report 2021/22

ABOUT US

Cobalt Health (Cobalt) is a medical charity, established in 1964 to help people affected by cancer, dementia and other conditions. Each year we provide diagnostic imaging for over 115,000 patients at imaging centres in Cheltenham and Birmingham, and through a fleet of mobile MRI, PET/CT and CT scanners* supporting NHS hospitals and other medical facilities across the UK.

We focus on offering equipment and services not always available within the NHS to support patients across the UK. Our imaging centres house the latest technology designed to improve patient comfort, enable shorter scanning times, and deliver superior image quality. Using ultra-low dose mobile CT, we are the leading provider of lung cancer screening services in the UK, working in partnership with the NHS.

We endeavour to deliver improvements in clinical diagnoses and treatments, mainly relating to cancer and dementia. This is achieved by investing in cuttingedge technology and supporting and participating in local, national and international research working with leading experts in the field. We also work closely with the Queen Elizabeth Hospital in Birmingham to deliver specialist research imaging for the Institute of Translational Medicine and the University of Birmingham.

By delivering a diverse training and education programme for medical professionals, we enhance their professional development and support opportunities to share research findings and best practice.

OUR VISION

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To pioneer innovation in medical imaging diagnosis by investing in
equipment, integrated research and education, to improve outcomes
for patients now and in the future.
OUR VALUES
I C A R E
INNOVATIVE CARING ACCESSIBLE RESPECTFUL ETHICAL
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Cobalt Health Annual Report 2021/22 – P.5

TRUSTEES' STRATEGIC REPORT

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ended 31 March 2022. The Charity reports its
diagnosis, research and education.
Public Benefit
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will contribute to the aims and objectives they have set.
The trustees believe that this report demonstrates the Charity’s
by supporting hospitals with urgent diagnostic scans through to
September 2021.
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Our commitment to quality

Cobalt is committed to exceptional patient care whilst delivering a consistently excellent standard of imaging and reporting. We publish a Quality Account on an annual basis, which details the processes and systems we manage and highlights our achievements in this area; achieving both the standards set by the Care Quality Commission and demonstrating the consistent audit and improvement required to meet the standards of the Quality Standard for Imaging, ISO 9001:2015 and ISO14001:2015. During the year, the Charity worked towards and achieved the ISO14001 standard.

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P.6 – Cobalt Health Annual Report 2021/22
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OUR OBJECTIVES

The detection, diagnosis, treatment and prevention of sickness, in particular cancer, in persons living in Gloucestershire, Herefordshire, Worcestershire and the West Midlands, and such other areas of Great Britain and by such means as the trustees may from time to time decide, including the provision and maintenance of equipment and to provide or assist in the provision of education and research into methods of detection, diagnosis, treatment and prevention of sickness, in particular cancer and dementia and publication of any useful results.

When reviewing whether the Charity has been successful the trustees consider:

Cobalt Health Annual Report 2021/22 – P.7

CORONAVIRUS IMPACT AND RESPONSE

All activities and areas of the Charity were risk assessed with appropriate procedures and infrastructure maintained in accordance with the changing guidance for healthcare settings, thus ensuring a safe and secure environment for staff to provide patients with continuing high quality, caring, diagnostic services during the pandemic.

Cobalt continued to work in partnership with NHS England and a large number of NHS trusts in the response to Covid-19 to help maintain key diagnostic services for patients. These services were available for up to 24 hours per day, seven days per week right across England wherever required.

Throughout 2021/22, Cobalt continued to invest in new CT scanners to extend the support provided to the NHS, this also enabled the Charity to maintain a good income stream during the pandemic. The work undertaken to support the NHS through the crisis has resulted in the Charity being in a stronger position to invest and continue to support the NHS in key initiatives, including CT lung cancer screening (lung health checks) and extending its PET/CT services for diagnosing and staging cancer and dementia.

Whilst at the current time all sectors are seeing increases in costs, the financial forecasts, cashflow analysis and reserves provide the trustees with sufficient confidence in Cobalt’s finances to be able to support the operations for the next 12 months.

“Friendly staff. Great Covid precautions.” Ashley Donlan.

P.8 – Cobalt Health Annual Report 2021/22

DIAGNOSIS AIMS FOR 2021/22 WERE:

The Charity aims to support NHS services to provide enhanced medical care to people who are sick and injured, using the most up-to-date imaging technology that may not otherwise have been available. The specific aims for 2021/22 included:

Cobalt Health trading as Cobalt

Cobalt Health Cobalt Health Annual Report 2021/22 – Annual Report 20 1921 /2 0 2 – P.9

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DIAGNOSIS
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to heed the latest advice on maintaining a safe working environment for staff and patients.
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Cobalt worked closely with NHS England during
the pandemic, to provide a rapid mobile CT
service to many NHS trusts across the country.
Operating seven mobile CT scanners and the
ability to deliver a flexible workforce, enabled the
Charity to extend services for up to 24 hours per
day. This enabled 1,500 patients each week to be
safely scanned outside hospitals, many of whom
required urgent oncology related imaging.
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Cobalt supported two international imaging
congresses in 2022, the United Kingdom Imaging
and Oncology Congress and the European
Congress of Radiology in Vienna. This included
displaying the latest mobile CT scanner, in order
to promote the use of ultra-low dose CT to
support the lung cancer screening programmes
in the UK and Europe.
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Cobalt continued to develop and promote its specialist patient friendly service for anxious /claustrophobic patients, combining the expertise of our staff with enhanced scanner patient comfort features; to enable almost 90% of these patients to receive a meaningful diagnosis and consequently better ongoing treatment. In 2021 Cobalt became the first imaging centre in the UK to introduce the new Siemens Innovision system, an MRI in bore entertainment system designed to significantly reduce patient anxiety. "I am very claustrophobic and explained this to the staff who were extremely kind and helpful and able to get me through my scan. Exceptional people.” Peter Howell

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We are very grateful for the support we receive from charitable trusts and foundations. The Clive Richards
Foundation, in memory of our late Patron, Clive Richards CBE KSG DL generously support our lung health
check cancer screening programmes.
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P.10 – Cobalt Health Annual Report 2021/22
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Worked with local consultants in Gloucestershire with the aim of reducing the cancer pathway for patients, the Charity integrated the PET/CT scan with a diagnostic CT scan during one visit. This study is currently being written up; early results demonstrate this reduced the diagnostic cancer pathway by up to 2 weeks, reducing patient wait times and anxiety and enabling faster treatment.

“I was very impressed with the way in which my scan was handled and the friendliness and competence of the staff. I don't think it could have gone smoother.” Brian Watts

In March 2022, Cobalt launched the Charity’s first mobile PET/CT service, using the latest Siemens PET/CT technology. This mobile facility is unique in providing a complete and fully integrated PET/CT department to support NHS hospitals across England.

Cobalt has become recognised for developing the use of new prostate cancer isotopes (F18 PSMA) for PET/CT, improving the diagnosis of recurrent prostate cancer. Patients are referred from a wide area to access these scans.

In 12 months, the Charity delivered over 3,500 PET/CT scans for NHS oncology patients from Gloucestershire, Herefordshire, Worcestershire and Swindon. Cobalt is also one of the largest centres in the UK to support the early diagnosis of dementia for the NHS, using PET/CT scanning.

Cobalt is working with the NHS to develop

Community Diagnostic Centres (CDCs), in line with NHS England's recommendations and funding initiatives. This includes developing the Charity’s first CDC in Gloucestershire.

Cobalt Health Annual Report 2021/22 – P.11

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DIAGNOSIS
Targeted Lung Health Check Programme. In
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cancers are identified early, allowing more
opportunity for successful intervention and
treatable stage. The benefit of these services
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82

14

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considerable cost and time of treating
for longer.
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2

2

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P.12 – Cobalt Health Annual Report 2021/22
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2021 Sep 20. PMID: 34583222.
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MEDICAI UW., *1 Cobalt Health Annual Report 2021122- P.13

To successfully launch Cobalt’s first mobile PET/CT scanner to help support the NHS across England as the demand for PET/CT continues to grow.

DIAGNOSIS THE FUTURE

The new digital scanner will also facilitate the Charity expanding its role in supporting research and clinical trials.

P.14 – Cobalt Health Annual Report 2021/22

RESEARCH

AIMS FOR 2021/22 WERE:

Cobalt aims to fund and participate in pioneering research into the detection of cancer and other long-term conditions such as dementia, with an emphasis on using diagnostic imaging.

A recent focus has been to increase internal research within the Charity as well as continuing to support external research projects which are in line with the Charity’s core objectives.

ACHIEVEMENTS AND IMPACT IN 2021/22

• Maintaining services to patients participating in timesensitive research trials. The percentage of research activity of all scans was increasing post pandemic. At the Cobalt Imaging Centre in Cheltenham, research scans represent over 6% of the total scans for PET/ CT and MRI. At the Institute of Translational Medicine Imaging Centre in Birmingham, around 25% of total scans are now research studies.

• The Charity is currently supporting over forty research projects and clinical trials providing imaging in CT, MRI and PET/CT. The main focus remains the diagnosis and treatment of cancer and dementia. Other projects are supported, including research into the impact of long Covid.

Cobalt continued to support the funding of four NHS research nurses through 2021/22. This funding enabled the two local trusts to recruit patients into clinical trials when many trusts had to reduce activity due to the impact of Covid-19 on their resources.

The trustees are pleased to report that Gloucestershire Health and Care Trust has been able to use the seed funding from Cobalt to build their research-based income streams and make a significant move to towards funding this activity themselves in the future.

We are grateful to charitable trusts, local businesses and individuals who donate to support the valuable work undertaken by these research nurses.

Cobalt Health Annual Report 2021/22 – P.15

THE INSTITUTE OF TRANSLATIONAL MEDICINE (ITM) IMAGING CENTRE

FIVE YEARS ON

The ITM Imaging Centre at Queen Elizabeth Hospital (QEH), Birmingham celebrated its fifth birthday in April 2022. The QEH and University of Birmingham, host a wide range of clinical research projects as many researchers need access to imaging, to help develop more effective targeted treatments with a personalised approach to healthcare.

Access to high quality MRI scanners to support this research was a problem, as the existing scanners were in use full-time to support clinical patients. With the support of the Clive Richards Foundation, Cobalt installed the very latest ultra-high field MRI scanner in a building adjacent to the ITM. This new facility was ring-fenced to support research.

During the Covid-19 pandemic, research slowed down and the imaging centre was repurposed as a safe ‘Green Site’ (Covid-19 secure site) outside of the QEH. The centre provided urgent support for oncology and vulnerable patients.

Research did not take long to recover at the imaging centre in the form of urgent studies into the longterm implications of Covid-19. One such study aims to understand the impact of long Covid on various organs within the body.

In the last 12 months the imaging centre has supported clinical trials looking at sarcopenia (a progressive skeletal muscle disorder), cardiac disease, stroke, brain tumours and liver disease. The unique technical capabilities and highly skilled team enable researchers to deliver the quality of imaging and patient care needed for any given trial.

The ITM Imaging Centre affords the opportunity to bring together radiographers, clinical scientists, specialist nurses, care assistants and administrative teams collaborating with clinicians and research fellows to deliver the services that would otherwise not exist in this unique setting.

P.16 – Cobalt Health Annual Report 2021/22

RESEARCH

THE FUTURE

tumour biopsy service. Their research focus will include:

Cobalt Health Annual Report 2021/22 – P.17

EDUCATION ACHIEVEMENTS AND THE FUTURE

Education: Aims for 2021/22 were:

Education: Achievements and impact in 2021/22 were:

of the research programme, the post will also lead on research, working with Professor Iain Lyburn, Cobalt’s Medical Director.

P.18 – Cobalt Health Annual Report 2021/22

EDUCATION THE FUTURE

With the impact of Covid-19 and delays in recruitment on the progress of our objectives, most of the key aims remain unchanged:

Cobalt Health Annual Report 2021/22 – P.19

FUNDRAISING REPORT

The total income achieved during 2021/2022 was the targeted £0.8m. This came from individual donations (£167k), fundraising activities (£359k) and bequests (£298k). We are grateful to past supporters, and their loved ones, who left a gift in their will and over a hundred more supporters, who have kindly let us know their intention to support Cobalt in this way.

Cobalt undertakes fundraising to support the objectives of the Charity. Funds raised help to provide the latest technology, enabling patients to have the earliest and most accurate diagnosis. We fund over 700 oncology scans including specialist breast MRI scans for ‘at risk’ women. These scans provide rapid access to the latest technology and hence a faster diagnosis at no charge to the NHS. Cobalt continues to fund free specialist PET/CT scans to support the early diagnosis of dementia – enabling the potential to access an appropriate treatment pathway sooner. We also raise funds to support two specialist dementia research nurses.

Cobalt has supported breast cancer services since the NHS screening programme was launched in 1990. Today the Charity provides funding for two breast cancer research nurses and access to imaging which has enabled the local NHS to participate in important research projects including the national BRAID trial. This trial is determining whether additional imaging using different techniques is helpful in diagnosing breast cancer for women with dense breast tissue (which has twice the risk of breast cancer).

Since 2011 the Charity has contributed funding to support the role of a cancer nurse specialist for teenagers and young adults. Megan Willsher, Cobalt's Teenagers and Young Adults with Cancer Specialist Nurse says, ‘My role ensures these patients are supported throughout their cancer journey and beyond, helping them to move forward with their life, as they would have without the intrusion of cancer.’ A new photography competition, ‘Capture a Moment for Cobalt’ was launched to help raise funds for this role. The winning images were collated to form a beautiful calendar to raise further funds.

Volunteers are important to the work of the charity and offer their time and expertise to support in various ways.

P.20 – Cobalt Health Annual Report 2021/22

55 Cobalt volunteers helped at the Steam and Country Extravaganza this year. Since 1992, the Woodchester and Nailsworth Supporter Group has raised over £132,000 for Cobalt.

The Fundraising Team achieved their set objectives in 2021/2022. Fundraising continues to support the key strategic aims of the Charity. In October 2021, an appeal was launched to raise funds to contribute to a new £2million PET/CT scanner.

Each year, in April partner solicitors volunteer their time to write simple wills in return for a donation to the Charity.

Cobalt Health Annual Report 2021/22 – P.21

GIVING WITH CONFIDENCE

Cobalt is a member of the Fundraising Regulator and complies with the standards laid out in the Code of Fundraising Practice. We agree to ensure our fundraising is legal, open, honest, and respectful. The Charity adheres to the ‘Fundraising Promise’ which is published on the Cobalt website. The Charity has also signed up to the Fundraising Preference Service which enables individuals to opt out from receiving fundraising communications from us. Cobalt staff and volunteers carry out their activities in accordance with these guidelines.

The Charity is also a member of the Institute of Fundraising and the Institute of Legacy Management and adheres to their best practice guidelines. External agencies are not employed to carry out fundraising on behalf of the Charity. There is no door-to-door fundraising. In line with our Data Protection Policy the Charity does not sell and has not given data to any third parties without express permission. Access to the Cobalt database by staff and volunteers is strictly controlled. Cobalt treats its responsibility towards supporters in vulnerable circumstances with the utmost importance and our fundraisers are provided with guidance and support to help them respond appropriately to any individual they consider this might apply to.

No complaints have been received during the year. Any complaints received are managed in accordance with our complaint handling procedures. Supporters are encouraged to provide feedback as this is an important source of information about the impact that the Charity’s work has on them and other members of the public.

We provide details of how to contact us, including our complaints process, on our website. The fundraising programme is reported on a regular basis to the board of trustees and the ongoing strategy approved by them, to make sure our fundraising activities are compliant with all relevant rules and regulations, remain ethical and deliver the highest possible standards. We want to ensure that everyone who supports us has the best possible experience and that our donors are confident of the difference they are making.

Most people who donate to us want to know how their money is making a difference. We ask whether they would like us to keep in touch with them and how, so we can update them on our work. We give supporters the option to let us know if they no longer wish to hear from us, and always respect their decision.

P.22 – Cobalt Health Annual Report 2021/22

FINANCIAL OVERVIEW

Total income for the year was

£22.9m (2021 – £21.7m).

The first half of the year saw continued support for NHS England in their response to the impact from Covid-19 with mobile CT and other imaging activities continuing to pick up after the pandemic. There was a full return of mobile MRI and CT operations, including supporting the NHS to relaunch their lung health check services. The number of mobile and relocatable CT scanners in service increased to twelve through acquisition and hiring in units, with another nine MRI scanners. The Charity continued to support oncology patients with PET/CT and MRI, whilst maintaining research capabilities for ongoing studies. Cobalt continued to provide free MRI, CT and PET/CT scans to help reduce oncology waiting times, improved diagnostic pathways and the early diagnosis of dementia.

With the increased number of scanners the cost of delivery of the charitable activities increased by £5m to £19.9m (2021 - £14.9m). At the same time the margin was reduced due to additional costs of operating and staffing all the services.

The surplus for the year was £2.9m (2021 - £6.8m). The Charity invested the surpluses from 2021 and 2022 in both renewing old equipment and adding new imaging equipment. During the year, £5.0m of medical equipment was acquired and £0.2m was spent on engineering plant upgrades at the imaging centre in Cheltenham. A further £3.6m of capital expenditure had been committed to at the year end, including replacing the PET/CT scanner at the imaging centre with a new digital scanner.

INCOME AND EXPENDITURE

The total income for 2021/22 was £22.9m (2021 - £21.7m).

MRI Services (£8.4m) (2021 - £6.4m)

MRI services improved through the year and were closer to pre-Covid-19 levels. The mobile services ran at 80% of capacity (2021 – 60%) and were enhanced by additional hired units, supporting NHS trusts to develop potential Community Diagnostic Centres. The income from the imaging centre in Cheltenham also increased, despite NHS referrals not yet fully recovering. The research imaging centre, based at the Queen Elizabeth Hospital in Birmingham, supported urgent NHS scans and enabled the return of research activity.

PET/CT and CT Services (£13.6m) (2021 - £13.8m)

PET/CT and CT income is derived from three primary sources;

During the year the number of diagnostic imaging scanners deployed increased through both acquisition and hiring in additional scanners.

Cobalt Health Annual Report 2021/22 – P.23

Fundraising Income (£0.8m) (2021 - £1.0m) of which:

Other income (£0.1m) (2021 - £0.4m)

This income is primarily from rent receivable and gains on fixed asset disposals.

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2% 2%
4%
59% 37%
64%
1%
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BREAKDOWN OF TOTAL INCOME (£22.9m)

Expenditure for 2021/22 totaled £20m (2021 - £14.9m).

MRI Services £8.0m (2021 - £6.8m)

Clinical staffing represents the highest proportion of the total costs. The increase in services has been partially met by increased recruitment. There remains a significant cost for bank and agency staff to support the services. Other increases in costs related to scanner hire, maintenance and mobile MRI and CT transport.

PET/CT and CT Services £11.2m (2021 - £7.4m)

As with the MRI service, although staffing numbers have increased, the expansion of services means that there was an increase in agency and bank staff costs in the year. The cost of hiring CT equipment to support the additional services was £860k. The rise in oil prices has led to a significant increase in transport and generator expenses.

Raising Funds £0.3m (2021 - £0.3m)

Costs relate to the work of the Charity and volunteers to raise philanthropic funds for Cobalt.

Charitable Funding, Nurses and Research £0.4m

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Fundraising activities Donations & legacies
MRI services Other income
PET/CT and CT Services
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2% 0%
56% 40%
1%
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BREAKDOWN OF TOTAL EXPENDITURE (£20m)
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Nurses and research Training and education MRI services Raising funds PET/CT and CT Services

(2021 - £0.3m)

This includes the funding of Cobalt’s Teenagers and Young Adults with Cancer Specialist Nurse, two breast cancer and two dementia research nurses. The increase in 2021/22 was largely due to increased funding for Cobalt’s Research Fellow, who moved to be fully employed by Cobalt during the year.

P.24 – Cobalt Health Annual Report 2021/22

Training and Education £0m (2021 - £0.1m)

No income was generated in the year as the focus for recent training and education activity has been on the provision of free online courses for medical professionals at negligible cost to the Charity. The aim for the newly appointed Head of Education, Training and Research is to increase the number of courses provided. This may generate a small contribution in the future.

Designated Funds £4.9m (2021 - £5.4m)

Capital Equipment £3.1m (2021 - £3.6m)

The funds are held for new equipment projects. The £3.1m carried forward has been retained to replace the static PET/CT scanner and to expand the current PET/CT department to include additional isotope uptake rooms, as well as purchase new CT support units. These projects are expected to be completed by September 2022.

RETAINED FUNDS

Charity Funds £32.5m (2021 - £29.6m)

Restricted Funds £166k (2021 - £29k)

Funds are held at the year end to purchase the replacement PET/CT scanner at the imaging centre in Cheltenham.

Equipment Replacement Fund £1.2m (2021 - £1.1m)

This fund is reserved to replace and refresh the installed imaging equipment as part of the Equipment Replacement Plan. £1.1m has been set aside to replace an older mobile with a new mobile MRI unit during 2022 and replace the X-ray machine at the imaging centre in Cheltenham.

Designated Funds £4.9m (2021 - £5.4m).

The trustees have allocated funds to address recognised needs for the Charity, these are identified below.

Tangible assets for use £27.5m (2021 - £19.7m)

The fund represents the net capital value of the property and working assets of the Charity required for its operation.

Grants Fund £0.4m (2021 - £0.5m)

Grants are to support oncology and dementia services and research. The fund will be expended against ongoing research projects, fellowships and research grant awards that will be advertised from time to time on the Charity’s website. This fund is expected to support these projects over the next two years.

Property Fund £0.1m (2021 - £0.2m)

General Fund and Reserves Policy £4.8m (2021 -

£4.4m)

To protect Cobalt’s activities, the Charity’s reserve policy is to maintain a minimum of 3 months' and a maximum of 5 months' working capital in reserves. At the year-end Cobalt held reserves sufficient for 2.9 months (2021 – 3.6 months). The reduction is partially due to reserving funds for investment in new medical equipment.

The Reserves Policy is regularly reviewed and is still deemed appropriate.

This fund is used to upgrade the facilities in the Charity’s properties. Funds carried forward are retained for upgrading the imaging centre in Cheltenham reception area within the next financial year.

Investments

The Charity considered it prudent to distribute its cash reserves amongst a number of UK banks. Cash has been held on deposit with differing maturity dates to maintain flexibility and attempt to earn some income in a low interest environment.

Cobalt Health Annual Report 2021/22 – P.25

GRANT MAKING POLICIES

The trustees will continue to identify suitable projects which can be supported by the Charity. Support will be given to projects which:

RISK MANAGEMENT

The Charity has a risk management strategy. This involves:

Details of key risks are recorded in a risk register. The following have been identified as key risks. Whilst these largely remain consistent, inflationary pressures have been included as this will have a potential impact on the Charity’s short to medium term resources.

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Risk Impact Mitigation
The Charity is diversifying its activities
Loss of major contract for diagnostic The loss of a contract may have a significant impact into other areas of clinical imaging and
imaging on income means of providing services – including
the addition of Mobile PET/CT in 2022
Staff undertake annual IT Governance
training, including cyber risks. The Charity
Cyber security failure or denial of Potential loss of data, inability to operate, impact on
service attack reputation continues to invest in critical systems,
technical support and remote disaster
recovery resources
Cobalt invests in comprehensive
maintenance and service level
Loss of a clinical scanner through Potential loss of income and key contracts, delay in
agreements to repair or compensate for
breakdown or damage diagnosis for patients
lost time. Growth enables duplication of
scanners and increased diversification
Provision in the budget, cost control,
Impact of inflation and cost drivers on Potential to reduce the capacity to invest in strategic diversification of supply, renegotiating
surpluses objectives in the medium term contracts, and reassessing services,
strong reserves.
Increased cost of working and failure to fulfil Cobalt has launched a recruitment
Shortage of suitably qualified staff website and offers more training and
contracts and grow flexible work opportunities to attract staff
Multiple actions – maintaining awareness
Pandemic/coronavirus – restrictions of infection levels, observing best clinical
on trading and inability to staff Financial and operational losses will impact on practice, diversification of activities and
income and reputation
activities due to illness and isolating retention of reserves to support a loss of
income for a number of months
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P.26 – Cobalt Health Annual Report 2021/22

STRUCTURE, GOVERNANCE AND MANAGEMENT

Cobalt Health (with registered charity number

1090790) is a company limited by guarantee (with company number 04366596) (also known as ‘Cobalt’) and has no share capital. In the event of the company being wound up the liability of each member is limited to £1.

The Charity is governed by Articles of Association dated 23 May 2017. Details of trustees, officers and advisers are given on page 54 of these Financial Statements.

Appointment of new trustees

governance and quality assurance for all clinical work, to ensure that safe, effective and patient-focused healthcare is provided.

• People Committee – meets 4 times a year to review staff pay and conditions, including those of the senior management, making recommendations to the board of trustees. The committee takes into consideration salary benchmarks in the health, commercial and charity sectors.

• Research Committee – meets 3 times each year to consider projects to support and monitor the effectiveness of research.

Day-to-day management of the Charity’s work within that general strategy is carried out by the Chief Executive, Mr Peter J Sharpe and the Charity’s Senior Management Team.

Committee Structure and Management

The board of trustees meets five times a year with occasional special meetings being called as required. It decides the general strategy for the work of the Charity and approves all major items of expenditure or funding. The following committees report to the board of trustees:

There is a dormant subsidiary, The Cobalt Unit Appeal Fund Limited (company number 09016631), with an issued share capital of £1 held by the Charity.

Charity Governance Code

The trustees recognise the benefits to be gained from adopting the Charity Governance Code. The trustees self-audit the governance of the Charity against the principles in the code on a cyclical basis.

In 2022 Cobalt recruited two new trustees. The Board employed an external agency to widen the reach and was pleased with the more diverse range of candidates applying for the roles. The Board will continue to use a mix of in person and online meetings, to help maintain the improved participation seen during the pandemic and access to experts in the various fields.

The trustees continue to endeavor to ensure that the standards expected in the code are maintained.

The trustees and advisers listed on page 54 form part of the Trustee’s Report.

Cobalt Health Annual Report 2021/22 – P.27

STATEMENT OF TRUSTEES’ RESPONSIBILITIES

The trustees (who are also directors of Cobalt Health for the purposes of company law) are responsible for preparing the trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards). Company law requires the trustees to prepare financial statements for each financial year. Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the 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:

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company’s transactions, 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 and the provisions of the

Charity’s constitution. 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.

STATEMENT OF DISCLOSURE TO AUDITOR

Insofar as each of the trustees of the Charity at the date of approval of this report is aware there is no relevant audit information (information needed by the Charity’s auditor in connection with preparing the audit report) of which the Charity’s auditor is unaware. Each Trustee has taken all of the steps that he/she should have taken as a Trustee in order to make himself/herself aware of any relevant audit information and to establish that the Charity’s auditor is aware of that information.

AUDITOR

During the year the Charity used its previously appointed auditor, Crowe U.K. LLP, who has been appointed in accordance with Section 485 of the Companies Act 2006. Crowe U.K. LLP has indicated its willingness to be reappointed as statutory auditor.

The trustees’ Report, comprising The Strategic Report and other information, was approved by the trustees on 15th September 2022 and signed on their behalf by

Neil Holbrook, Chairman

P.28 – Cobalt Health Annual Report 2021/22

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF COBALT HEALTH

Opinion

We have audited the financial statements of Cobalt Health (‘the charitable company’) for the year ended 31 March 2022 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

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 the financial 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 financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustee's use of the going concern

basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

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

Other information

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

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

Cobalt Health Annual Report 2021/22 – P.29

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF COBALT HEALTH

includes the directors’ report and the strategic report prepared for the purposes of company law, for the financial year for which the financial statements are prepared is consistent with the financial statements; and

Matters on which we are required to report by exception

In light of the knowledge and understanding of the charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the strategic report or the directors’ report included within the trustees’ report.

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

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 28, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the 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 financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a 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.

Details of the extent to which the audit was considered capable of detecting irregularities, including fraud and non-compliance with laws and regulations are set out below.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org. uk/auditorsresponsibilities. This description forms part of our auditor’s report.

Extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities, including fraud, are instances of noncompliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

P.30 – Cobalt Health Annual Report 2021/22

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF COBALT HEALTH

We obtained an understanding of the legal and regulatory frameworks within which the charitable company operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, the Charities Act 2011, together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company for fraud. The laws and regulations we considered in this context for the UK operations were UKAS and CQC Regulations.

Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the trustees and other management and inspection of regulatory and legal correspondence, if any.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the completeness and accuracy of income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management, and the Finance Committee about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, designing audit procedures over income, reviewing accounting estimates for biases, reviewing regulatory correspondence including that with the Charity Commission, UKAS and CQC, and reading minutes of meetings of those charged with governance.

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected

some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed noncompliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.

Use of our report

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

Tara Westcott

Senior Statutory Auditor

For and on behalf of

Crowe U.K. LLP 4th Floor, St James House St James Square, Cheltenham Gloucestershire GL50 3PR

8th November 2022

Cobalt Health Annual Report 2021/22 – P.31

COBALT HEALTH

STATEMENT OF FINANCIAL ACTIVITIES

(including an Income and Expenditure account) FOR THE YEAR ENDED 31 MARCH 2022

Note Unrestricted
Funds
 Restricted
Funds
 2022
Total
Funds
 2021
Total
Funds
£ £ £ £
INCOME FROM:
Donations and legacies
2		 331,247 133,477 464,724 929,605
Charitable activities
Clinical services
3		 21,934,585 - 21,934,585 20,262,609
Fundraising activities
4		 55,446 303,710 359,156 84,613
Investment income
5		 13,512 - 13,512 10,452
Other income
6		 112,201 - 112,201 387,290
TOTAL INCOME 22,446,991 437,187 22,884,178 21,674,569
EXPENDITURE ON:
Fundraising costs
9		 292,304 - 292,304 281,360
Charitable activities
9		 19,621,238 38,875 19,660,113 14,590,675
TOTAL EXPENDITURE
9		 19,913,542 38,875 19,952,417 14,872,035
NET INCOME 2,533,449 398,312 2,931,761 6,802,534
TRANSFERS BETWEEN FUNDS 261,642 (261,642) - -
NET MOVEMENT IN FUNDS 2,795,091 136,670 2,931,761 6,802,534
RECONCILIATION OF FUNDS
TOTAL FUNDS BROUGHT FORWARD 29,557,627 28,830 29,586,457 22,783,923
TOTAL FUNDS CARRIED FORWARD
19		 32,352,718 165,500 32,518,218 29,586,457

The notes on pages 35 to 54 form part of these financial statements.

P.32 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

BALANCE SHEET

AS AT 31 MARCH 2022

Company number 04366596

Note
FIXED ASSETS
Intangible assets
11
Tangible fixed assets
12
Investments
13
TOTAL FIXED ASSETS
CURRENT ASSETS
Debtors
14
2022
£
169,577
22,730,795
150,001
23,050,373
3,984,521		 Note
FIXED ASSETS
Intangible assets
11
Tangible fixed assets
12
Investments
13
TOTAL FIXED ASSETS
CURRENT ASSETS
Debtors
14
2022
£
169,577
22,730,795
150,001
23,050,373
3,984,521		 Note
FIXED ASSETS
Intangible assets
11
Tangible fixed assets
12
Investments
13
TOTAL FIXED ASSETS
CURRENT ASSETS
Debtors
14
2022
£
169,577
22,730,795
150,001
23,050,373
3,984,521
2021
£
189,491
19,763,130
150,001
20,102,622
3,790,125
Investments
13
3,045,102		 3,032,265
Cash at bank and in hand
TOTAL CURRENT ASSETS
LIABILITIES
Creditors - amounts falling
15
NET CURRENT ASSETS
Creditors - amounts falling
15
TOTAL NET ASSETS
FUNDS OF THE CHARITY
Unrestricted Funds:
Tangible fixed assets held for Charity's use
16
Designated funds
17
General fund
16
TOTAL UNRESTRICTED FUNDS
Restricted funds
18
TOTAL CHARITY FUNDS
19
Approved by the Trustees on 15th September 2022
and signed by
NEIL HOLBROOK
Chairman
due within one year
due greater than one year
5,929,071
12,958,694
(2,547,228)
10,411,466
(943,621)
32,518,218
22,730,795
4,855,786
4,766,137
32,352,718
165,500
32,518,218		 6,146,392
12,968,782
(2,547,228) (2,334,869)
10,633,913
(943,621) (1,150,078)
29,586,457
29,586,457
19,763,130
19,763,130
5,412,530
4,381,967
29,557,627
28,830
29,586,457

The notes on pages 35 to 54 form part of these financial statements.

Cobalt Health Annual Report 2021/22 – P.33

COBALT HEALTH

CASH FLOW STATEMENT

FOR THE YEAR ENDED 31 MARCH 2022

Note
2022 2021
£ £
Cash flows from operating activities
Net cash provided by operating activities 24 5,082,737 6,414,394
Cash flows from investing activities
Interest receivable and rents from investments 116,779 109,857
Purchase of intangible assets
11		 (47,235) (92,500)
Proceeds from the sale of fixed assets
Purchase of fixed assets
12		 1,480 178,500
(5,192,481) (4,420,099)
Net cash (used in) investing activities (5,121,457 (4,224,242)
Cash flows from financing activities
Repayments of borrowing - HP
(134,253) (79,888)
Repayments of borrowing - Bank loan (31,511) -
Cash inflows from new borrowing - 1,408,970
Net cash (used by)/provided by financing activities (165,764) 1,329,082
Change in cash and cash equivalents in the year (204,484) 3,519,234
Cash and cash equivalents at the beginning of the year 9,178,657 5,659,423
Cash and cash equivalents at the end of the year
25		 8,974,173 9,178,657

The notes on pages 35 to 54 form part of these financial statements.

P.34 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 1. ACCOUNTING POLICIES

Cobalt Health was incorporated in England and Wales as a company limited by guarantee (registered no. 04366596) and has no share capital. The liability in respect of the guarantee is limited to an amount not exceeding £1 per member of the company. Cobalt Health is registered as a Charity with the Charity Commission England and Wales (registered no. 1090790).

a) Basis of accounting

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102), the Charities Act 2011, the Charities SORP and UK Generally Accepted Accounting Practice.

The financial statements have been prepared under historical cost convention. Cobalt Health meets the definition of a public benefit entity under FRS 102.

Assets and liabilities are initially recognised at historical cost or transaction value, unless otherwise stated in the relevant accounting policy note.

Under Section 405 of the Companies Act 2006, consolidated accounts have not been prepared as the inclusion of the dormant subsidiary is not material for the purpose of giving a true and fair view. Therefore these financial statements present information on the parent entity as an individual undertaking only.

b) Preparation of the accounts on a going concern basis

At the year end the Charity had £8.97m in the bank and on deposit. The Charity is able to meet its planned capital expenditure for 2022/23 and thereby help underpin future income generation.

The Charity prepares an annual budget and three year projections. These have factored in anticipated increases in expenditure. Whilst recognising the challenges, the Charity expects to make a surplus over the next three years.

On this basis the trustees are able to adopt a going concern basis for the preparation of these financial statements.

c) Income

Income, including that from clinical services, is recognised in the period to which it relates, once the Charity has entitlement to the resources and once the trustees have probability that the resources will be received and when the monetary value can be measured with reliability.

Income from fundraising events is shown gross, with the associated expenditure shown in Fundraising costs. Where the Charity benefits from work carried out by volunteers without charge, no value is placed on this work for accounting purposes.

Donations including donated goods are recognised as income when they have been received and any conditions associated with the donation have been met.

Legacy income is recognised when there is a grant of probate; the executors have established that there are sufficient funds to distribute funds from the estate; the legacy can be valued with reasonable accuracy and any conditions attached to the legacy have been met or are

Cobalt Health Annual Report 2021/22 – P.35

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

within the control of the Charity. An adjustment is made to include legacy receipts up to two months of the year end which relate to probate notifications for the financial year or earlier.

Interest and investment income, including rental income, is included when receivable and the amount can be measured reliably. Rental income due to the Charity, applicable to operating leases, where substantially all of the benefits and risks of ownership of the asset remain with the Charity is recognised in the Statement of Financial Activities over the lease term.

Government grants receivable are credited to income as these become receivable, except in situations where they related to performance, in which case these are accrued as the charity earns the right through performance.

d) Expenditure

Expenditure is included in the Statement of Financial Activities on an accruals basis, inclusive of any VAT which cannot be recovered, as soon as there is a legal or constructive obligation committing the Charity to the expenditure.

Expenditure on fundraising are those costs incurred in providing services for which the Charity received a direct income and those incurred in fundraising activity.

Expenditure on charitable activities represents the cost of supporting the Charity’s objectives and as laid out in its memorandum and articles of association.

Governance costs are those incurred in the governance of the Charity and its assets and are primarily associated with constitutional and statutory compliance.

Support costs include central functions, principally connected with buildings and administration, which are indirectly incurred in support of the generation of funds and of charitable expenditure, and which are allocated to those headings on an appropriate apportionment.

Employees are entitled to join the Charity’s money purchase pension scheme. The associated cost is allocated across the Charity’s activities and funds depending on the role of the member of staff.

e) Redundancy payments

It is the trustees' policy to minimise the impact of organisational change. Redundancy payments only occur when absolutely necessary and are accounted for on an accruals basis when the commitment to terminate a post on the grounds of redundancy has been made.

f) Intangible assets

The intangible assets of the Charity comprise operational software packages. Once it has been tested and commissioned the software is amortised over the expected useful life of 4 years. Amortisation is charged to ‘Charitable activities’ in the Statement of Financial Activities.

g) Tangible fixed assets

Individual fixed assets costing £5,000 or more, and others of a smaller individual value but forming part of a capital expenditure programme, are capitalised at purchase cost.

Depreciation is provided on all tangible fixed assets in use, at rates and bases calculated to write off the cost less estimated residual value of each asset over its expected useful life. No depreciation is charged on land, and the land element is based on 25% of the total cost of the properties. Freehold buildings - 2% of cost, 10-20% for refurbishment Medical equipment - 10, 12½ & 20% of cost

P.36 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENT

FOR THE YEAR ENDED 31 MARCH 2022

Fixtures, fittings and computer equipment - 13% and 25% of cost

Motor vehicles - 20% of cost

h) Fixed asset investment

The Charity was bequeathed a 50% share in a freehold property as part of a legacy in 2020. The property is currently generating rental income for the Charity and as such is classified as an investment property. In accordance with FRS 102 this is included on the balance sheet as a 50% share of the estimated market value at 31 March 2022. No depreciation is charged on the property and it is reviewed annually for impairment.

i) Impairment

The carrying amounts of assets are reviewed at each balance sheet date, to determine whether there is any indication of impairment. If any such indication exists, the asset’s recoverable amount is estimated to determine the amount of impairment loss. Any loss is written off to the Statement of Financial Activities.

j) Debtors

Trade debtors, other debtors and accrued income are recognised at the settlement amount due after any trade discount. Prepayments are valued at the amount prepaid net of any trade discounts due.

l) Creditors

Creditors and provisions are recognised where the Charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably. Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due.

m) Hire purchase

Assets obtained under hire purchase contracts are capitalised as tangible fixed assets. Assets acquired by hire purchase are depreciated over their useful lives. Finance leases are those where substantially all of the benefits and risks of ownership are assumed by the Charity. Obligations under such agreements are included in creditors, net of the finance charge allocated to future periods. The finance element of the rental payment is charged to the Statement of Activities so as to produce a constant periodic rate of charge on the net obligation outstanding in each period.

n) Bank loan

Bank loans are measured initially at fair value, net of transaction costs, and are measured subsequently at amortised cost using the effective interest method.

o) Financial instruments

k) Investments

Investments represents cash held on deposit with differing maturity dates to maintain flexibility and to attempt to earn some income in a low interest environment.

Cobalt Health only has financial assets and financial liabilities of a kind that qualify as basic financial instruments, cash at bank, cash held on deposit, debtors and creditors (see notes 14 and 15). Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

Cobalt Health Annual Report 2021/22 – P.37

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

p) Significant estimates and judgements

Preparation of the financial statements requires management to make significant judgements and estimates. The items in the financial statements where these judgements and estimates have been made include:

Useful economic lives of intangible and tangible assets:

The annual amortisation and depreciation charges for the intangible and tangible assets are sensitive to changes in the estimated useful economic lives and residual values of the assets. The useful economic lives and residual values are amended when necessary to reflect current estimates, based on technological advancement, future investments, economic utilisation and the physical condition of the assets. See notes 11 and 12 for the carrying amount of the intangible and tangible assets and notes 1(f) and 1(g) for the useful lives for each class of asset.

Legacies:

Designated funds are unrestricted funds which have been designated for specific purposes by the trustees.

s) Taxation

As a recognised Charity, the company is exempt from Corporation Tax so far as it relates to its charitable objects. It is not exempt from VAT, and irrecoverable VAT is included in the cost of those items to which it relates.

t) Operating leases

Rentals under operating leases are charged to the Statement of Financial Activities on a straight line basis over the lease term.

u) Registered and Principal Office

Cobalt Health, Linton House Clinic, Thirlestaine Road, Cheltenham, Gloucestershire, GL53 7AS.

Management judgement is applied over the valuation of legacy income where cash is not yet received and evidence of entitlement exists and Cobalt Health is able to measure reliably. As a result, accrued legacy income is recognised at times, in advance of receiving the cash; see accounting policy 1(c) for further details.

q) Cash and cash equivalents

Cash is represented by cash in hand and deposits with financial institutions.

r) Funds

Restricted funds comprise income funds subject to specific conditions arising from the donor’s wishes or the terms of a particular fundraising initiative.

Unrestricted funds are the working capital of the Charity, which is expendable at the discretion of the trustees.

P.38 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 2. DONATIONS AND LEGACIES

NOTE 3. CHARITABLE ACTIVITIES

2022 2021
£ £
Donations 157,266 114,748
In Memoriam 9,890 3,516
Legacies 297,568 811,341
464,724 929,605
£133,477 of donations and legacies were restricted.
2022 2021
£ £
Clinical services
MRI Services 8,382,099 6,449,990
PET/CT and CT Services 13,552,486 13,812,619
21,934,585 20,262,609

NOTE 4. INCOME FROM FUNDRAISING ACTIVITIES

NOTE 5. INVESTMENT INCOME
2022
2021
£
£
Events
36,185
18,798
Card Sales
19,261
8,550
Grant income 303,710
57,265
359,156
84,613
2022
2021
£
£
Interest receivable 13,512
10,452

NOTE 6. OTHER INCOME

Rent receivable
Gain on disposal of fixed assets
Delegate Fees, room hire, other income
Government grants - furlough receipts		 2022
£
2021
£
103,267 99,405
1,480
7,454		 166,500
38,349
- 83,036
112,201
387,290

Cobalt Health Annual Report 2021/22 – P.39

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 7. ANALYSIS OF STAFF COSTS, TRUSTEE REMUNERATION AND EXPENSES, AND THE COSTS OF KEY MANAGEMENT PERSONNEL
2022
2021		 2022 2021
£
£		 £ £
Wages and salaries
4,261,294
3,516,191		 4,261,294 3,516,191
Social security costs
430,728
343,804
Pension contributions
553,631
481,444		 430,728 343,804
553,631 481,444
Other employee benefits
18,436
13,387		 18,436 13,387
5,264,089 4,354,826 5,264,089 4,354,826
The number of employees whose emoluments for the year fell within each band from £60,000 upwards was:
2022 2021 2022 2021
£60,000 - £69,999
5
1 5 1
£70,000 - £79,999
-		 3 - 3
£80,000 - £89,999
5
£140,000 - £149,999
1		 2 5 2
1 1 1 1

In the year contributions of £38,248 (2021 - £33,529) were made to 1 (2021 – 1) higher paid employees’personal defined contribution schemes.

The total emoluments (including pension costs and employer's national insurance contributions) of the 8members of the Senior management Team who have day-to-day influence on the activities of the Charity was £757,938 (2021, 8, £723,600). The 8 are the Chief Executive, Finance Director, Fundraising Director, Human Resources Manager, Communications Manager, Quality Manager and 2 Clinical Managers.

During the year, redundancy payments amounting to £35,875, were paid to members of staff (2021, £16,037).

The average monthly headcount of employees, analysed by function, was:

The average monthly headcount of employees, analysed by function, was: The average monthly headcount of employees, analysed by function, was: The average monthly headcount of employees, analysed by function, was:
2022
2021
2022 2021
MRI Services
57
60		 57 60
PET/CT and CT Services
46
32		 46 32
Fundraising
5
5		 5 5
Administration and Management
19
17		 19 17
Buildings 4 3 4 3
131 117 131 117
The average full-time equivalent number of staff for the year was 102_(2021 - 86_). No Trustees
received remuneration during the year (2021 - Nil). No Trustees were reimbursed travel expenses during
the year (2021 - Nil).

P.40 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 8. NET INCOME FOR THE FINANCIAL YEAR

Net income is stated after charging/(crediting): income is stated after charging/(crediting): income is stated after charging/(crediting): ): 2022 2021
£ £
Auditor's remuneration:
Audit 13,800 10,300
Tax advisory 1,138 700
Other services - 500
Depreciation 1 1,974,083 1,684,561
Amortisation 67,149 47,012
Surplus on disposal of fixed assets (1,480) (166,500)
Impairment 250,733 -
Operating lease costs 11,544 11,544
Pension contributions 553,631 481,444
NOTE 9. ANALYSIS OF EXPENDITURE
Amortisation
Direct Support and Total Total
Costs Costs Depreciation 2022 2021
£ £ £ £ £
Raising funds:
Costs of fundraising
and similar activities 182,359 95,246 14,699 292,304 281,360
182,359 95,246 14,699 292,304 281,360
Charitable activities:
MRI Services 6,464,008 622,674 957,009 8,043,691 6,824,692
PET-CT and CT Services 9,136,578 1,118,691 976,581 11,231,850 7,370,388
Charitable Funding 280,973 - 90,684* 371,657 317,059
Training and Education 1,541 9,115 2,259 12,915 78,536
15,883,100 1,750,480 2,026,533 19,660,113 14,590,675
16,065,459 1,845,726 2,041,232 19,952,417 14,872,035
TOTAL 2021 11,392,222 1,748,240 1,731,573 14,872,035

Cobalt Health Annual Report 2021/22 – P.41

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 10. SUPPORT COSTS

Admin Building Governance Building Governance Total Total
Costs Costs Costs 2022 2021
£ £ £ £ £
MRI Services 454,417 163,886 4,371 622,674 590,230
PET-CT and CT Services 938,151 171,516 9,024 1,118,691 1,059,056
Fundraising 73,293 21,248 705 95,246 90,241
Training and Education - 9,115 - 9,115 8,713
TOTAL 2022 1,465,861 365,765 14,100 1,845,726 1,748,240
TOTAL 2021 1,384,482 349,658 14,100 1,748,240

Support costs have been allocated on the basis of floor space occupied in respect of building costs andproportionate time spent on administrative matters in respect of administration costs. Governance costsinclude the cost of the audit and the direct costs of supporting the trustees.

NOTE 11. INTANGIBLE FIXED ASSETS

Software
Cost £
At 1 April 2021
Additions		 346,576
47,235
Disposals (116,314)
At 31 March 2022
277,497
Amortisation
At 1 April 2021
157,085
Charge for year 67,149
Disposals (116,314)
At 31 March 2022 107,920
Net Book Value
At 31 March 2022 169,577
At 31 March 2021
189,491

P.42 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 12. FIXED ASSETS

Freehold
Medical IT / Fixtures
Land & Buildings
Equipment
& Fittings		 Freehold
Medical IT / Fixtures
Land & Buildings
Equipment
& Fittings		 Freehold
Medical IT / Fixtures
Land & Buildings
Equipment
& Fittings		 Freehold
Medical IT / Fixtures
Land & Buildings
Equipment
& Fittings
Motor
Vehicles
£
£
£		 £
Cost
At 1 April 2021
11,373,559
18,338,244
626,033
82,140
Additions 8,184 4,973,996
210,301		 -
Disposals - (17,226) (233,657) (31,939)
At 31 March 2022 11,381,743 23,295,014
602,677		 50,201
Depreciation and Impairment
At 1 April 2021
Charge for year
2,636,491
7,597,530
379,294
181,367
1,671,250
111,426		 43,531
10,040
Eliminated on Disposals
-
(17,226)
(233,657)		 (31,939)
Impairment 80,439
170,294
-		 -
At 31 March 2022 2,898,297 9,421,848 257,063 21,632
Net Book Value
At 31 March 2022 8,483,446
13,873,166
345,614		 28,569
At 31 March 2021 8,737,068
10,740,714
246,739		 38,609

The net book value of assets held under hire purchase agreements is £596,716 ( 2021 - £667,613 ).

A bank loan was taken out in the previous year and is secured by way of a first legal charge over the freehold of Linton Cottage. The aggregate amount secured is £707k.

Cobalt Health Annual Report 2021/22 – P.43

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 13. INVESTMENTS
2022 2021
£ £
Fixed Assets
Investment in subsidiary 1 1
Investment property 150,000 150,000
Current Assets
Current asset investment - notice deposits 3,045,102 3,032,265

The share capital of Cobalt Unit Appeal Fund Ltd consists of one ordinary share of £1 nominal value and is wholly owned by Cobalt Health. The subsidiary is dormant and did not trade during the year. Cobalt Unit Appeal Fund Ltd was incorporated in England and Wales (registered no. 09016631) and registered at Linton House Clinic, Thirlestaine Road, Cheltenham, Gloucestershire, GL53 7AS.

The Charity owns a 50% share in a freehold investment property. In accordance with FRS 102 this is included on the balance sheet as a 50% share of the estimated market value at the reporting date.

The Charity has invested £3m in a short term deposit with Nationwide.

NOTE 14. DEBTORS
Clinical Service fees due
Accrued income
Prepayments
Other Debtors		 2022
£
3,417,832
254,052
312,637
-
3,984,521
2021
£
3,275,487
219,347
294,454
837
3,790,125

P.44 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 15. CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR
2022 2021
2021
2022
£ £
£
£
Trade creditors 1,198,722 1,345,550
1,345,550
1,198,722
Bank Loan 80,163 44,751
44,751
80,163
Accruals 720,291 650,917
650,917
720,291
Other creditors
18,067		 15,454
15,454
18,067
HP liability
139,534		 134,253
134,253
139,534
Taxation and social security
133,070		 102,571
102,571
133,070
Pension liability
51,885		 41,373
41,373
51,885
Deferred income
205,496		 -
205,496		 -
2,547,228 2,334,869
2,334,869
2,547,228
The movement in deferred income is set out below:
Rent and fees
received in
advance		 Total
Rent and fees
received in
advance		 Total
£ £
£		 £
At 1 April 2021
-		 -
-		 -
Released in the year
-		 -
-		 -
Deferred in the year
205,496		 205,496
205,496		 205,496
At 31 March 2022
205,496		 205,496
205,496		 205,496
Rent and fees received in advance is recognised as income in the month to which it relates.
CREDITORS: Amounts falling after one year:
2022 2021
2021
2022
£ £
£
£
Bank Loan 2-5 years
320,652		 306,863
306,863
320,652
Bank Loan > 5 years
275,001		 355,713
355,713
275,001
HP liability 347,968 487,502
487,502
347,968
943,621 1,150,078
1,150,078
943,621
A bank loan was taken out in the previous year and is secured by way of a 1st legal charge over the freehold of Linton Cottage.
Interest is charged at 1.75% p.a. over Base Rate. The initial term of the loan is 72 months.

Cobalt Health Annual Report 2021/22 – P.45

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 16. UNRESTRICTED FUNDS - 2022
Movement in Funds
Movement in Funds
Balance at
Income
Expenditure
Transfers
Balance at
Balance at
Income
Exp nditure
Tr nsfers		 Balance at
1 April 2021
31 March 2022
1 April 2021
31		 March 2022
£
£
£
£
£
£
£
£
£		 £
(19,398,451)
General Fund
4,381,967
22,446,991
(2,664,370)
4,766,137
(19,398,451)
4,381,967
22,446,991
(2 664,370)		 4,766,137
Tangible fixed assets held
for the Charity's use 19,763,130 -
(398,937)
3,366,602
22,730,795
19,763,130
-
(398,937)
3,366,602		 22,730,795
Total 24,145,097 22,446,991
702,232
27,496,932
(19,797,388)
24,145,097
22,446,991
702,232
(19,797,388)		 27,496,932

Unrestricted Funds includes a General Fund balance of £4,766,137. This constitutes 2.9 months’ working capitalrequirement. Transfers of £702,232 represent fixed asset additions and disposals in the year, as well astransfers to and from the designated funds, see note 17.

UNRESTRICTED FUNDS - 2021

UNRESTRICTED FUNDS - 2021 UNRESTRICTED FUNDS - 2021 UNRESTRICTED FUNDS - 2021 UNRESTRICTED FUNDS - 2021
Movement in Funds
Movement in Funds
Balance at
Income
Expenditure
Transfers
Balance at
Balance at
Income
Exp nditure
Transfers
Balance at
1 April 2020
31 March 2021
1 April 2020
31 March 2021
£
£
£
£
£
£
£
£
£		 £
General Fund
3,672,077
21,563,527
(15,461,467)
(5,392,170)
4,381,967
3,672,077
21,563,527
(15,461,467)
(5,392,170)		 4,381,967
Tangible fixed assets held
for the Charity's use 17,039,593 -
825,002
1,898,535
19,763,130
17,039,593
-
825,002
1,898,535		 19,763,130
Total 20,711,670 21,563,527
(14,636,465)
(3,493,635)
24,145,097
20,711,670
21,563,527
(14,636,465)
(3,493,635)		 24,145,097

P.46 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENT

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 17. DESIGNATED FUNDS - 2022
Balance at 1
April 2021		 Expenditure
Transfers
Funding of
Fixed Assets
Balance at
31 March
2022
Balance at 1
April 2021
Expenditure
Transfers
Funding of
Fixed Assets		 Balance at
31 March
2022
£ £
£
£
£
£
£
£
£		 £
Capital Equipment Fund
3,622,530		 -
3,144,974
(3,622,530)
3,144,974
3,622,530
-
3,144,974
(3,622,530)		 3,144,974
Equipment Replacement Fund
1,100,000		 -
128,548
-
1,228,548
1,100,000
-
128,548
-		 1,228,548
Grants Fund
470,000		 (116,154)
-
18,154
372,000
470,000
(116,154)
-
18,154		 372,000
Property Fund 220,000 -
50,264
(160,000)
110,264
220,000
-
50,264
(160,000)		 110,264
Total 5,412,530 (116,154)
3,323,786
(3,764,376)
4,855,786
5,412,530
(116,154)
3,323,786
(3,764,376)		 4,855,786
At the balance sheet date the purposes of the various sub-funds within Designated Funds are as follows:
Capital Equipment Fund
This fund is reserved for new equipment projects. The £3.6m brought forward has been used to purchase a new CT mobile unit,
relocatable units and PET mobile. The £3.1m carried forward has been retained to purchase a new PET/CT scanner and additional
take up rooms in Cheltenham, and a CT mobile unit. These are expected to be in place by October 2022.
Equipment Replacement Fund

This fund is reserved to replace and refresh the installed imaging equipment as part of the Equipment Replacement Plan. £1.1m has

been set aside to replace the formerly disposed of MRI scanner Cobalt 9 with a new mobile MRI unit in January 2023, and a modern

digital X-ray unit, which is expected to installed by November 2022.
Grants Fund
Grants are to support oncology and dementia services and research. This includes, but is not limited to,projects with the NHS Trusts,
d fdi h fllhi £116k f hi fd h b di h Gi fd h fd ill b dd i
an unng researc eowsps. o ts un as een spent urng te year. ong orwar, te un w e expene aganst
onoin research rojects fellowshis and research rant awards that will be advertised from time to time on the Charit’s website
gg p, p g y .
This fund is expected to support theseprojects over the next two years.
Property Fund
This fund is used to upgrade the facilities in the Charity’s properties and equipment. Funds were expended in the year on buildings
plant and imaging software upgrade. Funds carried forward are retained for upgrading the Cheltenham Imaging Centre reception area,
and buildings plant within the next financial year.
DESIGNATED FUNDS - 2021
Balance at 1
April 2020		 Expenditure
Transfers
Funding of
Fixed Assets
Balance at
31 March
2021
Balance at 1
April 2020
Expenditure
Transfers
Funding of
Fixed Assets		 Balance at
31 March
2021
£ £
£
£
£
£
£
£
£		 £
3,622,530
Capital Equipment Fund
442,000		 -
3,622,530
(442,000)
3,622,530
442,000
-
3,622,530
(442,000)


Equipment Replacement Fund
1,000,000		 -
100,000
-
1,100,000



1,000,000
-
100,000
-		 1,100,000


Grants Fund
230,247		 (163,264)
403,017
-
470,000


230,247
( 63,264)
403,017
-		 470,000
Property Fund 371,000 -
194,285
(345,285)
220,000



371,000
-
194,285
(345,285)		 220,000
Total 2,043,247 (163,264)
4,319,832
(787,285)
5,412,530
2,043,247
(163,264)
4,319,832
(787,285)		 5,412,530

DESIGNATED FUNDS - 2021

Expenditure
Transfers
Expenditure		 Expenditure
Transfers
Expenditure		 Expenditure
Transfers
Expenditure		 Funding of
Balance at
Transfers
Funding of		 Balance at
Balance at 1 Balance at 1 Fixed Assets
31 March
Fixed Assets		 31 March
April 2020 April 2020 2021 2021
£ £
£		 £ £ £
£
£
£		 £
Capital Equipment Fund 442,000 -
3,622,530
442,000		 - (442,000)
3,622,530
3,622,530
(442,000)		 3,622,530
Equipment Replacement Fund 1,000,000 -
1,000,000		 100,000 - -
1,100,000
100,000
-		 1,100,000
Grants Fund 230,247 (163,264)
230,247		 403,017
( 63,264)		 -
470,000
403,017
-		 470,000
Property Fund 371,000 -
371,000		 194,285 - (345,285)
220,000
194,285
(345,285)		 220,000
Total 2,043,247 (163,264)
4,319,832
2,043,247
(163,264)		 (787,285)
5,412,530
4,319,832
(787,285)		 5,412,530

Cobalt Health Annual Report 2021/22 – P.47

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 18. RESTRICTED FUNDS - 2022

TYA Nurse Fund
Cancer General Fund
Dementia Research Fund
Equipment Fund
Breast Cancer Research Nurses Fund
£
-
-
-
-
28,830
Balance at
1 April 2021
nd		 TYA Nurse Fund
Cancer General Fund
Dementia Research Fund
Equipment Fund
Breast Cancer Research Nurses Fund
£
-
-
-
-
28,830
Balance at
1 April 2021
nd		 TYA Nurse Fund
Cancer General Fund
Dementia Research Fund
Equipment Fund
Breast Cancer Research Nurses Fund
£
-
-
-
-
28,830
Balance at
1 April 2021
nd		 TYA Nurse Fund
Cancer General Fund
Dementia Research Fund
Equipment Fund
Breast Cancer Research Nurses Fund
£
-
-
-
-
28,830
Balance at
1 April 2021
nd		 Income
Expenditure
Funding of		 Income
Expenditure
Funding of		 Income
Expenditure
Funding of		 Balance at
Fixed Assets 31 March
2022
£
£		 £ £
22,155
(22,155)		 - -
TYA Nurse Fund - 13,503
(13,503)		 - -
Cancer General Fund - 1,278
(1,278)		 - -
Dementia Research Fund - 7,549
(1,549)		 - 6,000
Equipment Fund 28,830 392,312
-		 (261,642) 159,500
Research Fund - 390 (390) - -
TOTAL 28,830 437,187 (38,875) (261,642) 165,500

Restricted funds held totalled £165,500 at the balance sheet date. In the year restricted funds were used forspecifically allocated initiatives and equipment purchases.

Breast Cancer Research Nurses Fund

To fund breast cancer research nurses.

TYA Nurse Fund

The fund is used to support the work of a local Teenagers and Young Adults with Cancer Nurse Specialist. Cobalt has undertaken to fund 50% of this post until 2024 when it will be reviewed.

Cancer General Fund

The fund is used to support the Charity’s work providing free scans for oncology patients.

Dementia Research Fund

The fund is used to help fund research into dementia. Cobalt has been aiding research into the benefit of scanning patients to improve early diagnosis. £6k has been carried forward for a specific diagnostic project.

Equipment Fund

The fund was used to support the purchase of a new mobile CT scanner. Funds carried forward of £159,500 are restricted for the new PET/CT scanner.

Research Fund

The fund was used to support Cobalt's research activities in the year.

RESTRICTED FUNDS - 2021

RESTRICTED FUNDS - 2021
Breast Cancer Research Nurses Fund
TYA Nurse Fund
Cancer General Fund
Dementia Research Nurses Fund
Equipment Fund
Research Fund
TOTAL
n
 Balance at Income
Expenditure		 Funding of Balance at

April 2020
Fixed Assets
31 March

2021
£ £
£		 £ £
d
23,905		 5,300
(29,205)		 - -
TYA Nurse Fund 5,101 16,947
(22,048)		 - -
Cancer General Fund - 688
(688)		 - -
Dementia Research Nurses Fund - 19,777
(19,777)		 - -
Equipment Fund - 67,742
-		 (38,912) 28,830
Research Fund - 588 (588) - -
TOTAL 29,006 111,042 (72,306) (38,912) 28,830

P.48 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 19. ANALYSIS OF NET ASSETS - 2022

Unrestricted Funds
General Fund
Tangible Fixed Assets held for Charity use
Total Unrestricted Funds
Designated Funds
Capital Equipment Fund
Grants Fund
Equipment Replacement Fund
Property Fund
Total Designated Funds
Restricted Funds
Total Funds
Unrestricted Funds
General Fund
Tangible Fixed Assets held for Charity use
Total Unrestricted Funds
Designated Funds
Capital Equipment Fund
Grants Fund
Equipment Replacement Fund
Property Fund
Total Designated Funds
Restricted Funds
Total Funds
ANALYSIS OF NET ASSETS - 2021		 Unrestricted Funds
General Fund
Tangible Fixed Assets held for Charity use
Total Unrestricted Funds
Designated Funds
Capital Equipment Fund
Grants Fund
Equipment Replacement Fund
Property Fund
Total Designated Funds
Restricted Funds
Total Funds
Unrestricted Funds
General Fund
Tangible Fixed Assets held for Charity use
Total Unrestricted Funds
Designated Funds
Capital Equipment Fund
Grants Fund
Equipment Replacement Fund
Property Fund
Total Designated Funds
Restricted Funds
Total Funds
ANALYSIS OF NET ASSETS - 2021		 4,766,137
22,730,795
27,496,932
Total
£
3,144,974
372,000
1,228,548
110,264
4,855,786
165,500
32,518,218		 4,766,137
22,730,795
27,496,932
Total
£
3,144,974
372,000
1,228,548
110,264
4,855,786
165,500
32,518,218
C reditors due
Intangible Fixed Net Current greater than
Assets Assets Assets one year
£ £ £ £
169,577 150,001 5,390,180 (943,621)
- 22,730,795 - -
169,577 22,880,796 6 5,390,180 (943,621)
-
- 3,144,974 -
- - 372,000 -
- -
-		 1,228,548 -
- 110,264 -
-
- 4,855,786 -
- - 165,500 -
169,577 22,880,796 10,411,466 (943,621)
Creditors due
Intangible Fixed Net Current greater than Total
Assets Assets
£		 Assets one year
£ £ £ £
189,491 150,001
19,763,130		 5,192,553 (1,150,078) 4,381,967
- - - 19,763,130
19,913,131
189,491 5,192,553 (1,150,078) 24,145,097
- - 3,622,530 - 3,622,530
- -
-
-		 470,000 - 470,000
- 1,100,000 - 1,100,000
- 220,000 - 220,000
- - 5,412,530 - 5,412,530
- - 28,830 - 28,830
19,913,131
189,491 10,633,913 (1,150,078) 29,586,457

Cobalt Health Annual Report 2021/22 – P.49

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 20. CAPITAL COMMITMENTS
2022 2021
£ £
Future capital expenditure not otherwise included in the financial
al
statements at the balance sheet date:
Expenditure contracted for 2,455,016 3,624,249

NOTE 21. RELATED PARTY TRANSACTIONS

Members of the board of trustees are not entitled to, and did not receive, any remuneration during the year in relation to their services as trustees.

There have been no transactions with the Charity’s wholly-owned subsidiary company The Cobalt Unit Appeal Fund Ltd.

During the year, Phoenix MRC Limited, of which Susan Owen (Trustee) is a Director and shareholder, provided a staff survey to Cobalt for £nil (2021 - no service).

NOTE 22. LIABILITIES UNDER OPERATING LEASES

At 31 March 2022, the Charity had total commitments under non-cancellable operating leases in respect of equipment as follows:

Within one year 2022
2021
£ £
9,876
11,544
Between one and five years - 9,876
Total 9,876
21,420

P.50 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 23. ASSETS RECEIVABLE UNDER OPERATING LEASES

At 31 March 2022, the Charity had assets receivable under non-cancellable operating leases in respect of rental income of Cobalt House as follows:

Within one year
Between one and five years
Total		 2021
£
98,067
239,601
337,668
2022
£
99,992
139,609
239,601		 2021
£
98,067
239,601
337,668
2022
£
99,992
139,609
239,601

NOTE 24. RECONCILIATION OF CASH FLOWS FROM OPERATING ACTIVITIES

Net income for the reporting period
(as per the statement of financial activities)
Adjustments for:
Depreciation and amortisation charges
Impairment
Dividends, interest and rent from investments
(Surplus) on sale of fixed assets
(Increase) in debtors
Increase/(Decrease) in creditors
Net cash provided by operating activities		 2022 2021
£
(520,209)
(1,323,147)
6,802,534
1,731,573
-
(109,857)
(166,500)
6,414,394		 2021
£
(520,209)
(1,323,147)
6,802,534
1,731,573
-
(109,857)
(166,500)
6,414,394
£
2,931,761
2,041,232
250,733
(116,779)
(1,480)
(194,396)
171,666
5,082,737

Cobalt Health Annual Report 2021/22 – P.51

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 25. ANALYSIS OF CHANGES IN NET CASH/DEBT


cas
Cashflows
£
2021
£
cas
Cashflows
£
2021
£
cas
Cashflows
£
2021
£		 ther non-

h h		 2022
canges
£		 £
Cash at bank and in hand
(217,321)
6,146,392		 - 5,929,071
Current asset investments:
Notice deposits 12,837
3,032,265		 - 3,045,102
Total (204,484)
9,178,657
- 8,974,173
Loans falling due within one year
44,751
(44,751)		 (80,163) (80,163)
Loans falling due after more
than one year
(13,240)
(662,576)
80,163 (595,653)
Hire purchase obligations (621,755) 134,253 - (487,502)
Total (38,720)
7,849,575
- 7,810,855

P.52 – Cobalt Health Annual Report 2021/22

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2022

NOTE 26. 2021 STATEMENT OF FINANCIAL ACTIVITIES

Note Unrestricted
Funds		 Restricted
Funds		 2021
Total Funds
INCOME FROM: £ £ £
Donations and legacies
2		 875,828 53,777 929,605
Charitable activities:
Clinical services
3		 20,262,609 - 20,262,609
Fundraising activities
4		 27,348 57,265 84,613
Investment income
5		 10,452 - 10,452
Other income
6		 387,290 - 387,290
TOTAL INCOME 21,563,527 111,042 21,674,569
EXPENDITURE ON:
Fundraising costs
9		 281,360 - 281,360
Charitable activities
9		 14,518,369 72,306 14,590,675
TOTAL EXPENDITURE
9		 14,799,729 72,306 14,872,035
NET INCOME 6,763,798 38,736 6,802,534
TRANSFERS BETWEEN FUNDS 38,912 (38,912) -
NET MOVEMENT IN FUNDS 6,802,710 (176) 6,802,534
RECONCILIATION OF FUNDS
TOTAL FUNDS BROUGHT FORWARD 22,754,917 29,006 22,783,923
TOTAL FUNDS CARRIED FORWARD
19		 29,557,627 28,830 29,586,457

Cobalt Health Annual Report 2021/22 – P.53

TRUSTEES AND ADVISERS

Trustees and Directors Neil Holbrook (Chairman) Ruth Goddard Claire Morris (appointed 23/06/2022) Dr Susan Owen John Parker (resigned 16/11/2021) Dr Janet Ropner Pamela Sissons (appointed 23/06/2022) Dr Valerie Udale Prof Gordon Wilcock Chief Executive Officer Peter J Sharpe Company Secretary Malcolm J MacKeith Medical Director Prof Iain Lyburn (resigned 31/10/2022) Dr Umesh Udeshi (appointed 01/11/2022) Director of Clinical Research Prof Iain Lyburn (appointed 01/11/2022) President Howard Crooks Registered and Principal Office Linton House Clinic, Thirlestaine Road, Cheltenham, Gloucestershire, GL53 7AS Independent Auditor Crowe U.K.LLP, 4th Floor, St James House, St James’ Square, Cheltenham, GL50 3PR Bankers National Westminister Bank Plc, 21 Eastgate Street, Gloucester, GL1 2NH Lloyds Bank Plc, Montpellier Cheltenham Business Centre, PO Box 1000, BX1 1LT Nationwide Building Society, Kings Park Road, Moulton Park, Northampton, NN3 6NW Solicitors Willians LLP, 34 Imperial Square, Cheltenham, Gloucestershire, GL50 1RH

Cobalt Health was incorporated in England and Wales (registered no. 04366596 and has no share capital. Cobalt Health is a registered charity with the Charity Commission England and Wales (registered no. 1090790)

P.54 – Cobalt Health Annual Report 2021/22

GLOSSARY OF TERMS

CT

Computerised Tomography uses X-ray and a computer to generate detailed images of the inside of the body. A CT scanner consists of a X-ray tube that rotates around the body (in less than a second) and a series of detectors which collect the information from the X-rays; a computer then builds an image from the information received.

PET/CT

Positron Emission Tomography/Computerised Tomography, is a combination of two imaging technologies. A PET scan measures important body functions, such as blood flow, oxygen use and sugar (glucose) metabolism, to help doctors evaluate how well organs and tissues are functioning. Cancer cells, for example, use glucose differently to normal cells and for that reason look different on the pictures produced by the scan, this therefore enables doctors to diagnose and monitor cancer. The CT scan provides structural information of the body and by combining PET and CT this creates both a functional and structural image.

MRI

Magnetic Resonance Imaging is a non-invasive medical test that helps doctors diagnose and treat medical conditions. The MRI scanner uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues and virtually all other internal body structures. Detailed MR images allow doctors to better evaluate various parts of the body and determine the presence of certain diseases that may not be assessed adequately with other imaging methods, such as X-ray.

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Charity Registration Number: 1090790 Company Number: 04366596 Cobalt Health trading as Cobalt