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2023-03-31-accounts

COBALT HEALTH ANNUAL REPORT 2022/23

www.cobalthealth.co.uk

Charity Registration Number: 1090790 Company Number: 04366596

OUR VISION

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.

CONTENTS

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Chair’s statement 4
About us 5
Trustees’ strategic report 8
Our objectives and values 9
Diagnosis – aims, achievements, impact and the future 10 – 13
Research – aims, achievements, impact and the future 14 – 15
Education – aims, achievements, impact and the future 16 – 17
Fundraising 18 – 21
Looking back , a history of impact 22 – 25
Financial overview 27 – 31
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Structure, governance and management 32
Statement of trustees’ responsibilities 33
Independent auditors’ report to the trustees of Cobalt Health 34 – 36
Statement of financial activities 37
Balance sheet 38
Cash flow statement 39
Notes to the financial statements 40 – 59
Trustees, executive and and advisers 60
Glossary 61
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Cobalt Health Annual Report 2022/23 – P.3

CHAIR'S STATEMENT

For another year, Cobalt’s level of activity and range of services have both continued to grow. With our dedicated team of radiographers and support staff, we have scanned over 130,000 patients. We have also continued to invest in the very latest imaging technology. The past twelve months have been financially challenging, primarily due to inflationary pressures significantly increasing fuel and operational costs. Despite this, we have been able to achieve a reasonable surplus for the year, ensuring our planned developments and investments into the future growth and development of the Charity can continue.

We have invested £5m in replacing and expanding our range of diagnostic imaging equipment. This included the purchase of a new 1.5 Tesla mobile MRI scanner and a new PET/CT scanner installed at our imaging centre in Cheltenham, one of only a handful of its kind in the UK. The scanner utilises the very latest in digital PET/CT technology, offering shorter scanning times enabling us to perform more scans per day, reducing local waiting times for oncology patients. It has also enabled us to support more research and clinical trials, including those assessing new drugs being developed to treat dementia.

With oncology one of Cobalt’s core strategic areas, we continue to support the NHS. This year the Charity has not only funded scans for oncology patients, but also posts for local breast cancer research nurses and Cobalt’s Teenagers and Young Adults (TYA) Cancer Nurse Specialist (CNS) We have continued to partner with the NHS to provide ultra-low dose CT scanning and to expand the Lung Health Check (LHC) lung cancer screening programmes. These programmes

are designed to identify lung cancer at an earlier and more treatable stage, improving outcomes for patients.

Cobalt could not exist without the dedication and commitment of our team. The Charity has continued to grow, now employing 161 members of staff, and is further strengthened by over 200 volunteers. We continue to invest in people and have expanded our management team in preparation for planned future growth and development of the Charity.

We are very grateful to the many individuals, organisations and trusts who have kindly supported Cobalt and raised funds for our charitable activities. Their help is invaluable in enabling us to continue performing at this level.

I would like to thank my fellow trustees for their insight, direction and work in support of Cobalt. A particular thank you to Professor Gordon Wilcock and our former Chair, Neil Holbrook, for their contribution; both having this year concluded their tenure on our board. We look forward to welcoming new trustees this autumn.

In 2024, Cobalt will celebrate 60 years of supporting the NHS. We will be running a series of events, recognising decades of significant achievement and looking to the future. We are thankful to everyone who has made this possible.

Susan Owen

Chair of the Board of Trustees

ABOUT US

Cobalt Health (Cobalt) is an independent medical charity with a vision to pioneer innovation in medical imaging diagnosis. Cobalt invests in equipment, integrated research and education, to improve outcomes for patients now and in the future. Each year it provides diagnostic imaging for over 130,000 patients at its imaging centres in Cheltenham and Birmingham, and through a fleet of fourteen MRI, CT and PET/CT* mobile scanners. The Charity is the leading provider of ultra-low dose CT lung cancer screening services in the UK, working in partnership with the NHS.

access to a clear diagnosis and appropriate treatment plan facilitated by the best equipment, helping doctors to make a clear diagnosis and appropriate personalised treatment plan.

Alongside its diagnostic services, Cobalt also funds and participates in research on a national and international basis. The Charity is currently supporting many research projects and clinical trials, with the aim of advancing the detection and treatment of cancer, dementia and other long-term conditions. The Charity provides training programmes for medical professionals, including GPs, consultants, physiotherapists and chiropractors; and supports undergraduate radiography students with clinical placements.

Cobalt focuses on offering equipment and services not generally available within the NHS, using the latest technology to deliver superior image quality, improve patient comfort and enable shorter scanning times. The

Charity strongly believes that all patients should have

Following a period of significant growth, we are taking time to consolidate and ensure we have a strong infrastructure so we are fit for the future.

In 2022 we welcomed our new Head of HR, Rachel Burke.

Rachel said "It is thanks to our dedicated team of staff and volunteers that we have been able to grow and expand our impact both locally and nationally. We are especially proud that we continue to recruit highly skilled radiographers to join our team.

feedback received from service users/stakeholders. Together we will be celebrating Cobalt’s 60th Anniversary in 2024 and the contribution made by every staff member to this significant milestone.

We listen carefully to feedback from employees and act on it. We will shortly be launching Cobalt’s ICARE Fund, money which will enable staff to propose ideas to improve patient experience based on our values.”

The continued retention and recruitment of good staff who share our values is key to our success. It is important to celebrate and recognise achievements such as service milestones, qualifications and positive

Our ICARE values – Innovative, Caring, Accessible, Respectful and Ethical - are central to everything we do as a charity and an employer, and they lead the way we work.

I C A R E OUR VALUES INNOVATIVE CARING ACCESSIBLE RESPECTFUL ETHICAL

P.4 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.5

130,000 PATIENTS SCANNED A 13% INCREASE COMPARED TO 2021/22

59 RESEARCH PROJECTS AND TRIALS SUPPORTED

278

GOOGLE REVIEWS 4.8 OUT OF 5 STARS AND 49 FACEBOOK REVIEWS 5 OUT OF 5 STARS

FEWER THAN 0.01% OF PATIENTS MADE A COMPLAINT

LUNG HEALTH CHECK ULTRA-LOW DOSE CT SCANS 50,000

OF CLAUSTROPHOBIC PATIENTS SCANNED SUCCESSFULLY BY OUR SPECIALIST 88% RADIOGRAPHERS LAST YEAR*

CT MRI PET/CT MOBILE IMAGING SCANNERS SCANNERS SCANNERS PATIENT SUPPORT 12 10 2 8 UNITS

99.6% OF PATIENTS AND 95% OF STAFF SAID THEY WOULD RECOMMEND COBALT TO FRIENDS AND FAMILY WHO NEEDED A SCAN*

99.6%

** Patient experience questionaries 2021/22 from the Imaging Centre in Cheltenham *** Annual Staff survey 2022 - 115 employee return rate 69%

P.6 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.7

TRUSTEES' STRATEGIC REPORT

The Cobalt board of trustees present their Strategic Report and the Financial Statements for the year ending 31 March 2023. The Charity reports its achievements in 2022/23 against its core activities of diagnosis, research and education.

Public Benefit

When reviewing the aims and objectives, and planning future activities, the trustees have referred to and believe they have complied with the duty in section 17 of the Charities Act 2011. This relates to having due regard to The Charity Commission’s published general guidance on public benefit. In particular, to its supplementary public benefit guidance on fee-charging. The trustees have also considered how planned activities will contribute to the aims and objectives they have set.

The trustees believe that this report demonstrates the Charity’s commitment to providing public benefit through a range of activities, including the advancement of diagnostic practice, the sharing of knowledge with healthcare practitioners, and the provision of low cost and free scans to assist in patients’ diagnosis and treatment.

Our commitment to quality

Cobalt is committed to exceptional patient care whilst delivering a consistently excellent standard of imaging and reporting. The Charity publishes a Quality Account on an annual basis, which details its managed processes, systems and key achievements in this area. Cobalt fulfils Care Quality Commission standards, and demonstrates the consistent audit and improvement required to meet the Quality Standard for Imaging, ISO 9001:2015 and ISO14001:2015 requirements.

We are currently working towards accreditation and certification against the ISO45001 Health and Safety Standard, with external assessment scheduled to take place during August 2023 and January 2024.

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.

The Charity’s articles include the powers to develop, deliver and promote services that detect, diagnose, treat and prevent sickness in particular cancer and dementia.

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

P.8 – Cobalt Health Annual Report 202 12 /2 23

DIAGNOSIS

ACHIEVEMENTS AND IMPACT IN 2022/23

DIAGNOSIS

DIAGNOSIS - AIMS FOR 2022/23

The Charity aims to support NHS services to provide enhanced medical care to people who are sick or injured, using the most up-to-date imaging technology that otherwise would not have been available. Cobalt’s diagnostic aims for 2022/23 included:

PET/CT

PET/CT scanner launch left-right: Peter Sharpe (CEO), Prof Iain Lyburn (Director of Clinical Research), Roisin Dobbin-Stacey (Head of PET/CT and CT), Sylvia Richards (The Clive Richards Foundation), Neil Holbrook (Chair of the Board of Trustees).

prior to their PET/CT scans. The new state-of-theart mobile dispensers improve patient comfort and provide a safer environment for staff.

Educational Events

Cobalt supported presentations and demonstrations at several educational events and conferences throughout the year. This included demonstrations relating to lung cancer screening, featuring the latest mobile CT scanner, at the European Congress of Radiology and the UK Imaging and Oncology Congress. As the largest provider of ultra-low dose CT to support NHS England’s Lung Health Check programme, the Charity has worked with its NHS and commercial partners, to assist in the development of lung cancer screening in the UK and across Europe.

Growing our people

Cobalt is pleased to have welcomed 9 employed and 23 bank radiographers in 2022/23, plus a further 14 permanent and 8 casual non-clinical members of staff. These new starters have quickly integrated to become valuable and effective members of the team.

P.10 – Cobalt Health Annual Report 202 12 /2 23

Cobalt Health Cobalt Health Annual Report 2022/23 – Annual Report 20 1921 /2 0 2 – P.11 Cobalt Health trading as Cobalt

DIAGNOSIS

ACHIEVEMENTS AND IMPACT IN 2022/23

MRI

In January 2023, the Charity added its first Siemens mobile 1.5 Tesla* MRI scanner to the fleet. It is expected that there will be further upgrades to the MRI mobile fleet over the next couple of years, as technology advances and in line with Cobalt’s equipment replacement policy.

Cobalt’s new Siemens mobile 1.5 Tesla MRI scanner.

Cobalt's new X-ray suite was completed in March 2023, featuring a premium system incorporating the latest technology and advanced features, such as enabling the planning of joint replacements based on the individual patient's anatomy. The system produces higher-quality images, without any increase in radiation dose

L-R Vikki Clegg - MRI Assistant Practitioner, Karen Hackling-Searle, Head of MRI and X-ray, Jane Robinson - District General Manager, Health Systems, Philips UKI and Jonathan Humphris, MRI Operations Manager

Resilience

Over the last two years the Charity has focused on ensuring service resilience by investing in buildings and equipment. Improvements to core IT infrastructure ensures that patient systems are robust, data is secure and that potential disaster recovery timescales are shortened. Developments included increased use of cloud systems, to provide greater flexibility and data security.

Community Based Imaging

Cobalt has been working with the NHS in Gloucestershire and Dudley to support the development of Community Diagnostic Centres (CDCs). These new centres will provide imaging and other services, including MRI and CT scanning within a community. The new centres will also facilitate the training of radiography students.

DIAGNOSIS

THE FUTURE

MRI, CT and PET/CT scanners, facilitating increased support for staff, including a higher level of technical support, training and education, and improved patient safety.

P.12 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.13

RESEARCH

AIMS FOR 2022/23

Research is a key element of Cobalt’s vision to improve outcomes for patients now and in the future.

Cobalt's Research Team: Top L-R Jamie McAllister, Iain Lyburn, Julie Searle Bottom L-R Zoe Wray, Aine McGoven and Ayah Nawwar

• In September 2022, Dr Rahman, Cobalt’s first Lung Intervention Research Fellow at the Royal Brompton Hospital in London, commenced his research supporting the development of the lung tumour biopsy service. He made a good start to the year, publishing research papers, but has since taken up a new external role. Recruitment for a new Research Fellow is underway, through which Cobalt will continue to support the Royal Brompton Lung Cancer Programme.

• The Research team continues to publish papers and present them at conferences. A catalogue of recent work is available on the Research page of the Cobalt website.

Queen Elizabeth Hospital Birmingham

RESEARCH

RESEARCH

ACHIEVEMENTS AND IMPACT IN 2022/23

• The infrastructure of the research team is developing. The Head of Education, Training and Research took up post in the last quarter and a new Director of Clinical Research has been appointed, Professor Iain Lyburn. Together with a Research Fellow in PET/CT, the team will continue to grow, developing radiographer and radiologist research in Cobalt through peer support.

in inclusion on a published paper. The intern enjoyed their time, gaining research experience and learning from the team. Nicola is delighted to be joining the Cobalt MRI Training Progamme in 2023.

THE FUTURE

Zaide Nicholas, Student Radiographer Intern

P.14 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.15

EDUCATION

AIMS FOR 2022/23

EDUCATION

ACHIEVEMENTS AND IMPACT IN 2022/23:

• The apprentices employed through the government's National Apprenticeship Service continue to flourish, now entering their final stages of training, with completion expected this year.

• The Head of Education, Training and Research, Aine McGovern took up the post in the final quarter. With administrative support she is managing student placements and staff training, and promoting opportunities for CPD and further education.

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Aine McGovern
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EDUCATION THE FUTURE

• Cobalt were invited to lecture at a number of events, including:

P.16 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.17

FUNDRAISING REPORT

Happy volunteers taking a break from selling tea and cake.

at a cost of £57,000, to improve patient comfort and provide a safer environment for staff. The new scanner was officially launched on Friday 2 December by Sylvia Richards, Trustee of The Clive Richards Foundation. The Clive Richards Foundation is a long-term supporter of Cobalt. Clive Richards CBE KSG DL (1937 – 2021) was a former Patron of Cobalt, a keen supporter of our work, and a remarkable philanthropist along with his wife, Sylvia.

2022/23 was a challenging year for many of our supporters, as the cost-of-living crisis continued to have an impact. We are extremely grateful for all of the support we received throughout the year. The Fundraising Team achieved their set objectives with a total fundraising income achieved during 2022/2023 of £1.0m. This was £107,000 from individual donations, £87,000 from fundraising activities, £117,000 from trusts and foundations, and £664,000 was from legacies.

We are deeply thankful for the numerous public donations we received throughout this appeal, and would like to recognise the following trusts and foundations for their kind support: The Clive Richards Foundation, E F Bulmer Trust, Garfield Weston Foundation, Gordon Gray Trust, PF Charitable Trust, Philip Smith’s Charitable Trust, Summerfield Charitable Trust, The Caron Keating Foundation, The Fieldrose Charitable Trust, The Hobson Charity, The Hospital Saturday Fund, The R V J Cadbury Trust, The Saintbury Trust, W F Trust and Zurich Community Trust.

Cobalt undertakes fundraising to support the objectives and strategic aims of the Charity. Funds raised help us to provide the latest technology, enabling patients in their time of need to receive the earliest and most accurate diagnosis possible.

Our major fundraising appeal successfully raised £303,000 to support the purchase of the new PET/ CT scanner for the imaging centre in Cheltenham. Due to the success of this appeal, we were also able to purchase a PET/CT isotope infusion device

I was 38 and a new mummy when I was diagnosed with stage 3 cancer. Now, 5 years since diagnosis, and 4 years clear, I am considered one of the lucky ones. Clinical trials are so important as they increase our understanding about breast cancer in many ways.

Dawn Gregson, Senior CT Radiographer at Cobalt.

Our charitable activities in 2022/23 and ongoing include:

CELEBRATION OF VOLUNTEERS

We would like to recognise and thank our extraordinary volunteers who have collectively supported our work for over 30 years. They are at the heart of what we do. Together, volunteers donate over 10,000 hours of their time each year in a wide variety of roles.

Colin Ralph has volunteered for Cobalt for 28 years and currently helps with coin counting from cash donations. Colin said “I help gather in all of the coin collection tins and sort the contents through a specialist coin counting machine. It’s a great big contraption that does the job for us and sorts the coins into different denominations. Volunteering is a great means of filling your time. If you are retired you might think, well what am I going to do? I did have my garden, but I didn’t feel I could fill my time gardening 12 months of the year! You’ve got to go out and do something, especially if you are on your own”.

I am keen to support Cobalt as it is a unique, innovative medical charity involved in the diagnosis of cancer and dementia, to which I have sadly lost relatives. The work of Cobalt is constantly evolving through research, outreach projects, training, and the acquisition of 'state of the art' equipment. Cobalt is here for people locally but reaches those further afield through its work. Overall, in my opinion it is a very worthwhile cause, and we are extremely fortunate to have it, but for its continuation and development it needs our support.

Lynne, Cobalt Supporter

P.18 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.19

Make a Will Month

Throughout April each year, local solicitors donate their time and expertise to write or update straightforward wills in return for a donation to Cobalt. We are very grateful for the support of staff from David Gregory Solicitors, Dee & Griffin Solicitors, Sewell Mullings Logie LLP and Willans LLP for this popular scheme.

We would like to thank past supporters who left a gift in their will, and their loved ones, as well as over a hundred more supporters, who have kindly let us know their intention to support Cobalt in this way.

Nailsworth and Woodchester Support Group

This group has been fundraising for Cobalt for 36 years and made a significant donation of £9,238 at a special evening held at the Royal Oak in Woodchester. Donations were raised from a fundraising walk, donations of small change and events organised by the community and Stroud Vintage Transport and Engine Club. To date, the group have raised a staggering £141,000.

Richard Hardwick and John Perkins, of Nailsworth and Woodchester Support Group present Cobalt with their cheque.

New Charity Partnerships

Staff from Gloucestershire businesses Pure Offices Ltd, Peter Ball & Co, and Shearer Associates have committed to a series of fundraising events in support of Cobalt, as part of their commitment to the local community. For example, Peter Ball & Co are kindly donating £2.50 for every valuation they carry out as well as undertaking a range of fundraising events. Julian Carter of Peter Ball & Co said “We chose Cobalt

as a charity partner as it is very apparent the positive impact that Cobalt have on the local community and beyond.“

Local businesses and organisations have generously donated over 40 fantastic lots to bid for the Cobalt Christmas auction, and have raised over £2,000 for the charity. We are very grateful for the support of the local business community.

Breast Cancer Research Trials

I am fortunate to be part of a group of patients, who have access to annual scans due to a family history of cancer. Because of my scans, I feel that everything is being done to keep me safe. I have no doubt, that both, their scans and their research are an absolute lifeline to the community, helping patients, who have already been diagnosed as well as aiding in preventive care by providing imaging to the highest standard.

Silke, Cobalt Patient and Supporter.

Silke with her husband Jake.

Cobalt’s Capture a Moment photography competition

One of the winning entries used in the 2023 Cobalt Calendar.

350 entries were received for Cobalt’s annual photography competition. Entrants were asked to enter their best photo with a £2 donation. The winning entries were showcased in a calendar and in an exhibition, with the money raised helping to fund Cobalt's Teenagers and Young Adults with Cancer Nurse Specialist. Thanks to the following for their support of the competition: Light & Land, Wex Video, Royal Photographic Society, David Broadbent Photography, The Darkroom Cheltenham, Alan Ranger Photography, Digital Camera magazine, University of Gloucestershire, WallSpace, DSCL and USS audio visual.

Teenagers and Young Adults with Cancer Nurse Specialist

Since I was diagnosed, Meg has been with my family and me every step of the way. She’s given extra support by coming along to doctors’ appointments and helping me and my parents to understand everything that is going to happen. She is always there to message if I have any questions or need help arranging meetings or getting in touch with health professionals. I’m very grateful for all the help me and my family receive from her.

TYA Nurse, Megan Willsher, with one of her patients.

Maddie, patient, talking about Megan Willsher, Cobalt’s Teenagers and Young Adults with Cancer Nurse Specialist.

Our open garden events and community coffee mornings would not be possible without the help of volunteers. During 2002/23 we held two open garden events (each attracting over 600 guests), in conjunction with the Rare Plant Fair at The Old Rectory in Quenington, and at Highnam Court. We also held a pop-up café at Colesbourne Park during snowdrop weekend, and twelve community coffee mornings. Over £18,000 was raised through these activities. Our thanks to David and Lucy Abel Smith, Roger Head DL and Sir Henry Elwes for generously providing their gardens, and all those who held coffee mornings in aid of Cobalt.

The Big Sort and Cobalt Card Programme

Donated cards, upcycled by our volunteers, helped to raise £25,000 for the Charity in 2022/23. Printwaste, who specialise in shredding and recycling, are a key partner in this fundraising project and help to remove any waste including trimmings.

Cobalt Health Annual Report 2022/23 – P.21

LOOKING BACK,

60 YEARS OF INNOVATION Cobalt celebrates its 60th Anniversary in 2024. Here we look back on some key milestones through the decades:

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1960's 1970's 1980's
1964 1966 1982
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Cobalt provided funding for a whole-body X-ray scanner for the diagnosis of cancer and other diseases at the Oncology Centre.

The Cobalt Unit (now the Cheltenham Oncology Centre) at Cheltenham General Hospital was established.

The ‘Cobalt Unit Appeal Fund’ was established by Dr Fred Hanna who was responsible for Radiotherapy in the County. He remained President of the Charity until 2009.

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1975
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1982
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A two-storey extension was built with funding from Cobalt – housing additional treatment facilities, operating theatre and radioisotope accommodation.

Cobalt established a new headquarters in Cheltenham, Linton House.

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1986
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1978
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Dr. Fred Hanna OBE
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Cobalt funded a Cancer Prevention and Early Detection campaign in Gloucestershire, Herefordshire and Worcestershire, operating from Linton House.

An appeal raised funds for an X-ray body scanner at the Oncology Centre, and buildings to house it. Opened by HRH Princess Anne.

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1990's 2000's
1996
1989
Cobalt launched Europe’s first
The Gloucestershire breast
high-field mobile MRI scanner.
screening service for women
aged 50-64 was launched at
Linton House.
The service was provided 1999
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The Gloucestershire breast screening service for women aged 50-64 was launched at Linton House.

The service was provided by the NHS, but supported by Cobalt through accommodation and equipment, including a mobile mammography unit.

An advanced treatment machine is

purchased for the Oncology Centre, following a fundraising campaign by Cobalt.

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1994
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2000
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A mobile MRI service was launched for patients in Gloucestershire and Herefordshire at a cost of £1.5m.

A second mobile mammography unit was purchased to support the NHS breast cancer screening service.

1995 A second mobile MRI scanner extended services to patients in Worcestershire.

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2003
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Cobalt raised funds to support six clinical research projects, including a Research Registrar Physician for the development of bowel cancer screening.

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2005
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Building work began on a new imaging centre, Linton House Clinic in Cheltenham, funded by the Charity at a cost of £7m for construction and equipment.

P.22 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/23 – P.23

LOOKING BACK, 60 YEARS OF INNOVATION

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2000's 2010
2006 2009 2010
A new state-of-the-art PET/ The Thirlestaine Breast
CT scanner was installed Centre was handed over to
to support NHS oncology the NHS, following Cobalt’s
patients in Gloucestershire, £1m appeal.
Worcestershire and
Herefordshire.
2007
Thirlestaine
2011
Breast Centre
A £5.2m project was
2010
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Cobalt took delivery of Europe’s first 3.0 Tesla mobile MRI scanner, to support NHS patients across England.

A new state-of-the-art PET/ CT scanner was installed to support NHS oncology patients in Gloucestershire, Worcestershire and Herefordshire.

A £5.2m project was launched to provide a new breast cancer clinic for the NHS. £1m was raised by public appeal.

Cobalt launched an appeal to support the purchase of a £1m high-definition CT cardiac scanner for Cheltenham General Hospital.

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Dr Fred Hanna, Cobalt’s
founder, sadly passed away.
2010
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2012
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2007
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Mr. Howard Crooks was appointed President of Cobalt.

Digital mammography equipment was provided for Hereford County Hospital.

A new mobile digital mammography unit was provided for the NHS breast cancer service.

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Howard Crooks
2014
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Cobalt celebrated 50 years of supporting the community.

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2020
2015 2018 2022
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Cobalt became the first clinical site in the world to install a Cone Beam CT (CBCT) system.

Following a successful public appeal, a new PET/CT scanner was installed at Cobalt Imaging Centre in Cheltenham, to increase capacity for supporting oncology and dementia patients, and research studies.

Cobalt becomes the leading provider in NHS England’s Targeted Lung Health Check programme, with seven services operating in areas with the highest rates of lung cancer.

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2019
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2022
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2017
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The first commissioned CT lung cancer screening service was launched, in partnership with the NHS in Manchester.

£2.6m was invested in a new Siemens Biograph Vision digital PET/CT scanner and the expansion of Cobalt’s PET/CT department, to support more NHS patients and research.

Cobalt launched a research imaging centre for the Institute of Translational Medicine at the Queen Elizabeth Hospital in Birmingham, working in partnership with the NHS.

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2022
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2018
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Cobalt’s first mobile PET/CT service was launched, with a fully integrated PET/CT department, to support NHS hospitals across England.

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2020
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A public appeal supported the purchase of state-of-the-art 3.0 Tesla MRI scanner for Cobalt Imaging Centre in Cheltenham.

Cobalt supported NHS

England during the COVID-19 pandemic, deploying mobile CT scanners to hospitals across England including the NHS Nightingale field hospitals.

P.24 – Cobalt Health Annual Report 2022/23

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.

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.

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.

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.

FINANCIAL OVERVIEW

the mobile fleet in particular, the cost of agency staff rose, and so did transport and fuel costs. Whilst much of this was anticipated in the planning, costs were on the higher end of this envelope, and the trustees also took the decision to support staff facing inflationary pressures by making a one-off discretionary payment in December 2022 totalling £116k.

Total income for the year 2022/23 was £26.8m (2021/22 – £22.9m).

During the year, the number of scanners deployed increased to 25 (15 CT, 8 MRI and 2 PET/CT scanners), through a combination of acquisition and hiring in units. The Charity continued to maintain support for oncology patients with PET/CT and MRI, alongside research capabilities for ongoing studies. Cobalt provided free MRI, CT and PET/CT scans to help reduce oncology waiting times, improved diagnostic pathways and the early diagnosis of dementia.

The surplus for the year was £0.9m (2021/22 – £2.9m). The Charity invested £5m of the surpluses generated in previous years into new imaging equipment, buildings and plant. This included £2.6m on a new digital PET/CT scanner and associated works at Cobalt Imaging Centre, and £1.1m on a new 1.5 Tesla MRI mobile scanner. A further £1m of capital expenditure was committed at the year-end for an additional CT scanner to support the Lung Health Check screening programmes.

The cost of carrying out the charitable activities increased by £6m to £25.9m (2021/22 – £19.9m). This largely reflects the increase in services provided and also some of the inflationary factors that were beginning to impact the operation from late 2021. There was a sharp increase in the cost of operating

----- Start of picture text -----
1%
36%
60%
3%
1%
----- End of picture text -----

INCOME AND EXPENDITURE

The total income for 2022/23 was £26.8m (2021/22 – £22.9m).

MRI services £9.5m (2021/22 – £8.4m)

MRI services continued to improve on the previous year, with income rebuilding in the imaging centre in Cheltenham, and mobile services operating at 90% capacity, despite the refurbishment of one scanner for several weeks. Cobalt continued to support two NHS Trusts as they develop Community Diagnostic Centres. The Institute of Translational Medicine Imaging Centre at the Queen Elizabeth Hospital in Birmingham met expectations, supporting clinical services and an increasing demand for research work.

TOTAL INCOME (£26.84m)

----- Start of picture text -----
Fundraising activities Donations & legacies
MRI services Other income
PET/CT and CT services
----- End of picture text -----

PET/CT and CT services £16.1m (2021/22 – £13.6m)

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

P.26 – Cobalt Health Annual Report 2021/22

Cobalt Health Annual Report 2021/22 – P.27

digital scanner, has increased capacity, resulting in the average number of scans per month rising significantly.

Fundraising income £1.0m (2021/22 – £0.8m) of which:

----- Start of picture text -----
1% 0%
36%
61%
1%
----- End of picture text -----

TOTAL EXPENDITURE £25.91m

Nurses and research Training and education MRI services Raising funds PET/CT and CT services

----- Start of picture text -----
5%
15% 12%
0%
9%
58%
25%
76%
----- End of picture text -----

CHARITY FUNDS £33.45M (2021/22 – £32.5M)

DESIGNATED FUNDS £3.02M (2021/22 – £4.9M)

Restricted Funds Designated Funds Tangible Assets General Fund for use

Capital Equipment Equipment Replacement Fund Grants Property Fund

Other income £0.1m (2021/22 – £0.1m)

This income is primarily from rent receivable, interest on bank holdings, which have benefitted from the rise in rates, and any gains on fixed asset disposals.

Expenditure for 2022/23 totalled £25.9m (2021/22 – £19.9m).

The cost of hiring CT equipment to support the additional services was £1.76m. The rise in fuel prices, as well as other inflationary trends, led to significant cost increases including in transport, generator, and water and waste for the mobile services. It is anticipated that a significant portion of this increase in cost will be recovered, through increased pricing as contracts renew, and the use of fuel escalators in later contracts.

Raising funds £0.35m (2021/22 – £0.3m)

These costs relate to work carried out by the Charity and volunteers to raise philanthropic funds for Cobalt.

RETAINED FUNDS

Charity funds £33.5m (2021/22 – £32.5m) Restricted funds £0k (2021/22 – £166k)

Designated funds £3m (2021/22 – £4.9m).

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

Tangible assets for use £25.3m (2021/22 – £22.7m)

This fund represents the net capital value of the property and working assets required for the Charity’s operation.

Designated funds £3m (2021/22 – £4.9m)

Capital equipment fund £1.7m (2021/22 – £3.1m)

These funds are held for new equipment projects. £1.0m has been retained to purchase a new mobile CT scanner, which is expected to be acquired by September 2023. £0.75m is also reserved to install the PET/CT scanner, removed from Cobalt Imaging Centre during the digital upgrade project, into a new relocatable unit. This installation is expected to be completed in early 2024.

Equipment replacement fund £0.75m (2021/22 –

£1.2m)

MRI services £9.4m (2021/22 – £8.0m)

Clinical staffing represents the highest proportion of the total costs, including bank staff shifts and agency staffing. Recruitment and training have been effective in 2022/23 and the reliance on agency staff is reducing. Other cost increases related to hire of scanners, maintenance and mobile MRI transport. Work is being done to minimise the number of mobile moves to help control costs.

PET/CT and CT services £15.8m (2021/22 – £11.2m)

As with the MRI service, although staffing numbers have increased, the expansion of mobile services means that agency and bank staffing costs did increase this year.

Charitable funding, nurses and research £0.3m

(2021/22 – £0.4m)

This includes the funding of Cobalt’s Teenagers and Young Adults with Cancer Nurse Specialist, three breast cancer research nurses and a few months of the Royal Brompton research fellowship.

Training and education £0m (2021/22 - £0m)

No income was generated through training and education in 2022/23 as the focus has been on the provision of free online courses for medical professionals. The aim for the newly appointed Head of Education, Training and Research is to increase the number of courses provided. This may generate income in the future.

General fund and reserves policy £5.1m (2021/22 –

£4.8m)

To protect Cobalt’s activities, the Charity’s reserves policy is to maintain reserves equivalent to a minimum of 3 months and a maximum of 5 months of working capital. At year-end, Cobalt held reserves sufficient for 2.3 months (2021/22 – 2.7 months). Although this level falls just below the policy, this reduction was due to the reduced surplus, and due to reserving funds for investment in new medical equipment. Cash generation remains strong, and the level of the reserve is not seen as a significant risk at this time. Cobalt aims to increase its reserves in line with the policy.

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

These funds are reserved for replacing and refreshing the installed imaging equipment in line with the Equipment Replacement Plan. £0.75m has been reserved to upgrade the MRI scanner at the Queen Elizabeth Hospital in Birmingham, to enhance the research capability.

Grants fund £0.4m (2021/22 – £0.4m)

Grants are to support oncology services and research. This fund will be expended against ongoing research projects, fellowships and research grant awards,

P.28 – Cobalt Health Annual Report 2021/22

Cobalt Health Annual Report 2021/22 – P.29

which will be advertised from time to time on the Charity’s website. The grants fund is expected to support these projects over the next two years.

generated across the period, and indicative plans for investment in services, to ensure that these are sustainable. In doing so, the trustees maintain the commitment to replace existing scanners in a timely manner, to ensure that the Charity’s services reflect its vision and values.

Property fund £0.1m (2021/22 – £0.1m)

This fund is used to upgrade facilities at the Charity’s properties. Funds carried forward are retained for upgrading the Cobalt Imaging Centre reception area within the next financial year.

The post-pandemic period has seen cost increases for Cobalt, particularly in transport, materials, fuel, and staffing. With diagnostic and scanning service contracts often being multi-year, the ability to recover rising costs is constrained by the timing of contract renewals. This has resulted in lower forecast surpluses than those seen in recent years. Cash generation is forecast to remain strong, sufficient to meet the cost of existing projects and planned replacement of equipment.

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.

Based on this assessment and the reserves held, the trustees are confident of the ongoing financial viability of the Charity.

Financial viability consideration

As part of the strategic planning process, the trustees review and set annual budgets and three-year financial forecasts based on current information and plans. This review looks at the surpluses and cash

GRANT MAKING POLICIES

The trustees will continue to identify suitable projects for the Charity to support, which:

RISK MANAGEMENT

The Charity’s risk management strategy involves:

The following have been identified as key risks, details of which are recorded in a risk register. Whilst the key risks largely remain consistent, inflationary pressures have also been included which could potentially impact the Charity’s short to medium term resources.

----- Start of picture text -----
Risk Impact Mitigation
The Charity is diversifying its activities
Loss of major contract for diagnostic Potentially significant loss of income. into other services and areas of clinical
imaging. imaging – including the recent addition of
mobile PET/CT.
Staff undertake annual IT Governance
training, including cyber risks. Cobalt
Cyber security failure or denial-of- Potential loss of data, inability to operate, impact on
continues to invest in critical systems,
service attack. reputation.
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.
Impact of inflation and cost drivers Provision in the budget, cost control,
on surpluses. (2022/23 saw rises in Potential reduction in available funds to invest in diversification of supply, renegotiating
critical areas particularly with regards contracts, and reassessing services.
strategic objectives in the medium term.
transport and running of remote Working with suppliers to find efficiencies
services.) and innovation to reduce running costs.
Cobalt has launched a recruitment
Shortage of suitably qualified staff. website and offers more training and
(The recruitment market remains Increased cost of working, and failure to fulfil flexible work opportunities to attract
challenging with demand for imaging contracts and grow. staff. Recruitment support has been
increasing.) increased. Benefits will be reviewed in
2023/24.
----- End of picture text -----

P.30 – Cobalt Health Annual Report 2021/22

Cobalt Health Annual Report 2022/32 – P.31

STRUCTURE, GOVERNANCE AND MANAGEMENT

administrative affairs, including risk management.

Cobalt Health (registered charity number 1090790) is a company limited by guarantee (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 60 of these Financial Statements.

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

Appointment of new trustees

• New trustees go through a formal induction process, to enable them to become an effective member of the board. This includes spending time in the Charity, meetings with the senior management team, and structured training, including occasional sessions with the Charity’s auditor on the responsibilities of trustees. From 2022, the trustees also have access to a training portal, with links to key resources and current updates.

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

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 seven principles in the code on a cyclical basis.

Committee Structure and Management

The board of trustees meets five times per year, with occasional special meetings being called as required. The board 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:

This process has helped to establish a focus on areas where some improvements can be made, including meeting the challenge, that many charities face, of increasing diversity on the board of trustees. A nominations committee has been established, and the board is recruiting new trustees for 2023/24 with the help of a specialist agency to expand the pool of potential candidates.

STATEMENT OF TRUSTEES’ RESPONSIBILITIES

The trustees (who are also directors of Cobalt Health for the purposes of company law) are responsible for preparing the Annual Report, including the financial statements, in accordance with applicable law and UK Generally Accepted Accounting Practice (UK accounting standards).

company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

STATEMENT OF DISCLOSURE TO AUDITOR

I nsofar 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.

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:

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 Annual Report, comprising strategic report and other information, was approved by the trustees on 14th September 2023.

and signed on their behalf by

Dr. Susan Owen, Chair of the Board of Trustees

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

Cobalt Health Annual Report 2022/32 – P.33

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF COBALT HEALTH

concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Opinion

We have audited the financial statements of Cobalt Heath (‘the charitable company’) for the year ended 31 March 2023 which comprise Statement of Financial Activities, Balance Sheet, 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).

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.

In our opinion the financial statements:

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.

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.

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

Conclusions relating to going concern

In auditing the financial statements, we have

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

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

We have been appointed as auditor under the Companies Act 2006 and report in accordance with the Acts and relevant regulations made or having effect thereunder.

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.

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.

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:

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.

Responsibilities of trustees

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.

As explained more fully in the trustees’ responsibilities statement set out on page 33, 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.

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

In preparing the financial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing,

P.34 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.35

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF COBALT HEALTH

COBALT HEALTH

STATEMENT OF FINANCIAL ACTIVITIES

performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

We obtained an understanding of the legal and regulatory frameworks within which the charitable company 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 (FRS102) 2019. 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 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 St James House St James Square Cheltenham Gloucestershire GL50 3PR 6th October 2023

(including an Income and Expenditure account)

FOR THE YEAR ENDED 31 MARCH 2023

Note Unrestricted
Funds		 Restricted
Funds		 2023
Total Funds		 2022
Total
Funds
INCOME FROM: £ £ £ £
Dona%ons and legacies
2		 716,889 65,725 782,614 464,724
Charitable ac:vi:es
Clinical services
3		 25,674,613 - 25,674,613 21,934,585
Fundraising ac%vi%es
4		 87,387 117,018 204,405 359,156
Investment income
5		 67,197 - 67,197 13,512
Other income
6		 114,045 - 114,045 112,201
TOTAL INCOME 26,660,131 182,743 26,842,874 22,884,178
EXPENDITURE ON:
Fundraising costs
9		 345,062 - 345,062 292,304
Charitable ac%vi%es
9		 25,543,286 40,732 25,584,018 19,660,113
TOTAL EXPENDITURE
9		 25,888,348 40,732 25,929,080 19,952,417
NET INCOME 771,783 142,011 913,794 2,931,761
TRANSFERS BETWEEN FUNDS 307,373 (307,373) - -
NET MOVEMENT IN FUNDS 1,079,156 (165,362) 913,794 2,931,761
RECONCILIATION OF FUNDS
TOTAL FUNDS BROUGHT FORWARD 32,352,718 165,500 32,518,218 29,586,457
TOTAL FUNDS CARRIED FORWARD
19		 33,431,874 138 33,432,012 32,518,218

P.36 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.37

The notes on pages 40 to 59 form part of these financial statements.

COBALT HEALTH

BALANCE SHEET

COBALT HEALTH

CASH FLOW STATEMENT

AS AT 31 MARCH 2023

Company number 04366596
Note
2023
2022
£
£
FIXED ASSETS
Intangible assets

11
104,082
169,577
Tangible fxed assets
12
25,293,206
22,730,795
Investments
13
150,001
150,001
TOTAL FIXED ASSETS
25,547,289
23,050,373
CURRENT ASSETS
Debtors
14
4,417,477
3,984,521
Investments
Cash at bank and in hand
13
3,095,910
4,729,476
3,045,102
5,929,071
TOTAL CURRENT ASSETS
12,242,863
12,958,694
LIABILITIES
Creditors - amounts falling
due within one year
15
(4,155,194)
(2,547,228)
NET CURRENT ASSETS
8,087,669
10,411,466
Creditors - amounts falling
15
(202,946)
(943,621)
due greater than one year
TOTAL NET ASSETS
FUNDS OF THE CHARITY
33,432,012
32,518,218
Unrestricted Funds:
Tangible fxed assets held for Charity's use
Designated funds
16
25,293,206
17
3,018,109
22,730,795
4,855,786
General fund
16
5,120,559
4,766,137
TOTAL UNRESTRICTED FUNDS
33,431,874
32,352,718
Restricted funds
18
138
165,500
TOTAL CHARITY FUNDS
19
33,432,012
32,518,218
Approved by the Trustees on14th September 2023
and signed by

FOR THE YEAR ENDED 31 MARCH 2023
Note 2023 2022
£ £
Cash fows from opera_ng ac_vi_es
Net cash provided by opera%ng ac%vi%es
24		 3,852,378 5,082,737
Cash fows from inves_ng ac_vi_es

Interest receivable and rents from investments
5,6		 176,469
-		 116,779
(47,235)
Purchase of intangible assets
Proceeds from the sale of fxed assets
 180 1,480
Purchase of fxed assets
12		 (4,975,647)
(4,798,998)
(139,534)		 (5,192,481)
(5,121,457)
(134,253)
Net cash (used in) inves_ng ac_vi_es
Cash fows from fnancing ac_vi_es
Repayments of borrowing - HP
Repayments of borrowing - Bank loan (62,633) (31,511)
(202,167)
(1,148,787)		 (165,764)
(204,484)
Net cash provided by fnancing ac_vi_es
Change in cash and cash equivalents in the year
8,974,173
7,825,386		 9,178,657
8,974,173
Cash and cash equivalents at the beginning of the year
Cash and cash equivalents at the end of the year
25

Dr. Susan Owen, Chair

P.38 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.39

The notes on pages 40 to 59 form part of these financial statements.

The notes on pages 40 to 59 form part of these financial statements.

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

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 £7.8m in the bank and on deposit. The Charity is able to meet its planned capital expenditure for 2023/24 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 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

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

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, 5-10% for refurbishment

Medical equipment - 10, 12½ & 20% of cost

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

P.40 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.41

COBALT HEALTH

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

value at 31 March 2023. 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.

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.

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

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.

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.

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

Legacies:

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.

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.

P.42 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.43

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 2. DONATIONS AND LEGACIES
2023 2022
2023		 2022
£ £
£		 £
Dona%ons 107,035 157,266
107,035		 157,266
In Memoriam 11,571 9,890
11,571		 9,890
Legacies 664,008 297,568
664,008		 297,568
782,614 464,724
782,614		 464,724
£65,725 of dona%ons and legacies were restricted (2022 - £133,477).

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 4. INCOME FROM FUNDRAISING ACTIVITIES
2023 2022
£ £
Events 60,558 36,185
Card Sales 26,829 19,261
Grant income 117,018 303,710
204,405

NOTE 5. INVESTMENT INCOME

NOTE 3. CHARITABLE ACTIVITIES

2023
2022		 2023
2022		 2023
2022
£
£
Clinical services
MRI Services
PET/CT and CT Services
9,549,984
16,124,629
8,382,099
13,552,486
25,674,613
21,934,585
2023 2022
£
13,512
£
Interest receivable 67,197

NOTE 6. OTHER INCOME

2023
£		 2023
£		 2022
£
103,267
1,480
7,454
112,201
Rent receivable

109,272
Gain on disposal of fxed assets -
Delegate Fees, room hire, other income 4,773
114,045

P.44 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.45

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 7. ANALYSIS OF STAFF COSTS, TRUSTEE REMUNERATION AND EXPENSES, AND THE COSTS OF KEY MANAGEMENT PERSONNEL
2023
 2022
 2023
 2022
£ £ £ £

Wages and salaries
5,631,252		 4,261,294 5,631,252 4,261,294
Social security costs
606,517		 430,728 606,517 430,728
Pension contribu%ons
671,523
 553,631 671,523 553,631
Other employee benefts
23,717		 18,436 23,717 18,436
6,933,009 5,264,089 6,933,009 5,264,089
The number of employees whose emoluments for the year fell within each band from £60,000 upwards was:
2023 2022 2023 2022
£60,000 - £69,999
6		 5 6 5
£70,000 - £79,999
6		 - 6 -
£80,000 - £89,999
4		 5 4 5
£90,000 - £99,999
1		 - 1 -
£100,000 - £109,999
1		 - 1 -
£150,000 - £159,999
1		 1 1 1
I th tibt f £43351_2022 £38248_d t 1_2022_ _1_hih id l’ l dfd tibt
In the year contribu%ons of £43,351 (2022 - £38,248) were made to 1 (2022 – 1) higher paid employees’
personal defned contribu%on schemes.
n e year conruons o , (- ,) were mae o (–) ger pa empoyees persona ene conruon
schemes.

The total emoluments (includin ension costs and emloer's natonal insurance contributons) of the 9 members of the Senior manae-
The total emoluments (including pension costs and employer's na%onal insurance contribu%ons) of the 9

g p py g
ment Team who have day-to-day infuence on the actvites of the Charity was £830075 (2022 - 8 £757938) The 9 are the Chief Executve
members of the Senior management Team who have day-to-day infuence on the ac%vi%es of the Charity

,, ,. ,
Finance Director Fundraisin Director Human Resources Manaer Communicatons Manaer Educaton Trainin and Research Manaer
was £830,075 (2022 - 8, £757,938). The 9 are the Chief Execu%ve, Finance Director, Fundraising Director,

, g , g, g, , g g,
Quality Manager and 2 Clinical Managers
Human Resources Manager, Communica%ons Manager, Educa%on, Training and Research Manager,
.
Quality Manager and 2 Clinical Managers.

During the year, redundancy payments amountng to £nil, were paid to members of staf (2022 - £35,875).
During the year, redundancy payments amoun%ng to £nil, were paid to members of staf (2022 - £35,875).
The average monthly headcount of employees, analysed by func%on, was:
2023 2022 2023 2022
MRI Services
67		 57 67 57
PET/CT Services
65		 46 65 46
Fundraising
6		 5 6 5
Administra%on and Management
19		 19 19 19
Buildings 4 4 4 4
161 131 161 131

The average full-time equivalent number of staff for the year was 113 ( 2022 - 102 ). No Trustees received remuneration during the year

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 8. NET INCOME FOR THE FINANCIAL YEAR

Net income is stated ager charging/(credi%ng):
2023		 Net income is stated ager charging/(credi%ng):
2023		 Net income is stated ager charging/(credi%ng):
2023		 2022 2022
£ £
Auditor's remunera%on:
Audit
15,180
13,800
Tax advisory
12,504		 1,138
Other services
240		 -
Deprecia%on
2,388,570		 1,974,083
Amor%sa%on
Deficit/(Surplus) on disposal of fixed assets
65,495
24,487		 67,149
(1,480)
Impairment - 250,733
Opera%ng lease costs 9,876 11,544
Pension contribu%ons 671,523 553,631

NOTE 9. ANALYSIS OF EXPENDITURE

Direct
Support
Amor_sa_on
and
Total
Total		 Direct
Support
Amor_sa_on
and
Total
Total		 Direct
Support
Amor_sa_on
and
Total
Total		 Direct
Support
Amor_sa_on
and
Total
Total		 Direct
Support
Amor_sa_on
and
Total
Total		 Direct
Support
Amor_sa_on
and
Total
Total
Costs
Costs
Deprecia_on
2023
2022
Raising funds:
Costs of fundraising
and similar ac%vi%es		 £
£
£
£
£
214,298
115,845		 14,919
345,062
292,304
Charitable ac_vi_es:
MRI Services		 214,298
115,845		 14,919
345,062
292,304
7,685,326
758,273		 986,178
9,429,777
8,043,691
PET/CT and CT Services 13,106,957
1,357,742		 1,361,230
15,825,929
11,231,850
Charitable Funding
Training and Educa%on
TOTAL 2023
TOTAL 2022		 224,023
-		 89,508
313,531
371,657
1,202 11,349 2,230
14,781
12,915
21,017,508
2,127,364		 2,439,146
25,584,018
19,660,113
21,231,806
2,243,209		 2,454,065
25,929,080
19,952,417
16,065,459
1,845,726		 2,041,232
19,952,417

( 2022 - Nil ). No Trustees were reimbursed travel expenses during the year ( 2022 - Nil )

P.46 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.47

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023 NOTE 10. SUPPORT COSTS
Admin
Building
Governance
Total
Total
Costs
Costs
Costs
2023
2022
£
£
£
£
£
MRI Services 548,571
204,060
5,642
758,273
622,674
PET-CT and CT Services 1,132,533
213,561
11,648
1,357,742
1,118,691
Fundraising 88,479
26,456		 910
115,845
95,246
Training and Educa%on -
11,349		 -
11,349
9,115
TOTAL 2023 1,769,583
455,426
18,200
2,243,209
1,845,726
TOTAL 2022 1,465,861
365,765
14,100
1,845,726

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

NOTE 11. INTANGIBLE FIXED ASSETS
Socware
Cost £
At 1 April 2022 277,497
Addi_ons -
Disposals (15,516)
At 31 March 2023 261,981
Amor_sa_on
At 1 April 2022 107,920
Charge for year 65,495
Disposals (15,516)
At 31 March 2023 157,899
Net Book Value
At 31 March 2023 104,082
At 31 March 2022 169,577

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 12. FIXED ASSETS
Freehold
 Medical IT / Fixtures Motor
Land & Buildings Equipment & Figngs Vehicles Total
£ £ £ £ £
Cost
At 1 April 2022
 11,381,743 23,295,014 602,677 50,201 35,329,635
Addi_ons
 36,089 4,916,403
 - 23,155 4,975,647
Disposals (94,820) (1,837,005) - - (1,931,825)
At 31 March 2023 11,323,012 26,374,412 602,677 73,356 38,373,457
Deprecia_on and Impairment
At 1 April 2022 2,898,297 9,421,848 257,063 21,632 12,598,840
Charge for year 179,016 2,080,667 118,028 10,859 2,388,570
Eliminated on Disposals (94,820) (1,812,339) - - (1,907,159)
At 31 March 2023 2,982,493 9,690,176 375,091 32,491 13,080,251
Net Book Value
At 31 March 2023 8,340,519 16,684,236 227,586 40,865 25,293,206
At 31 March 2022 8,483,446 13,873,166 345,614 28,569 22,730,795
The net book value of assets held under hire purchase agreements is £525,819 (2022 - £596,716).
A bank loan was taken out in 2020 year and is secured by way of a frst legal charge over the freehold of Linton Coiage.
The aggregate amount secured is £707k. The loan was repaid in April 2023.

P.48 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.49

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 13. INVESTMENTS

FOR THE YEAR ENDED 31 MARCH 2023
NOTE 13. INVESTMENTS		 FOR THE YEAR ENDED 31 MARCH 2023
NOTE 13. INVESTMENTS
2023
2022
2023
2022
£ £
£
£
Fixed Assets
Investment in subsidiary
1
1
1
1
Investment property
150,000		 150,000
150,000
150,000
Total
150,001 150,001
150,001
150,001
Current Assets
Current asset investment - no%ce deposits
3,095,910
3,045,102
3,095,910
3,045,102

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

2023
£
2022
£
Clinical Service fees due 3,359,717 3,417,832
Accrued income
Prepayments		 490,148
567,612
4,417,477		 254,052
312,637
3,984,521

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 15. CREDITORS: Amounts falling due within one year

FOR THE YEAR ENDED 31 MARCH 2023
NOTE 15. CREDITORS: Amounts falling due within one year		 FOR THE YEAR ENDED 31 MARCH 2023
NOTE 15. CREDITORS: Amounts falling due within one year
2023 2022
2023
2022
£ £
£
£
Trade creditors
2,309,164		 1,198,722
2,309,164
1,198,722
Bank Loan
613,183		 80,163
613,183		 80,163
Accruals
821,413		 720,291
821,413		 720,291
Other creditors
16,529		 18,067
16,529		 18,067
HP liability
145,023		 139,534
145,023		 139,534
Taxa%on and social security
166,315		 133,070
166,315		 133,070
Pension liability 56,757 51,885
56,757		 51,885
Deferred income 26,810 205,496
26,810		 205,496
4,155,194 2,547,228
4,155,194
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 2022 205,496 205,496
205,496		 205,496
Released in the year (205,496) (205,496)
(205,496)		 (205,496)
Deferred in the year 26,810 26,810
26,810		 26,810
At 31 March 2023 26,810 26,810
26,810		 26,810
Rent and fees received in advance is recognised as income in the month to which it relates.
CREDITORS: Amounts falling acer one year:
2023 2022
2023		 2022
£ £
£		 £
Bank Loan 2-5 years - 320,652
-		 320,652
Bank Loan > 5 years - 275,001
-		 275,001
HP liability 202,946 347,968
202,946		 347,968
202,946 943,621
202,946		 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 Coiage.
Interest is charged at 1.75% p.a. over Base Rate. The loan was repaid in April 2023 and is shown due within one year above.

P.50 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.51

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023 NOTE 16. UNRESTRICTED FUNDS - 2023

General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559		 General Fund

Balance at
1 April 2022
£
4,766,137
Movement in Funds
Income
£
26,660,131
Expenditure
£
(25,313,744)
Transfers
£
(991,965)
Balance at
31 March 2023
£
5,120,559
Income Expenditure Transfers
£ £ £
26,660,131 (25,313,744) (991,965)
Tangible fxed assets held
for the Charity's use
22,730,795		 - (481,410) 3,043,821 25,293,206
Total
27,496,932		 26,660,131 (25,795,154) 2,051,856 30,413,765

Unrestricted Funds includes a General Fund balance of £5,120,559. This constitutes 2.4 months’ working capital requirement. Transfers of £2,051,856 represent fixed asset additions and disposals in the year, as well as transfers to and from the designated funds, see note 17.

UNRESTRICTED FUNDS - 2022

UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022 UNRESTRICTED FUNDS - 2022

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

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 17. DESIGNATED FUNDS - 2023
Balance at 1
April 2022		 Expenditure Transfers Funding of
Fixed Assets		 Balance at
31 March 2023
£ £ £ £ £
Capital Equipment Fund 3,144,974 - 1,756,109 (3,144,974) 1,756,109
Equipment Replacement Fund 1,228,548 - 750,000 (1,228,548) 750,000
Grants Fund 372,000 (57,930) 57,930 - 372,000
Property Fund 110,264 (35,264) 65,000 - 140,000
Total
4,855,786
(93,194)
2,629,039
(4,373,522)		 3,018,109
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 £3.1m brought forward has been used to purchase a new PET/CT
scanner and addi%onal take up rooms in Cheltenham, and a CT mobile unit. The £1.75m carried forward has been retained
to purchase a new CT scanner and a PET/CT relocatable unit. The CT scanner is expected to be in place by September 2023,
and the PET/CT relocatable during 2024.
Equipment Replacement Fund
This fund is reserved to replace and refresh the installed imaging equipment as part of the Equipment Replacement Plan.
£750k has been set aside to upgrade the ITM Imaging Centre in Birmingham.
Grants Fund
Grants are to support oncology and demen%a services and research. This includes, but is not limited to, projects with
the NHS Trusts, and funding research fellowships. £58k of this fund has been spent during the year. Going forward, the
fund will be expended against ongoing research projects, fellowships, and research grant awards that will be adver%sed
from %me to %me on the Charity’s website. This fund is expected to support these projects over the next two years.
Property Fund
This fund is used to upgrade the facili%es in the Charity’s proper%es and equipment. Funds were expended in the year
on bathroom refurbishments. Funds carried forward a
 re retained for upgrading the Cheltenham Imaging Centre
recep%on area within the next fnancial year.
DESIGNATED FUNDS - 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
Equipment Replacement Fund 1,100,000 - 128,548 - 1,228,548
Grants Fund 470,000 (116,154) - 18,154 372,000
Property Fund 220,000 - 50,264 (160,000) 110,264
Total 5,412,530 (116,154) 3,323,786 (3,764,376) 4,855,786

P.52 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.53

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 18. RESTRICTED FUNDS - 2023

FOR THE YEAR ENDED 31 MARCH 2023
NOTE 18. RESTRICTED FUNDS - 2023		 FOR THE YEAR ENDED 31 MARCH 2023
NOTE 18. RESTRICTED FUNDS - 2023		 FOR THE YEAR ENDED 31 MARCH 2023
NOTE 18. RESTRICTED FUNDS - 2023
Balance at
Income		 Expenditure Funding of Balance at
1 April 2022
£
£		 Fixed Assets 31 March
2023
£ £ £
Breast Cancer Research Nurses Fund
-
1,127		 (1,127) - -
TYA Nurse Fund
-
31,783		 (31,645) - 138
Cancer General Fund
-
Demen%a Research Fund
6,000
Equipment Fund
159,500
Research Fund
-
1,034
583
147,873
343		 (1,034) - -
(6,583) - -
- (307,373) -
Research Fund - (343) - -
TOTAL 165,500
182,743		 (40,732) (307,373) 138

Restricted funds held totalled £138 at the balance sheet date. In the year restricted funds were used for specifically 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 Teenage and Young Adult specialist cancer nurse post. 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 patents.

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.

Equipment Fund

The fund was used to support the purchase of a new PET/CT scanner. In addition 50% of card sales (£13.4k) has also been aiributed to this project in the year.

Research Fund

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

RESTRICTED FUNDS - 2022
Balance at Income Expenditure
Funding of		 Balance at
1 April 2021 Fixed Assets 31 March
2022
£ £ £
£		 £
Breast Cancer Research Nurses Fund
-		 22,155 (22,155)
-		 -
TYA Nurse Fund
-		 13,503 (13,503)
-		 -
Cancer General Fund
-		 1,278 (1,278)
-		 -
Demen:a Research Nurses 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

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 19. ANALYSIS OF NET ASSETS - 2023

FOR THE YEAR ENDED 31 MARCH 2023
NOTE 19. ANALYSIS OF NET ASSETS - 2023		 FOR THE YEAR ENDED 31 MARCH 2023
NOTE 19. ANALYSIS OF NET ASSETS - 2023
Unrestricted Funds
General Fund
Tangible Fixed Assets held for Charity use
Total Unrestricted Funds		 Creditors due
Intangible
Fixed
Net Current
greater than		 Total
Assets
Assets
Assets
one year
£
£
£
£		 £
104,082
150,001
5,069,422
(202,946)		 5,120,559
- 25,293,206 - - 25,293,206
104,082 25,443,207 5,069,422 (202,946) 30,413,765
Designated Funds
Capital Equipment Fund -
-		 1,756,109
-		 1,756,109
Grants Fund -
-		 372,000
-		 372,000
Equipment Replacement Fund
Property Fund
Total Designated Funds
Restricted Funds
Total Funds
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		 -
-		 750,000
-		 750,000
- - 140,000 - 140,000
- - 3,018,109 - 3,018,109
-
-		 138
-		 138
104,082 25,443,207 8,087,669 (202,946) 33,432,012
Creditors due
Intangible
Fixed
Net Current
greater than		 Total
Assets
Assets
Assets
one year
£
£
£
£		 £
169,577
150,001
5,390,180
(943,621)		 4,766,137
- 22,730,795 - - 22,730,795
169577 22880796 5390180 (943621) 27496932
, ,, ,, , ,,
-
-		 3,144,974
-		 3,144,974
-
-		 372,000
-		 372,000
-
-		 1,228,548
-		 1,228,548
- - 110,264 - 110,264
- - 4,855,786 - 4,855,786
- - 165,500 - 165,500
169,577 22,880,796 10,411,466 (943,621) 32,518,218

P.54 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.55

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 20. CAPITAL COMMITMENTS

Future capital expenditure not otherwise included in the fnancial
statements at the balance sheet date:
Expenditure contracted for
2023 2022
£ £
900,856 2,455,016

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 £2,730 ( 2022 - £nil ).

NOTE 22. LIABILITIES UNDER OPERATING LEASES

At 31 March 2023, the Charity had total commitments under non-cancellable operating leases in respect of equipment as follows:

Within one year
Between one and fve years
Total		 2023
£
11,706
38,998
50,704		 2022
£
9,876
-
9,876

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 23. ASSETS RECEIVABLE UNDER OPERATING LEASES

At 31 March 2023, the Charity had assets receivable under non-cancellable operating leases in respect of rental income of Cobalt House as follows:

2023 2022 2023 2022
£ £ £ £
Within one year 101,956 99,992 101,956 99,992
Between one and fve years 37,653 139,609 37,653 139,609
Total 139,609 239,601
NOTE 24. RECONCILIATION OF CASH FLOWS FROM OPERATING ACTIVITIES
2023 2022
Net income for the repor_ng period 913,794 2,931,761
(as per the statement of fnancial ac%vi%es)
Adjustments for:
Deprecia%on and amor%sa%on charges 2,454,065 2,041,232
Impairment - 250,733
Dividends, interest and rent from investments (176,469) (116,779)
Defcit/(Surplus) on sale of fxed assets 24,487 (1,480)
Increase in debtors (432,956) (194,396)
Increase in creditors 1,069,457 171,666
Net cash provided by opera_ng ac_vi_es 3,852,378 5,082,737

P.56 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.57

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 25. ANALYSIS OF CHANGES IN NET CASH/DEBT
Other non-
2022
Cashfows		 cash changes 2023
£
£		 £ £
Cash at bank and in hand
5,929,071
(1,199,595)		 - 4,729,476
Current asset investments:
No%ce deposits
3,045,102
50,808		 - 3,095,910
Total
8,974,173
(1,148,787)		 - 7,825,386
Loans falling due within one year
(80,163)
80,163		 (613,183) (613,183)
Loans falling due ager more
than one year
(595,653)
(17,530)		 613,183 -
Hire purchase obliga%ons
(487,502)
139,534		 - (347,968)
Total
7,810,855
(946,620)		 - (6,864,235)

COBALT HEALTH

NOTES TO THE FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MARCH 2023

NOTE 26. 2022 STATEMENT OF FINANCIAL ACTIVITIES
Note Unrestricted
Funds		 Restricted
Funds		 2022
Total Funds
INCOME FROM:
£ £ £
Dona:ons and legacies
2		 331,247 133,477 464,724
Charitable ac:vi:es:
Clinical services
3		 21,934,585 - 21,934,585
Fundraising ac:vi:es
4		 55,446 303,710 359,156
Investment income
5		 13,512 - 13,512
Other income
6		 112,201 - 112,201
TOTAL INCOME 22,446,991 437,187 22,884,178
EXPENDITURE ON:
Fundraising costs
9		 292,304 - 292,304
Charitable ac:vi:es
9		 19,621,238 38,875 19,660,113
TOTAL EXPENDITURE
9		 19,913,542 38,875 19,952,417
NET INCOME 2,533,449 398,312 2,931,761
TRANSFERS BETWEEN FUNDS 261,642 (261,642) -
NET MOVEMENT IN FUNDS 2,795,091 136,670 2,931,761
RECONCILIATION OF FUNDS
TOTAL FUNDS BROUGHT FORWARD 29,557,627 28,830 29,586,457
TOTAL FUNDS CARRIED FORWARD
19		 32,352,718 165,500 32,518,218

P.58 – Cobalt Health Annual Report 2022/23

Cobalt Health Annual Report 2022/32 – P.59

TRUSTEES, EXECUTIVE AND ADVISERS

Dr Susan Owen (Chair from 30th June 2023) Neil Holbrook (Chair to 29th June 2023 - resigned) Ruth Goddard Claire Morris (appointed 23rd June 2022) Dr Janet Ropner Pamela Sissons (appointed 23rd June 2022) Dr Valerie Udale Prof Gordon Wilcock (resigned 30th January 2023)

Trustees and Directors

Chief Executive Officer Company Secretary Medical Director

Peter J Sharpe

Malcolm J MacKeith

Dr Umesh Udeshi

Director of Clinical Research President Registered and Principal Office

Prof Iain Lyburn Howard Crooks

Linton House Clinic, Thirlestaine Road, Cheltenham, Gloucestershire, GL53 7AS

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

Independent Auditor

Bankers

Solicitors

Crowe U.K. LLP,

4th Floor, St James House, St James’ Square, Cheltenham, GL50 3PR

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

Willans LLP, 34 Imperial Square, Cheltenham, Gloucestershire, GL50 1RH

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.

Tesla

Tesla is the unit of measurement for the magnetic field strength of an MRI magnet. In general terms, a more powerful magnet can produce a more detailed image. 1 Tesla is equivalent to 20,000 times the Earth’s magnetic field. The majority of hospitals in the UK have a 1.5 Tesla scanner. Cobalt introduced one of the first 3.0 Tesla clinical service in the UK, and now has a mobile 3.0 Tesla scanner, in addition to the permanent one installed in Cobalt Imaging Centre.

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.60 – Cobalt Health Annual Report 2022/23

www.cobalthealth.co.uk

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