Somerset Unit for Radiotherapy Equipment. Charity Registration No. 1102299. surecharity.org.uk 44 Calder Crescent, Taunton, Somerset, TA1 2NH ANNUAL REPORT & FINANCIAL STATEMENTS YEAR ENDED 31[ST] DECEMBER 2022 ## Sections 1. Charity Information 2. Report of the Executive Committee 3. Internal Financial Controls policy 4. Financial Reserves policy 5. Report of the Independant Examiner SURE Annual Report 2022 1 of 15 5 July 2023 ## **Section 1. S.U.R.E. CHARITY INFORMATION For Year Ending 31st December 2022** TRUSTEES Paul Alway Roy Hole Vanessa Marchmont Barrie Palmer EXECUTIVE COMMITTEE P W Alway (Chair) B Palmer (Founder) V.H.R.Hole (Vice Chair & Hon.Financial Director) V Marchmont. (Secretary) C Summerfield (Treasurer) S Miller G Wills REGISTERED OFFICE 44 Calder Crescent Taunton, Somerset, TA1 2NH BANKERS CAF Bank Ltd 25 Kings Hill Avenue Kings Hill, West Malling Kent, ME19 4JQ Lloyds/TSB 31 Fore St, Taunton, TA1 1HN Bath Building Society c/o MJC Financial Planning Ltd 22 South Street Wellington TA21 8NS Scottish Widows 67 Morrison Street Edinburgh, EH3 8YJ Shawbrook Lutea House The Drive, Great Warley Brentwood, CM13 3BE Skipton Building Society 1 Cheapside Taunton, TA1 3LG INDEPENDANT EXAMINER TaxAssist Accountants 24 Bridge Street Taunton TA1 1UB SURE Annual Report 2022 5 July 2023 2 of 15 ## **Section 2. Report of the Executive Committee** The members of the Executive Committee, including all Trustees, present their Annual Report, Financial Statement of the Charity, and Independant Examiners Report for the year ended 31[st] December 2022. ## STRUCTURE, GOVERNANCE & MANAGEMENT S.U.R.E. is a fund raising charity and was founded in the year 2000. It became a Registered Charity in 2004 and the registered number is 1102299. S.U.R.E. is constituted under a model Declaration of Trust deed dated 6[th] February 2004, Registered 25[th] February 2004. The charities Management Committee consists of the 4 current Trustees plus Treasurer and 2 volunteer fundraisers. New trustees are appointed by the existing trustees and serve for 3 years after which they can put themselves forward for reappointment. The Trust Deed, as amended by Supplementary Trust Deed at a Special Committee Meeting held on 5[th] September 2013, provides for at least 3 Trustees. The Management Committee meet at least 4 times a year, at which they review and agree the broad strategy for the charity and areas of activity for the coming months, including considering any significant funding applications exceeding £5,000. Smaller funding requests, under £5,000 are generally considered by email outside of the main Management Committee meetings and need approval by all members of the Management Committee to go ahead. The Management Committee also review monitoring of performance of approved projects, outstanding invoices, committed funds, overall current financial position and funds available for future projects. The Management Committee also meet 4 times a year with the Beacon Centre Radiotherapy Department management and finance team to review performance of current projects, outstanding invoices, review the Vision & Roadmap and to discuss potential future projects for SURE funding. ## PRINCIPAL ACTIVITY The principal activity of the charity is to raise funds for radiotherapy equipment used in the treatment of cancer patients at the Beacon Centre, Musgrove Park Hospital, Taunton (Somerset NHS Foundation Trust). Alongside this the charity considers funding requests for equipment associated with cancer diagnosis, treatment planning, treatment delivery and patient care which will benefit cancer patients across Somerset. ## REVIEW OF THE YEAR The ability of SURE to fund major new projects in 2022 continued to be impacted by the recovery from the Covid-19 pandemic and the focus of the Beacon Centre during 2022 remained delivering patient treatment at the expense of planning for significant new equipment to be provided with SURE funding. In 2022 SURE fundraisers and supporters continued to give their generous support to the charity. Supporters leaving SURE a Gift in their will as a legacy has become significant in recent years in enabling the charity to fund major innovations in radiotherapy treatment that would not have been possible without them. Total donations received in 2022 was **£509,157** made up of: Donations **£72,900** ; Legacies **£430,000** ; Gift Aid **£613** ; Interest Received **£5,644** . Whilst funding of projects in 2022, outlined in the SURE Vision 2020 and Beyond roadmap, continued to be affected by the impact of Covid-19, S.U.R.E. has been able to pass to the Beacon Centre and Musgrove Park Hospital the sum of **£162,935** to fund the purchase of equipment and services in the year, whilst expenses have been kept to a minimum at **£851** for the year. General expenses also included Liability Insurance, postage, licenses, professional fees and bank charges. Total expenditure was **£163,786** resulting in net income for the year of **£345,370.** sureannualreport2022final.odt 5 July 2023 3 Of 15 The projects funded by SURE in 2022 are as listed in the following pages of this section titled ‘SUREEquipment Provided during 2022', which also includes a look at the way ahead in 2023 where SURE expects to begin funding delayed major new projects planned in the 2020 Vision & Roadmap, to ensure the Beacon Centre is able to make best use of the advanced treatment capabilities to the benefit of patients. In recent years the SURE AGM/Annual Supporters Meeting has taken place at the Beacon Centre and include a detailed tour of the Radiotherapy Department to show supporters where their donations have been used to the benefit of patients. SURE was unable to hold any meetings at the hospital in 2021 and 2022, as a result the AGM/Annual Supporters Meeting could not take place. It is planned that the 2023 Annual Supporters meeting will go ahead at the Beacon Centre later in the year. The Annual Report is highlighted on the SURE website including the extract from the Annual Report detailing the Equipment Provided each year. All SURE Committee and Trustees meetings in 2022 took place online over Zoom, with meetings with the Beacon Centre management taking place using Microsoft Teams meetings. It is hoped that in 2023 there will be a return to face to face meetings before the end of the year. This whole report was compiled by Chair Paul Alway, with a major contribution from Treasurer Carole Summerfield, and help as needed from Vice Chair Roy Hole. ## **– SURE Equipment Provided during 2022** During 2022 SURE committed funding of **£162,935** to the Radiotherapy Department at the Beacon Centre at Musgrove Park Hospital to further improve patient diagnosis, treatment and outcomes. The focus of the Beacon Centre and Radiotherapy Department in 2022 continued to be on delivering patient treatment as the hospital focussed on recovering from the Covid-19 pandemic, alongside the introduction of Stereotactic Ablative Radiotherapy treatment (SABR), as a consequence there were no major new projects delivered in 2022. ## **Projects Funded by SURE in 2022:** 1. Pinnacle Treatment Planning System Software Update: SURE approved funding in 2019 for the upgrade of the Pinnacle Treatment Planning System software to include AutoPlanning & Plan IQ upgrade with automatic upgrade entitlement to Pinnacle Evolution when launched. Final invoice cost paid by SURE in 2022 of **£135,240.06** 2. Oligomets Immobilisation Devices: In March 2022 SURE approved funding to purchase immobilisation devices in support of expansion of the next part of the SABR programme to include Oligometasteses 1 (simple non-vertebral bone and nodes), required to restrict movement during treatment of sites in the abdomen, at a final cost to SURE of **£25,452.20** 3. Monitor Rails: In 2019 SURE approved funding for monitor rails to better hold the monitors in the radiotherapy control room. Final invoice paid by SURE in 2022 of **£1,940.60** 4. Power Chargers for apple iPads: In 2019 SURE approved funding of replacement power chargers for the Apple iPads used by the radiotherapy team. Final invoice paid by SURE in 2022 of **£302.72** ## **The Way Ahead for 2023** SURE is committed to ensuring cancer services at Musgrove Park Hospital, and the Beacon Centre in particular, continues to offer high quality cancer care to internationally recognised standards, as SURE continues to provide equipment and support not otherwise available within the NHS budget that is assessed sureannualreport2022final.odt 5 July 2023 4 Of 15 to be of real benefit to patients, including enabling participation in national cancer treatment trials, leading to more patients being able to be treated locally at the Beacon Centre. In November 2020 the SURE management committee and Trustees agreed a new Vision and Roadmap paper for the future development of advanced radiotherapy services with the Radiotherapy management team, outlining where SURE support and funding might best be used to the benefit of patients, an extract of which is available to download from the SURE website. The Vision & Roadmap is not set in stone, it is a living document setting out an agreed pathway for key areas of development, it will continue to evolve as these new projects move forward. In December 2021 SURE and the Beacon Centre management reviewed the roadmap, the revised table shows how some projects had been moved/revisited and are likely to be revised further. |**YEAR**|**PROJECT**|**DELIVERY DATE**|**DELIVERY DATE**|**DELIVERY DATE**|**Approx Cost (£K)**|**Approx Cost (£K)**| |---|---|---|---|---|---|---| |2020|RT App|Feb-21|||£40|| |||||||| |2020|Staff room|Jan-21|||£10|| |||||||| |2021|SABR – ArcCheck and
MapCheck|Sep-22|||£150-200|| |||||||| |2021|Space Conversions|Dec-21/Jan22|||£30|| |||||||| |2022|Ra223/Lu177||Under review||£150|| |||||||| |||||||| |N/A|TrainingNeeds|||Annual|£20|| |||||||| |2021|ePROMS|||Mar-22||| |||||||| |2022|SABR – gating and
immobilisation|||Sep-22|£200|| |||||||| |2022|SGRT|||Jan-23|£500|| |||||||| |2022|Hexapods|||Mar-23|£150|| |||||||| |2023|MRIplanningsoftware|||May-24|£60|| |||||||| |2023|MRIplanningscanner|||2024|£1m|| |||||||| |2023|SXR|||Dec-24|£500|| |||||||| |2024|BiGART|not yet
commercialised||||| |||||||| |2025|AIplanningsystem|not yet
commercialised|||£750|| |||||||| |2025|Linac 4|2025|||£1.5m|| |||||||| Unfortunately the two big projects that were planned for delivery in 2022, Surface Guided Radiotherapy Treatment (SGRT) and Radium 223, were not able to move forward during the year. However planning has continued with the expectation they will both now be delivered in 2023. Also the planned SURE funding of the replacement of the Superficial X-Ray (SXR) machine was not taken up as the overall project costs escalated and the Trust funded the entire project, releasing ring-fenced SURE funds of £153,000 for other future projects. As a result we now have an ambitious programme of projects underway for 2023 **.** - In August 2022 SURE gave final approval and committed funding for the delivery of **Surface Guided Radiotherapy Treatment (SGRT)** on all 3 Linac treatment machines plus the SURE provided CT Scanner/Simulator, at a cost to SURE of **£650,600.** Installation is expected to be completed and service start with patients by September 2023. - SURE also committed to funding SGRT service and maintenance costs for year 2 and year 3, which will now be ring-fenced awaiting future invoices, at a cost to SURE of **£158,632** - In March 2023 SURE approved funding for licences from Elekta for the implementation of SGRT on sureannualreport2022final.odt 5 July 2023 5 Of 15 the 3 Linac radiotherapy treatment machines, at a cost to SURE of **£56,449** - SURE is also expecting to fund additional room works to enable the installation of SGRT equipment for the CT Scanner, awaiting final quotes for approval. - **Stereotactic Ablative Radiotherapy treatment (SABR)** – split into two elements: ArcCheck and MapCheck, awaiting proposal and quotes. - **Radium 223 treatment.** This project had been impacted by difficulty in identifying a suitable location, this has been resolved and Radium 223 is now planned to go ahead within the new SXR modular building. SURE has given outline approval of funding up to £150,000 for this project, planning for delivery in 2023 is now underway, awaiting final proposal and quotes for approval. Whilst the delivery timescales of individual projects cannot be guaranteed, the overall Vision Roadmap remains our joint view of how SURE funding will continue to help deliver world class treatment for patients. The Vision Roadmap will be reviewed in 2023 to ensure the proposed projects for the next 2-3 years will deliver the best outcomes for patients. ## **Section 3. Internal Financial Controls Policy** The charities trustees are responsible for safeguarding the assets of the charity and hence taking reasonable steps for the prevention and detection of fraud and other irregularities. To that end the trustees have reviewed the internal financial controls policy which is set out below. ## **Management of the charities bank accounts** - No payments are authorised for payment without an accompanying invoice or receipt. - Where the charity holds more than one account with the same bank, the Treasurer is authorised to move funds electronically between those accounts but cannot authorise payments out of the accounts in that way. - All payments made by the charity are made by cheque requiring two signatures, those of the Treasurer and the Hon. Finance Director. - For all online donation activity, eg. Just Giving, the charity uses a bank account into which you can deposit funds but not make outgoing payments. - All payments and receipts are logged manually. - A receipt is issued for all cash donations received from donors by any member of the charities management committee. ## **Working with the Somerset NHS Foundation Trust.** - All requests to SURE for consideration for funding must be accompanied by a paper outlining the needs and patient benefits together with final quotes for all equipment required. - All projects approved by the Management Committee and Trustees are given a unique SURE project number when authorised and a ceiling funding amount which cannot be exceeded without seeking further authority from the SURE management committee. - Invoices are received electronically from the Trust. No invoice will be accepted for payment unless it includes the SURE project number. - Approved invoices are then paid within 5 working days. ## **Donations for SURE made at the Beacon Centre Musgrove Park Hospital** Up until March 2022 donations were able to be left for SURE at the Beacon Centre reception desk where they were held in a safe until collected by a nominated SURE volunteer. However, following a suspected theft of a donation, reported to the police who after an investigation concluded the evidence was not likely to lead to a conviction, the Management Committee and trustees worked with the hospital management and fraud prevention officer to change how donations are to be handled in future. The incident was reported to the Charity Commission (Incident No.514570) who are satisfied that the trustees have dealt with the matter appropriately sureannualreport2022final.odt 5 July 2023 6 Of 15 and responsibly and that the matter is now closed. The agreed procedure for donations for SURE at the hospital is: - No donations can be left at the Beacon Centre reception - All donors are directed to the hospital's Main Office where the donation will be counted and a receipt issued to the donor. - All cash received is paid by the Trust into the nominated SURE bank account via BACS. - • All cheques and accompanying letter or other information received along with any donations is held by the Main Office until collected by the SURE Treasurer, as soon as possible after being notified, within the next 7 days. - All donations received by the Main Office are recorded in a spreadsheet, regularly passed to the charities Treasurer. - A new poster at the Beacon Centre reception includes the charities registered phone number if the donor would prefer us to arrange collection from them. ## **Section 4. Financial Reserves Policy** The S.U.R.E. Financial Reserves Policy is based upon a number of factors, and reviewed annually: 1. Forecast and historic annual income levels from fundraising activities, excluding legacy donations. 2. Historic underlying funding expenditures on equipment and services to maintain the treatment capabilities of the Radiotherapy Department at the Beacon Centre, Musgrove Park Hospital, excluding major funding undertakings such as replacing the S.U.R.E. funded CT Scanner/Simulator. 3. S.U.R.E. Does not commit to funding equipment unless the funds are readily available in S.U.R.E.'s bank accounts, the exception being for major undertakings such as replacing the S.U.R.E. CT Scanner where given the high cost an individual fundraising campaign is run. 4. The need to hold reserves against committed expenditure forecasts for future years, such as the ongoing maintenance of equipment funded by S.U.R.E. where a commitment has been made to fund multiple years maintenance costs, such as where S.U.R.E. committed to pay the first 3 years maintenance costs for the S.U.R.E. CT scanner. 5. S.U.R.E.'s Reserves Policy is to maintain reserves of a minimum of **£100,000** in the charities bank accounts 6. S.U.R.E. will not commit expenditure of any portion of the £100,000 financial reserve without the unanimous agreement of the Management Committee and the authority of ALL Trustees confirmed in writing to the Secretary. 7. This will enable S.U.R.E. to fund the provision of equipment urgently required by the Radiotherapy Department to ensure patient treatment is maintained at current levels of excellence. sureannualreport2022final.odt 5 July 2023 7 Of 15 ## **Section 5. Report of the Independant Examiner** S.U.R.E. Somerset Unit for Radiotherapy Equipment 110229 Report and Accounts for the Year ended 31st December 2022 This page left blank sureannualreport2022final.odt 5 July 2023 8 Of 15 S.U.R.E. Sometstt Unirfor Radiotherapy Equipment 110229 REPORT OF THE TrUSTEES forthe Year ended 31st Detrmber2022 co The charity is a fund raising organisation to provide equipment for the treatment of cancer patient5 and therefore 15 cash based with no 35sets of its own. It operates as a focal recei￿n8 point ftirthe Cash generated by a variety of fund r345ine events and has only mini%ule amount of operating expenditure. It wa5 founded in the year 21¥Xland became a regi5teTed chanty in 2CAY4. OPERATIN RESULTS Since inte ion Total ie5S Net Cash B31an Year DonatioThs Interest Income Income 6.818 34.739 49.250 64.617 93,768 159,074 153,839 165.952 255.044 301,289 174.774 154.930 161.165 117,111 135,035 294,892 297.267 130.564 192,623 521.201 928.291 70.528 503.513 6.818 34,843 49.843 66,682 97.456 167.501 169,140 187,207 321,392 307,549 178,118 160.202 164,752 118.935 136,128 296,378 299,545 133.018 196.395 524.191 932.206 71,5(M) 509,157 6,818 34,843 49,843 66,555 97,212 167,138 168,9)S 186,731 3r￿,856 1225,6721 82,875 184,6301 1275.0831 1125,8811 14,432 185,156 227,771 19.778 1299,4161 28.508 894,572 155,6561 345,370 6.818 41,661 91,504 158.059 255,271 422,409 591,314 778,045 1,084,901 859,229 942,104 857,474 582.391 456,510 470,942 656,098 883,869 903,647 604,231 632,739 1.527.311 1.471,655 1.817,025 2(Kll 104 593 2,065 2(NJ2 2(K)3 11271 12441 13631 12351 14761 11971 13141 I2,1￿)} 11751 14321 16641 15281 11,0771 11,(xx)I 11,1581 11.6491 11,3701 15421 19221 18511 21￿5 8,427 15,301 21.255 66,348 6,260 3.344 5.272 3.587 1,824 1,093 1.486 2.278 2.454 3.772 2,990 3.915 972 2(X>7 114,3391 1532,9071 193,0531 1244,6571 1439,4031 1244,1521 1121,1681 1110,1451 170.7741 1112,0821 1494,1621 1494.3131 137,0921 1126.2341 1162,9351 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Note Donations include GIft￿d aTrJ Legaoes Page 2 sureannualreport2022final.odt 90f15 5 July 2023 S.U.R.E. Sometset Unltfor Radiothtrnpy E9ulpmert 110229 INCOME & EXPENDITURE ACCOUNT forthe Yearended 315t December 2022 MING RESOLIRC 2021 Donations 72.9 430J 613 .580 8.806 1,142 972 Legacies 6ift Ai Interest Received Bank Adjustment Total Incomlrvx Resour￿$ 509.157 71.5(M> RESOURCE EXPENDED E4uipment Purchased Sundry Expenses Fundraising costs Postsge stationery Web51te 162.935 126.234 825 235 67 36 24 332 70 Insurance Licen5es Bank Charges 87 97 163,786 127,156 NET INCOME 345370 55.SS6 Page 3 sureannualreport2022final.odt IOOf15 5 July 2023 S.U.R.E. 110229 BALANCE SHEEr forthe Year ended 315t December2022 CURRENT ASSErs Cash at Bank and in Hafxl 1,817.025 1.471,655 I￿l7J)25 1/471.655 Balance brought forward 1.471,6S5 1.527.311 Income & Expendtture Account 345,370 55.656 Balarte carrfed forward I￿17.015 IA71.655 These financial statementswere approved by the Execulwe Committee on its behaw by.. and signed on V.H.R. Hole. Vice Chaimian C. Summerfield. Treasurer Paul Alwavt Chairnian Page4 sureannualreport2022final.odt 11 Of15 5 July 2023 S.U.R.E. Somerstt Unltfor Radiothela￿EqUiPrneDt 110229 Statement of Cashflows asat 31st Detember 2022 2021 Ca5hflow from operatin8adivities 339,726 56.628 Cashflow from Investment acts¥tttes 972 Movement in cash 345.370 55.656 Balance brought forward 1.471.655 1,527.311 Balance r4rr¢ed forward L817.025 1,471,655 sureannualreport2022final.odt 120f15 5 July 2023 S.U.R.E. 110229 NOTES TO THE FINANCIAL STATEMENTS as at 31st December 2022 Acfounting Pollues lal Ba515 of preparation The financial Statements have been prepared uThJerthE historbc C05tcon¥ention. The finanoal Statements have been PTepared in alxordance t•Mh the Statement of Recommended Pracbce." AccountirE and ReportinE by Charitses preparing their acwunts in accordance wtth the Financial Reporting Standard applicable in the UK and Republit of Ireland IFRS 1021 issued on 16July 2014 and the Financial Reporting Standard applicable In the United Kingdorn and Republic of Ireland IFRS 10213rKI the Charities Act 2011 and UK Generally Accepted Prartice as it applies from l January 2015. The trustees con5iderthat there 4re no material UfKXrtainties aknut the Charity's ability to continue as a going concern. There are no material ufitertainties 3ffectingthe current vearfs accoun Ibl Fund5 Structure All fund5 are unrestrirted. Icl Incomirvd resource5 All incoming resource5 ate recogni5ed upon receipt Idl Incoming resourcesfrtsm legacies Legacie50re accounted for as irKominK re￿rCeS u￿Th r**ipt. Idl Resources expended and irremverable VAT All expenditure is accounted foron an accruals ba￿$ and has been da55ified under heading5 that aggregate all costs related to each categoryof expense shown in the Income & Expenditure Account Irrecoverable VAT is tharged agalr￿the (ategory of resource5 expended forwhich it wa5 inturred. Page 6 sureannualreport2022final.odt 130f15 5 July 2023 S.U.R.E. 110229 INDEPENDENT EXAMINER'S REPORT ontheaccounts forthe year ended 3tst Oecernber 202Z I report to thE trLtstees on rnyexaminat¥)n of the accounts ofthe above d￿rity 1.the Tru5fl forthe year ended 3tst lknmber 2022 a5 SÈt out on pages 1- 6. As the thartws trustees. you are wnsible for the preparation of the xcounts in accordante with the requiTernents of the Charibe5A£t 20111-the Acfl. I report in re5pert of my examination of the TrusV5a(tsunts carried out under section 145 of the 2011 Act and in carryireout rny examination. I have followed all the applicable Directionsgiven bythe Charity Commtssion under5ection 14515llbl olthe Art. IndepÈndèntexwnlnerf5 siatemeirt The chaTiiVs gross income ex￿eded £250.(KA)3fLd l am qualifted to undertake the examination by being a gualffie(l rnernber of The Institute of Financial AccountaRts. I have cornpleted my examination. I confimi that no material matters have corne to mv attention in COTTnectson wtth the trxamination (other than that disdosed below I which gives me cause to believe that in. any material respect.. • the accounting record5 were not kept accordarKe w4th section 130 of the Charities • the accounts did not a￿1rd wf(h the a(wunting record5,' or . the accovnts did Th)t compty the applicable requiTements cOn￿MI￿athefor￿ and content of atcounts set out in the Charitie5 (Accounts and Reportsl Regulations 2CX)8 other than any requsrement that the accounts give a'true and frdirf ¥iew which is r￿t a rnatter considered as part of an independent exarnination. I have rKI cor￿MS and ha¥e (J)me acr055 r￿ other Matte￿ in tonnection wlth the examination to whtch attention should be dnwn in this reptsrt in ordertts enable a I￿Oper under5tandir8of the ac(x)unts to be reached. Signed.. Date: 24th May 2023 Name.. Edward Coton LTCLAFAIMIPA sureannualreport2022final.odt 140f15 5 July 2023 'rhe5e FindnLial Stalert￿lts were aPPn)V￿ by the SURE Exec￿]ye CthJJmI￿ & TnLSte£s 202? on 4￿d signed on khalfby.. PaBIAIw4y* Chxir, Carole Summerfield,TMsurer. VJLROY Hol4 Y￿e Ch•ir. 131,,113 Left Blank 150f15 5 July ?0?3 sureannualreport2022final.odt 150f15 5 July 2023