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2021-03-31-accounts

THE HEPATITIS C TRUST

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2021
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Annual Report & Accounts

T H E H E P A T I T I S T R U S T

Contents

TRUSTEES' REPORT

The Hepatitis C Trust, finding and supporting those living with, affected by or at risk of hepatitis C. On a mission with our partners to eliminate hepatitis C from the UK by 2030, leaving no one behind.

TRUSTEES' REPORT
WHO WE ARE 4
MESSAGE FROM THE TRUSTEES 6
FINANCIAL OVERVIEW 8
OBJECTIVES
ACHIEVEMENTS AND PERFORMANCE		 10
Advocacy and campaigning 12
Reaching our community 18
Training 24
Adapting to Covid-19 26
Supporting people 28
FUNDRAISING 32
THE YEAR AHEAD 34
GOVERNANCE AND MANAGEMENT 36
RISK ASSESSMENT 36
FINANCIAL REVIEW 37
STATEMENT OF TRUSTEES RESPONSIBILITIES 38
INDEPENDENT AUDITOR’S REPORT 39
FINANCIAL STATEMENT 43

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WHO WE ARE
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The Hepatitis C Trust

WHO WE

OUR AIMS

ARE

We are the UK charity for hepatitis C, a cancer-causing virus that can be cured if diagnosed on time. We support those living with, affected by or at risk of hepatitis C.

Most of our board, staff and volunteers have had either direct or indirect experience of hepatitis C.

We believe in patient-centred treatment and are committed to ensuring all our actions are to the benefit of each individual.

Our overarching objective is to help eliminate hepatitis C from the UK by 2030.

HOW WE WORK

Our strategy is based around the pillars of better prevention and more diagnosis and treatment for all. We work through a range of projects and services to deliver and support this.

With an elimination deal in place and our peer programmes now reaching across communities and prisons in the UK, we are currently working to identify and engage both those undiagnosed and those diagnosed but untreated.

Hepatitis C is a blood-borne � To provide comprehensive support throughout the treatment pathway to virus that predominantly individuals with hepatitis C. infects liver cells. This can � To provide a range of trusted information result in inflammation and about hepatitis C for all whether they significant damage to the are living with the virus, friends or families, healthcare professionals, liver. It can also affect the politicians, the media or the general liver’s ability to perform its public. essential functions. Although � To change the misperception of it has always been regarded hepatitis C as a ‘drug users’ disease, as a liver disease, recent misinformation which discourages those who have been exposed in research has shown that other ways from getting tested. the hepatitis C virus (HCV) � To provide individual representation for affects a number of other people with hepatitis C experiencing areas of the body. These can difficulties or discrimination in a number of settings, including include the digestive system, compensation and healthcare. the lymphatic system, the � To provide collective representation immune system and the for people with hepatitis C, who brain. A simple course of historically have not found a strong, coherent voice with which to direct-acting-antivirals address policy-makers at a local can now deliver a fast and or national level. effective cure for hepatitis C.

The Hepatitis C Trust and Changing Lives joint testing event, Yorkshire, July 2020

Our vision is to stop people dying from hepatitis C and eliminate it from the UK by 2030

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TRUSTEES’ MESSAGE

Message from the Trustees’

As we move into our 20th It has been a great year for partnership anniversary year, we leave working. A standout initiative being behind a year unlike any other. the large-scale testing of homeless The surge of activity we saw people, which came about as a result last year, following the launch of of the Government’s ‘Everyone In’ NHS England’s hepatitis C (HCV) Covid-19 scheme, where homeless elimination deal, was undoubtedly people were temporarily housed in set back this year by Covid-19 hotels and hostels. This initiative meant and the subsequent national that, working with partners, we were able to test concentrated numbers of shutdowns and restrictions. In homeless people in any one venue over spite of this we had some really the course of a day. Allowing us to positive achievements throughout test up to 100 high-risk and often the year. difficult-to-engage people at a time.

The Black Lives Matter movement prompted us to develop a work stream to assess race and equality within our organisation and our work. We formed a Black Lives Matter working group to develop and implement an action plan for improvement. Under the action plan we signed up to the Race at Work Charter and began to deliver against its commitments.

Harm prevention, including reinfection, remained high on our agenda throughout the year. We launched our reinfection and harm prevention strategy and priorities for the next few years, which includes focused pieces of work that will feed into national research and discussions about harm prevention, needle syringe programme provision and ultimately the maintenance of elimination. A key focus will be reinfection, which we believe may have been exacerbated by recent Covid-19 restrictions and reduced needle syringe programmes.

Our national helpline support service, in the community and prisons, proved more important than ever this year. We increased the number of hours our prison helpline was available, to provide maximum support for people in prison at a time when our staff were unable to access them in person. Our helpline support staff also maintained our work within The Infected Blood Inquiry as hearings moved online.

In line with the growth of our peer support work, our staff team almost doubled in size this year. Online platforms ensured we were able to stay connected as an organisation, welcome new staff, deliver a wide range of volunteer and staff training and a comprehensive programme of support to maintain the mental wellbeing of all.

The biggest loss this year was the closure, or scaling back, of hepatology services as nurses and doctors were redeployed to work on Covid-19. As a consequence, many clinics were cancelled, HCV testing ceased and new treatment starts were delayed.

As the Secretariat of HCV Action, we were able to bring together hepatitis C health professionals through a series of webinars. This allowed us to provide the health professional community with much needed national overviews of the impact of the pandemic on both hepatitis C services and the elimination drive across England and Scotland.

We also developed a new organisational

research strategy working with our staff, external researchers and academics. The new strategy will help us to raise the profile of the work we’re doing; show its impacts; better evidence and communicate the voice of people affected by hepatitis C; and allow us to take a more active role in shaping the national hepatitis C research landscape over the coming years.

However, working beside and supporting our NHS colleagues produced some welcome outcomes, including new ways of working with shorter care pathways and more responsibilities designated to our HCV peers. Responsibilities which included our peers picking up and delivering HCV medicines to patients and providing one-to-one support to those most anxious, isolated and vulnerable.

World Hepatitis Day provided a much needed breath of fresh air this year. Our challenge to walk the height of Everest on peaks across the UK brought together patients, staff and partners, walking in small socially distanced groups towards a collective goal, raising money for the work of our peers and the charity Mind.

In our 20th year, the Trust, despite the impact of Covid-19, has expanded its operations throughout the UK, and is striding towards our goal of elimination. Our innovative peer model continues to truly place the patient at the centre of their care.

Our Art on a Postcard fundraising arm continued to raise money for the Trust by holding some outstanding online art auctions throughout the year.

Once again, we owe a huge gratitude to our staff, and our supporters. ‘Leave no on behind’, remains the central tenet of our charity.

As we move forward, we are mindful that while there have been many positives over the past year, we also face some unknowns, including the rebuilding of the HCV elimination momentum that was so suddenly slowed down.

David Macmillan, Chair of Trustees

We do, however, move forward with hope and enthusiasm. There is the firm commitment from NHS England and many new initiatives that will come to fruition in the coming year, including A&E testing, community pharmacy testing and the implementation of local Trust outreach vans. All of which makes us optimistic that we can still reach the elimination goal before 2030.

We hope you enjoy the rest of the report

Thank you

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FINANCIAL OVERVIEW

Financial overview

An overview of our total income and expenditure for this year, with a comparison to that of last year. More in-depth details can be found in our financial report available on pages 39-55.

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TOTAL
INCOME
2019-20 2020-21
DONATIONS £0.32M £0.27M
INVESTMENTS £192 £152
RENTAL INCOME £0.05M £0.02M
OTHER INCOME £0.005M
GRANTS RECEIVED £2.4M £3.34M
TOTAL £2.77M £3.63M
1
0
2
2
-
-
0
9
2
1
0
0
2
2
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TOTAL
EXPENDITURE
2019-20 2020-21
RAISING FUNDS £0.18M £0.21M
CHARITABLE ACTIVITIES £2.1M £2.8M
OTHER INCOME £0.05M £0.02M
TOTAL £2.33M £3.03M
1
0
2
2
-
-
0
9
2
1
0
0
2
2
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OUR OBJECTIVES
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Our 2020/21 objectives

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ADVOCACY AND CAMPAIGNING

Our Achievements

Policy and parliamentary

A key focus of our work over the past year has been ensuring appropriate policies are in place to achieve hepatitis C elimination and that parliamentary oversight of NHS England’s hepatitis C elimination deal is fully supported.

A timely webinar in June provided us with the opportunity to present a comprehensive update on the pandemic’s impact on hepatitis C services and the elimination drive in England at the time. We followed this with a second webinar not long after, which focused on the impact on services in Scotland. Both webinars were well-received, and played a key role in supporting hepatitis C service providers with access to important information during a time of uncertainty.

UK

PARLIAMENT

We met with a range of parliamentarians this year, updating them on the progress towards achieving hepatitis C elimination and outlining the challenges requiring policy change. This included a meeting with Public Health Minister Jo Churchill, which focused on identifying the actions required to reduce the rate of new hepatitis C infections.

We have also played a significant role in keeping the hepatitis C professional community up-to-date on the impact of Covid-19 on hepatitis C services, while taking an active role in government consultations to ensure hepatitis C has been represented in inquiries into delivering core NHS services during the pandemic.

TAKING OUR NATIONAL HEPATITIS C ODN STAKEHOLDER EVENT ONLINE

SECRETARIAT OF THE ALL-PARTY PARLIAMENTARY GROUP ON LIVER HEALTH

This year we recast our National Hepatitis C Operational Delivery Network (ODN) Stakeholder Event as a week-long webinar series, featuring a half-day series of presentations and Q&As, alongside four focused webinars on subjects of current relevance to ODNs and other hepatitis C services. Our new online format meant that we were able to secure more speakers and attendees than previously.

In our role as the Secretariat of the All-Party Parliamentary Group on Liver Health, we continued to work with the group’s parliamentary members to table Parliamentary Questions related to hepatitis C. We held a number of well-attended online meetings, focusing on the impact of the pandemic on hepatitis C services; drug policy; harm reduction and hepatitis C; hepatitis C testing for homeless populations; and liver pathology. We also produced a monthly ‘liver health’ e-newsletter providing updates to parliamentarians and other stakeholders on hepatitis C and liver health.

HCV ACTION

WORK

The impact of Covid-19 made our work as the Coordinator of HCV Action, a network of over 1,000 hepatitis C health professionals, more important than ever this year.

CONDUCTING SURVEYS ON THE IMPACT OF COVID-19 ON HEPATITIS C SERVICES

Assisting the hepatitis C professional community more widely, we conducted surveys to understand the nature of the impact of Covid-19, and to gain a better understanding of the impact within individual ODNs in England. Our findings were published in HCV Action e-updates.

ADAPTING PLANS & COORDINATING UPDATES

CONSULTATION SUBMISSIONS

We adapted our plans to play a key role in informing the hepatitis C professional community of updates in relation to hepatitis C services at a time of significant disruption and disconnection between services.

We provided submissions to several consultations this year to ensure issues relevant to hepatitis C were represented. This included submissions to the Health and Social Care Committee’s inquiry into delivering core NHS and care services during the pandemic and beyond, and Dame Carol Black’s independent review of drugs.

We also partnered with Public Health England, tailoring survey questions to capture informaton not picked up by their existing surveillance, to help inform their monitoring reports.

GOOD PRACTICE CASE STUDIES

We produced a variety of good practice case studies and resources over the course of the year.

Sadiq Khan

Mayor of London

‘I’m proud that, despite the extraordinary challenges presented by Covid-19, our health and care services continue to do all they can towards our shared goal of eliminating hepatitis C.’

Alex Norris

L a b o u r Sh a d o w P u b l i c H e a l t h M i n i st e r

The impact of Covid-19 made our work as the Coordinator of HCV Action, a network of over 1,000 hepatitis C health professionals, more important than ever this year.

‘I am calling on the government to urgently address the dearth of harm reduction services which are proven to be so successful in preventing the transmission of hepatitis C. According to goverment data, over a third of injecting drug users report not having adequate needle and syringe equipment for their needs.’

Paul Davies

We ls h C o n se r va t i ve P a r t y L e a d e r

‘It is more important than ever that the Welsh Government re-focuses its efforts on eliminating hepatitis C. Over ten thousand people are currently living with the virus in Wales, of whom around half are not aware they have an infection which could be inflicting lasting damage on their liver.’

Statements of support from politicians for World Hepatitis Day

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ADVOCACY AND CAMPAIGNING

Our Achievements

Policy and parliamentary

SCOTTISH PARLIAMENT

With harm reduction and the drug deaths crisis becoming an increasingly prominent issue in Scottish politics, this year we engaged with a wide range of MSPs to ensure hepatitis C was represented in the conversation on this issue, particularly within parliamentary debates. We also supported politicians in tabling motions and Written Questions relating to hepatitis C and harm reduction.

With each of the devolved nations at different stages of reaching elimination, it is important we are able to work with, and support, all UK nations in meeting their goal.

SEXUAL HEALTH AND BLOOD-BORNE VIRUS (SHBBV) HEPATITIS C ELIMINATION GROUP

We supported our membership of the SHBBV Hepatitis C Elimination Group, whose remit is to ensure the outcomes of the Scottish Government’s Sexual Health and BBV Framework are delivered in Tayside, by attending meetings and providing updates to colleagues on the impact of Covid-19 on hepatitis C services.

Aidan Rylatt, Policy & Parliamentary, The Hepatitis C Trust

Mark Drakeford

F irs t Min is t e r o f Wa le s

‘Wales is committed to eliminating hepatitis C by 2030, sparing thousands of people from the increased risk of liver disease and cancer which this virus causes.’

Joe FitzPatrick

WELSH PARLIAMENT

PARLIAMENTARY CHAMPIONS

This year, we worked closely with our Welsh Hepatitis C Parliamentary Champions to lobby the Welsh Government to prioritise the recommendations outlined in the Health, Social Care and Sport Committee’s inquiry into hepatitis C elimination in Wale s.

ROUNDTABLE MEETINGS

We participated in a roundtable meeting with Members of the Senedd, key hepatitis C service representatives and other health care leaders to discuss the steps needed to achieve hepatitis C elimination in Wales.

With harm reduction and the drug deaths crisis becoming an increasingly prominent issue in Scottish politics, we engaged with a wide range of MSPs to ensure hepatitis C was represented in the conversation on this issue.

Sc o t t is h Go v e rn me n t Min is t e r f o r Pu b l i c H e a l t h , Sp o rt s a n d We llb e in g

‘Last World Hepatitis Day, the Scottish Government announced it was bringing forward its ambition to eliminate hepatitis C by six years, aiming for elimination by 2024. I am delighted to reaffirm our commitment.’

PUBLIC HEALTH WALES

We worked with the Public Health Wales National Hepatitis C Patient Re-Engagement Exercise Implementation Group, attending meetings to ensure representation for the patient perspective.

Statements of support from politicians for World Hepatitis Day

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ADVOCACY AND CAMPAIGNING

Our Achievements

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Everest Challenge, Parliament Hill, London
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World Hepatitis Day

NEWS & BLOGS

SOCIAL MEDIA EVENTS

World Hepatitis Day is held annually on 28 July. It is one of the World Health Organization’s officially mandated global public health days. For people and organisations around the world working to eliminate hepatitis C, World Hepatitis Day presents a great opportunity to raise collective awareness about the risks of hepatitis C and to push for increased testing and treatment, while also reflecting on how far we’ve come.

� The Trust’s CEO Rachel Halford wrote a blog for LocalGov looking at lessons learnt along the way to eliminating hepatitis C and the success of multi-agency partnership working; along with an article for Drink and Drug News calling for the re-doubling of efforts to eliminate hepatitis C.

On 26 July, two days ahead of World Hepatitis Day, we held a series of Facebook live streams featuring music and talks about hepatitis C, with the rapper DJ Mr C playing a rap about the Trust and its goals for elimination.

LANDMARK BUILDINGS LIT PURPLE

Landmark buildings such as town halls, museums and hospitals were once again lit up in purple across the UK to show support for hepatitis C elimination and in memory of those who lost their lives to the virus.

� Activist and writer Philip Baldwin wrote a guest blog for our website about the importance of testing, and a feature for Gay Times about his hepatitis C diagnosis and the similarities and differences between the hepatitis C virus, HIV and Covid-19.

This year, people and organisations were incredibly creative in raising both funds and awareness in Covid-safe ways.

POLITICAL SUPPORT

We secured a number of statements of support from politicians across the UK, including the Mayor of London Sadiq Khan, Shadow Public Health Minister Alex Norris, First Minister of Wales Mark Drakeford and Scottish Public Health Minister Joe FitzPatrick. These featured widely on our social media platforms.

CLIMBING THE HEIGHT OF MOUNT EVEREST

The Hepatitis C Trust staff and volunteers successfully took on the massive challenge of climbing the equivalent of the height of Mount Everest, an elevation of 8,848 metres. We achieved this by climbing different peaks across the UK, with the metres climbed by individuals and small groups accumulating to the total height count. The money raised went to our peer volunteers and the mental health charity Mind, in recognition of their work and the mental health challenges presented by Covid-19.

8,848m climbing UK peaks

People and organisations were incredibly creative in raising both funds and awareness in Covid-safe ways.

Everest Challenge, Ivinghoe Beacon, Buckinghamshire

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Everest Challenge, Pic de Céciré, French Pyrenees
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Everest Challenge, South Yorkshire
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Leeds City Museum lit up purple to mark World Hepatitis Day
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REACHING OUR COMMUNITY

Our Achievements

Reaching our community through peer work

The Hepatitis C Trust was founded on peer work and it remains core to our operations today.

Our peers, who have lived experience of hepatitis C, work within the community to actively engage those most at risk. By using their own personal stories and drawing on their treatment experience they are uniquely placed to provide support and advice to others through the treatment pathway.

This year our peers successfully helped to overcome some of the difficulties NHS Operational Delivery Networks (ODNs) faced in delivering hepatitis C services, refocusing their work to support in any way they could.

SUBSTANCE MISUSE SERVICES

The impact of Covid-19 this year meant that many of the substance misuse services (SMS) we work with were forced to operate on reduced services.

While we still focused on our work with people accessing these services, we also focused on those who had already tested positive, ensuring they were able to access treatment and support, and that their opportunity to clear hepatitis C was not put at risk.

This was our second focused year delivering our hepatitis C peer programmes within 20 of the 22 NHS ODN areas as part of NHS England’s elimination initiative. During this time we managed to secure some good successes while confronting the challenges of a Covid-19 environment.

Working in partnership with ODNs we were able to help them overcome some of the difficulties they faced in delivering hepatitis C services, the biggest being the redeployment of clinical staff to other services. For example in North Central London the whole of the hepatology team were redeployed to work on Covid-19, leaving hepatitis C services uncovered – in areas with less Covid-19, hepatology services were able to operate at a fuller capacity.

By implementing policies and guidance to protect staff, volunteers and the people we work with, our peers were able to continue their work in the community.

We developed new ways to engage with vulnerable patients, providing interventions to reduce isolation, while keeping patients both safe and engaged in the face of limited or no access to hepatitis C clinics.

DELIVERING MEDICATION

Providing support to NHS staff deployed to Covid-19, and patients who for health reasons were fearful of leaving their home, our peers took on the role of picking up medication from pharmacies and delivering it to patient’s homes, helping to ensure they could continue their treatment – a practice which was prohibited prior to Covid 19.

WHOLE VENUE TESTING

A unique opportunity was presented this year by the Covid-19 government ‘Everyone In’ initiative, in which homeless people across England found themselves temporarily housed in hostels or hotels.

A situation which allowed us, while working with partners, to test and treat a high-risk and particularly difficult-to-engage group in whole venue testing. Through our partnership work with NHS clinicians, drug service providers, accommodation providers and local authorities we were able to test up to 100 homeless people a day.

REACHING THE DISENGAGED

Our peers worked alongside ODNs to go through ‘look back’ lists of patients who had previously tested positive for hepatitis C, but who had disengaged from services and had not been treated, contacting them to check their current status and to re-engage them where possible.

PREVENTING REINFECTION

We increased the attention given to the scale of reinfection across each ODN, looking at how we could best support and identify reinfected patients.

PEER-ASSISTED POSTAL TESTING

With drug services operating at a reduced capacity, we worked to ensure people were still able to get tested. In some cases our peers, wearing PPE protection, visited clients’ homes to assist them in taking postal service tests, ensuring they carried their tests out correctly and sent them to the right place for diagnosis.

TELEPHONE SUPPORT

With restrictions on in-person contact, we maintained regular one-to-one contact with our patients by telephone, providing them with phones where required.

TELEPHONE ASSESSMENTS

Our peers supported patients in carrying out direct dial telephone assessments with specialist nurses. Nurses who were able to assess and proceed them on to a multidisciplinary team of relevant healthcare professionals for treatment if required.

Our north east peer team deliver hepatitis C testing, Middlesbrough, March 2021

LARGE SCALE TRAINING

We were able to upscale our training to frontline workers by taking advantage of TOTAL NUMBERS virtual technologies, a greater uptake of online training and an increased number of substance misuse services staff people engaged in working from home. 12,100

people engaged in hepatitis C interventions.

7,687 12,100

The readiness of our peers to adapt to change, develop new partnership opportunities, close gaps in service provision and safely manage new Covid-19 risks was commended by both our ODN and community partners this year.

people tested for hepatitis C. people found to be hepatitis C positive.

2,402

people supported to start treatment.

1,334

staff received Hepatitis Awareness Training.

3,926

‘Without this joint working we would not have been able to offer the follow up and support people needed in order to continue with treatment.’

Lizi Sims, Lead Hepatology Community Nurse

Outreach testing in Bradford, January 2021

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REACHING OUR COMMUNITY

Our

Achievements

Reaching our community through peer work

OUR WORK

OUR WORK

OUR WORK WITH

IN SCOTLAND

IN WALES

THE SOUTH ASIAN

COMMUNITY

For the first part of this year we focused our Follow Me peer programme within the Swansea area, working in partnership with local substance misuse providers and pharmacies; with our work in pharmacies proving to be particularly successful in supporting people in accessing testing and treatment.

The impact of Covid-19 was particularly difficult for our Scottish team this year as resources across the Forth Valley, Lothian and Fife shifted to Covid-19 related needs. Public Health Scotland staff working in the hepatitis C field remain redeployed and will not return to their work in this area until 2022.

The scope of our South Asian community work was limited this year, not only by Covid-19 but also, as with previous years, by a reduced budget.

We have, however, managed with the expertise of our South Asian Support Officer to provide support for a number of media pieces; some bespoke HCV support; as well as providing South Asian women with Covid-19 information and support.

The significant impact of Covid-19 meant that Welsh health services were forced to deploy their resources to Covid-19 related needs, and this, along with a national lockdown, led to our funding being placed on hold.

We are now, however, delighted to have recently secured new funding and recruited two posts to develop a Peer Support Service across Wales over the coming months.

Hepatitis C patient, 2021

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Our peers help deliver a hepatitis C testing event at YMCA Nomad, Lincolnshire, June 2020
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REACHING OUR COMMUNITY

Our Achievements

Health and Justice prison peer project

� We produced short animated videos for the Way Out prison TV channel, to keep hepatitis C firmly on the agenda of people in prison, reaching 40,000 prisoners.

Although restrictions to

The impact of Covid-19 was particularly difficult for people in prison this year. We worked hard to maintain contact and deliver our services remotely. We are pleased to once more be delivering face-to-face contact.

in-person access made delivering our face-to-face prison peer programme more difficult this year, we were still able to maintain good levels of awareness about hepatitis C through online platforms and specifically tailored communications products, a well as through the work of our prison peers who we trained and supported by telephone and online.

� We worked with health care professionals using the telemedicine system, which allowed our staff to join healthcare professionals virtually as they supported patients in prison.

PROBATION SERVICES

We worked with a wider group of people affected by the criminal justice system this year, laying the foundation for us to work beyond the prison gate into approved premises and local probation services.

Sean Cox, Director of Prisons

PRISON ENGAGEMENT DURING COVID-19

We came up with a number of innovative strategies and adaptations to our usual working practices this year in order to continue our services with people in prison , who were often restricted to their cells for 23 hour periods due to Covid-19.

PARTNERS & ENGAGING WITH STAKEHOLDERS

Our stakeholder engagement activities included collaborations with NHS England, HMPPS governors, healthcare providers and substance misuse services. We also worked with multiple partners throughout the year to increase screening rates for hepatitis C in prisons.

HIGH INTENSITY

TEST AND

TREAT (HITT)

WORKING REMOTELY

When unable to access prisons in person we worked remotely. At such times our prison peers delivered events through virtual platforms to both staff and people in prison across the UK.

We continued to deliver HITT, whole prison testing events, in 40 Practice Plus Group prisons, working in partnership with Gilead and PPCT as part of NHS England’s elimination initiative . However, due to Covid-19 restrictions we held less than we had hoped.

NHS OPERATIONAL DELIVERY NETWORKS (ODNs)

We continued to work with ODNs to find people who had recently left prison, ensuring a continuity of hepatitis C care from prison to the community.

During the gaps in between lockdowns, when we were able to gain access to prisons, we took part in six successful HITTs, in which, in most cases, we reached our goal of testing 95% of the whole prison population.

PEER TRAINING

Although unable to recruit and train any new prison peers, we were able to support and engage our current peers with learning, wellbeing activities and training.

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Hepatitis C testing at HMP Lincoln, Aug 2019
TOTAL NUMBERS
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HEPATITIS AWARENESS TRAINING (HAT) FOR PRISON STAFF:

staff from across the England prison estate attended our HAT training.

400

THE WOMEN’S PRISON ESTATE:

Covid-19 restrictions limited our access to the female prison estate this year. However, through being creative and working in partnerships with others:

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A HITT at HMP Stockton, Oct 2019
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women received a one-to-one intervention.

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Our prison peer programme
features in insidetime, Mar 2021
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700

THE MEN’S PRISON ESTATE:

835

men accessed a peer talk.

men recieved a one-to-one intervention.

7,635

HITTs:

people in prison were tested through whole prison testing events.

4,102

We supported 6,000 prisoners to get tested for hepatitis C this year.

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Hepatitis C testing at HMP East Sutton, Sept 2019
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OUR TRAINING

Our Achievements

Our training work

HEPATITIS

AWARENESS

TRAINING (HAT)

We use HAT in all areas of our work, from community to prisons, to health professionals working within the hepatitis C field. Our training ensures professionals who come into contact with people who have, or are at risk of, hepatitis C, are able to deliver the right information and advice.

This year, due to Covid-19 restrictions, we adapted our HAT to be delivered online.

OUR PEER

TRAINING

Training people with lived experience of hepatitis C to become peers is an integral part of our work; not only to ensure we are effective across our peer support programmes but also to offer an opportunity for training and development within a work setting.

Throughout this year we continued to recruit and train paid and volunteer peers.

PEER STAFF, TRAINING & SUPPORT

� We also introduced a 30 minute morning check-in session with breakout groups and daily discussions to encourage connection, emotional support and an opportunity for people to meet new people from across the organisation.

� We established a learning pathway so that peer volunteers could embark on a training programme which ensured they were compliant with CQC outcomes to perform regulated activities, helping them to develop their CV and supporting them to move into paid employment. A secondary learning pathway was also developed so that staff were able to achieve a level 2 or 3 Diploma in Health & Social Care.

� We have a separate accreditation pathway in development for peer volunteers within the prison estates. As part of this process the Trust has signed up to the Adult Social Care Data Set and is compliant with this government funded department. This allows the trust to access funding from Skills for Care for vocational training and workforce development.

We delivered a total of 91 peer training sessions this year.

Before I met the Peer Lead and volunteer Peer I missed so many of my appointments. But they reassured me and were there with me every step of the way. I felt really heard, and I am now about to start my treatment really soon.

Hepatitis C patient, 2020

Our peers work with partners at Coastline Homeless Service to deliver testing and health checks, December 2020

‘I love being a peer volunteer for The Hepatitis C Trust. They have given me an opportunity to give back to my community, and I have learnt skills and built my confidence.’

Volunteer peer, 2020

Training new peer volunteers, Chatham, Kent, June 2020

Our peers working in partnership to test homeless people in a hotel in Guildford, May 2020

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ADAPTING TO COVID-19

Adapting to Covid-19

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Adapting to Covid-19
TESTING THE HOUSED HOMELESS
UPDATING HEPATITIS C
HEALTH PROFESSIONALS
COMMUNITY TESTING
COVID-19 TOP TIPS POSTER
HELPING WITH HOME TESTING KITS
DELIVERING MEDICINES TO PATIENTS
2020-21
TRAINING AND SUPPORTING
OUR STAFF AND PEERS ONLINE
OUTREACH TESTING
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SUPPORTING PEOPLE

Supporting People Our Achievements

HELPLINE

INFORMATION AND SUPPORT

SERVICES

For much of the past year our staff have delivered our helpline service from home due to Covid-19 restrictions. Quick to adapt to change this resulted in little disruption to the continuity of our services and our ability to offer the best care, information and support to those affected by hepatitis C.

COVID-19, RESPONDING TO HEPATITIS C CONCERNS

Alongside our usual level of service provision, this year we became a main point of contact for people with concerns about Covid-19 and issues of increased susceptibility or risk due to hepatitis C related liver damage.

Many service users were shielding, or concerned they should be shielding, due to a hepatitis C infection; their level of liver damage as a result of a hepatitis C infection; or a compromised immune system brought about by the longer-term effects of the old interferon and ribavirin treatments.

With the arrival of the vaccination programme we also found ourselves providing reassurance andencouragement for people getting vaccinated.

REACHING OUT DURING COVID-19

We took a proactive role early on in the pandemic, contacting our more vulnerable, elderly and/or isolated callers, checking in to make sure they were aware of local mutual aid services, as well as providing emotional support thoughout a difficult time. Those with advanced liver disease were particularly worried about their medical appointments being repeatedly cancelled or delayed.

ANXIETY & ISOLATION

Depression, anxiety and other mental health issues, like obsessive compulsive disorder, frequently came up as people struggled with lockdown and being isolated from their medical teams or other sources of support.

It was also clear that there was a heightened anxiety in the general population about the transmission of Covid-19, hepatitis C and other viruses, as a result of ongoing health protection messages in the media.

THE CHANGING NATURE OF CALLS TO OUR SERVICE

Calls to our service changed as a result of a reduced number of people getting tested. We had just 129 calls from those recently diagnosed, compared to 277 for the same period last year. This was due to a combination of factors such as GP and hospital appointments being delayed or cancelled and less publicity around the Infected Blood Inquiry, which had previously done a lot to raise public awareness about getting tested.

Over this period we responded to 2,722 calls, emails and social media messages in total.

OUR PRISON

HELPLINE

RESTRICTED ACCESS

During this Covid-19 period many people in prison were kept inside their cells for up to 23 hours a day, largely due to staff shortages in the face of increased ill health. This made it more difficult for people in prison to access a telephone and consequently our prison telephone helpline services. We did, however, still receive 237 calls, most of which related to people wanting to be tested.

You were there for me when I was diagnosed in 2004, through my treatment in 2006, and you’re there for me now during this crisis. Thank you so much.

Helpline caller, 2020

INFORMATION

AND SERVICES

GENERAL INFORMATION

We continue to send out leaflets and other information resources from our helpline to both patients and professionals from a variety of settings.

OUR NEWSLETTER

Our newsletter is an important resource for a range of people wishing to keep up-to-date on our UK activities; to hear about personal experiences from people who have been infected by hepatitis C; for general updates on The Infected Blood Inquiry; and for news and other events connected with hepatitis C. We published five newsletters this year.

Our current newsletter membership stands at 3,800.

‘Great newsletter! Interesting… and I was pleased to read about such good progress being made during such challenging times.’

Newsletter subscriber, 2021

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SUPPORTING PEOPLE

Our Achievements

Supporting People

THE INFECTED

BLOOD INQUIRY

COVID RESTRICTIONS

Due to Covid-19 restrictions The Infected Blood Inquiry hearings were put on hold until September 2020, at which time we were able to attend in person again. However, the announcement of a second lockdown not long after meant that hearings soon returned to being online.

Both the publicity around the Inquiry and our ability to have personal contact with those directly involved in the Inquiry were greatly reduced as a result of this. We also received less contact with members of the public concerned about whether they should be tested for hepatitis C, without the media coverage previously generated by the Inquiry around the issue of infected blood.

OUR WORK WITH THOSE INFECTED AND AFFECTED

We look forward to the next stage of the inquiry, including the review of payments to those affected.

Samantha May, Helpline Information and Support Service Manager

Infected blood continues to be a large part of our work on the helpline. In total, we took 926 calls from people with various concerns about infected blood and blood products, of which 123 were directly related to the Inquiry itself, with 499 related to problems about making claims from payment schemes.

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FUNDRAISING

Fundraising

Our main income as an organisation comes from trusts and donors. However, we also raise money through fundraising initiatives. By far the most successful of these is Art on a Postcard. An established brand in the art world and a thriving small industry, it has gone from strength to strength over the seven years it has been running, raising over three quarters of a million pounds for the Trust.

ART ON

A POSTCARD

Set up as a one-off secret postcard auction in 2014, Art on a Postcard (AOAP) now has a number of outstanding events under its belt including partnerships with The Other Art Fair and Photo London, as well as annual outings with Art Car Boot Fair. In addition to AOAP auctions, we have a successful print shop which has released a number of sell out print editions including Hate’s Outta Date by Harland Miller. Artists we’ve worked with include Damien Hirst, Grayson Perry CBE, RA Marina Abramovic, Harland Miller, Rebecca Salter RA, Patrick Hughes, Larry Clark, Es Devlin, Jeremy Deller, Peter Blake, Gilbert and George, Wolfgang Tillmans, Marc Quinn and Cecily Brown.

----- Start of picture text -----
Boy George, Untitled
----- End of picture text -----

AUCTIONS

WINTER 2020

SUMMER 2020

As with the summer auction, this auction was organised and held during the Covid-19 ongoing pandemic. We continued our partnership with Dreweatts and joined forces with GowithYamo who produced a fantastic virtual exhibition. Despite working virtually, we managed to raise £75,000 with help from the outstanding artwork donated by Winston Branch, Faith Wilding, Erik van Lieshout, AnjSmith, Ryan Mosley and many more.

This year we had some outstanding artwork from the Chapman Brothers, Julian Opie, Oh de Laval, Lothar Goetz and Remi Rough, and many other artists including Boy George who having enjoyed a sell-out show in Monaco last year made his AOAP debut this year. Unlike previous years where our auction remained anonymous until the end of bidding, this year we gave our audience the opportunity to know the artist upfront. Partnering with the auction house Dreweatts we raised £45,000 in spite of the logistical challenges posed by Covid-19.

INTERNATIONAL WOMEN’S DAY, MARCH 2021

We celebrated International Women’s Day with a striking auction of artworks by international female-identifying artists with the theme ‘I am’, taken from an initiative run by The Hepatitis C Trust’s female prison team. Contributing artists included Claudette Johnson known for her large scale paintings of black women, Dr Chila Kumari Burman whose work has recently shown in Tate Britain, Yui Kugimiya a Brooklyn-based artist who uses traditional painting techniques to produce stop-motion animations and Antonia Showering who recently had a White Cube show. We continued our collaboration with Dreweatts auction house and GowithYamo, who created a virtual exhibition. A total of £67,000 was raised for the Trust’s work with women in prison.

These times call for empathy and the artistic community can always be relied upon to step up.

Gemma Peppé, Director, Art on a Postcard

----- Start of picture text -----
Walter Swennen, Poker Face
Martin Whatson, Scribble Postcard #1
----- End of picture text -----

----- Start of picture text -----
Walter Swennen, Poker Face
Jake and Dinos Chapman,
Solar Anus Alice Campbell, The Pianist
----- End of picture text -----

----- Start of picture text -----
Nasser Azam, Queen
----- End of picture text -----

----- Start of picture text -----
Susie Hamilton, Nurse/3
----- End of picture text -----

----- Start of picture text -----
Otto Schade, No Title
Walter Swennen, Captain Time Jess Quinn, He Had Been Wandering in the Wrong Lee Wagstaff, , Pandamoniun
----- End of picture text -----

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YEAR AHEAD

Looking foward

IN THE

YEAR AHEAD

WE WILL:

Having stepped up to the challenge of Covid-19 and truly felt the benefit of working in partnership with other key stakeholders, we go into next year with a renewed vigour to achieve elimination.

Rachel Halford,Chief Executive

----- Start of picture text -----
Caroline Coon, I am…for The Hepatitis C Trust 2021
----- End of picture text -----

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Governance and management

LEGAL ENTITY

The Trust was incorporated in England and Wales on 10 March 2004 (registration number 05069924) and gained charitable status on 10 June 2004 (charity number 1104279). On 1 September 2004 all the charitable activities, assets and liabilities from the original unincorporated charity, The Hepatitis C Trust (charity number 1083097), were transferred to this incorporated charity. On 1 October 2008 the charity registered in Scotland (charity number SCO39914). The current charity is governed by its Memorandum and Articles of Association.

CHARITABLE

OBJECTS

The objects of the Trust, as set out in the Memorandum and Articles of Association are:

1. The relief of persons suffering from hepatitis C and the provision of support to such persons and their families;

2. The advancement of education concerning hepatitis C; and

3. Research into all aspects of hepatitis C including (but not limited to) the causes, detection, transmission, prevention and treatment of hepatitis C and the publication and dissemination of the useful results of all such research.

TRUSTEES

(Those who served during the year and/or were responsible for the annual report)

Sir Adrian Baillie Bt Dr M F Bassendine Mr Peter Holt The Hon David Macmillan Mr Edward Mead Mr Charles Walsh Mr John Jolly Mr Simon Lincoln (from 9/12/2020)

attend a Board meeting to get a better understanding of the role of a trustee at The Hepatitis C Trust.

PATRONS

The Marchioness of Bute Ms Emilia Fox Ms Sadie Frost Boy George Mr Andrew Loog Oldham The Lord Mancroft Mr Alan McGee Ms Justine Roddick Mr Robbie Williams

Newly appointed Trustees are sent briefing information about The Trust and their role as a trustee, including the Charity Commission’s booklets, The Essential Trustee: what you need to know (CC3) and The Hallmarks of an Effective Charity (CC60). They are then asked to spend a day at the Trust’s London offices, meeting the staff and learning more about each project and in particular financial oversight.

CHIEF EXECUTIVE

KEY MANAGEMENT PERSONNEL

Rachel Halford

RECRUITMENT

The Trustees have determined that the Chief Executive and the Senior Directors, together with the Trustees themselves, are the key management personnel. Anita Klein, Singing Bird The Trustees are not remunerated and the pay of the Chief Executive and the Senior Directors has been set according to bands suggested by an independent consultant and by benchmarking against market rates.

AND APPOINTMENT

OF TRUSTEES

Financial review

The charity’s Trustees are also the company directors for the purposes of company law. Subsequent Trustees may be appointed by ordinary resolution. When vacancies occur on the Board, new Trustees are recruited through a variety of means including advertising, stating skills that are needed on the Board. The Trust wishes to have patients as a majority of its Board, which increases the challenge of finding suitable and willing Trustees.

RISK ASSESSMENT

With the continued successful delivery of our peer programmes, we remain confident in our financial position.

RESERVE POLICY

FUNDING

The Trustees have prepared a risk assessment, examining the major risks which the charity faces and have set out the necessary steps that need to be taken to lessen any risks. This register is updated on a regular basis. The key risks and the actions to be taken to mitigate them in the latest risk assessment are set out in the table below.

Following the successful delivery of our ongoing peer programmes, we received further investment under the NHS elimination initiative this year. As such our income has, once more, continued to significantly increase, allowing us to maintain a secure financial position for the Trust.

The policy of the Trustees is to hold a reserve of three months’ costs, amounting to £1,050,000. Our total unrestricted reserves for this year are £468,076. Alongside this are our current restricted reserves of £824,254 to fund activities in the year 31 March 2022. The Trustees are committed to raising core reserves through our fundraising strategy involving:

In relation to our raising funds, please see our costs in the financial statements at the back of the report, mainly in regard to income generation from Art on a Postcard (see page 22). We do not engage external professional fundraisers or commercial participators to carry out our fundraising activities and we do not engage in face-to-face or telephone fundraising. All our approaches to fundraising take account of the Code of Fundraising Practice issued by the Fundraising Regulator. We have � received no complaints about our � fundraising activities either during the � financial year or subsequently.

Potential Trustees have an initial meeting with the Chief Executive who gives them a copy of the governing document, the latest accounts and a description of all the Trust’s projects and explains the Trust’s philosophy and how it works in practice. They are then asked to

At £3,632,826 our income has significantly increased from that of the previous year £2,774,493, while our expenditure at £3,037,265 increased by £700,024. This increase in expenditure is in line with additional costs incurred through the implementation and running of our extended peer programme service delivery.

Broadening our base of possible trust funders by demonstrating that addressing hepatitis C has broader social benefits, not just positive health outcomes

----- Start of picture text -----
KEY RISKS MITIGATING ACTION
Covid risk Implement Covid strategies and procedures
Insufficient reserves New fundraising strategy to broaden funding base
Failures/errors in planning More resources devoted to planning/forecasting
Adverse publicity Media crisis planning
Owner sells property/need to find Contingency move planning
new premises
----- End of picture text -----

Engaging with corporate donors Expanding Art on a Postcard Moving our focus towards longer term statutory funding

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Statement of Trustees responsibilities

The Trustees (who are also directors of The Hepatitis C Trust for the purposes of company law) are responsible for preparing The Trustees’ Report and the Financial Statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires Trustees to prepare financial statements for each financial year which give a true and fair view of the state of the affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the Trustees are required to:

Independent Auditor's Report

The Trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. In so far as the Trustees are aware:

AUDITORS

Azets Audit Services (formerly Wilkins Kennedy Audit Services) have indicated their willingness to continue in office. A resolution proposing their re-appointment will be submitted at the Annual General Meeting.

SMALL COMPANY RULES

These accounts have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies and with the Statement of Recommended Practice, Accounting and Reporting by Charities (SORP FRS 102) issued in January 2015.

This report was approved by the Board of Trustees

and signed on its behalf by: ………………………………………

The Hon David Macmillan Date: 7 December 2021

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INDEPENDENT AUDITOR’S REPORT TO THE TRUSTEES AND MEMBERS OF THE HEPATITIS C TRUST

INDEPENDENT AUDITOR’S REPORT TO THE TRUSTEES AND MEMBERS OF THE HEPATITIS C TRUST

Opinion

We have audited the financial statements of The Hepatitis C Trust (the ‘charitable company’) for the year ended 31 March 2021 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

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

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

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

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

Other information

The other information comprises the information included in the trustees annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report. 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 course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the directors’ report.

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

Responsibilities of trustees

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

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

Auditor’s responsibilities for the audit of the financial statements

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud is detailed below:

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INDEPENDENT AUDITOR’S REPORT TO THE TRUSTEES AND MEMBERS OF THE HEPATITIS C TRUST

THE HEPATITIS C TRUST STATEMENT OF FINANCIAL ACTIVITIES INCORPORATING AN INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31ST MARCH 2021

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: https://www.frc.org.uk/Our-Work/Audit/Audit-and-assurance/Standards-and-guidance/Standards-and-guidancefor-auditors/Auditors-responsibilities-for-audit/Description-of-auditors-responsibilities-for-audit.aspx. This description forms part of our auditor’s report.

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.

John Howard FCA (Senior Statutory Auditor)

For and on behalf of Azets Audit Services Statutory Auditor 2[nd] Floor, Regis House

45 King William Street London EC4R 9AN

Date

Unrestricted
Note
Funds
£
Income from:
Donations
2
273,195
Investments
3
151
Charitable activities
4
400,506
Rental income
20,302
Other income
-
Total
694,154
Expenditure on:
Raising funds
5
210,094
Charitable activities
6
200,006
Other
20,302
Total
430,402
Net income for the year before
transfers
263,752
Transfers
13
6,979
Net income
270,731
Fund balances at 1st April 2020
13
197,345
Fund balances at 31st March 2021
13
468,076		 Restricted
Funds
£

-
-
2,938,672
-
-
2,938,672
-
2,606,863
-
2,606,863
331,809
(6,979)
324,830
499,424
824,254		 Total
2021
£
273,195
151
3,339,178
20,302
-
3,632,826
210,094
2,806,869
20,302
3,037,265
595,561
-
595,561
696,769
1,292,330		 Total
2020
£
323,146
192
2,398,115
47,915
5,125
2,774,493
180,467
2,103,286
53,488
2,337,241
437,252
-
437,252
259,517
696,769

All gains and losses arising in the year have been included in the Statement of Financial Activities and arise from continuing operations

The notes on pages 46 to 55 form part of the financial statements.

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THE HEPATITIS C TRUST BALANCE SHEET AS AT 31ST MARCH 2021

THE HEPATITIS C TRUST STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31ST MARCH 2021

Note
Fixed Assets
Tangible assets
10
Current Assets
Debtors
11
Cash at bank and in hand
Creditors: Amounts falling due
within one year
12
Net Current Assets
Total Net Assets
Funds
Unrestricted funds
13
Restricted funds
13		 2021
2021
2020
2020
£
£
£
£
-
-
575,383
372,915
1,615,073
397,921
2,190,456
770,836
(898,126)
(74,067)
696,769
1,292,330
696,769
468,076
197,345
824,254
499,424
1,292,330
696,769

The accounts have been prepared in accordance with FRS 102.

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

The financial statements were approved by the Board of Trustees and authorised for issue on 7 December 2021 and signed on their behalf by:

……………………………………… Hon David Macmillan

Notes
Cash (used in)/generated from operating activities:
Net cash (used in)/provided by operating activities
see
below
Cash flows from investing activities:
Interest income
3
Purchase of property, plant and equipment
10
Net cash (used in)/provided by investing and operating activities
Change in cash and cash equivalents in the reporting period
Cash and cash equivalents at the beginning of the reporting period
Cash and cash equivalents at the end of the reporting period		 2021
£
1,217,001
151
-
1,217,152
397,921
1,615,073		 2020
£
151,686
192
-
151,878
246,043
397,921

Reconciliation of net expenditure to net cash flow from operating activities

.,
Net expenditure (as per the statement of
financial activities)
SOFA
Adjustments for:
Depreciation charges
10
Investment income
3
(Increase)/Decrease in debtors
11
Increase /(Decrease) in creditors
12
Net cash (used in)/provided by operating activities
Analysis of cash and cash equivalents
Cash in hand
Total cash and cash equivalents		 2021
£
595,561
-
(151)
(202,468)
824,059
1,217,001
2021
£
1,615,073
1,615,073		 2020
£
437,252
-
(192)
(297,003)
11,629
151,686
2020
£
397,921
397,921

Registered Company Number: 5069924

The notes on pages 46 to 55 form part of the financial statements.

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THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

1. Accounting Policies

1. Accounting Policies (continued)

Basis of Preparation

The financial statements have been prepared in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), published on 16 July 2014. The Charitable Company is a public benefit entity for the purposes of FRS 102 and therefore the charity also prepared its financial statements in accordance with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (The FRS 102 Charities SORP), the Companies Act 2006 and the Charities Act 2011.

The financial statements are prepared in sterling, which is the functional currency of the company. Monetary amounts in these financial statements are rounded to the nearest pound.

Expenditure is included in the Statement of Financial Activities on an accruals basis, inclusive of any VAT which cannot be recovered. Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably.

Fund accounting

Restricted funds are subject to restrictions imposed by the donor. These are accounted for separately from unrestricted funds and full details are given in note 13.

Unrestricted funds are those which are not subject to restrictions, and any surpluses may be applied in furtherance of any of the organisation's objectives.

The financial statements are prepared under the historical cost concept.

The principle accounting policies adopted in the preparation of the financial statements are set out below.

Cash and Cash Equivalents

Cash and cash equivalents include cash at banks and in hand and short term deposits with a maturity date of three months or less.

Going Concern Basis

The trustees have assessed whether the use of the going concern basis is appropriate and have considered possible events or conditions that might cast significant doubt on the ability of the charity to continue as a going concern. The trustees have made this assessment for a period of at least one year from the date of approval of the financial statements. In particular the trustees have considered the charity’s forecasts and projections and have taken account of pressures on donation and investment income. After making enquiries the trustees have concluded that there is a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. The charity therefore continues to adopt the going concern basis in preparing its financial statements.

COVID 19

The Trustees have considered the organisation's work within Covid-19 restrictions this year. They have reviewed the innovative ways the Trust has developed to ensure services could still be delivered and patients fully supported. They are confident going forwards that should there be further restrictions in the coming year that with the Trust's workers being classified as essential workers, who have the ability to adjust models of delivery, there will be no negative financial impact on the financial year's projected and secured income.

Debtors and creditors

Debtors and creditors receivable or payable within one year of the reporting date are carried at their transaction price. Debtors and creditors that are receivable or payable in more than one year and not subject to a market rate of interest are measured at the present value of the expected future receipts or payment discounted at a market rate of interest.

Tangible Fixed Assets and Depreciation

Tangible fixed assets costing less than £500 are not capitalised and are written off in the year of purchase. Depreciation is provided so as to write off the cost of the fixed assets over their estimated useful lives at the following annual rates:

Computer and Office Equipment Property Improvements Motor Vehicles

Straight Line over 4 years Over the length of the lease Straight Line over 4 years

Income

Income is recognised in the period to which it relates, when the criteria of entitlement, measurable and probable receipt are met.

Pension

The charity operates a defined contribution stakeholder pension scheme. The assets of the scheme are held separately from the charity.

Deferred income is income which is received in respect of a future accounting period and is deferred to that period.

Critical accounting estimates and areas of judgement

Gifts in kind are valued and brought in as income and the appropriate resources expended, when the items are used/distributed. The values attributable to gifts in kind are an estimate of the gross value to the organisation, usually the market cost. Where this intangible income relates to project activities it is included as an activity in furtherance of the charity's objects.

Expenditure

The annual depreciation charge for property, plant and equipment is sensitive to change in useful economic life

and residual values of assets. These are reassessed annually.

In the view of the trustees in applying the accounting policies adopted, no other judgements were required that have a significant effect on the amounts recognised in the financial statements nor do any estimates or assumptions made carry a significant risk of material adjustment in the next financial year.

Direct charitable expenditure comprises all expenditure relating to the activities carried out to achieve the objectives.

Governance costs include those costs incurred in the governance of the charity and are primarily associated with constitutional compliance and statutory requirements.

Expenditure is allocated directly to the expenditure headings as far as practically possible to reflect the activities of the charity. Support costs have been allocated to the activities based on employee time spent on that activity.

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46

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

2. Donations

4a. Grants

. Donations
Year to 31 March 2021
Donations
Art on a Postcard
Year to 31 March 2020
Donations
Art on a Postcard

Investment Income
Year to 31 March 2021
Bank interest
Year to 31 March 2020
Bank interest		 Unrestricted
Funds
2021
£
11,423
261,772
273,195
Unrestricted
Funds
2020
£
13,703
309,443
323,146
Unrestricted
Funds
2021
£
151
151
Unrestricted
Funds
2020
£
192
192		 Restricted
funds
2021
£
-
-		 Total
2021
£
11,423
261,772
**- ** 273,195
Restricted
funds
2020
£
-
-		 Total
2020
£
13,703
309,443
- 323,146
Restricted
funds
2021
£
-
-
Restricted
funds
2020
£
-
-		 Total
2021
£
151
151
Total
2020
£
192
192

3. Investment Income

4. Income for Charitable Activities

Year to 31 March 2021
Unrestricted
Funds
2021
£
AbbVie Ltd
-
AbbVie Ltd (HCV Action)
-
Brighton and Sussex University Hospitals NHS Foundation Trust
25,000
Cambridge University Hospitals NHS Foundation Trust
1,022
Care UK/Practice Plus Group Health and Rehabilitation Services Limited
-
DWP
3,440
Enigma Consultancy Coaching Ltd
845
Frontier NX Limited
-
Gilead - HCV Action & Parliamentary Work
-
Gilead HITT
-
Kings College Hospital
53,000
Leeds Teaching Hospitals NHS Trust
42,320
MSD
-
MSD (HCV Action)
-
NHS England and NHS Improvement – East Midlands (H&J)
-
NHS England Health & Justice Materials
-
NHS Health and Justice Midlands (Peer Programme)
-
NHS Forth Valley
-
Nottingham University Hospitals NHS Trust
4,669
Other
2,990
Oxford University Hospitals NHS Foundation Trust
10,000
Pilgrim Trust
-
Royal Surrey NHS Foundation Trust
10,000
Sheffield Teaching Hospitals NHS Foundation Trust (Peer Programme)
103,809
Sheffield Teaching Hospitals NHS Foundation Trust(Training and
Volunteers)
-
St George's University Hospitals NHS
45,000
University College London Hospital
-
University Hospital Southampton NHS Foundation Trust
20,000
University Hospitals Bristol & Weston NHS Foundation Trust
25,000
University Hospitals of Leicester NHS Trust
53,411
400,506		 Restricted
funds
2021
£
456,250
25,000
-
-
665,512
-
-
2,000
37,500
130,680
51,000
-
1,068,200

57,865
23,500
100,000
67,500
20,000
-
1,165
-
7,500
-
-
75,000
-
150,000
-
-
-
2,938,672		 Total
2021
£
456,250
25,000
25,000
1,022
665,512
3,440
845
2,000
37,500
130,680
104,000
42,320
1,068,200
57,865
23,500
100,000
67,500
20,000
4,669
4,155
10,000
7,500
10,000
103,809
75,000
45,000
150,000
20,000
25,000
53,411
3,339,178
Income for Charitable Activities
Year to 31 March 2021
Grants
4a
Year to 31 March 2020
Grants
4a		 Unrestricted
Funds
2021
£
400,506
400,506
Unrestricted
Funds
2020
£
47,000
47,000		 Restricted
funds
2021
£
2,938,672
2,938,672
Restricted
funds
2020
£
2,351,115
2,351,115		 Total
2021
£
3,339,178
3,339,178
Total
2020
£
2,398,115
2,398,115

49

48

4a. Grants (Continued)

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021 y

6. Analysis of Charitable Expenditure by type

Year to 31 March 2020
AbbVie Ltd
BASL
Care UK
Gilead
Gilead HITT
King's College Hospital
Mary Kinross Charitable Trust
Medicash
MSD
NHS Birmingham
NHS Imperial (West London)
NHS Leicester
The Pilgrim Trust
Roddick Foundation
Russell Webster
St George's University Hospitals NHS
Other		 Unrestricted
Funds
2020
£
-
-
-
-
-
-
-
-
-
-
-
-
-
45,000
2,000
-
-
47,000		 Restricted
funds
2020
£
384,167
5,000
265,000
141,395
119,167
142,000
38,000
5,500
630,000
77,000
90,542
15,263
7,500
75,000
-
349,807
5,774
2,351,115
 Total
2020
£
384,167
5,000
265,000
141,395
119,167
142,000
38,000
5,500
630,000
77,000
90,542
15,263
7,500
120,000
2,000
349,807
5,774
2,398,115

5. Cost of Raising Funds

Year to 31 March 2021
Staff Costs
Direct Costs
Year to 31 March 2020
Staff Costs
Direct Costs		 Unrestricted
Funds
2021
£
87,405
122,689
210,094
Unrestricted
Funds
2020
£
79,914
100,553
180,467		 Restricted
funds
2021
£
-
-
-
Restricted
funds
2020
£
-
-
**- **		 Total
2021
£
87,405
122,689
210,094
Total
2020
£
79,914
100,553
180,467
Year to 31 March 2021
Advocacy and Drug Services
HCV Action and Parliamentary Work
National Volunteer & Trainer
NHS Health & Justice Materials
NHS Health & Justice Prison Peers
Scotland Peer Project
Women's Prisons
World Hepatitis Day
Year to 31 March 2020
Advocacy and Drug Services
Consulting
HCV Action and Parliamentary Work
Helpline
NHS Health & Justice Prison Peers
Scotland Peer Project
South Asian Awareness
Women's Prisons
World Hepatitis Day		 Staff Cost
2021
£
1,470,442
-
-
-
646,545
56,548
17,127
-
2,190,662
Staff Cost
2020
£
755,377
-
-
50,337
429,080
35,011
15
88,798
-
1,358,618		 Direct
Cost
2021
£
252,039
85,320
10
53,386
103,906
6,808
7,373
4,108
512,950
Direct
Cost
2020
£
216,345
489
52,499
25,551
281,165
3,316
2,000
34,977
5,781
622,123		 Support
Cost
2021
£
103,257
-
-
-
-
-
-
-
103,257
Support
Cost
2020
£
98,287
-
1
204
22,810
-
1,243
-
-
122,545		 Total
2021
£
1,825,738
85,320
10
53,386
750,451
63,356
24,500
4,108
2,806,869
Total
2020
£
1,070,009
489
52,500
76,092
733,055
38,327
3,258
123,775
5,781
2,103,286

7. Support Costs

Staff costs
Staff training
Rent, rates, light and heat
Travel and subsistence
Insurance
Office supplies and maintenance
Telephone
Computer Costs
Sundry costs
Legal and professional costs
Audit and accountancy
Bank charges		 Total
2021
£
10,697
-
61,643
585
2,050
5,881
1,900
1,148
1,110
13
17,870
360
**103,257 **		 Total
2020
£
-
3,220
53,681
380
7,373
20,199
8,157
10,758
1,787
2,505
14,206
279
122,545

Other expenses in the sofa are made up of Rent £20,302 (2020: £47,915) incurred by WHA, £nil (2020: £5,125 ) of costs covered by an insurance claim and other costs £nil (2020: £448).

50

51

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

8. Staff Costs

Wages and salaries
Social Security costs
Pension costs
Other staff costs
Average number of employees during the year
Average number of volunteers during the year		 2021
£
2,031,055
203,645
43,367
-
2,278,067
Number
63
100		 2020
£
1,283,798
123,615
28,122
2,997
**1,438,532 **
Number
42
150

One employee was paid in the range £60,000 to £69,999 in the year (2020: none).

Key management personnel include the Trustees, Chief Executive (and senior management reporting directly to the Chief Executive). The total employee benefits, including pension costs and employers national insurance contributions of the charity's key management personnel were £227,735 (2020: £121,426). Four employees (2020: two) were considered to be key management personnel during the year.

11. Debtors

Debtors
Trade debtors
Other debtors
Prepayments		 2021
£
568,249
2,850
4,284
575,383		 2020
£
366,665
-
6,250
372,915

12. Creditors: Amounts falling due within one year

Trade creditors
Tax and social security costs
Sundry creditors
Income received in advance
Accruals		 2021
£
8,709
58,744
3,206
733,094
94,373
898,126		 2020
£
10,262
38,336
3,615
-
21,854
74,067

Income received in advance is funding for project work to be completed in the year 2021-22

13. Statement of Funds

9. Trustees and related parties

No remuneration was paid to any trustee for services as a trustee and no expenses were reimbursed.

Trustees participated in the Art on a Post Card auction on an arms-length basis

The charity rents office space to the World Hepatitis Alliance (WHA). Rachel Halford is a European Board Member of WHA and Chief Executive of The Hepatitis C Trust. All rents charged to WHA on a fair proportion of the Hepatitis C Trust total rental costs

10. Fixed Assets

All fixed assets are held for use by the charity.

Cost
At 1 April 2020
Additions
At 31 March 2021
Depreciation
At 1 April 2020
Charge for the year
At 31 March 2021
Net Book Value
At 31 March 2021
At 31 March 2020		 Motor
Vehicles
£
35,746
-
35,746
35,746
-
35,746
-
-		 Computer
and Office
Equipment
£
58,402
-
58,402
58,402
-
58,402
-
-		 Property
Improvements
£
29,820
-
29,820
29,820
-
29,820
-
-		 Total
£
123,968
-
123,968
123,968
-
123,968
-
-
Unrestricted funds
Restricted funds
Advocacy and Drug Services
HCV Action and Parliamentary Work
National Volunteer & Training
NHS Health & Justice Prison Peers
Scotland Peer Project
Women's Prisons		 Funds at
31 March
2020
£
197,345
409,798

-
-
63,125
-
26,501
499,424
696,769		 Income
£
694,154
1,725,449
122,366
75,000
988,347
20,000
7,510
2,938,672
3,632,826		 Expenditure
£
(430,402)
(1,629,841)
(85,320)
(10)
(803,836)
(63,356)
(24,500)
(2,606,863)
(3,037,265)		 Transfer
of funds
£
6,979
(50,335)
-
-
43,356
(6,979)
-		 Funds at
31 March
2021
£
468,076
455,071
37,046
74,990
247,636
-
9,511
824,254
1,292,330

53

52

THE HEPATITIS C TRUST

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

THE HEPATITIS C TRUST NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31ST MARCH 2021

13. Statement of Funds (continued)

13. Statement of Funds (continued)

Unrestricted funds
Restricted funds
Advocacy and Drug Services
HCV Action and Parliamentary Work
Helpline
NHS Health & Justice Prison Peers
Scotland Peer Project
South Asian Awareness
Women's Prisons		 Funds at
31 March
2019
£
42,546
129,392
-
-
68,579
-
-
19,000
216,971
259,517		 Income
£
418,362
1,350,415
52,500
76,092
727,601
14,989
3,258
131,276
2,356,131
2,774,493		 Expenditure
£
(240,225)
(1,070,009)
(52,500)
(76,092)
(733,055)
(38,327)
(3,258)
(123,775)
(2,097,016)
(2,337,241)		 Transfer
of funds
£
(23,338)
-
-
-
-
23,338
-
-
23,338
-		 Funds at
31 March
2020
£
197,345
409,798
-
-
63,125
-
-
26,501
499,424
696,769

NHS Health and Justice Prison Peers : The Hepatitis C Trust engages in peer-to-peer and awareness raising activities across UK prisons in order to: 1) Provide information about hepatitis C to those at risk, who are often hard to engage. 2) Encourage and support people in prisons to get tested and to access treatment and care. 3) Train people in prison to become hepatitis C peers.

Scotland Peer Project : A peer-to-peer awareness and education project that provides key messages about hepatitis C prevention, diagnosis, treatment and care to people attending recovery cafes, homeless hostels, shelters as well as people in prison. Our Voices group brings together people affected by hepatitis C, building their knowledge and awareness, and supporting them in having their voices heard.

South Asian awareness: The Trust employs a South Asian worker to communicate awareness messages to the South Asian population in the UK; in areas where research indicates that prevalence rates are much higher than in the general population. We also attend Melas and community information events to conduct testing amongst people in the community.

Women’s Prisons : A women specific hepatitis C peer programme working across the female prison estate by educating, raising awareness, changing the conversation, reducing stigma and supporting women to get tested and treated.

A transfer of £6,979 (2020: £23,338) was made from the unrestricted fund to the restricted funds to cover overspends on restricted projects that will not be reimbursed next financial year.

Restricted Funds

The nature and purpose of each of the funds is as follows:

Advocacy and Drug Services: Includes peer-to peer education and awareness programmes, delivering key messages about hepatitis C prevention, diagnosis, treatment and care to people attending community drug services, hostels and homeless shelters. Staff training is carried out within the programme and is delivered to those staff working in services with people who are at a high risk of hepatitis C. We also have a mobile outreach programme which provides testing and raises awareness, especially amongst high prevalence communities and populations that are difficult to reach, such as the homeless community.

HCV Action : A very useful vehicle for collecting and disseminating best practice in hepatitis C care and treatment, and for supporting Hepatitis C as the patient voice.

The Helpline and Infected Blood Inquiry: Work to support people affected by hepatitis C. The helpline does this primarily through our helpline and support service (via telephone, email and the occasional face-to-face meetings). Our Infected Blood Inquiry work is delivered through our helpline one-to-one support to those affected by infected blood, and through working with professionals to provide them with information about hepatitis C and its impacts.

National Volunteer and Training Service:

The National service team operate through two strands:

1) The delivery and oversight of core mandatory training and development of our staff, including induction, and hepatitis C training to professionals and other service providers.

2) The delivery of The Hepatitis C Trust volunteering programme, which includes supporting our volunteers across different areas of our work ensuring that all volunteers are provided with the opportunity to access training and development to support them in their role and further their employment opportunities.

14. Analysis of Net Assets between Funds

Year to 31 March 2021 Unrestricted Unrestricted Restricted
Funds
2021		 funds
2021
Total
2021
Fixed assets £
-		 £
-
£
-
Current assets
Current liabilities		 1,366,202
(898,126)
468,076		 824,254
-
**824,254 **

2,190,456
(898,126)
1,292,330
Year to 31 March 2020 Unrestricted Restricted
Funds funds Total
2020
£		 2020
£
2020
£
Fixed assets - - -
Current assets 271,412 499,424 770,836
Current liabilities (74,067) - (74,067)
197,345 499,424 696,769
Equipment Land and buildings
2021 2020 2021 2020
£ £ £ £
Operating lease which expire:
Less than 1 year 3,239 539 13,204 38,975
Within 2-5 years 12,955
-		 - -
16,194
539		 13,204 38,975

55

54

Thank You

We would like to take this opportunity to thank our funders, from individual donors to large statutory and trust funders, with who we would not be able to achieve the work we have reported on this year.

We greatly appreciate their commitment to our cause and the resources they provide in order for us to reach our goals.

We would like, in particular, to thank:

AbbVie Ltd Brighton and Sussex University Hospitals NHS Foundation Trust Cambridge University Hospitals NHS Foundation Trust Care UK/Practice Plus Group Health and Rehabilitation Services Limited DWP Enigma Consultancy Coaching Ltd Frontier NX Limited Gilead Kings College Hospital Leeds Teaching Hospitals NHS Trust MSD NHS England and NHS Improvement, East Midlands NHS England Health and Justice Materials NHS Health and Justice Midlands NHS Forth Valley Nottingham University Hospitals NHS Trust Oxford University Hospitals NHS Foundation Trust The Pilgrim Trust Royal Surrey NHS Foundation Trust Sheffield Teaching Hospitals NHS Foundation Trust St George’s University Hospitals NHS University College London Hospital University Hospital Southampton NHS Foundation Trust University Hospitals Bristol & Weston NHS Foundation Trust University Hospitals of Leicester NHS Trust

A big thank you also to all our partners who share our ambitions and enable us to bring about change together. As well as all the artists who have so generously donated their artworks to our Art on A Postcard fundraising and awareness raising initiative.

Design and Production: LJ Design and Production

Photo credits: Pg11 Alamy Stock Photo/Phanie, Pg26/27 Science Photo Library/Eduard Muzhevskyi, Pg29 Shutterstock/fizkes (middle), Alamy Stock Photo/Raw8 (bottom), Pg31 Shutterstock/Gurzoglu. All other photos The Hepatitis C Trust.

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