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← The Aplastic Anaemia Trust

2025-03-31-accounts

Company registration number: 05174065 Charity registration number: 1107539 Charity number (Scotland): SC049810

The Aplastic Anaemia Trust

(A company limited by guarantee) Annual Report and Financial Statements for the Year Ended 31 March 2025

KM Chartered Accountants 1st Floor, Block C The Wharf Manchester Road Burnley Lancashire BB11 1JG

The Aplastic Anaemia Trust

Contents

Reference and Administrative Details 1
Trustees' Report 2 to 14
Statement of Trustees' Responsibilities 15
Independent Auditors' Report 16 to 19
Statement of Financial Activities 20
Balance Sheet 21
Statement of Cash Flows 22
Notes to the Financial Statements 23 to 30

The Aplastic Anaemia Trust

Reference and Administrative Details Reference and Administrative Details
Trustees A Conquy
C Tempest
J L Cozens
J Williamson
K Agarwal
S Gilbert
S Oliver
Principal Office 1st Floor, Block C
The Wharf
Manchester Road
Burnley
Lancashire
BB11 1JG
Company Registration Number 05174065
Charity Registration Number 1107539
Charity Registration Number SC049810
Scotland
Bankers CAF Bank Ltd
25 Kings Hill Avenue
Kings Hill
West Malling
Kent
ME19 5JQ
Auditor KM
Chartered Accountants
1st Floor, Block C
The Wharf
Manchester Road
Burnley
Lancashire
BB11 1JG

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The Aplastic Anaemia Trust

Trustees' Report

The trustees, who are directors for the purposes of company law, present the annual report together with the financial statements and auditors' report of the charitable company for the year ended 31 March 2025.

Trustees

A Conquy

C Tempest J Beart (resigned 31 May 2025)

J L Cozens J Williamson K Agarwal (appointed 31 March 2025) S Gilbert S Oliver T Stephenson (resigned 30 April 2025)

Research and Clinical Advisory Panel

Professor Josu de la Fuente Dr Morag Griffin Dr Austin Kulasekararaj Dr David Irvine Professor Ghulam Mufti (Chair) Dr Bethany Mitchell Dr Sujith Samarasinghe Professor John Snowden Professor Rod Skinner (Vice Chair) Dr Sanjay Tewari Professor Alan Warren Dr Keith Wilson Callum Tempest (Patient Advocate & Trustee)

INTRODUCTION

The Aplastic Anaemia Trust (AAT) has continued to be the leading organisation supporting patients with aplastic anaemia and their families, as well as people with other rare bone marrow conditions. This past year has seen us expand our support offer through both in person and digital offerings, invest in groundbreaking research projects, develop new relationships with leading healthcare professionals and crucially grow our community.

Despite the ongoing cost-of-living crisis and rising prices, income generation has remained strong due to our community, partners and funders. We are deeply grateful for the efforts of our community in continuing to fundraise and support us during these difficult times.

The AAT has worked with external partners to carry out an equality, diversity and inclusion audit of the organisation, develop an ED&I strategy and begin the process of implementing recommendations and embedding practices. There has also been a greater focus on monitoring and evaluation to ensure the support we offer is meeting the needs of our community.

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The Aplastic Anaemia Trust

Trustees' Report

The National Health Service has remained under strain in all four nations of the UK and this has continued to impact our patient community when accessing treatment or related services such as mental health support. The AAT has continued to provide one-to-one and group support for our community, produce industry leading patient information free of charge, offer psychological support and professional benefits advice. These services could not be possible without the support of our strategic partners and funders.

We continued to put patients’ voices at the heart of everything we do and our commitment to delivering change for them has never been stronger. We launched our campaign to get aplastic anaemia listed on the NHS website. A search for aplastic anaemia on the NHS England website would only bring up results relating to anaemia (Iron deficiency) which causes frustration among patients looking for support and confusion among their families and some professionals. Since the launch of the campaign we have already made significant progress, the issue has been raised in the House of Commons and we have had success in Scotland as the NHS Inform website has been updated to include aplastic anaemia.

The Better Together For Healthy Marrow Partnership continues to be a huge benefit for the AAT and the rare bone marrow disease community as the project approaches the end of its current funding in August 2025. The six small but mighty organisations in this partnership are:

We work together to deliver improved support for our communities - people affected by a range of related rare bone marrow failures that are not caused by cancer. Together we have continued to provide excellent psychological and emotional support in the form of courses, as well as 1-1 provision. We have delivered a range of training courses for our members and the rare bone marrow failure community. The partnership also delivered our most successful ‘Super Rare’ community fundraising campaign to date.

As a small charity who strive always to punch above our weight, strong partnerships are key to our organisational strategy. This approach is enabling us to deliver both support and research more effectively and at a higher quality than we could achieve alone.

This past year has brought us towards the end of our current strategy cycle and created an opportunity for us to both reflect on the progress the Aplastic Anaemia Trust has had and where we wish to go in the future.

OBJECTIVES AND ACTIVITIES

What is Aplastic Anaemia?

Aplastic anaemia is a rare and life-threatening form of bone marrow failure. It can affect people of any age, but it is most common in children and older people.

The majority of cases are acquired, but many of our community are also diagnosed with inherited types of aplastic anaemia. The Aplastic Anaemia Trust is the only UK charity working at grassroots to support every person diagnosed with aplastic anaemia and their loved ones, to help relieve the immense disease burden. We estimate 150 to 250 people per year are diagnosed with AA - there is no registry collecting this information at the moment so it is impossible to give an accurate number. However we know from our clinical networks that this figure is on the rise in adults and children.

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The Aplastic Anaemia Trust

Trustees' Report

Our Mission, Vision and Objectives

The objectives of the charity as defined in its Articles of Association are to relieve the sickness of those people suffering from bone marrow disease .

Vision:

Everyone affected by aplastic anaemia in the UK should feel empowered, and have access to the best possible treatment, care and support. And one day, everyone with rare bone marrow failure will be able to lead a full and healthy life.

Mission:

We deliver our vision though two key missions:

Our strategic objectives

A. Ensure everyone affected by aplastic anaemia has the informational, practical, and emotional support they need to lead healthy and fulfilling lives.

B. Improve the knowledge and understanding of aplastic anaemia through education, campaigning, community outreach, leveraging partnerships, advocacy, and system change.

C. Enable ground-breaking research partnerships which lead to improved treatments and better outcomes.

D. Underpinning the above, build and hold an evidence base on our community, their experiences and the needs they have.

Our fundraising acts as an enabler in our strategy, ensuring we have the resources to deliver these objectives.

CHALLENGES OF 24/25

Growth and Transition

After nearly five years with the Aplastic Anaemia Trust, Stevie Tyler announced she was leaving the charity. During her time as Chief Executive, the charity grew from one staff member to eleven team members (8.1 FTE), critical clinical and community reference groups were instituted, the Better Together for Healthy Bone Marrow charity alliance began and countless relationships with key stakeholders, strategic partners and funders were established. As with any change of this nature there is substantial risk that these relationships may not be maintained and the hard fought for growth slips back. However thanks to the rigorous and thorough recruitment put in place by the Trustee Board with the support of an external recruitment agency they appointed an experienced charity leader who was able to maintain and grow these strategic partnerships, quickly establish meaningful relationships with stakeholders and provide reassurance to the AAT staff team through attending our staff conference and meeting with team members before taking up the post. The new Chief Executive, Joe Kirwin, joins us having most recently been the Chief Executive of a national cancer charity.

Our staff team also continued to grow which is both a positive and a challenge as we meet the hurdles of upscaling projects. This past year we were able to add additional resource to our fundraising team allowing us to better support our community fundraising ambitions and our volunteers. Fitting in with our research aims included in the current strategy, the AAT also invested in appointing a Clinical Research Project Manager to allow us to give research the dedicated focus it needs to grow and deliver results for our community.

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The Aplastic Anaemia Trust

Trustees' Report

Ongoing pressure in the NHS and the Ten-Year Plan

Aplastic anaemia is an ultra-rare condition, and as the UK health system faced another turbulent year, with services overstretched, our work to support patients and their families has been more important than ever. Integrated Care Boards had significant budget reductions, all but two NHS foundation trusts reported a deficit, it was announced that NHS England would be abolished and the ongoing workforce shortage continues to impact patients. While there has been a small improvement in length of time that patients have been waiting for emergency, routine and cancer treatments which frequently applies to our community too, this has not been significantly large for our patient community to have experienced the impact.

Whilst we continue to support the UK Government Rare Disease Framework and the ambitions set out within the plan there does not yet appear to be any result that has tangibly improved the care, treatment or diagnosis pathway of those with aplastic anaemia or other rare bone marrow failure conditions. The current Rare Disease Framework plan is due to come to an end in 2026 and going forward the Aplastic Anaemia Trust will work to influence the Governments in all four nations to deliver on the promises set out within the plan.

In October 2024 the UK government announced development of a new 10-year Health Plan for England. The plan aims to ensure the NHS is fit for the future by focusing on three ‘shifts’:

  1. Moving care from hospitals to communities.

  2. Making better use of technology

  3. Focusing on preventing sickness, not just treating it

At time of writing the new NHS 10 Year plan is still in development and it is still unclear what the potential impact on the aplastic anaemia and other rare bone marrow failure condition communities will be. Regardless of the final version of the 10 Year Plan, the AAT will continue to champion patients and ensure that decision-makers hear their voices.

What did people affected by aplastic anaemia need in 2024?

We have seen a significant increase in the number of patients, their families and healthcare professionals accessing our patient information. This growth in demand has partly come around due to news in the previous financial year that our fellow charity, Leukaemia Care, informed us that they would no longer produce patient information about aplastic anaemia, and would instead signpost hospitals and healthcare professionals to order this from us. We have also seen growth in the number of people contacting us for support, whether by phone, email, or interacting via our private Facebook Support Group, which has more than 2,600 members.

We have also recorded a significant increase in the number of people accessing trusted information and support via our website. Our ‘What is aplastic anaemia?’ webpage is one of the most frequently accessed pages on our website, and it was viewed on 3154 occasions, by 2225 users based in the UK in 2024-25. In comparison, the same page was accessed on 2606 occasions by 1655 UK-based users in 2023-24, representing a 34% increase in the number of users visiting the page. We believe that this is representative of an increase in demand for people accessing the resources on our website as a whole. In 2024-25, we provided direct support to 320 individuals, compared to 312 individuals in 2023-24.

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The Aplastic Anaemia Trust

Trustees' Report

Individuals receiving direct support from Support & Outreach in 2024-25

Country Number of individuals Number of interactions
England 278 1,495
Scotland 25 74
Wales 8 11
Northern Ireland 9 70
UK (no nation recorded) 179 700
Other countries (including
ROI)		 68 154

We know with certainty that we provided direct support to 320 individuals based in England, Scotland, Wales and Northern Ireland and recorded 1650 interactions with them. We also have another 179 individuals for whom we do not know for certain where they are based within the UK, and logged 700 interactions with them.

In 2024-25, we focussed on developing relationships with clinicians across the UK to raise awareness of the support that we can offer to their patients. In total, we contacted 127 clinicians and allied health professionals based in the UK.

Clinicians supported/contacted in the UK

Clinicians supported/contacted in the UK
Country Number of clinicians contacted
England 90
Scotland 27
Wales 8
Northern Ireland 2

Our efforts to raise awareness of The AAT resulted in clinicians ordering 28 different publications, information booklets and leaflets to provide accurate and reliable information to their patients - in total, 907 individual copies of our resources were sent out to clinicians in 2024-25.

Regardless of the stage in their treatment journey at which a person affected by aplastic anaemia reaches out to us, we are often in contact with our community members on numerous occasions throughout their journey - indeed, it is very unusual for a person to only reach out to us for support on one occasion. In 2024-25, we recorded a total of 1650 support ‘interactions’ with people based in England, Scotland Wales and Northern Ireland, and a further 700 with people based in the United Kingdom where their precise location is not known, whether that be answering a question via email or phone or signposting them to a specialist to support them with their financial or emotional wellbeing. This resulted in a total of 2350 interactions being recorded with our community members based in the UK.

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The Aplastic Anaemia Trust

Trustees' Report

A diagnosis of aplastic anaemia can be incredibly debilitating and impacts every aspect of daily life. In these challenging times, our patient community continues to experience financial challenges, whether related to the ongoing cost of living crisis, or difficulties in accessing, or navigating the welfare benefits system. In 2024/2025 we supported 26 community members with benefit consultants, of whom twenty were supported by benefits advisors at Maggie’s Centres across the UK through our partnership with them, and the remaining six received support from the Benefits Advisor provision made available through the Better Together for Healthy Marrow Partnership where Maggie’s were unable to help, such as where enquiries concerned benefits for children and young people. In comparison, 21 requests for benefits consultations were made in 2023-24, and 23 requests made in 2022-23. Regardless, we frequently hear from our community about the financial issues and pressures that they face, often exacerbated by issues in applying for benefits such as PIP, where claims are frequently rejected, with our community members having to go through the mandatory consideration and tribunal processes in order to access the benefits that they are entitled to. In turn, this creates an additional practical and psychological burden for those affected by aplastic anaemia, further exacerbating an already difficult situation.

ACHIEVEMENTS AND PERFORMANCE HIGHLIGHTS

How The AAT delivered public benefit in 2024/2025

The Board of Trustees confirm they have had regard to the Charity Commission's guidance on public benefit and have complied with their duty under section 4 of the Charities Act 2011 when reviewing the charity's aims and objectives and in implementing current and planning future activities.

In line with the governing document, the Memorandum and Articles of Association, our performance highlights for the last year in relation to the Charity's aims are set out below.

Delivering support

Our small and agile Support and Outreach team are swift to adapt to the evolving needs of aplastic anaemia patients in a rapidly changing world. Investment in the project management of this team has seen these abilities strengthened, as the online services we developed during lockdown are iterated and expanded into in-person support.

This year our support team and small group of dedicated volunteers:

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The Aplastic Anaemia Trust

Trustees' Report

Building partnerships and Better Together for Healthy Bone Marrow (BT)

Building successful partnerships is at the heart of our organisational strategy, and this year has seen very positive results from this approach. We are approaching the end of Phase 1 of the three-year National Lottery Community Fund project ‘Better Together for Healthy Bone Marrow’.

We have continued to make significant progress in a whole range of areas from organisational resilience building and succession planning to creating spaces for those with rare conditions to come together and delivering innovative test and learn projects. Together we are also providing an ongoing programme of webinars and courses as well as tailored one-to-one support from our Psychology Team.

The current round of Better Together funding is due to come to an end on August 31st, 2025. The team have worked to ensure that there is a detailed delivery plan in place, and we are on track to deliver in full against our commitments with no budget deviations expected.

Other project highlights over the last year included:

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The Aplastic Anaemia Trust

Trustees' Report

Research highlights

The Aplastic Anaemia Trust enables research into aplastic anaemia and other rare bone marrow failures. We encourage and support research that is truly transformative and can accelerate access to better treatments and cures.

Guided by our Patient Support Group and by our peer-led Research and Clinical Advisory Panel, our research strategy, launched in 2018, focuses on both types of aplastic anaemia - acquired and inherited, in adult and child populations. While the primary focus is on aplastic anaemia, recognising the links with other rare bone marrow failures, we will consider research into dyskeratosis congenita, fanconi anaemia, PNH and others.

Our research priorities

In Autumn 2024, The Aplastic Anaemia Trust embarked on a project to identify and prioritise the opportunities for improvement in clinical care and research into AA and inherited BMF syndromes. Given the rarity of both AA and constitutional BMF syndromes, diagnosis and administration of appropriate treatments can be delayed, leading to considerable added morbidity and mortality. Furthermore, programmed research funding is grossly deficient in the UK which seriously jeopardises the possibility of identifying novel therapeutic approaches.

Investment in research in the past has been transformative by moving the understanding of the condition forward leading to successful methods of treatment with improved clinical outcomes for patients. To inform future priorities, the Trustees of The AAT, on the advice of The AAT’s Research & Clinical Advisory Group (RCAP), led by its chair, Professor Ghulam Mufti, assembled a group of experts to discuss potential future areas of discovery and improvement in research and clinical provision. A conference took place in October 2024 and the resulting report into the priority areas identified will be published in 2025. This report will inform our own future research funding priorities and also, we hope, provide information and context to others working or funding in the field, sparking interest and highlighting opportunities.

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The Aplastic Anaemia Trust

Trustees' Report

TIARA clinical trial – Exciting early results

The TIARA Trial at King’s College Hospital, which is co-funded between The Aplastic Anaemia Trust and LifeArc is trialling cutting-edge cell therapy to develop a brand new treatment for the condition.

On 7th December 2024, Dr Nazia Matto, the trial’s lead GMP (Good Manufacturing Practice) production scientist presented initial findings from the TIARA trial, revealing promising results in a presentation at the American Association on Haematologists (ASH) conference in San Diego.

This stage one trial is investigating the safety and tolerability of expanded autologous regulatory T cells (immune cells, also referred to as Tregs) in treating patients with aplastic anaemia. The early results have confirmed that that Tregs from AA patients are expandable, safe to infuse and may dampen immune system abnormalities associated with the condition.

TIARA trial participants are given two infusions of their own expanded autologous Tregs - a type of cellular therapy - to treat the condition, and will be monitored for two years. Three of the treated patients had been diagnosed with severe AA, two with non-severe, and one with Very Severe AA.

Tregs were successfully expanded from all six patients and all have completed the treatment with both doses. Five patients did so without any safety concerns. One patient developed antibiotic-responsive low-grade fever within 24 hours of the first infusion but received the second dose without any side effects.

A year on from one of the trial participant’s treatment, they have gone from being transfusion-dependent to no longer requiring transfusions. Another patient also showed improvements, with red cell transfusion independence lasting 100 days.

The next round of patients are currently undergoing treatment and the AAT is working with researchers to secure additional funding for the second phase of the project and further clinical trials.

Genomic Sequencing to understand Mutation timing and clonal trajectories in aplastic anaemia.

We funded a portion of the costs for a study into Mutation timing and clonal trajectories in aplastic anaemia. This research project brings together researchers from Leeds, Cambridge and the Sangar Institute working in partnership to investigate the genes of people with aplastic anaemia as a first step to find ways to better predict treatment responses and later complications, such as cancer. This project is ongoing and results will be shared with our community in Summer 2025.

A national registry for aplastic anaemia

Following the success of our previous funding for building a national paediatric registry for children with aplastic anaemia in 23/24 we began the process of exploring various avenues to pursue the creation of a national registry, in partnership with existing bone marrow transplant registries. This project has been put on hold because due to the ongoing progress of the UK Government’s Rare Disease Framework and the commitment to deliver a Government funded national rare disease registry. We continue to hold the UK Government to account to deliver the commitments made by the end of the current Rare Disease Framework in 2026.

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The Aplastic Anaemia Trust

Trustees' Report

FUNDRAISING HIGHLIGHTS

We recognise that the financial year 2024/25 was a particularly tough time for many organisations in the voluntary sector, especially those who do not receive any statutory income from public sector contracts. However, despite these challenging circumstances the Aplastic Anaemia Trust was not only able to meet our income targets but surpass them in the majority of our income streams due to strong relationships we have built with our community and funding partners, as well as being registered with the Fundraising Regulator.

This was the fifth year of running our annual Super Rare campaign, and our third year of running the campaign with the five other small organisations in the Better Together for Healthy Bone Marrow partnership fundraising alongside us with support from our staff team. Collectively all five of the charity partners raised £65,489 with a total of 83 new fundraisers taking part in activity. The AAT alone had 71 New fundraisers sign up and take part. They raised a total of £42,210 against our internal target of £20,000. Over the past three years of partnership we have collectively engaged 157 new fundraisers and raised £158,365 for all charities.

People Powered Fundraising

Trusts, Grants & Foundations

We thank the following Trusts, Foundations and organisations for their funding and support this year:

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The Aplastic Anaemia Trust

Trustees' Report

FINANCIAL REVIEW

How our income and expenditure changed in 2024/2025

Unrestricted income for the year totalled £396,589 (23/24: £196,609) and expenditure amounted to £369,231 (23/24 £224,876) resulting in a net surplus on unrestricted funds for the year of £27,358 (23/24: deficit of £28,267). Restricted income of £250,621 (23/24 £282,161) was received in the year. Expenditure incurred and charged against restricted income funds amounted to £224,562 (23/24: £275,449), leaving balances on restricted funds totalling £142,771 at 31 March 2025.

Managing our income across a range of rare bone marrow failures

As we move into the third year of funding complex partnership projects, it is useful to note with these accounts that the grant income from The National Lottery Community Fund represents budget which is managed by The Aplastic Anaemia Trust to deliver work that is designed to benefit our Better Together partnership of six small organisations (listed above), and the communities of people that all six organisations represent. This project falls within The Aplastic Anaemia Trust’s charitable objectives of supporting people suffering from bone marrow disease and by working collaboratively with partnership organisations who are expert in their specific conditions, we can replicate benefits and learning across all our organisations and speak with one voice.

This demonstrates a strategic and forward-thinking approach to having impact in the field of bone marrow failure as per our charitable purpose.

Our reserves position and policy update

The ongoing challenge we face is how to be sure of sustainable funding for these essential support services, while also being able to invest in research.

In response, our reserves policy has been updated for 24/25 to ensure we hold between 6 and 9 months core operating costs in unrestricted reserves (previously 9 months), so that the charity will be able to maintain vital services and re-establish our income, should one source of income drop unexpectedly. Our reasoning, method of calculating required funds, and the purpose for retaining these reserves are outlined in our reserves policy.

The 6-9 months of core operating costs will be recalculated annually. As at March 2025 we calculated that the target range should be £179k - £269k and unrestricted reserves stand at £329k (£60k above target and representing 11 months of core operating costs). We took the decision to phase the spend down over two years, to manage the financial instability we were seeing, and by March 2026 expect to have reduced unrestricted reserves to our target.

Our priority for the next financial year is to continue to seek funding to cover the costs of work delivered by our support team, which will provide confidence that our current level of support is sustainable and enable us to invest future income raised by community fundraising in research partnership projects. This budget does not include investment in new research projects, however we are investing in some expert fundraising resource to run a feasibility study on the research funding landscape, and to establish whether the AAT should be investing in this area of fundraising as an additional budgeted income stream over and above the current financial framework.

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The Aplastic Anaemia Trust

Trustees' Report

Pharmaceutical industry income in 24/25

In 2024/25 we continued to develop strong and collaborative relationships with Sobi, Roche, Alexion AstraZeneca Rare Disease, Pfizer and Ono.

We have been pleased to receive funding from the following pharmaceutical companies this year:

In line with our funding policy, income from pharmaceutical companies is limited to no more than one third of our overall income, ensuring a diverse and balanced funding portfolio.

STRUCTURE, GOVERNANCE AND MANAGEMENT

Evolution of our board

Following the successful embedding of trustees into the organisation through offering training and attendance at staff conferences who had been recruited in previous financial years, some of our longer-serving Trustees felt the confidence to move on from their position, knowing that the Board will have the knowledge, skills and experience to carry out its functions effectively. We wish to extend our thanks to Tracy Stephenson and to Julia Beart for their many and important contributions as trustees. We were very pleased to welcome Kavita Agarwal as the newest member of the Board. She brings lived experience as a parent of a child with aplastic anaemia. Professionally, Kavita has spent much of her career in marketing and business strategy with Diageo and Unilever, working with teams across the globe to develop brands, grow businesses, and navigate change. She has also previously been involved with charities focused on youth employment and the arts, where she has helped with governance and strategic planning.

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The Aplastic Anaemia Trust

Trustees' Report

Research and Clinical Advisory Panel and Youth Board

Our Research and Clinical Advisory Panel welcomed Dr David Irvine as a new representative from Scotland. Callum Tempest also joined the Research & Clinical Advisory Panel as a representative of the Trustee Board. The rest of the board remains the same and we thank them for their ongoing service.

There were also changes to our Youth Board. India Wyldmore-Smith and Daisy Hall left the board during this year, having simply reached too great an age (i.e. over 25 years old) to sit on the Youth Board. We were also pleased to welcome new members. The membership currently consists of Ella Bearpark (Co-Chair), Sophie Ouzman (Co-Chair), Dan Ord, Sophie Byrom, Adya Gupta and Esme de Villiers. The Youth Board members are working on developing a strategy for the next three years, and we thank all Youth Board Members, retired and current, for their insight and ideas which have been extremely valuable.

Risk management

The Trustees have a duty to identify, assess and regularly scrutinise the risks to which the charity is exposed and to ensure appropriate controls are in place to provide reasonable assurance against fraud and error. The Trustees have mapped significant risks that may have an adverse effect on the AAT’s charitable activities. A robust risk management framework is in place and remains effective in enabling the Trustees to oversee and monitor strategic risks, reviewing progress against specific action plans quarterly.

Going concern

The Trustees consider there are no material uncertainties about the charitable company’s ability to continue as a going concern. The review of the financial position and future plans gives Trustees confidence that the charity remains a going concern for the foreseeable future.

Disclosure of information to auditor

Each trustee has taken steps that they ought to have taken as a trustee in order to make themselves aware of any relevant audit information and to establish that the charity's auditor is aware of that information. The trustees confirm that there is no relevant information that they know of and of which they know the auditor is unaware.

Small companies provision statement

The accounts are prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies.

The annual report was approved by the trustees of the charity on 14 October 2025 and signed on their behalf by:

......................................... A Conquy Trustee

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The Aplastic Anaemia Trust

Statement of Trustees' Responsibilities

The trustees (who are also the directors of The Aplastic Anaemia Trust for the purposes of company law) are responsible for preparing the trustees' report and the financial statements in accordance with the United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) and applicable law and regulations.

Company law requires the trustees to prepare financial statements for each financial year. Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of its incoming resources and application of resources, including its income and expenditure, for that period. In preparing these financial statements, the trustees are required to:

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company's transactions and 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.

Approved by the trustees of the charity on 14 October 2025 and signed on its behalf by:

......................................... A Conquy Trustee

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The Aplastic Anaemia Trust

Independent Auditor's Report to the Members of The Aplastic Anaemia Trust

Opinion

We have audited the financial statements of The Aplastic Anaemia Trust (the 'charity') for the year ended 31 March 2025, which comprise the Statement of Financial Activities, Balance Sheet, Statement of Cash Flows, and Notes to the Financial Statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is United Kingdom Accounting Standards, comprising Charities SORP - FRS 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and applicable law (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 charity 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

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

Other information

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

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

We have nothing to report in this regard.

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The Aplastic Anaemia Trust

Independent Auditor's Report to the Members of The Aplastic Anaemia Trust

Opinion on other matters prescribed by the Companies Act 2006

Matters on which we are required to report by exception

In the light of our knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees' Report.

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

Responsibilities of trustees

As explained more fully in the Statement of Trustees' Responsibilities (set out on page 15), the trustees 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 charity'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 charity 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.

Our approach to identifying and assessing the risks of material misstatement respect of irregularities, including fraud and non-compliance with laws and regulations, was as follows:

Page 17

The Aplastic Anaemia Trust

Independent Auditor's Report to the Members of The Aplastic Anaemia Trust

We assessed the susceptibility of the charity's financial statements to material misstatement, including obtaining an understanding of how fraud might occur, by:

To address the risk of fraud through management bias and override of controls, we:

There are inherent limitations in our audit procedures described above. The more removed that laws and regulations are from financial transactions, the less likely it is that we would become aware of noncompliance. Auditing standards also limit the audit procedures required to identify non-compliance with laws and regulations to enquiry of the directors and other management and the inspection of regulatory and legal correspondence, if any.

Material misstatements that arise due to fraud can be harder to detect than those that arise from error as they may involve deliberate concealment or collusion.

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

Use of our report

This report is made solely to the charitable company's trustees, 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 charity's trustees 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 its trustees as a body, for our audit work, for this report, or for the opinions we have formed.

Page 18

The Aplastic Anaemia Trust

Independent Auditor's Report to the Members of The Aplastic Anaemia Trust

==> picture [32 x 42] intentionally omitted <==

...................................... Mark Heaton FCCA FCIE DChA (Senior Statutory Auditor) For and on behalf of KM, Statutory Auditor

1st Floor, Block C The Wharf Manchester Road Burnley Lancashire BB11 1JG Date:.............................

Page 19

The Aplastic Anaemia Trust

Statement of Financial Activities for the Year Ended 31 March 2025

(Including Income and Expenditure Account and Statement of Total Recognised Gains and Losses)

Note
Income from:
Donations and legacies
3
Grants receivable
4
Fund-raising events
5
Investment income
6
Total income
Expenditure on:
Raising funds
7
Charitable activities
8
Total expenditure
Net income/(expenditure)
Net movement in funds
Reconciliation of funds
Total funds brought forward
Total funds carried forward
18		 Unrestricted
funds
£
363,207
-
24,379
9,003
396,589
(37,043)
(332,188)
(369,231)
27,358
27,358
301,851
329,209		 Restricted
funds
£
-
250,621
-
-
250,621
-
(224,562)
(224,562)
26,059
26,059
116,712
142,771		 Total
2025
£
363,207
250,621
24,379
9,003
647,210
(37,043)
(556,750)
(593,793)
53,417
53,417
418,563
471,980		 Unrestricted
funds
£
146,207
19,940
22,779
7,683
196,609
(34,539)
(190,337)
(224,876)
(28,267)
(28,267)
330,118
301,851		 Restricted
funds
£
70,150
212,011
-
-
282,161
-
(275,449)
(275,449)
6,712
6,712
110,000
116,712		 Total
2024
£
216,357
231,951
22,779
7,683
478,770
(34,539)
(465,786)
(500,325)
(21,555)
(21,555)
440,118
418,563

All of the charity's activities derive from continuing operations during the above two periods. The funds breakdown for 2024 is shown in note 18.

Page 20

The Aplastic Anaemia Trust

(Registration number: 05174065) Balance Sheet as at 31 March 2025

2025 2024
Note £ £
Current assets
Debtors 14 44,064 21,686
Cash at bank and in hand 526,862 522,970
570,926 544,656
Creditors: Amounts falling due within one year 15 (62,635) (73,193)
Total assets less current liabilities 508,291 471,463
Creditors: Amounts falling due after more than one year 16 (36,311) (52,900)
Net assets 471,980 418,563
Funds of the charity:
Restricted income funds
Restricted funds 142,771 116,712
Unrestricted income funds
Unrestricted funds 329,209 301,851
Total funds 18 471,980 418,563

The financial statements on pages 20 to 30 were approved by the trustees, and authorised for issue on 14 October 2025 and signed on their behalf by:

......................................... A Conquy Trustee

Page 21

The Aplastic Anaemia Trust

Statement of Cash Flows for the Year Ended 31 March 2025

Note
Cash flows from operating activities
Net cash income/(expenditure)
Adjustments to cash flows from non-cash items
Investment income
6
Working capital adjustments
Increase in debtors
14
Decrease in creditors
15
Net cash flows from operating activities
Cash flows from investing activities
Interest receivable and similar income
6
Net increase/(decrease) in cash and cash equivalents
Cash and cash equivalents at 1 April
Cash and cash equivalents at 31 March		 2025
£
53,417
(9,003)
44,414
(22,378)
(27,147)
(5,111)
9,003
3,892
522,970
526,862		 2024
£
(21,555)
(7,683)
(29,238)
(2,564)
(67,861)
(99,663)
7,683
(91,980)
614,950
522,970

All of the cash flows are derived from continuing operations during the above two periods.

Page 22

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

1 Charity status

The charity is limited by guarantee, incorporated in England, and consequently does not have share capital. Each of the trustees is liable to contribute an amount not exceeding £100 towards the assets of the charity in the event of liquidation.

The address of its registered office is: 1st Floor, Block C The Wharf Manchester Road Burnley Lancashire BB11 1JG

These financial statements were authorised for issue by the trustees on 14 October 2025.

2 Accounting policies

Summary of significant accounting policies and key accounting estimates

The principal accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all the years presented, unless otherwise stated.

Statement of compliance

The financial statements have been prepared under the historical cost convention, on a going concern basis, in accordance with the Charity Commissioners' "Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland" (effective January 2019) ("the SORP (FRS 102)"), FRS 102, the Charities and Trustees Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006, the Charities Act 2011 and the Companies Act 2006.

Basis of preparation

The Aplastic Anaemia Trust meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy notes.

Going concern

The trustees consider that there are no material uncertainties about the charity's ability to continue as a going concern nor any significant areas of uncertainty that affect the carrying value of assets held by the charity.

Income

All income is recognised once the charity has entitlement to the income, it is probable that the income will be received and the amount of the income receivable can be measured reliably.

Grants receivable

Grants are recognised when the charity has an entitlement to the funds and any conditions linked to the grants have been met. Where performance conditions are attached to the grant and are yet to be met, the income is recognised as a liability and included on the balance sheet as deferred income to be released.

Page 23

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

Expenditure

All expenditure is recognised once there is a legal or constructive obligation to that expenditure, it is probable settlement is required and the amount can be measured reliably. All costs are allocated to the applicable expenditure heading that aggregate similar costs to that category. Where costs cannot be directly attributed to particular headings they have been allocated on a basis consistent with the use of resources.

Governance costs

These include the costs attributable to the charity’s compliance with constitutional and statutory requirements.

Fund structure

Unrestricted income funds are general funds that are available for use at the trustees's discretion in furtherance of the objectives of the charity.

Restricted income funds are those donated for use in a particular area or for specific purposes, the use of which is restricted to that area or purpose.

Pensions and other post retirement obligations

The charity operates a defined contribution pension scheme which is a pension plan under which fixed contributions are paid into a pension fund and the charity has no legal or constructive obligation to pay further contributions even if the fund does not hold sufficient assets to pay all employees the benefits relating to employee service in the current and prior periods.

Contributions to defined contribution plans are recognised in the Statement of Financial Activities when they are due. If contribution payments exceed the contribution due for service, the excess is recognised as a prepayment.

3 Income from donations

Donations and legacies Unrestricted
funds
General
£
363,207
363,207		 Restricted
funds
£
-
-		 Total
2025
£
363,207
363,207		 Total
2024
£
216,357
216,357

4 Income from charitable activities

Grants receivable Unrestricted
funds
General
£
-
-		 Restricted
funds
£
250,621
250,621		 Total
2025
£
250,621
250,621		 Total
2024
£
231,951
231,951

Page 24

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

5 Income from fund-raising

Unrestricted
funds
General
£
Fund-raising events
24,379
24,379
6
Investment income
Unrestricted
funds
General
£
Interest receivable on bank deposits
9,003
7
Expenditure on raising funds
Unrestricted
funds
General
£
Fundraising staff costs
37,043
37,043
8
Expenditure on charitable activities
Unrestricted
funds
Note
General
£
Patient Information,
outreach & support
328,788
Governance costs
9
3,400
332,188		 Restricted
funds
£
-
-
Restricted
funds
£
-
Restricted
funds
£
-
-
Restricted
funds
£
224,562
-
224,562		 Total
2025
£
24,379
24,379
Total
2025
£
9,003
Total
2025
£
37,043
37,043
Total
2025
£
553,350
3,400
556,750		 Total
2024
£
22,779
22,779
Total
2024
£
7,683
Total
2024
£
34,539
34,539
Total
2024
£
463,936
1,850
465,786

Page 25

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

9 Analysis of governance and support costs

Governance costs

Independent Examiner’s remuneration
Audit of the financial statements		 Unrestricted
funds
General
£
-
3,400
3,400		 Restricted
funds
£
-
-
-		 Total
2025
£
-
3,400
3,400		 Total
2024
£
1,850
-
1,850

10 Trustees remuneration and expenses

During the year the charity made the following transactions with trustees:

£224 (2024: £Nil) of expenses in relation to travel were reimbursed to two trustees during the year.

No trustees, nor any persons connected with them, have received any remuneration from the charity during the year.

No trustees have received any other benefits from the charity during the year.

Page 26

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

11 Staff costs

The aggregate payroll costs were as follows:

Staff costs during the year were:
Wages and salaries
Social security costs
Pension costs		 2025
£
317,772
25,496
7,352
350,620		 2024
£
258,488
18,881
7,739
285,108

The monthly average number of persons (including senior management team) employed by the charity during the year was as follows:

Charitable activites
The number of employees whose emoluments fell within the following bands
£60,001 - £70,000
£70,001 - £80,000
12 Auditors' remuneration
Audit of the financial statements		 2025
No
11
was:
2025
No
-
1
2025
£
3,400		 2024
No
10
2024
No
1
-
2024
£
-

13 Taxation

The charity is a registered charity and is therefore exempt from taxation.

Page 27

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

14 Debtors

14 Debtors
Trade debtors
Prepayments
Accrued income
Other debtors		 2025
£
-
13,793
30,041
230
44,064		 2024
£
159
7,677
13,850
-
21,686

15 Creditors: amounts falling due within one year

Research grant commitments
Pension scheme creditor
Accruals		 2025
£
58,133
1,102
3,400
62,635		 2024
£
68,542
1,005
3,646
73,193

16 Creditors: amounts falling due after one year

Research grant commitments 2025
£
36,311		 2024
£
52,900

17 Pension and other schemes

Defined contribution pension scheme

The charity operates a defined contribution pension scheme. The pension cost charge for the year represents contributions payable by the charity to the scheme and amounted to £7,352 (2024 - £7,739).

Contributions totalling £1,102 (2024 - £1,005) were payable to the scheme at the end of the year and are included in creditors.

Page 28

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

18 Funds

Current Year

Unrestricted funds
General
Restricted funds
National Lottery - Better Together
Contact a Family
Family Support
Children and Young People
Individualised Support Project
National Community Survey
Total funds
Prior Year
Unrestricted funds
General
Restricted funds
National Community Survey
National Lottery - Better Together
Contact a family
Total funds		 Balance at 1
April 2024
£
301,851
112,189
4,523
-
-
-
-
116,712
418,563
Balance at 1
April 2023
£
330,118
-
105,674
4,326
110,000
440,118		 Incoming
resources
£
396,589
204,705
-
19,922
10,994
-
15,000
250,621
647,210
Incoming
resources
£
196,609
70,000
203,661
8,500
282,161
478,770		 Resources
expended
£
(369,231)
(208,312)
(4,523)
(4,306)
(2,079)
(5,342)
-
(224,562)
(593,793)
Resources
expended
£
(224,876)
(70,000)
(197,146)
(8,303)
(275,449)
(500,325)		 Balance at 31
March 2025
£
329,209
108,582
-
15,616
8,915
(5,342)
15,000
142,771
471,980
Balance at 31
March 2024
£
301,851
-
112,189
4,523
116,712
418,563

Page 29

The Aplastic Anaemia Trust

Notes to the Financial Statements for the Year Ended 31 March 2025

19 Analysis of net assets between funds

Current Year

Current Year
Current assets
Current liabilities
Creditors over 1 year
Total net assets		 Unrestricted
funds
General
£
428,155
(62,635)
(36,311)
329,209		 Restricted
funds
£
142,771
-
-
142,771		 2025 Total
funds
£
570,926
(62,635)
(36,311)
471,980

Prior Year

Prior Year
Current assets
Current liabilities
Creditors over 1 year
Total net assets		 Unrestricted
funds
General
£
427,944
(73,193)
(52,900)
301,851		 Restricted
funds
£
116,712
-
-
116,712		 2024 Total
funds
£
544,656
(73,193)
(52,900)
418,563

Page 30