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← Orthopaedic Research UK

2024-03-31-accounts

Orthopaedic Research UK ee's advance Annual Report and Accounts 2023-24

Contents

Charity Reference and Administrative Details 3
Messages from our Chair and Chief Executive 4-5
Report of the Trustees 7-15
Independent Auditor’s Report 16-18
Statement of Financial Activities
(including an Income and Expenditure Account)
current period 19
Statement of Financial Activities
(including an Income and Expenditure Account)
comparative 20
Balance Sheet 21
Statement of Cash Flows 22
Notes to the Financial Statements 23

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Orthopaedic Research UK

Reference and Administrative Details for the Year Ended 31 March 2024

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Charity registration number 1111657
Company registration number 5585452
Trustees Dr C J Ball
Ms J Chong (appointed 26.5.23)
Mr A H Downing (Chair)
Mr M Gouldstone (resigned 21.3.24)
Mrs S Harkness
Mr P E Harrison (resigned 27.6.23)
Professor M Reed (appointed 12.12.23)
Professor N Rushton
Mr J K Tucker (resigned 4.12.23)
CEO/CFO Dr A Angadji / Mrs C Barnard
Executive Officer Mrs D Palmer
Senior management team
Professor M Hurley
Mr M Thomas
Miss R Threadgold
Registered office Furlong House
10a Chandos Street
London W1G 9DQ
Principal place of operations Furlong House
10a Chandos Street
London W1G 9DQ
Auditor Sayer Vincent
Chartered Accountants & Statutory Auditors
110 Golden Lane
London EC1Y 0TG
Solicitor Weightmans
105 Fenchurch Street
London EC3M 5JG
Bankers National Westminster Bank Plc
10 Marylebone High Street
London W1U 4BT
Investment managers Sarasin & Partners LLP
Juxon House, 100 St Paul’s Churchyard
London EC4M 8BU
Rathbone Brothers Plc
30 Gresham Street
London EC2V 7QN
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Message from our Chair

Impatience can be a virtue. We are a small charity set up to respond to an enormous societal challenge – the poor musculoskeletal (MSK) health affecting the lives of tens of millions of people across the UK. It represents the third largest area of expenditure for the NHS and is linked to rising levels of obesity, anxiety, isolation and depression.

Demand for MSK health services will only grow in an ageing society. This is why we are determined to accelerate the impact of our investments. There will always be a place for the funding of long-term research projects, which is why we will continue to be one of the largest funders of MSK research in the UK, but moving fast means increasing our investments in activities capable of delivering a more immediate impact.

Education is one area in which we can make a difference in days, as opposed to years. Healthcare professionals experiencing one of our training programmes can begin improving the lives of their patients from ‘day one’. This is why we have further expanded our educational offer across an even wider range of healthcare specialities, including primary care, and enhanced our online offer.

The other area in which we have made significant progress in recent years has been in funding and supporting innovation. To even come close to addressing the demand for MSK health services we need a culture of innovation and a pipeline of technology solutions focused on solving MSK health challenges, especially those associated with ageing. We are following in the footsteps of our founder Ronald Furlong who combined a highly successful career as an orthopaedic surgeon with an equally successful career as a business entrepreneur. We need to embrace Furlong’s spirit of

entrepreneurialism because the scale of the challenges facing all of us involved in MSK health continue to require new ideas and techniques.

We will continue to invest in entrepreneurial people and organisations delivering breakthrough innovations, using The Ronald Furlong Fund to support the development of innovative and commercially viable ideas from UK-based start-ups. Our support for innovation has included partnerships with ‘innovation enablers’ such as MedTech SuperConnector (MTSC) and the NHS Clinical Entrepreneur Programme. The MSK Innovation Accelerator programme, hosted by MedTech SuperConnector, is a perfect example of how we deploy our investments to help create and scale early-stage MSK ventures across the UK.

Our decision to focus on the potential role of AI in supporting MSK health services has also been highly successful, leading to a series of discussion forums, educational programmes and investment from the NIHR and commercial sector. We may be a small charity, but we have proven our value as a facilitator, connector and enabler.

I would like to thank our Trustees for dedicating their time, energy, and expertise to support our executive team, and our executive team and the charity’s many partners for an outstanding year.

Adrian Downing, Chair of the Board of Trustees

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Message from our Chief Executive

The dictionary definition of ‘convening power’ is the ability to initiate gatherings of individuals or groups to focus on a common purpose and to mobilise their collective resources to focus on a specific challenge. This is a good summary of the way in which our charity is able to make a difference. Our MSK for the Workplace initiative provided a perfect illustration of convening in action – we identified the impact of poor MSK health on employment (and by implication the nation’s economic health) and brought together a wide range of organisations to identify problems and debate solutions.

During the kick-off meeting for the initiative we joked that we were probably the smallest organisation in the room, but that our neutrality (unlike most MSK charities we are not focused on a specific condition) and relatively limited executional capacity made us the perfect organisation to convene such an event.

We recently undertook an informal survey of our partners across the healthcare eco-system from the leading medical schools to other charities and the NHS and were pleased to hear that our role as convenors, collaborative partners and supporters was widely appreciated. This does not happen by accident: it reflects a deliberate strategy over the past few years to reach out to partners, support their initiatives and foster a culture of collaboration. Far too many charities operate in silos – determined to protect their own interests and wary of sharing activities and plaudits. This has not been our approach and is the reason why our many partnerships with academic institutions, charities, entrepreneurs, and major corporations have proven

so productive. During the last year we received £2.2m in partner funding, including an award of over £750,000 from the Government to increase our support for early-career clinical researchers and academic scientists interested in building and expanding their MSK research portfolio.

We are proud of our heritage as a charity created by an orthopaedic surgeon and will continue to invest in breakthrough surgical innovation – 56% of our research grants since 2020 have been awarded to orthopaedic surgeons. However, with around 32% of the UK adult population (17.1 million people) experiencing poor MSK health and given the sheer scale of the MSK health challenges posed by an ageing population, we cannot focus simply on improvements to diagnosis and surgical intervention. We have therefore extended our research investments to include MSK wellbeing and prevention. This aligns us with the shifting focus of government and NHS England’s from ‘recovery’ to ‘prevention’, with particular emphasis on ‘alleviating pressure on the healthcare system’ and ‘reducing labour market inactivity.’

We continued to invest in research into the impact of the ESCAPE-pain programme, which remains an exemplar of community-based, nonsurgical intervention. To encourage greater MSK literacy we co-funded RatLab, an educational, interactive show aimed at 7–11-year-olds, that introduces young people to biomechanics and the importance of bone, joint and muscle health.

Other important initiatives during the past 12 months have included the MSK Innovation Accelerator programme with Imperial College London’s MedTech SuperConnector, the co-funding of an initiative to apply AI to MSK health as part of the NIHR’s Invention for Innovation (i4i) programme, and a joint fellowship with The Daphne Jackson Trust to support individuals (in many

cases, women) returning to research after a career break due to illness, caring or family responsibilities. We continued to work in close partnership with British Orthopaedic Medical Students Association (BOMSA) and British Orthopaedic Trainee Association (BOTA) to highlight the importance of MSK research and the opportunities that are available.

Our success in the past year owes much to the support of our partners within leading institutions including Association of Medical Research Charities (AMRC), Arthritis and Musculoskeletal Alliance (ARMA), the National Institute for Health and Care Research (NIHR), Royal College of Surgeons of England (RCSEng), the British Hip Society (BHS), Royal College of Surgeons of Edinburgh (RCSEd), British Orthopaedic Association (BOA), British Association for Surgery of the Knee (BASK), National Joint Registry (NJR), British Scoliosis Society (BSS), British Association of Spine Surgeons (BASS), Versus Arthritis, Information Governance Services (IGS), MedTec SuperConnector (MTSC), Impeller Ventures, Shionogi, NHS Clinical Entrepreneur Programme (NHS CEP) and the Daphne Jackson Trust. Together we will continue to make a difference.

Dr Arash Angadji, Chief Executive

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Our impact at a glance

(key performance indicators 2023/24)

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£1 m+ £900 k+
18
Research projects invested by ORUK partner funding
(£1,062, 804) (£976,420)
Rated by
£253 k
53 3,757 94 %
Education events attendees of participants as excellent or good (£253,601)income
394 £4.5 m
21 280 [+] savings for health
ESCAPE-pain events (2,500+ in total) people trained active sites & care budgets
since 2021
Investments in
10
7
Trained on the
3 Innovation
Innovation start-ups partners MSK accelerator
programme
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Introduction

The trustees present their report and the audited accounts for the year ended 31 March 2024.

The trustees have adopted the provisions of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).

The financial statements have been prepared in accordance with the accounting policies set out in the notes to the accounts and comply with the charity’s governing document, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). Information required to be disclosed under Schedule 7 of the Companies Act 2006 is disclosed within the Strategic Report, which starts on page 11.

Objectives and activities

Our principal, and over-riding, objectives are to promote the advancement of orthopaedic research and education and, in particular, the encouragement of innovation and partnership to advance knowledge and awareness of bone, joint and muscle health in the UK. These are the objects as set out in our governing document. Our specific aims and significant activities to achieve those principal aims are outlined below, along with the activities undertaken to achieve them.

To fund high quality research and innovation at centres of excellence in the field of musculoskeletal (MSK) medicine to support bone, joint and muscle wellbeing in the following areas:

  1. Underpinning: understanding biological, psychological and socioeconomic processes.

  2. Aetiology: risks, causes and development of health conditions.

  3. Prevention: interventions to prevent disease, promote wellbeing and reduce risks of ill health.

  4. Detection and

Diagnosis: population screening, using new diagnostic technologies and biomarker discovery and development.

  1. Treatment Development: translating basic research into experimental medicine in preclinical settings and/ or model systems.

  2. Treatment Evaluation: testing and evaluating interventions in human clinical/applied settings.

  3. Disease Management: understanding patient needs and practitioner experiences.

  4. Health Services: examining healthcare at an organisational level, such as service provision and economic and policy issues.

We funded 18 new research projects worth £1,062,804 in 2023/24, compared to 11 research projects worth £651,797 in 2022/23.

Along with other organisations involved in funding medical research, we have noted a reduction in the number of applications. We are part of a working group investigating the reasons for this decline. We also published a report into the factors behind this decline – Where have all the research applicants gone? What we discovered was a system under pressure from backlogs and workforce disputes, which is leading to competing priorities and a squeeze on research. In addition, clinical research appears to be less attractive as a career option because of financial pressures, a lack of career security, bureaucracy, a lack of support and what is described as ‘a poor research culture’. Although we alone cannot address the structural and financial issues, highlighted in our report, we can make a difference by:

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We publish the results of our research at the end of the studies to demonstrate the impact of our funding. Our measures for success are:

Our most significant co-funded project was an award of £769,616 from the Medical Research Council. In addition, we attracted approximately £2.2m from our other partners to co-fund research during 2023-24.

We use Researchfish to capture the outputs and impacts of the research we fund. This is an online system

developed specifically for collecting research outputs on behalf of funding organisations and is used by hundreds of research funders across the world. It provides us with vital information about the impact of the research we fund, ensuring we have a comprehensive picture of the outputs from our research portfolio.

To fund education, primarily through workshops, training courses, lectures, virtual conferences, and webinars that will improve knowledge of prevention, diagnosis, treatment and the management of MSK conditions. Our ambition is to be the leading provider of continuous learning in MSK health in the UK and the first stop for MSK health education in the UK, starting with medical students.

During the past year we staged 53 events (not including ESCAPE-pain) compared to 56 events in 2022/23, and in total educated 3,757 healthcare professionals with the support of 490 faculty members. On average, 94% of participants rated our events as ‘excellent’ or ‘good’ in terms of educational value. Income from events was £253,601 in 2023/24 compared to £284,366 in 2022/23, and from ESCAPEpain training £92,399 in 2023/24 compared to £95,263 in 2022/23.

Our blended learning model – a mix of online and face-to-face tuition – has enabled us to expand the range of our offer and reach a more diverse audience, including healthcare professionals in developing markets where affordability can be an issue.

We are increasing the number of interdisciplinary events to encourage more collaborative working and are involved in initiatives to address recruitment shortfalls in orthopaedics and orthopaedic research through training partnerships with the British Orthopaedic Medical Students Association (BOMSA) and British Orthopaedic Trainees Association (BOTA). We also worked with BOTA in an initiative to promote sustainability in orthopaedics and with the Royal College of Podiatry on a webinar series.

The ESCAPE-pain programme delivered the following during 2023/24:

ESCAPE-pain was a partner in the government funded MSK Hubs initiative, a national pilot programme to transform leisure centres, swimming pools, and gyms into MSK health hubs, designed and provided in collaboration between Good Boost, ukactive, Orthopaedic Research UK, ESCAPEpain, and Arthritis Action. The results of the pilot study will be published in the second half of 2024.

To provide information about our charitable activities to the general public through publishing and funding awards and prizes for outstanding publications and presentations in the field of MSK. We have two books in publication which provide preparation aids for the FRCS (Orth) examinations and complement our basic science training courses. Sales to orthopaedic trainees of both publications form part of our fundraising strategy. They are available to buy online or at our course events. During the year we sold 62 books, a 20% decrease on the previous year, which is an expected result considering that the books were published some years ago. We are publishing another educational product aimed at primary care professionals in 2024 - Managing Upper Limb Musculoskeletal Problems, A Companion Guide for Primary Care.

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Our three-year strategy

In addition to the over-arching objectives as outlined in the previous paragraph, our operating decisions were shaped by our 2020-2023 Strategy, which was built on 10 strategic initiatives:

  1. Focus our investments on unmet patient needs and specifically on diagnosis and treatment – we do this by making funding available via The ORUK Inspiration Fund and The ORUK Early-career Research Fellowships which are designed to support innovative projects that meet unmet needs and help patients achieve a better quality of life. These are open to orthopaedic surgeons, scientists, and physiotherapists.

During the past 12 months we have continued to fund high quality applicants across a wide range of research areas from rare MSK conditions and orthopaedic components to advanced imaging and data analytics.

  1. Extend the impact of our investments and attract additional funding for orthopaedic health by partnering with other sources of grant giving.

We partner with other organisations including the Royal College of Surgeons of England, the Royal College of Surgeons of Edinburgh, and the British Hip Society. By ‘match-funding’ we are able to support more of the MSK community than we would be able to do alone, and this funding is available via the Joint Partnership Fund.

  1. Broaden our remit beyond pure orthopaedics to include the important surrounding ecosystem of orthopaedic wellbeing, including physiotherapy.

We do this primarily through the delivery of the ESCAPE-pain programme, which:

Our educational programme has been broadened to embrace primary care professionals, physiotherapists, and allied disciplines.

  1. Build an influencer network across the orthopaedic ecosystem including clinicians, academics, GPs, physiotherapists, specialist medical member associations, entrepreneurs, and investors.

We measure the growth and vitality of our network by tracking:

Our MSK Health for the Workplace initiative was a good example of how we mobilise our community to focus on the MSK health needs of the working age population, at a time when 2.5 million people are currently unemployed in the UK due to health-related issues, including back and neck pain.

  1. Operate as a facilitator – connecting innovators with funders, academics with clinicians, and encouraging collaboration across the whole MSK community.

The success of our AI in Orthopaedics initiative demonstrates the increasing power and influence of our MSK network.

  1. Invest in entrepreneurial people and organisations delivering breakthrough innovations – The Ronald Furlong Fund is designed to support the development of any innovative and commercially viable idea from a UK-based startup that solves the unmet needs of society around bone, joint and muscle well-being.

To date we have invested in three start-up companies from this fund – Renovos Biologics, which is pioneering the use of a nanoclay in an injectable gel form that can carry biologic drugs capable of augmenting bone tissue regeneration; Novara Therapeutics, a joint venture company in which we have partnered with investment company Embryo Ventures to commercialise the world’s first patented bio-specific solution for the targeted diagnosis and treatment of bone microfractures; and Radii Devices, a company that uses state-of-the-art AI and biomechanical modelling to help clinicians design better fitting prosthetic sockets for people with limb loss or limb difference.

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  1. Expand the breadth and depth of our educational programme to include more on and off-line courses and more subjects designed to appeal to a broader audience, including GPs and physiotherapists – our educational programme is based on a blended model of virtual and in-person events (as well as recorded events available to purchase and download) that will improve knowledge of prevention, diagnosis, treatment, and the management of MSK conditions.

  2. Review and challenge our investment strategy and cost base to ensure the maximum impact.

  3. Report our programmes and impact openly and share our learnings with partners and collaborators. We annually publish our impact report (www.oruk.org/about-us/ourimpact/download) to demonstrate our progress against our strategy.

Grant making policy

We consider the support of grant applications that are within the scope of our charitable aims; that is to promote the advancement of orthopaedic research and education and, in particular, the encouragement of innovation and partnerships to advance bone, joint and muscle wellbeing in the UK. More information on the funding that is made available is given on our website at www.oruk.org/research/ explaining further the different Funds that are available, as well as examples of recent research projects that were funded. A new research strategy for 2024-27 has been approved by the Trustees and published on our website - https://oruk.org/research strategy/

Public benefit

The Trustees confirm that they have referred to the guidance contained in the Charity Commission’s general guidance on public benefit when reviewing the Charity’s aims and objectives and in planning future activities. We aim to bring together relevant stakeholders to identify patients’ priorities for diagnosis and

Short-term impact is provided by our conferences and other knowledgesharing events, and our educational programme.

treatment and to support innovative ideas with the clear aim of delivering substantive and safe solutions. We aim to tackle debilitating bone, joint and muscle disorders and ultimately enhance the quality of life, not only of patients but also of their carers and families. We have raised the public profile of the organisation through the staging of high-quality training and educational events. We continue to further raise the quality and public benefit of these events by engaging thought-provoking MSK opinion leaders as speakers and meeting hosts.

Although we have deliberately created a diverse investment programme with projects at different stages of development, our priority has been to identify opportunities that have the potential to deliver an impact in the medium term.

The societal benefit from our research investments can typically only be measured over the longer term. However, this does not mean that they do not have the potential to make a valuable contribution by increasing our knowledge and understanding of MSK conditions.

Clinical and scientific research is key to the advancement of knowledge and expertise within medical schools in universities and hospitals. Through our funding, these institutions are able to provide academic research positions or research fellowships that may not otherwise be possible. This opens-up new research areas and directly benefits researchers at all levels, including post-doctorates. Surgeons also benefit from access to cutting-edge research and improved training, helping them to provide better treatment and outcomes to patients.

Achievements and performance

The summary of our main achievements is outlined in our CEO’s opening message and in the section for objectives and activities on pages 7 to 8. We believe that we make a significant difference to beneficiaries and wider society in the areas of furthering academic research, supporting the work of MSK clinicians, furthering awareness of MSK conditions amongst the general public and in prioritising the needs of patients and

The results of research are generally readily available in the public domain through the publication of results in the media and the public presentation of research projects. These presentations and publications are always peer the NHS. reviewed to ensure a consistently high quality of research. By adopting these measures, we are able to satisfy the public benefit funding requirements.

Short-term and longer-term aims and objectives

Given that we are a medical research charity, patients are always our focus. Our aim is to reduce the demand on the NHS, for the treatment and support of patients with poor bone, joint and muscle health, by investing in innovative programmes that have the capability to deliver the maximum impact on the population as a whole.

We focus on the difference we can make over the short, medium, and longer term.

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Strategic report

Financial review

Financial position

In the 12 months to 31st March 2024, we generated total income of £2,309,786 compared to £2,059,531 in the previous year.

During the year we continued to offer our educational events via a hybrid or blended offering of virtual and faceto-face. These different platforms enable us to continue to drive income from education and the ESCAPE-pain programme. More information on education & events, and the ESCAPEpain programme, is given on page 8.

The financial year opened to a position of continuing uncertainties in the banking sector, along with concerns around interest rates and high rates of inflation, resulting in the first two quarters of the year continuing to show volatility on the stock market. However, by 31 March 2024 the equity markets and our portfolios were showing recovery from the position at which we opened the financial year and at the balance sheet date, we reflect gains on our listed investments of £1,524,961 compared to losses at the same time last year of £1,672,999. Our long-term investments in property have also been

challenged by high interest rates, by way of influencing their attractiveness on the open market. In line with our accounting policy, this year we have obtained formal ‘Red Book’ valuations on both properties; whilst our Sheffield property showed a small increase in value, the valuation on our London property reflected a further drop in value (further detail on this is given in notes 16 and 18). We hold our assets for the long term, acting as custodians; it remains the trustees’ firm intention to hold on to these assets. Income generated from all of our investments is absolutely essential to us, representing our principal funding source. Sustaining the listed investments in particular will allow us to continue to invest in quality research across all the Funds that we have available. Our reserves policy on page 12 explains how we have committed to protect these key assets for the future. More detail on our income and expenditure is given in the Statement of Financial Activities (SoFA). On 31[st] March 2024, our net assets were £29.7 million, compared to £27.7 million on 31[st] March 2023, and 97% of our funds are Designated.

Indemnity provisions – as part of the agreement relating to the 2018 sale of JRI there were indemnity provisions that related to past events of that entity. A number of those indemnity provisions

came to an end during the 19/20 accounting year. Each year subsequent, the Trustees have undertaken a judgement exercise to reassess the likelihood of the remaining provisions having a material impact. The final indemnity had a time limit which expired on 8 April 2024 - as a result, all provisions have now been released with the final amount of £250,000 being shown in the SoFA for 23/24.

The principal risks and uncertainties that we face at this time are outlined in our Risk Register. This is kept under regular review by the Executive and is considered by the Finance Committee on a quarterly basis to update, identify and review existing and arising risks. Our most recent Risk Register outlined our Top 3 Risks as being the maintenance of income from investments, organisational resilience/ talent retention/talent sourcing, and Trustee succession planning.

We need our investments to continue to generate the income required to fund our research. The Board considers that the choice of two investment managers spreads this risk, with each manager deploying different investment strategies. The Board meets both managers regularly (at least twice a year) to carefully review their performance against our objectives. Uncertain times, both politically and

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economically, mean that risks can never be completely avoided, but the Board has put in place as many checks and balances as possible to mitigate these risks. A summary of our investment policy and investment objectives is shown below.

In common with many other businesses and charities, ORUK has felt the effects of the cost-of-living crisis. The main focus of this is ensuring that the charity is able to retain its talent, being its staff, offering competitive salaries in line with the cost of living. In addition, the charity offers flexible working arrangements – in 22/23 we successfully trialled a 4-day working week on an informal basis, and we rolled this out more broadly in 23/24. In 24/25, we have made available to all our staff a Wellbeing App – syncing to existing wearables, this App encourages ‘movement’ and enables access to health professionals, including mental health support and mindfulness content.

With a small team, organisational resilience can be a source of concern – the charity looks to mitigate this with its systems, offering ongoing support to its staff, and competitive pay and working arrangements, with flexibility around how and where work is done. Also, many functions are outsourced, which enables us to effectively augment our skill base. The executive team has worked tirelessly and dynamically to embrace change so that it can continue to deliver our charitable aims and objectives.

Whilst not a key risk for ORUK, we do fear that junior investigators and post-docs may decide to move out of academic research simply because funding becomes ever harder to come by. We have seen a sharp decline in the number of applications from the MSK research community, particularly from orthopaedic surgeons, which is in line with what our other research partners are observing in recent years. We are part of a working group investigating the reasons for this decline, which may reflect current workload pressures within the health system. We also published a report into factors behind

the decline – Where have all the research applicants gone?

Investment policy and objectives

The Board receives quarterly reports from Sarasin & Partners and Rathbones, two investment management companies specialising in the charity field, each of whom handles an investment portfolio on our behalf.

Whilst the investment managers work to various benchmarks and indices, our overarching target for the investment portfolios is a total return of RPI plus 4% per annum on a 3-year rolling basis. Our income target for each fund has previously been around the £320,000 per annum mark. Income received from investments in 23/24 was £620,813 compared to £625,457 in 22/23. Our budget for investment income for 24/25 is for just over £630k across both funds, therefore still not quite at the overall income target level that we would ideally look for. In 23/24 we also looked at fixed term deposit accounts/bonds on the market, achieving a better rate of interest, and in that way topped up our investment income budget – in 23/24 our bank interest received was £38,066 compared to £9,232 in 22/23. We are continuing to monitor savings accounts available to the charity to achieve the best rate possible, particularly as and when our fixed term bonds mature.

The charity has set ethical investment policies for its investment managers, for example, we will not invest in companies trading in tobacco.

Reserves policy

Our reserves policy ensures that we have sufficient funds to cover ongoing commitments and we are able to continue to fund our charitable activities. The trustees review our reserves policy annually and keep the position under careful review at Board meetings to ensure that it evolves with our strategy. Our key income-generating assets are our two properties and our mixed-motive and listed investments (these assets are

marked with an asterisk* in the table on the next page). Maintaining the ‘capital’ value of those assets will be imperative in order to generate sufficient income to sustain our future plans.

After the sale of our trading subsidiary in April 2018, the trustees collectively agreed that the proceeds of the sale should be spent carefully, as this will be the key to enabling us to invest in the long-term, not only in our charitable activities but also in strategic initiatives. We consider that these key assets are effectively ring-fenced to enable us to use the income that is generated from them to support our routine and ongoing running costs. The trustees consider that although there is no legal endowment in place to separate these assets, they should be considered to be endowed and in doing so, the trustees are acting in the spirit of the original intention of the founder of our charity.

At the balance sheet date our designated funds amounted to £28,718,329. Part of this represents our ‘Capital Fund’ [£26,833,829] and our ‘Fabric Fund’ [£250,000]. The remainder represents our ‘Strategy Development Fund’ (SDF) [£1,634,500]. The SDF has been reset at the balance sheet date to the level of our budget for the next financial year for New Research (both academic and non-academic projects) – the SDF encompasses The ORUK Inspiration Fund, The Ronald Furlong Fund, The ORUK Early Career Research Fellowships, and The Joint Partnership Fund. Thanks to monies received from the Medical Research Council for the second year in a row (see our CEO’s message on page 5), we were able to (again) increase our budget for 24/25 for Early Career Researchers, providing key support to this vital sector.

Designations are a choice for the Board and are kept under close review.

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Net assets
Tangible fixed assets		 Unrestricted
£
£20,791		 Designated
(unrestricted)
£
£340,878*		 Totals
£
£361,669
Investments £85 £27,971,036* £27,971,121
Net current assets £953,612 £791,979 £1,745,591
Long-term liabilities – (£385,564) (£385,564)
Total £974,488 £28,718,329 £29,692,817

*these are our key income-generating assets, as referred to on the previous page.

Our free reserves

Our free reserves are identified as £953,697; being £974,488 as calculated above, less £20,791 of tangible fixed assets which are illiquid. Our ongoing target is to hold between £750k and £1m in readily available liquid funds in order to cover the running costs of the charity for 12 months, including cashflow requirements in relation to research grant commitments which are significant. On 31st March 2024, cash in our current accounts amounted to £2.1m and we are therefore satisfied that we are continuing to hit our ‘liquid funds’ target.

Going concern

The financial statements of the charitable company have been prepared on a going concern basis as the trustees have assessed the going concern position and have no reason to believe that there are any material uncertainties that would affect the ability of the charitable company to continue as a going concern for the foreseeable future. In order to plan for future cashflow requirements, the trustees have considered the period covering the next 12 months and have reviewed forecasts for that period in making their assessment.

Plans for future periods

Our work is an investment in the future that will benefit all of us. It will ease the burden on the NHS, reduce workplace sickness and improve the quality of life for millions of people. Pain, immobility, and the resulting isolation are serious issues, but we do not believe they are inevitable. We have outlined earlier in the Trustees Report (on pages 9-10) how our 3-year Strategy guides us and how we have achieved our aims so far. Our Research Strategy for 2024-27 reaffirms our direction of travel over the past few years, which has been based on:

  1. Embracing all aspects of MSK health.

  2. Broadening our remit beyond orthopaedic surgery to include the important surrounding ecosystem of MSK wellbeing, including physiotherapy.

  3. Extending the impact of our investments by partnering with other sources of grant giving.

  4. Supporting the work of MSK researchers (especially Early Careers Researchers) including the direct funding of research projects and salaries.

  5. Opening-up longer-term opportunities and pathways for researchers by helping translate their research ideas into practice/ process improvements or new products and services.

  6. Encouraging junior clinicians to consider a career in MSK research.

  7. Supporting the development of a more equal, diverse and inclusive research culture.

  8. Helping to make the case for increased research investment in MSK conditions.

We continue to expand the portfolio of our education and training events, offering a variety of topics tailored for the MSK community, including academic scientists, orthopaedic surgeons, and physiotherapists. We will be exploring greater use of online, on-demand content, which we believe will both better serve the needs of healthcare professionals (many of whom lack the time to attend faceto-face training events) and generate additional revenue. We will be testing an online learning platform, focusing on an AI for MSK Health training programme.

13

or she will then be invited to attend a trustee meeting at which they can ask any further questions before being appointed as a trustee and member of the board.

Key management personnel remuneration

Key management personnel (KMP) of the charity are considered to be the CEO and the trustees. To set the CEO’s salary, a sub-committee of trustees undertakes research to benchmark average CEO salaries which is then discussed at an appraisal. Details of KMP remuneration is given in note 15 of the accounts.

Risk management

Structure, Governance and Management

Governing document

The charity is controlled by its governing document, a deed of trust, and constitutes a limited company, limited by guarantee, as defined by the Companies Act 2006.

Committees

In addition to the Board of ORUK, there are three sub-committees that oversee the various activities of the charity: ‘Research’, ‘Finance, Investment and Audit’ (FIAC) and a new committee focused on Education. The Research Committee’s responsibility is to ensure the integrity of the charity’s programme of scientific research support and its relevance and importance to people affected by MSK conditions. The FIAC’s responsibility is to help the Board of ORUK Trustees to discharge its fiduciary duties and responsibilities. The Education committee will be shaping our future approach to learning, including the use of new technologies.

Decision making

The Charity has a Board of Trustee Directors who have the requisite skills, knowledge, and experience

to discharge their duties as trustees of this incorporated charitable organisation. Day-to-day management of the charity is delegated to ORUK’s leadership team, as detailed on page 3. At periodic meetings, the trustees agree broad strategic activities including investments, reserves, risk management and grant making. Ongoing performance of the research projects is also reported, as is the performance of the listed investments. The Scientific Advisory Committee (SAC) meets at regular intervals to assist with the review process of our research applications across our available Funds, and to recommend to the Trustees the best projects submitted for funding. The SAC is an independent review panel assessing each project separately to the charity www.oruk.org/about-us/ team/#tab_scientific-advisorycommittee

Induction and training of new trustees

New trustees are recruited either by recommendation or by advertising in relevant publications or media. A potential trustee then meets the trustees to receive a briefing on the Charity’s activities and structure and is given a package of information which includes the agendas and minutes of the Board meetings of the last twelve months. He

The risks to which the charity may be exposed are under regular review, and systems and procedures have been established to address and manage those risks. Our risks and the steps taken to address them are further explained on pages 11 to 12.

Fundraising standards information

Our fundraising practices meet the values and principles of ORUK as an organisation. We are registered with the Fundraising Regulator. The impact of Covid-19 led us to cease our fundraising activities. We do not use external professional fundraisers, nor do we employ the services of any fundraising agencies or third parties. Most of our fundraising during the year related to Trust and Foundations and there is currently only a small amount of public fundraising. We will be reviewing the potential value of a more proactive fundraising effort during the next few months. We have ensured that we meet the criteria set by the GDPR data protection regulations and all other relevant codes of conduct. To ensure that we take all reasonable care to protect vulnerable people, we comply with the guidance set out by the Institute of Fundraising. We received no complaints about our fundraising practices during the period.

14

Trustees’ responsibilities statement

The trustees (who are also directors of Orthopaedic Research UK for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the trustees to prepare financial statements for each financial year. Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the trustees are required to:

The trustees are responsible for keeping adequate accounting records that 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:

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

The Trustees’ Annual Report, incorporating a strategic report, is approved by order of the Board of trustees, as the company directors, on 11 November 2024

and signed on the board’s behalf by:

Adrian Downing Chair of the Board of Trustees

15

Independent Auditor’s Report to the members of Orthopaedic Research UK

Opinion

We have audited the financial statements of Orthopaedic Research UK (the ‘charitable company’) for the year ended 31 March 2024 which comprise the statement of financial activities, balance sheet, statement of cash flows 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 FRS 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 Orthopaedic Research UK’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 trustees’ 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 trustees’ annual 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:

16

Responsibilities of trustees

As explained more fully in the statement of trustees’ responsibilities set out in the trustees’ annual report, 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 extent to which our procedures are capable of detecting irregularities, including fraud are set out below.

Capability of the audit in detecting irregularities

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and noncompliance with laws and regulations, our procedures included the following:

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 noncompliance 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 concealment, forgery, collusion, omission, or misrepresentation.

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

17

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.

Judith Miller (Senior statutory auditor)

Date: 14 November 2024

for and on behalf of Sayer Vincent LLP, Statutory Auditor Invicta House, 110 Golden Lane, London EC1Y 0TG

18

Statement of Financial Activities

(incorporating an income and expenditure account) For the year ended 31 March 2024

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----- Start of picture text -----
CURRENT YEAR
Unrestricted Restricted 31 March 2024 31 March 2023
funds funds Total Total
Note £ £ £ £
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Income from:
Donations and legacies 2 8,609 - 8,609 2,528
Charitable activities 4/30 347,671 849,102 1,196,773 949,259
Investments 3 1,104,404 - 1,104,404 1,107,744
Total income 1,460,684 849,102 2,309,786 2,059,531
Expenditure on:
Raising funds 5 50 - 50 746
Charitable activities 6 1,493,232 586,430 2,079,662 1,716,576
Total expenditure 1,493,282 586,430 2,079,712 1,717,322
Exceptional item
- reversal of brought forward indemnity provision 21 250,000 - 250,000 -
Net income/(expenditure) before gains 217,402 262,672 480,074 1,717,322
Net gains/(losses) on investments 17 1,538,753 - 1,538,753 (2,446,290)
Losses on revaluation of fixed assets 16 (8,792) - (8,792) (96,711)
Net income/(expenditure) 1,747,363 262,672 2,010,035 (2,200,792)
Transfers between funds 24 262,672 (262,672) - -
Net movement in funds 2,010,035 - 2,010,035 (2,200,792)
Reconciliation of funds:
Total funds brought forward 24 27,682,782 - 27,682,782 29,883,574
Total funds carried forward 24 29,692,817 - 29,692,817 27,682,782

All income and expenditure derive from continuing activities. The statement of financial activities includes all gains and losses recognised during the period.

19

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----- Start of picture text -----
PRIOR YEAR
Unrestricted Restricted 31 March 2023
funds funds
Note £ £ Total
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Income from:
Donations and legacies 2 2,528 - 2,528
Charitable activities 4 381,594 567,665 949,259
Investments 3 1,107,744 - 1,107,744
Total income 1,491,866 567,665 2,059,531
Expenditure on:
Raising funds 5 746 - 746
Charitable activities 6 1,445,315 271,261 1,716,576
Total expenditure 1,446,061 271,261 1,717,322
Losses on revaluation of fixed assets 24 (96,711) - (96,711)
Net losses on investments 24 (2,446,290) - (2,446,290)
Net expenditure (2,497,196) 296,404 (2,200,792)
Transfers between funds 24 296,404 (296,404) -
Net movement in funds (2,200,792) - (2,200,792)
Reconciliation of funds:
Total funds brought forward 24 29,883,574 - 29,883,574
Total funds carried forward 24 27,682,782 - 27,682,782

All income and expenditure derive from continuing activities. The statement of financial activities includes all gains and losses recognised during the period.

20

For the year ended 31 March 2024

Balance Sheet

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31 March 2024 31 March 2023
Note Total Total
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Fixed assets
Tangible assets 16 361,669 398,076
Mixed motive investments 17 226,510 219,490
Investments 17 27,744,611 26,572,454
28,332,790 27,190,020
Current assets
Stock 612 919
Debtors 19 143,596 583,723
Short term deposits 255,000 -
Cash at bank and in hand 3,048,412 2,045,570
3,447,620 2,630,212
Creditors: amounts falling due within one year 20 (1,702,029) (1,521,732)
Net current assets 1,745,591 1,108,480
Total assets less current liabilities 30,078,381 28,298,500
Creditors:
amounts falling due after more than one year 22 (385,564) (365,718)
Provisions for liabilities 21 - (250,000)
Net assets 25 29,692,817 27,682,782
Charity Funds
Restricted income funds - -
Unrestricted funds:
General funds 974,488 559,490
Designated funds – capital assets fund 29 26,833,829 25,663,292
Designated funds - fabric fund 29 250,000 250,000
Designated funds – strategy development fund 29 1,634,500 1,210,000
Total charity funds 24 29,692,817 27,682,782

The financial statements were approved and authorised for issue by the Board on 11 November 2024

Signed on behalf of the board of trustees

Mr A Downing, Trustee

The notes on pages 23 to 45 form part of these financial statements

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Statement of Cash Flows

For the year ended 31 March 2024

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31 March 2024 31 March 2023
Note Total Total
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Cash flow from operating activities 26 (190,010) (850,037)
Net cash flow from operating activities (190,010) (850,037)
Cash flow from investing activities
Income from investments 3 620,813 625,457
Rent from investments 3 445,525 473,055
Net interest received 3 38,066 9,232
Purchase of property, plant & equipment 16 (16,128) (3,752)
Purchase of investments less net cash
acquired 17 (1,367,926) (1,585,005)
Receipts from sale of investments 17 1,727,502 1,391,286
Net cash flow from investing activities 1,447,852 910,273
Net increase in cash and cash equivalents 1,257,842 60,236
Cash and cash equivalents at 31 March
2023 2,045,570 1,985,334
Cash and cash equivalents at 31 March
2024		 3,303,412 2,045,570

The notes on pages 23 to 45 form part of these financial statements

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Notes to the Financial Statements

For the year ended 31 March 2024

1. Summary of significant accounting policies

Basis of preparation

Orthopaedic Research UK is a charitable company, limited by guarantee, incorporated in England and Wales. The address of the registered office is given in the charity information on page 3 of these financial statements. The nature of the charity’s operations and principal activities are given on pages 7-8 of these financial statements.

The charity constitutes a public benefit entity as defined by FRS 102 and these financial statements contain information about the charity as an individual body. The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice (SORP) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), the Charities Act 2011, the Companies Act 2006 and UK Generally Accepted Accounting Practice.

The charity has complied with the requirements of FRS 102, and with the provisions of the SORP currently in effect.

The financial statements are prepared on a going concern basis under the historical cost convention, modified to include certain items at fair value. The financial statements are prepared in sterling which is the functional currency of the charity and rounded to the nearest £.

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

In applying the financial reporting framework, the trustees have made a number of subjective judgements, for example in respect of significant accounting estimates. Estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances. The nature of the estimation means the actual outcomes could differ from those estimates. Any significant estimates and judgements affecting those financial statements are detailed within the relevant accounting policy below.

Fund accounting

Unrestricted funds are available for use at the discretion of the trustees in furtherance of the general objectives of the charity and which have not been designated for other purposes.

Designated funds are unrestricted funds earmarked by the trustees for particular purposes.

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the charity for particular purposes.

Income recognition

All incoming resources are included in the Statement of Financial Activities (SoFA) when the charity is legally entitled to the income after any performance conditions have been met, the amount can be measured reliably and it is probable that the income will be received.

Income from educational training and Escape-pain training events is recognised in full in the period in which the event takes place. Income from government grants is recognised as the performance criteria is met.

For donations to be recognised the charity will have been notified of the amounts and the settlement date in writing. If there are conditions attached to the donation and this requires a level of performance before entitlement can be obtained then income is deferred until those conditions are fully met or the fulfilment of those conditions is within the control of the charity and it is probable that they will be fulfilled.

Investment income is earned through holding assets for investment purposes such as shares and property. It includes dividends, interest and rent. Interest income is recognised using the effective interest method and dividend and rent income is recognised as the charity’s right to receive payment is established.

Expenditure recognition

All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Expenditure is recognised where there is a legal or constructive obligation to make payment to third parties, it is probable that the settlement will be required and the amount of the obligation can be measured reliably. It is classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of resources.

All expenditure is recognised inclusive of VAT, where VAT applies. The charity is able to recover some of its VAT under partial exemption, and this VAT recovery is shown as an expenditure line, rather than being offset against the expenditure on which it was incurred.

Grants payable to third parties are within the charitable objectives. Where grants are offered subject to conditions

23

which have not been met at the year-end date, these are noted as a commitment but not accrued as expenditure. Research grants payable are recognised in full, as expenditure with a related liability, from the date on which the grants are awarded and communicated.

Support cost allocation

Support costs are those that assist the work of the charity but do not directly represent charitable activities and include office costs, governance costs and administrative payroll costs. They are incurred directly in support of expenditure on the objects of the charity and include project management. Where support costs cannot be directly attributed to particular headings they have been allocated to the cost of raising funds and expenditure on charitable activities on a basis consistent with use of the resources.

Going concern

The trustees consider that there are no material uncertainties about the charity’s ability to continue as a going concern. The trustees do not consider that there are any sources of estimation uncertainty at the reporting date that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next reporting period.

Tangible fixed assets

Tangible fixed assets are stated at cost (or deemed cost) or valuation less accumulated depreciation and accumulated impairment losses. Cost includes costs directly attributable to making the asset capable of operating as intended. Assets are capitalised where their cost exceeds £1,500.

Freehold property, for which fair value can be measured reliably, is measured at fair value at each reporting date with changes in fair value recognised in ‘net gains/(losses) on revaluation of fixed assets’ in the SoFA. The trustees have adopted a policy of regular revaluation of freehold property, and undertake this professionally once every three years, with informal reviews annually. Freehold property includes the space the charity occupies within its London property. See note 16 for further detail.

Depreciation is provided on all tangible fixed assets, at rates calculated to write off the cost, less estimated residual value, of each asset on a systematic basis over its expected useful life as follows:

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Freehold land not depreciated
Freehold buildings straight line over 50 years
Fixtures and fittings 20%-25% on cost
Computer equipment & website 33 1/3% on cost
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Impairment

Assets not measured at fair value are reviewed for any indication that the asset may be impaired at each balance sheet date. If such indication exists, the recoverable amount of the asset is estimated and compared to the carrying amount. Where the carrying amount exceeds its recoverable amount, an impairment loss is recognised in the SoFA unless the asset is carried at a revalued amount where the impairment loss is a revaluation decrease.

Investment property

Investment properties are measured at fair value at each reporting date with changes in fair value recognised in ‘net gains/(losses) on investments’ in the SoFA. Investment properties are not depreciated. The trustees have adopted a policy of regular revaluation of investment properties, and will undertake this professionally once every three years, with informal reviews annually. Investment properties include the tenant occupied space in the London and Sheffield properties. See note 18 for further detail.

Investments

Investments are recognised initially at fair value which is normally the transaction price excluding transaction costs. Subsequently, they are measured at fair value with changes recognised in ‘net gains/(losses) on investments’ in the SoFA if the shares are publicly traded or their fair value can otherwise be measured reliably. Mixed motive investments are those held to generate a financial return as well as further the charitable objects. These investments are valued at historic cost and reviewed for indicators of impairment at each balance sheet date. Investments in subsidiary undertakings are valued at historic cost and reviewed for impairment.

Stock

Stock is stated at the lower of cost and estimated selling price less costs to complete and sell. In general, cost is determined on a first in first out basis and includes transport and handling costs. Provision is made where necessary for obsolete, slow moving and defective stock.

Debtors and creditors receivable / payable within one year

Debtors and creditors with no stated interest rate and receivable or payable within one year are recorded at transaction price. Any losses arising from impairment are recognised in expenditure.

24

Provisions

Provisions are recognised when the charity has an obligation at the balance sheet date as a result of a past event, it is probable that an outflow of economic benefits will be required in settlement and the amount can be reliably estimated.

Operating leases

Rental charges are charged on a straight line basis over the term of the lease.

Foreign currency

Foreign currency transactions are initially recognised by applying to the foreign currency amount the spot exchange rate between the functional currency and the foreign currency at the date of the transaction.

Employee benefits

When employees have rendered service to the charity, shortterm employee benefits to which the employees are entitled are recognised at the undiscounted amount expected to be paid in exchange for that service.

Tax

The charity is an exempt charity within the meaning of schedule 3 of the Charities Act 2011 and is considered to pass the tests set out in Paragraph 1 Schedule 6 Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes.

Cash and cash equivalents

Cash and cash equivalents include cash in hand and cash deposits with financial institutions (including investment managers) that are readily convertible to known amounts of cash with an insignificant risk of change in value.

Short term deposits

Short term deposits include cash balances that are invested in accounts with a maturity date of between 3 and 12 months.

Financial instruments

The charity only enters into basic financial instrument transactions that result in the recognition of financial assets and liabilities like trade and other accounts receivable and payable, loans from banks and other third parties, loans to related parties and investments in non-puttable ordinary shares.

Pensions

The charity operates a defined contribution plan for the benefit of its employees. Contributions are expensed as they become payable.

Judgements and key sources of estimation uncertainty

The following judgements (apart from those involving estimates) have been made in the process of applying the above accounting policies that have had the most significant effect on amounts recognised in the financial statements:

Indemnity provisions – as part of the sales agreement relating to JRI, there were a number of indemnity provisions in relation to past events of the entity. The trustees undertook a judgement exercise whereby the varying degrees of probability of each provision was assessed and, as a result, a total provision in relation to indemnities of £575,000 was recorded. In 2019, the trustees updated the judgement exercise and concluded that £325,000 of the provision could be released as not required. This amount was released to the SoFA and was shown as an exceptional item. See note 21. The remaining indemnity’s timeframe expired shortly after 31 March 2024 and the amount has been released to the SoFA during the year.

Key sources of estimation uncertainty

The following key sources of estimation uncertainty at the end of the reporting period have a significant risk of causing a material adjustment to the carrying amounts of liabilities within the next financial year:

Spread of rent free period (RFP) - the charity has a longterm commitment on premises. The lease commitment is for 40 years, effective January 2017, with a significant RFP. At the end of the RFP, rent will be charged at market value. The charity is accruing for estimated rent calculated using RPI. In prior years, RPI had not been significant, but at the previous balance sheet date inflation was high resulting in a significant adjustment to the accrued rent during that accounting period. As inflation has dropped in the months leading up to 31 March 2024, an adjustment has been made in the year to reduce the rent accrued in the balance sheet. If inflation should rise again in the next financial year, this estimation may be subject to a material adjustment.

25

2. Donations and legacies

31 March 2024
£		 31 March 2023
£
Donations 8,609 2,528

The donations figure noted above includes both restricted and unrestricted income (where applicable). Unrestricted donations received during the year amounted to £8,609 (2023 - £2,528) and restricted donations received during the year amounted to £nil (2023- £nil).

3. Investment income (unrestricted)

31 March 2024
£		 31 March 2023
£
Rental income 445,525 473,055
Dividends received 620,813 625,457
Bank interest received 38,066 9,232
1,104,404 1,107,744
4. Income from charitable activities
Unrestricted
funds
£		 Restricted
funds
£		 31 March 2024
£		 31 March 2023
£
Medical Research Council grant income
(see note 10) - 769,616 769,616 507,701
Education (training courses) 253,601 - 253,601 284,366
Escape-pain (training courses and grant income
[see note 6]) 92,399 79,486 171,885 155,227
Publishing 1,671 - 1,671 1,965
347,671 849,102 1,196,773 949,259

The income from charitable activities figure noted above includes both restricted and unrestricted income. Unrestricted income received during the year amounted to £347,671 (2023 - £381,594) and restricted income received during the year amounted to £849,102 (2023 - £567,665).

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5. Expenditure on raising funds

31 March 2024
£		 31 March 2023
£
Fundraising costs 50 746

6. Charitable activities costs

Direct &
support costs
£		 Grant funding of
activities 31.3.24
(see note 10)
£		 Totals
£
Promoting best orthopaedic practice through education 530,646 - 530,646
Publishing and sponsorship 66,900 - 66,900
Research into best orthopaedic practice - 1,216,586 1,216,586
Governance costs (note 9) 265,530 - 265,530
863,076 1,216,586 2,079,662

Charitable activities costs above include support cost allocations, which are analysed in note 9.

Investment management costs are included in governance costs and total £25,875 (2023 - £26,395).

Restricted fund costs in relation to ESCAPE-pain grant income amounted to £82,126 (2023 - £59,964) - actual costs in relation to the grant exceed that figure.

Direct &
support costs
£		 Grant funding of
activities 31.3.23
(see note 10)
£		 Totals
£
Promoting best orthopaedic practice through education 565,559 - 565,559
Publishing and sponsorship 45,106 - 45,106
Research into best orthopaedic practice - 811,801 811,801
Governance costs (note 9) 294,110 - 294,110
904,775 811,801 1,716,576

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7. Grants payable

31 March 2024
£		 31 March 2023
£
Research into best orthopaedic practice 1,216,586 811,801
See note 10 for an analysis.

8. Net income/(expenditure)

31 March 2024
£		 31 March 2023
£
Net income/(expenditure) on page 19 is stated after charging/(receiving):
Depreciation - owned assets 42,531 31,660
Foreign currency translation - realised currency losses/(gains) 154 (13,042)

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9. Allocation of support cost

Support cost Research
£		 Promoting
(through education
& advancement of
knowledge)
£		 Fundraising
£		 Governance
£		 31 March 2024
Total
£
Human resources 59,559 24,645 - 121,171 205,375
Premises/insurance 632 262 - 1,286 2,180
Communications & PR 23,682 9,799 - 48,179 81,660
Travel expenses 223 13 - 692 928
Other expenses 24,151 8,346 - 68,393 100,890
Depreciation & loss on disposal 12,686 5,249 - 25,809 43,744
Total 120,933 48,314 - 265,530 434,777

Support costs are allocated to the activities they support based on an apportionment of employees’ time spent on each activity. The costs analysed above are included in charitable activities costs (see note 6).

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----- Start of picture text -----
Support cost Research Promoting Fundraising Governance 31 March 2023
(through education) Total
£ £ £ £ £
----- End of picture text -----

Human resources 60,622 13,990 - 111,918 186,530
Premises/insurance 43,234 9,977 - 79,816 133,027
Communications & PR 13,389 3,076 - 25,128 41,593
Travel expenses 65 8 - 703 776
Other expenses 18,119 4,181 - 57,548 79,848
Depreciation 10,289 2,374 - 18,997 31,660
Total 145,718 33,606 - 294,110 473,434

29

10. Grant making

CURRENT YEAR

==> picture [512 x 32] intentionally omitted <==

----- Start of picture text -----
Name of institution Purpose for which grants made (research) 31 March 2024
£
----- End of picture text -----

Queen Mary University of London JPF - the effect of mental health on knee replacement outcomes 98,725
(QMUL)
Aston University JPF - modelling of the spinal cord for greater understanding of aetiology and 30,000
management of compressive spinal cord pathology
University of Manchester JPF - investigating the biomechanical and functional outcomes of autologous 56,419
chondrocyte implantation
Keele University JPF - big data analyses of the long-term benefits of knee cartilage surgery 55,000
Medtech JPF - MSK Accelerator Programme, supporting early career researchers 125,000
translate their early-stage MedTech innovations
British Hip Society JPF - day case hip replacement in the NHS: a registry-based national cohort 55,000
study
Uni Hospitals of Leicester JPF - surgical treatment of pathological posterior medial meniscal extrusion 30,000
British Orthopaedic Association (BOA) JPF - mesenchymal stromal cells in cartilage regeneration 32,500
BOA JPF - can a novel machine learning algorithm for analysis of pelvic 16,660
radiographs improve the prediction of hip displacement in cerebral palsy?
Northumbria University ECRF - development and feasibility of a digital health intervention to 105,200
encourage exercise maintenance after falls prevention exercise programmes
end
Cardiff University IF - identifying objective measures of sex-specific pain in humans that can be 47,000
used diagnostically to target treatment
University of Birmingham ECRF - torque visuo-motor feedback training: a new way to manage patella 105,300
tendinopathy
Royal Infirmary of Edinburgh IF - development of a diagnostic protocol to aid the investigation and 23,000
management of posterior malleolus ankle fractures
University of Oxford IF - improving wrist injury pathways 45,000
University of Exeter IF - developing a core outcome set for studies of patients sustaining 38,000
periprosthetic femoral fractures
QMUL ECRF - establishing the feasibility of real-world surveillance of orthopaedic 50,000
devices using routinely collected data
University of Cambridge JPF - a precision health approach to osteoarthritis 50,000
University of Reading JPF - machine learning-enabled decision support system to improve early 100,000
detection and referral of rheumatic and MSK diseases
Seed Funding Prizes 4,500
University of Nottingham project underspend (see note below) (3,412)
Newcastle University project underspend (see note below) (1,533)
University of Bristol project underspend (see note below) (13,923)
SWLEOCUB project underspend (see note below) (16,667)
University of Edinburgh project underspend (see note below) (4,336)
Grants to institutions 1,027,433

30

10. Grant making (cont...)

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----- Start of picture text -----
CURRENT YEAR (CONT..)
31 March 2024
£
----- End of picture text -----

Patent fees, Scientific Advisory
Committee costs, research staff costs
and research specific promotion 68,220
Direct costs of grant making 1,095,653
Support costs of grant making
– see note 9 120,933
TOTAL COSTS OF GRANT MAKING 1,216,586

JPF= Joint Partnership Fund ;IF= Inspiration Fund; ECRF= Early-career Research Fellowship

The projects marked with an asterisk (*) above are shown within restricted fund expenditure. During the year the charity received grant monies of £769,616 (2023 - £507,701) from the Medical Research Council to be used to support early-career researchers. Restricted expenditure on research grants during the year amounted to £504,304 (2023 - £211,297) and unrestricted expenditure on research grants during the year amounted to £523,129 (2023 - £439,639).

Occasionally universities, for various reasons, do not spend all the funds that they initially requested to carry out their research activities. There is a provision in the contract signed between the parties that enables ORUK to ask for any ‘underspend’ monies to be returned to the charity. The adjustments above relate to refunds of unspent funds, or credits of agreed funding, where the universities have confirmed that not all of the grant was required.

31

10. Grant making (cont...)

PRIOR YEAR

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----- Start of picture text -----
Name of institution Purpose for which grants made (research) 31 March 2023
£
----- End of picture text -----

Northumbria Healthcare NHS JPF - using an AI system to predict outcomes for surgical patients 55,000
Foundation Trust
Northumbria Healthcare NHS JPF - study of patients undergoing primary hip and knee replacement in the 28,343
Foundation Trust United Kingdom*
Newcastle Upon Tyne NHS Foundation JPF - development of patient cell lines to investigate the pathophysiology of 32,500
Trust osteogenesis imperfecta and the mechanotransduction of these cells during
mechanical strain
University of Cambridge JPF - femoroacetabular impingement and hip osteoarthritis: identifying new 30,000
treatment targets
Manchester Metropolitan University ECRF - development of a 3D ultrasound imaging technique with auto- 108,000
segmentation
Queen Mary University of London IF - defining the pro-nociceptive role of neutrophils in chronic widespread pain 30,000
University College London ECRF - MRI assessment of reinnervated muscle for an ibuprofen trial 110,000
Royal National Orthopaedic Hospital IF - virtual reality plus sensory feedback for the management of chronic 49,954
NHS Trust musculoskeletal pain in adults
King's College Hospital London IF - does small fibre neuropathy predict the development and progression of 50,000
Charcot neuroarthropathy bone and joint destruction (a pilot study)
Staffordshire University IF - evidence based guidelines for the optimal design of rigid ankle-foot 48,000
orthosis
University of Oxford ECRF - reduction of ‘non-specific’ anterior knee pain after total knee 110,000
replacements by the diagnosis of patella mal-tracking using a novel ultrasound
method in the clinic
University College London project underspend (see note below) (354)
Newcastle University project underspend (see note below) (507)
Grants to institutions 650,936
Patent fees, Scientific Advisory
Committee costs and research
specific promotion 15,147
Direct costs of grant making 666,083
Support costs of grant making
– see note 9 145,718
TOTAL COSTS OF GRANT MAKING 811,801

32

11. Auditor’s remuneration

Amounts payable to the auditor for statutory audit services of the charity, excluding VAT, are £14k (2023 - £13k).

Amounts payable to the auditor and its associates for other services (tax advisory) of the charity, excluding VAT, are £nil (2023 - £1k).

12. Trustees’ remuneration and benefits

No trustees received remuneration or benefits from the charity. One trustee, Mr M Gouldstone, is also a director of Novara Therapeutics Ltd - no remuneration or benefits was received for this but travelling expenses of £43 was reimbursed in the year.

At the balance sheet date, there were two ongoing research projects where trustees were involved as collaborators/supervisors - the expenditure on these was recognised in previous years. The trustees involved were Mr K Tucker and Mr M Reed. Collaboration/supervising means being part of the research team, supervising the primary researcher. Neither trustee received any remuneration or benefits in relation to this collaboration work. As outlined in the charity’s Articles, the trustees declared their conflict of interest in relation to these research projects and excused themselves from discussions on both the Scientific Advisory Committee and on the Research Committee.

Trustees’ expenses

Expenses totalling £149 (2023 - £410) were paid to 2 trustees in the year (2023 - 3) by the charity, representing reimbursement of travelling expenditure. In addition, the charity expended £5,617 (2023 - £8,332) on hosting trustee meetings and away-day strategy meetings.

13. Staff costs and employee benefits

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Wages and salaries 400,726 382,224
Social security costs 40,865 38,761
Employer’s contribution to defined contribution pension schemes 34,790 24,779
476,381 445,764

The amount of £476,381 (2023 - £445,764) above includes £131,551 (2023 - £120,157) of employee benefits received by key management personnel, including the CEO, for services to the charity. Key management personnel are defined on page 14.

33

14. Staff costs

The average number of employees, by headcount, in the period was as follows:

2024 (Charity)
Number		 2023 (Charity)
Number
Charitable activities 7 6
Governance 2 2
9 8

The charity pays contributions into a money purchase group personal scheme for the benefit of the employees. The assets of the scheme are administered by trustees in a fund independent from those of the company. Contributions paid into the scheme by the charity in the period were £34,790 (2023 - £24,779). The pension creditor at the period end was £2,555 (2023 - £nil).

The number of employees who received total employee benefits (excluding employer pension costs and employer social security costs but including benefits in kind) of more than £60,000 was as shown in the table below.

2024
Number		 2023
Number
£90,000 - £99,999 - 1
£100,000 - £109,999 1 -

15. Related party transactions

There are no related party transactions other than those disclosed in notes 12 and 13.

34

16. Tangible fixed assets

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----- Start of picture text -----
Freehold land & Fixtures, fittings Totals
buildings & equipment
£ £ £
----- End of picture text -----

COST/VALUATION
At 31 March 2023 491,718 92,711 584,429
Additions - 16,128 16,128
Disposals - (3,356) (3,356)
Revaluations (8,792) - (8,792)
At 31 March 2024 482,926 105,483 588,409
DEPRECIATION
At 31 March 2023 140,412 45,941 186,353
Charge for the year 1,636 40,895 42,531
Disposals - (2,144) (2,144)
At 31 March 2024 142,048 84,692 226,740
NET BOOK VALUE
At 31 March 2024 340,878 20,791 361,669
At 31 March 2023 351,306 46,770 398,076

The freehold building relates to the charity-occupied part of 10a Chandos House in London. This building was acquired in January 2008. The property was recognised at fair value on transition to SORP (FRS 102) using a previous fair value valuation. The building is being depreciated from the FRS 102 transition date of 1/4/14 and has a net book value of £340,878; land is not depreciated. The historic cost equivalent of this asset at net book value is £389,097, and depreciation at historic cost would be £351. The trustees have adopted a policy of regular revaluation of freehold property, and undertake this professionally once every three years, with informal reviews annually. The freehold property was subject to an formal valuation on 31/3/24. The valuation was undertaken by Colliers International Valuation UK LLP, a firm of independent valuers. Further information on property valuations is contained in note 18.

35

17. Fixed asset investments

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----- Start of picture text -----
Unlisted Mixed motive Investment Listed Totals
investments investments properties investments
(18)
£ £ £ £ £
----- End of picture text -----

COST/ MARKET VALUE
At 31 March 2023 85 219,490 7,173,282 19,399,087 26,791,944
Revaluations - - 13,792 1,524,961 1,538,753
Additions - 7,020 - 1,360,906 1,367,926
Disposals - - - (1,727,502) (1,727,502)
At 31 March 2024 85 226,510 7,187,074 20,557,452 27,971,121
NET BOOK VALUE/FAIR VALUE
At 31 March 2024 85 226,510 7,187,074 20,557,452 27,971,121
At 31 March 2023 85 219,490 7,173,282 19,399,087 26,791,944

In addition to the investment management costs which have been disclosed in note 6, one of our fund managers (Sarasin & Partners) charges a range of ongoing, explicit, and implicit charges which have not been presented as expenditure in the accounts. The cost applied is approximately 1% of the average portfolio value which is deemed immaterial to the accounts. Income from investments is shown in note 3. Shares in group undertakings were included at cost less impairment. Investment properties and listed investments are included at market value. This is commented on in more detail in note 18 below. Unlisted investments are included at cost which at the year end is considered to be the equivalent of market value.

The unlisted investment above relates to an 85% shareholding in a subsidiary undertaking, Novara Therapeutics Limited, a company registered in England and Wales under company number 12841228. The subsidiary has been excluded from consolidation as its inclusion is not material for the purpose of giving a true and fair view. The company’s aggregate liabilities at 31/3/24 were £28,818 (2023 £26,934), it had no turnover in the accounting period and its loss for the year was £1,884 (2023 £1,780).

36

17. Fixed asset investments (cont...)

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----- Start of picture text -----
Unlisted Mixed motive Investment Listed Totals
investments investments properties investments
£ £ £ £ £
----- End of picture text -----

COST/ MARKET VALUE
At 31 March 2022 85 209,995 7,946,572 20,887,862 29,044,514
Revaluations - - (773,290) (1,672,999) (2,446,289)
Additions - 9,495 - 1,575,510 1,585,005
Disposals - - - (1,391,286) (1,391,286)
At 31 March 2023 85 219,490 7,173,282 19,399,087 26,791,944
NET BOOK VALUE
At 31 March 2023 85 219,490 7,173,282 19,399,087 26,791,944
At 31 March 2022 85 209,995 7,946,572 20,887,862 29,044,514

18. Investment properties

The charity has two investment properties – the London property is the tenant-occupied part of 10a Chandos House in London and the Sheffield property is in Chapeltown in Sheffield.

The investment properties were last subject to independent, professional valuation as at 31/3/24. The property valuations were undertaken by Colliers International Property Consultants Limited, a firm of independent valuers. Both valuations were carried out in accordance with the requirements of the RICS Valuation - Professional Standards Manual. The historic cost equivalent of these assets is £4,411,349 and £3,498,868 respectively.

The trustees carry out a formal valuation of properties every three years, checking in with valuers in between.

The Sheffield property was valued at £3.825m on a formal valuation basis on 31/3/24.

The London property was valued at £3.845m on a formal valuation basis on 31/3/24. Adjustments for both properties have been reflected in the year.

It remains the trustees’ current intention to hold both properties for the long term.

37

19. Debtors: amounts falling due within one year

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Trade debtors 10,168 476,562
Other debtors 25,948 5,558
Amounts owed by group undertakings 27,480 25,596
Prepayments and accrued income 80,000 76,007
143,596 583,723

20. Creditors: amounts falling due within one year

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Trade creditors 91,159 72,153
Grants payable 1,092,522 864,156
Taxation and social security 28,538 42,487
Other creditors 57,445 44,993
Accruals and deferred income 432,365 497,943
1,702,029 1,521,732

Deferred income includes monies held for courses to be held in the next financial year amounting to £54,300 (2023 - £89,983), and rents invoiced in advance, amounting to £127,619 (2023 - £133,714).

31 March 2024
£		 31 March 2023
£
Balance at the beginning of the period 223,697 179,912
Amount released to income in the period (223,697) (179,912)
Amount deferred in the period 181,919 223,697
Balance at the end of the period 181,919 223,697

38

21. Reconciliation of grant commitments and provisions

Grant commitments at 31 March 2023 31 March 2024
£
1,229,874		 31 March 2023
£
1,039,847
Grants adjusted/charged in the period (note 10) 1,027,433 650,936
Grants paid in the period (779,221) (460,909)
Grant commitments at 31 March 2024 1,478,086 1,229,874
31 March 2024
£		 31 March 2023
£
Provisions at 31 March 2023 250,000 250,000
Indemnity provision released in the period (250,000) -
Provisions at 31 March 2024 - 250,000

As part of the sales agreement relating to JRI, ORUK committed to a number of indemnity provisions relating to past JRI events. The indemnities had specific, but varying, time periods applied. For each of the indemnities, the trustees considered the likelihood of the provision crystallising and concluded that provision in the accounts should be made for those considered most probable. Just after the balance sheet date, and prior to the date of signing these accounts, all time periods applied to the indemnities have expired and the trustees consider that the provisions brought forward from the prior year should be released to the SoFA. More information is supplied in note 27.

22. Creditors: amounts falling due after more than one year

31 March 2024
£		 31 March 2023
£
Grants payable 385,564 365,718

39

23a. Operating lease commitments payable as a lessee

The charity’s total future minimum lease payments under non-cancellable operating leases is as follows for each of the following periods. Lease payments recognised as an expense are shown below in italics:

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Less than one year 3,458 3,458
Two to five years - -
Over five years 487,953 908,028
491,411 911,486
Land and buildings see note 1 included in support cost allocation 487,953 908,028
Other (HR contract) £3,458 included in support cost allocation 3,458 3,458
491,411 911,486

23b. Operating lease commitments receivable as a lessor

Amounts receivable under non-cancellable operating leases are as follows for each of the following periods, and all relate to land and buildings:

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Less than one year 387,641 410,046
Two to five years 562,635 893,216
Over five years - -
950,276 1,303,262

40

24. Fund reconciliation

Balance at
31 March 2023
£		 Income
£		 Expenditure
£		 Transfers
£		 Gains
£		 Balance at 31
March 2024
£
Other charitable funds 27,682,782 1,460,684 (1,493,282) 262,672 1,779,961 29,692,817
Restricted - 849,102 (586,430) (262,672) - -
27,682,782 2,309,786 (2,079,712) - 1,779,961 29,692,817

Of the £29,692,817 of other charitable funds above, £28,718,329 has been identified as being ‘designated’ at the period-end; this is further explained in note 25a and note 29. The purpose of the designated fund is to ring-fence key income-generating assets so that the charity can continue with its charitable activity of investing in research, and to enable the charity to invest in its fundraising plan to realise its vision of ‘pain-free movement for all’.

See note 30 for an analysis of the transfer from restricted to unrestricted funds.

Balance at
31 March 2022
£		 Income
£		 Expenditure
£		 Transfers
£		 Losses
£		 Balance at 31
March 2023
£
Other charitable funds 29,883,574 1,491,866 (1,446,061) 296,404 (2,543,001) 27,682,782
Restricted - 567,665 (271,261) (296,404) - -
29,883,574 2,059,531 (1,717,322) - (2,543,001) 27,682,782

41

25a. Analysis of net assets between funds (current period)

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----- Start of picture text -----
General Designated Restricted Total Funds
£ £ £ £
----- End of picture text -----

Tangible fixed assets 20,791 340,878 - 361,669
Investments 85 27,971,036 - 27,971,121
Net current assets 953,612 740,212 - 1,693,824
Long term liabilities - (385,564) - (385,564)
Provisions - - - -
Net assets at 31 March 2024 974,488 28,666,562 - 29,641,050

25b. Analysis of net assets between funds (prior period)

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----- Start of picture text -----
General Designated Restricted Total Funds
Unrestricted
£ £ £ £
----- End of picture text -----

Tangible fixed assets 46,770 351,306 - 398,076
Investments 85 26,791,859 - 26,791,944
Net current assets 512,635 595,845 - 1,108,480
Long term liabilities - (365,718) - (365,718)
Provisions - (250,000) - (250,000)
Net assets at 31 March 2023 559,490 27,123,292 - 27,682,782

42

26. Reconciliation of net income to net cash flow from operating activities

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----- Start of picture text -----
31 March 2024 31 March 2023
£ £
----- End of picture text -----

Net income for period 2,010,035 (2,200,792)
Dividends received (620,813) (625,457)
Interest receivable (38,066) (9,232)
Depreciation of tangible fixed assets 42,531 31,660
(Gains)/losses on investments and on revaluation of fixed assets (1,779,961) 2,543,001
Reverse indemnity provision 250,000 -
Loss on disposal of tangible fixed assets 1,212 -
Rent from freehold investment property (445,525) (473,055)
Decrease in stock 307 408
Decrease/(increase) in debtors 440,127 (480,504)
(Decrease)/increase in creditors (49,857) 363,934
Net cash flow from operating activities (190,010) (850,037)

Cash and cash equivalents at 31 March 2024 were £3,303,412 (2023 - £2,045,570). This amount is analysed as £3,002,971 (2023 - £2,044,848) of bank balances, £300,441 held by investment houses as ‘cash’ balances available to invest (2023 - £220) and £nil (2023 - £502) of cash.

ANALYSIS OF CHANGES IN NET DEBT

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----- Start of picture text -----
Balance at Cashflows Balance at
31 March 2023 31 March 2024
£ £ £
----- End of picture text -----

Cash 2,045,350 957,621 3,002,971
Cash-equivalents 220 300,221 300,441
Grants falling due within 1 year (864,156) (280,133) (1,144,289)
Grants falling due in more than 1 year (365,718) 31,921 (333,797)
815,696 1,009,630 1,825,326

43

27. Contingent liabilities

As outlined in note 21, in prior periods ORUK committed to a number of indemnity provisions - initially these were provided for within the accounts but as the likelihood of these crystallising reduced, the provisions were reversed. As of the prior balance sheet date, of the four indemnities committed to, three had already fallen outside the time limit restriction, and one remained provided for in the accounts. The remaining indemnity period expired shortly after 31/3/24 and, at the date of signing the accounts, there are no contingent liabilities remaining.

28. Legal status of the charity

The charity is a company limited by guarantee and has no share capital. The liability of each member in the event of winding up is not to exceed £10.

29. Analysis of designated funds

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----- Start of picture text -----
31 March 2024 31 March 2023
An analysis of the funds is given below: £ £
----- End of picture text -----

Strategy Development Fund new research (academic and non-academic) 1,634,500 1,210,000
Fabric Fund ongoing maintenance to Furlong House (grade II listed) 250,000 250,000
Capital Fund to ring fence key income generating assets 26,833,829 25,663,292
28,718,329 27,123,292

Included within the Strategy Development Fund is additional funding to be made available to support early career researchers.

44

30. Analysis of restricted fund

Medical
Research
Council
£		 Innovate
Grant
£		 Total restricted
funds 31.3.24
£
Grant monies received note 4 769,616 79,486 849,102
Grant projects funded in year note 10 (504,304) - (504,304)
Grant expenditure note 6 - (82,126) (82,126)
Transfer from restricted to unrestricted funds note 24 (265,312) 2,640 (262,672)
- - -

The transfer of £265,312 above relates to the monies received from the Medical Research Council - the transfer relates to expenditure incurred in previous years, recognised as per the accounting policy and, at the time, treated as expenditure within unrestricted funds. The funding aims to protect the pipeline of early career researchers (ECRs) and to help support the charity research sector regain it’s pre-COVID levels of research and innovation investment in the UK. It was available to support ECRs and research grants active in FY 2023/24 based in a UK organisation eligible for UKRI research funding - the funding provided through this scheme must be used to support the researchers and projects submitted to the scheme.

The transfer of £2,640 above relates to the grant received from Innovate in relation to the ESCAPE-pain programme - this is expenditure incurred on an Independent Accountants Report that cannot be claimed as part of the grant expenditure and has therefore been treated as expenditure within unrestricted funds. The funding was awarded to a project consortium (of which ESCAPE-pain was a part) looking at a market-demand-led and co-designed solution to transform community gyms and leisure centres into ‘MSK hubs’. This project has the potential to save the NHS >£200m by 2030.

45

Orthopaedic Research UK Furlong House 10a Chandos Street London W1G 9DQ

+44 (0)20 7637 5789 info@oruk.org

www.oruk.org UK Registered Charity No. 1111657