2023-06-30-accounts

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SMILE TRAIN UK ANNUAL REPORT 2022-2023 •SmileTrain

Our Vision �� 2 Susie’s Letter �� 3 Topline Stats �� 4 Our Global Network �� 5 DEIBA �� 6 Standing with Ukraine �� 7 Comprehensive Cleft Care �� 8 Prisca’s Story �� 9 Education and Training �� 10 Community Programs �� 11 Corporate Partners �� 12 Safety & Quality �� 13 �� 14 Staff Spotlight Trustee’s Report �� 16 Independent Auditor’s Report �� 26 Group Statement of Financial Activities �� 29 Group and Parent Charitable Company Balance Sheets �� 30 Group Statement of Cash Flows �� 31 Notes to the Accounts �� 32 Journey Ahead �� 40

2022 -2023 UK Annual Report

OUR VISION

A world where everyone has access to safe, high-quality comprehensive cleft care and is able to live a full and healthy life.

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Smile Train: Cleft Care That’s Always There

Even as much of the world reopened from the COVID-19 pandemic, the past year was a profoundly difficult one for so many. Yet, if you look beyond the headlines, you’ll see that the bad news was not the full story�

At Smile Train, when we think of the year that was, we also think of cleftaffected babies who once might have died from malnutrition who are now thriving. Children who once might have dropped out of school due to constant bullying now confidently raising their hands in class. Parents who once might have abandoned their newborns now eager to raise them. Young adults who once knew nothing but exclusion and depression now looking to a future brimming with possibility.

In all, the lives of more than 108,000 people with clefts in 75+ countries were transformed last year because people like you looked at the world as it is and decided to invest in the power and potential of a child’s smile�

And surgery numbers alone don’t even begin to tell the full story of the global impact for good we made together in fiscal year 2023 (July 1, 2022-June 30, 2023). Thanks to you, we also:

Launched partnerships with 57 surgical centres across 26 countries, including new surgical programmes in Algeria, Barbados, North Macedonia, and Oman.
Inaugurated 73 new non-surgical, comprehensive cleft care programmes in 25 countries, including:
Offering 16 new non-surgical cleft care treatments at 14 different partners in India.
Starting our first cleft nutritional programmes in the Central African Republic, Chad, Madagascar, and Afghanistan.
Establishing our first cleft orthodontics programmes in Togo, the Democratic Republic of the Congo, El Salvador, and the Dominican Republic.
Initiating our first cleft speech treatment programmes in the Central African Republic, Madagascar, Morocco, Thailand, and Ukraine.
Opened a new state-of-the-art Smile Train Cleft Leadership Center in Vietnam�
Jointly published the first-ever State of the World’s Cleft Care Report with the Institute for Health Metrics and Evaluation at the University of Washington (USA), validating that nutritional support is vital to every cleft journey�

None of these accomplishments was easy or inevitable. It is only thanks to the dedication of our global network of partner health professionals and the continued, critical support of people like you that we have emerged from this year of crises stronger and more resilient than ever before.

Yet so much remains to be done. Every day, children continue to suffer needlessly because of a treatable birth difference.

And another child is born with a cleft every three minutes�

If the past three years have taught me anything, it’s that, come what may, our model is strong and nimble enough to reach every child with a cleft with care that is safe, high-quality, comprehensive, and 100% free, performed by local experts who share their culture and know them by name. In fact, with your support, I know we will. That’s the power of cleft care that’s always there. That’s the power of Smile Train.

This report is dedicated to Smile Train’s 2,100+ heroic partners – including healthcare workers, hospitals, nonprofits, and so many others – for the safe and selfless care they provide their communities each and every day.

Susannah Schaefer

President & CEO, Smile Train

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Topline Stats

1.5M[+]

SURGERIES PERFORMED ON PEOPLE OF ALL AGES SINCE OUR FOUNDING IN 1999

EVERY 3 MINUTES ANOTHER BABY IS BORN WITH A CLEFT.

540 BABIES ARE BORN EACH DAY WITH A CLEFT

1,10 ~~0~~[+] PARTNER HOSPITALS

2,100[+] TRAINED MEDICAL PROFESSIONALS

40,000[+] TRAINING OPPORTUNITIES

90[+] COUNTRIES WHERE SMILE TRAIN HAS SPONSORED FREE CLEFT TREATMENT

35 COUNTRIES WHERE SMILE TRAIN OFFERS ESSENTIAL NON-SURGICAL CLEFT CARE SERVICES

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Our Global Network

Map as of January 2023

*Smile Train has provided support for cleft organizations in the U.S. and U.K.

Smile Train, Inc. can accept donations worldwide and has fundraising programs in Brazil, Germany, India, Indonesia, Mexico, Philippines, U.A.E., U.K. and U.S.

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DEIBA

Diversity, Equity, Inclusion, Belonging, and Accessibility (DEIBA)

At Smile Train, diversity, equity, inclusion, belonging, and accessibility (DEIBA) have always been at the heart of our model. From our founding, we have believed that actively and thoughtfully centring DEIBA principles – leveraging diverse skills and perspectives, treating everyone with respect, creating equitable opportunities for growth and development – in all that we do is not only right, it is true to all that we are and all that we strive to be� DEIBA makes us a stronger, more effective organisation.

DEIBA is also a continuous journey, and we are committed to doing it thoughtfully.

To more fully live our values, Smile Train is directly involving staff across more than a dozen countries in crafting policies and practices around things like how we do our work, how we operationalise DEIBA, and how

we position ourselves to bolster talent management and workforce capacity. These contributions, in turn, also strengthen our sustainable model of making world-class, life-changing cleft care accessible to all who need it, no matter what�

DEIBA highlight: Simulare Medical, a Division of Smile Train

By late 2021, a year after acquiring Simulare Medical, we had sent more than 1,000 of their premier cleft lip and cleft palate simulator models around the world�

One piece of feedback was consistent: These don’t look like my patients.

It was true: Every simulator was the colour of a Caucasian baby’s skin. That was not acceptable.

So, we got straight to work to make them better. With help from experts at The Hospital for Sick Children in Toronto, our team searched for a skin tone that all of our patients and partners could see themselves in�

After considering 20 variations, the Simulare Medical team and board members selected the tone that was determined to be the most inclusive�

The revised simulators have met with global applause. After seeing them at a conference in Namibia, one local surgeon even tweeted: “Afroskin models! Such little details speak a lot to the inclusion of Afro skin in medical illustrations and simulations!”

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Standing with Ukraine

“One day, when I was walking to the hospital to work, I saw a rocket hit one of the buildings in front of me. I had to take a different route, but I still went to work that day.”

At Smile Train, the courage and selflessness every one of our more than 2,100 partner health workers in 75+ countries brings to their work each day is our constant inspiration� But over the past year, the manifest heroism of our Ukrainian partners deserves special recognition.

We have been partnering with Dr Natalia Tetruieva and the cleft team at OHMATDIT, Ukraine’s national children’s hospital in Kyiv, since 2008. When Russia invaded in February 2022, the entire staff, including the cleft team, immediately pivoted to healing the wounded and treating weapon trauma, often sleeping in the hospital to meet the unrelenting need.

Since the start of the war, Smile Train has funded essential medical services for our Ukrainian partner hospitals, including:

Critical medications and consumable supplies for cleft surgeries.
Meals and transportation for the cleft team and cleft patients�
Essential medications and consumable supplies for wounded Ukrainians.
Food and lodging for patients and their families�

As the war rages on, life has not gotten any easier for Dr Tetruieva or her team. But their resolve, like that of their compatriots, has not waned� She and her staff continue to walk to the hospital each day to bring smiles to children from all areas of Ukraine amid incessant rocket fire and power outages.

“The support of the international community is very important for us. It is crucial for us to know that we are not alone in this fight. When we win, united as we are as a nation now, we will restore and rebuild our country that we are so proud of.”

Dr Natalia Tetruieva

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Comprehensive Cleft Care

Smile Train knows that truly healing from a cleft requires a holistic process that is as unique as each patient.

That’s why the secret to our model’s success is that it is really a promise: We will be there for you no matter what� We will strive to provide you with the nutritional support you need to reach a healthy weight and thrive. Once you reach it, a local, wellequipped team will perform the cleft surgery – or surgeries – that will change your life forever. After surgery, we will work to provide you with speech therapy, dental treatment, and orthodontics for as long as you need to communicate clearly and smile your brightest. Our model is ultimately a promise that, whatever the need, Smile Train will be there to meet it with the safest, highest-quality care possible because our donors know that children with clefts deserve no less.

Writing the Book on Clefts and Nutrition

Listening to the needs of our patients and their caregivers has always been at the heart of our work. Patients’ mothers are always telling our local staff that the free, continuous nutritional support we sponsor at our partner centres is the reason their child is healthy enough for cleft surgery. That it has saved their life.

Yet, shockingly, the relationship between malnutrition and clefts has never been scientifically examined on a global level. Until now.

In honour of World Smile Day® 7 October, Smile Train partnered with the Institute for Health Metrics and Evaluation (IHME) at the University of Washington to produce a landmark, first-of-itskind research study: A Generation Lost: The Devastating Effect of Malnutrition on Children with Clefts.

We now can say with certainty:

Babies with clefts are twice as likely to suffer severe malnutrition as those without
200,000+ children with clefts are dangerously underweight
Between 2000 and 2020, more than 46,000 children with clefts died from malnutrition before their fifth birthday

“Societies and the global community continue to fail the most disadvantaged children. Our findings should be a wake-up call for initiatives that promote feeding and nutrition care for infants with clefts from the time of birth.”

Dr Barbara Delage, Director, Global Nutrition Programs, Smile Train

These findings are not acceptable,

and we are already taking action to ensure that the next 20 years will not be like the last. Together with our local partners, we are on the ground across five continents building a grassroots movement to speak out and speak up for those in need and deliver resources and training where they are needed most�

It’s already saving children’s lives. Like Prisca from Tanzania.

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Prisca’s Story

When Prisca was born, her family was shocked; they had never seen anyone with a cleft before� The hole in her mouth made it impossible for her mother, Regina, to breastfeed her�

The family lives in a region so remote that the closest village is a two-hour walk away. So, one day after giving birth, Regina walked for hours with her newborn to get her to the nearest hospital. There, she learned how to express milk and feed Prisca by cup. The doctor recommended surgery, but the cost put it far, far out of reach�

Meanwhile, Prisca struggled to eat even with the doctor’s help� At four months old, she weighed just four kilos. And rather than help, the neighbours spat myths and blame at both of them each time they stepped outside. It got so bad that Regina was afraid to leave the house, but she had no choice – her baby was wasting away and would die if she didn’t get help fast. Mustering all her courage, she took Prisca out to seek care.

Every head turned, every eye glared, every mouth laughed. Except for one, whose voice rose above the rest. It belonged to a village government official, who told Regina her baby could receive all the cleft care she would ever need for free at Bugando Medical Centre (BMC), a Smile Train partner in the city of Mwanza, Tanzania. That very moment, the family put their baby on a bike and pedalled for more than an hour to the nearest town centre, where they boarded a bus and rode for four hours to catch a ferry to Mwanza.

It is not safe to perform surgery on an underweight baby, so the hospital staff enrolled Prisca in BMC’s Smile Train-supported cleft nutrition programme and kept her for monitoring. Regina stayed by her side the whole time�

One week went by, then another. Slowly, Prisca’s cheeks got chubbier; her eyes regained the spark of life. After three weeks of constant attention and care, Prisca gained two kilos! At last, she was ready for the cleft surgery that would save her life�

Regina couldn’t sit still for one moment while Prisca was in surgery. She had to be reminded even to breathe�

But once she saw her child’s smile for the first time, all the anxiety of the last four months washed out in tears of pure joy.

Prisca can now eat, smile, and grow just like every other child in her village. And when the neighbours look at her these days, they see only a miracle�

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Education and Training

With Smile Train, talented, passionate health professionals from historically marginalised regions are bringing cuttingedge medical techniques to their communities… and training their peers. This self-sustaining, global ecosystem of empowerment is saving countless lives each day, and you make it possible.

Smile Train COSECSA Scholars Graduate at the Top of Their Class: In December, Smile Train congratulated seven new graduates of the plastic surgery training scholarship programme we sponsor in conjunction with the College of Surgeons of East, Central, and South Africa (COSECSA). Two Smile Train scholars were named the best in their respective disciplines: paediatric surgeon Dr Martha Mukonka and Dr Francoise Mkagaju — who became Rwanda’s first female plastic surgeon!

The fellows now head back to their home countries — Rwanda, Uganda, Ethiopia, and Zambia — to serve in a charitable cleft surgery programme for at least three years�

Through this five-year programme, Smile Train aims to improve surgical capacity in sub-Saharan Africa by sponsoring scholarships for aspiring plastic and paediatric surgeons in COSECSA’s training programme.

Bringing Local Representation to the Latin American Cranio-Facial Association (LATICFA) Congress: In October, Smile Train was honoured to convene 317 partners from 26 countries in Mexico as cosponsor and co-host of LATICFA Congress IV, Latin America’s premier cleft conference� As in Edinburgh, our partners stole the show, contributing 167 accepted abstracts — 70 of which were published in the Journal of Craniofacial Surgery—LATICFA Special Edition. We also sponsored a Simulare Medical Cleft Lip workshop for 20 surgeons and a concurrent Simulare Medical Cleft Palate workshop for 19 partners� True to our model, each of our partners left committed to implementing at least two learnings from the conference with their cleft teams back home.

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Community Programmes

Community means knowing you are never alone.

It’s an irony tragic as it is unnecessary. Though everyone with a cleft has their own, unique experience, if there’s one thing that unites nearly every cleftaffected person from the Great Wall to Stonehenge, it’s that, at some point or another, they have all felt alone�

Yet, more than 5 million people are living with an untreated cleft. Another baby with a cleft is born every three minutes� That’s a lot of people who might understand; a lot of people yearning to connect. They just need a way�

Enter Smile Train�

Every day since our founding, Smile Train has sought to bring people affected by clefts together in partnership and pride� For more than two decades, we have witnessed people who grew up never speaking about the way they were born become outspoken ambassadors for the cleft community, helping empower a whole new generation to grow up #CleftProud.

In July, Smile Train bought together 200+ medical partners from 46+ countries to Edinburgh for the world’s largest cleft conference� and research in multidisciplinary areas of cleft care ranging from surgery to nutrition to technological advances in education and training.

Smile Train UK’s Cleft Community Advisory Council members continued to support in raising awareness of clefts, with Council members sharing powerful words and experiences that shaped their unique cleft journeys during the

conference and through a variety of campaigns, including World Smile Day® and Cleft Awareness Week

“Whilst trekking with the team of porters that supported us, I was able to talk to them about the work Smile Train does and share before-and-after pictures of children that we have helped.

Our Team EMPOWER participants once again turned their miles into smiles at events up and down the country, as well as overseas, taking on marathons, cycles, swims, and even a trek up to Everest Base Camp, bringing the word of Smile Train along with them and raising funds to help provide free cleft treatment to children around the world�

As these porters live remotely in the mountains, they can act as our eyes and ears to find children that may need our help, so spreading the word with them is a great outreach opportunity..”

Support. Friendship. Inspiration. A lifeline. That’s the life-affirming power of community. And thanks to you, that’s what we were able to provide the UK and global cleft communities in this fiscal year like never before�

Sue Maughan, CCAC UK member following her fundraising trek to Peru.

“Smile Train has always been a charity I have a lot of time and respect for. Having been through the journey myself, I admire the work they do and the number of children and families that they support.”

Ryan Crane, who completed three marathons in three weeks for Smile Train UK

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After only one year of partnership, we’ve already:

Corporate Partners

Smile Train is proud to partner with businesses large and small across the globe who share our commitment to healthcare, sustainability, and smiles.

“Dentsply Sirona has already proven to be an invaluable thought partner in scaling high-quality, comprehensive cleft treatment all over the world. We look forward to many more years ahead of making smiles and advancing with confidence together with their team.”

In September 2021, we launched a five-year partnership with Dentsply Sirona, the world’s largest manufacturer of professional dental products and technologies, to improve oral health globally and build a brighter, more sustainable future for cleft-affected children and families worldwide.

Dr Monica Dominguez Director, Oral Health Programs

Supported the development of global treatment standards and best practices for digitalised cleft care
Leveraged digital technologies to make treatments safer, more efficient and convenient for children
Provided high-quality equipment to develop state-of-the-art centres for cleft treatment
Made Dentsply Sirona’s entire online catalogue of clinical education courses available to all Smile Train oral health professionals
Brought Smile Train partners to the annual DS World conference to network, participate in clinical education sessions, and learn the latest innovations in digital dentistry
Sponsored more than 2,700 life-changing cleft surgeries in 11 countries

Their $5 million USD financial contribution is providing highvisibility opportunities, elevating the level of care at several Smile Train partners through clinical education access and in-kind support, and generating even more donations through employee giving campaigns and public fundraisers�

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saving lives. In late 2022 and early 2023, Team Cleft workshops were piloted in Uganda, Kenya, and Ethiopia with at least 55 surgeons, anaesthesiologists, and nurses trained. The scope of the training will expand to 12 cities in Africa, Southeast Asia, and India with at least 250 clinicians trained by late April 2024.

Safety & Quality

Every Child Deserves Safe Surgery Every Time

Just imagine: The routine cleft surgery that should have saved your baby’s life irrevocably harms it due to lack of equipment, electricity, training, or other imminently avoidable issue� This is never acceptable, and it’s why safety and quality (S&Q) is always Smile Train’s number-one priority.

The reason Smile Train can enable the safest possible surgery for every child, every time is the same reason we have been able to sponsor more cleft surgeries than every other cleft-focused organisation combined: Our model of empowering local experts, as our safety and quality highlights from the past year make clear.

Team Cleft with Lifebox: Effective communication in the operating room is one of the most important non-technical skills cleft teams can have, yet it has historically also been one of the most overlooked, until now� In partnership with the Lifebox Foundation, we developed Team Cleft, a firstof-its-kind course that trains surgical teams to communicate like just that — teams: different specialists uniting to achieve a shared goal of creating smiles and

Smile Train-Lifebox Safe Surgery and Anesthesia Initiative: In many parts of the world, inadequate monitoring for patients under anaesthesia is one of the most severe impediments to safe surgery, sometimes leading to catastrophic outcomes� To address this challenge, Smile Train and Lifebox have put ourselves at the forefront of distributing and training on robust and costeffective pulse oximeters and capnographs — two of the most important basic anaesthesia monitoring tools, yet also some of the scarcest in underdeveloped regions. These lifesaving devices will improve the outcomes for not only children with clefts, but all people undergoing surgery at our partner hospitals�

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Staff Spotlight

Dr Elizabeth Igaga: 100,000+ Cleft

Surgeries a Year; One Uncompromising Standard of Excellence

Based in Kampala, Uganda, Dr Elizabeth Igaga is Smile Train’s global Director of Safety and Quality (S&Q). In this role, she ensures that every one of the 100,000+ cleft surgeries Smile Train sponsors each year meets the same rigorous standards of safety and quality. We caught up with her to discuss her path to this role, her vision for the future of global surgery, and much more.

What made you want to be a doctor and how did you pursue this goal?

We had many challenges growing up, but my dad made sure we went to good schools. I gravitated towards the sciences and ended up in medicine. Medical school in Uganda is a five-year course, and in the last two years, you get to try different disciplines. I did great in all of them, but nothing felt like home until I tried anaesthesia� As it happens, my university was also trying to recruit doctors to study anaesthesiology at that time, because there were only about 40 of them in a country of 40 million.

During my training, I took Safer Anaesthesia from Education (SAFE) courses that opened my mind to the world of advocacy and implementing safe surgical practices� Sometime later, I was delighted to receive an offer to do this work alongside auditors and reviewers� This experience narrowed my focus

to perioperative safety; I went around assessing the quality of anaesthesia care being offered at Smile Train partner hospitals in Uganda and other parts of Africa, and doing whatever I could to make it even safer.

What are the stakes of your role, for Smile Train as for our patients and partners?

The stakes are high. Smile Train has already proven that we’re able to train healthcare workers in countries with minimal resources� I believe that, by working through our model, we have the capacity to likewise create an environment that will ensure every surgery we sponsor is safe and of the highest quality. So, my work is about ensuring the safety and quality of care provided to all Smile Train patients by building on the work we’re already doing. It’s about making sure that if anything goes wrong, the cleft team members are adequately trained and equipped to respond�

Why is it beneficial that our Director of Safety and Quality live close to our programmes instead of in the US or UK?

I think it is important for contextualising our partners’ work and for diversifying ideas. I know a lot more about working in an OR in a low- and middle-income country than someone who has never been in a situation where they haven’t always had all the tools they need right at hand.

It’s also important for me to show little girls here that it is possible. I think if you told 19-year-old me that I would be this role someday, I wouldn’t have believed you. But it’s possible and we’re able to do it. We’re no different. Yes, we have challenges with resources sometimes, but we’re able to do jobs like mine and we’re able to advocate for S&Q.

From your perspective, why does Smile Train’s model of local partnership and investment matter?

Smile Train’s model matters

“We had many challenges growing up, but my dad made sure we went to good schools. I gravitated towards the sciences and ended up in medicine. Medical school in Uganda is a five-year course, and in the last two years, you get to try different disciplines. I did great in all of them, but nothing felt like home until I tried anaesthesia �”

Dr Elizabeth Igaga

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because it causes a ripple effect. You train one person, that person goes on to train two more, who then go on to train more, and so you’re able to create a bigger network in less time and reach more people in a more efficient manner� It also allows you to leave the skills with the people you are training. With a mission-trip-based model, someone does surgery, stays for a week, then goes away. Unfortunately, when a child then develops a complication, no one knows what to do.

That’s why building local capacity is so important� Smile Train helps build local resources — instead of flying people in, we’re investing that funding into training local teams and making sure they have the resources that they need to treat patients safely� The impact is exponential.

What S&Q issues are you addressing?

One recurrent issue is that governments are not prioritising surgery. It was only recently that the World Health Organization recognised surgery as an important part of primary healthcare�

The late Dr Paul Farmer, a founder of Partners in Health, dubbed surgery as the “forgotten stepchild of global health.” Surgery isn’t prioritised in policymaking, and as such, the infrastructure, training, and human resources that could potentially be channelled towards ensuring safe surgery for all are diverted towards other pressing needs. We also just don’t have enough people doing this work. The Lancet Commission on Global Surgery recommended increasing the surgical workforce density to 20 surgical, anaesthetic, and obstetric providers per 100,000 people in developing countries by 2030. This goal is a far cry from current reality�

Malnutrition is another major issue. Children with clefts often have lots of trouble feeding adequately. We’re working with our nutrition specialists to ensure all cleft teams can assess each patient’s nutrition

and provide additional support to those who are malnourished before they have their surgery.

What changes have you seen at our partners since you started in this role?

I haven’t been here long, but I’ve already seen the beginnings of a culture shift. Different specialists are working more as a team, taking collective responsibility for each patient. I’m also seeing the creation of a culture of safety� Partners feel safe talking to Smile Train because they know we are here to walk together with them on this important journey towards providing the absolute safest, highest-quality treatment for all people with clefts. That makes me happy — I wanted to be part of creating a space where people feel comfortable reaching out when they need help�

How does what we do for cleft care help improve other services at our partner hospitals?

The standards of safety that we set are not just for children with clefts� Yes, Smile Train is a cleft charity and we only fund cleft care, but we work with partners who are treating all patients. So, when an anaesthesiologist is trained, they aren’t just going to take care of the children with clefts, they’re also going to take care of all children.

It’s the same with equipment.

Smile Train supports our partners with grants to buy and train their staff to use the latest medical equipment needed for cleft care, but once it’s in the OR, it’s there to benefit everybody. Everything that we do for our partners eventually benefits every patient. So, while we are trying to solve one medical issue, we are also solving a bigger problem — universal safe surgery. It’s the same for nutrition and other aspects of care: if we’re training nutritionists to help children with clefts, they’re going to apply those learnings to other children. I think it’s very important to impact the world even beyond clefts�

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THE SMILE TRAIN UK TRUSTEES’ REPORT AND ACCOUNTS FOR THE YEAR ENDED 30 JUNE 2023

Charity Registration No. 1114748 Company Registration No. 05738962 (England and Wales)

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THE SMILE TRAIN UK LEGAL AND ADMINISTRATIVE INFORMATION

Trustees

S Schaefer E F Monopoli R Reichbach T Poliakova S Dransfield K Spindler M Wenham M Wood-Williams

Key Management personnel

Director, Head of Individual Giving and Smile Train’s CEO and CFO

Secretary

BWB Secretarial Limited 10 Queen Street Place London EC4R 1BE

Charity number

1114748

Company number

05738962

Principal address

30 Stamford Street London SE1 9LQ

Registered office

C/O Bates Wells & Braithwaite London LLP 10 Queen Street Place London EC4R 1BE

Auditor

Crowe U.K. LLP 55 Ludgate Hill London, EC4M 7JW

Bankers

HSBC Plc 60 Queen Victoria Street London EC4N 4TR

Solicitors

Bates Wells & Braithwaite London LLP 10 Queen Street Place London EC4R 1BE

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THE SMILE TRAIN UK TRUSTEES’ REPORT FOR THE YEAR ENDED 30 JUNE 2023

The Trustees, who are also the directors of The Smile Train UK (“the Charity”) for the purposes of company law, submit their annual report and the audited consolidated financial statements for the year ended 30 June 2023. Its subsidiary undertaking, The Smile Train UK Trading Company Limited, was incorporated on 20 June 2014. The company is wholly owned and the Trustees’ report and accounts have been prepared for the Group.

The Trustees confirm that the annual report and consolidated financial statements have been prepared in accordance with the accounting policies set out in note 1 to the financial statements and comply with the Charity’s Memorandum and Articles of Association, the Companies Act 2006 and Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015).

The Trustees’ report is also the directors’ report required by s417 of the Companies Act 2006.

Structure, governance and management

Management of the Charity

The Board of Trustees (which has a minimum of three) is the body responsible for the management of the Charity. The Board meets periodically as needed and aims to meet quarterly each year. Implementation of the day to day activities of the Charity during the fiscal year was undertaken by I Vallance (Director), S Selby (Head of Individual Giving, Development), S Schaefer (CEO) and B Gonzalez (CFO until 30 June 2023). S Schaefer and B Gonzalez are employees of Smile Train, Inc. (‘Smile Train’) and neither of these two receive any remuneration from the Charity for this work. S Schaefer and R Reichbach, directors of Smile Train, Inc., were also Trustees of the Charity and receive no remuneration from the Charity. In addition, during the year there were six Trustees who are not on the Board of Smile Train, Inc. nor are they paid employees or consultants of Smile Train, Inc. This governance arrangement is in accordance with the Articles of Association of the Charity. All major and strategic decisions regarding the Charity are approved by the Charity’s Board of Trustees�

Smile Train, Inc. is a US-based non-profit organisation headquartered in New York City. Its offices are located at 633 Third Avenue, New York, NY 10017. Smile Train, Inc. and the Charity are dedicated to helping children worldwide who are born with cleft lips and palates. This is stated in the Charity’s objects. Smile Train, Inc. has charitable affiliates operating in Brazil, Canada, Germany, India, Indonesia, Mexico and Philippines. Smile Train, Inc. and the Charity share common goals, objectives and a management team. The Charity benefits from a number of donated services from Smile Train, Inc., including the time of Smile Train, Inc. employees, for which the Charity is not charged. Further details of these donated services are provided in Note 5 of the financial statements.

Smile Train, Inc� is the sole company law member of the Charity� The Charity is therefore a subsidiary of Smile Train, Inc. although the Board of Trustees of the Charity are responsible for its day to day management and ensuring it furthers its charitable purposes. Smile Train, Inc. is controlled by a Board of Directors who has nominated R Reichbach, a Director of Smile Train, Inc., as their authorised representative for all dealings with the Charity as sole member.

Governing document

The Charity is a charitable company limited by guarantee and is governed by its Memorandum and Articles of Association, as amended by special resolutions dated 23 March 2006, 29 August 2012, and 11 October 2013.

Smile Train agrees to contribute £1 in the event of the Charity winding up.

The Charity is a registered charity with the Charity Commission (Charity registration no. 1114748).

2022 -2023 UK Annual Report

Since the issuance of the updated Charity Governance Code in July 2017, the Charity has utilised the Code as a support tool for the Trustees to reflect upon its current governance structures and consider the ways in which the Charity and its Trustees currently apply the Charity Governance Code’s seven principles and recommended practice�

The Charity already applies a considerable number of the recommended practices, where applicable, relating to each of the Charity Governance Code’s seven principles and is committed to further improvement of the Charity’s governance standards to increase its overall effectiveness as an organisation. With our Trustees, we have ensured we are substantially compliant with the code. The following are areas where we have not applied the code’s provisions, and deemed unnecessary, considering the small size of its board of trustees:

The code recommends that the board have a vice-chair or similar who provides a sounding board for the chair and serves as an intermediary for the other trustees�
The code recommends that the Charity consider using a nominations committee to lead the board appointment process and to make recommendations to the board.

Appointment and election of Trustees

Trustees shall be appointed by resolution of the sole member for a renewable term of three years�

None of the Trustees has any beneficial interest in the Charity and none is a member of the Charity.

The Trustees, who are also the directors for the purpose of company law, and who served during the year were:

S Schaefer E F Monopoli R Reichbach T Poliakova S Dransfield K Spindler M Wenham M Wood-Williams

Induction and training of Trustees

Once appointed, Trustees are briefed on their legal obligations under charity and company law, provided with a copy of the Memorandum and Articles of Association of the Charity and the current budget and updated on the business plan and recent financial performance of the Charity. Trustees are encouraged to attend appropriate external training events where these will facilitate the undertaking of their role.

Risk management

We are committed to identifying, monitoring and managing the risks that might adversely affect the activities in which we are involved. In this context, risk is defined as the potential to fail to achieve the Charity’s objectives and for loss, financial and reputational, inherent in the environment in which we operate and in the nature of the transactions undertaken.

There has been in place throughout the year an on-going process for identifying, evaluating and managing the significant risks faced by the Charity, which has been regularly reviewed by the Trustees. Appropriate actions have been put in place to mitigate the exposure to and the consequences of these risks.

The principal risks facing the Group are threats to income in the form of internal or external factors affecting fundraising efforts. The Charity considers internal operational risks such as its ability to accurately capture Gift Aid declarations, reliance on external vendors to deliver on contracted services, and the consistent functioning of its donor database. These risks are considered regularly at meetings by Management and the Trustees so internal controls and assurances can be established and monitored. For example, to ensure timely and proper Gift Aid declarations, the Charity has developed a capture, reporting and claims process that is reviewed annually by the Trustees, the auditors and an external Gift Aid vendor. Additionally, the Charity performs periodic due diligence on its critical vendors to ensure they are delivering on their services and that their business continuity plans are sound in the event of a service failure�

2022 -2023 UK Annual Report

External risk factors considered by the Charity are the effects of changing privacy laws on its ability to maintain fundraising levels. The Charity mitigates these risks by continuing to monitor new developments and diversify its fundraising.

Safeguarding

We recognize that, in the course of our charitable activities, Smile Train and its partner’s may come into contact with people who may be at increased risk of abuse and/or exploitation, particularly children and those living in poverty. We are committed to safeguarding children and vulnerable adults and ensuring that their rights to protection are realized. We believe that it is always unacceptable for a child or vulnerable adult to experience abuse of any kind and we recognize our duties of care to all children and vulnerable adults where our operations necessitate contact with them and/or have an impact on them�

To this end, Smile Train has implemented a global safeguarding policy that details out individuals’ responsibilities to safeguard children and vulnerable adults and the proper reporting and investigation procedures. The policy provides guidance on how Smile Train’s staff and partners should interact with children and vulnerable adults and how to recognize signs of abuse. Smile Train’s commitment to safeguarding begins with the safe recruitment, selection and vetting of staff and trustees which is also detailed in its policy�

Objectives and activities

As stated in the Memorandum and Articles of Association, the objects of the Charity are:

to relieve the suffering of children with cleft lips or palates or both;
to advance the education and training of the public, including doctors, nurses and medical support staff in all matters relating to cleft lip and palate surgery and treatment and the support of those with this condition; and
to promote research into and the knowledge and study of the cause, improvement and application of treatments, cures and other medicinal agents, methods and processes that may relieve the suffering of those with cleft lips and palates.

The Trustees have paid due regard to guidance on public benefit issued by the Charity Commission in deciding what activities the Charity should undertake and believe that in reading the Trustees’ report in totality, any reader would be satisfied the objects of the Charity have been achieved through the performance of the various worthwhile causes.

These objectives are achieved through on-going direct mail and advertising campaigns used to advance the education of the public and raise awareness of cleft lips and palates. These campaigns are also targeted at raising donations within the UK. The Charity uses the income received from these donations and other sources, net of related expenses, to fund cleft lip and palate treatment in countries around the world, by granting funds to Smile Train who has the infrastructure in place to directly carry out the Charity’s objectives. Smile Train supports free cleft surgery and comprehensive cleft care to children in developing countries. Through training local doctors and empowering partner hospitals around the world, Smile Train advances a sustainable solution and scalable model to treat clefts, drastically improving children’s lives, including their ability to eat, breathe, and speak over time. There are many children living with untreated clefts who do not have access to proper treatment�

To support our important work, the Charity will focus on three strategic goals over the next few years. The priority will be to grow and diversify fundraising in the areas of individual giving, trusts and legacies, corporate giving and events. In order to support this fundraising growth, the Charity will maintain and evolve effective governance and focus efforts on increasing brand awareness for the Charity as well as around cleft�

Throughout the year staff employed by Smile Train provide management and operational services to the Charity, along with various marketing and administrative services. These services are not paid for by the Charity. The value of these donated services is £473,509 (2022: £467,282) and this has been included within the Group Statement of Financial Activities.

2022 -2023 UK Annual Report

Achievements and performance

During the year the Charity paid £4,100,000 (2022: £6,500,000) in programme activities cost (see Note 5). The Charity granted these funds to Smile Train to fund cleft lip and palate treatment in countries in need around the world�

Through its public education and awareness initiatives the Charity believes it has reached millions of households in the UK and has successfully brought attention to the cause of cleft lip and palate, help to prevent clefts, how to repair clefts and the prevalence of this birth defect in developing countries. The Charity benefits from its relationship with Smile Train by leveraging management, operational support and administration as well as its contractual relationships with Smile Train partner hospitals. The Charity grants funds to Smile Train for cleft treatment primarily in Bangladesh, Cambodia, Pakistan and Vietnam.

We have referred to Smile Train’s treatment programmes in Bangladesh, Cambodia, Pakistan and Vietnam but Smile Train undertakes a number of other activities. Below are examples of some of the work undertaken by Smile Train around the world, which is in part funded by grants received from the Charity. More information along with the Smile Train, Inc. and Affiliates Combined Audited Financial Statements and the annual report can be found on Smile Train’s website www.smiletrain.org.

Surgeries Performed

The Charity funded approximately 10,200 (2022: 17,911) free cleft surgeries through Smile Train partner hospitals for children primarily in Bangladesh, Cambodia, Pakistan and Vietnam. Smile Train, its affiliates and the Charity continue to lead the way in free, high-quality cleft surgery for poor children around the world. In 2023, Smile Train’s cleft care spanned 5 continents through partnerships with more than 2,100 health professionals and 1,100 hospitals. Since its founding in 1999, Smile Train has now supported more than 1,500,000 free cleft surgeries and comprehensive cleft care for patients in 90+ countries.

Smile Train, Inc. and its affiliates also performed the following charitable activities, among other initiatives, during the fiscal year. In the future, in addition to funding cleft surgeries, the Charity may choose to fund similar activities�

Partnerships

The key to helping more children is investing in partnerships with local medical professionals and collaborative organisations that can provide free cleft surgeries and the related cleft care that these children need. Smile Train is always searching for new partners in the developing world who have the experience, passion, human resources and infrastructure to provide safe and high-quality cleft lip and palate treatment�

At the end of fiscal year 2023, there were more than 1,100 Smile Train partner hospitals around the world, serving children in need of cleft care in their communities. Through partnerships and programmes with Smile Train, these hospitals and local medical teams were able to provide safe, free, high-quality cleft treatment to children with clefts in their communities.

Grants awarded

In addition to the partner programmes that deliver the free cleft surgeries that Smile Train provides, the following grants are also awarded to help strengthen the cleft programmes of hundreds of doctors, hospitals, charities and organisations who help poor children suffering with clefts.

Education and Training Grants

Smile Train supported educational and training opportunities in fiscal year 2023, including:

July 2022 – American Heart Association and Nursing Care Saves Lives Trainings Through its International Training Center affiliation with the American Heart Association (AHA), Smile Train held a training for 52 medical professionals from Kenya including nurses and anaesthetists to certify them in the AHA Basic Life Support (BLS) and Pediatric Advanced Life Support (PALS) from July 18-21, 2022.

2022 -2023 UK Annual Report

August 2022 – Nutrition Training

Smile Train supported 14 cleft providers from the Central Africa region in a 5-day nutrition training course in Cameroon from August 22-26. Trainees learned optimal weight and measurement techniques, cleft nutrition guidelines, and how to share cleft feeding recommendations with parents and caregivers to avoid complications related to cleft-related malnutrition.

September 2022 – First Francophone Conference Cleft Conference

Smile Train hosted the first Francophone Conference on Comprehensive Cleft Care for African cleft care professionals from September 5-6, 2022 in Morocco. 127 trainees from 19 African countries participated in this 2-day conference which provided opportunities for continuing education and created awareness of cleft lip and palate in the region.

September 2022 – Simulare Workshop

In partnership with the Argentine Society of Plastic Surgeons, Smile Train trained 20 surgeons in cleft lip and palate repair using its hyper-realistic Simulare Cleft Lip and Palate 3D-printed simulators in Argentina from Sept 6-7, 2022.

September – October 2022 – Nursing Care Saves Lives

Smile Train hosted a 7-day workshop in Madagascar to increase the competency and confidence of nurses providing perioperative care for children undergoing cleft lip and palate surgery. This workshop included a “training of trainers” (TOT) for the Nursing Care Saves Lives course followed by a standard training where the new trainers could further hone their skills with a group of trainees�

October – November 2022 – Orthodontic Training

Smile Train hosted a training on essential cleft orthodontic training in Thailand from October 26-November 8, 2022. 13 orthodontists and dentists from 7 countries across Southeast Asia attended this training focused on increasing the skill and capacity of cleft orthodontic providers in the region.

Awareness Grants

Awareness funding supports communication messages and publicity to educate people about clefts and the free cleft surgery programs available to them, reducing the stigma and driving thousands of patients to our partner hospitals�

Patient Logistics

While Smile Train grants predominantly focus on medical treatment, this grant programme targets the poorest of the poor who would never make it to the hospital for treatment without additional financial support to help the family with expenses such as food and shelter during their stay, and money to cover the cost of traveling to and from the hospital. While the amount of support a family needs in this regard is often relatively small, it can mean the difference between a child receiving surgery or living their life with an unrepaired cleft.

Comprehensive Care Grants

Smile Train’s vision is to ensure every child born with a cleft can lead a full and productive life� A key to this is the critical pre-operative and follow-up care such as nutritional support, speech therapy and orthodontics that many patients require along with cleft surgery. Comprehensive Cleft Care Grants augment and enhance the free cleft surgery programmes to help ensure children in Smile Train’s programs have the opportunity for a full, healthy and productive life ahead.

Equipment Grants

These grants assist hospitals in purchasing essential equipment such as surgical instruments, pulse oximeters, and anesthesia machines for the operating room to help increase the number of children who can be treated and to ensure safe surgery and cleft care for all Smile Train patients.

Outreach Grants

This funding supports cleft teams with travel, food, and lodging during outreach treatment trips outside their main surgical centers, either within their own country or in neighboring countries.

2022 -2023 UK Annual Report

Financial review

We have set out the full details of our consolidated income and expenditure in the group statement of financial activities (SOFA) on page 29. The income for the year, principally representing income from donors was £11.13m (2022: £10.33m). The group total expenditure, principally representing programme and fundraising costs, were £10.37m (2022: £11.3m). As a result, recorded net income resources was £760k (2022 net expenditure: £970k). Unrestricted funds at the end of fiscal year 2023 stood at £1.09m (2022: £330k).

The summarized results for the year’s trading of The Smile Train UK Trading Company Limited is given on page 35 of the notes to the financial statements. The Smile Train UK Trading Company Limited directors consider the company’s state of affairs to be satisfactory. The directors are not anticipating any major changes to the activities of the company.

Funds

The Charity holds two types of funds – Restricted Funds and Unrestricted Funds.

Restricted Funds are those funds for which the original donors specified, directly or indirectly, the purposes for which they wanted the money to be used. The Trustees manage these funds but are governed by the donors’ wishes as to how the funds are utilised. During the year ended 30 June 2023, £143,056 (2022: £23,388) of such restricted donations were spent in accordance with the donors’ directions and £14,119 (2022: £1,000) were remaining to be spent.

Unrestricted Funds are those funds for which the original donors did not give any particular instructions as to how they wished the funds spent� These funds are allocated by the Trustees at their discretion. At the end of the year, the value of these funds stood at £1.09m (2022: £330k).

Reserves policy

The reserves policy is reviewed annually by the Trustees. In reviewing the risks faced by the Charity and its operational plans for the forthcoming period, the Trustees have decided that it is appropriate that the Charity holds cash reserves between £800k - £1.3m. This level of cash reserves has been maintained throughout the year. Our closing cash balance as of 30 June 2023 was approximately £1.7m which is in excess of the target range.

Fundraising

As a registered member of the Fundraising Regulator, Smile Train UK is committed to fundraising in a transparent and accountable way in accordance with our Pledge to Donors which can be found at https://smiletrain.org.uk/about/our-pledge-to-donors. We are happy to receive feedback from our donors and members of the public. Details on how to reach out to us with a question or concern can be found at: https://smiletrain.org.uk/about/faq#n8485. Through the period July 1st 2022-June 30th 2023 we received 37 new complaints, all of which were resolved in accordance with Smile Train UK’s Complaints Procedure.

We understand the importance of keeping our donors’ personal data safe and secure in accordance with our https://smiletrain.org.uk/about/privacy-policy-uk designed to ensure continued compliance with the General Data Protection Regulation (GDPR). Our Fulfilment and Supporter Care agency is on hand to respond to supporter requests, including updating donor details and contact preferences, responding to questions and queries about Smile Train’s work, our finances and our fundraising.

Along with our in-house fundraising team, we rely on trusted partners to fundraise on our behalf. All third-party fundraising organisations go through a robust procurement process. Formal, regular training is undertaken to ensure that the Smile Train is represented in a way that reflects our values and mission at all times. Fundraising activities are monitored through regular call recordings and performance is evaluated on an on-going basis by the campaign manager and partner agencies.

We are committed to ensuring that all donors are treated fairly. Our fundraisers and fundraising partners are trained on the Code of Fundraising Practice and Smile Train UK’s Socially Responsible Fundraising Policy which can be found at: https://smiletrain.org.uk/about/smile-train-uks-socially- - responsible fundraising policy. Our Policy is consistent with both the Institute of Fundraising’s Guidance “Treating Donors Fairly” and the Direct Marketing Association’s White paper “Guidelines for call centers dealing with vulnerable consumers. We aim to ensure every one of our supporters feels inspired and in control of their experience with us, and we encourage and welcome their feedback and involvement to help us improve. Without them, we couldn’t continue to make a difference to children’s lives.

2022 -2023 UK Annual Report

Key management personnel compensation

As part of the annual budgeting process the Trustees review and approve, as appropriate, recommended compensation and changes to positions based on market analysis process. Trustees determine that compensation is reasonable based upon information sufficient to determine whether the value of services is the amount that would ordinarily be paid for like services by similar organisations; the availability of similar services in the geographic area of the Charity and current compensation surveys compiled by independent firms.

Plans for the future

Thanks to the generosity of our donors, Smile Train, its affiliates and the Charity, during fiscal year 2023, were able to support safe, free cleft surgeries (10,200 for the Charity) for children born with clefts in resource-poor countries, launch programmes in new sites, train a record number of cleft care providers and grow our programmes all over the world.

In contribution to Smile Train’s Global Fundraising Strategy Goal to increase gross income from our international fundraising entities to $20m by end FY’26 (which includes but is not limited to Smile Train UK’s contribution), the charity continued with its approach of increasing sustainable income, growing gross income to £10.66m in FY’23. This growth is underpinned by our continued strategy of attracting loyal, long-term supporters across a diverse portfolio of fundraising activity, with an increased emphasis on identifying, stewarding, and cultivating relationships with Major Donors, Trusts, Foundations and Corporate partners�

Mass acquisition of new donors through a further increase of investment in Direct Response Television, in line with Smile Train’s Global Fundraising Strategy Goal One of growing prioritized Individual Giving streams to deliver 10% growth annually continued to be highly effective, as did digital fundraising initiatives through social media and other online opportunities. The charity grew income from the Sustainer base by 17% across FY23.

Strategic assessments of the Trusts and Foundations fundraising channels were completed, and which offered additional insight into future opportunities for growth and development within these areas, which supports our goal of continued diversification of the charity’s fundraising portfolio. The Charity continues to monitor additional fundraising through Major Givers, Schools, Community, Sporting and Challenge Event fundraising activities.

Despite the challenging economic environment, several successful new initiatives to engage new and existing donors performed well and are reflected in the positive end of year results. This year, the current fundraising performance ratio was 54%, when comparing costs of £5.76m against the income raised of £10.66m.

In fiscal year 2023, grants from the Charity to Smile Train will continue to be made under a grant agreement, which outlines Smile Train’s reporting obligations to the Charity.

While Smile Train and the Charity were busy doing all of these things this past year, an estimated 170,000 children were born with clefts in the developing world. Without intervention, these children have little prospect of ever receiving the cleft care they so desperately need. Their families, often living on less than £1 a day are too poor to ever afford surgery. Without Smile Train support, their local doctors and hospitals are too overburdened to provide free cleft care programmes. And their governments may not consider the problem of clefts a high priority when compared to other life-threatening afflictions.

The Charity cares about these children and with the continued support of our donors, and working with Smile Train, will keep working hard to grow cleft lip and palate treatment programmes, train more medical specialists, raise awareness, find more partners and, ultimately, help more children in need�

In addition to providing much needed surgery, the Charity will fund programmes to address comprehensive cleft care, including nutrition, speech therapy, orthodontics and psychological support.

The Charity will continue to work with Smile Train to meet its objectives for the future.

2022 -2023 UK Annual Report

Going Concern

The trustees monitor the reserves and cash flow of the charity to ensure the day to day needs are being met, taking into consideration challenges of the current economic conditions. The trustees have a reasonable expectation that the group has adequate resources to continue in operational existence for the foreseeable future. The group therefore continues to adopt the going concern basis in preparing its financial statements.

Statement of Trustees’ Responsibilities

The trustees (who are also directors of The Smile Train 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 regulations.

Company law requires the trustees to prepare financial statements for each financial year. Under that law the trustees have elected to prepare the financial statements in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law), including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland. 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 the group and of the incoming resources and application of resources, including the income and expenditure, of the charitable group for that period. In preparing these financial statements, the trustees are required to:

select suitable accounting policies and then apply them consistently;
observe the methods and principles in the Charities SORP (FRS 102);
make judgments and accounting estimates that are reasonable and prudent;
state whether applicable UK accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements; and
prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company group will continue in business.

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company’s transactions and disclose with reasonable accuracy at any time the financial position of the 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.

The trustees confirm that:

so far as each trustee is aware, there is no relevant audit information of which the charitable company’s auditor is unaware; and
the trustees have taken all the steps that they ought to have taken as trustees in order to make themselves aware of any relevant audit information and to establish that the charitable company’s auditor is aware of that information�

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�

This report is prepared in accordance with the provisions of the Companies Act applicable to small entities�

By order of the board of trustees

Susannah Schaefer Trustee Date: 4 December 2023

2022 -2023 UK Annual Report

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF THE SMILE TRAIN UK

Opinion

We have audited the financial statements of the Smile Train UK (‘the charitable company’) and its subsidiary (‘the group’) for the year ended 30 June 2023 which comprise the group statement of financial activities, the group and parent charitable company balance sheets, the consolidated 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 Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements:

give a true and fair view of the state of the group’s and the charitable company’s affairs as at 30 June 2023 and of the group’s income and expenditure, for the year then ended;
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
have been prepared in accordance with the requirements of the Companies Act 2006.

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 group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion�

Conclusions relating to going concern

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company’s or the group’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 trustees are responsible for the other information contained within the annual report� The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

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

We have nothing to report in this regard.

2022 -2023 UK Annual Report

Opinions on other matters prescribed by the Companies Act 2006

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

the information given in the trustees’ report, which includes the directors’ report prepared for the purposes of company law, for the financial year for which the financial statements are prepared is consistent with the financial statements; and
the directors’ report included within the trustees’ report have been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In light of the knowledge and understanding of the group and charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the directors’ report included within the trustees’ 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:

adequate and proper accounting records have not been kept; or
the financial statements are not in agreement with the accounting records and returns; or
certain disclosures of trustees’ remuneration specified by law are not made; or
we have not received all the information and explanations we require for our audit; or
the trustees were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies’ exemptions in preparing the trustees’ directors’ report and from the requirement to prepare a strategic report.

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement [set out on page 26], 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.

Details of the extent to which the audit was considered capable of detecting irregularities, including fraud and non-compliance with laws and regulations are set out below.

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

Extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

2022 -2023 UK Annual Report

We obtained an understanding of the legal and regulatory frameworks within which the charitable company and group operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, the Charities Act 2011 together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the charitable company’s and the group’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charitable company and the group for fraud. The laws and regulations we considered in this context for the UK operations were anti-fraud, bribery and corruption legislation, taxation legislation and health and safety legislation.

Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the Trustees and other management and inspection of regulatory and legal correspondence, if any.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within the timing of recognition of income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management and the Board of Trustees about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission and reading minutes of meetings of those charged with governance.

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non-compliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.

Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Dipesh Chhatralia Senior Statutory Auditor For and on behalf of Crowe U.K. LLP Statutory Auditor London

15 December 2023

Crowe U.K. LLP is eligible for appointment as auditor of the charity by virtue of its eligibility for appointment as auditor of a company under section 1212 of the Companies Act 2006.

2022 -2023 UK Annual Report

THE SMILE TRAIN UK GROUP STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 30 JUNE 2023

Note
Income from:
Donations and legacies
2
Investments
Total
Expenditure on:
Raising funds
5
Charitable activities
5
Other
5
Total
Net income/
(expenditure)
Fund balances at
1 July 2022
Fund balances at
30 June 2023

Unrestricted
funds
Restricted
funds
Total 2023
Total 2022
£
£
£
£
10,975,640
156,175
11,131,815
10,334,768
3,665
-
3,665
3,018
10,979,305
156,175
11,135,480
10,337,786
5,762,142
-
5,762,142
4,341,892
3,956,944
143,056
4,100,000
6,500,000
509,114
-
509,114
462,407
10,228,200
143,056
10,371,256
11,304,299
751,105
13,119
764,224
(966,513)
332,708
1,000
333,708
1,300,221
1,083,813
14,119
1,097,932
333,708

The statement of financial activities also complies with the requirements for an income and expenditure account under the Companies Act 2006.

2022 -2023 UK Annual Report

THE SMILE TRAIN UK GROUP & PARENT CHARITABLE COMPANY BALANCE SHEETS AS AT 30 JUNE 2023

Note Fixed assets Tangible assets 8 Investments Total Fixed Assets Current assets Debtors 9 Cash at bank and in hand Total Current Assets Liabilities Creditors falling due within one year 10 Current assets less current liabilities Net Assets The funds of the charity and group Restricted funds 11 Unrestricted funds General funds Total charity and group funds	Group 2023 Group 2022 Charity 2023 Charity 2022 £ £ £ £ - 72 - 72 - - 1 1
	- 72 1 73 266,885 374,430 283,719 388,341 1,729,967 1,197,972 1,719,673 1,185,812
	1,996,852 1,572,402 2,003,392 1,574,153 (898,920) (1,238,766) (898,044) (1,235,166)
	1,097,932 333,636 1,105,348 338.987
	1,097,932 333,708 1,105,349 339,060

	14,119 1,000- 14,119 1,000- 1,083,813 332,708 1,091,230 338,060
	1,097,932 333,708 1,105,349 339,060

The net income for the charity only for the year ended 30 June 2023 was £766,289 (2022 net expenditure: £963,760)

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

Approved and authorised for issue by the Board of Trustees on 4 December 2023 and signed on their behalf

Susannah Schaefer Trustee Date: 4 December 2023

Charity Registration No. 114748 Company Registration No. 05738962

2022 -2023 UK Annual Report

THE SMILE TRAIN UK CONSOLIDATED STATEMENT OF CASH FLOWS AS AT 30 JUNE 2023

Note
Cash fows from operating activities:
Net cash provided by (used in)
operating activities
(a)
Change in cash at bank and in hand
in the reporting period
Cash at bank and in hand at the
beginning of the reporting period
Cash at bank and in hand at the end of
the reporting period
Notes to the statement of cash fows
(a) Reconciliation of net cash used in
operating activities
Net income (expenditure) for the
reporting period
Adjustments for:
Depreciation
Decrease in debtors
Increase (decrease) in creditors
Net cash provided by operating
activities

2023
2022
£
£
531,995
201,980
531,995
201,980
1,197,972
995,992
1,729,967
1,197,972

764,224
(966,513)
72
286
107,545
408,150
(339,846)
760,057
531,995
201,980

2022 -2023 UK Annual Report

THE SMILE TRAIN UK NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 30 JUNE 2023

1 Accounting policies

The principal accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are as follows:

1.1 Basis of preparation

The Smile Train UK was incorporated in England and Wales as a charitable company limited by guarantee and governed by its Memorandum of Association.

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2015) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

The Smile Train UK meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy note(s).

The financial statements are presented in sterling (£).

1.2 Preparation of the accounts on a going concern basis

1.3 Group financial statements

The financial statements consolidate the results of the charity The Smile Train UK and its wholly owned subsidiary, The Smile Train UK Trading Company Limited (the ‘Group) on a line-by-line basis.

The Charity has taken the exemption under section 408 of Companies Act 2006 from presenting an individual company Statement of Financial Activities�

1.4 Income

Donations and other forms of voluntary income are recognised when the charity has entitlement to the funds, any performance conditions attached to the item(s) of income have been met, it is probable that the income will be received and the amount can be measured reliably�

For legacies, entitlement is taken once the charity is aware that probate has been granted and either final estate accounts have been approved, notification has been made by the executor(s) that a distribution will be made, or a distribution has been received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably and the charity has been notified of the executor’s intention to make a distribution. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is a treated as a contingent asset and disclosed if material (see note 3).

1.5 Donated services

The Group benefits from services donated to it by Smile Train, Inc. These donated services are recognised within the Group Statement of Financial Activities and are valued at the cost incurred by Smile Train, Inc being the value to the Group.

1.6 Expenditure

All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to that category.

2022 -2023 UK Annual Report

Expenditure on raising funds is that incurred in attracting voluntary income.

Other costs are those incurred in connection with administration of the charity and compliance with statutory requirements.

Charitable activity costs reflect the costs associated with funding surgeries and grants through Smile Train, Inc� and the production of printed public educational material and services to raise awareness, both of which are considered to further the Group’s objectives. When educational material is distributed as part of a joint-purpose mailing, the costs are allocated across the expenditure categories on the basis of word count.

1.7 Foreign currency translation

Transactions denominated in foreign currencies are recorded at the rate ruling at the date of the transaction�

Monetary assets and liabilities denominated in foreign currencies are translated into sterling at the rates of exchange ruling at the balance sheet date. All differences are included in net outgoing resources�

1.8 Funds

Restricted funds are subject to specific conditions by donors as to how they may be used. The purposes and uses of the restricted funds are set out in the notes to the accounts�

Designated funds comprise funds which have been set aside at the discretion of the Trustees, for specific purposes.

1.9 Tangible fixed assets and depreciation

The Group capitalises expenditures for fixtures, fittings and equipment in excess of £1,000 which are stated at cost less accumulated depreciation�

Depreciation of fixtures, fittings and equipment is provided using the straight-line method over the following estimated useful lives:

Fixtures and fittings 5 years Equipment 3 years

1.10 Debtors

Trade and other debtors are recognised at the settlement amount due after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

1.11 Creditors and provisions

Creditors are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or estimated reliably.

Creditors and provisions are normally recognised at their settlement amount after allowing for any trade discounts due�

1.12 Accounting judgements and sources of estimation uncertainty

In the application of the charity’s accounting policies, trustees are required to make judgements, estimates and assumptions about the carrying values of assets and liabilities that are not readily apparent from other sources. The estimates and underlying assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates�

The items in the accounts that are considered to involve significant judgements and sources of uncertainty through estimation, when applying Smile Train UK’s accounting policies include:

Revenue recognition where judgement is required to appropriately apply the income accounting policies explained in accounting policy note (1.4) above most notably in respect of the judgement as to whether a legacy meets the criteria for recognition in the financial statements and gift aid

2022 -2023 UK Annual Report

where income is only recognised to the extent that trustees are satisfied that the charity has the appropriate documentation in place to demonstrate entitlement to this income�

Gifts in kind and donated services where an estimate of the time spent on Smile Train UK activities by Smile Train Inc staff is recognised in both income and expenditure in the financial statements.

In the view of the Trustees, no assumptions concerning the future or estimation uncertainty affecting assets and liabilities at the balance sheet date, are likely to result in a material adjustment to their carrying amounts in the next financial year.

There are no items in the financial statements where management were required to make significant judgements and estimates that would have a significant risk of causing a material adjustment to the financial statements.

1.13 Retirement benefits

The Group offers its employees the opportunity to participate in a defined contribution scheme. The amounts charged to the Statement of Financial Activities represent the contributions payable to the scheme during the period.

1.14 Financial instruments

The Group has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at amortised cost using the effective interest method.

2 Donations and legacies

Donations Legacies Donated Services Total	Unrestricted funds Restricted funds Total 2023 Total 2022 £ £ £ £ 7,758,560 156,175 7,914,735 6,561,145 2,743,571 - 2,743,571 3,306,341 473,509 - 473,509 467,282
	10,975,640 156,175 11,131,815 10,334,768

Donated services are represented by management, operational, administrative, marketing and fundraising services provided by Smile Train, Inc. staff to the Group at no cost, of £473,509 (2022: £467,282).

Income from donations and legacies in 2022 was £10,334,768 of which £10,312,072 was unrestricted and £22,696 was restricted.

3 Legacy Notifications

At 30 June 2023, in addition to legacy income that has been included in voluntary income, the Group is expected to benefit from a number of legacies from estates for which the administration had yet to be finalised. The Group’s future income from these legacies is estimated at approximately £3.5m (2022: £2.53m).

4 Investment in Subsidiary

The Smile Train UK Trading Company Limited - Registration No. 09094982

The company acts as a trading subsidiary for its parent company, The Smile Train UK, which is a charity registered with the Charity Commission in England and Wales. The principal activity of the company in the year under review was to conduct the trading activities of its parent company. The profits of The Smile Train UK Trading Company Limited are paid to the charity. The Smile Train UK Trading Company Limited’s directors during 2023 were R Bell, A McCarthy and S Schaefer.

2022 -2023 UK Annual Report

Profit and Loss Account of the Smile Train UK Trading Company Limited

2023 2022 £ £ Turnover - - Expenditure (2,065) (2,753) Proft (loss) for the year (2,065) (2,753) *Balance Sheet of The Smile Train UK Trading Company Limited* 2023 2022 £ £ Current Assets Cash at bank and in hand 10,294 12,160 Accounts receivable - - Creditors: amounts falling due within one year (17,710) (17,511) Net assets (7,416) (5,351) Capital and reserves Called up share capital 1 1 Proft and loss account (7,417) (5,352) Equity shareholders’ funds (7,416) (5,351) 5 *Expenditure* Staf costs Other costs Total 2023 Total 2022 £ £ £ £ Raising funds Advertising and fundraising costs 309,963 5,161,237 5,471,200 4,042,813 Smile Train Inc. staf 290,942 - 290,942 299,079 600,905 5,161,237 5,762,142 4,341,892 Charitable activities Programme costs - 4,100,000 4,100,000 6,500,000 Support costs and governance Staf costs 154,981 - 154,981 121,449 Audit fees - 29,400 29,400 25,200 Other accounting fees - 3,396 3,396 1,800 Legal fees - 33,613 33,613 44,192 Smile Train Inc. staf 182,567 - 182,567 168,203 Other administrative expenses - 105,157 105,157 101,563 337,548 171,566 509,114 462,407 Total 938,453 9,432,803 10,371,256 11,304,299	2023 2022 £ £ Turnover - - Expenditure (2,065) (2,753) Proft (loss) for the year (2,065) (2,753) *Balance Sheet of The Smile Train UK Trading Company Limited* 2023 2022 £ £ Current Assets Cash at bank and in hand 10,294 12,160 Accounts receivable - - Creditors: amounts falling due within one year (17,710) (17,511) Net assets (7,416) (5,351) Capital and reserves Called up share capital 1 1 Proft and loss account (7,417) (5,352) Equity shareholders’ funds (7,416) (5,351) 5 *Expenditure* Staf costs Other costs Total 2023 Total 2022 £ £ £ £ Raising funds Advertising and fundraising costs 309,963 5,161,237 5,471,200 4,042,813 Smile Train Inc. staf 290,942 - 290,942 299,079 600,905 5,161,237 5,762,142 4,341,892 Charitable activities Programme costs - 4,100,000 4,100,000 6,500,000 Support costs and governance Staf costs 154,981 - 154,981 121,449 Audit fees - 29,400 29,400 25,200 Other accounting fees - 3,396 3,396 1,800 Legal fees - 33,613 33,613 44,192 Smile Train Inc. staf 182,567 - 182,567 168,203 Other administrative expenses - 105,157 105,157 101,563 337,548 171,566 509,114 462,407 Total 938,453 9,432,803 10,371,256 11,304,299	2023 2022 £ £ Turnover - - Expenditure (2,065) (2,753) Proft (loss) for the year (2,065) (2,753) *Balance Sheet of The Smile Train UK Trading Company Limited* 2023 2022 £ £ Current Assets Cash at bank and in hand 10,294 12,160 Accounts receivable - - Creditors: amounts falling due within one year (17,710) (17,511) Net assets (7,416) (5,351) Capital and reserves Called up share capital 1 1 Proft and loss account (7,417) (5,352) Equity shareholders’ funds (7,416) (5,351) 5 *Expenditure* Staf costs Other costs Total 2023 Total 2022 £ £ £ £ Raising funds Advertising and fundraising costs 309,963 5,161,237 5,471,200 4,042,813 Smile Train Inc. staf 290,942 - 290,942 299,079 600,905 5,161,237 5,762,142 4,341,892 Charitable activities Programme costs - 4,100,000 4,100,000 6,500,000 Support costs and governance Staf costs 154,981 - 154,981 121,449 Audit fees - 29,400 29,400 25,200 Other accounting fees - 3,396 3,396 1,800 Legal fees - 33,613 33,613 44,192 Smile Train Inc. staf 182,567 - 182,567 168,203 Other administrative expenses - 105,157 105,157 101,563 337,548 171,566 509,114 462,407 Total 938,453 9,432,803 10,371,256 11,304,299
		(7,416) (5,351)

		1 1 (7,417) (5,352)
		(7,416) (5,351)

		Other costs Total 2023 Total 2022 £ £ £ 5,161,237 5,471,200 4,042,813 - 290,942 299,079 5,161,237 5,762,142 4,341,892 4,100,000 4,100,000 6,500,000 - 154,981 121,449 29,400 29,400 25,200 3,396 3,396 1,800 33,613 33,613 44,192 - 182,567 168,203 105,157 105,157 101,563 171,566 509,114 462,407 9,432,803 10,371,256 11,304,299
	600,905 - 154,981 - - - 182,567 -
	337,548
	938,453

2022 -2023 UK Annual Report

The Group staff costs relate to work carried out on the marketing and fundraising strategies, the cultivation of major donors and the management of the donation processing, direct marketing and media placement suppliers. Two thirds of staff compensation have been allocated to advertising and fundraising costs while one third is allocated to support staff costs.

Grants made to Smile Train Inc. of £4,100,000 (2022: £6,500,000) are included in programme costs for direct inclusion in their programme expenses.

Donated services are management, operational, administrative, marketing and fundraising services provided by Smile Train staff or other third parties to the Charity at no cost.

6 Trustees

During the year ended 30 June 2023, none of the trustees received compensation for his or her services or were reimbursed expenses by the Group.

7 Employees Number of employees

There were 8 employees throughout the year (2022: 7).

Employee Costs Wages and salaries Social security costs Other pension costs	2023 2022 £ £ 395,371 312,913 38,349 28,413 11,632 8,542
	445,352 349,868

One employee earned between £90,000 and £100,000 and one employee earned between £60,000 and £70,000 during the year (2022: One employee earned between £80,000 and £90,000 during the year).

Of these employees, retirement benefits are accruing under pension schemes funded by the group to 2 employees (2022: 1).

The key management personnel of the group are comprised of the Charity’s trustees, Director, Head of Individual Giving Development and Smile Train’s CEO and CFO. Only the Director and the Head of Individual Giving, Development are paid through the Charity. The employee benefits of these two Charity’s key management personnel amounted to £169,315 (2022: £150,700).

2022 -2023 UK Annual Report

8 Tangible fixed assets

Group and Charity

Fixtures, fittings and equipment

Cost At 1 July 2022 Additions At 30 June 2023 Depreciation At 1 July 2022 Charge for the year At 30 June 2023 Net book value At 1 July 2022 At 30 June 2023	£ 1,937 -
	1,937
	1,865 72
	1,937
	72
	-

9 Debtors

Prepayments and accrued income Amounts due from subsidiary Total	Group Charity Group Charity 2023 2023 2022 2022 £ £ £ £ 266,885 266,885 374,430 374,430 - 16,834 - 13,911 266,885 283,719 374,430 388,341

10 Creditors: amounts falling due within one year

Trade creditors Amounts owed to group undertakings Accruals Total	Group Charity Group Charity 2023 2023 2022 2022 £ £ £ £ 562,331 562,331 394,952 394,952 44,448 44,448 549,986 549,986 292,141 291,265 293,828 290,228
	898,920 898,044 1,238,766 1,235,166

2022 -2023 UK Annual Report

11 Funds of the Charity

Restricted Funds

The income funds of the Group include restricted funds comprising the following unexpended balances of donations and grants held on trust for specific purposes:

Group and Charity

Restricted donations Restricted donations	Balance at 1 July 2022 Income Expenditure Balance at 30 June 2023 £ £ £ £ 1,000 156,175 (143,056) 14,119
	1,000 156,175 (143,056) 14,119
	Balance at 1 July 2021 Income Expenditure Balance at 30 June 2022 £ £ £ £ 1,692 22,696 (23,388) 1,000
	1,692 22,696 (23,388) 1,000

Donations received are recorded as unrestricted or restricted, depending on the nature of the donor’s restriction� All donor-restricted donations are recorded as restricted income if the donation is received with donor conditions that restrict its use. Of the £156,175 of restricted funds received in 2023, approximately £70,000 was restricted to support our programmes in Africa.

Unrestricted Funds

Group and Charity

Designated Fund General Reserve	Balance at 1 July 2022 Income Expenditure Transfers Balance at 30 June 2023 £ £ £ £ £ - - - - - 332,708 10,979,305 (10,228,200) - 1,083,813
	332,708 10,979,305 (10,228,200) - 1,083,813

The designated funds represent a historic amount set aside for reserves. Upon review, it has been determined that such designated funds are no longer required and therefore transferred back to the general reserve.

Group and Charity

Designated Fund General Reserve	Balance at 1 July 2021 Income Expenditure Transfers Balance at 30 June 2022 £ £ £ £ £ 150,000 - - (150,000) - 1,148,529 10,315,090 (11,280,911) 150,000 332,708
	1,298,529 10,315,090 (11,280,911) - 332,708

2022 -2023 UK Annual Report

12 Analysis of net assets between funds

Group

Fund balances at 30 June 2023 are represented by: Fixed assets Current assets Creditors: amounts falling due within one year Total Fund balances at 30 June 2022 are represented by: Fixed assets Current assets Creditors: amounts falling due within one year Total	Unrestricted funds Restricted funds Total £ £ £ - - - 1,982,733 14,119 1,996,852 (898,920) - (898,920)
	1,083,813 14,119 1,097,932

	Unrestricted funds Restricted funds Total £ £ £ 72 - 72 1,571,402 1,000 1,572,402 (1,238,766) - (1,238,766)
	332,708 1,000 333,708

13 Related parties

During the year, Smile Train Inc., the sole member of the Group, was repaid the sum of £550,000 (2022: £ nil) owed by the Group to Smile Train Inc. in relation to expenses paid by Smile Train Inc. on behalf of the Group. Smile Train Inc. paid expenses totaling £44,463 (2022: £390,618) on behalf of the Group during the year and the Group paid £nil (2022: £ nil) on behalf of Smile Train Inc. during the year. £44,448 (2022: £549,986) was owed to Smile Train Inc. as at 30 June 2022.

In addition, the Group granted £4,100,000 (2022: £6,500,000) to Smile Train Inc. to fund their jointly-stated charitable activities. In addition, the time of Smile Train Inc. staff provided at no cost has been recognised as a Gift in Kind (in income and expenditure) as stated in Note 2.

Smile Train Inc. is the sole company law member of the Group. The Group is therefore a subsidiary of Smile Train Inc. although the Board of Trustees of the Group are responsible for its day to day management.

For year end 30 June, 2022, Head of Individual Giving Development attended a training course at a cost of £266.40. The course was facilitated by Adaptaa, Ltd., which is the employer of a trustee, Tatiana Poliakova.

14 Parent undertaking

The company’s ultimate parent undertaking is Smile Train Inc., a US-based non-profit organisation headquartered in New York City. Its offices are located at 633 Third Avenue, New York, NY 10017. Smile Train Inc. and Affiliates accounts are available on www.smiletrain.org.

2022 -2023 UK Annual Report

Journey Ahead

Smile Train stands for cleft care that’s always there. In a year of turmoil and uncertainty, our heroic local partners boldly made smiles and saved lives. Nearly 108,000 of them.

And they could do it only because you likewise showed up for them.

Thank you for choosing hope in 2023. Thank you for choosing to make miracles — and smiles — possible for children in need.

Thank you for once again helping us change the world one smile at a time.

2022 -2023 UK Annual Report

A charity registered with the Charity Commission for England and Wales No. 1114748

The Smile Train UK is a company limited by guarantee, registered in England and Wales

Registered Office 10 Queen Street Place, London EC4R 1BE. Company No. 05738962

Table of Contents

OUR VISION

Smile Train: Cleft Care That’s Always There

Topline Stats

1.5M[+]

Our Global Network

DEIBA

DEIBA highlight: Simulare Medical, a Division of Smile Train

Standing with Ukraine

Dr Natalia Tetruieva

Comprehensive Cleft Care

Writing the Book on Clefts and Nutrition

Prisca’s Story

Education and Training

Community Programmes

After only one year of partnership, we’ve already:

Corporate Partners

Safety & Quality

Every Child Deserves Safe Surgery Every Time

Staff Spotlight

Surgeries a Year; One Uncompromising Standard of Excellence

What made you want to be a doctor and how did you pursue this goal?

What are the stakes of your role, for Smile Train as for our patients and partners?

Dr Elizabeth Igaga

What S&Q issues are you addressing?

What changes have you seen at our partners since you started in this role?

How does what we do for cleft care help improve other services at our partner hospitals?

It’s the same with equipment.

THE SMILE TRAIN UK TRUSTEES’ REPORT AND ACCOUNTS FOR THE YEAR ENDED 30 JUNE 2023

THE SMILE TRAIN UK LEGAL AND ADMINISTRATIVE INFORMATION

Trustees

Key Management personnel

Secretary

Charity number

Company number

Principal address

Registered office

Auditor

Bankers

Solicitors

THE SMILE TRAIN UK TRUSTEES’ REPORT FOR THE YEAR ENDED 30 JUNE 2023

Structure, governance and management

Management of the Charity

Governing document

Appointment and election of Trustees

Induction and training of Trustees

Risk management

Safeguarding

Objectives and activities

Achievements and performance

Surgeries Performed

Partnerships

Grants awarded

Education and Training Grants

August 2022 – Nutrition Training

September 2022 – First Francophone Conference Cleft Conference

September 2022 – Simulare Workshop

September – October 2022 – Nursing Care Saves Lives

October – November 2022 – Orthodontic Training

Awareness Grants

Patient Logistics

Comprehensive Care Grants

Equipment Grants

Outreach Grants

Financial review

Funds

Reserves policy

Fundraising

Key management personnel compensation

Plans for the future

Going Concern

Statement of Trustees’ Responsibilities

INDEPENDENT AUDITOR’S REPORT TO THE MEMBERS OF THE SMILE TRAIN UK

Opinion

Basis for opinion

Conclusions relating to going concern

Other information

Opinions on other matters prescribed by the Companies Act 2006

Matters on which we are required to report by exception