National Migraine Centre
Report of the Trustees and Financial Statements for the year ended 31 March 2023
Registered company no: 05846538 (England and Wales) Registered charity no: 1115935
Report of the Trustees and Financial Statements for the year ended 31 March 2023
NATIONAL MIGRAINE CENTRE
CONTENTS
| CONTENTS | |
|---|---|
| Page | |
| Chair’s Statement | 3 |
| Trustees’ Report | |
| Introduction | 4 |
| Vision & Values | 7 |
| Structure, Governance & Management | 8 |
| Review of the Year | 12 |
| Statement of Trustees’ Responsibilities | 17 |
| Independent Examiner’s Report | 18 |
| Statement of Financial Activities | 19 |
| Balance Sheet | 20 |
| Statement of Cashflows | 22 |
| Notes to the Financial Statements | 23 |
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Chair’s Statement
As chair of the National Migraine Centre, it gives me great pleasure to present our annual report and accounts for the year to 31 March 2023.
Following two very challenging years through the pandemic period, the fiscal year 2022/23 was one of positive change for the charity in terms of financial health and the centre’s capacity to treat patients.
Following a successful recruitment drive for our headache specialists team, we started the year with a record number of clinicians in the team, reaching 18 in total, who are based throughout the UK and also the Channel Islands.
This increased capacity allowed us to provide consultations to 2,174 patients: an increase of almost 60 per cent over the prior year and an all-time high.
A comprehensive re-branding exercise was completed in September alongside the launch of the new website, with much improved functionality and online booking capability. New online tools to help patients access appropriate and trusted information, designed to improve self-management options, are being developed alongside and with the generous support of the University of Warwick.
We continue to see strong demand for our service due to the large unmet need of those suffering migraine and headache conditions.
Financially, the higher patient numbers combined with a strong fundraising performance generated an 78 per cent increase in income and took the National Migraine Centre above £500,000 for the first time. Combined with a continued focus on cost control, this resulted in an operating surplus of £150,114 versus a prior year deficit of £55,661.
As a charity dependent on voluntary donations, we are grateful to all those who have supported us during the year, not least our patients, who continue to donate so generously following appointments. We are also indebted to all those who kindly responded to our fundraising appeals during the year.
Alongside the University of Warwick, we received support from a number of corporates, trusts and other funders over the course of the year, and would like to thank in particular Pfizer and OUCH (UK).
This year, we are especially grateful for the extraordinary support we have received from the Postcode Innovation Trust, which has provided the National Migraine Centre with truly transformational funding that will, in the years ahead, allow the charity to continue to expand, recruiting additional headache specialists, reaching many more people in great need and guaranteeing a sustainable and secure future.
We successfully added to our board strength with the recruitment of Ms Katie Cotton and Ms Julie Price, who bring fundraising and healthcare leadership experience to the team.
With a strong leadership team, a dedicated, growing team of clinicians and solid financial foundations, the National Migraine Centre is in a position to continue to provide much needed treatment to the migraine and headache patient community.
Anthony Stratton Chair
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
TRUSTEES’ REPORT
Introduction
The National Migraine Centre is the UK’s only charity providing diagnosis and treatment for the one in seven people who suffer migraine. Over more than four decades, our dedicated teams of world-class consultant neurologists and GP headache specialists have helped more than 66,000 people affected by migraine and other primary headache.
We receive no NHS or government funding; our work is largely funded by our patients. Since we provide consultations to all irrespective of their ability to pay, we rely on support from those trusts, foundations and corporate partners who share our belief that all those affected by migraine deserve effective treatment.
Migraine: more than ‘just a headache’
Headache affects almost everyone at some point, but around 14 per cent of the population suffer migraine, a condition that can, at its worst, severely reduce quality of life and cause chronic, disabling pain.
More people suffer migraine than those living with asthma, diabetes and epilepsy combined.
Migraine accounts for 89 per cent of headaches experienced worldwide and affects three times as many women as men. Around 2 per cent of people with migraine require medical intervention. Without effective treatment, migraine can undermine mental health, relationships and employment.
Migraine is the most common neurological condition in the developed world. The World Health Organization ranks migraine as the second highest cause of disability globally, following lower back pain.
Those affected by chronic symptoms (3 per cent to 5 per cent of people with migraine) endure severe and disabling symptoms on 15 or more days a month.
Migraine and work
A survey undertaken by the National Migraine Centre suggests more than 50 per cent of chronic migraine sufferers feel that their employer is not supportive of their condition. The research also shows:
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25 per cent had to change careers because of migraine / headaches
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16 per cent lost their job because of migraine / headaches
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97 per cent of respondents worked while in pain caused by headache
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54 per cent suffer financially due to migraine / headaches
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Chronic sufferers lose 16.8 days of work each year due to headache-related conditions
The impact of migraine and headaches on work is often unseen, underestimated and misunderstood by employers and can be underplayed by those affected in order to hold on to their jobs. Access to effective
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
treatment can minimise the impact on the individual and benefit employers by improving staff wellbeing and boosting productivity.
The cost of migraine to society
According to research undertaken by The Work Foundation:
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Migraine is the biggest cause of years lived with disability among those aged 15 to 49 – a time when people are often at their most productive, furthering their careers and starting families, with a major impact on career development and the wider economy
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5.7 days are lost per person with migraine every year, equating to 43 million workdays at a cost of almost £4.4 billion
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An estimated additional £4.4 billion is lost to the economy each year due to reduced productivity as those with migraines continue working – many express concerns about the negative impact on their careers of taking extended or regular sick leave
In spite of its extraordinary cost to society, migraine is the least publicly funded of all neurological diseases relative to its economic impact.
Misunderstood, misdiagnosed, mistreated
Despite the prevalence of migraine and the cost to the individual and society, headache is rarely mentioned in NHS plans while most GPs will have five or fewer hours training on the condition. Consequently, the quality of care inevitably varies greatly across the UK.
According to The Work Foundation’s research, GPs ‘…do not know enough about [migraine] and appear to have little interest in it given the wide range of competing medical conditions.’
These weaknesses in primary care result in unnecessary referrals to already over-burdened secondary care, leading to extensive waiting lists and problems accessing services for those in greatest need.
Secondary care at NHS hospitals remains greatly under resourced to handle this scale of demand. Only 20 per cent of NHS Trusts responding a freedom of information request by The Migraine Trust said they had a specialist headache clinic. The UK has just 1.1 full-time equivalent neurologists per 100,000 people (compared to more than four in France and Germany).
As a result of these inadequacies and capacity issues across both primary and secondary care in the NHS, there are over 16,500 emergency admissions for headache every year – up 14 per cent in five years. Most of these would be avoidable with the effective care.
These service gaps leave many people in great distress, and the National Migraine Centre their last resort.
A lifeline for people with headache
The National Migraine Centre was founded in 1980 to provide treatment to those affected by migraine and other primary headaches, to share skills and train professionals, to conduct and promote research, and to improve self-management.
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Neither private nor within the NHS, we remain the only charity in the UK dedicated to delivering treatment for headache. Last year, we provided 2,174 consultations and treatments (up from 1,375 in 2021/22) to people affected by migraine and primary headache.
Our charity brings together some of the UIK’s most renowned headache clinicians, including leading consultant neurologists and GP headache specialists, who support the charity in both governance and patient-facing roles.
National Migraine Centre clinicians are based around the UK, seeing patients affected by migraine and primary headache nationwide using videolink technology. For those requiring face-to-face treatments, such as Botox or nerve block injections, doctors offer in-person appointments at special procedure clinics.
We also help those affected by migraine by improving self-management, with a range of tools, including our Heads Up podcast and online resources, providing essential, evidence-based guidance and information.
The National Migraine Centre is inspected and regulated by the Care Quality Commission (CQC). The most recent CQC report on our work found our clinic to be safe, effective, caring, responsive and wellled. Ongoing surveys and patient feedback continue to show extremely high patient satisfaction ratings.
All our medical staff are fully qualified clinicians with a specialist interest and additional training in migraine and headache, registered with either the UK’s General Medical Council or the Nursing and Midwifery Council. Our clinicians provide additional and overlapping expertise on various specialist areas, such as women’s health, mental health and ophthalmology.
Our clinicians devote one hour to each first appointment, giving every patient around 40 minutes with the doctor, far more time than they might receive in NHS or many private settings, to discuss their individual case. Our doctors will then liaise with patients’ GPs to ensure ongoing appropriate care, recommending medication and care plans.
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Our Vision
Our vision is for all those affected by migraine to have access to life-changing support and world class treatment. We empower people to take control of their headaches and lead better lives by providing expert patient care, facilitating research, improving professional skills and supporting better selfmanagement.
Our Values
We are:
COMPASSIONATE. We are always patient focused, treating every individual with dignity and respect. We extend that care and consideration to our clinicians, staff, trustees, supporters and all those with whom we interact in the course of our work.
EXPERT. We bring together leading clinicians, policymakers and researchers in the field of headache treatment, continually striving to develop skills and expertise across our charity, the NHS and wherever those affected by migraine seek treatment and support.
PROFESSIONAL. We are dedicated to upholding the highest standards of professionalism and integrity. We are committed to delivering safe, high-quality and evidence-based care for every patient. We are always open, transparent and supportive.
COLLABORATIVE. We work together with our patients to deliver the best outcomes for every individual. We work with clinicians, charities, researchers and others to advance our vision.
DRIVEN. We are dedicated and passionate, single-minded in our commitment to improving the lives of all those affected by headache. We actively work to improve access and transform outcomes for everyone in need, always striving for equity in the provision of services and support.
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Structure, Governance & Management
Organisational structure
Our governing body, the board of trustees (the board), is responsible for the overall governance and work of the charity. The trustees are volunteers and do not receive any remuneration for their services.
Strategic decision-making takes place at board level, which monitors progress towards strategic objectives through board meetings, reports from the executive and one-to-one meetings between board members with particular specialisms and senior members of the executive team.
The chief executive supports the board, assists the board in setting strategy and implements that strategy through the management of a small administrative team and a world class clinical team. Operational decision making on a day-to-day basis rests with the chief executive, informed by weekly meetings with senior managers and regular discussions and formal meetings with the clinical team.
The chief executive and chair also discuss and agree decision-making processes during regular meetings scheduled ahead of board meetings.
Appointment of Trustees
Trustees are appointed in line with the charity’s Equal Opportunities Policy, following open advertising of roles. Candidates are evaluated objectively against an agreed procedure designed to fill any skills and experience gaps that have been identified, or which may be a priority for the delivery of our strategic aims.
New trustees all undertake a structured programme on appointment, which includes meetings with key staff and trustees, an induction into the charity’s full suite of policies, as well as our governance processes.
During the course of the year, the board recruited two additional trustees, Ms Katie Cotton and Ms Julie Price, who were appointed on 28 October 2022. No trustees retired during the year.
Staff remuneration
The charity has a Staff Pay Policy, which guides our approach to employee remuneration. are set and reviewed against the following principles:
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Competitiveness with similar roles in the voluntary sector
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The nature of the role, including its complexity and the particular skills required
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The ability of the charity to attract and retain capable and motivated people
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Performance over a sustained period of time which exceeds the reasonable expectations of the role
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The financial sustainability of the National Migraine Centre
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A fair approach to decision-making
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Our commitment to equity, diversity and inclusion, as outlined in other policies
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Objectives and activities
The National Migraine Centre was founded in 1980 as a registered medical charity by Dr Blau and Dr Wilkinson, both consultant neurologists with a special interest in migraine. The original governing document is a trust deed dated 23 May 1980, later replaced by a set of Articles of Association.
The trustees confirm that they have referred to the Charity Commission’s guidelines and that the National Migraine Centre’s current aims and objectives are charitable and fall within our governing documents.
Our charitable objects, set out in our Articles of Association, are:
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the provision of clinics offering diagnosis, treatment and support for patients suffering with migraine or other primary headache
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the provision of information and signposting to alleviate the impact of such disorders and to grow awareness
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the promotion of research into the causes, treatment and alleviation of migraine and other forms of headache
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the publication of the useful results of such research
In order to achieve these objectives, the board oversees the development of a strategy, which it monitors and reviews at regular board meetings and at dedicated strategic review meetings. Our next dedicated strategic review day is planned for autumn 2023. Implementation of operational plans is delegated to the chief executive and the executive team.
We have adopted a social enterprise strategy in order to extend our charitable activities and benefit more people affected by migraine. Income from private appointments is allowing us to expand the number of treatments we are able to offer to those in clinical need who, for financial or other reasons, might not otherwise be able to access effective treatment for headache conditions.
Beyond the provision of treatment, our strategy encourages working with other organisations, including charities and professional bodies, and the NHS in particular, to provide and promote evidence-based information and signposting. We also engage actively in print, broadcast and social media communications to promote awareness and self-management options, training key members of our clinical team to act as media spokespersons.
Standard key performance indicators are agreed at board level, which are designed to show progress against strategic objectives. The executive produces a report on these indicators ahead of each board meeting, which is then analysed and discussed as a standing item at every meeting.
We prioritise developing relationships with researchers within academia and the pharmaceutical industry in order to support new treatment options, and we are currently involved in several promising projects.
The board also reviews progress against research objectives with regular reports from the executive, and we ensure the board always includes a senior clinician member with the relevant experience to ensure we have the skills to properly interrogate research plans and outcomes.
During four decades as an independent medical charity, the National Migraine Centre has:
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Treated over 66,000 patients affected by migraine or other primary headache
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Gained a global reputation for clinical excellence, with high levels of patient satisfaction
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
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Supported research into treatments that have since become the recommended standard by the British Association for the Study of Headaches
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Delivered headache masterclasses for thousands of healthcare professionals, improving the quality of care across the NHS and beyond
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Distributed self-management information, and information on research and treatment options, through the media and digital channels
The charity is supported by a small number of valued volunteers, who play a key role in providing administrative support. Our work with volunteers is guided by our Volunteer Policy, which commits the charity to:
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ensuring equal opportunities to all prospective volunteers
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matching the skills, experience, motivations and aspirations of volunteers with the most appropriate role
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providing a clear description of roles
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offering appropriate training and support where appropriate
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maintaining a healthy and safe working environment
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listening to and respecting volunteer feedback
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recognising the contribution of volunteers
Risk management
The board recognises its responsibility in the identification, management and mitigation of risks and works closely with the executive team in this regard.
We maintain a risk register and continue to review risks on a regular basis, ensuring financial, compliance, reputational and other risks are considered, and plans updated accordingly.
Financial review
The charity’s income can fluctuate significantly, and the trustees have adopted the policy of aiming to keep a general reserve equal to three months’ running costs. The charity currently holds sufficient reserves to meet this policy. The amount of restricted reserves at the end of financial year 2022/3 was £91,141.
Although the charity has strong reserves and increasing demand, we have identified attrition of key clinical personnel as a risk, leading to loss of income. To combat this, we have begun recruitment of a new intake of clinicians, significantly expanding the staff team and ensuring the charity continues to meet the growing demand for its services. Despite a challenging external economic environment, the charity has thrived during 2022/3, with income growing significantly. We continue to see strong demand for appointments, including private appointments.
Grant income was also exceptionally strong during 2022/3, with a very generous donation from the Postcode Innovation Trust.
Income continues to derive primarily from patient appointments, with private income now a more significant source of funding than donated income from routine, no-fee appointments. Grant income,
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
from trusts and corporate funders, and individual giving income from appeals and regular giving are also significant sources of income.
With a low appetite for risk and, until recently, very limited reserves, the board has chosen not to invest funds in products which carry a higher risk and so has no material financial investments and thus no investment performance to report against investment objectives. Subject to future reviews and our forthcoming strategic plan, we intend to continue holding reserves in our two CAF Bank accounts, with most held in an account attracting a higher rate of interest but with no capital volatility risks.
Future plans
As part of our ongoing governance process, the charity will this year review strategy, with a trustees’ meeting planned for this purpose in autumn 2023.
We are also planning for a substantial increase in clinical capacity, with work underway to recruit and train a new cohort of clinicians.
The funding from the Postcode Innovation Trust, detailed elsewhere, has enabled this clinical growth. It will also fund an expansion in our administrative team (to support the increased clinician numbers) and marketing activity to help us reach more people in need of our services.
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Governance and administration details
Registered office and principal address: 999 Finchley Road London NW11 7HB Contact details: info@nationalmigrainecentre.org.uk 020 7251 3322 Registered company number: 05846538 (England and Wales) Registered charity number: 1115935 Trustees: Dr Bal Athwal Ms Katie Cotton (appointed 28 October 2022) Mr Simon Kingsnorth Ms Julie Price (appointed 28 October 2022) Ms Ruth Robertson Mr Anthony Stratton (Chair) Ms Penny Wilson Senior management team: Ms Charlotte Burr (clinical & communications director) Ms Swati Raina (operations director) Mr Daniel Tickle (chief executive)
Independent examiner: Giles Thrush Richardson Jones Chartered Accountants
Bankers: CAF Bank Limited 25 Kings Hill Avenue Kings Hill West Malling Kent ME19 4TA
Accountant: AJC Accountancy Unit 40 Thrales End Business Centre Thrales End Lane Harpenden Herts AL5 3NS
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Achievements and performance
The charity began 2022/23 with plans to ensure greater financial resilience, grow charitable reach, overhaul our brand and website, review our premises with a view to reducing overheads, extend our board team and develop new research partnerships. Set against these objectives, the National Migraine Centre has enjoyed a very successful year and key achievements are outlined below.
Growth and sustainability
2021/2 marked a challenging year for the charity, as it continued to deal with the impact of the Covid-19 pandemic and the implications for the delivery of healthcare services.
The far-reaching changes to strategy and operations this entailed resulted in a loss of income and additional costs as we pivoted to embrace telemedicine.
However, 2022/3 saw these changes deliver remarkable growth for the charity, enabling us to help more patients in need and support our continued expansion. We end 2022/3 with a charity that is more sustainable and impactful than ever before.
With a programme of recruitment, training and mentoring overseen by leading GP headache specialists, the charity delivered a substantial growth in clinical capacity over the course of the year, resulting in appointment numbers increasing 58 per cent year on year.
Meanwhile, a new brand and website supported our move towards a social enterprise strategy, with greater income from private appointments subsidising and ensuring the sustainability of our routine clinics, where patients receive consultations with world-class headache clinicians without a fee. We are now able to confidently plan for further expansion of our charitable work.
This additional income, coupled with substantial grants from funders including the Postcode Innovation Trust, resulted in our total income growing from £323,271 in 2021/2 to £577,853 in 2022/3. These additional funds will be invested in further expanding our clinical capacity in the year ahead to meet our increasing patient demand.
Website and brand
The charity’s new website and brand were launched simultaneously on 1 September 2022, in time for the beginning of Migraine Awareness Week.
The new site features an extended and updated range of factsheets alongside a streamlined booking and administration process.
The website and brand resulted in a marked and sustained increase in demand for appointments that has driven our recent expansion.
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Research
We are currently working with several partners on research projects that aim to improve the range and efficacy of treatments available to those with headache. These include research projects to develop novel therapies, to extend the benefits of existing treatments to more patients, and to improve selfmanagement tools.
Premises
The process of moving to remote working was completed in August, as we vacated our previous head office location in Millbank, London. A new registered office address was identified in north-west London, although administrative staff will now work remotely.
Clinical work continues to be largely remote, although a limited number of procedure appointments will take place at our new registered office, a Care Quality Commission-registered clinic, and elsewhere.
Heads Up podcast
Our award-winning Heads Up podcast returned for a fifth series. Hosted by Dr Katy Munro, Heads Up provides information and support on migraine and other primary headache and has so far received almost 200,000 downloads.
Migraine Awareness Week 2022
Our focus for Migraine Awareness Week was the impact of anti-CGRP treatment, including our work to improve access to this class of medication through the NHS.
Activity for the week began with a story placed in the Mail on Sunday that detailed new developments in anti-CGRP treatment.
Social media activity during the week resulted in:
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A 297% increase in Facebook reach
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A 344% increase in Instagram reach
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A surge in demand for anti-CGRP appointments
Clinical team
2021/2 was a period of significant change for the charity, as we moved to a telemedicine model and, consequently, began to build up our clinical team anew.
We underwent a very significant period of expansion in 2022/3, attracting and training a new cohort of headache specialist GPs and consultants, increasing the size of our clinical team to 18 consultants, GPs and headache specialist nurses.
With growing demand, we ended the year with plans for another significant increase in clinician numbers.
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
Policies
All the charity’s policies were reviewed and updated, to ensure best practice and compliance. Our full suite of 20 policies reflects our commitments and responsibilities to our patients, staff, donors and other key stakeholders.
Governing document
Our Articles of Association were updated during the year, which included a review of our charitable objects. Our new objects are detailed above.
New trustees
Following a skills audit, we appointed two additional trustees, Katie Cotton and Julie Price, enhancing the board’s capacity for strategic direction and oversight. Our new trustees bring particular expertise in voluntary and health sector management, compliance and fundraising.
Postcode Innovation Trust
We were delighted to receive the support of the Postcode Innovation Trust during the year, which recognised the social impact of our work with the award of blended social investment funding.
The grant and financing will support the charity’s continued growth, funding the recruitment and training of a new wave of headache specialist GPs and the additional administration infrastructure required to support them.
We are very grateful for the support we have received from the Postcode Innovation Trust, which will have a transformative effect on the charity in the years ahead, enabling us to increase capacity and help many more people affected by migraine and primary headache.
Fundraising
The charity ran two individual giving fundraising appeals during the year. In total, our fundraising income from income during 2022/3 was £62,104 (2021/22: £38,814), significantly ahead of our budget target.
We have recently appointed a fundraising specialist to our board and will be reviewing fundraising strategy in 2023 with a view to growing income and developing additional products.
During the course of the year, no material expenditure was incurred to raise income in future years.
Our thanks
We are extremely grateful to the many individual supporters who funded the charity throughout the year, with generous gifts to our appeals and donations towards the cost of their appointments. Our two appeals together raised more than £40,000 towards the work of the charity.
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We are committed to providing the very highest standards of care, which is only possible thanks to the quality of training and mentoring we are able to offer clinicians. We are therefore indebted to our Education Fellow, Dr Richard Wood, who continues to kindly give his valuable time and expertise to train and support our new GP headache specialists.
We wish to express our thanks to those consultants, agencies and contractors who have supported the charity at no cost. In particular, we are grateful to Dentons for their ongoing legal advice, including significant support in the development of our new website.
Our update to the charity’s governing document was only possible thanks to the expert advice and support kindly provided by Michele Price, specialist charity and philanthropy solicitor at gunnercooke LLP.
This year we are also especially grateful to strategic adviser Katharine Danton, who is working with the charity pro bono on the development of a project to improve headache training for primary care professionals.
Finally, we thank all those trusts, foundations, corporate supporters and academic institutions who so generously donated, or who worked with us in partnership, during the course of the year, including:
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OUCH (UK)
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Pfizer
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Postcode Innovation Trust
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University of Warwick
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Statement of Trustees’ Responsibilities
The trustees (who are also the directors of the National Migraine Centre for the purposes of company law) are responsible for preparing the Report of the Trustees and the Financial Statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).
Company law requires the trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing those financial statements, the trustees are required to
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select suitable accounting policies and then apply them consistently;
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observe the methods and principles in the Charity SORP;
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make judgements and estimates that are reasonable and prudent;
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prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.
The trustees are responsible for keeping proper accounting records, which disclose with reasonable accuracy at any time the financial position of the charitable company and to 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 are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company's website.
This report has been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small companies.
On behalf of the Board:
Anthony Stratton Chair 5[th] July 2023
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INDEPENDENT EXAMINER'S REPORT TO THE TRUSTEES OF NATIONAL MIGRAINE CENTRE
I report on the accounts for the year ended 31 March 2023 set out on pages 18 to 28.
Respective responsibilities of trustees and examiner
The charity's trustees are responsible for the preparation of the accounts. The charity's trustees consider that an audit is not required for this year (under Section 144(2) of the Charities Act 2011 (the 2011 Act)) and that an independent examination is required.
Having satisfied myself that the charity is not subject to audit under company law and is eligible for independent examination, it is my responsibility to:
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examine the accounts under Section 145 of the 2011 Act;
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to follow the procedures laid down in the General Directions given by the Charity Commission under Section 145(5)(b) of the 2011 Act; and
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to state whether particular matters have come to my attention.
Basis of the independent examiner's report
My examination was carried out in accordance with the General Directions given by the Charity Commission. An examination includes a review of the accounting records kept by the charity and a comparison of the accounts presented with those records. It also includes consideration of any unusual items or disclosures in the accounts and seeking explanations from you as trustees concerning any such matters. The procedures undertaken do not provide all the evidence that would be required in an audit, and consequently no opinion is given as to whether the accounts present a 'true and fair view ' and the report is limited to those matters set out in the statements below.
Independent examiner's statement
In connection with my examination, no matter has come to my attention:
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which gives me reasonable cause to believe that, in any material respect, the requirements
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to keep accounting records in accordance with Section 386 of the Companies Act 2006; and
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to prepare accounts which accord with the accounting records, comply with the accounting requirements of Section 396 of the Companies Act 2006 and with the methods and principles of the Statement of Recommended Practice: Accounting and Reporting by Charities
have not been met; or
- to which, in my opinion, attention should be drawn in order to enable a proper understanding of the accounts to be reached.
Giles Thrush Richardson Jones Independent Examiner Date: 05[th] July 2023
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STATEMENT OF FINANCIAL ACTIVITIES
(Incorporating an income and expenditure account)
For the year ended 31 March 2023
| Notes INCOME Donations and legacies Donations 2 Legacies Other trading activities Fundraising Fees 3 Income from investments 4 Income from charitable activities Grants Contract income 5 Other income 6 |
Unrestricted funds Restricted funds 2023 Total funds 2022 Total funds £ £ £ £ 139,294 - 139,294 107,134 - - - |
|---|---|
| 139,294 - 139,294 107,134 62,104 - 62,104 38,814 255,089 - 255,089 101,596 |
|
| 317,193 - 317,193 140,410 1,078 - 1,078 25 4,047 108,441 112,488 38,880 7,800 - 7,800 35,603 |
|
| 11,847 108,441 120,288 74,483 - - - 1,219 |
|
| Total income | 469,412 108,441 577,853 323,271 |
| Less: Expenditure on raising funds Marketing costs Net income available for charitable activities Expenditure on charitable activities Research and medical costs Operating costs 7 Governance costs 8 |
(11,181) - (11,181) (6,074) 458,231 108,441 566,672 317,197 163,944 208 164,152 120,979 212,405 38,952 251,357 250,879 |
| 376,349 39,160 415,508 371,858 1,050 - 1,050 1,000 |
|
| Total expenditure | 377,399 39,160 416,558 372,858 |
| NET INCOME / EXPENDITURE | 80,832 69,281 150,114 (55,661) |
| Transfers between funds 16 RECONCILIATION OF FUNDS Total funds brought forward |
- - - - 13,509 21,860 35,369 91,030 |
| TOTAL FUNDS CARRIED FORWARD | 94,341 91,141 185,482 35,369 |
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Report of the Trustees and Financial Statements for the year ended 31 March 2023
BALANCE SHEET
At 31 March 2023
| Notes FIXED ASSETS Tangible assets 13 CURRENT ASSETS Debtors 14 Cash at bank CREDITORS Amounts falling due within one year 15 NET CURRENT ASSETS TOTAL ASSETS LESS CURRENT LIABILITIES CREDITORS Amounts falling due after one year Bank loans |
2023 2022 £ £ 134 584 4,820 10,924 372,699 129,782 |
|---|---|
| 377,519 140,706 (39,251) (15,841) 338,268 124,865 338,402 125,449 (152,924) (90,080) |
|
| NET ASSETS | 185,478 35,369 |
| FUNDS 16 Unrestricted funds Restricted funds |
94,341 13,509 91,141 21,860 |
| TOTAL FUNDS | 185,482 36,369 |
The charitable company is entitled to exemption from audit under Section 477 of the Companies Act 2006 for the year ended 31 March 2023.
The members have not required the charitable company to obtain an audit of its financial statements for the year ended 31 March 2023 in accordance with Section 476 of the Companies Act 2006.
The directors / trustees acknowledge their responsibilities for:
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ensuring that the charitable company keeps accounting records that comply with Sections 386 and 387 of the Companies Act 2006, and
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preparing financial statements which give a true and fair view of the state of affairs of the charitable company at the end of each financial year and of its surplus or deficit for each financial year in accordance with the requirements of Sections 394 and 395 and which otherwise comply with the requirements of the Companies Act 2006 relating to financial statements, so far as applicable to the charitable company.
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
These financial statements have been prepared in accordance with the special provisions of Part 15 of the Companies Act 2006 relating to small charitable companies.
The financial statements were approved by the Board of Trustees and were signed on its behalf by:
Anthony Stratton Chair
5[th] July 2023
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
STATEMENT OF CASHFLOWS
For the year ended 31 March 2023
Analysis of cash and cash equivalents
| 2023 | 2022 | |
|---|---|---|
| £ | £ | |
| Bank balance | 372,699 | 129,781 |
Reconciliation of net income to net cashflow
| Net income (SOFA) Adjustment: Depreciation Interest received (Inc) / Dec Debtors Inc / (Dec) Creditors Net cash provided by / (used in) activities |
2023 2022 £ £ 150,114 -55,664 450 1,318 -1,078 -25 6,104 14,008 7,523 -8,321 |
|---|---|
| 163,113 -48,684 |
Statement of Cashflows
| Cash flows from operating activities Cash flows from investing activities: Interest received Purchase of equipment Cash flows from financial activities: Repayment of borrowings New Borrowings Change in cash in year Cash brought forward Cash carried forward |
2023 2022 £ £ 163,113 -48,684 1,078 25 0 -459 -12,414 -4,918 91,141 0 |
|---|---|
| 242,918 -54,036 129,781 183,817 372,699 129,781 |
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
NOTES TO THE FINANCIAL STATEMENTS
For the year ended 31 March 2023
1. Accounting Policies
Basis of accounting
The financial statements of the charitable company, which is a public benefit entity under FRS 102, have been prepared in accordance with the Charities SORP (FRS 102) '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 2019)', Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and the Companies Act 2006.
The Charity meets the definition of a public benefit entity under FRS 102.
Accounting convention
These financial statements have been prepared under the historic cost convention and the accounting policies set out therein.
Incoming resources
All incoming resources are included on the Statement of Financial Activities when the charity is legally entitled to the income and the amount can be quantified with reasonable accuracy.
Resources expended
Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all cost related to the category. Where costs cannot be directly attributed to a particular heading, they have been allocated to activities on a basis consistent with the use of resources.
Direct charitable expenditure includes costs directly incurred in carrying out charitable objectives.
Governance costs are costs associated with the governance arrangements of the charity, which relate to the general running of the charity.
Tangible fixed assets
Depreciation is provided at the following annual rates in order to write off each asset over its estimated useful life. Items over £1,000 are capitalised.
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Fixtures and fittings: 33% on cost
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Computer equipment: 33% on cost
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Leasehold premises: over 5 years
Stocks
Stocks are valued at the lower of cost and net realisable value, after making allowances for obsolete and slow-moving items.
items.
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
Debtors
Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid, net of any trade discount due.
Cash at bank and in hand
Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months of less from the date of acquisition or opening of the deposit or similar account.
Taxation
The charity is exempt from corporation tax on its charitable activities.
Fund accounting
Unrestricted funds can be used in accordance with the charitable objectives at the discretion of the trustees.
Restricted funds can only be used for particular restricted purposes within the objects of the charity. Restrictions arise when specified by the donor or when funds are raised for particular restricted purposes. Further explanation of the nature and purpose of each fund is included in the notes to the financial statements.
Liabilities and provisions
Liabilities are recognised when there is an obligation as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be reliably estimated.
Provisions are measured at the best estimate of the amounts required to settle the relevant obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the discount rate that reflects the risks specific to that liability. The unwinding of the discount is recognised in the statement of financial activities as a finance cost.
Hire purchase and leasing commitments
Rentals paid under operating leases are charged to the statement of financial activities on a straight-line basis over the period of the lease.
Pension costs and other post-retirement benefits
Staff members are entitled to join one of two personal pension schemes. During the financial year 2022/23, any salaried medical professionals were entitled to join the NHS final salary scheme.
Government grants
Government grants are recognised on the accrual model. Under the accrual model, a grant relating to revenue shall be recognised as income on a systematic basis over the periods in which the entity recognises the related costs for which the grant is intended to compensate.
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
2. Donations and Legacies
| Charitable Donations Gift Aid – tax recovered Legacies (net) . Other Trading Activities Fundraising Fees Fees include: Private patients Clinical procedures Sundry . Income from Investments Deposit account interest . Income from Charitable Activities Grants Contact income Grants received, included in the above: Arnold Clark Community Fund Adrian Swire Trust PF Charitable Trust Postcode Innovation Trust (restricted) Pfizer (restricted) CAF (unrestricted) CHK Foundation (restricted) Miscellaneous Warwick Medical School |
2023 2022 £ £ 111,064 90,983 28,229 16,151 - - |
|---|---|
| 139,294 107,134 2023 2022 £ £ 62,104 38,814 255,089 101,596 |
|
| 317,193 140,410 116,434 36,450 138,495 65,146 160 - |
|
| 255,089 101,596 2023 2022 £ £ 1,078 25 2023 2022 £ £ 112,488 38,880 7,800 35,603 |
|
| 120,288 74,483 - 1,000 - 3,000 - 3,000 91,141 - 17,300 - - 1,500 - 30,000 275 - 3,772 - |
|
| 112,488 38,880 |
3. Other Trading Activities
4. Income from Investments
5. Income from Charitable Activities
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
| Contract income, included in the above: St Pancras Clinical Research Richmond Training Hub Warwick Medical School Other contract income 6. Other Income Miscellaneous income Government grant (BBL interest) 7. Expenditure on Charitable Activities Research and medical costs Operating costs 8. Governance Costs Independent Examiner’s fees Legal and professional fees 9. Net incoming / (outgoing) resources Net resources are stated after charging / crediting: Depreciation |
2,200 - 5,600 - 1,500 33,945 - 158 |
|---|---|
| 7,800 35,603 2023 2022 £ £ - - 514 705 2023 2022 £ £ 164,152 120,979 251,357 250,879 |
|
| 415,509 371,858 2023 2022 £ £ 1,050 1,000 - - |
|
| 1,050 1,000 2023 2022 £ £ 450 1,318 |
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
10. Trustees’ Remuneration and Benefits
There were no trustees’ remuneration or other benefits for the year ended 31 March 2023, nor for the year ended 31 March 2022.
Trustees’ expenses
There were no trustees’ expenses paid for the year ended 31 March 2023, nor for the year ended 31 March 2022.
11. Staff Costs
| 1. Staff Costs | |
|---|---|
| Wages and salaries Employer’s National Insurance Employer’s pension costs |
2023 2022 £ £ 199,518 211,698 14,794 13,976 8,985 8,986 |
| 223,297 234,660 |
One employee received emoluments in excess of £70,000 (2022: one employee received emoluments in excess of £60,000).
The average monthly number of employees during the year was as follows:
| 2023 | 2022 | |
|---|---|---|
| No. | No. | |
| Direct charitable | 5.9 | 7.5 |
12. Pension Costs
Staff members are entitled to join one of two personal pension schemes. During the financial year 2022/3, any salaried medical professionals were entitled to join the NHS final salary scheme.
During the year ended 31 March 2023, the company’s total contributions amounted to £8,986 (2022: £8,986).
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
13. Tangible Fixed Assets
| 13. Tangible Fixed Assets | 13. Tangible Fixed Assets | |
|---|---|---|
| Improvement leasehold premises Hardware and software £ £ COST At 1 April 2022 - - Additions - - Disposals - - At 31 March 2023 - - DEPRECIATION At 1 April 2022 - - Charge for the year - - Disposals - - At 31 March 2023 - - NET BOOK VALUE At 31 March 2023 - - NET BOOK VALUE At 31 March 2022 - - 14. Debtors: Amounts Falling Due Within One Year Prepayments Other debtors 15. Creditors: Amounts Falling Due Within One Year Creditors and accruals Loans Social security and taxes 16. Creditors: Amounts Falling Due After More Than One Year Loans |
Fixtures, fittings & equipment TOTALS £ £ 21,711 21,711 - - (16,988) (16,988) |
|
| - - - - - - - - |
4,723 4,723 21,127 21,127 450 450 (16,988) (16,088) |
|
| 4,589 4,589 134 134 584 584 2023 2022 £ £ 2,620 911 2,200 10,013 |
||
| 4,820 10,924 2023 2022 £ £ 16,621 15,885 11,608 15,885 6,745 4,233 |
||
| 39,251 31,726 2023 2022 £ £ 152,924 74,197 |
||
| 152,924 74,197 |
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
17. Movement in Funds
| 7. Movement in Funds | ||
|---|---|---|
| At 1 April 2022 £ Unrestricted funds General funds 13,509 Restricted funds Restricted funds 21,860 TOTAL FUNDS 35,369 Net movement in funds, included in the above: Unrestricted funds General funds Restricted funds Restricted funds TOTAL FUNDS |
At 1 April 2022 £ 13,509 21,860 |
Net movement in funds Transfers between funds At 31 March 2023 £ £ £ 80,832 - 94,341 69,281 - 91,141 |
| 150,113 - 185,482 Incoming resources Resources expended Movement in funds £ £ £ 458,231 (377,399) 80,832 108,441 (39,160) 69,281 |
||
| 566,672 (416,559) 150,113 |
18. Related Party Disclosures
There were no related party transactions in the reporting period that require disclosure.
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
INCOME
| INCOME | |
|---|---|
| Donations and legacies Charitable donations Gift Aid donations Legacies Other trading activities Fundraising Fees Investment income Deposit account interest Charitable activities Grants Contract income Other income |
2023 2022 £ £ 111,064 90,983 28,229 16,151 - - |
| 139,294 107,134 62,104 38,814 255,089 101,596 |
|
| 317,193 140,410 1,078 25 112,488 38,880 7,800 35,603 |
|
| 120,288 74,483 - 1,219 |
|
| TOTAL INCOME | 577,853 323,271 |
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NATIONAL MIGRAINE CENTRE
Report of the Trustees and Financial Statements for the year ended 31 March 2023
EXPENDITURE
| EXPENDITURE | |
|---|---|
| Research and medical costs Salaries Other research and medical costs Operating costs Salaries and staff costs Repairs and renewals Rent Rates Telephone and internet costs Light and heat Insurance Incidental office costs (including relocation) Subscriptions Cleaning Website development Finance costs Financial outsourcing and ICT Bank interest Depreciation – fixtures, fittings & equipment Expenditure on raising funds Marketing costs Governance costs Independent Examiner’s fee Legal and professional fees |
2023 2022 £ £ 125,565 104,557 38,587 16,422 |
| 164,152 120,979 179,525 173,873 - 204 11,546 22,189 - - 4,442 6,649 - - 1,717 1,475 3,855 7,656 2,752 3,134 - - 19,526 13,216 6,050 3,497 17,936 13,951 3,558 450 3,717 1,318 |
|
| 251,357 250,879 11,181 6,074 1,050 1,000 - - |
|
| 1,050 1,000 |
|
| TOTAL EXPENDITURE | 427,739 378,932 |
| NET INCOME / (EXPENDITURE) | ||
|---|---|---|
| 2023 | 2022 |
|
| £ | £ | |
| NET INCOME / (EXPENDITURE) | 150,114 | (55,662) |
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