ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS)
COMPANY NUMBER: 06452601
## TABLE OF CONTENTS
## Interactive table of contents:
Click on any of the sections below to jump to the corresponding page; Click on the arrow at the bottom left corner of each page to jump back to the table of contents.
|**1. PRESIDENT’S FOREWORD**|**3**|
|---|---|
|**2. REFERENCE AND ADMINISTRATIVE DETAILS**|**4**|
|**3. TRUSTEES’ REPORT**|**5**|
|**4. STRUCTURE, GOVERNANCE AND MANAGEMENT**|**6**|
|**5. OUR MEMBERSHIP**|**10**|
|**6. COVID-19 PANDEMIC RESPONSE**|**13**|
|**7. ENT UK MEETINGS**|**14**|
|**8. EDUCATION**|**18**|
|**9. SPECIALIST ADVISORY COMMITTEE (SAC)**|**24**|
|**10. CLINICAL EXCELLENCE AWARDS**|**27**|
|**11. PATIENT INFORMATION LEAFLETS**|**28**|
|**12. ENT UK GROUPS**|**29**|
|**13. INTEGRATE**|**40**|
|**14. ENT UK FOUNDATION**|**43**|
|**15. FINANCIAL REVIEW**|**45**|
|**16. INDEPENDENT AUDITOR’S REPORT & FINANCIAL STATEMENTS**|**51**|
|**17. GLOSSARY**|**71**|
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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PRESIDENT’S
FOREWORD
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## 1. PRESIDENT’S FOREWORD
I am writing the foreword to this final report in my third year as President of ENT UK. This was an extended term due to the exigencies imposed by the pandemic, and we worked collaboratively with all the sub-specialty associations supporting our members and clinicians around the world. Our national efforts to recover from the pandemic and provide high-quality services in otolaryngology for the benefit of our patients continue to be hampered by the need to protect our colleagues and patients from the ravages of the “virus”, which shows no signs of disappearing, but is testing us in ways we did not imagine would happen in our lifetimes. We have, however, brought out the best in each other, and our collaborative efforts have been recognised by the recent Association Excellence Awards, taking first place for membership support during the pandemic. The efforts made by the entire team at ENT UK in achieving this must be commended and I am indebted to each one of the members, ENT UK staff, executives and trustees who have worked hard to make my time as President memorable!
As we launch the ENT UK Foundation, the philanthropic and fund-raising arm of ENT UK, I am reminded of a quote from Pope John Paul II: “let us remember the past with gratitude, live the present with enthusiasm, and look forward to the future with confidence”. In the next generation I have the fullest confidence that our specialty will continue to grow and flourish.
Professor B Nirmal Kumar, President of ENT UK
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) ANNUAL REPORT 2020 – 2021 | 3 Company number 06452601
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REFERENCE AND
ADMINISTRATIVE
DETAILS
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## 2. REFERENCE AND ADMINISTRATIVE DETAILS
## **Principal office**
## **Bankers**
The Royal College of Surgeons England 38-43 Lincoln's Inn Fields London WC2A 3PE The charity is incorporated in England and Wales.
National Westminster Bank Plc Bloomsbury Parr's PO Box 158 214 High Holborn London WC1V 7BX
## **Company Registration**
## **Auditor**
Edmund Carr LLP Chartered Accountants & Statutory Auditor 146 New London Road Chelmsford Essex CM2 0AW
## **Number**
6452601
## **Charity Registration**
## **Number**
1125524
## **Investment fund**
## **Solicitors**
## **managers**
SA Law 60 London Road St Albans Hertfordshire AL1 1NG
Brewin Dolphin Limited 12 Smithfield Street London EC1A 9BD
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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TRUSTEE’S REPORT
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## 3. TRUSTEES’ REPORT
## **Charter**
ENT UK is the professional membership body representing ear, nose and throat surgery, Head, Neck and Thyroid Surgery, in the United Kingdom.
ENT UK supports members at every stage of their careers, from medical student, trainee, academic posts, and senior clinical roles through to retirement - encompassing a total of more than 2,300 medical practitioners.
As well as supporting surgeons and associated medical professionals, ENT UK promotes the understanding of ENT in the media and provides the specialty with a voice. ENT UK is a source of valuable medical information for patients as well as practitioners, and supports research, provides continuing education for specialists, and champions high standards in training. In all of our professional activities we seek to improve the care available to patients suffering from conditions of the ear, nose, throat, head and neck.
## **Mission statement**
The mission of the association consists of the following aims:
- To improve the care available to patients suffering from conditions of the ear, nose, throat, head and neck through supporting research and guideline development.
- To promote the understanding of the range of conditions treated by the specialty through better public education.
- To provide information on the specialty to the general public and media through improved web-based information.
- To support and provide continuing education for specialists through courses, conferences and e-learning.
- To encourage recruitment into the specialty through greater exposure in medical school and foundation-year training.
- To promote high standards in the training of specialists through support for trainees seeking subspecialist training and academic career pathways. To represent the specialty to the Royal Surgical Colleges and to government bodies through increased representation.
## **Strategic aims**
The strategy aims to be:
**1. Patient-centred by focusing on**
- patient outcomes patient information closer liaison with related ENT charities advocacy for patients.
**2. Supportive to members from medical school to retirement through provision of or support for** :
- continuing medical education and training maintaining professional standards
- advancing knowledge of ear, nose and throat disorders through research and education
- specialty-specific professional capabilities addressing the non-medical elements of the NHS adequate representation in the Royal Surgical Colleges.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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STRUCTURE,
GOVERNANCE AND
MANAGEMENT
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## 4. STRUCTURE, GOVERNANCE AND MANAGEMENT
The following provides the governance and management of ENT UK during the period 2020-2021.
## **The Board of Trustees**
**Professor Nirmal Kumar** President
Trustee _since February 2011_ as Asst Honorary Secretary of ENT UK (2011-2015); Honorary Secretary & Company Secretary of ENT UK (February 2015 to March 2017); President-elect of ENT UK (March 2017 to March 2019); President of ENT UK _since March 2019._
**Mr Andrew Swift** President-elect
Trustee and President-elect _since March 2019_
**Mr Taran Tatla** Honorary Secretary
Trustee and Honorary Secretary and Company Secretary _since April 2020_
**Miss Kay Seymour** Honorary Treasurer
Trustee and Honorary Treasurer _since September 2018_
**Professor Gerry O’Donoghue** Master of BACO 2020
Trustee _since 3 Dec 2015_ and BACO Master 2021 _Until May 2021_
**Miss Catherine Spinou** BACO Treasurer/Project Lead
Trustee _since September 2019_
**Miss Victoria Ward** Clinical Trustee
Trustee _since December 2018_
**Mr Tim Mitchell** Clinical Trustee
Trustee _since April 2020_
**Mr Andrew Gamble** Lay Member
Lay Trustee _since May 2016_
**Mr Andrew Foster** Lay Trustee _since April 2020_ Lay Member
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **The Executive Committee**
## **Professor Nirmal Kumar**
President
**Mr Andrew Swift** President-elect **Mr Taran Tatla** Honorary Secretary _since April 2020_ **Miss May Yaneza** 1[st] Assistant Honorary Secretary **Miss Nara Oban** 2[nd] Assistant Honorary Secretary **Miss Kay Seymour** Honorary Treasurer **Mr William Hellier** Assistant Honorary Treasurer **Miss Catherine Spinou** BACO Treasurer/Project Lead **Professor Philippa Tostevin** Director of Education **Mr Craig Murray** Chair of SAC in Otorhinolaryngology
## **The Finance Committee**
**Mr Andrew Swift** President-elect, Chair **Mr Taran Tatla** Honorary Secretary _since April 2020_ **Miss Kay Seymour** Honorary Treasurer **Miss Catherine Spinou** BACO Treasurer/Project Lead **Mr William Hellier** Assistant Honorary Treasurer **Mr Patrick Way** Lay Member **Mr Andrew Foster** Lay Trustee **Ms Julianne Ilebode-Akisanya** General Manager _until December 2021_ **Mr Bikram Gurung** Financial Officer
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **ENT UK office**
**Ms Julianne Ilebode-Akisanya** General Manager _until December 2021_ **Ms Janet Stephen** Education Officer **Mr Bikram Gurung** Financial Controller **Ms Christy Hillman** Events Officer and BACO Organiser **Ms Jessica Leigh** Events Officer **Mr Davide Gorgoglione** IT/Website Officer **Mr John Nixon** Copywriter and Content Editor
## **The ENT UK Council**
**Professor Nirmal Kumar** President **Mr Andrew Swift** President-elect **Mr Taran Tatla** Honorary Secretary _since April 2020_ **Miss Kay Seymour** Honorary Treasurer **Professor Gerry O’Donoghue** Master of BACO 2020 **Miss Catherine Spinou** BACO Treasurer/Project Lead **Miss May Yaneza** 1[st] Assistant Honorary Secretary **Miss Nara Oban** 2[nd] Assistant Honorary Secretary **Mr William Hellier** Assistant Honorary Treasurer **Professor Philippa Tostevin** Director of Education
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Regional representatives**
## **Ameera Abdelrahim**
West Midlands (RSPA West Midlands)
**Robin Adair** Northern Ireland **Mohiemen Anwar** N. W. Thames (RSPA N W Thames) **David Baring** Scotland – East **Nazir Bhat** East Anglia (RSPA East of England) **Mriganka De** West Midlands (RSPA West Midlands) **Sam Fishpool** Wales **Rhodri Costello** Wales **Tony Jacob** S. Thames (RSPA S.E. Coast ) & S.W. Thames (RSPA S W Thames) **Simon Lloyd** North Western (RSPA North West and Mersey) **Ram Moorthy** Oxford (RSPA South Central and Wessex) **Yujay Ramakrishnan** Trent (RSPA East Midlands) **Paul Spraggs** ENT UK rep on RCS England council **Frank Stafford** Northern (RSPA Northern) **Beverley Yu** Yorkshire (RSPA Yorkshire and Humber)
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) ANNUAL REPORT 2020 – 2021 | 9 Company number 06452601
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OUR MEMBERSHIP
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## 5. OUR MEMBERSHIP
During the 2020/21 financial year ENT UK welcomed 606 new members. This was a net gain of 238 paying members (plus 32 free members), bringing our total membership at the end of the financial year to 2,370.
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13% 3%
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We continue to experience a year-on-year increase in membership with this year’s growth of paying membership by 13% continuing the upward trend. Our fastest growing cohort this year was International members, which has grown by 33% in the past year. This is closely followed by Trainee groups at 23% and Students and Foundation doctors’ grade (SFO) at 22%.
With the continued increase in membership numbers, we are still not experiencing a comparable growth in membership revenue. This is due to an increase in lowerfinancial-value memberships such as International, Trainees and SFO. Total membership revenue during the 2020/21 financial year was £448k. This represented a 3% growth on revenue from the previous year.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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OUR MEMBERSHIP
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## **Membership income by year**
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Year Revenue YoY% Head count YoY%
2014-15 325k 1262
2015-16 342k 5 1340 6
2016-17 371k 8 1387 4
2017-18 410k 11 1485 7
2018-19 411k 0 1617 9
2019-20 434k 5 1880 16
2020 -21 448k 3 2117 13
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Paying members by grade This year Last year
Total 2117 1880
Consultant 567 572
SFO 459 375
Trainees 442 358
International 215 162
Associate 139 124
YCOHNS 135 149
Allied 110 96
Retired 50 44
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Free members This year Last year
Total 253 221
Hinari 109 86
Life 81 81
Honorary 47 44
Parental leave 16 10
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ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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ACHIEVEMENTS
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DURING 2019-20
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ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS)
COMPANY NUMBER: 06452601
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COVID-19
PANDEMIC
RESPONSE
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## 6. COVID-19 PANDEMIC RESPONSE
## Provided by Taran Tatla, Honorary Secretary
The three waves of the COVID-19 pandemic have adversely impacted upon UK healthcare service delivery during these last 12 months. ENT UK has worked tirelessly through its leadership, sub-specialty groups and allied organisations, supported by an agile, adaptable office (working from home) and an engaged, growing membership.
The COVID-19 response has been a true team effort for responsive guideline development, considered interpretation and assimilation of new evidence-base, providing a basis for local service risk assessment and virus transmission risk mitigation measures. Communication again has been key for disseminating guidelines to support our members, allied professionals and local service managers, as well as inform the public through a variety of traditional news and social media portals.
An early spotlight on Personal and Protective Equipment (PPE) availability, and ongoing focus on Aerosol Generating Procedures (AGPs), endoscopy and tracheostomy, has allowed the need for both healthcare professional and patient safety to be underscored during ENT face-to-face clinical encounters. Following early engagement and successful lobbying of Public Health England, ENT UK has provided input to the multi-disciplinary NIHR AGP Task and Finish group, chaired by Professor of Gastroenterology Mark Hull. A clear route for prioritising relevant research questions and urgent funding needs has been set.
Multiple ENT UK working groups (interdisciplinary and sub-specialty-specific) have provided a plethora of consensus guidelines, statements and reviews to help support emergency care delivery, as well as the safe return and prioritisation of elective services following exit from the first wave of the pandemic. This material has been freely shared and publicised, benefiting patient care both in the UK and beyond; overseas colleagues and linked organisations have expressed their gratitude in numbers.
ENT UK has steered inclusivity and consensus working, promoting large multicentre audits for recording COVID-19 tracheostomy outcomes (CovidTrach) and the work of the UK ENT Trainee Research Network (INTEGRATE) for 2ww cancer risk calculation during telephone consultations. This effort is celebrated and promises much for delivering safer future patient care and innovative service delivery models. Other innovations, such as the St George’s Shield were supported in attempts to protect our members on the frontline with emergency COVID-19 activity.
Guidelines emphasising the need for early recognition of anosmia as a presenting symptom of COVID-19, to minimise undetected virus spread, made headline news globally and impacted government guidance.
ENT UK continues to adapt and evolve member services through digital technology. The cancellation of face-to-face meetings heralded a shift in focus to delivering virtual events and online webinars, including a successful BACO 2021. This has increased access and involvement in activities for our members, a change that is likely to continue long-term in hybrid manner as COVID-19 travel and other restrictions start to be lifted.
As well as ensuring member resources and communications are optimally presented and widely disseminated, much work has been ongoing behind the scenes in preparation for a restructured website, member and patient information portal. Website and social media communications have continued to be supplemented by fortnightly emailing of a member’s round-up throughout the year. Following the release of Baroness Kennedy’s report in March 2021, diversity, equity and inclusion continues to be a key focus for change and development at the heart of this organisation.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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ENT UK MEETINGS
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## 7. ENT UK MEETINGS
## **BACO International 2021: Master’s report**
## Provided by Gerard O’Donoghue, Master BACO 2021.
The 17[th] BACO International took place virtually 10-13 January 2021. The meeting had originally been scheduled for 2020 and, unlike any previous BACO, the academic programme had been finalised no less than a year in advance. However, little was to prepare us for the pandemic that lay ahead, and which reaped havoc on our best laid plans. The meeting was postponed twice – with all the organisational challenges that involved – and gave way ultimately to a meeting that was held entirely virtually due to the prevailing COVID-19 pandemic. Never in the chequered history of BACO did any group have to face such monumental challenges. It is indeed a great credit to all concerned and a tribute to the dedication and resourcefulness of our members that this meeting actually took place.
The founding fathers of BACO back in the 1960s had ambitious designs for the meeting, intending it to showcase the very best of British and Irish otolaryngology, with the participation of the greatest experts in our professions from around the world. The strapline chosen for the 2021 meeting was ‘translating research, transforming lives’ which represented the desires of the organisers to foster the close collaboration between our clinical and research activities that is so essential to advancing patient care.
In keeping with the international ethos of BACO, our guest specialty organisation was the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS), a collaboration organised with the generous assistance of Dr. James Denneny, Executive Vice President, and his colleagues on the governing body of AAO-HNS. The collaboration proved most fruitful, and it is to be hoped this will lay the foundations for other joint initiatives in the future. In addition, BACO 2021 awarded Master’s Citations to a number of highly distinguished contributors to our specialty: Sujana Chandrasekhar (New York), Farah Bhatti (Swansea), Padraig Kitterick (Nottingham), Ugur Sahin (Mainz), Jatin Shah (New York), Deborah Tucci (Washington D.C.) and Laura Viani (Dublin).
BACO 2021 also wished to recognise those within our specialty who made exceptional contributions. The initiative was led by Emma Stapleton, Communications Lead for BACO, and the following awards were made: Outstanding Trainers: Janet Wilson and Andrew Robson; Global Health: Mahmood Bhutta; Innovation: Vin Paleri; Rising Star: Misha Verkerk. In addition, BACO made a number of Fellowships available to colleagues from low-income countries to facilitate their attendance at the meeting.
Recognising the historical links with Irish otolaryngology, Nash Patil, President of the Irish Otolaryngology Association, lent his enthusiastic support and ensured the welcome involvement of many Irish colleagues in the meeting.
The guest of honour at the meeting was the legendary otologist Navnit Shah – who had the honour of attending the very first BACO, which took place in London in 1963!
BACO 2021 was fortunate to receive generous support from a number of charitable foundations, and this was of great assistance due to the financial uncertainty that
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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surrounded the pandemic. Thus we would like to recognise the generosity of the Lionel College Trust, the TWJ Foundation, the Narula, Shah and Shyamala Foundations and the Harbans Kaur Fellowships.
The Academic Chair for BACO 2021 was Hisham Mehanna and this proved to be a propitious choice as he dedicated his intellectual might to the task and accepted no compromise on academic excellence. He was ably helped by the Deputy Academic Chair, Paul Nankivell, and their leadership was central to the meeting’s resounding academic success. Our specialty today is a sprawling network of sub-specialty associations whose joint contributions are absolutely essential to the success of BACO. These specialty groups were represented as follows: otology by Manohar Bance and Simon Lloyd; rhinology by Leisha McClelland, Carl Philpott and Shaz Ahmed; Head and Neck by Hisham Mehanna and Paul Nankivell; laryngology by Declan Costello, Joanne Patterson and Kate Heathcote; paediatrics by Michelle Wyatt and Michael Kuo; professionalism and guidelines by Tim Mitchell; research by Mat Daniels and Anne Schilder; family practice by Philippa Tostevin. There were also welcome contributions from our trainees, through AOT, NAPDENT and others. The crucial role of sponsorship was magnificently managed by Shahed Quraishi, who professionalised BACO’s approach to the industry and worked tirelessly to raise sponsorship support against the gloomy backdrop of the pandemic.
What was the result of this huge collaborative effort? The academic faculty was the largest ever assembled for a BACO meeting and comprised 24 distinguished professors from ten countries; 35 other international guest faculty from 15 countries, over 300 speakers, 180 sessions and no less than 450 lectures! Given the exceptional circumstances imposed by the pandemic, to have delivered such an exceptional, global programme is a truly remarkable achievement.
Apart from the academic aspect of BACO, the meeting represents a huge financial risk for ENT UK, and this became manifestly clear during the pandemic. The trustees and Council of ENT UK could not have been more understanding and supportive during the unprecedented challenges we faced with BACO 2021. The unwavering support and wise counsel of ENT UK President Nirmal Kumar throughout this entire period is especially recognised. The role of project lead for BACO 2021 was fulfilled by Catherine Spinou. As BACO 2021 was organised ‘in-house’, huge responsibilities and an almost impossible workload fell on our outstanding office staff – notably Christy Hillman, Jillian Hart, Julianne Ilebode-Akisanya – who never flinched despite the often unreasonable pressures imposed on them.
Ronald Macbeth and the other founding members of BACO had high expectations when they set out with trepidation in the 1960s. I am certain these founding fathers would feel their vision was fully encapsulated in BACO 2021 and they would be immensely proud of what was achieved under considerable duress. BACO 2021 reflects well on the state of our speciality, its resilience and resourcefulness and its capacity to face whatever challenges lie ahead.
Thus, it merely remains for me to thank all those who so generously contributed to the spectacular success of BACO 2021 and to thank you for the honour of serving you as Master.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **BACO 2021**
## Provided by Catherine Spinou, BACO Treasurer/Project Lead
In March 2020 the Board of Trustees assessed the COVID-19 situation and deemed it to be in the best interests of the delegation and staff to postpone the live BACO event from July 2020 to January 2021. We were relatively optimistic that by then the lockdown would have been long ended and the effect of the virus would have diminished and allowed for resumption of activities as we knew them. By May 2020 it became evident to me and the people working on BACO on a daily basis that a ‘live’ BACO in January 2021 was a potentially dangerous scenario, and information we were receiving suggested that a live event would be completely unpredictable, if it happened at all. If not mitigated at least partially, the financial hole this risk could leave for ENT UK would be significant.
The trustees took the decision to turn BACO into a virtual event, which opened in January 2021, lasted three days and stayed open on a virtual platform for six months. The event was a success, academically and financially.
BACO 2021 attracted a total of 1,292 delegates from across the world and had a net surplus of £109k which put ENT UK in a safe financial position. A small number of delegates took up the offer of becoming a member of ENT UK.
Overall, the event was deemed a success and it provided ENT UK experience in setting virtual events for the future. It seems that this form of event is here to stay and ENT UK can capitalise on this experience.
## **ENT UK Annual General Meeting (AGM)**
## 9 June 2021
Presentations of ENT UK’s financial situation demonstrated that, following turbulence at the outset of the pandemic, the association is in a robust financial position. Despite the expense of moving BACO to a virtual platform, these costs were ultimately recovered and Virtual BACO International was a resounding success.
The membership enjoyed continued growth throughout the year, standing at 2,394 as of May 2021, with particular growth in the run up to BACO. The efforts of Professor Kumar, the ENT UK team and sub-specialty organisations in the early days of the pandemic helped to drive this increase. While membership fees were frozen last year due to the pandemic, unfortunately these fees must now rise by 1.4%, in line with RPI.
The ENT UK Foundation to support education and research was introduced, funded not by membership subscriptions but by raising money through donations.
Attendees were updated on the new webinar platforms now available; further virtual learning plans for next year were also discussed. The new curriculum group is also creating resources, such as those developed for GPs as part of the Community ENT Group.
Professor Kumar acknowledged the collaborative effort of many stakeholders throughout this critical period. He thanked the ENT UK team, ENT UK Executive
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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ENT UK MEETINGSENT UK MEETINGS
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Board and Board of Trustees, the BACO team, immediate past President, the subspecialties and ENT UK Council, ENT UK’s media advisor, the e-learning editors, AOT president, and the new BRS President.
## **ENT UK Autumn Annual Meeting 2021**
## (Rowena Ryan Awards 2021)
The ENT UK 2021 Autumn Annual Meeting inaugurated the expansion and extension of the Rowena Ryan Awards to a national/international ENT audience under the auspices of the newly created ENT UK Academic Foundation. It was held as a hybrid event (face-to-face and virtual attendees) on Friday 17 September at the newly refurbished Barry Building of the Royal College of Surgeons of England, London.
The Rowena Ryan awards celebrate excellence in audit, research and training, providing a platform and acknowledgement of the hidden hard work, sacrifices and achievements of ENT trainees, trainers and researchers for service improvement and patient benefit.
The awards were initially set up in 2015, within the London and South East England deanery, on the tenth anniversary of Rowena Ryan’s death. Miss Ryan, a young consultant ENT surgeon at Northwick Park, London, was a trainees’ champion and strong advocate for improving training and clinical practice standards. With various hats on in regional (TPD) and national (SAC) roles, she provided support and mentorship for basic and higher surgical trainees, and oversaw clinical practice guideline development and national audit projects through the work of ENT UK’s CAPAG. She died of pancreatic cancer in her early forties, following a short illness. She left behind her husband and two young children with whom we now remember and celebrate her legacy annually.
The 2021 Rowena Ryan awards were sponsored by a number of industry sponsors, and categories included Best Trainee-delivered Audit, Research and Training Projects, Best Young-Consultant-delivered Audit, Research and Training Project, Best SAS and Best Overseas Trainee-delivered Audit, Research and Training Projects. The Rowena Ryan ‘Paper Knife’ award acknowledged a unique and special contribution among applicants, on this occasion awarded to a medical student. Best ENT Trainer and Overall Lifetime Trainer Awards were made additionally, following trainee member and council nominations.
Shortlisted abstracts from over 100 applications were invited to present through oral presentations and posters at the day’s meeting, judging panels comprising a diverse group of trainers and academics from across the UK. The day’s programme was completed through memorable talks provided by invited home and overseas speakers, including Professor Al Merati, former President of AAO-HNSF, who managed to surmount many obstacles placed in his way for international travel amid COVID-19 restrictions.
An energetic performance from members of the DanceSyndrome charity ensured a befitting finale to the celebration, with all attendees (junior and senior, trainees and trainers, executives, trustees and ENT office staff) brought to their feet in dance and laughter together.
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## 8. EDUCATION
## Provided by Philippa Tostevin, Director of Education, ENT UK
This report has been produced with the help of the Education Officer, Janet Stephen, who has provided exemplary support for all educational activities under the remit of the Education and Training Committee of the organisation. All educational meetings have taken place on a virtual platform this year, with minutes taken from recordings. The ENT UK Education and Training committee, with representation from the leadership of established educational groups CPD, SFO, SAS, AOT, PESC, ESCC, SAC and the Community ENT Group has met and updated the executive, trustee and council committees throughout the year. The undergraduate forum developed by the SFO group last year has met remotely to support the delivery of undergraduate education in ENT throughout this period.
This report represents a summary of educational activities to demonstrate how they have progressed in alignment with the mission statement of ENT UK, noting the strategic objectives and key deliverables in the five- to ten-year strategy document of September 2018. For all educational courses, the ENT UK events policy has been followed and the feedback has been produced and analysed in timely fashion with particular thanks to Christy Hillman and Jessica Leigh of the events team.
## **1. Mission statement:**
## **To promote an understanding of the range of conditions treated by the specialty**
## **a. e-lefENT**
James Tysome (Director of e-learning) and Somiah Siddiq (Editor-in-Chief of e- lefENT) have continued to collaborate with the digital transformation team from Medtronic, who support the virtual learning platform. The new VLE is easy to view on a mobile phone and has features to allow viewing of content in a pathway that is appropriate for the stage of the user. The new curriculum for otolaryngology has been mapped at a high level to the e-lefENT content, to identify areas in need of development and to increase the overt usefulness of the platform for trainees. A mapping exercise with the ENT UK GP curriculum guidance document and e-lefENT was undertaken by Eason Sivayoham, member of the Community ENT Group and GP representative on Council. This work has led to the development of new resources for the VLE to support GPs with an interest in ENT. Two new paediatric section editors have been appointed this year, Matthew Ellis and Lily Labalenska. After an analysis of the usage of the platform data, it was agreed that both Hinari A and B countries should be able to access the ENT UK VLE without charge.
## **b. Community ENT Group**
The Community ENT Group has met virtually during the pandemic and has a growing membership from around the UK. This group supports the specific educational needs of GPs, GPs with an extended role in ENT and allied healthcare workers who care for ENT patients. A key development this year is the addition of a physician associate member of the group, Emily Harrison. A working group (which
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is a subgroup of the Community ENT Group) has been collaborating with others to develop a curriculum guidance document for physician associates in ENT. The group have been very active throughout the year, developing patient information leaflets for GPs on ‘anosmia’ and ‘how to look after your voice’ – these are available on the ENT UK website. Standard operating procedures were developed for microsuction and dewaxing in the community during the pandemic. As mentioned above, GP-specific e-leFENT resources have been developed and this work is ongoing.
## **c. GP and Allied Professionals Day at BACO**
A successful GP and Allied Professionals Day was delivered as part of the virtual BACO conference in January 2021. The content had been developed to align with the curriculum guidance for GPs with an interest in ENT and the physician associate curriculum. Pre-recorded questions that were posed by the Community ENT Group to the speakers helped to enrich the experience of the day. The educational material was available for six months following BACO as an educational resource. The day was well received and also provided excellent ideas for the planning of the next BACO.
## **2. Mission statement:**
## **To support and provide continuing education for specialists**
## **a. CPD**
The CPD committee, led by Declan Costello, has provided kite mark accreditation on behalf of ENT UK as a marker of quality of educational provision. Over this time period, 32 applications for CPD approval were received and two applications were received for advertising only. The regular programme of quality assurance visits to courses was not achieved due to travel restrictions, but oversight has been rigorously maintained with feedback from all courses reviewed and action taken as required. There has been a recent change of leadership of the group with Marianne Elloy taking the helm.
## **b. Specialty Doctor Group (SAS)**
The SAS group, led by Shyam Sunder Singam, delivered SAS-specific sessions at virtual BACO, includinge CESR, education and tongue tie clinic talks. The plans for the sixth annual ENT UK SAS conference in Wales for June 2022 are ongoing. The ENT UK CESR buddy scheme to support applicants across the UK continues to be a useful resource to the SAS membership. The changes to the SAS contracts in 2021 have been discussed within the SAS group, as have the implications of the new otolaryngology curriculum requirements on CESR applicants.
## **c. Webinars**
The webinar series is a free resource, livestreamed through the RCSEd using a Webex platform. The subsequent learning resource videos are then uploaded onto the ENT UK website and the e-lefENT virtual learning platform. This popular series attracted an international audience of trainees, SAS doctors and consultants. Topics covered included facial nerve palsy post-parotid and post-ear-surgery, pharyngeal leak, vocal cord palsy, post-operative hearing loss, CSF leak, chyle leak, flap failure
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and displaced tracheostomy tube. Mira de Kruif was appointed to a new role as ENT UK webinar coordinator, and she has planned an exciting new series covering the multidisciplinary approach to ENT conditions for the next academic year. The administration of this activity falls within the remit of the RCSEd under the leadership of Mr Omar Hilmi, collaborating with the ENT UK team.
## **d. Paediatric Emergency Surgical Skills Course (PESSC)**
## Course leads Michael Saunders and Neil Bateman
This simulation course has been developed primarily to support ENT consultants who cover emergency work but who do not work in tertiary paediatric ENT centres. This is an ongoing requirement. Due to the pandemic, only one course ran this year – this took place in Birmingham in September, and had excellent feedback.
## **e. Adult Emergency Surgical Skills Course (ESSC)**
## Course lead Raj Lakhani
We were unable to run an adult course in the timeframe of this document due to safety concerns during the pandemic and issues with the planned venue that necessitated cancelling plans. It is hoped that the course will be delivered in the next academic year. A strategic approach to try to deliver this course as a membership benefit has been adopted in the past. The use of cadaveric material is the main challenge in relation to the cost of this course, although the geographical area and their facilities also contributes to the range of costings. It has previously been delivered as a membership benefit at the subsidised rate of £200 each. Each course requires six faculty to deliver, so while they are popular and enormously beneficial to the maintenance of general emergency skills in the increasingly specialised consultant workforce, this has to be balanced against a considerable cost to the organisation.
## **f. International Paediatric Anaesthesia and Airway Course**
## Course lead David Howard
Travel restrictions in the period covered by this document have limited the delivery of international courses this year. This course is designed for the needs of nurse anaesthetists and medical students.
## **g. Medical Training Initiative scheme (MTI)**
The MTI scheme is run by HEE on behalf of the Department of Health (the government sponsor) operating under the Home Office Tier 5 Government Authorised Exchange visa scheme. In alignment to the strategic objective to run an effective recruitment scheme for MTI, ENT UK aims to sponsor clinical training and improve the quality of healthcare in developing countries. Three MTI doctors were accepted for training in the UK during the period covered by this document, interviewed via videoconference by an ENT UK executive representative and host trust representatives: Southampton (Jamaica), Sunderland (Jamaica) and Monklands (Sri Lanka). The pandemic impacted on the start dates for some MTI doctors when international travel restrictions were in place. Following a suspension of the MTI programme it was reinstated with the additional requirement of support from the local postgraduate dean to ensure that the presence of an MTI surgeon would not have a negative impact on a UK trainee.
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## **h. Induction package for junior doctors**
A great new resource has been developed which represents a huge collaborative effort led by James Tysome, and we are grateful for the efforts of all contributors, with particular thanks to Chloe Swords, Matthew Smith and Ananth Vijendren. These educational resources can be used for the benefit of all ENT departments in the UK and can be used to augment your existing local offering. They include lectures, ENT clinical skills videos and moulage of ENT emergency scenarios that will be of particular use for junior doctors who may have qualified during the pandemic with limited exposure to ENT on their clinical placements.
## **i. Podcast development**
Plans for the 2021/2022 academic year podcast series started in collaboration with RCS Ed. The content will be coordinated with the webinar series and mapped to the new curriculum for otolaryngology.
## **j. ENT UK Educational Library**
The viewing figures for BACO 2020 were analysed, including for live and on-demand sessions. The top scoring five in each of the main topic areas (otology, head and neck, laryngology, rhinology, paediatrics and facial plastics) have been selected to form a new ENT UK Educational Library resource. This is being released two subject areas at a time on the website. These have been mapped to the curriculum content for the trainees.
## **k. GP Guideline Live event**
ENT UK representatives Wendy Smith and Thomas Jacques presented at a UK-wide conference on 17 November 2021 with great feedback, and the ENT contribution was noted as a highlight of the conference. This was a great opportunity to advertise the BACO GP Day to a vast number of GPs and community nurses.
## **3. Mission statement:**
## **To encourage recruitment into the specialty**
## **a. SFO group**
## Chair Dheeraj Karamchandani
In alignment with the 2018 strategy to support the training of members from medical school, the membership of the SFO group continues to grow and we hope that the enthusiasm can be maintained and translated into a vibrant future for the specialty. During the pandemic, the SFO group supported the undergraduates around the UK with free access to the e-book _The Official Handbook for Medical Students and Junior Doctors_ , produced by ENT UK. It also negotiated free access for the e-lefENT platform while there was restricted access to clinical placements in ENT due to the potential infection risk posed by the usual ENT clinics and theatre sessions. The undergraduate forum continued to meet during the year, bringing together 22 educational leads for ENT from UK medical schools. This has enabled sharing of best practice and innovations to overcome the challenges of the delivery of ENT education safely in the COVID era. The SFO BACO team delivered an exceptionally good virtual BACO session, including interviews with many ENT surgeons to show different career pathways.
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## **b. AOT**
A key educational relationship that has been actively nurtured throughout the year is that of ENT UK with the AOT group. The president of AOT, Manish George, and the Education representative, Summy Bola, have been active contributors to the Education and Training committee, and as such provide a key bridge of essential communication between the organisations. The AOT education team are to be congratulated on their fantastic achievements during the pandemic, bringing together a wide collection of educational materials to support the UK trainees.
## **4. Mission statement:**
## **To promote high standards in the training of specialists**
## **a. SAC**
The key relationship between educational committees and ENT UK is maintained by the President of ENT UK and the DoE sitting on the SAC, as well as the Chair of the SAC, Craig Murray, being a member of the ENT UK Board of Executives and the Education and Training Committee.
During this year, the new otolaryngology outcomes-based curriculum went live in August 2021 and a new assessment system for all surgical trainees was introduced featuring a multi-consultant reporting system.
## **b. Recruitment**
National Selection in 2021 took the form of a virtual portfolio review due to the lockdown restrictions. The highest scoring candidates were then interviewed over a virtual platform. The DoE of ENT UK supported the quality assurance of the process working with the national selection team in Yorkshire and Humber. An efficient process was delivered, but it was generally felt that the absence of a surgical skills station was a great pity for all concerned. It is of note that the recruitment of new assessors may be a challenge with the remote format.
## **c. Examinations**
The DOHNS examination was undertaken successfully, with COVID restrictions in place both in October 2020 and May 2021. The written element of the examination was undertaken remotely with a four-station face-to-face OSCE in three centres.
## **d. Education awards**
The inaugural Narula and Frances Shah Education Fellowships were announced at the general meeting in September. These awards were for applicants from specific groups: SFO, YCONS, SAS and AOT. Next year it is hoped that the award winners will present what they have achieved over the year.
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## **5. Mission statement:**
## **To represent the specialty at the Royal College of Surgeons**
## **a. Fellowships**
ENT UK provides support to the RCS fellowship scheme by reviewing applications. The Birmingham thyroid fellowship and Guy’s Oncology fellowship applications were supported.
## **b. Surgical care practitioner plans**
The ENT UK, DoE and ENT representative for RCSEng, Paul Spraggs, have met with RCSEng representatives to discuss their model of surgical care practitioner training and its relevance to the needs of ENT as we recover from the pandemic. Current plans are for ENT UK to focus on supporting the development of the physician associate role in ENT, as it was felt that developing a new model for outpatient support might have more of an impact on our recovery plans, rather than additional support in the theatre. This work is ongoing.
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SPECIALIST
ADVISORY
COMMITTEE (SAC)
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## 9. SPECIALIST ADVISORY COMMITTEE
## (SAC)
Provided by Craig Murray, Chair of SAC
## **SAC membership and governance**
All liaison member and lead roles have been filled. One new member was appointed within the timescale of the report. Going into effect shortly after the period of this report will be a significant change within the SAC, with the appointment of the new Chair, Ann-Louise McDermott, who is due to start in January 2022. There will therefore be an upcoming need for new members.
## **Selection and recruitment**
National Selection in 2021 was again run on a modified approach, with the assessment being fully online. On this occasion we were able to include a modified interview process undertaken through Microsoft Teams. We were successfully able to fill all available registrar posts. Going forward, the MDRS has resisted any faceto-face component. We are concerned about this being their ongoing stance. While this does have convenience and cost in its favor, we feel that such a key interview, essentially determining our consultants of the future, requires the most appropriate assessment process, including essential skills and communication that online methods cannot deliver as effectively, if at all. We will continue to push for a hybrid model with a face-to-face component.
We are also concerned about the loss of networking and the difficulty to enthuse remotely new people interested in extended training roles. This was a vital core advantage of the prior face-to-face model.
## **Workforce**
We remain concerned regarding the workforce position within the UK, and are keen to increase numbers. This is raised yet again at JCST. Going forward, Bill Irish (Dean) is engaging with Adrian Brooks from HEE to establish a review of figures. The impression is that HEE’s workforce figures are wide of the mark and need reassessment. We are well aware of this situation in our own workplace, with challenges to recruit into available consultant positions.
## **Training program and trainee issues**
COVID remains a significant impact on training experience. The following figure shows the ebb and flow of logbook numbers. We remain well short of where we need to be. This is exacerbated by the lack of a level playing field. Head and Neck has been minimally affected and will in reality make up the majority of the cases. There is a worrying dearth of rhinology and otology cases. This will affect not only those looking for a career in those special interest areas but also will affect opportunity for our head and neck trainees to fulfil the remaining curriculum and emergency safe requirements.
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We are at the point now where the measured loss of surgical training cases is in excess of 1 million across the surgical specialties.
Because of this, curriculum derogations will remain in place for as long as COVID impacts training. There has been a recent publication by HEE explaining the various options to access alternative training opportunities. Monies have been made available to support such opportunities. We are hoping not only to access some of these funds for increasing available posts by incorporating some of the ‘Fellowship’ training posts, but also in increasing potential access to training through simulation.
The numbers of 10.1 and 10.2 are not as high as in some of the other specialties such as orthopaedics. However, I am very concerned going forward that we have stored up a lot of potential trainees who will simply not reach the required standard to progress, or fulfil requirements for critical progression points and CCT. I think that at ARCP in 2022 we will see that the problem is actually far greater than the modelling suggests. I hope I am wrong but without a rapid increase in training opportunities, I do not see an easy pathway forwards. I remind you all that we need to ensure that any trainee at CCT has been trained to the appropriate standard. If this means extension to training time as a result of COVID then this needs to be accepted. The safety of the general public remains paramount.
## **Curriculum and logbook**
The curriculum commenced successfully in Aug/Oct 2021. All trainees who are due to progress will now be underway. At time of writing, the MCR midpoint meeting will not yet be done. The curriculum itself is very similar in overall content and standards to before, but has greater clarity around special interest areas and measured competences. The overall ’holistic’ measurement of progress and the required steps to make progress will be via the MCR. I am sure this will be a difficult transitional period for both trainees and trainers alike. There is a rich resource available online via either the JCST or ISCP websites or the JCST YouTube channel.
The Logbook is making positive progress. This will continue to improve and become far more integrated into ISCP. Interrogation tools are available to show comparative training opportunities between regions and trainers.
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## **Run-through Training**
We have now reached the end point of the run-through pilot. However, concern has been raised by CoPSS regarding the sustainability and workability of a ‘mixed economy’ model. This affects all specialties, including our own. In reality, it is likely that the options for consideration will be either sole entry at ST1 with full runthrough or entry at ST3 following Core. Because of this uncertainty, there will be no ST1 recruitment in 2022.
The situation going forward has not been fully determined, but it is likely that recruitment into formal specialty training will be at the ST3 entry level. A new Core curriculum is in the early stages of development which, at its heart, consists of specialty themed posts with components of ST2 ‘drawing down’ from our own ENT curriculum. If effective, at least it will ensure that trainees applying for ENT will be able to have themed training prior to selection at ST3. The great loss of our pilot was the clear separation of those wishing to enter at ST3 versus those with more career and geographic certainty entering at ST1. I do believe that with a good, wellconstructed Core curriculum we can try to retain all the positive aspects of runthrough with the only loss being geographic certainty.
The run-through pilot was worthwhile and I thank all those who took part and allowed us to gather the necessary data. Those trainees who have already commenced their run-through posts should not be concerned and will be supported and allowed to complete their training with no changes.
## **TIG**
The final TIG recruitment has already been done for TIGs commencing their placement in 2021. The TIG programs as stand will continue, but will become postCCT. These will be quality assured via the JCST framework. Expansion of areas suitable for TIG Fellowships is hoped to continue.
## **Finally**
I thank everyone for the support to our trainees shown throughout this pandemic. We are nowhere near the end of the impact on training and I am sure we will feel the effect of this for many years to come, even when the numbers fall and nearnormality resumes.
It has been a challenging time to be the SAC Chair. I have received good support and guidance from my SAC liaison members and leads, as well as from ENT UK and the JCST. I also hope that AOT feel the relationship with the SAC was strong, and that it was included in decisions affecting training.
I hope I have passed on to Ann-Louise something that shows potential for positive progress. I wish Ann-Louise well and am sure she will be an excellent Chair.
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## 10. CLINICAL EXCELLENCE AWARDS
As a recognised specialist society, the role of ENT UK is welcomed by ACCEA, as we can highlight excellence at a national level. It was expected that the number of submissions would be higher due to the cancellation of the 2020 round with oneyear extensions being given. However, the number of nominations that we are allowed is based on our eligible consultant membership and it is currently no more than eight for bronze, four for silver, and two for gold awards. Platinum awards are submitted to ACCEA by the Academy of Royal Colleges. One difference this year, reflecting the importance of the support from specialist societies, was not overlapping with other organisations – in other words, ENT UK did not submit a list to RCS England, Edinburgh, etc., and applicants were entitled to seek support separately from other recognised nominating bodies or specialist societies.
The ENT UK Awards Committee comprised of members who are senior award holders and represent the range and diversity in membership. All submissions were scored independently by each committee member and these total scores form the basis of the committee deliberations. Ranking was based solely on the scoring by the panel members, unless there was a tie-break. All rankings and citations were submitted in good time within the timelines outlined by the ACCEA.
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INFORMATION
LEAFLETS
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## 11. PATIENT INFORMATION LEAFLETS
Throughout the period running from 1 October 2020 to 30 September 2021, the ENT UK patient information leaflets remained a popular resource. Orders were slower than they had been previous to the COVID-19 pandemic but continued to come in at a reasonable pace under the circumstances, and the online versions remained the most frequently visited webpages on the ENT UK website.
In February 2021, May Yaneza went on 12-months’ maternity leave and was replaced in the role of project lead for that duration by Nashreen Oozeer. During this period the expanding scope of the patient information leaflets stabilised at 56, increased from an original 27, with new titles added as prospective authors were identified. New content was edited and reviewed from clinical, lay and editorial perspectives and, where appropriate, illustrations were sourced or created to accompany the leaflets. Finances were made available for three titles to be sent to the Plain English Campaign for editing to the point where they were eligible for a Crystal Mark. Due to the considerable expense of this process, it was agreed that only the first three titles would ultimately be published with the Crystal Mark, while a close study of the changes made by the Plain English editors would inform future in-house editing, a process which began immediately.
During this period, a number of new or updated leaflets were uploaded to the website; several more very close to completion, with their written content finalised.
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## 12. ENT UK GROUPS
## **BSO**
## **British Society of Otology**
## Provided by Simon Lloyd (Secretary)
The last year has seen a return to some degree of normality in our practices after the unprecedented disruption of the COVID pandemic. There is, however, still much to do in order to catch up with the backlog of work resulting from the first lockdown, while coping with ongoing disruption from lower staffing levels and the continuing use of additional COVID protective measures. Throughout this period the BSO has continued to be busy in pursuing its aims of promoting excellence, providing firstclass education and developing the field of otology.
We continue to strive to represent the breadth of our specialty and have welcomed two new members to council (Paramita Baruah and Will Hellier). We are very grateful to Ian Bottrill, who demitted from his council position this year, for his outstanding service. There are also some forthcoming changes to the executive members of the council, with Professor Simon Lloyd appointed as President-elect, replacing the current President, Professor Peter Rea, Miss Kay Seymour appointed as Secretary and Peter Monksfield appointed as Treasurer. They will take up their posts in February 2022.
The key event, as every year, was the BSO annual conference. With ongoing COVIDrelated concerns, we decided to run the conference virtually this year. Although many of us have experienced increasing frustration with our lack of social interaction at this type of event, there are certain advantages, and we were able to enlist some outstanding international speakers covering topics such as local anesthetic ear surgery, the physiology of the endolymphatic sac and robotic surgery in otology. The accessibility of the virtual platforms also meant that we had over 150 delegates, more than at any previous meeting. We were able to run a very successful virtual balance course with 44 delegates. We are very grateful to the ENT UK office for all the help they provided in organising these events. The 2022 conference is already in advanced preparation and will be hosted by Manohar Bance, BSO Academic Secretary, in Cambridge in May 2022 as a hybrid face-to-face and virtual conference.
A further excellent virtual event, this time in collaboration with the RSM, focused on the genetics of hearing loss and highlighted the introduction of Genomics England’s new genetic hearing loss screening panel. Hopefully there will be more of this type of collaborative event between our two closely aligned organisations. At the time of going to press the BSO Council, under the leadership of Kay Seymour, is in the process of developing the otology programme for BACO 2023, with some very exciting sessions in store. Our current President, Professor Peter Rea, is Academic Vice-chair of BACO 2023 and, with the BSO committee, has already secured an outstanding panel of six international keynote otology speakers for 2023, reflecting the diversity and breadth of our specialty around the world. We very much hope that we will be back to face-to-face meetings in the not-too-distant future, COVID allowing.
Over several years, we had built up a financial surplus that has allowed us to develop a financial strategy to maximise our goals. We have provided a significant sum to help develop the BSO part of the new ENT UK website. We have also been able to support a round of funding for small research projects, successfully led by
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our Academic Secretary, Professor Manohar Bance. We had 12 excellent applications and were able to support five projects with £1,000 funding each. Congratulations to the successful applicants. We are very much looking forward to seeing these projects come to fruition next year, as well as funding further projects going forward. We also plan to support trainee and consultant fellowships, support international experts in coming to BACO to speak, and support the development of educational material.
We have continued to contribute to the development of a number of clinical guidance documents that are now available on the ENT UK website, and have advised NHSE and NICE on several guideline documents related to otology. We have also developed a series of evidence-based otology consent forms taking into consideration the requirements following on from the Montgomery ruling, and have updated a good proportion of the patient information leaflets published by ENT UK.
The remarkable enthusiasm and diligence of the BSO Juniors under the leadership of Elinor Warner have continued to be an enormous asset to UK otology. They led a national audit investigating how otology practice restarted as we came out of the first COVID lockdown, which has been submitted for publication. They ran a parallel meeting for ENT junior doctors at the BSO annual conference and organised a stand-alone virtual conference combining invited speakers and free papers for medical students and junior doctors of different seniority levels. The submissions were first class and bode well for the future of our specialty. BSO was able to provide a £1,000 prize for the best presentations. It has also organised a series of otological grand rounds and developed a database of otology fellowships. BSOJ has also played an integral part in a BSO/BAPO collaboration investigating the presentation and management of paediatric acute mastoiditis and how COVID impacted this across the UK. This has been accepted for publication and is one of the world’s largest studies of its kind.
We have also worked hard to ensure our COVID guidance remains up to date as the pandemic has progressed, and have been involved in progressive development of the return-to-practice guidelines published and regularly updated by the Federation of Surgical Specialty Associations (FSSA).
By way of conclusion, the BSO executives are incredibly grateful to our council members, who have worked tirelessly under difficult circumstances to keep our organisation vibrant, dynamic and relevant. After such a challenging period we wish you all the very best for the forthcoming year.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **BOARS**
## **British Otorhinolaryngology & Allied Sciences Research Society** Provided by David Hamilton, Secretary
BOARS was formed in 2017 by a merger of the Otorhinolaryngological Research Society (ORS) with the British Society of Academic Otorhinolaryngology (BSAO). BOARS aims to provide a forum for the best current research in ENT, hearing and balance in the UK. Two meetings are held each year that combine oral presentations in the style of the ORS with research education for academic trainees.
BOARS held a fully online Spring BOARS meeting on 19 March 2021. Rohma Abrar won the Phillip Stell Prize and Thomas McLelland won the junior prize. There was a hustings for new council members, with appointment of a new secretary (David Hamilton) and treasurer (Stuart Winter) as well as ordinary council members (Colin Leonard and Nail Tan), discovery scientist (Matthew Farr), audiovestibular representative (Jaswinder Sandhu), webmaster (Syed Zaidi), senior trainee representative (Haroon Saeed), junior trainee representative (Tanya Ta) and student representatives (Molly Bond and Kiran Joshi).
The relationship between BOARS and ENT UK has become gradually more formalised, with ENT UK supporting the Autumn meeting in October 2020. At this meeting the Angell James prize was won by Tobias James and the junior prize by Leo Gundle and Joseph Henry.
In November, we launched the BOARS pump priming grant for £1,500 and we are currently reviewing the quality of the applications.
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## **BSFPS**
## **British Society of Facial Plastic Surgery**
## Provided by Anil Joshi, Secretary
BSFPS had a successful 2021 all around. Membership grew to 845 which was a significant increase from the previous term. Annual meeting was held in Glasgow in October 2021 and was conducted across two days. Day one was a junior forum along with viva voce for FRCS-exam-going candidates in the afternoon. Day two had fabulous lectures delivered by internationally-reputed faculty. The speakers were from the UK, Belgium and Germany. All aspects of facial plastic surgery were covered in these two days. There were junior doctors’ poster and oral presentations. These were rewarded with prizes that were adjudicated by a nominated jury.
The annual fresh cadaveric dissection course had to be cancelled due to the pandemic. However, plans are already in place to hold one in 2022 ahead of our annual meeting.
BSFPS has also been heavily involved in formulating the programmes for international meetings such as ERS, CEORL-HNS and BACO.
Responding to the need to further training opportunities during the pandemic, BSFPS formulated a spring run of live and interactive online lectures in the early part of 2021. Mr Anil Joshi, our General Secretary, took active lead in organising this programme with significant help from the junior wing of BSFPS. These lectures were held every week and ran close to three months. The lectures were geared towards FRCS examination and were attended by junior doctors and consultants alike, not only from the UK but from across the world. These were received very well, judging from the feedback provided.
Our President, Mr Peter Andrews, has been actively involved in and headed the recovery plans for the pan-London COVID-19 ENT recovery programme appointed by NHS England. These involve nasal airway surgery and endoscopic sinus surgery pathways. Awake surgery for inferior turbinate procedures has also been promoted.
There has been ongoing involvement of our past-president Professor Hashem Saleh towards the cosmetic surgery certification scheme with the Royal College of Surgeons of England.
The annual board meeting of BSFPS was held in the first week of December. All the above points were discussed. The nomination process for the president-elect was announced. The next annual meeting for 2022, along with a cadaveric dissection programme, was discussed.
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## **BSHENT**
## **British Society for the History of ENT**
Provided by Neil Weir, President and Emma Stapleton, Ordinary Committee member/Honorary Secretary
The Annual Meeting of the British Society for the History of ENT (BSHENT) was held virtually on Thursday 3 December 2020. 35 papers were submitted from which 12 were chosen for presentation. An additional paper entitled ‘A Disaster for the World – the Death of Kaisser Frederick III’ was introduced by Professor Michael Gleeson and presented by Dr Ian Calder. The Journal of Laryngology and Otology (JLO) prize was won equally by Katherine Conroy and Mairead Kelly.
The co-chairs, Neil Weir and Richard Irving, thanked the judges: Edward Fisher, Albert Mudry and Emma Stapleton, as well as Jessica Leigh for her excellent organisation of the meeting, which was recorded and is available to be seen on the BSHENT website.
During the year, the BSHENT committee consolidated the Society’s Constitution in preparation for becoming fully incorporated into ENT UK, adding a Trainee Committee Member (Katherine Conroy) and Webmaster (Stefan Linton) to the committee, electing Neil Weir back into the presidential role, Albery Mudry as International Committee Member, and Emma Stapleton, Richard Irving and Edward Fisher as Ordinary Committee Members.
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## **GLOBAL HEALTH**
## Provided by Vijay Pothula, President
Global Health conference: In October 2020 and 2021 our Committee, led by Mr Eynon Lewis, ran an international conference attended by delegates across the world. There were eminent speakers from around the world and from the UK. The conference was well received and more than 95% of the delegates felt it was good to excellent. It promoted the activities of our committee and helped make collaborations with various organisations.
Education: Mr Kambekar has represented the Global Health Committee on the ENT UK Educational Committee, and was successful in convincing the latter of the need for e-lefENT to be accessible for Hinari countries.
Committee members are writing up guidelines for medical and non-medical officers in low- and middle-income countries delivering care for ear and hearing. Use of technology for remote guidance is being explored.
BACO: The Global Health Committee managed to secure four sessions in BACO for Global Health, and all four sessions were chaired by members of the Global Health Committee, who conducted them extremely well and made the panel discussion by the eminent speakers very interesting. Plans are underway for developing the presence of Global Health at the next BACO, in 2023.
_Journal of ENT UK Global Health_ : The committee published a journal in 2020 and 2021; the 2022 edition is nearly ready. The articles are contributed by senior clinicians from the UK and across the world, and even the World Health Organisation has contributed an article this year in our forthcoming edition. In addition, this journal also generated much-desired funds for the activities of Global Health.
Grants for Global Health projects: Our Committee, led by Ms Stephenson, Ms Dulani Mendis and Mr Kambekar, has advertised and awarded a grant to one project from the funds generated by the Committee last year. The Committee wishes to continue supporting organisations promoting global health with these grants.
Fundraising: One of the main plans of the Committee was to create infrastructure and training in countries where ENT services are poor or non-existent. These plans are to be achieved by collaboration with the industry and through fund-raising projects. The Committee has planned a project in Zambia led by Mr Clarke, where we have established partnership with local ENT surgeons serving in the government. The plans are delayed due to pandemic-related restrictions, as a visit by one of the members to Zambia to work out the details of the project could not take place.
Research: Professor Mood Bhutta and Mr Robin Youngs are leading various global Health research projects, some of which were presented as research papers in the Global Health conference 2021.
IT and social media: Mr Cheka Spencer and Ms Baveena Heer are leading this, liaising with the ENT UK IT Officer to update the website regularly with information on the activities of Global Health, advertising the grants, promoting the Global Health conference and other activities of the Committee on social media.
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## **HEAD & NECK SOCIETY**
## Provided by Sanjai Sood, President
Despite a lack of meetings due to the COVID-19 pandemic, much work has been ongoing by the Head & Neck Society in 2020-21. The 6th Edition of the Head and Neck Cancer United Kingdom National Multidisciplinary Guidelines is making good progress under the editors Jarrod Homer and Stuart Winter, with all chapters recruited and authors confirmed. It should be a truly multidisciplinary document with engagement from various head and neck oncology stakeholders, and we hope to get this out in the next year. The JLO has agreed in principle to publish the chapters.
Patient information leaflets on various topics including neck lump clinics, HPV, submandibular gland surgery, TNO, microlaryngoscopy, pharyngoscopy, TORS, pharyngeal pouch and thyroid lumps have all been revised by the Head & Neck Society, working with ENT UK staff members and Nashreen Oozeer, and these should also be ready in the near future. They are certainly a big improvement on the previous leaflets and will be a welcome asset to all outpatient departments.
The pandemic clearly presented challenges for head and neck services and the electronic HNC referral triaging (risk calculator) for telephone triage, set up by Vin Paleri and his team, has been found to be very useful by many centres. The date from this has been analysed and has been submitted for publication.
The annual evidence-based meetings were on hold during the pandemic but the team worked hard for the excellent meeting held in November 2021 in Newcastle (full details will be given in the next annual report). We anticipate the meetings to return to an annual event. Attendance and feedback confirmed how popular these meetings continue to be. The events team at ENT UK were exceptional in their support in helping to organise such an excellent meeting.
Work with GIRFT and NHSE on head and neck services continued with Frank Stafford doing an excellent job at representing our speciality. As always with such projects there is a degree of frustration in getting things finished, but the will is there to try and implement a minimum acceptable standard for provision of head and neck cancer services. Issues and challenges include organising specialist centres geographically and in line with population sizes, addressing potential on-call services for head and neck cancer, ensuring accurate coding for head and neck surgical oncology procedures to allow data from GIRFT reports to be accurate and meaningful, as well as ensuring outcome data is accurate and unbiased from each centre. This is work in progress and further GIRFT meetings are scheduled for next year.
Finally, I would like to thank Paul Pracy for his excellent leadership over the last 6 years of the Head and Neck society, and Costa Repanos, who has been an excellent Secretary. Shane Lester has taken over as Secretary and Jemy Jose as Treasurer. It is likely that there will be some vacancies arising on council next year and we encourage applications at that time.
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## **SAS**
## **Staff and Associate Specialist Doctors**
## Provided by Shyam Sunder Singam, Chair
Yet another year has rolled by, in a blink! Sadly, COVID remains to be the highlight and, days, weeks and months seem to blur into oblivion. The SAS group has had a relatively uneventful year, barring the much-anticipated new 2021 SAS contract and a fantastic virtual BACO.
Virtual BACO 2021 was well received. It was very well planned, organised and meticulously executed. It was actually a revelation, where despite the lack of faceto-face interaction, we gained so much more, by being able to attend most sessions in our own time – and this over a six-month period. The virtual aspect was particularly useful for the SAS group, as we are traditionally holding the fort in our respective hospitals, during BACO. A big thank you to the BACO organising team.
The new 2021 SAS contract elicited a lot of interest and went through with an overwhelming ‘yes’ vote. However, on closer analysis, it seems less attractive than it appeared at the outset. There have been definite improvements made towards pay progression and job planning. The previously closed associate specialist grade has been reopened as the specialist grade. Creation of the SAS advocate role will go a long way in helping the SAS doctors address various issues at a local and national level. But there were setbacks in certain key areas, like SPA and weekend working. There is scope to negate these negatives, through negotiation with Trusts, in accordance with local agreements, with help from the LNC and BMA. The new contract has also attracted an increased interest in the SAS group from the Royal Colleges, which should help in the long run.
There have been a few appointments this year:
- Ms Prerana Rao as the SAS rep for BACO 2023 Organising Committee
- Ms Jeena Narayan as the ENT SAS rep for RCS Ed Intercollegiate SAS Education Committee
- Mr Shyam Singam as the ENT SAS rep at the Surgical Speciality Board (SSB) RCS Ed
Our SAS Conference scheduled for June 2021 had to be postponed in view of the dreaded coronavirus. This will now be the ‘6th ENT UK SAS Conference – Wales 2022’ (23 and 24 June - a face-to-face event), where we will have an exciting programme, with a terrific speaker line-up and a compelling social calendar. Something to look forward to and lift our spirits.
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## **SFO**
## **Student and Foundation Doctors in Otolaryngology**
## Provided by Dheeraj Karamchandani, Chair
This year has been an exciting one for the team at SFO UK. Our membership numbers have been steadily increasing and have currently crossed 400 members. At the end of September 2021, we had a majority of our representative posts filled including 100% of the foundation doctor posts, with university representative posts at 81%. Our undergraduate forum has been a great success, with commendable engagement from the undergraduate leads, and several regional events and webinars organised with their support.
SFO UK had a dedicated session at Virtual BACO International, held in January 2021. The main attraction was a career information video comprising almost 40 ENT surgeons from different stages of their career discussing the various aspects of ENT and its subspecialties as a career choice. The support and hard work of ENT UK and its Board of Executives enabled SFO UK to have a panel discussion which was broadcast live on the virtual BACO platform. The feedback received for the session was overwhelmingly positive and pleased the SFO UK organisers immensely, given the challenges of a virtual conference.
Our social media outreach has also increased with more than 1,000 followers on Twitter and 900+ followers on Facebook. A lot of career fairs and conferences are being undertaken online, with leadership from SFO UK representatives under the guidance of SFO UK. An ENT surgical societies forum is under consideration and the NENTSS team has now merged with SFO UK. We are planning further innovative changes in the near future and look forward to your support in our upcoming endeavours.
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## **YCOHNS**
## **Young Consultants in Otolaryngology and Head and Neck Surgery** Provided by James Barraclough, Chair
Young Consultants in Otolaryngology and Head and Neck Surgery’ (YCOHNS) was established over 30 years ago by a group of young ENT consultants to establish a voice for the younger generation of consultants, so that decision making made at a national level could include their views and wishes. New ENT consultants previously included anyone within ten years of their appointment. To make the discussions more relevant to new appointees, the group recently decided to narrow this down to ENT consultants five years beyond their appointment or trainees six months from their CCT. This therefore includes anyone who is an ENT UK member on a post-CCT fellowship as well. YCOHNS was always built on regular face-to-face meetings, but due to COVID this was not possible during 2020-2021. However, it is hoped such meetings will once again take place in 2022.
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## **WENTS UK**
## **Women in ENT Surgery**
## Provided by WENTS UK Executive committee
A new WENTS UK committee was formed at BACO in January 2021. We quickly set about formulating our agenda for our first year as a committee.
An International Women’s Day event in March 2021 was held virtually with a talk from Professor Sujana Chandrasekhar about her personal journey in ENT followed by a roundtable discussion chaired by our President, Miss Ekpemi Irune. The committee would like to thank Professor Chandrasekhar as well as Professor Hesham Saleh, Mr Tim Mitchell, Professor Claire Hopkins and Professor Nirmal Kumar for giving up their time and ensuring this event was a success.
The committee launched a new initiative titled ‘WENTs and Friends’ and so far this year have delivered two podcasts with eminent speakers. The idea behind creating this podcast was to allow the open discussion of important topics on Equality, Diversity and Inclusivity (ED&I) and for that content to be easily accessible to our members and others.
HIVE, the newsletter for WENTS UK was also conceived. To date, we have published three instalments.
Furthermore, WENTS UK launched a competition to submit designs for a new scarf. The winners of this competition were Celestine Nicod and Isra Jalaly who each won a £100 prize. The scarf design chosen is in honour of Esme Havelock Hadfield, the first female ENT surgeon in the UK. The scarves will go on sale in the New Year, with proceeds going to the newly created WENTS Women’s Wellness Bursary and the WENTS charity of the year - the Sophie Hayes Foundation.
The mentoring programme, steered by Miss Emma Stapleton, goes from strength to strength and currently has 160 participants. There have been two mentor training events and two mentor cafes in the past year, which have received excellent feedback.
The WENTS UK Autumn Forum rounded off our year and started with an insightful discussion between Professor Neil Mortensen, President of the Royal College of Surgeons of England and Miss Ekpemi Irune, WENTS UK President. Mr Simon Fleming spoke on the subject of being a male ally and the evening was concluded with a round table discussion between Miss Stella Vig, Miss Hermien Hartog, Miss Zarina Shaikh and Miss Caroline Hing on the topic of Women in Surgery, which was enjoyed by all. The committee would like to thank all those involved for participating in this forum. Three brand-new WENTS research grants, each of £500, were awarded for studies in the field of ED&I to very deserving individuals.
Our social media liaison continues to provide educational material relevant to women in the workplace, providing tips on understanding discrimination, allyship, etc. The WENTS UK Twitter account, overseen by Alex Ashman, specifically acts to signpost people to resources that make our professional community more informed and accountable.
The WENTS UK committee would like to thank the wider ENT UK community, all our collaborators and sponsors for their support and encouragement in all of our endeavours.
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## 13. INTEGRATE
## Provided by John Hardman, Chair at INTEGRATE
Please find a summary of outputs since our last report, and work currently being undertaken, by INTEGRATE, the UK ENT Trainee Research Network.
## **Publications**
- Smith ME, Hardman JC, Mehta N, Jones GH, Mandavia R, Anderson C, et al. on behalf of INTEGRATE (The UK ENT Trainee Research Network). Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development. PLOS ONE. Public Library of Science; 2021;16:e0251395. doi.org/gcj5
- Hardman JC, Tikka T, Paleri V, ENT UK, BAHNO and INTEGRATE (The UK ENT Trainee Research Network). Remote triage incorporating symptom-based risk stratification for suspected head and neck cancer referrals: A prospective population-based study. Cancer. 2021;127:4177–89. doi.org/grst
- Smith ME, Jones GH, Hardman JC, Nichani J, Khwaja S, INTEGRATE (The UK ENT Trainee Research Network). et al. Acute paediatric mastoiditis in the UK before and during the COVID-19 pandemic: A national observational study. Clinical Otolaryngology. 2021. doi.org/g2xr
- Zhang H, Hardman JC, Nankivell PC, Mehanna H, Paleri V, ENT UK, BAHNO and INTEGRATE (The UK ENT Trainee Research Network). Symptom-based remote assessment in post treatment head and neck cancer surveillance: a prospective national study. Clinical Otolaryngology. 2021. (Accepted with minor amendments).
## **Presentations**
ENT UK Multidisciplinary Consensus Day on the Management of Head and Neck Squamous Cell Carcinoma of Unknown Primary, 15 November 2021, Sage Gateshead.
- Investigations before diagnostic biopsies – John Hardman and James Constable
- Diagnostic biopsies before starting treatment – Chris Hogan and Kris Milinis
- Surgical management after MDT diagnosis – Kate Hulse and Andrew Williamson
- Non-surgical management after MDT diagnosis – Sian Dobbs and Shivun Khosla.
## **Successful grant applications**
- £1,000 – ENT UK Foundation Research Grants Programme HNSCCUP National Audit
- £1,000 –BSO small grant award 2021 Cochlear Implant Eligibility Study.
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## **Main committee**
We saw a complete change of committee and adoption of new projects in Q1 of this year. Additionally, in collaboration with University Hospitals Plymouth NHS Trust, we appointed a Junior Research Fellow (Ben Tudor-Green) in October 2021 who has come on board the main committee with some dedicated research sessions, under the supervision of INTEGRATE, within his job plan.
With entirely new teams, most of our current work is in its infancy but is suitably aspirational for the two-year tenure of the 20 individuals taking up positions on committees.
Our website continues to be a focal resource for study documents and for dissemination of our research and audit work https://entintegrate.co.uk.
INTEGRATE studies have now reached 167 different UK centres, engaging with over 600 clinicians in ENT. Participation can be tracked here: https://bit.ly/entintegrate.
## **H&N subspecialty committee**
Our National Service Evaluation of remote triage for suspected HN cancer and posttreatment surveillance, in combination with ENT UK and BAHNO, has achieved two publications: the former in _Cancer_ ; and the latter in _Clinical Otolaryngology_ .
We conducted a National Audit of Management of Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP) across 56 centres, collecting data on over 1,000 patients, presenting an interim analysis at the national consensus day in November. We are in the process of cleaning and validating the data with contributing sites and hope to produce an audit report and further outcomes-based analysis for publication.
## **Rhinology subspecialty committee**
We continue to build on our prior work to put together a grant application to investigate the pragmatic use of Floseal in the management of acute epistaxis. This is likely to include a cluster RCT working alongside Ms Sadie Khwaja as chief investigator.
We are preparing a manuscript to learn further from patients who were discharged with non-dissolvable packs _in situ_ , identified through the COVID-19 emergency care audit.
## **Otology subspecialty committee**
We will be working closely with The STARFISH Trial team to deliver their NIHR funded RCT investigating route of steroid administration in sudden onset sensorineural hearing loss. Using the Associate PI scheme to ensure engagement of trainees and mentorship into the world of NIHR supported multicentre clinical research.
We continue to put together a package of studies to lay the foundations for a grant application for an interventional trial to improve the management of chronic dizzy patients in the UK.
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- We have completed a systematic review of smartphone apps to treat vertigo
- We have conducted a 50-site survey of dizzy services
- We have designed an audit of vertigo referrals to understand the potential recruitment rates of suspected BBPV referrals to secondary care We are conducting a systematic review of BBPV assessment tools.
Additionally, we will be conducting a multicentre retrospective audit of rates of appropriate referral for consideration of cochlear implantation on the back of a successful grant application to the ENT UK Foundation Research Grants Programme.
## **Thank you**
We are grateful for the continued support from ENT UK. We are delighted that ST3 Applications now award points for participation in multicentre collaborative projects, in recognition of the important role this work can play in a trainee’s development. We look forward to continuing our work of mentoring the next generation of ENT trainees, with our ethos delivering high quality research and audit, with transparent recognition for the trainees’ involvement in meaningful projects.
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## 14. ENT UK FOUNDATION
The ENT UK Foundation is the philanthropic and fund-raising arm of ENT UK. The Foundation officially launched in September 2021 with the unanimous approval of the ENT UK Executive and Trustees.
The Foundation Committee consists of six members chaired by Prof Nirmal Kumar. A five-member advisory group assists the Committee. In addition, the ENT UK President, Honorary Treasurer and Honorary Secretary have the right to attend Foundation Committee meetings.
The Foundation’s mission is to:
- **Invest in the speciality** through endowments, research grants, international fellowships, and humanitarian projects.
- **Highlight and facilitate global innovation in ENT practice** through support and funding of global health and international programmes. **Enable sustainability and longevity** through fund-raising and other income-generating activities.
- **Promote inclusivity, diversity, and equality** as an integral part of its activities.
The Foundation’s aims and objectives are based on five themes:
- **Patient and public** : To commit to and focus on patient and public involvement and engagement (PPIE). To promote prevention and early screening of ill health by educating patients, the public and clinicians, and use technology to reduce health inequalities, improve our patient’s ability to access healthcare, and promote healthy lifestyles.
- **Educate** : To promote affiliated groups and societies in the improvement of knowledge, involving universities via access to the ENT portal, and using Technology Enhanced Learning (TEL) to advance worldwide training. **Engage** : To engage with stakeholders (including the public, clinicians, allied charities, industry, and technological partners) to improve patient journeys and pathways, provide support, mentorship, and develop clinicians as leaders.
- **Research** : To advance knowledge. To set up research portfolio and funding with NIHR adoption to produce high-quality clinical research. ENT UK is now an approved NIHR non-commercial partner.
- **Celebrate** : To celebrate achievements in holistic care by clinicians and the public. Run an annual gala to reward and recognise the achievements of ENT practitioners and public initiatives in the field of ENT and audiology health and wellness, locally and abroad.
## **Key activities**
The Foundation has taken over the stewardship of the following existing designated funds from ENT UK:
- Prakash Narula Fund Francis Shah Fellowship Fund NIHR Research Fund Shyamala scholarship Fund
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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ENT UK
FOUNDATION
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The group will actively seek to raise funds from legacy donations and industry partners.
The first batch of applications was invited for academic peer review during the year. After peer reviews, 19 winners were selected based on their merits. The awards follow, by award names:
ENT UK Foundation Research Grants – 15 awards, totalling £11,500 Francis Shah Fellowship – two awards, totalling £2,500 Prakash Narula Fellowship – two awards, totalling £1,500.
The winners of the above awards were formally announced at the ENT UK Autumn Meeting held at RCS England on 17 September 2021.
In partnership with WENTS UK, ENT UK Foundation paid out two grants for the sum of £1,000 as the Shyamala/WENTS Education Grant.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## 15. FINANCIAL REVIEW
Provided Kay Seymour, Honorary Treasurer (2018-present)
## **Operational financial position**
This financial report covers the year from 1 October 2020 to 30 September 2021, and therefore includes the onset of the second and subsequent waves of the COVID-19 pandemic, as well as the return to face-to-face meetings towards the end of quarter 4. The financial position of ENT UK has undoubtedly benefitted from the largely virtual platform for conferences, meetings and office activity, which predominated over this 12-month period. The highlight of the year was the successful transition of BACO 2020 to a virtual event, held in January 2021 after being postponed as a result of the pandemic. BACO is the largest event held by ENT UK, and the net surplus for BACO 2021 in this financial year was £109k. However, this should be set against a loss of £175k written off in 2019-20 when the face-toface meeting had to be postponed, so the combined events of BACO 2020 and 2021 made a loss of £66k overall.
Membership revenue income increased by 3% with a total cumulative membership income of £448k (£434k in 2020) and a net increase over the year of 238 members. The total number of paying members on 30 September 2021 was 2,117, up from 1,880 members on 30 September 2020.
The operational figures ex-BACO for the year showed that ENT UK made an operational surplus, for the first time in recent history, of £73k. Of this surplus, £24k will be set aside against a budgeted forecast loss for 2021-22, leaving a surplus of £48k.
£44k has been received in donations to the ENT UK Foundation, to fund research within the ENT specialty, which is ring-fenced separately within the accounts. ENT UK is extremely grateful to Mr Shah and Professor Ray, and Professor and Mrs Kumar, as well as all our other donors, for their generosity and support. A list of key donors can be found on the ENT UK website at https://www.entuk.org/donors.
## **Investment portfolio income**
The Finance Committee oversees all matters pertaining to financial planning and performance, including investment management, and advises and reports to the Board of Trustees on the performance of the investment portfolios and the appointed fund managers. Brewin Dolphin have been our fund managers since 2010. Funds are invested in a wide range of products, with a restriction against investing in tobacco companies.
The book value of our investments at year-end 2021 was £2m (compared with £1.8m for year-end 2020). The market value was £2.9m, (£2.4m in 2020), with a dividend income of £50k (£55k in 2020). The forecast dividend income for 2021-22 is £52k.
## **Expenditure activity**
The financial impact of rescheduling BACO was mitigated as far as possible by transferring the headline conference to a virtual platform in 2021 and carrying forward venue costs for the face-to-face event until 2023. Ten events were
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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successfully held in an online format, and there was one hybrid meeting, which will be the likely format for most meetings in the near future. £25k in financial grants were awarded by the ENT UK Foundation and by the British Society of Otology (BSO) for research.
## **Summary and financial outlook for 2021-22**
The total surplus reported for this financial year on the statutory account is £203k of this day-to-day operational surplus excluding BACO for the financial year was £73k. £24k of this surplus will be set aside against a budgeted forecast loss for 202122, leaving a surplus of £48k. The surplus from BACO 2021 recognised in this year’s accounts was £109k, but this should be set against a deficit of £175k, which was written off in 2019-20. £44k has been received in ring-fenced donations, and £25k has been awarded in grants.
On 30 September 2021, the revaluation of the ENT UK investment increased by £429k on the balance sheet. This increase was recognised on the income and expenditure statement at year-end. Thus the final surplus on the income and expenditure statement for the financial year is £632k.
The total value of ENT UK’s fund at 30 September 2021 were £3.4m of which £3.3m is in unrestricted fund and £0.87m in designated funds.
Trustees have commissioned a review of the pension arrangements we have with SAUL, which may have financial implications if a change in pension provision is recommended.
The pandemic has continued to impact every aspect of ENT UK’s function, but from a financial perspective, many of the changes have been positive. Trustees are examining options for utilising the year-end operational surplus to best fulfil our charitable aims and objectives. ENT UK has been successful in transferring its educational activities to online and hybrid formats, and implementing a hybrid model of staff working from home or at our office in the newly renovated Barry Building at The Royal College of Surgeons of England. The trustees are satisfied that we continue to manage our operational and financial risks successfully and have sufficient resources to remain in operational existence for the foreseeable future.
## **Reserves policy**
## **1. Background**
Following a discussion at the Finance Committee in November 2021 the Assistant Honorary Treasurer presented a Reserves Policy to the Board of Trustees in December 2021. In this meeting the Trustees also discussed how to approach the pension liability following a presentation by pension experts.
## **2. Reserves**
The proposed Reserves Policy and related calculations presented by the Assistant Honorary Treasurer suggested that if net unrestricted cash held is included, there is a potential surplus over Reserves and Designated funds of around £400 to £500k within the portfolio. Trustees agreed that a Reserves Policy was required, a Reserves Policy could allow for up to £400,000 of excess funds to be made available and that any calls on this should have strong governance around it. A final decision on the Reserves Policy was not agreed and as such, the Finance Committee is asked to
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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consider the proposals and feedback from Trustees and recommend a Reserves Policy to Trustees.
Trustees discussed the options presented by experts in relation to the continued participation of ENT UK in the SAUL pension scheme following concerns raised in relation to continuing lack of control of the scheme and the funding increase risk over time with increasing maturity of the scheme, future salary increases and additional benefit accrual. The Trustees agreed to stay in SAUL and explore closing the scheme to new employees and encouraging employees to transfer the value of their benefit to an alternative pension arrangement. As such the potential pension liability still exists. The section 75 debt is currently estimated at £344,604 as at 31 March 2020 although the true cost could be more or less once calculated and will include additional and significant adviser fees.
Given the above, the Finance Committee is asked to consider whether a suggested amount of around £250k estimated excess cash is an appropriate sum for investment to meet ENT UK’s charitable aims (subject to confirmation that the pension liability is covered in the reserves).
## **3. Investment Approach**
The Finance Committee is asked to:
- discuss the Reserves proposals and feedback from Trustees and recommend a Reserves Policy to Trustees
- agree that a two-year budget should be prepared going forward
- consider whether an amount of around £250k estimated excess cash is an appropriate sum for investment to meet ENT UK’s charitable aims and make a recommendation to Trustees
- recommend to Trustees that an amount of excess cash be invested over a fiveyear time frame (2021/22 to 2025/26) which will cover the terms of two future Presidents
- recommend to Trustees that the amount and timeframe be reviewed by the Finance Committee each year in line with the budget setting process
- recommend to Trustees that the total investment amount must only be directed to activity which aligns with the ENT UK strategy (which could include areas such as research, education, international and membership) - the plan is for Trustees to develop and agree a strategy in quarter three this year
- recommend to Trustees that up to £50k be allocated to be invested in this financial year (2021/22) subject to the agreement of an ENT UK strategy – noting that we are already in quarter two and a strategy has yet to be agreed
- recommend to Trustees that, subject to alignment with the strategy, they decide an allocation to invest through ENT UK (for education activity or membership developments for example) and an allocation to the Foundation for both this financial year and over the five-year time frame
- agree suitable governance arrangements and decision-making mechanisms for investments that will be made by ENT UK
- recommend to Trustees that any allocation to the Foundation will only be agreed once the Finance Committee has reviewed and the Trustees have approved the governance of the Foundation and the decision-making process for the allocation of funds through the Foundation (business case presentation, scoring, treatment of conflicts of interests etc)
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **4. Next Steps**
The next steps are as follows:
- Assistant Honorary Treasurer to draft a final Reserves Policy document to present to Trustees.
- Assistant Honorary Treasurer to present Finance Committee recommendations to Trustees
- Assistant Honorary Secretary and General Manager to develop proposals for the governance structure required for any investment made through ENT UK.
- Foundation Chair to present governance structure and decision-making process to the Finance Committee.
- President-elect and General Manager to plan and lead strategy development work (in line with the Membership Review and Group Governance Review).
## **5. Diversity Statement**
There are no specific diversity implications in relation to this recommendation. Trustees may decide to invest in activity to support activity in relation to Equality, Diversity and Inclusion; however, this will be through the agreed mechanisms.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Statement of Trustees’ responsibilities**
The Trustees (who are also directors of ENT UK for the purposes of company law) are responsible for preparing the annual report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).
Company law requires the Trustees to prepare financial statements for each financial year, 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 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 judgements and 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;
- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in operation.
The Trustees are responsible for keeping adequate accounting records that disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.
In so far as the Trustees are aware:
- there is no relevant audit information of which the charitable company’s auditor is unaware; and
- the Trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the 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.
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Nirmal Kumar
President of ENT UK
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## 10 March 2022
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Kay Seymour
Honorary Treasurer
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ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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INDEPENDENT
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ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS)
COMPANY NUMBER: 06452601
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INDEPENDENT
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## 16. INDEPENDENT AUDITOR’S REPORT AND FINANCIAL STATEMENTS
## **Opinion**
We have audited the financial statements of ENT UK trading as British Academic Conference in Otolaryngology (BACO) and British Association of Otorhinolaryngology - Head and Neck Surgery (BAO-HNS) (the 'charity') for the year ended 30 September 2021, which comprise the Statement of Financial Activities, Balance Sheet, Statement of Cash Flows, and Notes to the Financial Statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is United Kingdom Accounting Standards, comprising Charities SORP - FRS 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' and applicable law (United Kingdom Generally Accepted Accounting Practice).
In our opinion the financial statements:
- give a true and fair view of the state of the charity's affairs as at 30 September 2021 and of its incoming resources and application of resources, including its 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 responsibilities for the audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and the provisions available for small entities, in the circumstances set out in note to the financial statements, 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 charity's ability to continue as a going concern for a period of at least twelve months from when the original financial statements were 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.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Other information**
The other information comprises the information included in the trustees' report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the trustees' report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.
In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.
We have nothing to report in this regard.
## **Opinion on other matters prescribed by the Companies Act 2006**
In our opinion, based on the work undertaken in the course of the audit:
- the information given in the for the financial year for which the financial statements are prepared is consistent with the financial statements; and the has been prepared in accordance with applicable legal requirements.
## **Matters on which we are required to report by exception**
In the light of our knowledge and understanding of the charity and its environment obtained in the course of the audit, we have not identified material misstatements.
We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:
- adequate accounting records have not been kept, or returns adequate for our audit have not been received from branches not visited by us; 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.
- the directors 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 directors’ report and from the requirement to prepare a strategic report.
## **Other matters**
The prior year financial statements are unaudited.
## **Responsibilities of trustees**
As explained more fully in the Statement of Trustees’ Responsibilities, the trustees are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the trustees are responsible for assessing the charity's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charity or to cease operations, or have no realistic alternative but to do so.
## **Auditor responsibilities for the audit of the financial statements**
Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.
Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:
Our approach to identifying and assessing the risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, was as follows:
- The engagement partner ensured that the engagement team collectively had the appropriate competence, capabilities and skills to identify or recognise non-compliance with applicable laws and regulations.
- We focused on specific laws and regulations which we considered may have a direct material effect on the financial statements or the operations for the company, including the Companies Act 2006, tax legislation and data protection, anti-bribery, employment, environmental and health and safety legislation.
We assessed the susceptibility of the company’s financial statements to material misstatement, including obtaining an understanding of how fraud might occur by: Making enquiries of management as to where they considered there was susceptibility to fraud, their knowledge of actual, suspected and alleged fraud.
- Considered the internal controls in place to mitigate the risks of fraud and non-compliance with laws and regulations.
Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor’s report.
## **Use of our report**
This report is made solely to the charitable company's trustees, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charity's trustees those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and its trustees as a body, for our audit work, for this report, or for the opinions we have formed.
Colin Andrew Barker FCA (Senior Statutory Auditor) For and on behalf of Edmund Carr LLP, Statutory Auditor
146 New London Road, Chelmsford, Essex, CM2 0AW
Date: .............................10 March 2022
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Statement of Financial Activities for the Year Ended 30 September 2021**
(Including Income and Expenditure Account and Other Comprehensive Income)
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Balance Sheet as at 30 September 2021**
These financial statements have been prepared in accordance with the special provisions relating to companies subject to the small companies’ regime within Part 15 of the Companies Act 2006.
The financial statements on pages 58 to 69 were approved by the trustees, and authorised for issue on .................... and signed on their behalf by:10 / 03 / 2022
........................... K. Seymour Trustee
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Statement of Cash Flows for the Year**
## **Ended 30 September 2021**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Notes to the Financial Statements for the Year Ended 30 September 2021**
## **1. Charity status**
The charity is limited by guarantee, incorporated in England & Wales, and consequently does not have share capital. Each member is liable to contribute £1 towards the assets of the charity in the event of liquidation.
## **2. Accounting policies**
## **Summary of significant accounting policies and key**
## **accounting estimates**
The principal accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all the years presented, unless otherwise stated.
## **Statement of compliance**
The financial statements have been prepared 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)) (issued in October 2019) - (Charities SORP (FRS 102)), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.
## **Basis of preparation**
ENT UK trading as British Academic Conference in Otolaryngology (BACO) and British Association of Otorhinolaryngology - Head and Neck Surgery (BAO-HNS) meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy notes.
## **Going concern**
The trustees consider that there are no material uncertainties about the charity's ability to continue as a going concern nor any significant areas of uncertainty that affect the carrying value of assets held by the charity.
## **Income and endowments**
## **Donations and legacies**
General donations and other similar types of voluntary income are brought into account when receivable and donated income is included gross of any attributable tax recoverable, where relevant. Donations given for specific purposes are treated as restricted income.
## **Deferred income**
Deferred income relates to conference attendance fees and exhibitor fees received for conferences due to take place after the year end.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Investment income**
Investment income is accounted for on a receivable basis once the dividend or interest has been declared.
## **Charitable activities**
Subscriptions:
Subscriptions are accounted for on a receivable basis, with the exception of life subscriptions that are recognised as income in full in the period in which they are received.
## **Other income**
All other types of income are accounted for on an accruals basis.
## **Expenditure**
All expenditure is recognised once there is a legal or constructive obligation to that expenditure, it is probable settlement is required and the amount can be measured reliably. All costs are allocated to the applicable expenditure heading that aggregate similar costs to that category. Where costs cannot be directly attributed to particular headings they have been allocated on a basis consistent with the use of resources, with central staff costs allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use. Other support costs are allocated based on the spread of staff costs.
All resources expended are inclusive of irrecoverable VAT.
## **Raising funds**
These are costs incurred in attracting voluntary income, the management of investments and those incurred in trading activities that raise funds.
## **Charitable activities**
Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries. It includes both costs that can be allocated directly to such activities and those costs of an indirect nature necessary to support them.
## **Grant expenditure**
Grants payable are recognised in the period in which the approved offer is conveyed to the recipient except in those cases where the offer is conditional, such grants being recognised only when the conditions attaching to the award are fulfilled. Grants offered subject to conditions, which have not been met at the balance sheet date, are noted as a potential commitment, but are not treated as a liability.
## **Grant provisions**
Provisions for grants are made when the intention to make a grant has been communicated to the recipient but there is uncertainty about either the timing of the grant or the amount of grant payable.
## **Support costs**
Support costs include central functions and have been allocated to activity cost categories on a basis consistent with the use of resources, for example, allocating property costs by floor areas, or per capita, staff costs by the time spent and other costs by their usage.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Taxation**
The charity is considered to pass the tests set out in Paragraph 1 Schedule 6 of the Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes. Accordingly, the charity is potentially exempt from taxation in respect of income or capital gains received within categories covered by Chapter 3 Part 11 of the Corporation Tax Act 2010 or Section 256 of the Taxation of Chargeable Gains Act 1992, to the extent that such income or gains are applied exclusively to charitable purposes.
## **Tangible fixed assets**
Individual fixed assets costing £1,000 or more are initially recorded at cost, less any subsequent accumulated depreciation and subsequent accumulated impairment losses.
## **Depreciation and amortisation**
Depreciation is provided on tangible fixed assets so as to write off the cost or valuation, less any estimated residual value, over their expected useful economic life as follows:
|life as follows:||
|---|---|
|**Asset class**|**Depreciation method and rate**|
|Office refurbishment|Over 5years,straight-line|
|Computers|Over 4years,straight-line|
|Office equipment|Over 5years,straight-line|
## **Fixed asset investments**
Fixed asset investments are included at market value at the balance sheet date. Realised gains and losses on investments are calculated as the difference between sales proceeds and their market value at the start of the year, or their subsequent cost, and are charged or credited to the Statement of Financial Activities in the period of disposal.
Unrealised gains and losses represent the movement in market values during the year and are credited or charged to the Statement of Financial Activities based on the market value at the year end.
## **Stock**
Stock is valued at the lower of cost and estimated selling price less costs to complete and sell, after due regard for obsolete and slow-moving stocks. Cost is determined using the first-in, first-out (FIFO).
## **Trade debtors**
Trade debtors are amounts due from members and delegates for subscription and conference fees.
Trade debtors are recognised initially at the transaction price. A provision for the impairment of trade debtors is established when there is objective evidence that the Association will not be able to collect all amounts due according to the original terms of the receivables.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **Cash and cash equivalents**
Cash and cash equivalents comprise cash on hand, deposits and cash balances held by investment managers.
## **Trade creditors**
Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of business from suppliers. Accounts payable are classified as current liabilities if the Association does not have an unconditional right, at the end of the reporting period, to defer settlement of the creditor for at least twelve months after the reporting date. If there is an unconditional right to defer settlement for at least twelve months after the reporting date, they are presented as non-current liabilities.
Trade creditors are recognised at the transaction price.
## **Fund structure**
Unrestricted income funds are general funds that are available for use at the trustees' discretion in furtherance of the objectives of the Association. Designated funds are unrestricted funds set aside for specific purposes at the discretion of the trustees.
## **Pensions and other post retirement obligations**
The charitable company participates in the Superannuation Arrangements of the University of London (SAUL), which is a centralised defined benefit scheme and is contracted-out of the Second State Pension. SAUL is a "last man standing" scheme so that in the event of the insolvency of any of the participating employers in SAUL, the amount of any pension funding shortfall (which cannot otherwise be recovered) in respect of that employer will be spread across the remaining participant employers and reflected in the next actuarial valuation. A formal valuation of SAUL is carried out every three years by professionally qualified and independent actuaries using the Projected Unit method. Informal reviews of SAUL's position are carried out between formal valuations.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **3. Income from charitable activities**
## **4. Investment income**
## **5. Expenditure on raising funds**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **6. Expenditure on charitable activities**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **7. Analysis of support costs**
## **8. Net incoming/outgoing resources**
## **9. Trustees remuneration and expenses**
No trustees, nor any persons connected with them, have received any remuneration from the charity during the year.
During the year, 5 Trustees (2020: 5) were reimbursed for reasonable travel and meetings expenses amounting to £1,315 (2020: £2,654).
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **10. Staff costs**
The aggregate payroll costs were as follows:
The monthly average number of persons (including senior management team) employed by the charity during the year expressed by head count was as follows:
7 (2020 - 9) of the above employees participated in the defined benefit pension scheme.
Contributions to the employee pension scheme for the year totalled £47,006 (2020 - £53,282).
During the year, the charity made redundancy and/or termination payments which totalled £Nil (2020 - £9,055).
The number of employees whose emoluments fell within the following bands was:
The total employee benefits of the key management personnel of the charity were £102,787 (2020 - £102,024).
## **11. Tangible fixed assets**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **12. Fixed asset investments**
At the balance sheet date, the historical cost of the investments was £2,081,145 (2020: £1,874,116).
## **13. Stock**
## **14. Debtors**
## **15. Cash and cash equivalents**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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## **16. Creditors: amounts falling due within one year**
## **17. Obligations under leases and hire purchase contracts**
## **18. Pension and other schemes**
## **Defined benefit pension schemes**
## **Superannuation Arrangements of the University of London (SAUL)**
The charitable company participates in the Superannuation Arrangements of the University of London (SAUL), which is a centralised defined benefit scheme and is contracted-out of the Second State Pension for all eligible employees with the assets held in separate Trustee administered funds.
The charitable company has adopted FRS 102 for accounting for pension costs. It is not possible to identify the Charity's share of the underlying assets and liabilities of SAUL. Therefore contributions are accounted for as if SAUL were a defined contribution scheme and pension costs are based on the amounts actually paid (i.e. cash amounts) in accordance with FRS 102. SAUL is subject to triennial valuations by professionally qualified and independent actuaries.
The last available valuation was carried out as at 31 March 2020 using the projected unit credit method in which the actuarial liability makes allowance for projected earnings.
The main assumptions used to assess the technical provisions were:
- Pre-retirement discount rate 3.15% (31/03/2017: 4.06%) Post-retirement discount rate 1.05% (31/03/2017: 1.96%) General salary increases 3.49% (31/03/2017: 3.49%) Price inflation - RPI 2.70% (31/03/2017: 3.39%) Price inflation - CPI 1.70% (2017: 2.49%)
- Pension increases in payment 1.70% (31/03/2017: 2.49%)
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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As a whole, the market value of the scheme's assets was £3.612 million (31/03/2017: £3.204 million) representing 94% (31/03/2017: 102%) of the liability for benefits after allowing for expected future increases in salaries. The Trustee and the employers agreed to increase employer contributions to 19% of salaries from 1 April 2022 (currently 16%) . Member contributions are set at 6% of salaries.
The total cost relating to defined benefit schemes for the year recognised in profit or loss as an expense was £47,006 (2020 - £53,283).
## **19. Funds**
The specific purposes for which the funds are to be applied are as follows:
A sum of £25,000 was left to the charity by the estate of Mrs Prakash Narula. These funds have been designated by the Trustees to be used for travelling fellowship awards.
The Otorhinolaryngological Research Society transferred £15,000 to ENT UK on transferring its activities to the charity.
The transfer relates to £30,000 committed by the trustees to set up the BSO research fund.
A sum of £25,000 was donated to ENT UK by Mr Navnit Shah in his wife’s name to setup a fellowship. The newly formed ENT UK foundation will take over the stewardship of this designated fund and award Francis Shah fellowship on an annual basis.
£10.6k was received from various sources during the year to setup the NIHR research fund. This designated fund is being managed by the newly formed ENT UK foundation and will award research grants.
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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Comparative information in respect of the preceding period is as follows:
## **20. Analysis of net assets between funds**
## **21. Prior year Statement of Financial Activities**
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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GLOSSARY
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ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS)
COMPANY NUMBER: 06452601
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GLOSSARY
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## 17. GLOSSARY
|**AAO-HNS**|American Academy of Otolaryngology-Head and Neck Surgery|
|---|---|
|**AOMRC**|Academy of Medical Royal Colleges|
|**AOT**|Association of Otolaryngologists in Training|
|**ASGBI**|Association of Surgeons of Great Britain and Ireland|
|**AsiT**|Association of Surgeons in Training|
|**BACO**|British Academic Conference of Otolaryngology|
|**BAETS**|British Association of Thyroid and Endocrine Surgeons|
|**BAOMS**|British Association or Oral and Maxillofacial Surgeons|
|**BAPO**|British Association of Paediatric Otorhinolaryngologists|
|**BAPRAS**|British Association of Plastic Reconstructive and Aesthetic Surgeons|
|**BAPS**|British Association of Paediatric Surgeons|
|**BLA**|British Laryngological Association|
|**BOARS**|The British Otorhinolaryngology and Allied Sciences Research Society|
|**BRS**|British Society of Rhinology|
|**BSACI**|British Society for Allergy and Clinical Immunology|
|**BSHENT**|British Society for the History of ENT|
|**BSFPS**|The British Society of Facial Plastic Surgery (formerly FPS UK)|
|**BSO**|The British Society of Otology|
|**BTA**|British Thyroid Association|
|**BVA**|British Voice Association|
|**e-lefENT**|e-learning platform|
|**EAFPS**|The European Academy of Facial Plastic Surgery|
|**ENT**|common abbreviation for ear, nose and throat|
|**ERS**|European Rhinological Society|
|**ESPO**|The European Society of Paediatric Otorhinolaryngology|
|**FPS UK**|former name of The British Society of Facial Plastic Surgery (BSFPS)|
|**FSSA**|Federation of Surgical Specialty Associations|
|**GMC**|General Medical Council|
|**H&N**|Head and Neck Society|
|**IOS**|Irish Otorhinolaryngology/Head & Neck Surgery Society|
|**IPC**|Independent Practice Committee|
|**MTI**|Medical Training Initiative|
|**NICE**|National Institute for Health and Care Excellence|
|**RCGP**|Royal College of General Practitioners|
|**RCN**|Royal College of Nursing|
|**RCPSG**|Royal College of Physicians and Surgeons of Glasgow|
|**RCSEd**|Royal College of Surgeons of Edinburgh|
|**RCSEng**|Royal College of Surgeons of England|
|**RCSI**|Royal College of Surgeons of Ireland|
|**RSM**|Royal Society of Medicine|
|**SAC**|Special Advisory Committee|
|**SAS**|Staff and Associate Specialists (i.e. the ENT Staff and Associate
Specialist Doctors’ Group of the Education and Training Committee)|
|**SFO UK**|Student and Foundation Doctors in Otolaryngology|
|**TWJ Foundation**|Thomas Wickham Jones Foundation|
|**WENTS UK**|Women in ENT Surgery|
|**YCOHNS**|Young Consultants in Otolaryngology Head and Neck Surgery|
ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company number 06452601
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