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ANNUAL REPORT 2021-2022

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS)

COMPANY REGISTRATION NUMBER: 06452601 CHARITABLE COMPANY REGISTRATION NUMBER: 1125524

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TABLE OF
CONTENTS
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1. PRESIDENT’S FOREWORD	3
2. CEO’S FOREWORD	4
3. VISION, MISSION AND OBJECTIVES	5
4. OUR GOVERNANCE	7
5. OUR MEMBERSHIP	10
6. OUR IMPACT	13
7. EDUCATION	21
8. SPECIALIST ADVISORY COMMITTEE (SAC)	28
9. ENT UK MEETINGS	32
10. ENT UK MEMBERSHIP GROUPS	36
11. ENT UK SPECIAL INTEREST GROUPS	45
12. FINANCIAL REVIEW	52
13. INDEPENDENT EXAMINER’S REPORT AND FINANCIAL STATEMENTS	59
14. OUR ADMINISTRATION	78
15. GLOSSARY	79

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number: 06452601 Charitable company registration number: 1125524

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1. PRESIDENT’S FOREWORD

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PRESIDENT’S
FOREWORD
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We are living in interesting times, marked by major world events and uncertainty that impacts on all of us. We are also in direct contact with an NHS that has many issues of concern. However, as a Specialty Association, we continue to enjoy a position of strength and influence for the good of health care. Our strength largely comes with unity and our support for each other; there has never been a time in recent years when this has been more important. 2022 has been a year where our collaboration and companionship has made great progress. We have been very pleased to welcome the British Rhinological Society (BRS) into ENT UK as a specialist membership group and the Association of Otolaryngologists in Training (AOT) as a partner organisation.

From the wider NHS situation, we continue to interact closely with all four of the Royal Surgical Colleges, as well as advising NHSE and GIRFT regarding the waiting list backlog. We have also remained very proactive in producing revised guidance documents that will directly help members with clinic management as well as Covid-safe endoscopy.

As a membership Association we have held our very first strategy day, under the inspiration and leadership of our CEO, Ms Katie Nurcombe. We ventured into a territory that was completely new and unknown to most of the Trustees. This challenged our conventional thinking and was designed to generate ambitious ideas to enhance and benefit the organisation and especially the members.

This Annual Report will be published at the ENT UK AGM at BACO 2023. I would like to give many thanks to our BACO team, Professor Claire Hopkins as Academic Chair, Professor Chris Raine as Project Lead, Mr Declan Costello as Industry and Sponsor lead, and Ms Helen Cocks as Presidentelect and Chair of the BACO Executive Committee, as well as to Ms Amber Wilson for her excellent administrative support.

Mr Andrew C Swift President of ENT UK

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2. CEO’S FOREWORD

Since joining ENT UK in January 2022, I have been impressed with the impact of the association and have enjoyed meeting members at the many events and meetings we run throughout the year. I am grateful for the warm welcome and I am proud to serve the association as its CEO.

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CEO’S FOREWORD
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There is so much work going on behind the scenes for the benefit of members and this report only provides a brief summary of the wealth of activity underway. I’d like to thank the excellent and hard-working team, Trustees and Executives, and all those mentioned in this report who give up their time to support ENT UK.

I want to make sure this work is recognised, from the educational activity we lead on, to the up-to-date information we provide to both professionals and patients. We are here to support our membership groups and special interest groups to achieve their goals, but also bring everyone together under a strong ENT UK banner for the benefit of the wider specialty.

I am personally passionate about driving forward ENT UK’s work on Equity, Diversity and Inclusion and am delighted that we will have a new Strategy and Action Plan in place going forward. This is an important step forward for ENT UK and I look forward to taking this further with the support and involvement of members.

A lot of work has gone into strengthening the governance and finances of ENT UK and one of my key priorities is to ensure we meet our responsibilities as a professional membership body, reputable charity and responsible employer.

ENT is a small specialty but by working together we can have a powerful voice for the benefit of all. I have already seen the association go from strength to strength and I am excited for the future. ENT UK would not exist without our members, so I’d like to finish by thanking all of our members for their support, participation in, and contribution to the association.

Katie Nurcombe ENT UK CEO

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3. VISION, MISSION AND OBJECTIVES

Charter

ENT UK is the professional membership body representing ear, nose and throat surgery, as well as its related specialities, in the United Kingdom. ENT UK supports members at every stage of their careers, from student level through to retirement – a total of some 2,500 medical practitioners.

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VISION, MISSION
AND OBJECTIVES
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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 our activities we seek to improve the care available to patients suffering from conditions of the ear, nose, throat, head and neck.

Mission

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 at the Royal Surgical Colleges and to government bodies through increased representation.

Strategic objectives

The strategy aims to be:

Patient-centred by focusing on
patient outcomes
patient information
closer liaison with related ENT charities
advocacy for patients.

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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.

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VISION, MISSION
AND OBJECTIVES
3
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In July 2022, ENT UK Trustees started work to develop a vision for ENT UK which will be supported by strategic objectives and a new set of values for the Association. Members will be asked for their comments and feedback on this work as it develops.

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4. OUR GOVERNANCE

The following sets out the management and governance of ENT UK during this financial year.

ENT UK office

Ms Katie Nurcombe | CEO & Company Secretary Ms Janet Stephen | Education & Governance Officer

Mr Bikram Gurung | Financial Controller

Mr Davide Gorgoglione | Web & IT Officer

Mr John Nixon | Communications Lead

Ms Amber Wilson | Conference & Events Organiser Ms Pam Moharir | Events Officer

Ms Julianne Ilebode-Akisanya, General Manager & Company Secretary (demitted December 2021)

The Board of Trustees

Mr Andrew C Swift | President

President-elect (March 2019 – March 2022) President (appointed April 2022)

Miss Helen Cocks | President-elect President-elect (appointed April 2022)

Professor B Nirmal Kumar | Past President

President (demitted April 2022)

Continued as Trustee and Chair of ENT UK Foundation (April 2022) Miss May Yaneza | Honorary Secretary

Honorary Secretary (appointed April 2022)

Mr William Hellier | Honorary Treasurer

Honorary Treasurer (appointed July 2022) Miss Victoria Ward | Clinical Trustee Mr Tim Mitchell | Clinical Trustee Mr Andrew Gamble | Lay Trustee Mr Andrew Foster | Lay Trustee

Demitted from the Board of Trustees: Mr Taran Tatla, Honorary Secretary (demitted April 2022) Miss Kay Seymour, Honorary Treasurer (demitted June 2022) Miss Catherine Spinou, BACO Treasurer (demitted August 2022)

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The Executive Committee

Mr Andrew C Swift | President Miss Helen Cocks | President-elect

Miss May Yaneza | Honorary Secretary

Miss Nara Orban | Assistant Honorary Secretary (appointed April 2022) Mr William Hellier | Honorary Treasurer

Mr Andrew Kinshuck | Assistant Honorary Treasurer (appointed July 2022) Professor Philippa Tostevin | Director of Education

Miss Ann-Louise McDermott | Chair of Specialist Advisory Committee (SAC) in Otorhinolaryngology (appointed January 2022)

Demitted from Executive Committee:

Mr Craig Murray – Chair of SAC in Otorhinolaryngology (demitted December 2021)

The Finance Committee

The Education & Training Committee (ETC)

Professor Philippa Tostevin | Director of Education & Chair Ms Janet Stephen | Education & Governance Officer Mr Dheeraj Karamchandani | Student & Trainee Rep (SFOUK) Miss Marianne Elloy | CPD Committee Chair

Mr James Tysome | Director of e-learning Miss Somiah Siddiq | Chief Editor of e-learning Miss Mira de Krujif | Webinar Co-Ordinator

Mr Shyam Sunder Singam | Chair of SAS Committee Miss Ann-Louise McDermott - Chair of SAC in Otorhinolaryngology Miss Tharsika Myuran | AOT President Mr Hussein Walijee | AOT Rep Mr Johann Bastianpillai | AOT Education Rep

Mr Sanjiv Kumar | Global Health Committee

Mr Michael Saunders | Joint Clinical Lead for Paediatric ENT Skills Course (PESC)

Mr Neil Bateman | Joint Clinical Lead for Paediatric ENT Skills Course (PESC) Mr Raj Lakhani | Clinical Lead for Emergency Surgical Skills Course (ESSC)

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The ENT UK Foundation Committee

The ENT UK Council

Mr Andrew C Swift | President Miss Helen Cocks | President-elect Miss May Yaneza | Honorary Secretary Miss Nara Orban | Assistant Honorary Secretary

Mr William Hellier | Honorary Treasurer

Mr Andrew Kinshuck | Assistant Honorary Treasurer Professor Philippa Tostevin | Director of Education

Miss Ann-Louise McDermott | Chair of SAC in Otorhinolaryngology

Colin Leonard | Northern Ireland David Baring | Scotland – East Andrew Hall | Wales Catriona Douglas | Scotland - West

William Hellier | Wessex (RSPA South Central Wessex)

Tony Jacob | S. Thames (RSPA South East Coast) & S.W. Thames (RSPA S W Thames)

Sonia Kumar | Oxford (RSPA South Central Oxford)

Mriganka De | West Midlands (RSPA West Midlands) (Council Regional Representative)

Ameera Abdelrahim | West Midlands (RSPA West Midlands) (Deputy Council Regional Representative)

Yujay Ramakrishnan | Trent (RSPA East Midlands) Beverley Yu | Yorkshire (RSPA Yorkshire and Humber) Julian Gaskin | South Western (RSPA South Western) Mohiemen Anwar | N. W. Thames (RSPA N W Thames) Simon Lloyd | North Western (RSPA North West and Mersey) Abir K Bhattacharyya | N. E. Thames (RSPA N E Thames)

vacant | Northern (RSPA Northern)
vacant | East Anglia

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5. OUR MEMBERSHIP

During the 2021/22 financial year, ENT UK welcomed 588 new members. This was a net gain of 310 paying members bringing our total membership at the end of the financial year to 2,427.

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15%
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We continue to experience a year-on-year increase in membership, with this year’s growth of 15% continuing the upward trend. Our fastest growing cohort this year was the Students and Foundation doctors’ grade (SFO) which has grown by 33% in the past year. This is closely followed by the Trainee Groups which has grown by 22%.

Whilst we are experiencing an increase in membership numbers, we are not experiencing a comparable growth in membership revenue. This is due to an increase in lower financial value memberships and a small decrease in Consultant members. Total membership revenue during the 2021/22 financial year was £448k. This shows the membership revenue has largely stayed stable compared to the previous year.

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Membership income by year

Year	Revenue	YoY%	Head count	YoY%
2014-15	325k		1,262
2015-16	342k	5	1,340	6
2016-17	371k	8	1,387	4
2017-18	410k	11	1,485	7
2018-19	411k	-	1,617	9
2019-20	434k	5	1,880	16
2020 -21	448k	3	2,117	13
2021–22	448k	-	2,427	15

Payingmembers by grade	Thisyear	Lastyear
Total	2,427	2,117
Consultant	591(+24)	567
Trainees	540(+98)	442
SFO	612(+153)	459
International	202(-13)	215
YCOHNS	145(+10)	135
Associate	163(+24)	139
Allied	120(+10)	110
Retired	54(+4)	50

Free members	Thisyear	Lastyear
Total	300	253
Hinari	149	109
Life	81	81
Honorary	47	47
Parental leave	23	16

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Membership Developments

In this financial year, important membership-focused projects were completed and launched to members following a lot of hard work from the ENT UK team, Trustees and Executives.

A new tailor-made Medical Indemnity Insurance Scheme was launched in January 2022. ENT UK arranged for Howden Insurance Brokers Ltd. to provide this scheme, to ensure that members can access suitable, up-todate indemnity cover and protection. The risks inherent to frontline surgery mean that access to suitable indemnity cover is vitally important to our members, as well as to the specialty in general.

The brand-new ENT UK website was launched in March 2022. The new site is a major overhaul of the old version, featuring improved design, usability, and functionality. The members’ area is now fully integrated with our CRM, which means that members can manage their profile, monitor events and abstracts, download invoices and upload documents. It has an upgraded public and patients’ section which is now much more prominent and will help fulfil our remit to provide patients with high-quality information. It also features an improved search function allowing members to better navigate our growing library of high-quality resources. Finally, it has a future-proof design, meaning the website will continue to develop in line with the needs of our members.

We have also undertaken a significant review of our governance, in particular how we work with our groups and partners, to ensure that we meet our responsibilities as a professional membership body, reputable charity and responsible employer.

You can read more about the impact we are having on our members in the following chapters.

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6. OUR IMPACT

Clinical Guidelines

During the beginning and height of the COVID-19 pandemic, a number of clinical guidelines were rapidly produced for the benefit of all those working within ENT departments, to ensure that we could see patients as safely as possible during this time. The last 12 months have been relatively quiet in comparison. Relevant COVID-19 guidelines were updated to reflect the changes in recommendations.

ENT UK worked together with the Difficult Airway Society (DAS) and the British Association of Endocrine and Thyroid Surgeons (BAETS) to produce a systematic review and multidisciplinary consensus guideline on management of haematoma after thyroid surgery. The guideline is available to download from the ENT UK website.

Another important guideline, this time aimed at our Emergency Department colleagues or those who are not part of the ENT team, was published on ‘Adult acute severe sore throat management guidelines for emergency department doctors’. This guideline was created in response to a request from NHS England and Improvement’s National Patient Safety Team following a reported fatality from acute epiglottitis. The guideline is aimed at doctors who do not work, or have had no experience, in ENT, and takes account of situations where ENT may not be on the hospital site. The guideline has been designed to be succinct but includes all relevant information to manage a patient with suspected supraglottitis. This document is available to non-members. If you have not already done so, please share with your non-ENT colleagues.

The British Rhinological Society also produced an excellent guideline on Local Anaesthetic Rhinological Surgery (LARS), which will help interested parties navigate a path to the successful set-up of their own LARS service. The guideline is very comprehensive and includes guidance on which procedures would be appropriate, equipment and setting, clinical governance, outcome measures, safety, anaesthetic considerations, and advice on information that may be required for a business case. This fantastic document had input from the BRS Juniors team (Mr Richard Green, Mr Stephen Hayes, Miss Abi Walker, Mr Rajeev Advani, Mr Afiq Slim, Mr Sridhayan Mahalingam, Dr Tanya Ta), anaesthetics (Dr Jonathan Bannard-Smith) and the BRS Executive and Council (Mr Raj Bhalla, Professor Claire Hopkins and Mr Sean Carrie).

Other guidelines in progress relate to common ENT problems (wax and tonsils).

ENT UK was asked recently to respond to a case where a toddler had a fatal choking event and a history of enlarged tonsils. In our response, we found

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that there is little evidence in the literature on the relationship between the size of tonsils and choking. However, some of us have been involved in significant or life-threatening choking events, where tonsil size may have been deemed a factor.

Along with BAPO, BLA and the British Association of Paediatric Surgeons (BAPS), we have been working on a survey to distribute to our various members – a national survey is expected to capture the collective experience of those who may have been involved in similar cases.

Wax is a common problem that can cause significant quality-of-life issues for the public. Unfortunately, across the UK, there is wide variability in the provision of wax removal services within the NHS, and numerous independent practitioners are offering their services to remove wax. Work is occurring (lead by BSO) to create information for patients about who should be carrying out this medical intervention and guidance about what they should expect. BSO have also liaised with the Care Quality Commission about regulation of wax removal procedures, and there will be further recommendations from Mr Frank Stafford, GIRFT lead for ENT surgery.

Miss May Yaneza ENT UK Honorary Secretary

ENT UK Patient Information

The new patient information e-leaflets were launched this year, published on the ENT UK website (see https://www.entuk.org/patients/conditions). Miss Nashreen Oozeer, Head and Neck ENT Consultant at Sunderland Royal Hospital and ENT UK Patient Information Clinical Lead, has led the momentous overhaul of patient information since February 2021. The nonclinical team consists of John Nixon, ENT UK Communications Lead and Davide Gorgoglione, ENT UK Web and IT Officer, as well as an external illustrator.

The illustrator was employed after funds were secured from the Trustees to include professional illustrations as a crucial element of the patient information e-leaflets. This has allowed a wide range of diverse illustrations to be commissioned without any copyright issues. The illustrations and pictures are designed to reflect the diversity of the British population.

The three most commonly downloaded and sold leaflets (‘Mastoid surgery’, ‘Hole in the eardrum’, ‘Adult tonsillectomy’) were funded to go through the Plain English Campaign process and have received Crystal Mark approval.

Health literacy is a crucial consideration in the preparation of patient information. We aim to reduce the reading age of our patient information pages as much as possible and are working with the Patient Information Forum to achieve this. Tools such as the Flesh-Kincaid readability calculator are now utilised at key stages of the editorial process, enabling us to determine the reading age of the e-leaflets. ENT UK has joined the Patient

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Information Forum and signed up to the PIF Charter, and is using their resources to improve and formalise the documentation processes around the development of the patient information e-leaflets. The current template was written by Miss May Yaneza, former Patient Information Clinical Lead.

A key ambition for the e-leaflets is to translate them into the most commonly spoken languages in the UK – Polish, Punjabi, Urdu and others. ENT Wales have kindly offered to translate the e-leaflets into Welsh.

The patient information team is exploring the possibility of working with partners to produce short video clips illustrating simple procedures, such as a patient applying a nasal spray or nasal drops correctly or doing the balance retraining exercises. We are also exploring the possibility of producing ‘easy-read’ versions of the e-leaflets, featuring less text and more images to ensure additional accessibility.

The decision was made to go ‘paperlight’, as many hospitals move towards a paperless or paperlight ethos. All patient information is now available online and freely accessible to patients and clinicians (both on desktop computers and on their smartphones). Patients and clinicians can print the information in an A4 format.

The patient information webpages are under continuing review and revision. The number of e-leaflets has increased from 32 to 54 and they are written by ENT surgeons across the UK who have contributed to revising previous versions on the website and writing new ones. Please get in touch if you would like to be part of the clinical team!

Miss Nashreen Oozeer Miss May Yaneza ENT UK Patient Information ENT UK Honorary Secretary Clinical Lead

National Clinical Impact Awards

In early 2022, ENT UK was delighted to see that a number of ENT consultants had been successful in the final round of National Clinical Excellence Awards 2021. This comprised of both new awards and renewal of existing awards. Such awards are very hard to achieve and recognise sustained excellence in every aspect of a consultant’s work. They are a highly prestigious way of recognising the most outstanding clinicians in the country and we are very proud of their successes.

During April 2022 the application process opened under the new name of the National Clinical Impact Awards scheme. ENT UK hosted a webinar for its members giving advice and tips on the application process and exploring the changes to the Awards. ENT UK is a National Nominating Organisation meaning that our expert diverse panel was able to endorse, rank and provide citations for nine applications from ENT UK consultants.

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Mentoring

ENT UK Mentoring Scheme

hosted and led by WENTS UK

Since launching its mentoring scheme in February 2020, just prior to the pandemic, WENTS UK has matched and supported over 80 mentor-mentee pairings. Some of these continue, while others have completed an 18month course and pairings have refreshed. We currently have around 200 participants signed up.

During the period 2021-2022, the scheme has been more formally promoted and supported by ENT UK to widen access and no longer be restricted to WENTS UK members.

There have been two virtual mentor training courses. We continue our support and networking of our volunteer mentors with Virtual Mentor Cafes, the next of which is scheduled to take place in October 2022. Our Virtual Mentor Cafes can include external mentoring experts, such as Dr Nancy Redfern from the Association of Anaesthetists' Mentoring Scheme. We are planning our first face-to-face training event around best possible Covid mitigation, so that as many as possible who wish to attend can feel safe to do so, as we continue our drive to support diversity and inclusion while increasing our pool of mentors. We continue to welcome those mentees seeking a mentor. Members can register their interest as a prospective mentor or mentee at surveymonkey.co.uk/r/HGXXJDV.

We would like to take this opportunity to acknowledge and thank all our mentors, who are kindly volunteering within the scheme – it would not exist without your kindness, effort and engagement.

ENT UK CESR Buddy Scheme

Each year, fewer than ten ENT specialty doctors apply for specialist registration via the CESR route in the UK. This is an expensive process and the support for these doctors in preparation for their submission is variable around the UK, due to the variety of experience that may be available in each region. The aim of this voluntary ‘buddy’ scheme is to provide informal support and advice to a colleague in order to maximise their chance of success in what is a very expensive process.

There has been great interest from our consultant members in supporting this mentorship scheme. Mentors have been able to support colleagues through the CESR process as a result of their own experience of applying via this route. We are enormously grateful for this mentorship and the support of surgeons who will take an alternative pathway through their career development in ENT.

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The ENT UK Foundation

Since the launch of the ENT UK Foundation as the philanthropic and fundraising arm of ENT UK in September 2021, great strides have been taken in pursuit of its vision to improve ENT healthcare for all.

The Foundation seeks to achieve this by:

investing in the specialty , in particular by providing research grants, educational fellowships and support for humanitarian projects, nationally and internationally.
engaging with stakeholders , including patients, the public, clinicians, industry, and charity partners, and those involved in advancements in technology; and
facilitating global innovation , including through the funding of global health and international programmes.

In undertaking its vision, the ENT UK Foundation will seek financial sustainability and longevity through fundraising and other incomegenerating activities. The Foundation has been very successful in raising sufficient funds to support another round of Foundation Awards this year. The ENT UK Foundation agreed to fund 18 Research Grants (totalling £19,206) and four Educational Fellowships (totalling £6,000) under an enhanced framework of financial governance. We were grateful to receive further offers of donations from legacy, personal donors, and industries which will enable the Foundation to fund further awards and activities to achieve its vision. A full list of our donors can be found on the ENT UK website.

Successful award recipients from the ENT UK Foundation Awards in 2021 shared progress on their projects at the ENT UK Foundation Showcase event in July 2022, held in an impressive venue in London, at which stakeholders, industry partners and clinicians in the specialty were represented.

The ENT UK Foundation, as an approved National Institute of Health Research (NIHR) non-commercial partner, opened another round of

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applications for the joint Clinical Research Network Awards this financial year. The results of these awards will be announced at an ENT UK event due to be held on 4 November 2022 in York, alongside the announcement of the ENT UK Foundation Awards 2022 and the Rowena Ryan Awards (which are now National Awards). The outputs from the Foundation Awards will pump-prime funding with NIHR adoption to produce high-quality clinical research aiming to improve patient outcomes.

The Foundation Committee and its advisory group have also worked hard to establish a sustainable model of enhancing international collaborations and seek to do this by engaging with colleagues from all over the world. The ENT UK Foundation has agreed to fund several Travelling Fellowships for BACO International 2023, supporting doctors from Hinari A and B lowresource countries to attend the event and to visit centres of excellence in the UK. This will enable clinicians to take skills back for the benefit of patients everywhere. There will also be partnership development of skills in-house in developing countries, enabling more clinicians to benefit and thereby drive high-quality clinical care for patients, especially where there is a scarcity of skills.

Though the Foundation is in its infancy, we are now establishing a sound base and there is an exciting time ahead for our specialty enhancing the reputation of UK otolaryngology.

Professor B Nirmal Kumar ENT UK Foundation Committee Chair

Equity, Diversity and Inclusion

ENT UK has agreed four Equity, Diversity and Inclusion goals. These goals were developed through discussion and engagement with Trustees, representatives from WENTS UK and a forum of members interested in EDI activity. They were also shared with the ENT UK membership for comment.

Our goals are that:

our culture supports all our members to feel that they belong
our people represent the specialty
we are inclusive, accessible and relevant to patients
we advocate for and support the needs of those who need it most.

In this financial year, ENT UK launched a new Equity, Diversity and Inclusion Strategy and Action Plan and shared this with members for comment. A final Strategy and Action Plan will be sent to members and progress will be reported to Trustees. A new action plan will be reviewed and updated each year (in line with the ENT UK Business Plan) and an update will be provided in the Annual Report.

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New values were also shared with members:

Teamwork

We are a supportive community of professionals dedicated to help improve ENT healthcare through collaboration. We serve our members, build meaningful relationships with other organisations, share what we know and support each other.

Ambition

We are passionately driven to advance knowledge, education, and research in ENT for the benefit of patients. We are focused on strong leadership and strategic investment to revolutionise ENT healthcare both nationally and internationally.

Respect

We act with integrity, welcome difference, listen to our members and patients, and show care for others. Respect is at the heart of everything we do, including our approach to equity, diversity, and inclusion, and we aim to live up to our reputation as a ‘friendly specialty’.

Innovation

We are forward-thinking and committed to learning and adapting to solve current and future challenges to help support clinicians throughout their career. We face challenges with creativity and ingenuity and seek out opportunities from advances in technology.

Quality

We strive for the highest quality, focus our efforts on where we can have the most impact and celebrate our successes. We look for new and better ways of working, and invest in research, education and training to drive improvements in surgical practice and patient care.

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The Association Excellence Awards 2021

ENT UK wins ‘Best Membership Support During Covid-19’ and is shortlisted for 'Best Lobbying Campaign or Advancement of a Cause During Covid-19’

Following the excellent work undertaken by ENT UK during the pandemic, we entered the Association Excellence Awards in the categories ‘Best Membership Support During Covid-19 (800-5,000 members)’ and 'Best Lobbying Campaign or Advancement of a Cause During Covid-19 (Over 500 members)’.

These categories best reflected the association’s considerable achievements during this period, including establishing the Covid-19 national registry, successfully lobbying Public Health England, disseminating guidance and striving to update, canvas and inform our members on an often-daily basis.

Following strong applications written by ENT UK Communications Lead Mr John Nixon, ENT UK was subsequently shortlisted as a finalist in both categories. The winners were revealed at a ceremony at the Oval in London in October 2022 and ENT UK was delighted to receive the award for ‘Best Membership Support During Covid-19’.

We have subsequently applied again in 2022 and have been shortlisted in the categories ‘Best Association Digital Transformation’ and ‘Best Association Newsletter, Blog or Online Publication (Circulation up to 6,500)’. The winners will be announced in October 2022.

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7. EDUCATION

This report has been produced with the help of the ENT UK Education and Governance Officer, Ms Janet Stephen, who has provided exemplary support for all educational activities over the last year. 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, PESCC, ESCC, SAC and the Community Group have met and updated the Executive Committee, Board of Trustees and Council throughout the year.

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 5–10-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 many thanks to the events team.

1. Mission statement:

To promote an understanding of the range of conditions treated by the specialty

e-lefENT

The Director of e-learning, Mr James Tysome, and Editor-in-Chief of e- lefENT, Ms Somiah Siddiq, have continued to collaborate with the digital transformation team from Medtronic who support the virtual learning platform. New section editors have been appointed over the last year and content has been updated with new modules provided, including some for the general practitioners with interest in ENT. This continuous evolution of the platform provides a highly valuable current resource for trainees and for CPD refreshers for everyone. There are ongoing discussions with Medtronic, who support the platform, about the future.

Section editor recruitment

Changes were made to section editor recruitment to comply with Equity, Diversity and Inclusion policy instituted by e-lefENT, with posts being advertised through ENT UK’s fortnightly newsletter and online through social media, encouraging applications from under-represented members. Interviews were conducted in conjunction with ENT UK education committee representation. Two new paediatric section editors were appointed in July 2021 and a rhinology and anterior skull base editor in April 2022. Future section editor advertisements are planned for otology and laryngology.

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Increasing wider access agenda

Delegates from Hinari A countries have free membership to ENT UK with e- lefENT access as part of this membership benefit. Ms Siddiq submitted a proposal in July 2020 for members residing in Hinari B countries to have free access to e-lefENT alone if they were unable to afford full membership with ENT UK. This has been agreed by ENT UK Trustees and reflected in the standalone e-lefENT site. Membership fees for the standalone e-lefENT site were also streamlined to a single fee of £50 per year following ratification by ENT UK Trustees.

Production

The initial phase of focus for e-lefENT has been the review/edit and update of existing learning zone modules (most produced in 2012/13) in conjunction with production of new modules to reflect current gaps within the FRCS syllabus and/or essential core knowledge for clinical practice. In total, 26 new learning zone modules have been produced and uploaded (11 new modules advertised through ENT UK fortnightly newsletter in Feb 2022 with a further 15 new module titles to be advertised shortly). Further social media support with an e-lefENT Twitter feed is under discussion. Funding for illustration support for modules has been negotiated and secured with ENT UK to address the increasing issue of addressing copyright images and limited internal image resources available for authors contributing to the learning zone content. The potential of mixed reality technology is currently being explored.

Medtronic support and standalone e-lefENT platform

Ms Siddiq has led meetings with the web developers to address and make changes to support user analytics reports, improve access and ease of use of platform, streamlining payments/administrative duplicate tasks and updating home page to better reflect the new ENT UK website. To address conformity of branding, development of appropriate terms and reference for cancellation of fees, defining roles and responsibilities for the administrative support for e-lefENT and diversity data of current learners accessing e-lefENT. It has been acknowledged that e-lefENT is in a core benefit for ENT UK members and going forward does require greater administrative support in order to stay current. The Medtronic contract for the e-lefENT platform support and maintenance is due for renewal in December 2022. Meetings are ongoing for a further extension and possible incorporation of immersive technology through wider collaboration from industry.

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2. Mission statement:

To support and provide continuing education for specialists

CPD

Lead Miss Marianne Elloy

The CPD committee led by Miss Marianne Elloy has provided kite mark accreditation on behalf of ENT UK as a marker of quality of educational provision. Over this period, 44 applications for CPD approval were received. Two were received for advertising only. The regular programme of quality assurance visits to courses was not achieved due to the pandemic but oversight has been rigorously maintained with feedback from all courses reviewed and action taken if required. An additional clause to applications to consider the diversity of the makeup of any faculty has been added this year.

Webinars

Lead Mrs Mira de Kruijf

The webinar series is a free resource that is livestreamed through the RCSEd. This popular second series attracted an international audience of trainees, Specialty doctors and consultants. Mrs Mira de Kruijf has worked in collaboration with Miss Sarah Healy from RCSEd to deliver paired sessions focussing on a multidisciplinary approach to various conditions. Each session featured an ENT surgeon and a colleague from an affiliated medical specialty presenting their perspectives or approach to a given pathology. An hour was allocated for each session – 20 minutes for each speaker followed by 10 minutes of questions for each. The administration of this activity falls within the remit of the RCSEd. All new sessions were mapped to the new curriculum for otolaryngology to ensure relevance remains current. The webinars are also stored in the Education Library on the ENT UK website and represent a valuable resource for trainees. The feedback from these dual speaker sessions has been excellent, but as the organisation represents a huge administrative burden, it is likely that we will return to single speaker webinars for the next academic year.

Microtia and atresia with Mrs Jaya Nichani/Ms Elizabeth Whittle (Mr James Ramsden chair)
Flap and graft reconstructive options Mr Neville Shine/Mr Fiachra Martin (Miss Susannah Penney chair)
Monitoring and management of CPA lesions Mr Simon Freeman/Mrs Charlotte Hammerbeck-Ward (Chair Mr Simon Carr)
Management of thy3a nodule Mr Jonathan Bernstein/Dr Olivia Francies (Mr Iain Nixon chair)
ENT related syndromes Miss Michelle Wyatt/Dr Meyer Parsonson (Mr Sunil Sharma chair)

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Paediatric Emergency Surgical Skills Course (PESC)

Course Leads Mr Michael Saunders and Mr 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. Two courses have been held this year, one in Sheffield in June and one in London in August, with great feedback.

Adult Emergency Surgical Skills Course (ESSC)

Course Lead Mr 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 again in the next academic year and discussions with a new venue are ongoing. 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.

Induction package for junior doctors

Collaboration

Mr James Tysome led a collaboration of consultants and trainees to develop ENT UK’s junior doctors Induction programme. This includes a series of lectures, instructional videos, moulages and an assessment that can be downloaded from ENT UK’s website and has been widely utilised. These educational resources have been very well received and can be used for the benefit of all ENT departments in the UK as an adjunct to existing local offerings. A new development this year to allow the new doctor to have a certificate of completion of the associated assessment so that they

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can provide some evidence of engagement with this resource. It is suggested that there is ongoing advertising of this resource at times of junior doctor change over.

Podcast development

Lead Mr James Tysome

Mr James Tysome devised the concept of ‘A coffee room chat in ENT’, gained the support of the Royal College of Surgeons of Edinburgh and then organised and edited a new series of podcasts held by ENT UK in collaboration with the Royal College of Surgeons of Edinburgh. In this first series of eight podcasts released in Spring 2022, sub-specialty groups (HNSOC, BSO, BSFPS and BRS) were involved to nominate speakers. Each podcast lasted 20-25 minutes and all are still freely available on all standard podcast channels. The podcasts gained a large audience across the UK as well as internationally. A second series is being planned for release in 2023.

Endoscopic ear surgery, with Mrs Wendy Smith and Mr Gerard Kelly
Managing frontal sinus disease, with Mrs Archana Jaiswal and Miss Caroline Smith
Day case parotidectomy, with Mr Shane Lester and Mr Jai Manick
Patient selection in rhinoplasty, with Mr Peter Andrews and Mr Raj Bhalla
Options in conductive hearing loss, with Mr Neil Donnelly and Professor Myrthe Hol
Recurrent pleomorphic salivary adenoma, with Mr Sanjai Sood and Mr Stuart Winter
Managing spontaneous CSF leaks, with Mr Shahz Ahmed and Mr Omar Pathmanaban
Management of septal perforations, with Mr Raj Bhalla and Miss Nara Orban

Education Library

The Education Library is a valuable repository on the new website for useful educational resources such as the top performing BACO lectures and also induction lectures for doctors new to ENT.

Educational Fellowship Awards

The second year of ENT UK Foundation Educational Fellowships were offered and following a competitive process, successful applicants will be announced at the ENT UK meeting in November 2022.

3. Mission statement:

To encourage recruitment into the specialty

Association of Otolaryngologists in Training (AOT)

A key educational relationship that has been actively nurtured throughout the year is that between ENT UK and the AOT group. The president of AOT

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and the Education representatives have been active contributors to the Education and Training committee and as such provide a key bridge of essential communication between the organisations. A formal partnership agreement has been agreed with ENT UK and AOT.

Medical Training Initiative (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 with 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, interviewing by videoconference by an ENT UK executive representative and host trust representatives. The process of appointing a new MTI doctor has become increasingly complex so a guide has been produced that is available on the website to help people navigate the new process. We were able to place trainees from Sri Lanka to Northwick Park and Lanarkshire with the help of the NAPDENT team ensuring that this was achieved without negatively impacting any UK trainees, and a trainee from Jamaica has been appointed to Hereford.

4. Mission statement:

To promote high standards in the training of specialists

Recruitment

National selection in 2022 took the form of a virtual portfolio review. There is a considerable cost benefit to this approach that evolved due to the pandemic restrictions, so it seems likely that this virtual approach will continue. The highest-scoring candidates were interviewed over a virtual platform on 10 and 11 March 2022. The DoE of ENT UK supported the quality assurance of the process working with the national selection team in Yorkshire and Humber. Innovations this year included analysis of a research paper in an effort to sample the breadth of the ability of the candidates.

Specialty Advisory Committee (SAC)

A key relationship between educational committees and ENT UK is maintained by the President of ENT UK and the DoE sitting on the SAC, while SAC Chair Miss Ann-Louise McDermott is also a member of the ENT UK Executive Committee and the ENT UK Education and Training Committee.

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5. Mission statement:

To represent the specialty at the Royal College of Surgeons

Fellowships

ENT UK provides support to the RCS fellowship scheme by reviewing applications from teams who wish to provide a fellowship. In the last year review and support of fellowship applications has been undertaken for Guy’s Laryngology fellowship, Alder Hey Paediatric Otolaryngology fellowship and the Lister Thyroid fellowship.

Final Note

The work of the SFO Group (led by Mr Dheeraj Karamchandani) and the Community ENT Group is fundamental to the success of the education activity and reports on their activity can be found in chapter 10 of this Annual Report. I’d also like to give my personal thanks to Mr Shyam Sunder Singam who has led the SAS group with great enthusiasm and good humour, and we wish his successor well.

Professor Philippa Tostevin ENT UK Director of Education

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8. SPECIALIST ADVISORY COMMITTEE (SAC) IN OTORHINOLARYNGOLOGY

Governance

I was delighted to be appointed as the new SAC Chair as of January 2022. SAC membership is currently at full capacity. One new member was appointed in the past 12 months and a further three applications are being assessed for upcoming vacancies in 2023.

COVID-19

COVID-19 is still an issue and recent media news reports indicate a resurgence heading into the winter months, with further disruption expected. There is still disruption to many ENT services and training across the UK. As previously noted, the non-Head-and-Neck procedures have been, and still are, disproportionally affected. Below is the latest logbook data released by JCST in May 2022.

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JCST-collated data on COVID-19 derogations from 2022 once again demonstrate that despite the impact on trainee logbooks seen in the above graph, ENT as a speciality, used COVID-19 derogation much less than many other surgical specialities (see graph below).

There is some good news: both outcomes 10.1 and 10.2 will continue for the foreseeable future.

Curriculum

The new curriculum has bedded in well and more than 97% of trainees have transitioned over from the old curriculum.

The MCRs have rolled out this year and the ARCP season is almost finished for 2022. Early feedback from the JCST curriculum team indicate that MCRs on the whole were carried out at appropriate points in trainees’ placements, with 76% mid-term and end of placement MCRs completed on time. Also, MCRs, if used well, appear to be a good tool for both trainees and trainers alike. There have been some recent improvements to the process such as reducing the window of time for clinical supervisor reports from two weeks to 48 hours.

The debate about ‘checklists’ continues, and there is slight progress being made on this front as we await another update from JCST about our specialty ‘aide memoire.’

The new curriculum cites the ATLS course or equivalent as the only ‘mandatory’ course for ST3-8. Work is underway for a specialty-specific themed trauma course that fulfils the GMC idea of ‘equivalent’.

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National selection

Run-through trainees already appointed to run-through training continue their training as guaranteed at the onset of the pilot subject to successful completion of the stated objectives. This year’s entry was to ST3 only. There were 169 applicants, 80 were interviewed and 46 were appointed to ST posts. (2 LATS in Scotland.) Again, the assessment was fully online.

There were some changes to the format of national selection with the reintroduction of actors for the communication stations as well as a new style management station. 40% of trainees reported a preference to continue national selection in its virtual format. This virtual format offers MDRS a very significant financial saving. Despite continued lobbying for a face-to-face or hybrid-style assessment, national selection will remain in its virtual format for 2023.

Details of the latest requirements for 2023 national selection will be released shortly. Every effort is being made to reduce the delays seen in 2022. Bootcamps continue with two venues this year and once again thanks to ENT UK for support.

Core Training

With ST3 being the only entry point to Phase 2, and we are still awaiting the release of new core curriculum details designed to produce a ‘Registrarready’ trainee by the end of CT2.

Workforce

National selection 2022 had the benefit of a Health Education England (HEE) decision to fund ten additional NTNs in England. These additional ten training numbers are here to stay for the time being.

Ongoing ENT workforce analysis continues, supported by ENT UK. We are hopeful the results should be available towards the end of 2022. HEE have recently announced a Distribution of Medical Specialty Training Programme to consider re-distribution of the future ENT training posts across the UK. There have been no details yet as to how this will be assessed.

Training Interface Groups

The last of the pre-CCT TIG interviews have been completed in all three TIGs. These will now run as post CCT training and be quality assured by JCST. It is important to have ENT UK representation in addition to that of the SAC in each.

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Joint Committee on Intercollegiate Examination (JCIE) - Otolaryngology

April 2022: Overall, 83% candidates passed the JCIE examination.

July 2022 section 1 written examination: 60% of candidates passed and now section 2 clinical examinations are planned for November 2022 in Birmingham with the reintroduction of clinical cases. There is currently no waiting list for the section 2 examination.

Finally, I would like to thank all the members of the SAC for all their hard work this past year, and also to ENT UK which has been a great source of support and guidance especially with workforce research.

Miss Ann-Louise McDermott Chair of SAC in Otorhinolaryngology

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9. ENT UK MEETINGS

ENT UK Spring Annual Meeting 2022

Morning session

The ENT UK Spring Meeting was held at the Royal College of Surgeons of England, London, and being only the second face-to-face hybrid meeting since the COVID-19 pandemic, there was still an air of excitement, though delegates were naturally cautious. The ENT UK team worked hard to ensure that the hybrid element worked well.

The meeting got off to a great start with a presentation on sustainable healthcare by Professor Mahmood Bhutta. This is an important area where the specialty can contribute greatly delivering positive social impact. This was followed by presentations under the banner of British Otolaryngology Allied Sciences Research Society (BOARS) showing novel research being undertaken in all sub-specialties. Ms Katie Nurcombe, ENT UK CEO, updated all delegates on member developments in ENT UK, including exciting news about the new website and the Association Excellence Award for member support during the pandemic at their event held in autumn 2021.

This was followed by an exciting panel discussion on celebrating diversity in ENT. The panellists, Ms Isma Iqbal, Ms Ginny Bowbrick and Ms Katherine Conroy were ably chaired by Ms Nina Mistry, co-chair of Women in ENT Surgery (WENTS UK). Mr Andrew Swift then gave delegates a sneak preview

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of BACO 2023 – with Professor Claire Hopkins as Academic Chair, it promises to be an academic feast in Birmingham.

The handover of the presidency concluded the morning session, marking the end of my exciting and extended three-year term, and the beginning of Mr Andrew Swift’s, in whose capable hands ENT UK should continue to flourish.

Professor B Nirmal Kumar Past-president of ENT UK

Afternoon session

After an excellent lunch in the airy ambience of the new Royal College of Surgeons of England building, the afternoon session was hosted by myself in my very new role as President, while trying my best to keep my nerves imperceptible and controlled. We started off with a formal RCSEng gowned procession for the prestigious College Family Fund lecture, led by Professor Tony Narula. Our invited lecturer, Professor Darlene Lubbe, from Groot Schuur Hospital, Cape Town, SA, gave a wonderful delivery of her innovative experience with transorbital endoscopic surgery in the management of orbital lesions and disorders of the anterior skull base. This was followed by our second excellent presentation of the afternoon entitled ‘Transoral microsurgery of advanced tumours of the larynx’, delivered by our other very eminent guest speaker, Professor Manuel Bernal-Sprekelsen from Barcelona. We then had the fun event of announcing the winners for the free papers and posters, hosted by Professors Carl Philpot and David Hamilton. The winners of these awards are noted in the BOARS report in Chapter 10.

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After a short break, we proceeded with the AGM as the final component of what had been a really stimulating event, with an amazing range of topics and discussions that had been enjoyed by all. However, the event continued with a very popular networking event with refreshments.

ENT UK Annual General Meeting (AGM)

The AGM for 2021-2022 followed the Spring Meeting and was well attended by many members. We commenced with a minute’s silence for those colleagues that had sadly passed away during the year, including Mr John Evans, a past BACO Master (from 1999).

Professor Kumar led on the initial section of the AGM and gave an excellent report that mentioned particularly the collaborative activities during the Covid pandemic and his extended three years as President. His report noted the launch of the ENT UK Foundation and its charitable activity, the various educational activities undertaken by ENT UK, and the Rowena Ryan awards. It was noted that there were 606 new members and a total membership of 2,370.

Mr William Hellier, Assistant Honorary Treasurer provided a clear summary of the Association finances. He proposed a 5.5% increase in membership fees that was approved by the members present without comment.

A special resolution was approved by the membership for the tenure of non-medical Trustees. The term of office was changed from two terms of three years to a more flexible situation, without this restriction, whereby the Trustees could extend tenures in exceptional circumstances.

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Mr Taran Tatla and Professor Gerry O’Donoghue were both thanked for their excellent commitment and support as Trustees, as well as Honorary Secretary and BACO Master respectively. Ms Helen Cocks was welcomed as President-elect and thanks were extended to Mr Andrew Gamble and Mr Andrew Foster as our supportive Lay Trustees. Professor Kumar will remain on the Trustee Board as Chair of the new ENT UK Foundation Committee.

Finally, Professor Helge Rask-Andersen from Uppsala University, Sweden, was presented with Honorary membership of ENT UK and a special message that had been sent by Professor Rask-Andersen was read out to the members.

Mr Andrew C. Swift President of ENT UK

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10. ENT UK MEMBERSHIP GROUPS

British Society of Facial Plastic Surgery (BSFPS)

Autumn 2022 is upon us and the BSFPS membership grows from strength to strength particularly among our junior section.

I am very pleased to announce Mr Natarajan Balaji will be our new President-elect. We offer our congratulations and look forward to his future leadership. Mr Balaji is a senior consultant otolaryngologist and facial plastic surgeon at the University Hospital of Monklands, Glasgow, and an Honorary Associate Professor at University of Glasgow. He will provide immense wisdom and experience in taking the Society forward.

We hosted our first post-Covid ‘face-to-face’ BSFPS Conference in Glasgow on 21 and 22 October 2021, which was superbly organised by Mr Balaji and supported by ENT UK. The first day focused on our junior training and was a great success. We will be hosting our next BSFPS conference in London in October 2022.

BSFPS continues to advise on functional septorhinoplasty guidelines, recommendations and consent processes and informing the NHS England ENT elective Covid recovery programme. I’m proud to have signed off the new NHSE nasal airway surgery pathway, which embraces transformational ways of working, in collaboration with ENT UK, BRS and BSO.

It’s a great pleasure to see the junior section expand and grow during my tenure, and thank you again to our junior section leaders Mr Ryan Cheong, Mr Kristian Hutson and Miss Anna Slovick, who have enabled this to happen. I would like to thank the expertise of our Treasurer, Miss Pei Pei Cheang, in holding the fort during these incredibly challenging Covid times and has now handed over the reins to Professor Anshul Sama. Equally, I would like to thank the continued expertise of Miss Sadie Khwaja in spearheading our website design in collaboration with ENT UK.

Mr Peter Andrews President of BSFPS

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British Society of Otology (BSO)

This year has been one of change for the BSO Council. Changes to our constitution will have long-term advantages but have meant that seven members demitted this year. The council are very grateful for all their hard work. They were replaced by a first-class group of predominantly young otologists at the 2022 AGM. I took over from Mr Peter Rea as President in February 2022 and I’d like to thank him for his diligence and guidance in his two years in office.

BSO successfully introduced small research grants led very effectively by Professor Manohar Bance and now Miss Paramita Baruah. The initial reports of the first round of projects demonstrated what can be achieved with even a relatively small amount of funding and highlighted the importance of this type of support for research.

A further key role of the BSO is to encourage the next generation of otologists and it has been a real pleasure to see the BSO Juniors continue to go from strength to strength. One initiative that has proven to be particularly helpful is the development of a database of all the otologyrelated fellowships available worldwide.

The BSO Annual Meeting was held in May at St John’s College, Cambridge, and focused on learning from colleagues in specialties related to otology, including neurology, rheumatology, anaesthetics, cardiology and maxillofacial surgery. The insights gained from them were extremely useful with outstanding feedback received. Thanks again to Professor Bance and the ENT UK team. Next year’s meeting will take place on 4 May in London, and we plan to celebrate the twentieth year of the BSO.

The BSO balance course has now been running for many years and, as with previous years, the 2022 course was a great success and all the better for a return to a face-to-face format. We are very grateful to Mr Gerard Kelly for his excellent stewardship over the last few years.

Other projects completed over the last year or currently underway include:

a review of the variation in intellectual property policies across different NHS Trusts
the development of evidence-based consent forms
closer working with other academic otological organisations
input into a number of national documents including NICE guidance
support for the continuation of the MRCS (ENT) examination
educational material for GPs and ENT surgeons

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the re-development of the otology section of the ENT UK website.
Ms Smith is standing down from her role as Education Lead this year and we are very grateful for all she has done in her time in this role.

BSO continues to be on a good footing financially and I am very grateful to Miss Kay Seymour, our previous Treasurer and to Mr Peter Monksfield, our current Treasurer. I would also like to thank Miss Kay Seymour for taking over the role of Secretary from me.

That just leaves me to say thank you to our membership for all the support you have given us over the last year.

Professor Simon Lloyd President of BSO

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Community ENT Group

The Community 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. The Group has been very active throughout the year, developing patient information leaflets for GPs on the topics of vestibular rehabilitation and administration of ear and nose drops. The group requested a Co-Chair with representation from the community as well as secondary care. Dr Eason Sivayoham, who is a GP with an extended role in ENT and also an ENT UK Council member has been appointed as Co-Chair. The Group has developed the programme for the GP Day for BACO 2023 and used the feedback from the last BACO GP day to improve on the style of delivery of the content in a format that will be valued most by the audience. Speakers from around the UK and Ireland have been agreed. Formal agreement of the governance of the Community Group has been established and published. The curriculum guidance document for physician associates in ENT was developed by a subset of this group with additional membership from around the UK and this has now been agreed and published on the website.

GP Guidelines Live event

ENT UK representatives Mr David Selvadurai and Ms Wendy Smith both presented brilliantly at the ‘Guidelines Live’ event for GPs at the Excel Centre on 1 December 2021, which allowed advertising of ENT UK events to a large number of GPs from around the UK.

Professor Philippa Tostevin Community ENT Group Co-Chair

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Head and Neck Society

It has been a very productive and busy year for the Head and Neck Society (HNSoc). The highlight of the year was the hugely successful evidencebased meeting held in November 2021 at the Sage Centre in Newcastle on the ‘Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP)’. Led by Professor Vin Paleri, the meeting was a hybrid meeting consisting of 54 attendees in person and 173 who attended virtually. The meeting was made possible by funding from exhibitors, as well as a £5k grant from the Oracle Cancer Trust, which led to an overall net profit for the meeting.

The meeting involved a significant amount of work from the organising faculty and had a truly MDT contribution from many regions of the UK at the meeting. It received outstanding feedback and was the first of its kind at ENT UK; breakout sessions and a Delphi exercise has led to robust guidelines being formulated for management of HNSCCUP. The HNSoc also invited all UK Head and Neck MDTs to contribute further on proposed guidelines with a near 100% response helping to further solidify the guidelines.

The guidelines and the methodology for generating the HNSCCUP consensus guidelines are due to be published. The multi-phase strategy highlighted by the meeting may be a model for future developments of national clinical practice guidelines of controversial or uncommon conditions.

The Society has been working hard during 2021-22 on revising the guidelines document for Head and Neck Cancer, which should be published in 2023. Professor Homer and Mr Winter have taken the lead as editors of the guidelines and there have been many contributors from various specialities, as usual, which has led to excellent MDT guidelines. All chapters have been peer-reviewed by the HNSoc. The format appears very clear and should be a very useful reference for all clinicians involved in the management of Head and Neck Cancer, as well as for trainees revising for examinations.

There has also been work on the development of TORS guidelines, with particular reference to credentials required for surgeons practicing TORS to ensure that surgeons have been adequately trained to perform this surgery. This work is ongoing and may involve discussion with BAHNO.

We are all looking forward to BACO International 2023 and the HNSoc has actively contributed to the development of the programme, which has been a challenging task. The programme looks excellent, with many aspects of both benign and malignant head and neck disease covered in a

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contemporary manner. We have invited some excellent international speakers to the meeting.

There have been meetings with the NCIP (National Consultant Information Programme) in which a tool for collecting surgical data is being developed. As always, this will need input from clinicians as the initial data review appeared to be inadequate and inaccurate and work is ongoing to improve this.

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Professor Vin Paleri is demitting from council – his contribution over the years has consistently been nothing short of tremendous, and thanks are unreservedly given for his time and effort over the years.

Mr Sanjai Sood Head and Neck Society President

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ENT Staff and Associate Specialists (SAS)

At last, we finally had our face-to-face, 6th ENT UK SAS Conference on 2324 June 2022 in the Brecon Beacons in Wales, which was well worth the wait. The conference was expertly put together by Mr Sam Fishpool and his team, along with the ENT UK office team. It was an impressive speaker line up, covering a wide range of topics, from latest in robotic surgery to ancient and fascinating perceptions of ear wax. The conference was very well received and well attended. A Welsh gastronomic experience, on the banks of the river Usk, complimented it perfectly. A huge thank you to all involved.

COVID-19 seems to be settling and most SAS doctors are trotting back to some form of normalcy, while still trying to get to grips with the new 2021 SAS contracts. There have been encouraging signs regarding the take-up of the new specialist grade post, with a good number of appointments.

The ENT UK CESR buddy scheme to support CESR applicants across the UK continues to be a useful resource to the SAS membership.

BACO International 2023, face-to-face this time, is around the corner, with an amazing programme where we have a nicely lined-up SAS hour.

As all good things come to an end, so must my tenure as SAS Chair, and I have stepped down (after an extended stint) to give way to ‘young blood’. It has truly been a privilege – a sincere thank you from me to all.

Mr Shyam Singam Former SAS Chair

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Student and Foundation Doctors in Otolaryngology (SFO UK)

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 this enthusiasm can be maintained and translated into a vibrant future for the specialty. There is a steady growth in membership to 415 at the time of writing. All medical schools have representatives on the SFO group. The Official Handbook for Medical Students and Junior Doctors e-book, produced by the SFO group, is freely available to all medical students in the UK and for many represents a core text. Work is ongoing to improve its functionality and alignment with the forthcoming GMC medical licensing exam. Over a six-month period there were 612 views of the SFO e-book. A highly successful SFO conference was held on 9 October 2021 at the University Hospitals in Warwickshire, with some exceptional speakers and practical skills stations. Over the last year, the SFO team has been developing its plans for BACO International 2023, which will also involve the ever-popular ENT skill stations with capacity for 80 attendees.

Professor Philippa Tostevin ENT UK Director of Education

Mr Dheeraj Karamchandani SFO Chair

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Young Consultants in Otolaryngology and Head and Neck Surgery (YCOHNS)

By accepting ENT consultants five years beyond appointment, trainees six months from their CCT and ENT UK members on post-CCT fellowships, YCOHNS membership is now at its highest level yet. This is mainly possible due to the generous rates offered to YCOHNS members, providing them with full membership advantages of ENT UK.

YCOHNS was always built on regular face-to-face meetings and the pandemic has continued to have an impact on this, despite our best attempts. We have therefore decided on a different approach.

In September 2022 we formed a wider leadership, including an events rep and website rep, and have now formed links with the Association or Otorhinolaryngologists in Training, featuring an AOT rep within our leadership group. We are planning a session at BACO International 2023 in February and a YCOHNS conference in autumn 2023. There are exciting times ahead while we get back to our previous networking prowess in faceto-face environments and look forward to bringing these to the ENT UK membership. We also plan to vastly develop the website for YCOHNS as we see this as an excellent channel for our members to utilise.

Mr James Barraclough YCOHNS Chair

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11. ENT UK SPECIAL INTEREST GROUPS

The British Otorhinolaryngology and Allied Sciences Research Society (BOARS)

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 Autumn BOARS Meeting on 15 October 2021. At this meeting the Angell James prize was won by Mr Tobias James for his work ‘Post-operative C-reactive protein trend does not predict healing following laryngectomy’. The junior prize was won by Mr Leo Gundle and Mr Joseph Henry for their work ‘Stenting vs. stent-less repair in bilateral choanal atresia: A systematic review’.

The Spring Meeting was held at the Royal College of Surgeons of England on Friday 8 April 2021, as a joint meeting with ENT UK. Mr Mark Wilkie won the Philip Stell Prize for his work ‘The Liverpool lymph node metastasis lymph node score for cutaneous squamous cell carcinoma of the head and neck: developing a predictive scoring system through a large-scale casecontrol study’. Mr Andreas Espehana won the junior prize with his work ‘Establishing research priorities for smell and taste disorders: The James Lind Alliance Priority Setting Partnership’. Miss Ellen Skelly, a fourth-year medical student, won the poster prize with her work ‘Capsaicin for the treatment of non-allergic rhinitis: a systematic review’.

In November 2021 we launched the BOARS pump priming grant: £1500 was awarded to Dr Elizabeth Garden for her work ‘A cohort study investigating the role of a screening smell and taste test in patients following head injury’. BOARS are preparing a session for the BACO meeting in February 2023 entitled ‘The questions you had about Research but were too afraid to ask’. We are holding the BOARS Autumn Meeting on 4 November 2022.

Mr David Hamilton BOARS Secretary

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British Society for the History of ENT (BSHENT)

The Annual Meeting of the British Society for the History of ENT was held virtually on Thursday 2 December 2021. In all, 31 papers were submitted, from which 12 were chosen for presentation. An additional paper entitled ‘A Personal History of Innovation in ENT’ was given by Mr Navnit Shah FRCS. The Journal of Laryngology and Otology (JLO) prize was won equally by Mr James McGregor and Mr Chang Lee.

The Co-chairs, Mr Neil Weir and Mr Richard Irving, thanked the judges, Mr Edward Fisher, Professor Albert Mudry and Miss Emma Stapleton. They also thanked Ms Jessica Leigh for her excellent organisation of the meeting, which was recorded and made available on the BSHENT website.

There has been no change in the BSHENT committee. The committee consists of Mr Neil Weir as President, Mr Richard Irving, Mr Edward Fisher and Miss Emma Stapleton as Committee Members, Professor Albert Mudry as International Committee Member, Mr Stefan Linton as Webmaster and Ms Katherine Conroy as Trainee Committee Member.

Mr Neil Weir BSHENT President

Miss Emma Stapleton BSHENT Ordinary Committee Member and Honorary Secretary

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Global Health Committee

Mr Vijay Pothula handed over the reins as Chair of the Committee in March, having done an excellent job over the past two years. The year has been a positive one for the Global Health Committee. Although two of our most experienced and knowledgeable Committee members, Mr Robin Youngs and Professor Mahmood Bhutta, left us after making significant contributions, a young ENT trainee, Ms Sara Timms, has joined us. She already has experience in global health and I am sure that she will make a valuable contribution.

We have sought to restructure the Committee and allocate specific roles. We now have a Chair, Vice-chair, Secretary, Treasurer, Social Media and IT lead, Trainee Rep, Student Rep, Research Lead and WHO Lead. We now hold our Committee meetings virtually, which has allowed us to meet more frequently.

We have been able to define our financial arrangements with ENT UK and can use our funds to offer grants of up to £2,000 for research and initiatives in global health. The first grant was awarded to an organisation called Let the Children Hear. This grant was used to enable the training of two paediatric audiologists in Uganda which has already started to impact on services there. The grant scheme will continue under the oversight of a Subcommittee.

Our annual Global Health Conference was held on 1 October 2021. This was held as a webinar again which has proved to be an appropriate format. We had speakers from many countries including Rwanda, Brazil, Sri Lanka, South Africa and Australia. We also awarded a prize to the best research paper on global health. The feedback for the event was positive. We are currently planning the next conference, to be held on 18 November 2022.

Following the conference in October, Mr Vijay Pothula edited our annual Global Health journal, which was packed with interesting articles and which managed to attract excellent sponsorship, providing funds for the grant scheme.

We continue to provide information about global health on the ENT UK website and on social media.

We continue to be a stakeholder at the World Hearing Forum, a global network of stakeholders promoting ear and hearing care worldwide. This group was established by the WHO.

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New initiatives this year have included a series of lectures provided as webinars, following a request for teaching by Mongolian ENT surgeons. This was a successful venture led by Miss Emma Stapleton.

Another exciting new initiative is a collaboration with the Global OHNS, a research collaborative dedicated to promoting equitable access to highquality, affordable otolaryngology care for all. The project will provide ENT internet guidelines on a number of subjects, catering for varying levels of available resources. This is quite a large project and we look forward to seeing some of the results in the next six months or so.

We have done another global health survey of ENT UK members and will be collating the results for this in due course.

We have appreciated the support throughout this period of ENT UK, and in particular that of the Past President, Professor Nirmal Kumar.

Mr Nick Eynon-Lewis Global Health Committee Chair

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Private Practice Committee

I would like to start the annual report of the Private Practice Committee (PPC) by thanking my predecessor Mr Tony Jacobs for all his hard work over the years as Chair of PPC, supporting and advocating for colleagues undertaking private practice.

A new committee is now in place since early 2022, and I would like to thank my colleagues who have joined, Mr Prad Murthy, Mr Mark Simmons and Mr Sankalp Sunkaraneni.

The current private practice environment is very uncertain. There has been patient growth, but fees paid by private insurers have not increased for many years, in some cases they have decreased, but costs incurred by consultants continue to rise. We are planning to run a survey over the next few months to clarify the scale of the issue, allowing us to lobby the private health insurers and private hospital groups directly, as well as via organisations such as FIPO (Federation of Independent Practice Organisations).

We are also concerned regarding reports of consultants having practice privileges unilaterally revoked by insurers and hospital groups. The process is not transparent, and we hope that the survey will enable us to understand the scale of the problem.

We are actively engaging with FIPO regarding the CMA (Competition and Markets Authority) order regarding publication of fees. PHIN (Private Health Information Network) is also developing proposals to publish outcome data, which is causing some concern, and we are engaging both directly within PHIN working groups and via FIPO.

We are always keen to hear colleagues’ views and concerns and can be contacted via ENT UK or directly at rammoorthy@mac.com.

Mr Ram Moorthy Private Practice Committee Chair

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Women in ENT Surgery (WENTS UK)

This year brought some changes to the WENTS Committee, as we welcomed Professor Claire Hopkins as Patron, and Miss Nina Mistry and Miss Emma Stapleton as Co-chairs. Prof Hopkins was the founder of WENTS in 2015 and has been a constant source of wisdom and support to the group.

Three further podcasts have been recorded, produced, and delivered in collaboration with the talented Ms Heather Pownall, supported by a grant from Karl Storz UK. You can stream them on Spotify and all major streaming platforms. Episode 3, ‘The M Word: Breaking the Taboo’ is our most popular podcast yet, addressing women’s health, with input from some fantastic speakers. Episodes 4 and 5 focus on surgical training, with valuable insights from surgical trainers in Episode 4, and from surgical trainees in Episode 5. In March 2022 we hosted a virtual International Women’s Day event which attracted over 200 delegates, and included talks on leadership and equality in the corporate world from Ms Michele Oliver, Vice President of Mars and Vice Chair of Stonewall; neurodiversity in the medical profession from Dr Mary Doherty, consultant anaesthetist and founder of Autistic Doctors International; and the ethnic and gender pay gap from Mr Surash Surash. There was also a live discussion on the theme of sexual harassment in surgery, chaired by our very own Miss Victoria Sinclair.

Our Co-chair, Miss Nina Mistry, chaired an Equality, Diversity and Inclusion discussion panel at the ENT UK Spring meeting in April 2022. Our committee has supported many speaker requests from a variety of medical and surgical societies, including the delivery of an ENT-themed webinar for Cardiff Women in Surgery Society, and an ‘Everything you Wanted to Know about ACCIA Awards’ webinar for ENT UK.

One of the jewels in our crown is our social media extraordinaire, Dr Alex Ashman. Alex’s enthusiastic and informative social media work has attracted attention from far and wide, with our Twitter follower count increasing by over 50% in the past 12 months, as well as a steady increase in activity and followers on Instagram and LinkedIn.

The ENT UK Mentoring Programme led by WENTS continues to flourish, with a steady increase in participants to over 200. The team has enjoyed a number of drop-in ‘Mentor Cafes’, one of which included the fantastic Nancy Redfern, mentoring lead at the Association of Anaesthetists. Watch out for more Mentor Cafes and another mentor training event, coming soon. We have also achieved our first publication, led by Dr Rohma Abrar, on the theme of participant expectations in a national otolaryngology mentorship programme.

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We’re currently looking forward to BACO International 2023 in Birmingham, where we have an exciting debate planned on the theme of tokenism and meritocracy, as well as a social event on the Wednesday evening. We look forward to seeing you there.

The WENTS UK Committee would like to thank the wider ENT UK community, all our collaborators and sponsors, and all who have attended or participated in our activities of the past year. Thank you.

WENTS UK Executive Committee

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12. FINANCIAL REVIEW

Overview of ENT UK finances in the period 2021-2022

Introduction

This financial report covers the year from the 1st of October 2021 to the 30th of September 2022. It therefore includes the latter end of the COVID19 pandemic, as well as the invasion of Ukraine by Russia, the subsequent economic turmoil and the rise of inflation. The return of high inflation to the UK, has affected many and has and will affect the expenditure of ENT UK.

There has been a return to face-to-face meetings, but many still containing a hybrid element of virtual attendance. The BACO Executive Committee has been working hard preparing for the rescheduled face to face BACO in February 2023. The British Rhinological Society (BRS) joined ENT UK in 2022 bringing with them a number of new members.

Revenue

Membership revenue income remained flat at the 2021 level, with a total cumulative membership income of £448k. There was a net increase over the year of 310 members. The total number of paying members on the 30th of September 2022 was 2,427, up from 2,117 members on the 30th of September 2021. This includes 120 BRS members who joined ENT UK in 21/22.

The ENT UK Foundation has received £62k in donations over the year, raised from individual and institutional donors, to fund research and international collaborations within the ENT specialty. This is ringfenced separately within the accounts as designated funds. ENT UK is extremely grateful to all our individual and institutional donors, for their generosity and support. A full list of donors can be found on the ENT UK website at https://www.entuk.org/donors.

Investment portfolio

The Finance Committee oversees all matters pertaining to the financial planning and performance of ENT UK, including investment management, and advises and reports to the Board of Trustees on the performance of the investment portfolio 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 global economic turmoil affected all stock markets around the world. This has therefore affected the market value of ENT UK’s investment

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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portfolio. The book value of the investments at the end of September 2022 remained flat at £2.1m. The market value on the 1st of October 2022 was £2.4m (compared to its valuation of £2.9m at a similar date in 2021). This valuation is inclusive of £50k withdrawn from the portfolio by ENT UK to fund strategic projects, as detailed in the reserves policy.

The loss of value of ENT UK‘s investment portfolio this year, is very similar to the gain in the value of the portfolio in the preceding 2020-21 year. Stock market values do fluctuate in the short term, but ENT UK has a long-term outlook for its investment portfolio. The loss in the portfolio, does mean that the overall ENT UK accounts will show a significant deficit; however, ENT UK still owns the investments and over a longer term, like most stock markets, it is likely that their value will slowly increase.

The rise of inflationary pressures, and of interest rates, have increased the income derived from the portfolio to a degree. The dividend income for the year was £55k (£50k in 2021). The forecast dividend income for 2022-23 is £58k.

Expenditure

The operating expenditure for the year was £638k and it includes all costs including the direct cost of organising events and all costs related to the running of the office on a day-to-day basis including payroll. It excludes the activities directly related to the ringfenced activities of the designated funds.

ENT UK and its sub-groups spent £67k during the financial year to fund fellowships and strategic projects from the designated funds. ENT UK spent £26k (details of which is discussed in the reserve policy below), the ENT UK Foundation awarded £26k in educational and research grants, the British Society of Otology awarded total of £5k in smaller research grants to 5 individuals, and the Global Health Committee and the BOARS awarded £3k each in fellowship and award payments during the year.

Summary and Financial Outlook

The total turnover for the year was £729k and the expenditure was £705k. Thus, the Trustees of ENT UK are pleased to report a small operational surplus of £24k for the financial year 2021-22 before the revaluation of the investment portfolio.

However, due to the global turmoil, the valuation of the ENT UK investment portfolio on 1 October 2022 fell by £429k. This reduction was recognised on the income and expenditure statement at the year-end. Thus, the final accounting deficit for the financial year is £405k.

The total value of ENT UK’s charity funds (balance sheet) at the 30th of September 2022 were £3.0m (£3.4m in 2021).

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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It is hoped that BACO in February 2023 will be an educational and financial success. Money spent by ENT UK on preparing for BACO, including venue costs and payroll costs, as well as any income already received from delegates and sponsors, will be included in the 2022-23 financial statement.

In summary, the tail end of the COVID-19 pandemic has continued to impact ENT UK’s function, and the economy has been further hampered by the Russian invasion of Ukraine, and the rise in inflation. There has been a fall in the revaluation of ENT UK’s investment portfolio, related to the falls in the stock markets around the world. Nevertheless, ENT UK remains in a robust financial position due to the strong operational performance of its staff and Executive Committee, and the long-term stewardship of its Trustees. 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

What are Reserves

Reserves are that part of a charity’s unrestricted funds that are freely available to spend on any of the charity’s purposes. The starting point for calculating the reserves held is therefore the amount of unrestricted funds held by a charity. However, some or all of the unrestricted funds of a charity may not be readily available for spending. This is because spending those funds may adversely impact on the charity’s ability to deliver its aims. The items that should be excluded from reserves are:

tangible fixed assets used to carry out the charity’s activities, such as land and buildings
programme-related investments those held solely to further the charity’s purposes
designated funds set aside to meet essential future spending, such as funding a project that could not be met from future income
commitments that have not been provided for as a liability in the accounts

Purpose

The purpose of the Reserves Policy for ENT UK is to ensure the stability of the mission, programmes, employment, and ongoing operations of the association and to provide a source of internal funds for organisational priorities.

The Reserves Policy will be implemented in line with the other governance and financial policies of ENT UK and is intended to support the goals and strategies contained in these related policies and in ENT UK’s strategic and operational plans.

There will be two Reserves:

Operating Reserve
Opportunity Reserve

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Operating Reserve

The operating reserve is to fund the day-to-day operational costs and any in-year actual or forecast deficit. The Operating Reserve is intended to provide an internal source of funds for situations such as covering the deficit from strategic loss-making activities as agreed in the budget setting process, a sudden increase in expenses, one-time unbudgeted expenses, unanticipated loss in funding, or uninsured losses, including redundancies and material financial commitments.

The operating reserves are not intended to replace a permanent loss of funds or eliminate an ongoing budget gap.

The Operating Reserve fund is defined as a designated fund set aside by action of the Board of Trustees following a recommendation by the Finance Committee. The minimum amount to be designated as Operating Reserve will be established in an amount sufficient to maintain ongoing operations and programs measured for a set period of time, measured in annual cost.

The Operating Reserve serves a dynamic role and will be reviewed and adjusted in response to both internal and external environmental changes. The target current minimum Operating Reserve Fund will be calculated based on 12 month’s operating costs.

The calculation of average annual operating costs includes all recurring, predictable expenses such as staff salaries and benefits, occupancy, office, travel, program, and ongoing professional services.

Depreciation, benefit in-kind, and other non-cash expenses are not included in the calculation. The calculation of average annual expenses also excludes ring-fenced fund activities, capital expenses and partner payments.

The amount of the Operating Reserve Fund target minimum will be calculated each year after approval of the annual budget, reported to the Finance Committee/Board of Trustees, and included in the regular financial reports.

Opportunity Reserve

The opportunity to fund activities that help achieve the charity’s objectives, but are not essential costs: The Opportunity Reserve is intended to provide funds to meet special targets of opportunity or need that further the objectives of ENT UK and which may or may not have a specific expectation of incremental or long-term increased income.

The Opportunity Reserve is also intended as a source of internal funds for organisational capacity building such as research and development, membership development, staff development, or investment in infrastructure that will build long-term capacity.

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This reserve is intended to be set aside based on a 5-year time horizon of need and it is expected that it will be used, monitored and replenished frequently from the unrestricted reserve.

Significant (large) legacies will be assigned to this reserve, so that their use can be ring-fenced for specific projects and ensure that they are not, so far as is possible, eaten up by general overheads.

The target amount of the Opportunity Reserve will be determined annually by the Board, based on a recommendation from the Finance Committee taking into account the following:

Level of allocation of unrestricted funds to Operating Reserve
ENT UK Strategy and progress against the Key Performance Indicators
Specific requests for Opportunity Funding for example from the General Manager, Executive Committee or Foundation

Accounting of Reserves

Designated/ring-fenced funds are excluded from the calculation of Reserves.

Reserves will be reported to Finance Committee on a quarterly basis.

Funding of Reserves

The Operating Reserve will be funded with surplus unrestricted operating funds.

The Board of Trustees may from time to time direct that a specific source of revenue be set aside for Operating Reserves. Examples could include one-time gifts or bequests, special grants, or special appeals.

The Opportunity Reserve will be funded with occasional special designations made by the Board of Trustees and significant legacies that have not been directed to the ENT UK Foundation.

Use of Reserves

1. Identification of appropriate use of Opportunity Reserve

Use of the Opportunity Reserve must only be for projects which demonstrate that they align with the ENT UK Strategy
Projects must include a clear rational for investments – ideally demonstrated by a Business Case demonstrating clear expected outputs

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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2. Authority to use Opportunity Reserve Funds

Trustee discussion and approval will be required for any use of the Opportunity Reserve
Requests for use of the Opportunity Reserve should ideally be considered in advance of the financial year in line with budget setting processes; however, requests may be considered during the financial year if unallocated funds are available.

3. Reporting and monitoring

Approval of spending decisions must be confirmed in the Board of Trustee minutes
Reserve withdrawal and funding commitments will be reported in the quarterly financial reports

Review of Policy

This Policy will be reviewed every year, at minimum, by the Finance Committee, or sooner if warranted by internal or external events or changes. Changes to the Policy will be recommended by the Finance Committee to the Board of Trustees.

Approved by – Board of Trustees – 17 Feb 2022 (Use of Reserves process approved by Board of Trustees – 21 July) Date of Policy – July 2022 Next Review Date – July 2023

Statement on Reserves

The total value of ENT UK’s balance sheet on 1[st] October 2022 was £3.0m down from £3.4m on 1[st] October 2021.

In 2021-2022, the Trustees of ENT UK revised the Reserves Policy. This policy revision was made to

identify the amount of reserve funding that was needed to underwrite the operational costs of the organisation, and
to identify any opportunity reserve funds, that could be mobilised to help achieve the ENT UK’s charitable objectives.

This process identified there were potential available funds, over and above those needed as an operational reserve. The Trustees voted to draw £50k per year from the investment portfolio, over a five-year period, to create an Opportunity Reserve fund that should be used to support strategic projects.

The trustees of ENT UK will review this policy on a periodic basis to ensure the level of reserves being maintained is at the optimum level.

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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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.

• •

The Trustees are responsible for the maintenance and integrity of the website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Andrew Swift William Hellier

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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President of ENT UK Honorary Treasurer

13. INDEPENDENT EXAMINER’S REPORT AND FINANCIAL STATEMENTS

Independent Examiner's Report to the trustees of ENT UK trading as British Academic Conference in Otolaryngology (BACO) and British Association of Otorhinolaryngology - Head and Neck Surgery

(BAO-HNS)

I report to the charitable company trustees on my examination of the accounts of the company for the year ended 30 September 2022 which are set out on pages 62 to 77.

Responsibilities and basis of the report

As the charity trustees of the company (and also its directors for the purposes of company law) you are responsible for the preparation of the accounts in accordance with the requirements of the Companies Act 2006 (‘the 2006 Act’).

Having satisfied myself that the accounts of the company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your company's accounts as carried out under section 145 of the Charities Act 2011 (‘the 2011 Act’). In carrying out my examination I have followed the Directions given by the Charity Commission under section 145(5)(b) of the 2011 Act.

Independent examiner’s statement

Since the company's gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of the Institute of Chartered Accountants in England and Wales, which is one of the listed bodies.

I have completed my examination. I confirm that no matters have come to my attention in connection with the examination giving me cause to believe:

accounting records were not kept in respect of the Company as required by section 386 of the 2006 Act; or

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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the accounts do not accord with those records; or
the accounts do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the accounts give a ‘true and fair view' which is not a matter considered as part of an independent examination; or
the accounts have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice for accounting and reporting by charities applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102).

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Colin Andrew Barker FCA 146 New London Road Chelmsford, Essex CM2 0AW

6 March 2023 Date:________

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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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)

(A company limited by guarantee)

Annual Report and Financial Statements

for the Year Ended 30 September 2022

Contents
Statement of Financial Activities		62
Balance Sheet		63
Statement of Cash Flows		64
Notes to the Financial Statements	65	to 77

Edmund Carr LLP Chartered Accountants & Statutory Auditor 146 New London Road Chelmsford Essex CM2 0AW

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Statement of Financial Activities

For the Year Ended 30 September 2022

(Including Income and Expenditure Account and Other Comprehensive Income)

Note	Total Total
	2022 2021
	£ £
Income from:
Charitable activities 3	673,205 950,282
Investment income 4	56,221 50,939
Total income	729,426 1,001,221
Expenditure on:
Raising funds 5	14,762 14,977
Charitable activities 6	690,619 782,806
Total expenditure	705,381 797,783
Net income before investmentgains	24,045 203,438
Gains/losses on investment assets	(429,138) 429,046
Net(expenditure)/income	(405,093) 632,484
Net movement in funds	(405,093) 632,484
Reconciliation of funds
Total funds brought forward	3,398,327 2,765,843
Total funds carried forward 19	2,993,234 3,398,327

All of the charitable company's activities derive from continuing operations during the above two periods.

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Balance Sheet

as at 30 September 2022

Balance Sheet as at 30 September 2022
	2022 £ 2021 £ 52,245 14,340 2,345,208 2,840,952 2,397,453 2,855,292 - 7,049 433,701 289,983 592,366 527,061 1,026,067 824,093 (430,286) (281,058) 595,781 543,035 2,993,234 3,398,327 2,993,234 3,398,327 2,993,234 3,398,327
Note

Fixed assets
Tangible assets 11
Investments 12

Current assets
Stock 13
Debtors 14
Cash at bank and in hand 15

Creditors: Amounts falling due within oneyear 16
Net currentassets
Netassets
Funds of the charitable company:
Unrestricted income funds
Unrestricted funds
Total funds 19

For the financial year ending 30 September 2022 the charitable company was entitled to exemption from audit under section 477 of the Companies Act 2006 relating to small companies.

Directors' responsibilities:

The members have not required the charitable company to obtain an audit of its accounts for the year in question in accordance with section 476; and
The directors acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and the preparation of accounts.

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 62 to 77 were approved by the trustees, authorised for issue on 26/01/2023 and signed on their behalf by:

W Hellier Trustee

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Statement of Cash Flows

For the Year Ended 30 September 2022

	2022 2021
Note
	£ £

Cash flows from operating activities
Net movement in funds	(405,093) 632,484
Adjustments to cash flows from non- cash items


Depreciation 11	7,086 13,804
Investment income 4	(56,221) (50,939)
Loss on disposal of tangible fixed assets	- 2,591
Loss/(profit) on disposal of investments	10,014 (85,136)
Unrealised gains/losses on investment assets 12
	419,124 (343,910)

	(25,090) 168,894
Working capital adjustments
Decrease in stocks 13	7,049 1,790
(Increase)/decrease in debtors 14	(143,718) 36,555
Decrease in creditors 16	(57,836) (36,537)
Increase/(decrease)in deferred income	207,064 (74,224)
Net cash flows from operatingactivities	(12,531) 96,478
Cash flows from investing activities
Interest receivable and similar income 4	1,207 63
Purchase of tangible fixed assets 11	(44,991) (9,408)
Sale of tangible fixed assets	- 667
Purchase of investments 12	(220,884) (706,520)
Sale of investments	287,490 720,672
Income from dividends 4	55,014 50,876
Net cash flows from investingactivities	77,836 56,350
Net increase in cash and cash equivalents
	65,305 152,828

Cash and cash equivalents at 1 October	527,061 374,233
Cash and cash equivalents at 30 September
	592,366 527,061

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

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Notes to the Financial Statements

For the Year Ended 30 September 2022

1. Charitable company status

The charitable company is limited by guarantee, incorporated in England & Wales, and consequently does not have share capital. Each member is liable to contribute an amount not exceeding £1 towards the assets of the charitable company 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 charitable company's ability to continue as a going concern nor any significant areas of uncertainty that affect the carrying value of assets held by the charitable company.

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.

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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Deferred income

Deferred income relates to conference attendance fees and exhibitor fees received for conferences due to take place after the year end.

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 charitable company 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.

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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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.

Taxation

The charitable company 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 charitable company 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:

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.

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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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.

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 registration number 06452601 Charitable company registration number: 1125524

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3. Income from charitable activities

	Unrestricted Restricted Total	Unrestricted Restricted Total
	funds funds 2022
	£ £ £
Subscription income from
	447,718 - 447,718
members

Meeting and conference income	109,605 - 109,605
ENT UK product income	22,280 - 22,280
Consultancy income	12,000 - 12,000
Marketing services Income	15,000 - 15,000
Other income	66,602 - 66,602
	673,205 - 673,205

	Unrestricted Restricted Total
	funds funds 2021
	£ £ £
Subscription income from members 448,347 - 448,347
Meeting and conference income		424,590 - 424,590
ENT UK product income		27,008 - 27,008
Other income		50,337 - 50,337
		950,282 - 950,282

4. Investment income

	Unrestricted Restricted Total Total
	funds funds 2022 2021
	£ £ £ £
Income from listed	55,014 - 55,014 50,876
investments
Interest receivable on	1,207 - 1,207 63
bank deposits
	56,221 - 56,221 50,939

5. Expenditure on raising funds

Investment management costs

Investment management costs
	Unrestricted Restricted Total
Note	funds funds funds
	£ £ £
Other investment management costs;


Investment management costs	14,762 - 14,762
Total for 2022	14,762 - 14,762
Total for 2021	14,977 - 14,977

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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6. Expenditure on charitable activities

	Activity undertaken directly £ Activity support costs £ 2022 £ 17,183 518,783 535,966 56,655 24,065 80,720 9,648 - 9,648 51,366 - 12,900 7,015 - 7,015 5,904 - 5,904 - - 38,466 147,771 542,848 690,619 Activity undertaken directly £ Activity support costs £ 2021 £ 11,900 446,280 458,180 87,670 185,380 273,050 6,346 - 6,346 28,658 - 28,658 7,158 - 7,158 8,394 - 8,394 1,020 - 1,020 151,146 631,660 782,806

Clinoto Journal and other support
costs
Conference costs
ENT UK product costs
Grants, bursaries and prizes
awarded to individuals
Director of Education costs
Subscription to other relevant
bodies
Donations




Clinoto Journal and other support
costs
Conference costs
ENT UK product costs
Grants, bursaries and prizes
awarded to individuals
Director of Education costs
Subscription to other relevant
bodies
Donations

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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7. Analysis of support costs

Support costs allocated to charitable activities

	Governance Administration Total
	costs costs 2022
	£ £ £
Staff costs	- 330,518 330,518
Travel and meetings expenses	- 8,422 8,422
Website and other computer	- 46,607 46,607
costs
Advertising and marketing	- 6,018 6,018
Rent	- 21,834 21,834
Other office costs	- 32,749 32,749
Legal and professional fees	- 75,058 75,058
Independent examination fees	4,000 - 4,000
Accountancy fees	4,633 - 4,633
Depreciation	- 7,086 7,086
Bank and credit charges	- 6,474 6,474
Sundryexpenses	- (551) (551)
	8,633 534,215 542,848

Governance Administration Total	Governance Administration Total
costs costs 2021
£ £ £
Staff costs - 415,635 415,635
Travel and meetings expenses - 8,239 8,239
Website and other computer
	- 46,569 46,569
costs

Advertising and marketing	- 4,961 4,961
Rent	- 20,707 20,707
Other office costs	- 23,284 23,284
Legal and professional fees	- 76,522 76,522
Audit fees	7,800 - 7,800
Accountancy fees	4,629 - 4,629
Depreciation	- 13,804 13,804
Bank and credit charges	- 6,973 6,973
Sundryexpenses	- 2,537 2,537
	12,429 619,231 631,660

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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8. Net incoming/outgoing resources

Net incoming resources for the year include:

	2022 £ 2021 £ 30,511 22,042 - 2,591 10,014 (85,136) 7,086 13,804


Operating leases - other assets
Loss on disposal of tangible fixed assets
Loss/(profit) on disposal of investments
Depreciation of fixed assets

9. Trustees remuneration and expenses

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

During the year, 4 Trustees (2021: 5) were reimbursed for reasonable travel and meetings expenses amounting to £1,701 (2021: £1,315).

10. Staff costs

The aggregate payroll costs were as follows:

10. Staff costs The aggregate payroll costs were as follows:
	2022 £ 2021 £ 247,628 308,690 30,562 28,578 52,328 47,006 - 31,361 330,518 415,635


Staff costs during the year were:
Wages and salaries
Social security costs
Pension costs
Other staff costs

The monthly average number of persons (including senior management team) employed by the charitable company during the year expressed by head count was as follows:

head count was as follows:
	2022	2021
	No	No
Administration	8	7
8 (2021 - 7) of the above employees participated in the defined		benefit
pension scheme.

Contributions to the employee pension scheme for the year totalled £52,328 (2021 - £47,006).

No employee received emoluments of more than £60,000 during the year.

The number of employees whose emoluments fell within the following bands was:

bands was:
	2022	2021
	No	No
£70,001 - £80,000	-	1
The total employee benefits of the key management personnel		of the
charitable company were £94,737 (2021 - £102,787).

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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11. Tangible fixed assets

11. Tangible fixed assets
	Computers and office equipment £ Total £


Cost
At 1 October 2021	159,570 159,570
Additions	44,991 44,991
At 30 September 2022	204,561 204,561
Depreciation
At 1 October 2021	145,230 145,230
Charge for theyear	7,086 7,086
At 30 September 2022	152,316 152,316
Net book value
At 30 September 2022	52,245 52,245
At 30 September 2021	14,340 14,340

12. Fixed asset investments

Listed investments

12. Fixed asset investments Listed investments
	Listed investments

	£

Cost or Valuation
At 1 October 2021	2,840,952
Revaluation	(419,124)
Additions	220,884
Disposals	(297,504)
At 30 September 2022	2,345,208
Net book value
At 30 September 2022	2,345,208
At 30 September 2021	2,840,952

At the balance sheet date, the historical cost of the investments was £2,110,170 (2021: £2,081,145).

13. Stock

13. Stock
	2022 2021
	£ £
Patient leaflets	- 7,049
14. Debtors
	2022 2021

	£ £

Trade debtors	56,205 44,853
Prepayments	322,380 244,951
Other debtors	55,116 179
	433,701 289,983

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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15. Cash and cash equivalents

	2022 2021

	£ £

Cash at bank	592,366 527,061

16. Creditors: amounts falling due within one year

	2022 2021	2022 2021

	£ £

Trade creditors	22,472 33,789
Other taxation and social security	24,611 9,758
Other creditors	39,509 148,969
Pension scheme creditor	6,569 5,485
Accruals	107,757 60,753
Deferred income	229,368 22,304
	430,286 281,058


		2022

		£

Deferred income at 1 October 2021		22,304
Resources deferred in the period		228,432
Amounts released frompreviousperiods		(21,368)
Deferred income at 30 September 2022		229,368

17. Obligations under leases and hire purchase contracts

Operating lease commitments

Total future minimum lease payments under non-cancellable operating leases are as follows:

contracts Operating lease commitments Total future minimum lease payments leases are as follows:	under non-cancellable operating
	2022 2021

	£ £

Within one year	30,511 30,511
Between one and fiveyears	76,278 106,789
	106,789 137,300

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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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%)

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 and to 21% of salaries from 1 January 2023. 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 £52,328 (2021 - £47,006).

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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19. Funds

19. Funds	19. Funds
Balance at 1 October 2021 Incoming resources Resources expended Transfers Other recognised gains/(losses) Balance at 30 September 2022
£ £ £ £ £ £
Unrestricted funds
General fund 3,310,729 655,012 (638,683) (68,737) (429,138) (2,835,787)
Designated funds
ENT UK Foundation 35,314 61,625 (26,526) - - 70,415
BOARS Fund 11,016 9,189 (3024) - - 17,181
BSO Fund 31,846 - (5,000) 3,181 - 30,027
Global Health Committee 8,258 - (3,000) 5,289 - 10,547
Women in ENT Surgery 1,164 3,600 (500) - - 4,264
Head and Neck Society - - (2,388) 10267 7879
Society
ENT UK
drawing	- - (26,260) 50,000 - 23,740
account
	87,598 74,414 (66,698) 68,737 0 164,053
Total funds	3,398,327 729,426 (705,381) 0 (429,138) 2,999,840

The specific purposes for which the funds are to be applied are as follows:

The ENT UK Foundation fund comprises various funds donated to the charity and designated by the Trustees to be used for various fellowship awards.

The BOARS fund started when the Otorhinolaryngological Research Society transferred £15,000 to ENT UK on transferring its activities to the charity.

The ENT UK drawing account consists of transfers in for the proceeds of the sale of investments to be used for future fellowship awards.

Comparative information in respect of the preceding period is as follows:

	Balance at 1 October 2020 Incoming resources Resources expended Transfers Other recognised gains/(losses) Balance at 30 September 2021
	£ £ £ £ £ £
Unrestricted
funds
General fund	2,735,533 946,230 (770,080) (30,000) 429,046 3,310,729
Designated
funds
ENT UK	17,489 36,165 (18,340) - - 35,314
Foundation
BOARS Fund	11,836 - (820) - - 11,016
BSO Fund	- 7,696 (5,850) 30,000 - 31,846
Global Health	985 8,273 (1,000) - - 8,258
Committee
Women in	- 2,857 (1,693) - - 1,164
ENT Surgery
	30,310 54,991 (27,703) 30,000 - 87,598
Total funds	2,765,843 1,001,221 (797,783) - 429,046 3,398,327

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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20. Analysis of net assets between funds

	Unrestricted funds Restricted funds Total funds 2022
	£ £ £
Tangible fixed assets	52,245 - 52,245
Fixed asset investments	2,345,208 - 2,345,208
Current assets	1,026,067 - 1,026,067
Current liabilities	(430,286) - (430,286)
Total net assets	2,993,234 - 2,993,234
Prior year:
	Unrestricted Restricted Total funds
	funds funds 2021
	£ £ £
Tangible fixed assets	14,340 - 14,340
Fixed asset investments	2,840,952 - 2,840,952
Current assets	824,093 - 824,093
Current liabilities	(281,058) - (281,058)
Total net assets	3,398,327 - 3,398,327

21. Related party transactions

There were no related party transactions in the year.

22. Prior year Statement of Financial Activities

Note	Total
	Unrestricted Restricted 2021
	£ £ £
Income and Endowments from:
Charitable activities 3	950,282 - 950,282
Investment income 4	50,939 - 50,939
Total income	1,001,221 - 1,001,221
Expenditure on:
Raising funds 5	14,977 - 14,977
Charitable activities 6	782,806 - 782,806
Total expenditure	797,783 - 797,783
Gains/losses on investment assets	429,046 - 429,046
Net income	632,484 - 632,484
Net movement in funds	632,484 - 632,484
Reconciliation of funds
Total funds brought forward	2,765,843 - 2,765,843
Total funds carried forward 19	3,398,327 - 3,398,327

ENT UK TRADING AS BRITISH ACADEMIC CONFERENCE IN OTOLARYNGOLOGY (BACO) AND BRITISH ASSOCIATION OF OTORHINOLARYNGOLOGY - HEAD AND NECK SURGERY (BAO-HNS) Company registration number 06452601 Charitable company registration number: 1125524

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14. OUR ADMINISTRATION

Principal Office

----- Start of picture text -----
OUR
ADMINISTRATION
14
----- End of picture text -----

The Royal College of Surgeons 38-43 Lincoln's Inn Fields London WC2A 3PE The charity is incorporated in England and Wales.

Company Registration Number: 6452601

Charity Registration Number: 1125524

VAT No:

215668302

Solicitors

SA Law 60 London Road St Albans Hertfordshire AL1 1NG

Bankers

National Westminster Bank Plc Bloomsbury Parr's PO Box 158 214 High Holborn London WC1V 7BX

Auditor

Edmund Carr LLP Chartered Accountants & Statutory Auditor 146 New London Road Chelmsford Essex CM2 0AW

Investment fund managers

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

ANNUAL REPORT 2020 – 2021 | 78

TABLE OF CONTENTS

15. GLOSSARY

AAO-HNS	American Academyof Otolaryngology-Head and Neck Surgery
AOMRC	Academyof 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 of 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 Otorhinolaryngologyand Allied Sciences Research Society
BRS	British Societyof Rhinology
BSACI	British Societyfor Allergyand Clinical Immunology
BSHENT	British Societyfor the Historyof ENT
BSFPS	The British Societyof Facial Plastic Surgery
BSO	The British Societyof Otology
BTA	British Thyroid Association
BVA	British Voice Association
e-lefENT	e-learning platform
EAFPS	The European Academyof Facial Plastic Surgery
ENT	common abbreviation for ear,nose and throat
ERS	European Rhinological Society
ESPO	The European Societyof Paediatric Otorhinolaryngology
FPS UK	Former name of The British Societyof Facial Plastic Surgery (BSFPS)
FSSA	Federation of Surgical SpecialtyAssociations
GMC	General Medical Council
HNSoc	Head and Neck Society
IOS	Irish Otorhinolaryngology/Head & Neck SurgerySociety
IPC	Independent Practice Committee
MTI	Medical TrainingInitiative
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 Societyof Medicine
SAC	Special AdvisoryCommittee
SAS	Staff and Associate Specialists (i.e. the ENT Staff and Associate Specialist Doctors’ Groupof the Education and TrainingCommittee)
SFO UK	Student and Foundation Doctors in Otolaryngology
TWJ Foundation	Thomas Wickham Jones Foundation
WENTS UK	Women in ENT Surgery
YCOHNS	YoungConsultants 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

ANNUAL REPORT 2020 – 2021 | 79

TABLE OF CONTENTS

2022-09-30-accounts

ANNUAL REPORT 2021-2022

TABLE OF CONTENTS

1. PRESIDENT’S FOREWORD

2. CEO’S FOREWORD

3. VISION, MISSION AND OBJECTIVES

Charter

Mission

Strategic objectives

4. OUR GOVERNANCE

ENT UK office

The Board of Trustees

The Executive Committee

The Finance Committee

The Education & Training Committee (ETC)

The ENT UK Foundation Committee

The ENT UK Council

5. OUR MEMBERSHIP

Membership income by year

Membership Developments

6. OUR IMPACT

Clinical Guidelines

ENT UK Patient Information

National Clinical Impact Awards

Mentoring

ENT UK Mentoring Scheme

hosted and led by WENTS UK

ENT UK CESR Buddy Scheme

The ENT UK Foundation

Equity, Diversity and Inclusion

Teamwork

Ambition

Respect

Innovation

Quality

The Association Excellence Awards 2021

7. EDUCATION

1. Mission statement:

e-lefENT

Section editor recruitment

Increasing wider access agenda

Production

Medtronic support and standalone e-lefENT platform

2. Mission statement:

CPD

Lead Miss Marianne Elloy

Webinars

Lead Mrs Mira de Kruijf

Paediatric Emergency Surgical Skills Course (PESC)

Adult Emergency Surgical Skills Course (ESSC)

Course Lead Mr Raj Lakhani

Induction package for junior doctors

Collaboration

Podcast development

Lead Mr James Tysome

Education Library

Educational Fellowship Awards

3. Mission statement:

Association of Otolaryngologists in Training (AOT)

Medical Training Initiative (MTI)

4. Mission statement:

Recruitment

Specialty Advisory Committee (SAC)

5. Mission statement:

Fellowships

Final Note

8. SPECIALIST ADVISORY COMMITTEE (SAC) IN OTORHINOLARYNGOLOGY

Governance

COVID-19

Curriculum

National selection

Core Training

Workforce

Training Interface Groups

Joint Committee on Intercollegiate Examination (JCIE) - Otolaryngology

9. ENT UK MEETINGS

ENT UK Spring Annual Meeting 2022

Morning session

Afternoon session

ENT UK Annual General Meeting (AGM)