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2022-12-31-accounts

Company registration number: 7207053 Charitable company registration number: 1135699

Association of Breast Surgery

(A company limited by guarantee) Annual Report and Financial Statements

for the Year Ended 31 December 2022

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

Association of Breast Surgery

Contents

Reference and Administrative Details 1 to 2
Trustees' Annual Report 3 to 12
Independent Auditors' Report 13 to 17
Statement of Financial Activities 18
Balance Sheet 19
Statement of Cash Flows 20
Notes to the Financial Statements 21 to 35

Association of Breast Surgery

Reference and Administrative Details

Trustees Prof C Holcombe (Chair)
Miss L Chagla
Miss K Cox
Prof R Cutress
Miss J Doughty (to 16/5/2022)
Miss S Down (from 16/5/2022)
Ms S Downey
Mr D Ferguson
Mrs S Holcombe
Miss T Irvine (from 16/5/2022)
Mr Y Masannat (from 16/5/2022)
Miss M Mullan (to 16/5/2022)
Mr S Narayanan (to 16/5/2022)
Miss N Roche
Miss A Tansley (to 16/5/2022)
Prof L Wyld
Senior Management / Ms L Davies, Association Manager
Leadership Team
Registered Office The Royal College Of Surgeons
38-43 Lincoln's Inn Fields
London
WC2A 3PE
The charitable company is incorporated in England and Wales.

Page 1

Association of Breast Surgery

Reference and Administrative Details

Company Registration Number 7207053 Charitable company 1135699 Registration Number Bankers Lloyds Bank Plc 25 Gresham Street London EC2V 7HN Flagstone 1st Floor, Clareville House 26-27 Oxendon Street London SW1Y 4EL Auditor Edmund Carr LLP Chartered Accountants & Statutory Auditor 146 New London Road Chelmsford Essex CM2 0AW

Page 2

Association of Breast Surgery

Trustees' Annual Report

The trustees, who are directors for the purposes of company law, present the annual report together with the financial statements of the charitable company for the year ended 31 December 2022.

Objectives and activities

Objects and aims

The Charity’s objects are restricted specifically to the following:

  1. to advance the practice of breast surgery for the benefit of the public; and

  2. to advance education, research and training in relation to breast conditions and breast surgery for the benefit of the public

Public benefit

The trustees confirm that they have complied with the requirements of section 17 of the Charities Act 2011 to have due regard to the public benefit guidance published by the Charity Commission for England and Wales.

Achievements and performance

Membership

The ABS’ membership continues to grow, currently totalling 2036. There are 671 full members and 186 senior trainees are ABS members. The ABS continues to offer free membership to nurses working in the UK and Ireland. The nursing committee continues to be developed and in 2021 regional nursing representatives were recruited with the aim of improving communication with and input from the nurse members. Membership also continues to be free for trainees up to ST3 and is discounted for members from low and middle income countries.

The provision of membership benefits continues to be a focus for the Trustees. These include not only reductions in delegate fees for the ABS Conference and most ABS courses, but also the provision of webcasts of the presentations from the ABS Conference. This enables members to catch up on the talks free of charge after the event and talks are accessible to all regardless of whether they were a registered delegate at the conference.

Page 3

Association of Breast Surgery

Trustees' Annual Report

Events and Courses

The ABS Conference was held as a face to face meeting in May 2022. This was delivered for the first time by a Professional Conference Organiser (PCO), Profile Productions, who were initially appointed for the 2020 Conference. The ABS’ Association Manager continues to be responsible for the sales of the exhibition stands and sponsorship packages and she liaises with the PCO in all aspects of the delivery of the conference. This relationship was felt to have delivered a successful conference and has been extended for the 2023 Conference.

The ABS was able to deliver the full programme of its existing courses in 2022, except the Advanced Skills in Breast Disease Management Course, and also added new courses; the Medicolegal Course, the Advanced Breast Reconstruction Course and a Nursing Conference. These were all delivered in November 2022 and the feedback on all was very positive. It is intended to run all these courses and events again in 2023.

It was not possible to hold the Trainees Meeting at the Glasgow Royal Infirmary in 2022 as normal due to Covid-19 regulations in place in the hospital. It was felt that it was important to run this meeting and so it was moved to the University of Strathclyde’s Technology & Innovation Centre. This was a more expensive venue and income for the meeting could not be increased at such short notice, so it was accepted that the ABS may need to subsidise the meeting on this occasion. However this new venue worked very well and is likely to be the venue of choice for future meetings.

Following the postponement of the Advanced Skills in Breast Disease Management Course in March 2020 one of the speakers, Mr Ismail Jatoi, was holding a voucher for a flight paid for by the ABS. This was due to expire in 2022 and there was no suitable opportunity for him to travel for an ABS course or event. It was therefore decided that the ABS would sponsor his attendance to give an invited lecture at the Cambridge Imaging Conference and it was agreed that ABS members would be given online access to the event for free in exchange.

The ABS continued to deliver online content through a series of webinars. Consideration is being given as to the best way to continue to deliver online content throughout the year in future.

Page 4

Association of Breast Surgery

Trustees' Annual Report

Committees

The ABS now has six main committees:

Each committee now aims to meet four times a year, with at least two of these meetings being virtual. As there are now six committees the schedule for the committee meetings has been reviewed so that priority is not given to the scheduling of the three original committees.

The Trustees’ Strategy Day in June 2022 enabled the Executive Board to define its strategic priorities for 2022 - 2023 and these have been communicated to the membership in order to keep them informed as to what the ABS will be focusing on in the coming year.

The specialty status application requested by the GMC in 2019, was submitted in 2022. The ABS Trustees have sought to make representations to the relevant groups in relation to the application and await feedback from the JSCT on the application.

The Academic and Research Committee and Clinical Practice & Standards Committee have continued to look at the issues around the volume of breast pain referrals being seen by breast clinics in the UK. To this end ASPIRE (Breast Pain Pathway Rapid Evaluation) has been developed by the ABS. This multicentre platform study will evaluate novel breast pain pathways, which are already being used. The primary outcome of the study will be pathway safety measured by the number of breast cancers diagnosed in the 12 months following assessment. Patient satisfaction and costs of different approaches will also be assessed. The project has been allocated £110,000 over two years by the Trustees. The funds will contribute towards sessional time for the clinical leads and also the funding of a research assistant post for the duration of the study.

The Academic and Research Committee also continues to allocate its Research Development Grants annually and to support the development of new studies through the provision of sandpit sessions to give feedback on studies in development. The Clinical Practice & Standards Committee continues to review the issues being faced by members in the region through the reports of the Regional Representatives. The Trustees have also agreed funding for an ABS regional meeting in each of the 14 regions and nations of the UK every two years. The regional representatives have been charged with finding the best opportunity to run these meetings, which will be attended by ABS Trustees, in order to both inform the members of the projects the ABS is working on and hear from the members both what their issues are locally and what the ABS can do to support them. The first of these meetings was held in Northern Ireland in November 2022 and was much appreciated by our members in the region.

The James Lind Alliance Priority Setting Partnership reached its conclusion in 2022. The final workshop finalised a list of 10 breast cancer surgery research priorities, which are now being used to inform the work of the Academic and Research Committee, especially in relation to future research grant applications.

Page 5

Association of Breast Surgery

Trustees' Annual Report

The Clinical Practice & Standards Committee also continues to develop guidance, including Neoadjuvant Chemotherapy: Multidisciplinary Guidance in association with the Association of Breast Pathologists, the British Association of Breast Radiologists and the UK Breast Cancer Group. The committee has commissioned a critical analysis of two systematic reviews on breast cancer surgical margins, which will be carried out in early 2023 and is giving consideration to commissioning a human factors study to look at how best the members can be supported to work effectively in their units.

The Education and Training Committee is keen to develop interest for breast surgery in medical students and early years trainees. In 2022 it reinstituted bursaries for medical students to attend the ABS Conference. This was very successful and has been expanded in 2023 to provide bursaries for medical students, nurses and those from LMI countries to attend the ABS Conference. Funding has also been allocated for the committee to develop a network of Medical School Champions and to look at the provision of online learning for ABS members. These projects will be progressed in 2023.

The Aesthetic Breast Surgery Committee continues to provide guidance and in 2022 produced information for patients considering going abroad for cosmetic breast surgery. It has also been working on information for patients considering breast reduction surgery and this will be published early in 2023. It continues to represent the ABS on PRASEAG in relation to Breast Implant Associated Anaplastic Large Cell Lymphoma.

The International Forum continues to progress the project in Matabeleland South. It has received a further grant of £24,062 from the Steel Fund Charitable Trust and will continue to work with the local team to deliver the proposed pilot clinics. A Memorandum of Understanding with the Ministry of Health and Child Care is being reviewed prior to the Trustees giving it their consent.

As part of the Matabeleland South project the ABS has provided an ultrasound probe, which has been donated to the pilot clinics for their use. This was bought using the charitable funds raised by the International Forum. The ABS Trustees agreed to fund a second probe for use by its members when teaching on overseas courses, which will be retained by the ABS.

Members of the ABS’ International Forum have been contributing to the establishment of an online Introduction to Breast Care Nursing course with the University of East Anglia. This course can be accessed by participants both in the UK and abroad, and will be free to access for those from low and middle income countries. It was agreed that the ABS would contribute towards the set up costs of this course and also honoraria for the nurse consultants, who were involved in giving clinical input to the design the course. In exchange the ABS will receive a share of any profits from the University of East Anglia in due course.

The Nursing Committee expanded in 2022 and is meeting four times a year. It is looking at how best it can support the nurse members and what issues face the nursing community in breast care in the UK. It is hoping to progress guidance, educational support and address grading issues in the coming year.

Page 6

Association of Breast Surgery

Trustees' Annual Report

Other ABS projects and contributions

The ABS has developed the courses and events section of its website, so that all its courses and events can use its app in future. This both makes the programme and other event information more readily available to delegates and also avoids the need to print so many materials for courses and events, thus making the ABS’ courses and events more sustainable.

The ABS is intending to develop a resources app, which will make many of the resources on its website more easily accessible. Consideration is being given to how best to deliver this and develop the ABS’ website and this project will be progressed in the coming year.

The ABS completed the process of digitising its records and archives in 2022. All membership records are now held electronically, which reduces the amount of storage required and also facilitates hybrid working.

Association Staff and Office

The ABS desk space in the Barry Building of the Royal College of Surgeons is working well and the ABS’ staff are normally in the office on two days each week. Off-site storage is continuing to be used as storage space is limited. Less storage is now required due to the digitisation of the records. At a recent tenants’ meeting the College raised the issue of the amount of items Associations were storing around their desks. This was a concern before the recant for all the Associations, and is especially an issue when running events. The ABS will continue to work with the College to ensure that the office space available fits its needs.

The ABS continues to employ three members of staff and to use a Professional Conference Organiser (PCO) to deliver its annual Conference. This model is working well although workloads are increasing now that face to face meetings and events have returned. The ABS is using an agency on a trial basis to provide it with communications support and to develop a patient focused platform on Instagram. The Trustees will continue to review the need for additional or specialist support.

The ABS continues to have a service agreement with BASO~ACS and has adjacent desks to them in the College. The EJSO continues to be provided to ABS members under the auspices of BASO ~ ACS and discussions will recommence in due course as to how best this can be facilitated in future.

Page 7

Association of Breast Surgery

Trustees' Annual Report

Financial review

The ABS continues to hold its funds in Lloyds Bank and the Flagstone IM investment platform. The latter is enabling the Association to hold its reserves both securely and to obtain a better return on its savings. While interest rates continue to change regularly the platform is enabling the ABS to move its funds easily in order to take advantage of better interest rates on the wide portfolio of accounts available.

The ABS’ risk register is now reviewed annually and is considered to meet its purposes. The delivery of the majority of its regular courses and events in 2022 meant that the ABS was able to consider allocating some of its reserves to future projects, rather than to take a more cautious approach in the face of potential cancellations of its Conference, course and events. The ABS is currently contracted for its Conference in 2023, 2024 and 2025, with the last two being amended contracts from the venues, which were due to be used in 2020 and 2021. The ABS Conference runs in May each year, which is a popular month for such events and so venue contracts have to be entered into several years in advance to ensure appropriate venues are available. The ABS is looking to contract for 2026 and 2027 in the coming year to ensure it has venues secured in good time for future events.

The ABS continues to make savings by running more of its meetings online. The Executive Board and Committees continue to hold about half their meetings online, with the other half being face to face meetings. The ABS has access to free meeting rooms at the Royal College of Surgeons and is normally able to take advantage of these for its meetings. There continue to be issues with the IT provision in some of the College’s meeting rooms, which the Associations are asking the College to address.

The ABS was again able to award its research grants in 2022, one jointly with Prevent Breast Cancer, and also its travelling fellowships. It has also provided joint funding with Breast Cancer Now for a second Royal College of Surgeons Surgical Specialty Lead post, which will run for three years.

Following a question from a member at the Annual General Meeting the ABS has reviewed the provision of its accountancy services by Edmund Carr LLP. Having obtained quotes from other providers, investigated what other Associations of a similar size are paying and also reviewed a benchmarking document by Charity Financials, it has assessed that the costs of its accountancy services are in line with what can be expected and to continue with the long standing relationship it has in place.

Page 8

Association of Breast Surgery

Trustees' Annual Report

Policy on reserves

It was agreed at the Strategy Day in June 2022 that the Reserves Policy should be reviewed annually to reflect inflationary increases to the ABS’ overheads. This has now been implemented and the limit will be increased annually by the mean average of CPI for the previous year. The reserves policy for the year ended 31 December 2022 was to hold free reserves (being unrestricted funds not designated for a specific purpose or represented by fixed assets) of at least £300,000. This figure increased to £331,500 with effect from 1 January 2023. Free reserves at that date totalled £557,270. The Trustees have been cautious about the spending of its reserves during the pandemic but following the successful delivery of the ABS Conference in 2022 they are seeking to allocate funds to future projects as outlined earlier in this report. It is envisaged that these commitments will bring the ABS’ holdings more in line with the Reserves Policy in the coming year.

The Trustees are also aware of the increased costs it is facing as a result of the sharp increase in CPI over the past year. It has held its conference delegate fees at 2021 rates, but faces increased costs for catering and the provision of other services at the venue. It is also awaiting the notification of the increase in its desk licence fee from the Royal College of Surgeons. This was not notified or applied in a timely fashion in 2022 and at the time of writing information about the increase to be applied retrospectively from the RCS is still awaited. Attempts will be made to ensure that the 2023 increase is notified at the commencement of the third year of the licence agreement in May.

Plans for future periods

Aims and key objectives for future periods

The ABS will continue to run its courses and events in 2023. The ABS Conference will be held in Belfast in May and it is hoped it will be well attended again.

The Association will also continue to implement its rolling programme of regional meetings across the UK and is looking at ways of holding an educational networking day for all ABS committee members to attend. A committee liaison working group has been set up to improve communications between the committees and to look at projects on which committees could collaborate. The ABS is also looking to set up a Conference Working Group to assist the smooth running of its Conference now that a PCO is involved in the running of the event.

Structure, governance and management

Nature of governing document

The Association of Breast Surgery was established as a company limited by guarantee (Company number 7207053 and Registered as Charity 1135699) on the 1st July 2010 and constituted under a Memorandum and Articles of Association.

Page 9

Association of Breast Surgery

Trustees' Annual Report

Organisational structure

The day to day administration of the Association continues to be overseen by the Association Manager in liaison with the Honorary Officers. Areas of work, including the courses portfolio, are managed by the Senior Administrator and the administration of the membership is largely undertaken by the Membership and Registrations Administrator. A hybrid model of working is currently being used, with staff working from the office two days per week and from home the rest of the time. The ABS Conference is overseen by the Association Manager, but the organisation of the conference is undertaken by Profile Productions. The Association Manager is responsible for selling the exhibition space for the event.

94 ABS members sit on its Executive Board and committees. Engagement remains high with committee and trustee vacancies attracting good numbers of applications. The ABS is also looking to create two new Trustee posts at the AGM in May. It will be proposed to the membership that the Chairs of the Aesthetic Breast Surgery Committee and the International Forum (to be known as the International Committee) be made Trustee posts. This is to improve the oversight of these committees and to reinforce the important work they are doing on the Association’s behalf.

The main business of the Association is discussed by the committees and at the Executive Board. Decisions in between times are made by telephone and e-mail communication between the Honorary Officers, Trustees and committee members. Video conferencing is now being widely used for committee and other meetings.

The risk register and reserves policy are reviewed annually, unless a more urgent review is required. An annual review of the controls over key financial systems is carried out through an internal audit programme. The trustees pay due regard to the Charity Commission’s guidance on public benefit when deciding what activities the Charity should undertake. Remuneration for all staff is set by the Board of Trustees in line with its pay scales and standardised system for annual pay awards.

Page 10

Association of Breast Surgery

Trustees' Annual Report

Statement of Responsibilities

The trustees (who are also the directors of Association of Breast Surgery for the purposes of company law) are responsible for preparing the Trustees' Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the trustees to prepare financial statements for each financial year. Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including its income and expenditure, of the charitable company for that period. In preparing these financial statements, the trustees are required to:

The trustees are responsible for keeping proper accounting records that can disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In so far as the trustees are aware:

• the trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditor is aware of that information.

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

Small companies provision statement

This report has been prepared in accordance with the small companies regime under the Companies Act 2006.

Compliance with prevailing laws and regulations

The financial statements have been prepared in accordance with the accounting policies set out in notes to the accounts and comply with the charity’s governing document, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland published on 16 July 2014.

This report has been prepared having taken advantage of the small companies exemption in the Companies Act 2006.

Page 11

Association of Breast Surgery

Trustees' Annual Report

The annual report was approved by the trustees of the charitable company on 15 May 2023.................... and signed on their behalf by:

......................................... Mr D Ferguson Trustee

Page 12

Association of Breast Surgery

Independent Auditor's Report to the Trustees of Association of Breast Surgery

Opinion

We have audited the financial statements of Association of Breast Surgery (the 'charitable company') for the year ended 31 December 2022, which comprise the Statement of Financial Activities, Balance Sheet, Statement of Cash Flows, and Notes to the Financial Statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law United Kingdom Accounting Standards, including Financial Reporting Standard 102, The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the auditor responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company's ability to continue as a going concern for a period of at least twelve months from when the original financial statements were authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Page 13

Association of Breast Surgery

Independent Auditor's Report to the Trustees of Association of Breast Surgery

Other Information

The other information comprises the information included in the trustees annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

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

We have nothing to report in this regard.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters in relation to which the Charities (Accounts and Reports) Regulations 2008 require us to report to you if, in our opinion:

Responsibilities of trustees

As explained more fully in the Statement of Trustees' Responsibilities (set out on page 11), the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

In preparing the financial statements, the trustees are responsible for assessing the charitable company's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

Page 14

Association of Breast Surgery

Independent Auditor's Report to the Trustees of Association of Breast Surgery

Auditor responsibilities for the audit of the financial statements

We have been appointed as auditor under section 145 of the Charities Act 2011 and report in accordance with regulations made under 154 of that Act.

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud is detailed below:

Our approach to identifying and assessing the risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, was as follows; • The engagement partner ensured that the engagement team collectively had the appropriate competence, capabilities and skills to identify or recognise non-compliance with applicable laws and regulations.

We assessed the susceptibility of the company’s financial statements to material misstatement, including obtaining an understanding of how fraud might occur by; • Making enquiries of management as to where they considered there was susceptibility to fraud, their knowledge of actual, suspected and alleged fraud.

To address the risk of fraud through management bias and override of controls, we;

•Performed analytical procedures to identify any unusual or unexpected relationships

•Tested journal entries to identify unusual transactions.

In response to the risk of irregularities and non-compliance with laws and regulations, we designed procedures which included, but were not limited to:

•Agreeing financial statement disclosures to underlying supporting documentation

•Reading the minutes of meetings of those charged with governance

•Enquiring of management as to actual and potential litigation and claims.

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

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Association of Breast Surgery

Independent Auditor's Report to the Trustees of Association of Breast Surgery

As part of an audit in accordance with ISAs (UK), we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

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Association of Breast Surgery

Independent Auditor's Report to the Trustees of Association of Breast Surgery

Use of our report

This report is made solely to the charitable company's trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008. Our audit work has been undertaken so that we might state to the charitable company's trustees those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and its trustees as a body, for our audit work, for this report, or for the opinions we have formed.

...................................... Edmund Carr LLP Statutory Auditor

146 New London Road Chelmsford Essex CM2 0AW

Date: 22 May 2023

Edmund Carr LLP is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006.

Page 17

Association of Breast Surgery

Statement of Financial Activities for the Year Ended 31 December 2022 (Including Income and Expenditure Account)

Note
Income and Endowments from:
Donations and legacies
2
Charitable activities
3
Investment income
4
Total income
Expenditure on:
Charitable activities
5
Total expenditure
Net income
Net movement in funds
Reconciliation of funds
Total funds brought forward
Total funds carried forward
15		 Unrestricted
£
10,038
908,488
2,469
920,995
774,999
774,999
145,996
145,996
575,700
721,696		 Restricted
£
25,038
-
-
25,038
13,968
13,968
11,070
11,070
22,240
33,310		 Total
2022
£
35,076
908,488
2,469
946,033
788,967
788,967
157,066
157,066
597,940
755,006		 Total
2021
£
18,188
477,882
709
496,779
396,969
396,969
99,810
99,810
498,130
597,940

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

Page 18

Association of Breast Surgery

(Registration number: 7207053) Balance Sheet as at 31 December 2022

Note
Fixed assets
Tangible assets
9
Current assets
Debtors
10
Cash at bank and in hand
11
Creditors: Amounts falling due within one year
12
Net current assets
Net assets
Funds of the charitable company:
Restricted income funds
Restricted funds
15
Unrestricted income funds
Unrestricted funds
Designated funds
Total unrestricted funds
Total funds
15		 2022
£
13,402
125,516
805,981
931,497
(189,893)
741,604
755,006
33,310
570,672
151,024
721,696
755,006		 2021
£
5,698
83,723
623,188
706,911
(114,669)
592,242
597,940
22,240
479,334
96,366
575,700
597,940

For the financial year ending 31 December 2022 the company was entitled to exemption from audit under section 477 of the Companies Act 2006 relating to small companies but as this company is a charity, it has opted for an audit under the Charities Act 2011.

Directors' responsibilities:

The accounts have been prepared in accordance with the provisions applicable to companies subject to the small companies regime and in accordance with FRS102.

The financial statements on pages 18 to 35 were approved by the trustees, and authorised for issue on ....................15 May 2023 and signed on their behalf by:

.........................................

Mr D Ferguson Trustee

Page 19

Association of Breast Surgery

Statement of Cash Flows for the Year Ended 31 December 2022

Note
Cash flows from operating activities
Net income
Adjustments:
Depreciation
Investment income
4
Working capital adjustments
(Increase)/decrease in debtors
10
Increase in creditors
12
Increase/(decrease) in deferred income
Net cash flows from operating activities
Cash flows from investing activities
Interest receivable and similar income
4
Purchase of tangible fixed assets
9
Net cash flows from investing activities
Net increase in cash and cash equivalents
Cash and cash equivalents at 1 January
Cash and cash equivalents at 31 December		 2022
£
157,066
2,058
(2,469)
156,655
(41,793)
8,788
66,436
190,086
2,469
(9,762)
(7,293)
182,793
623,188
805,981		 2021
£
99,810
1,624
(709)
100,725
33,395
52,829
(26,827)
160,122
709
-
709
160,831
462,357
623,188

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

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Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

1 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

Association of Breast Surgery 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 are of the opinion that the charity has sufficient resources to continue trading for the next 12 months from the date of signing these accounts.

Income and endowments

Income from conferences held during the year is accounted for on an accruals basis. Income from annual membership subscriptions is accounted for as received.

Donations and legacies

Donations are recognised when the charitable company has been notified in writing of both the amount and settlement date. In the event that a donation is subject to conditions that require a level of performance by the charitable company before the charitable company is entitled to the funds, the income is deferred and not recognised until either those conditions are fully met, or the fulfilment of those conditions is wholly within the control of the charitable company and it is probable that these conditions will be fulfilled in the reporting period.

Grants receivable

Grants are recognised when the Charity has an entitlement to the funds and any conditions linked to the grants have been met. Where performance conditions are attached to the grant and are yet to be met, the income is recognised as a liability and included on the balance sheet as deferred income to be released.

Page 21

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

Deferred income

Deferred income represents delegate and trade fees received for future events (conferences and courses) and is released to incoming resources in the period in which the events takes place.

Investment income

Bank interest in recognised when received.

Expenditure

All expenditure is accounted for on an accruals basis. Fellowships and awards are accounted for in the period in which they are notified to the recipient. Governance costs are associated with the governance arrangements of the Charity.

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.

Support costs

Support costs include central functions and have been allocated to activity cost categories on a basis consistent with the use of resources.

Governance costs

These include the costs attributable to the Charity’s compliance with constitutional and statutory requirements, including audit, strategic management and Trustees' meetings.

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

Major expenditure on tangible fixed assets is capitalised. The cost of other items is written off as incurred.

Page 22

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

Depreciation and amortisation

Depreciation is calculated so as to write off the cost of an asset, less its estimated residual value, over the useful economic life of that asset as follows:

Asset class Computer equipment Fixtures & fittings

Depreciation method and rate

25% reducing balance 25% reducing balance

Trade debtors

Trade and other debtors are recognised at the settlement amount due.

Cash and cash equivalents

Cash and cash equivalents comprise cash on hand, bank accounts and bank deposits.

Trade creditors

Creditors are recognised at their settlement amount.

Fund structure

Unrestricted general funds – these are funds which can be used in accordance with the charitable objects at the discretion of the trustees.

Designated funds – these are funds set aside by the trustees out of unrestricted funds for specific future purposes or projects.

Restricted funds – these are funds that are given to the Charity for use in a particular area or for a specific purpose, the use of which is restricted to that area or purpose.

Pensions and other post retirement obligations

The charitable company operates a defined contribution pension scheme which is a pension plan under which fixed contributions are paid into a pension fund and the charitable company has no legal or constructive obligation to pay further contributions even if the fund does not hold sufficient assets to pay all employees the benefits relating to employee service in the current and prior periods.

Contributions to defined contribution plans are recognised in the Statement of Financial Activities when they are due. If contribution payments exceed the contribution due for service, the excess is recognised as a prepayment.

Page 23

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

2 Income from donations and legacies

Donations receivable
Grants receivable		 Unrestricted
funds
£
38
10,000
10,038		 Restricted
funds
£
976
24,062
25,038		 Total
2022
£
1,014
34,062
35,076		 Total
2021
£
3,188
15,000
18,188

In 2021 donations receivable were split between £150 being restricted and £3,038 being unrestricted. In 2021 all grants receivable were restricted.

3 Income from charitable activities

Events and courses delegate
fees
Events and courses trade fees
Yearbook income
Members' subscriptions		 Unrestricted
funds
£
416,766
273,492
1,000
217,230
908,488		 Restricted
£
-
-
-
-
-		 Total
2022
£
416,766
273,492
1,000
217,230
908,488		 Total
2021
£
109,179
164,750
-
203,953
477,882

All income from charitable activities in 2021 was unrestricted.

Page 24

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

4
Investment income
Interest receivable on bank
deposits		 Unrestricted
funds
£
2,469		 Restricted
funds
£
-		 Total
2022
£
2,469		 Total
2021
£
709

Interest receivable in 2021 was unrestricted.

Page 25

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

5 Expenditure on charitable activities

Events costs:
Venue, catering &
accommodation
costs
Speaker expenses
Audio visual costs
Printing, postage &
stationery
Other direct
conference costs
ABS Conf - Event
Organiser
Membership
costs:
EJSO Journal costs
ESSO membership
subs
Grants and
awards:
Fellowships and
awards
Research grants		 Unrestricted
funds
£
255,644
27,989
30,376
9,294
57,690
28,350
409,343
27,028
2,471
29,499
4,529
17,936
22,465		 Restricted
funds
£
-
-
-
-
-
-
-
-
-
-
-
-
-		 Total
2022
£
255,644
27,989
30,376
9,294
57,690
28,350
409,343
27,028
2,471
29,499
4,529
17,936
22,465		 Total
2021
£
49,499
5,344
12,488
893
19,620
28,150
115,994
11,826
2,406
14,232
4,100
19,607
23,707

Page 26

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

Other charitable
expenditure:
Surgical Specialty
Lead
Yearbook
expenditure
Other charitable
projects
ASPIRE evaluation
study
THET Grant
Expenditure
Support costs
6
Governance costs6		 Unrestricted
funds
£
-
5,133
14,627
7,400
-
27,160
271,882
14,650
774,999		 Restricted
funds
£
-
-
13,968
-
-
13,968
-
-
13,968		 Total
2022
£
-
5,133
28,595
7,400
-
41,128
271,882
14,650
788,967		 Total
2021
£
30,000
4,727
4,804
-
431
39,962
189,928
13,146
396,969

All research grants were paid to institutions to support research projects.

All expenditure for 2021 was unrestricted.

Page 27

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

6 Analysis of governance and support costs

Charitable activities expenditure
Trustee, Council & Committee
costs
Staff costs
Other staff costs & training
Office, Trustee & event
insurance
Printing, postage & stationery
IT, telephone & website costs
HR
Sundry & office running
expenses
Rent
Legal & professional fees
Events general expenditure
Depreciation, amortisation and
other similar costs
Irrecoverable VAT
Governance costs
Audit fees
Audit of the financial
statements
Other fees paid to auditors
Bank charges
Other governance costs		 Unrestricted
funds
£
12,774
153,504
624
6,373
2,286
16,392
1,250
506
10,719
663
-
2,058
64,733
271,882
Unrestricted
funds
£
3,475
6,919
2,471
1,785
14,650		 Restricted
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Restricted
funds
£
-
-
-
-
-		 Total
2022
£
12,774
153,504
624
6,373
2,286
16,392
1,250
506
10,719
663
-
2,058
64,733
271,882
Total
2022
£
3,475
6,919
2,471
1,785
14,650		 Total
2021
£
9,687
145,412
541
2,901
2,824
14,705
1,250
114
7,830
-
446
1,624
2,594
189,928
Total
2021
£
2,835
6,379
2,117
1,815
13,146

Page 28

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

7 Trustees remuneration and expenses

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

Trustees are reimbursed reasonable travel and subsistence expenses incurred when acting on behalf of the charity.

Expenses totalling £3,813 (2021: £2,234) were reimbursed to 13 Trustees (2021: 11) during the period.

8 Staff costs

The aggregate payroll costs were as follows:

Staff costs during the year were:
Wages and salaries
Social security costs
Pension costs		 2022
£
130,470
10,018
13,016
153,504		 2021
£
123,520
9,390
12,502
145,412

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:

Administrative
The number of employees whose emoluments fell within the following
£70,001 - £80,000		 2022
No
3
bands was:
2022
No
1		 2021
No
3
2021
No
1

The total employee benefits of the key management personnel of the charitable company were £83,604 (2021 - £79,976).

Page 29

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

9 Tangible fixed assets

Cost
At 1 January 2022
Additions
At 31 December 2022
Depreciation
At 1 January 2022
Charge for the year
At 31 December 2022
Net book value
At 31 December 2022
At 31 December 2021
10 Debtors
Prepayments
Accrued income
Other debtors
11 Cash and cash equivalents
Cash at bank		 Furniture and
equipment
£
5,264
-
5,264
5,264
-
5,264
-
-		 Furniture and
equipment
£
5,264
-
5,264
5,264
-
5,264
-
-		 Computer
equipment
£
15,284
9,762		 Total
£
20,548
9,762
30,310
14,850
2,058
16,908
13,402
5,698
2021
£
71,307
3,447
8,969
5,264 25,046
5,264
-		 9,586
2,058
5,264 11,644
- 13,402
- 5,698
2022
£
112,316
-
13,200
125,516
2022
£
805,981
83,723
2021
£
623,188

Page 30

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

12 Creditors: amounts falling due within one year

12 Creditors: amounts falling due within one year
Trade creditors
Other taxation and social security
Other creditors
Accruals
Deferred income
Accruals for grants payable
Deferred income at 1 January 2022
Resources deferred in the period
Amounts released from previous periods
Deferred income at year end		 2022
£
-
9,137
1,539
39,271
87,185
52,761
189,893
2022
£
20,749
87,185
(20,749)
87,185		 2021
£
77
5,886
5,388
26,211
20,749
56,358
114,669
2021
£
47,576
20,749
(47,576)
20,749

Deferred income relates to trade and delegate fees received in advance for events held after the year end.

13 Obligations under leases

Operating lease commitments

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

Other
Within one year		 2022
£
5,438		 2021
£
-

14 Charitable company status

The charitable company is limited by guarantee, incorporated in England and Wales, and consequently does not have share capital. Each of the trustees is liable to contribute an amount not exceeding £1 towards the assets of the charitable company in the event of liquidation.

Page 31

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

15 Funds

Balance at
1 January
2022
£
Unrestricted funds
General unrestricted funds
479,334
Designated funds
a) Mammary Fold Trainees
Group
684
b) Support for RCS Surgical
Specialty Lead
31,250
c) DCIS margin review
14,574
d) Professional Advice
18,950
e) Educational Fellowships
9,100
f) James Lind Alliance
application
9,025
g) Support and development
funds
12,783
h) ASPIRE Project
-
i) SCHARR margins review
-
96,366
Total Unrestricted
575,700
Restricted
j) THET fund
537
k) International Forum
6,653
l) Research development
grant fund
50
m) Matabeleland South
Project
15,000
Total restricted
22,240
Total funds
597,940		 Incoming
resources
£
920,995
-
-
-
-
-
-
-
-
-
-
920,995
-
150
-
24,888
25,038
946,033		 Resources
expended
£
(742,642)
-
(15,000)
(4,574)
-
-
-
(12,783)
-
-
(32,357)
(774,999)
-
(2,980)
-
(10,988)
(13,968)
(788,967)		 Transfers
£
(87,015)
-
(1,250)
(10,000)
(18,950)
4,000
(9,025)
-
110,000
12,240
87,015
-
-
-
-
-
-
-		 Balance at
31
December
2022
£
570,672
684
15,000
-
-
13,100
-
-
110,000
12,240
151,024
721,696
537
3,823
50
28,900
33,310
755,006

Page 32

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

Unrestricted funds
General unrestricted funds
Designated funds
a) Mammary Fold
Trainees Group
b) Support for RCS
Surgical Specialty Lead
c) DCIS margin review
d) Professional Advice
e) Educational Fellowships
f) James Lind Alliance
application
g) Support and
development funds
Total unrestricted funds
Restricted
j) THET fund
k) International Forum
l) Research development
grant fund
Total restricted funds
Total funds		 Balance at
1 January
2021
£
417,750
684
2,500
10,000
18,950
4,100
9,025
27,600
72,859
490,609
968
6,553
-
7,521
498,130		 Incoming
resources
£
478,629
-
-
-
-
-
-
3,000
3,000
481,629
-
15,100
50
15,150
496,779		 Resources
expended
£
(395,288)
-
(1,250)
-
-
-
-
-
(1,250)
(396,538)
(431)
-
-
(431)
(396,969)		 Transfers
£
(21,757)
-
30,000
4,574
-
5,000
-
(17,817)
21,757
-
-
-
-
-
-		 Balance at
31
December
2021
£
479,334
684
31,250
14,574
18,950
9,100
9,025
12,783
96,366
575,700
537
21,653
50
22,240
597,940

Page 33

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

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

a) Money held on behalf of the Mammary Fold Trainees Group.

b) Support for the Royal College of Surgeons Surgical Specialty Lead.

c) Grant to support DCIS margin review.

d) Funds set aside for professional advice with BAAPS and BAPRAS.

e) Funds allocated for educational fellowships.

f) Funds to support the James Lind Alliance application.

g) Support and development funds have been allocated to support iBRa Net, Clinical Practice and Standards Committee, International Forum, Course Portfolio development, Medical School Champions and Breast Nurse Advisory Board.

h) A national platform evaluation study of breast pain pathways. Money is funding two clinical leads and a research assistant.

i) A review of two existing papers on margins to look at the evidence base and conclusions of both. j)THET provided a grant for a needs assessment project in Bulawayo.

k)The International Forum raised funds and were the recipients of fundraising that are restricted for their charitable and educational projects.

l) Prevent Breast Cancer and other donations received towards ABS's research grant programme. m) Project to establish three pilot breast clinics in Matabaleland South in Zimbabwe.

16 Analysis of net assets between funds

Current year:

Unrestricted

Tangible fixed assets
Current assets
Current liabilities
Total net assets
Prior year:
Tangible fixed assets
Current assets
Current liabilities
Total net assets		 General
£
Designated
£
13,402
-
747,163
151,024
(189,893)
-
570,672
151,024
Unrestricted
General
£
Designated
£
5,698
-
588,305
96,366
(114,669)
-
479,334
96,366		 Restricted
£
-
33,310
-
33,310
Restricted
£
-
22,240
-
22,240		 Total funds
2022
£
13,402
931,497
(189,893)
755,006
Total funds
2021
£
5,698
706,911
(114,669)
597,940

Page 34

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2022

17 Related party transactions

There were no related party transactions in the year.

18 Taxation

The charitable company is a registered charity and is therefore exempt from taxation.

Page 35