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← Association Of Breast Surgery

2023-12-31-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 2023

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 11
Independent Auditors' Report 12 to 16
Statement of Financial Activities 17
Balance Sheet 18
Statement of Cash Flows 19
Notes to the Financial Statements 20 to 32

Association of Breast Surgery

Reference and Administrative Details

Trustees Miss L Chagla (Chair from 15/05/2023)
Prof J Benson (from 15/05/2023)
Miss K Cox
Prof R Cutress
Miss S Down
Ms S Downey
Mr D Ferguson
Prof C Holcombe (Chair to 15/05/2023)
Mrs S Holcombe
Miss T Irvine
Mr Y Masannat
Mr M McKirdy (from 15/05/2023)
Miss N Roche (to 15/05/2023)
Mr S Thrush (from 15/05/2023)
Miss R Vidya (from 15/05/2023)
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 and auditors' report of the charitable company for the year ended 31 December 2023.

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 regards to the public benefit guidance published by the Charity Commission for England and Wales.

Achievements and performance

Membership

The membership of the Association continues to grow and is now 2135. There are 683 full members, 179 Mammary Fold Associate Senior members, 75 Mammary Fold Associate Junior members, 1058 Nurse members, 4 Non Surgical Interspecialty members, 84 Overseas members, 40 Senior Retired members, 10 Honorary members and 2 Affiliate members. The ABS continues to offer free membership to nurses and trainees of ST3 and below. It also offers reduced membership fees to senior trainees and surgeons from low and middle income countries. In 2023 the subscriptions were held at the same level as 2022. This decision was taken in light of the cost of living crisis being experienced by the ABS’ UK based members and was facilitated by healthy reserves, which have been sustained in recent years by excellent support for the ABS Conference by its sponsors.

The ABS Service Agreement with BASO ~ ACS was amended in 2023 to reflect the increasingly separate nature of the two Associations’ administration. It was agreed that the ABS would continue to subscribe its members to the European Journal of Surgical Oncology through BASO ~ ACS. This arrangement allows the ABS to pay a reduced fee for its members’ subscriptions. The ABS also continues to offer ESSO affiliate membership to its members for an additional fee.

ABS members, who pay a subscription, continue to benefit from reduced delegate fees for the ABS Conference and most ABS courses and events. The ABS also offer free access to its webinars for members as well as the ability to watch the webinars and talks from the ABS Conference back via its website.

Page 3

Association of Breast Surgery

Trustees' Annual Report

Events and Courses

The ABS continues to run a busy programme of events and courses. In 2023 the ABS Conference was held in Belfast, with 800 delegates in attendance. The ABS Conference continues to attract good sponsorship from companies and this underpins the financial success of the meeting. Like the subscriptions, the delegate fees for the ABS Conference were held at the 2022 rates in order to support healthcare professionals attendance, despite financial pressures they might be experiencing. The ABS Conference is delivered by a Professional Conference Organiser (PCO), Profile Productions. The ABS’ Association Manager is responsible for the sale of the exhibition stands and sponsorship packages and she liaises with the PCO in order to ensure the delivery of all aspects of the Conference.

In 2022 the ABS set up a Conference Organising Group, with representatives from each of its committees, to support the Meeting Secretary in the planning of the programme for the ABS Conference and to look at other ways the Conference can be developed to ensure it continues to meet the members’ needs.

The ABS was also able to provide a number of bursaries for delegates attending the ABS Conference; including for medical students, nurses and those living and working in low and middle income countries. These provided free registration and a grant towards travel and accommodation.

The ABS MDT Meeting was run as a virtual meeting in 2023 due to concerns about holding a face to face meeting in January. Access to the meeting was provided for free to ABS members.

The ABS’ course portfolio continues to run successfully. In 2023 it ran the OOPS Course, Advanced Skills in Breast Disease Management, Specialty Skills in Breast Surgery Level 1 and 2, Medicolegal Course and the Advanced Implant Based Breast Reconstruction Course. It also ran its Trainees Meeting and Nursing Conference. Additionally the ABS runs webinars throughout the year. The Education & Training Committee are now coordinating these. The ABS Trustees, Education & Training Committee and Course Directors continue to evaluate its programme of meetings to ensure that it meets the needs of breast surgeons, breast nurses and members of the breast MDT.

The trainees group, the Mammary Fold, continue to run a successful Pre-ABS Meeting and a Communications Skills Course as well as regular webinars. They work with the Association of Surgeons in Training to provide courses suitable for early year trainees, to encourage them to consider breast surgery as a career.

The OOPS course has relied upon being able to borrow some equipment in order to run its practical sessions. Dopplers were purchased from Huntleigh in December 2023 in order to support the delivery of future ABS courses.

Page 4

Association of Breast Surgery

Trustees' Annual Report

Committees

Following changes to its Articles at the AGM the ABS now has six permanent committees; Academic & Research, Aesthetic, Clinical Practice & Standards, Education & Training, International and Nursing. The Chair of each of these committees is now a Trustee in order to ensure good governance and reporting of their work at Executive Board meeting. Each committee meets up to four times a year, with meetings being held both online and in person. The ABS has also introduced a Committee Liaison Group, with representatives from each of the ABS’ committees, to facilitate discussion between the committees about areas of common interest, where they could work together. Over 80 ABS members have contributed to ABS committees in the last year and this input helps to ensure the success of many of the ABS’ work programmes.

The Aesthetic Committee continues to produce good quality patient information about both cosmetic and breast reconstruction surgery. It inputs to PRASEAG in relation to Breast Implant Associated Anaplastic Large Cell Lymphoma. In 2023 it also began to look at the provision of cosmetic surgery abroad and how this affects UK Breast Units when patient are seen with complications from their surgery. It has produced patient information about what patients should consider when going abroad for cosmetic surgery and is looking at the best ways of reaching prospective patients with this guidance.

The Academic & Research Committee continues to badge and endorse studies on behalf of the ABS and administer its annual research grants. It holds sandpit sessions in order to facilitate members with a trial idea to discuss it with a group of experienced surgeons. The Committee is working with iBRA NET to look at ways to involve more members in trials and research.

The Clinical Practice & Standards Committee receives the feedback of the members through the Regional Representatives, who report into the meetings. It continues to develop new guidance, and in 2023 commissioned a critical analysis of two systematic reviews on breast cancer surgical margins by the SCHARR team in Sheffield. This was the focus of discussion at a session at the ABS Conference and has led to the revision of the guidance on the management of radial surgical margins in relation to breast conservation surgery for invasive breast cancer. This guidance was released early in 2024 and it is hoped will be shortly followed by the publication of guidance on Phyllodes tumours, which has been finished and submitted to a journal for publication. The Clinical Practice & Standards Committee has also been looking at undertaking a human factors study to support the breast MDT workforce to evolve better ways to work. This exercise is still being scoped.

The Education & Training Committee continues to review the training needs of the members, including SAS grade surgeons and Allied Healthcare Professionals. In 2023 it has established Medical School Champions across the UK and begun to run a series of events for medical students to encourage them to consider breast surgery as a career option at an early stage.

The International Forum became the International Committee in 2023 and their Chair is now a Trustee of the Committee. It continues to deliver twice yearly Network Meetings, which aim to inform members about overseas projects. In 2023 members of the committee contributed to a breast education and awareness event in Chandrapur, India. The Matabeleland South project continues to progress well. With support from the Steel Fund Charitable Trust and other fundraising it has supported three observers coming to the UK in 2023 to further their knowledge of breast ultrasound. Portable ultrasound equipment has now been provided to each of the three clinics in Zimbabwe. The establishment of three breast clinics in the region continues to be progressed and in 2024 a second breast course will be run in Bulawayo.

Page 5

Association of Breast Surgery

Trustees' Annual Report

The Nursing Committee was also formalised as a permanent committee in 2023. The Regional Representatives have been reaching out to the nurse members in their region in order to understand issues they may be facing and how best the committee can support the membership. It continues to look at issues of training and grading for nurses. In 2023 it again organised sessions for the ABS Conference and developed the programme for the ABS Nursing Conference.

Other ABS projects and contributions

ASPIRE (Breast Pain Pathway Rapid Evaluation) is progressing well. Data relating to over 1,000 patients has been collected and additional Units are being enrolled to the project. The ASPIRE team continues to liaise with the East Midlands Pathway team in relation to the audit they are undertaking. The project is being extended in order to collect follow up data on all patients and a request for additional funding is being considered to facilitate this. The study protocol has been accepted for publication.

The ABS’ Regional Meetings are going from strength to strength and are proving popular with the members. These are organised by the regional representatives, with input from the ABS Trustees and Association Manager. A grant is available from the ABS to cover some costs. Following an initial meeting in Northern Ireland in November 2022 meetings were held in North West & Merseyside, Scotland, East Midlands and West Midlands in 2023. Further meetings will be held in 2024 and it is anticipated that these will be run in each region every two years.

The Executive Board continues to look at ways of promoting breast surgery. Following the rejection of the specialty status application in 2023, the Trustees are seeking to improve the ABS’ input to the Councils of the Royal Colleges of Surgeons and also to the General Surgery specialty association, the Association of Surgeons of Great Britain and Ireland. It continues to look for areas of collaborative working with BAPRAS and to input to the Training Interface Group for the oncoplastic breast surgery fellowships. It is also contributing to a Breast Cancer Now working group looking at ways to improve access to DIEP flap services.

The ABS has entered into a partnership with the University of East Anglia/ Blended Learning UK for the development and provision of an online Introduction to Breast Care Nursing Course. It has contributed £4,000 towards the development costs of this course. The course was originally envisaged by the ABS International Committee to support healthcare professionals from low and middle income countries and it is still provided to delegates from these countries for free. The course has been developed by the UEA and the ABS has contributed towards the set up costs. In due course the ABS will receive a share of any profits from it.

Page 6

Association of Breast Surgery

Trustees' Annual Report

Financial review

The ABS holds its funds in Lloyds Bank and the Flagstone IM investment platform. The latter is enabling the Association to hold its reserves securely and ensure that it can move its money easily in order to obtain better rates of interest on it.

The ABS’ risk register is now reviewed annually and is considered to meet its purposes. The ABS continues to hold contracts in relation to its future Conferences. Contracts have now been signed for the 2026 Conference to be held in Newcastle and the 2027 Conference to be held at the ICC Wales in Newport.

The ABS continues to make savings where possible. It holds at least half of its Executive Board and committee meetings online and this has been a notable saving from before the pandemic. In 2023 its pay award to its staff matched the rate of the CPI in December 2022.

Policy on reserves

The Reserves Policy is reviewed annually and is increased annually in line with inflation. The reserves policy for the year ended 31 December 2023 was to hold free reserves (being unrestricted funds not designated for a specific purpose or represented by fixed assets) of at least £331,500. This figure increased to £356,031 with effect from the 1st January 2024. Free reserves held at that date totalled £459,186. The Trustees continue to look at projects to fund with its excess reserves and to work its funds down to the level outlined in its reserves policy.

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.

Organisational structure

The Executive Board (EB) provides a regular forum for the Trustees to meet and progress the ABS’ work. The Chairs of all six committees are now Trustees and they report regularly to the EB meetings. The EB also reviews the Association’s financial position and confirms the new members’ applications.

The six committees sit under the EB and progress the work within their remits. Each committee is allocated to a specific member of staff, who provides administrative support.

The ABS also has a number of working groups inputting to the Conference, developing guidance and progressing other areas of work as required.

Page 7

Association of Breast Surgery

Trustees' Annual Report

Association staff and office

The day to day administration of the Association is overseen by the Association Manager in liaison with the Honorary Officers. Until October 2022 a company was used to help support the ABS’ communications output. A Communications Coordinator has now been employed part time on a one year contract. Other job titles in the Association have been updated to give clarity to the roles being undertaken by the ABS’ staff. The Courses & Events Coordinator administers the ABS’ courses and events portfolio and the Membership Coordinator administers the membership and subscriptions.

The ABS staff continue to work in a hybrid model with some time at home but attending the office on a regular basis each week. The ABS desk space in the Barry Building of the Royal College of Surgeons continues to work well. Off site storage is continuing to be used as storage space is limited. The College is engaging with the specialty associations in order to improve access to onsite storage.

The workload of the Association continues to increase and ongoing consideration is being given to the best staffing structure for the ABS. The ABS is also mindful of the lack of cover for its Association Manager and consideration is being given to how cover could be provided for an extended absence on their part.

In 2023 the ABS’ Office Insurance was extended to also provide cyber cover.

The main business of the Association is discussed by the committees and at Executive Board meetings. Day to day work is progressed by e-mail, telephone and video conferencing.

Page 8

Association of Breast Surgery

Trustees' Annual Report

Plans for future periods

The Trustees have agreed to fund a clinical fellow for the National Audit of Primary Breast Cancer/ Metastatic Cancer. This individual will be based in the Clinical Effectiveness Unit at the Royal College of Surgeons of England. Funding of £150,000 over two years has been approved, commencing in 2024.

The ABS is also working with Astrazeneca and the Royal College of Surgeons of England to establish a Clinical Research Fellowship. It is intended that the post holder will undertake a higher research degree training in research methodology and conducting clinical research in an area of breast surgical importance, for example neoadjuvant and adjuvant therapy, genomics, risk reducing surgery, surgical outcomes and evaluation.

The ABS is looking to redevelop its website in 2024 and to establish a resources hub as part of the new site. This work is ongoing and will require both funding for the redevelopment of the structure of the site and staff resource to upload and develop the content. It is also looking at integrating the website more with the ABS database to facilitate members updating their details more easily.

The ABS will continue with its Regional Meetings and Medical School Champions events in 2024. In addition it held a committee dinner in January 2024 and it is hoped that this will become an annual networking event.

The Academic & Research Committee are working with iBRA NET to set up the ABS & iBRA NET Research Network. This is designed to bring the work undertaken by iBRA NET fully under the umbrella of the ABS, improve communication about and access to trials and studies and to avoid duplication between the ABS and iBRA NET. It is intended that the new network will run online meetings, accessible by all ABS members, 2 or 3 times a year.

The ABS is continuing to develop new guidance, including guidelines for the management of radial surgical margins in patients having breast conserving surgery for DCIS. The Clinical Practice & Standards Committee is also reviewing the guidance platform to ensure that all guidance on it is current. A working group has been set up with the Royal College of Obstetricians & Gynaecologists and NHS England to explore the feasibility of establishing a register of Pregnancy Associated Breast Cancer patients.

Page 9

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.

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 10

Association of Breast Surgery

Trustees' Annual Report

The annual report was approved by the trustees of the charitable company on ..............................................6 June 2024 and signed on their behalf by:

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

Page 11

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 2023, 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 12

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 10), 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 13

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.

Page 14

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.

Page 15

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: 7 June 2024

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

Page 16

Association of Breast Surgery

Statement of Financial Activities for the Year Ended 31 December 2023 (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 (expenditure)/income
Transfers between funds
Net movement in funds
Reconciliation of funds
Total funds brought forward
Total funds carried forward
15		 Unrestricted
£
38
947,237
13,254
960,529
961,721
961,721
(1,192)
(1,000)
(2,192)
721,696
719,504		 Restricted
£
3,926
-
-
3,926
21,983
21,983
(18,057)
1,000
(17,057)
33,310
16,253		 Total
2023
£
3,964
947,237
13,254
964,455
983,704
983,704
(19,249)
-
(19,249)
755,006
735,757		 Total
2022
£
35,076
908,488
2,469
946,033
788,967
788,967
157,066
-
157,066
597,940
755,006

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

Page 17

Association of Breast Surgery

(Registration number: 7207053) Balance Sheet as at 31 December 2023

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		 2023
£
13,956
117,303
771,526
888,829
(167,028)
721,801
735,757
16,253
473,142
246,362
719,504
735,757		 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

For the financial year ending 31 December 2023 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 17 to 32 were approved by the trustees, and authorised for issue on ....................6 June 2024 and signed on their behalf by:

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

Page 18

Association of Breast Surgery

Statement of Cash Flows for the Year Ended 31 December 2023

Note
Cash flows from operating activities
Net (expenditure)/income
Adjustments:
Depreciation
Investment income
4
Working capital adjustments
Decrease/(increase) in debtors
10
(Decrease)/increase in creditors
12
Increase 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 (decrease)/increase in cash and cash equivalents
Cash and cash equivalents at 1 January
Cash and cash equivalents at 31 December		 2023
£
(19,249)
3,350
(13,254)
(29,153)
8,213
(23,451)
586
(43,805)
13,254
(3,904)
9,350
(34,455)
805,981
771,526		 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

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

Page 19

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

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.

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.

Page 20

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

Investment income

Bank interest is 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 21

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

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 22

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

2 Income from donations and legacies

Donations receivable
Grants receivable		 Unrestricted
funds
£
38
-
38		 Restricted
funds
£
3,926
-
3,926		 Total
2023
£
3,964
-
3,964		 Total
2022
£
1,014
34,062
35,076

In 2022 donations receivable were split between £976 being restricted and £38 being unrestricted. In 2022 grants receivable were split between £24,062 being restricted and £10,000 being unrestricted.

3 Income from charitable activities

Events and courses delegate
fees
Events and courses trade fees
Other conference income
Yearbook income
Members' subscriptions		 Unrestricted
funds
£
395,952
302,320
15,000
-
233,965
947,237		 Restricted
£
-
-
-
-
-
-		 Total
2023
£
395,952
302,320
15,000
-
233,965
947,237		 Total
2022
£
416,766
273,492
-
1,000
217,230
908,488

All income from charitable activities in 2022 was unrestricted.

4 Investment income

Interest receivable on bank
deposits		 Unrestricted
funds
£
13,254		 Restricted
funds
£
-		 Total
2023
£
13,254		 Total
2022
£
2,469

Interest receivable in 2022 was unrestricted.

Page 23

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

5 Expenditure on charitable activities

Note
Unrestricted
funds
£
Events costs:
Venue, catering & accommodation
364,481
Speaker expenses
32,454
Audio visual costs
16,100
Printing, postage & stationery
6,788
Other direct conference costs
49,538
ABS conference event organiser
29,200
498,561
Membership costs:
EJSO Journal costs
15,717
ESSO membership subs
2,579
18,296
Grants and awards:
Fellowships and awards
5,935
Research grants
19,863
25,798
Other charitable expenditure:
Yearbook expenditure
9,674
Other charitable projects
14,962
ASPIRE Project
39,922
64,558
Support costs
6
339,617
Governance costs
6
14,891
961,721		 Restricted
funds
£
-
-
-
-
-
-
-
-
-
-
-
3,000
3,000
-
18,983
-
18,983
-
-
21,983		 Total
2023
£
364,481
32,454
16,100
6,788
49,538
29,200
498,561
15,717
2,579
18,296
5,935
22,863
28,798
9,674
33,945
39,922
83,541
339,617
14,891
983,704		 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
5,133
28,595
7,400
41,128
271,882
14,650
788,967

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

In 2022 total expenditure was split between £13,968 being restricted and £774,999 being unrestricted.

Page 24

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

6 Analysis of governance and support costs

Charitable activities expenditure
Trustee, Council & Committee
costs
Staff costs
Other staff costs & training
Staff recruitment
Trustee media training
Office, Trustee & event
insurance
Printing, postage & stationery
IT, telephone & website costs
HR
Sundry & office running
expenses
Rent
Legal & professional fees
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
£
21,749
180,676
418
5,869
3,000
6,559
2,058
30,522
1,250
1,019
10,895
6,185
3,350
66,067
339,617
Unrestricted
funds
£
3,445
6,887
2,774
1,785
14,891		 Restricted
£
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
Restricted
funds
£
-
-
-
-
-		 Total
2023
£
21,749
180,676
418
5,869
3,000
6,559
2,058
30,522
1,250
1,019
10,895
6,185
3,350
66,067
339,617
Total
2023
£
3,445
6,887
2,774
1,785
14,891		 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

Page 25

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

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 £3,607 (2022: £3,813) were reimbursed to 12 Trustees (2022: 13) 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		 2023
£
153,760
12,169
14,747
180,676		 2022
£
130,470
10,018
13,016
153,504

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:

2023 2022
No No
Administrative 3.25 3.00

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

£70,001 - £80,000
£80,001 - £90,000		 2023
No
-
1		 2022
No
1
-

The total employee benefits of the key management personnel of the charitable company were £93,444 (2022 - £80,742).

Page 26

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

9 Tangible fixed assets

Cost
At 1 January 2023
Additions
At 31 December 2023
Depreciation
At 1 January 2023
Charge for the year
At 31 December 2023
Net book value
At 31 December 2023
At 31 December 2022
10 Debtors
Prepayments
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
£
25,046
3,904		 Total
£
30,310
3,904
34,214
16,908
3,350
20,258
13,956
13,402
2022
£
112,316
13,200
5,264 28,950
5,264
-		 11,644
3,350
5,264 14,994
- 13,956
- 13,402
2023
£
93,163
24,140
117,303
2023
£
771,526
125,516
2022
£
805,981

Page 27

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

12 Creditors: amounts falling due within one year

Other taxation and social security
Other creditors
Accruals
Deferred income
Accruals for grants payable
Deferred income at 1 January 2023
Resources deferred in the period
Amounts released from previous periods
Deferred income at year end		 2023
£
11,436
1,953
26,068
87,771
39,800
167,028
2023
£
87,185
87,771
(87,185)
87,771		 2022
£
9,137
1,539
39,271
87,185
52,761
189,893
2022
£
20,749
87,185
(20,749)
87,185

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		 2023
£
7,576		 2022
£
5,438

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 28

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

15 Funds

Balance at
1 January
2023
£
Unrestricted funds
General unrestricted funds
570,672
Designated funds
a) Mammary Fold Trainees
Group
684
b) Support for RCS Surgical
Specialty Lead
15,000
e) Educational Fellowships
13,100
h) ASPIRE Project
110,000
i) SCHARR margins review
12,240
o) NATCAN audit fellow
-
151,024
Total Unrestricted
721,696
Restricted
j) THET fund
537
k) International Forum
3,823
l) Research development
grant fund
50
m) Matabeleland South
Project
28,900
n) Overseas bursary
-
Total restricted
33,310
Total funds
755,006		 Incoming
resources
£
960,529
-
-
-
-
-
-
-
960,529
-
150
3,000
776
-
3,926
964,455		 Resources
expended
£
(904,559)
-
(5,000)
-
(39,922)
(12,240)
-
(57,162)
(961,721)
-
-
(3,000)
(18,983)
-
(21,983)
(983,704)		 Transfers
£
(153,500)
-
-
-
2,500
-
150,000
152,500
(1,000)
(537)
-
-
537
1,000
1,000
-		 Balance at
31
December
2023
£
473,142
684
10,000
13,100
72,578
-
150,000
246,362
719,504
-
3,973
50
11,230
1,000
16,253
735,757

Page 29

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

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
h) ASPIRE Project
i) SCHARR margins
review
Total unrestricted funds
Restricted
j) THET fund
k) International Forum
l) Research development
grant fund
m) Matabeleland South
Project
Total restricted funds
Total funds		 Balance at
1 January
2022
£
479,334
684
31,250
14,574
18,950
9,100
9,025
12,783
-
-
96,366
575,700
537
6,653
50
15,000
22,240
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 30

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

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 Matabeleland South in Zimbabwe.

n) A donation to fund an individual as part of an overseas bursary.

o) Funding provided for one fellow to work on two audits being undertaken by the RCS Clinical Effectiveness Unit. The start date is expected to be in 2024 for a period of two years.

16 Analysis of net assets between funds

Current year:

Unrestricted

Tangible fixed assets
Current assets
Current liabilities
Total net assets		 General
£
13,956
626,214
(167,028)
473,142		 Designated
£
-
246,362
-
246,362		 Restricted
£
-
16,253
-
16,253		 Total funds
2023
£
13,956
888,829
(167,028)
735,757

Prior year:

Unrestricted

Tangible fixed assets
Current assets
Current liabilities
Total net assets		 General
£
13,402
747,163
(189,893)
570,672		 Designated
£
-
151,024
-
151,024		 Restricted
£
-
33,310
-
33,310		 Total funds
2022
£
13,402
931,497
(189,893)
755,006

Page 31

Association of Breast Surgery

Notes to the Financial Statements for the Year Ended 31 December 2023

17 Related party transactions

There were no related party transactions in the year.

Page 32