2020-12-31-accounts

Annual Repor 2020 St John of Jerusalem Eye Hospital Group ! f t,

SAVING CHANGING SIGHT LIVES

St John of Jerusalem Eye Hospital Group is the only charitable provider of expert eye care in East Jerusalem, Gaza and the West Bank. Our aim is to end preventable blindness throughout the oPt. We have been treating patients in the region regardless of their ethnicity, religion, social class or ability to pay for over 138 years. Our sight-saving work is carried out against challenging odds to the highest international standards.

Contents

• 3 CEO and Chairman introduction 4 Hospitaller’s Report 6 Snapshot of 2020 7 About Us 8 Patient Centred Services 12 Excellence, Education, & Innovation 16 Investing in our People

• 18 Good Governance and Partnerships 19 Spotlight on a Partnership: CBM 20 Thank You to the Guild 21 Sustainability 22 Celebrating a hero 24 Trustees and Committee Members 28 Governance Structure 29 The Chief Executive/Public Benefit 30 Strategic Report: Strategic Vision 33 Strategic Report: Financial Review 36 Statement of Trustees' Responsibilities 37 Fundraising Statement 38 Stakeholder Engagement

• 40 Independent Auditors' Report 42 SJEHG Financial Statements 58 Professional Advisers and Administrative Information 59 Thank You

GLOSSARY: JCI - Joint Commission International; the gold-standard for healthcare worldwide. NGO - nongovernmental organisation. NIS - New Israeli Shekel. oPt - occupied Palestinian territories. PA - Palestinian Authority. SJEHG - St John of Jerusalem Eye Hospital Group; this refers to all of our entities. UNDP - United Nations Development Programme. UNRWA - United Nations Relief and Works Agency, the UN branch responsible for Palestinian refugees. USAID - United States Agency for International Development

All uncredited photos throughout this Annual Report have been taken by staff of SJEHG. All the images used in this report are of actual SJEHG staff and patients and they have given their consent.

St John of Jerusalem Eye Hospital Group Company no: 7355619 Charity no: 1139527 Registered Office: 4 Charterhouse Mews, London, EC1M 6BB

Chairman & CEO Introduction

Even for a region which is not shy of crisis, 2020 was one of our toughest years yet. In spite of this, SJEHG emerges from last year with a lot to be proud of and more to be thankful for.

The Covid-19 global pandemic had an influence across all areas of our operations and income. First and foremost, it unfortunately impacted upon our ability to treat our patients. Across Israel and the PA, strict lockdown measures were imposed at various times throughout the year in response to public health guidance. Our Mobile Outreach services were also suspended for the majority of the year. These measures resulted in a 20% downturn in our patients reached across 2020 (see page 6 for a full breakdown).

Sir Andrew Cash and Dr Ahmad Ma'ali in the Jerusalem Hospital Gardens

Patient safety and quality of care remains a top focus at SJEHG and where we believe that our team excelled throughout 2020. The pandemic brought with it new, unparalleled safety requirements which were implemented and maintained across all our services to the highest of standards. Though some of our staff did contract the virus outside of SJEHG settings (and made a full recovery), we were relieved to report no cross contamination from within any of our hospitals or clinics. We also celebrated a year of high levels of quality care in our theatre, with no major infections or other sentinel events. Our team deserves our highest praise. We cannot thank you enough for all that you have achieved this year in such difficult circumstances.

The economic impact of Covid-19 has brought with it its own challenges. Patient related income was down by almost £1.4m GBP and voluntary income was down by almost £519k GBP against our 2020 budget. Difficult decisions such as giving all staff one month’s unpaid leave and freezing all recruitment and promotion enabled us to save £1.4m GBP, and other cuts across areas of every department brought our total savings to almost £2.5m GBP. We thank our staff once again for their sacrifices made here.

We were relieved to have made these savings with almost no redundancies and few cuts to our vital services, but this solution is certainly not sustainable. The economic impacts of the past five years of events out with our control such as, Brexit, political cuts to Palestinian funding and the pandemic, have left SJEHG in a challenging position. We are therefore working to diversify our income by focusing on strengthening services provided to paying customers and seeking funding from a range of new sources. You can read our full financial review on page 33.

We remain incredibly grateful to the Priories of St John who managed to continue their remarkable support despite the challenges faced in their own countries. Your support remains as over 34% of our overall voluntary income and has an enormous impact on what we are able to achieve every year. We are especially grateful to the Chair of the Guild, Georgie Brooks and Guild members for their exceptional achievements in taking their events online to support our Mobile Outreach services – and raising over £100,000 in the process.

We would like to take this opportunity to thank all of you who continue to support our vision to end preventable blindness across Jerusalem, the West Bank and Gaza. This report will demonstrate what can be achieved at St John even in the toughest times of crisis; we look forward to working with you to carry our mission even further in 2021/22.

Sir Andrew Cash OBE Dr Ahmad Ma’ali Chairman CEO

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Hospitaller’s Report International Partnerships and Excellence in Medicine

Despite the challenges of 2020, over the past 18 months we have continued to develop our fellowship, research, and virtual training programmes, and are grateful to the wider family of St John for their constant support for our postgraduate activities.

In particular, we continue to build our partnerships both with regional units, and with the wider international ophthalmic community. These collaborations lie at the heart of our postgraduate strategy, supporting research, teaching, and training - the three ‘pillars’ of postgraduate medicine.

Hospitaller David Verity (left) and Professor Richard Collin (right) cross the Gaza border on a surgical visit, March 2020.

and diabetic retinopathy (DR) as leading and preventable causes of visual impairment in the Palestinian population. DR in particular is a growing epidemic in the oPt and, to this end, we are continuing our decade-long efforts to screen patients and establish best practice methods on managing the condition at a population level. You can read more on all our research on page 14.

In 2015 the St John Ophthalmic Association (SOA) was founded, and thanks to support from the SJEHG Board is now a formal part of the Hospital Group, with its own Board of Directors and governance structure. This is a significant milestone for the Hospital Group because it brings a focus to our postgraduate work, and unites the expertise and support of clinicians across the Priories of St John for our teaching, training and research. Despite lock-down, and with the last physical SOA meeting in London in March 2020, the Association has recently launched two initiatives – the virtual MasterClass Series , and the St John Ophthalmic Case Series , or ‘SOCS’. The latter unites clinicians, virtually,

Research at St John has made great strides since our original trachoma work in the 1960’s, and the immunogenetics studies in Behçet’s disease in the 1990’s. We now run a modern DNA laboratory, focussing on the genetics of retinal disease, particularly retinitis pigmentosa (RP), which affects up to one in 4,000 people, and can lead to profound sight loss. You can read more on our efforts to diagnose and search for a cure for inherited retinal disease on page 14, and review St John’s published scientific citations and research projects on the SOA website.

Our regional Fellowship training programme also continues apace, and includes training in glaucoma, paediatrics, and oculoplastics. This investment has a profound long-term impact on eye care, and we are indebted to our supporters who have donated to this programme.

Our recent ‘Rapid Assessment of Avoidable Blindness’ study, completed in 2019, identified the need for glasses, cataract,

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The SOA Youth Arm, iYouth, launched in Dublin in February 2021, attended by the iYouth committee, iYouth patron Lionel Jarvis
and SJEHG Hospitaller and SOA founder David Verity
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across SJEHG and the Priories and has run 3 meetings to date (USA, Canada, Australia), with Europe and Sweden booked for 2021/22. As part of the SOA, iYouth, the emerging branch for young professionals , was launched in Dublin shortly before lockdown. You can read more on achievements of the SOA in 2020 on page 12 and can learn more about joining the association at www.soa.global

visits we spent time with our postgraduate department is ophthalmic and general surgical vital for our service delivery and colleagues, visited a range of our international reputation. hospitals in Gaza, performed We are building our training complex operations, engaged in capabilities, have formed local teaching programmes, and an international ophthalmic contributed to an ophthalmic research advisory committee conference held in Gaza City. (ORAC), are developing our digital platforms, and engaging clinicians across the Priories.

Since our earliest Hospitallers, clinicians across the Priories. St John has enjoyed a tradition of support from In all this, we owe a debt of distinguished international thanks to the Trustees of the surgeons. I am glad to report Board of SJEHG, and to our that this tradition continues staff, clinicians, and supporters to thrive, and that we have a across the Priories, without new and evolving Ophthalmic whom this progress would not Association to engage be possible. I send a sincere healthcare professionals across message of thanks to you All. the Priories and promote postgraduate excellence in St John. Their dedication to our work across our clinics and hospitals is greatly appreciated.

Although ‘virtual’ educational activities have their advantages, they also have their limits and, as a surgeon, there is no substitute for spending time with colleagues and patients. In 2020, shortly before lockdown, I was fortunate to lead two surgical visits to Jerusalem and Gaza, accompanied by distinguished colleagues from Moorfields Hospital in London, Professors Lyndon da Cruz and Richard Collin. During these

In summary, SJEHG is working tirelessly to develop our training KStJ BCh FRCOphth and academic profile. As a Order Hospitaller, teaching hospital, a thriving Chair, SOA

David H. Verity, MD MA BM

4 St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Snapshot of 2020

We reached over 107,000 patients, performed over 5,700 major surgeries and employed 254 people across our services.*

Jerusalem Hospital

Anabta Clinic

We treated almost 14,200 outpatients at our Anabta Clinic. A new school screening programme in the region also saw almost 500 children throughout 2020 and our introduction of crosslinking services allowed us to perform our first 28 major operations from the clinic.

We treated almost 40,200 patients in our East Jerusalem Hospital, and performed over 3,100 major operations.

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TULKAREM
ANABTA
TEL AVIV
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176 staff members, including 108 medical, allied health and nursing professionals, and 8 nursing students.

Muristan Clinic

17 staff members including 12 medical, allied health and nursing professionals

We saw over 400 patients in 2020 in our mobile Old City screening programme and Muristan Clinic.

Gaza Hospital

We treated almost 29,900 patients, and performed over 2,100 major operations (a 31% increase on last year’s major operations).

Hebron Hospital Our Hebron Hospital saw over 10,900 patients and performed over 450 major surgeries. A new school screening programme in the region also saw over 1,100 children throughout 2020.

43 staff members, including 23 medical, allied health and nursing professionals.

18 staff members including 14 medical, allied health and nursing professionals.

Mobile Services (Gaza) Our outreach services reached over 3,800 patients via our Mobile Outreach Programme and Diabetic Retinopathy Screening Programme.

Mobile Services (West Bank) Our Mobile Outreach Programme and our new Kufer Aqab Jerusalem Outreach Clinic screened over 6,000 patients.

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RUNNING COSTS 2020 R unning Costs 202UNNING COSTS 202 0 % covered by covered by % needing % covered % covered
fundraising fundraising by patient by patient
£'000£´000 activitiesactivities incomeincome
Jerusalem Hospital Jerusalem Hospital 728 , 3 1 3 9 5 61 % 44% 49%
Muristan Muristan 60 92 99% 98% 1% 2%
Outreach Outreach 183 411 98% 98% 2% 2%
Hebron Hebron 0 6 6 4 11% 12% 89%88%
Gaza Gaza 2 1, 5 1 3 5 47% 38% 53%62%
Anabta Anabta 468 559 37% 28% 63% 72%
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Staff numbers do not include three London staff. *Muristan and West Bank Mobile Services staff are counted in our Jerusalem Hospital figures.

*** Gazan Mobile Services staff are counted in our Gaza Hospital figures.

About Us

Mission Statement:

St John Eye Hospital Group provides high quality ophthalmic care to the people of the Holy Land irrespective of race, creed, social class or ability to pay.

Vision:

We work to eliminate avoidable blindness in the Holy Land and be recognised as the leader in the provision of quality eye care in Jerusalem, the Gaza Strip and the West Bank.

Values:

Compassion: Providing eye care with empathy

Accountability: Accepting responsibility for continuous improvement and embracing change

Respect: Honouring the dignity and diversity of each person

Excellence: Providing exceptionally high quality and advanced care

Strategic Aims (2020-22)

Patient-Centred Services – Commitment to accessible and quality eye care.

Excellence, Education, and Innovation – Developing a centre of excellence for eye health education, research and innovation.

Investing in our People - Promoting supportive working environments whilst developing a sustainable, skilled workforce.

Good Governance and Partnerships – Strengthening our governance practices and partnerships to ensure best practice and maintain our heritage and reputation.

Sustainability – Diversifying and strengthening our financial sustainability to ensure our mission can continue to the future.

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Ne’ema, The girl who spent Christmas alone at St John

Patient Centred Services

Accessibility

We are committed to reaching the most isolated and marginalised communities in our remit, and ensuring that all who walk through our door receive the best care possible.

Accessibility 43%

43% patients and companions were delayed or denied access to advanced treatment outside of Gaza in December 2020, similar issues for West Bank patients

Prevention and early treatment The Covid-19 global pandemic of eye conditions are vital. This is and subsequent lockdowns because many eye conditions, if impacted our ability to reach left untreated, cause permanent our patients throughout 2020 vision loss. Delivering accessible and we have had to adapt eye health services in the oPt where necessary. Though carries with it unique problems, certain services, such as mobile as the movement of people, even screening, were limited, we were for medical care, is limited by able to introduce a new clinic just checkpoints, permit systems and beyond the Separation Wall for the Separation Wall. Jerusalemites seeking eye care in the town of Kufer Aqab. Although We work to ensure that as many these patients are classed as patients as possible receive eye Jerusalemites they cannot access care through mobile outreach, our nearby flagship hospital screening services, and hospitals without a medical permit, and this and clinics strategically located is a solution to screen for potential across the West Bank and Gaza. advanced cases for referral. We also make sure that our patients adhere to any referrals We also successfully harnessed for advanced treatments at our our digital platforms in 2020 to hospitals by helping them navigate educate the Palestinian population permit requirements, transport and on health advice and the opening accommodation for longer stays. hours of our clinics during the You can view a detailed map of Covid-19 pandemic, as well as our services on page 6. specific campaigns to promote the dangers of consanguity, and the

risk factors for diabetic retinopathy. A new digital working group has been established to innovate new ways to utilise these platforms to promote eye health to our target population.

Retinopathy of Prematurity: We are developing our screening programme for retinopathy of prematurity (ROP), a disorder which affects as many as 60% of premature infants and, if untreated, leads to irreversible blindness in up to 10%. With state-of-the-art digital imaging and telemedicine, screening can be done by a technician, releasing clinicians to focus on remote diagnosis and treatment of identified cases. The greatest need is in Gaza, with an increasing number of neonatal units, and we are working to procure a number of mobile camera systems for the area.

Patient's Stor : y

to a pressure build up which caused her to develop glaucoma in her right eye, for which she had previously had a tube implanted to remove pressure.

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Ne'ma pictured in front of the Jerusalem Hospital Christmas tree.
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In December 2020, Ne’ma was due for the next stage of her treatment: two major surgeries – one with our glaucoma specialist Dr Amer Muhsein to insert her long awaited artificial lens in her right eye and ensure her glaucoma implant was still functioning, and another with our pediatric specialist, Dr Mohammad

Daraghmeh, to insert an artificial lens in her left eye.

Ne’ma, an eight-year-old girl from Gaza, has had vision problems her entire life, as her father, Mohammad, explains:

This would be a difficult treatment for any child and their family to go through, but Ne’ma’s family also had to deal with the permit system – only one person would be allowed to leave Gaza to accompany Ne’ma for surgery. Her mother stayed behind, whilst her father accompanied Ne’ma for treatment. However when Mohammad, himself fell ill on the trip with a major infection and was rushed to another hospital in Jerusalem, Ne’ma was left, unaccompanied and facing two major surgeries without the comforting arms of a parent to turn to.

‘Ne’ma was only a few weeks old when we observed that our beautiful baby girl could not see the world. We took her to one of the general hospitals in Gaza who advised we wait a few more months, but we became increasingly concerned. We decided to seek specialist advice from St John Hospital in Gaza, who confirmed our fear – our daughter had been born with cataracts in both eyes and was blind.’

Her case was a complicated one. It has involved eight years of treatment with St John – first to remove her cataracts when she was 2 months, resulting in Ne’ma being without the lens of her eyes until she was old enough to have artificial ones implanted. This led

Our Jerusalem Hospital staff stepped up to fill the gap as best as possible, as our Inpatient Nursing Director Ahmad Amer explains:

“Most of us have children so could understand the stress both the child and her father would have felt being separated at such a crucial time. Our team cooperated to ensure Ne’ma was mentally and physically okay by playing and walking with her to keep her busy. We also minimised her anxiety by connecting her with her family and father via video call a few times day.”

Fortunately, for Ne’ma, after years of treatment and suffering, and the tough experience in December, her journey to vision is taking a positive turn. In February 2021, her stitches were removed and our staff in Gaza were delighted to report she now has better vision and she will wear glasses to improve her vision with time. Mohammad also made a full recovery and shared of the experience:

“I’m so thankful for the care that was provided for my daughter. Ne’ma was lucky to be treated at St John.”

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Quality Eye Care

A commitment to the highest standards of quality and comprehensive eye care is vital to ensure the greatest chance of treating or managing each patient successfully.

Our Mobile Outreach team load up a van with equipment during the Covid-19 pandemic.

We take this commitment oncology), and each of our satellite seriously. We were the first centres receive regular visits Palestinian hospital to achieve from our specialists for treatment Joint Commission International or surgical referrals. In Gaza we accreditation in 2013. This are working to increase local accreditation is the most sub-specialist capacity to enable stringent certificate awarded to the mostly locked-in population hospitals throughout the world, constant access to the best reflecting the highest standard of possible eye care. excellence in medical care. We are independently reviewed on our At our core, our values of accreditation every three years and compassion, accountability, respect have continuously achieved 97% and excellence drives the ethos or higher. of care across our services –

The Covid-19 pandemic brought with it new challenges to patient and staff safety, which our team met with expected diligence. Several new safety protocols were introduced to ensure that we were able continue to treat patients in the safest possible manner, and we are happy to report there was no cases of internal contamination across our services. We are proud of how our team rose to the occasion, demonstrating, once again, how St John can continue to provide the highest standards of care for our patients even in the most difficult situations.

At our core, our values of compassion, accountability, respect and excellence drives the ethos of care across our services – ensuring each patient is not just given first-rate medical treatment, but are treated with dignity and empathy at every step of their journey with us.

Our Jerusalem Hospital is also the only Palestinian healthcare provider to have locally trained specialists in all 14 subspecialties of ophthalmology (except

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Head of Infection Control, Nasrallah Khalilel(right) and staff nurse Osama Jarrara(left) Dr. Issa Abu Sa’da, Head of Anesthesia with
with the Covid-19 vaccine patient Georgete Daibes.
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Staff Highlight: Nasrallah Khalileh, Head of Infection Control

When the cases of Covid-19 began spreading across Israel and the oPt, Nasrallah Khalileh, our Infection Control Manager was charged with spearheading St John Eye Hospital’s efforts to keep our patients and staff safe through the pandemic. He explains some of the experience below:

training and monitoring. This year has been incredibly Conducting investigations on taxing for all. Our staff are also positive cases and sending staff fathers, mothers, brothers and for home quarantine was quite sisters, and a big concern for all psychologically challenging too. was potentially contracting the Cooperation from my incredible disease and bringing it home colleagues enabled us all to beloved family members. to effectively overcome any However, all our team were obstacles put in front of us. inspired by their professional duty to provide care in one of Every cloud has a silver lining, the most difficult times we have Covid-19 has strengthened our ever witnessed, and remained confidence and dedication as a steadfastly committed to their team to maintain high quality care roles.

duty to provide care in one of Every cloud has a silver lining, the most difficult times we have Covid-19 has strengthened our ever witnessed, and remained confidence and dedication as a steadfastly committed to their team to maintain high quality care roles. in a safe environment during the most challenging of times. I’m Personally, being the lead in sure this learning will carry on a pandemic situation was not long after the pandemic has an easy job. I was ultimately been suppressed.” responsible for ensuring safety, covering the legal requirements and providing policies, staff

“From the beginning of the pandemic we were proactive in implementing evidence-based infection control practices to fight Covid-19. Our commitment as a team has been the key element in setting successful preventive measures that limited the spread of Covid-19 and ensured a safe environment for staff and patients.

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Gaza Hospital
Major Surgeries
31%
Highlights:
No community
transmission of Covid-19
In 2020 we opened
in any SJEHG centre
our 2nd surgical
unit in our Gaza
Performed over 5,700
Hospital – and saw
major surgeries
a 31% increase in
major surgeries
No major infection or
other sentinel events
St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020
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10 St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

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Excellence, Education, & Innovation

For over 138 years SJEHG has led on eye health for the oPt, and as part of the wider international ophthalmic community.

Education

There is a shortage of both nursing and medical professionals across the oPt, and this shortage is even more pronounced in eye care – there are only 19 ophthalmologists per million of the population (compared to 49 per million in the UK). To combat this, and ensure that we remain ophthalmic leaders, we provide world-class education to the next generation of Palestinian eye health professionals.

Nursing and Allied Health: We offer up to ten places each year at our prestigious Sir Stephen Miller School of Nursing. This is complemented by a training programme for ophthalmic assistants in Gaza, as well as training general community health workers to identify and refer eye conditions to SJEHG centres. Since the 1980s we have trained over 200 ophthalmic nurses and nursing assistants in both Jerusalem and Gaza. Those who stay with us have opportunities for further career development. A number of our graduates go on to train as allied health specialists such as orthoptists or retinal diagnostics.

Medical: Our ability to offer all 14 subspecialties of eye care (excluding oncology) is achieved through our Medical Residency Programme and Joint Teaching Programme. Our Residency Programme is the only training opportunity offered to Palestinians to specialise in ophthalmology. Once qualified, our specialists will work across our services and are given the opportunity to undertake fellowships in subspecialties at St John or at one of our partner organisations.

St John Ophthalmic Association:

Established in 2015, the St John Ophthalmic Association promotes the coordination of postgraduate training, education and other activities across the Order of St John, with a special focus on St John Eye Hospital. Spearheaded by our Hospitaller, David Verity, it also enables fundraising and shared knowledge for St John through annual historical summits and medical conferences. In 2020 the group celebrated several highlights including:

1. The 3rd European SOA Meeting was held in March 2020

2. The first on-line St John Ophthalmic Case Series meeting was held in 2020, bringing together Orders clinicians and SJEHG doctors:

3. The online SOA MasterClass Series was launched

4. SOA's iYouth organisation was established in 2020 in Ireland.

5. SOA funds enabled the sponsorship of three fellowships and one training course:

Glaucoma fellowship at Khadera Hospital in Northern Israel (finishes May 2021) Paediatric fellowship at Tel Aviv Hospital (September 2021)

Oculoplastic Fellowship at Al Foula Hospital VR Training at Bier Shiva Hospital (October 2021)

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Only 19 qualified
Lack of Specialists
ophthalmologists
per 1 million
19 per
population in the
1 million oPt (compared to
49 in the UK), this
trend is reflected
across all eye
health specialists
Highlights:
ophthalmic nurses
were trained.
8
Unfortunately our
2020/21 cohort could
not be recruited due to
the pandemic.
medical residents
completed their
3 training. Our nursing students undertake a lesson in eye health.
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Professor Richard Collin, Dr Hisham Al Faleet, and Dr David Verity examine a child at our Gaza Hospital, March 2020
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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Research and Innovation

In 2020, we have continued our almost decadelong screening and research into DR across the oPt. Its current iteration is a screening service in Gaza which screened over 1,500 patients in spite of the Covid-19 pandemic. Our findings from this study will help us to understand barriers to both diagnosis and management of diabetes and to develop a new comprehensive programme to combat this growing epidemic.

We work to deliver a service which reflects current population needs and provides state-of-the-art high quality treatment for those who require it. We do this by researching our population needs and ensuring that our specialists collaborate on developing ophthalmic best practice with their cohorts across the globe.

Genetics Research: Since 2016, we have been conducting extensive research into inherited retinal disease across the oPt. This was, until 2019, ‘Peace for Sight’ - a joint project between St John Eye Hospital and Hadassah Medical Hospital funded by the German Johanniter Unfall Hilfe (Johanniter Aid for Accident services) and the European Union Peacebuilding Initiative. This project allowed us to train a dedicated genetics research team and establish the oPt’s first ever retinal genetics laboratory.

Diabetic Retinopathy: We completed a Rapid Assessment of Avoidable Blindness in partnership with the London School of Hygiene and Tropical Medicine and Peek Vision in 2019 which identified diabetic retinopathy as the fastest growing eye health issue in the oPt (and the number two cause of blindness in the oPt after cataracts).

Our dedicated genetics research team continued their research in 2020, with continued focus on the genetics of retinal disease, particularly retinitis pigmentosa (RP). RP affects up to one in 4,000 people, and can lead to profound sight loss. In parallel, we are also applying to a multicentre phase III retinal gene therapy trial, enabling SJEHG to contribute to the global search for a cure for this disease.

Overall, we have been able to screen over 470 patients with inherited retinal degenerations. In 2020, our genetics team published two papers - one was a large paper in collaboration with many European Centers led by Prof Frans Kremer and the other was in collaboration with Hadassah Medical Center.

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Diabe tes Diabetic
retinopathy is now
24% one of the leading causes of blindness
in the oPt - up from
8.3% of the overall
causes of blindness
in 2008 to 24% in
2018.
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Other Research: Research publication is the currency of postgraduate medicine. To this end, in 2020, we established an Ophthalmic Research Advisory Committee (ORAC). ORAC is led by the Asia-Pacific branch of the St John Ophthalmic Association, and will support SJEHG colleagues as required, particularly with manuscript preparation and submission. A number of our medical team are working on research focussed on their specialisms, some of which were published in 2020. We aim to increase our research output over the next three years to ensure that our team are focussing on the most innovative approaches to eye health.

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The isolation and
desire to preserve
Genetics cultural traditions and
retain property within
the family has led to
50% a rise in intra-familial
marriage – which
causes high levels of
genetic eye disease.
50% of marriages
in the oPt are intra-
familial.
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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Investing in our people

Our staff are our most valuable asset. We are dedicated to creating an atmosphere which cultivates respect, development, transparency and well-being for all our employees.

Although we have always valued our people, our new 2020-22 strategy has introduced a focus to ensure that we engage and develop all staff members. In 2020 we initiated a hospital-wide pay scale and introduced policies to ensure that every department has succession planning and professional development as core priorities. As they are currently disproportionally represented at senior levels, we are also placing a distinct focus on encouraging our female and disabled staff members into management and development opportunities. Staff are encouraged to apply for any training that is relevant to their specialty and can help their development and productivity.

Staff are trained and coached to be multi skilled in their departments by working on rotational basis where possible, without affecting quality. This increases their knowledge and helps SJEHG to use its human resources efficiently. Internal training is conducted on a regular basis which is essential for staff continuous development. We have morning lectures for doctors and nurses to increase their knowledge and discuss special cases. We also hold regular mandatory training in First Aid, and other social topics such as Sexual Harassment in the Workplace.

In response to the unprecedented Covid-19 pandemic; SJEHG has been conducting specialised training in Infection Control and Health & Safety. We have also been taking great care of our staff needs and wellbeing;

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Staff nurse Ahmad Odeh with Head of our Jerusalem Hospital
surgical department Jamil Abu Hani
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including introducing flexible working hours, working from home, where possible, and providing vaccination for staff and their relatives.

Senior management keep in direct communication with all staff and pay regular visits to our satellite clinics to ensure that the whole of SJEHG work cohesively and effectively together. We distribute a Team Brief every three months to keep staff engaged and informed of all developments across the Group.

We continue to reward staff for their distinguished performance through the “Employee of the Month” nominations and thank you letters. Where our finances permit, the Board provides a bonus. Last year, as a thank you for efforts over the Covid-19 pandemic all staff received a Christmas Bonus of £250.

Highlights:

Staff development highlights in 2020 included:

Dr Omar Abd AlNurse Nadia Abu Dayem was promoted Sbeitan was sent to to Deputy Medical Turkey to undertake Director to cover for specialised training in the Acting Medical artificial eyes and is Director during his being and coached by absence. the current Artificial Eyes nurse in the Hospital.

CASE STUDY Janat and Mohammad are siblings from Ramallah who suffer from Leber’s Congenital Armaurosis, which causes severe vision loss and night blindness.

They have two older siblings who have already been fully blinded by this progressive condition. Their parents are first degree cousins which causes a myriad of health conditions in children, including a number of ophthalmic conditions. Although this is a difficult situation there is some hope for the youngest two. Thanks Some of our Jerusalem Hospital theatre staff. to our Genetic Research clinic, the family were diagnosed with a mutation in the RPE65 gene, one of the only genes Some of our Gaza Hospital theatre staff. which has been approved for genetic therapy treatment. This treatment has the potential to prevent the condition from getting worse, though as it is at the cutting edge of ophthalmic care, nothing is certain. Although it is a very expensive treatment, thanks to our donors we were able to offer testing and treatment to the family for free. The parents will also be able to use this diagnosis to take precautionary steps for any future children they may have. STATS: Almost 50% of marriages in the oPt are consanguious. SJEHG has been spreading awareness of the dangers through social media and outreach sessions. Father Wala' with daughter Janat and son Mohammad in our Jerusalem Hospital.

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Good Governance & Partnerships

We rely on our reputation to enable us to deliver our services further and to a higher standard than anyone else in the region.

SJEHG continues to seek the correct level. As such, we partnership opportunities in are registered with official the Middle East and globally. charity bodies in the UK and are independently audited each Technical Support and year. To see our full fundraising Grant Partnerships: statement see page 37, to see our There are a number of other Independent Auditors' report from development organisations who PwC see page 40.

Local: Our strategic partnerships with local health networks are vital to ensure that an integrated approach to eye health. We have a Memorandum of Understanding in place with the Ministry of Health in both the West Bank

There are a number of other development organisations who collaborate with SJEHG on eye health projects across the oPt. We rely on their expertise or influence to deliver our services at the highest level. Several of these bodies are also donors, to see a full list of major donors in 2020 refer to page 59.

and Gaza, to guarantee patients who present with eye conditions at general clinics are referred to us for specialist treatment. In 2020 we have been collaborating with the Ministry of Health to ensure that eye health is a key consideration in the national healthcare strategy.

2020 refer to page 59. St John Family: SJEHG enjoys a unique position as a foundation member of The Most Venerable Order of the Hospital of St John of Jerusalem, which was given a Royal Charter by Queen Victoria in 1888. Our Sovereign Head is HRH Queen Elizabeth II and our Grand Prior is HRH the Duke of Gloucester. Being a founding member of one of the world’s biggest providers of healthcare gives St John access Quality and Transparency: to partnership with Johanniter Through our commitment to International, the Order of St quality eye care (see page 10) John and the Alliance of the we have been accredited by the Orders. Together, and alongside ISO 9001:2015 (Accreditation several other international for Quality Control) and JCI bodies, we collaborate on best International and are subject practice for clinical governance, to regular external audits to sustainability and more. ensure that we are adhering to their gold-standard for quality healthcare. We take transparency very seriously, following all UK guidelines to ensure both our accounting and fundraising practices are operating to

Training: Both our Sir Stephen Miller School of Nursing and our Medical Residency Programme are internationally accredited, ensuring that our staff are trained to the highest possible standard. Our medical team benefit from opportunities to train in subspecialties internationally, and regularly collaborate on medical research with their cohort across the globe (see Research page 14). This collaboration has been encouraged by the introduction of the St John Ophthalmic Association (see Hospitaller's Report page 4).

“With a partnership that started in 1975, SJEHG is one of the most long-standing partners of CBM and of utmost importance Hundreds of children were given health education for our work worldwide sessions and screening across the West Bank thanks our CBM-funded School Screening Project and, particularly, in the Middle East as we strive for our common objective to prevent blindness whenever possible and include those people with unavoidable visual impairment in all areas - Markus Baldus of society.” Project Portfolio Manager, CBM

preventing irreversible vision loss. Given the high level of vulnerability of refugees in the oPt, UNRWA refugees make up the majority of our beneficiaries requiring patient-relief to access treatment.

CBM and SJEHG, along with support from the Fred Hollows Foundation, have also established baseline data on the prevalence of visual impairment in the oPt through implementing the second national Rapid Assessment of Avoidable Blindness (RAAB) in the oPt, 10 years after the first ever RAAB study conducted by SJEHG. This national piece of research aimed at assessing the depth of the problem has helped us strategically steer the eye health strategy across the oPt.

S otli ht on a Partnershi : p g p

Together, we have also

SJEHG’s partnership with CBM is one of our longest standing and most impactful collaborations to date which can be summarised with the phrase “Inclusive Eye Health”. The majority of our CBM supported projects are focused on serving our most marginalised and impoverished communities as well as to promote standards of living for those living with sight loss.

are the single largest, and only charitable eye care provider to the Palestinian people, we have proven ourselves to be ideal partners for large-scale eye health projects in the oPt. Our well-connected and advanced eye health system across Gaza, the West Bank and East Jerusalem is especially vital given the lack of any government-led plan or specific investment in eye health.

implemented inclusive eye health charitable eye care provider to initiatives aimed to strengthen the Palestinian people, we have the access to eye health for proven ourselves to be ideal refugees across the oPt. We are partners for large-scale eye currently working to strengthen health projects in the oPt. Our UNRWA’s health system in Gaza well-connected and advanced eye and the West Bank through health system across Gaza, the integration of Primary Eye Care West Bank and East Jerusalem into the general primary health is especially vital given the lack care provision of UNRWA. This of any government-led plan or initiative aims to make basic specific investment in eye health. preventative eye care available and affordable to all refugees With technical and financial in the oPt, which will ultimately support of CBM, together with reduce disability from visual its backing donors, mainly impairment across the region, the German Federal Ministry but will also provide rehabilitation for Economic Cooperation services for those patients with and Development (BMZ), we unavoidable blindness. implemented the first ever Diabetic Retinopathy Screening We are incredibly grateful Programme as a pilot project to CBM for their continued for integration within the United support and look forward to Nation Relief and Works Agency seeing the impact that our (UNRWA). This ground-breaking partnership will have on the eye initiative had allowed SJEHG health of the Palestinian people to screen over 40,000 known in years to come. diabetic patients and treat over 30% of the screened patients

Since 2012, SJEHG and CBM have scaled up their partnership with the aim to invest more funding and efforts into preventing avoidable blindness in the oPt taking into strategic consideration the complexity of the political and socioeconomic situation that has led to a fractured health system across the country.

We are incredibly grateful to CBM for their continued support and look forward to seeing the impact that our partnership will have on the eye health of the Palestinian people in years to come.

CBM has trusted us technically and medically to improve eye health across the oPt. As SJEHG

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Thank you to the Guild

Not even a pandemic stopped who visited our Gaza Hospital our wonderful group of in 2014, as well as a talk from fundraising volunteers – the renowned war artist Arabella Fundraising Guild from raising Dorman. awareness and vital funds for SJEHG throughout 2020. Attendees also heard from two

What has been a fantastic consequence of these ‘virtual’ happenings is that the guestlist for Guild events, which is usually limited to the London area, has gone truly global! We would like to express of gratitude to all who have kindly adapted and joined these events online.

SJEHG throughout 2020. Attendees also heard from two eye hospital stalwarts - Ahmad It was quite the transition to Ma’ali, SJEHG CEO and Denise take their normally in person Magauran, former Chief Medical fundraising events digital this Officer of the eye hospital. All year with little notice, but the of these talks, as well as the Guild rose to the challenge and documentary can be viewed hosted a wonderful array of on the St John Eye Hospital occasions to celebrate the eye Youtube channel. hospital.

We would like to thank all at the Guild for going above and beyond to continue raising awareness and funds for SJEHG. We would especially like to thank Georgie Brooks who stepped down as Chairperson of the Guild in March 2021, and extend a warm welcome to incoming Chairperson Julia Corkey.

They rounded off the year with a This year they have hosted fantastic virtual take on the Gift celebrated film-makers Carlo of Sight Fair (normally held in Nero and Vanessa Redgrave, Chelsea Old Town Hall) as well who produced an awardas a charity auction which was winning documentary on so successful there are plans to our work in 2015. This was do a joint in person/digital event followed by a fascinating talk in 2021. from broadcaster Jon Snow,

You can learn more about joining the Guild or attending a Guild event at guildstjohn.com

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37%
Other
Voluntary
41% Income
Patient
Related
Income
----- End of picture text -----

Sustainability Statement of Financial Activities 2020

Incoming Resources: £10.7m	GBP £000	$000 USD	%
Patient Related Income	4,378	5,604	41
Priory Income	2,113	2,705	20
Other VoluntaryIncome	4,033	5,162	37
Investment & Other Income	184	236	2
Total	10,708	13,707
Resources Expended: £10.5m	GBP £000	USD $000	%
Charitable Activities	9,723	12,445	93
Cost of GeneratingFunds	586	750	6
Governance and Other Expenditure	167	214	1
Total	10,476	13,409

----- Start of picture text -----
20%
Priory
Income
----- End of picture text -----

----- Start of picture text -----
2%
Investment
Income
93%
Charitable
Activities
1%
Governance
----- End of picture text -----

Thanks to the incredible generosity of our donors, we have expanded our services over the past ten years to reach more patients.

6% Cost of Generating Funds

heritage, which reflects the almost 1,000 year old tradition for the Order of St John of delivering health care in the Holy Land.

both the Palestinian Ministry of Health and the Israeli Sick Fund. Through these efforts we aim to increase hospital related income from 53% to 57% by 2022.

However, this has come at some cost, and at a time when the landscape for giving is complicated by political unrest and an economic downturn caused by both Brexit and the Covid-19 pandemic.

Our St John Family remain a However – there will always vital donor, and in 2020 gave remain a large portion of our 34% of our voluntary income patients who will need eye care – we recognise and appreciate given at subsidised rates, or that, even when you were for free, to ensure that money responding to a major pandemic is not a barrier in their eye at home, you remained steadfast health journey. Poverty rates are in your commitment to us. Eye currently 22% across the oPt disease did not let up during with unemployment at 27% (up the pandemic, and neither did to 49% in Gaza and 15% in the the need to treat it. To all our West Bank). Our donors remain donors, and especially our major vital for us to be able to deliver donors, we thank you for your eye health to those who need it generosity (please see a full list most – the most marginalised, of major donors on page 59). underprivileged and at risk. They also allow us to preserve our rich

The Palestinian need for eyecare only continues to grow, and with it brings a vital requirement to source new methods of funding. As part of our 202022 strategy we are committing to diversifying our sources of funding by looking to increase our income from private and medically-insured patients. We will do this by remaining a competitive leader in private eye care across the oPt, and by cementing our partnerships with

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Celebrating a hero Angus Rhodes and the Knights of the Vision Beautiful

For the past five years Angus Rhodes from the Knights Templar (KT), has been taking part in a series of challenges to raise funds for SJEHG. Spurred on by his inspiring actions, other members of the KT have joined up with Angus to form the ‘Knights of the Vision Beautiful’ – a dedicated fundraising group in aid of our work. In 2020 they raised an incredible £15,000 to support our surgical services. Angus shares their journey so far below.

“In 2015, I was told by doctors I had a less than 50% chance of leaving the hospital as a blood clot had almost filled both my lungs and my heart began to fail. On my third night in hospital, I almost didn’t make it, but was saved by my wonderful wife (who is an NHS Pharmacist) pushing for me to receive a dose of a drug that ultimately saved my life.

Coming back from the brink of death, and physically much weaker than I had ever been, was incredibly difficult. I decided I needed a focus to help me get back into shape – and, as I’ve always been quite an old soul, settled on my own interpretations of the 12 Labours of Hercules – the physical and mental challenges given to the demi-god Hercules to prove his worth in Greek mythology.

quite an old soul, settled on the KT for as long as I can my own interpretations of the remember as my father was 12 Labours of Hercules – the also a member and would physical and mental challenges bring me to family meetups given to the demi-god Hercules as a young lad. The KT and to prove his worth in Greek the Order of St John share a mythology. rich and storied history as they both served with each other I knew I had to give myself the for hundreds of years. Settling momentum to do it by setting on raising funds for SJEHG myself a fundraising challenge was therefore an easy choice, too. I’ve been involved with especially as I too have suffered

the terrifying experience of temporary sight loss.

Raising funds for St John Eye Hospital has been an inspiration and a privilege. I regularly receive news of the incredible work that they do, which keeps me motivated throughout my challenges. There is one Gazan girl in particular, Lana, who had lost her sight

unnecessarily due to a missed diagnosis of glaucoma, who I think of often as a reminder that though my challenges may be difficult, it is nothing in comparison to what she will have to struggle through as a blind young woman with a painful condition living in the Gaza Strip. I hope the money that I raise can spare many more children across the Holy Land the pain of irreversible sight loss.

Sadly, this year my father who started me on this journey, Terence James Rhodes, passed away. His legacy lives on in the over £1,100 raised from his memorial fund which has been added to our overall funds. My fundraising is now dedicated in his honour.

My challenges so far have been quite the wild journey (you can read my checklist to the right). I am delighted now to be joined by so many of my friends in the Knights of the Vision Beautiful, and last year we completed an excellent 24-hour relay event through the streets of lockdown London. We are hoping in 2021 to complete another of these and more – put it this way, I am just getting started!”

We would like to thank Angus, the Knights of the Vision Beautiful and the wider Knights Templar group for their amazing support so far. You can read more of our major donors on page 59 and follow Angus' journey on his Justgiving page.

Angus’ Challenges

Training Challenges Samson and Delilah:

A monetary vote to keep or lose the beard (it went) (May 2017) 5k Race (July 2017) 10k Race (July 2017) Half Marathon (October 2017)

Hercules Acts of Labour

1. The Nimean Lion: One Hundred Press Ups (2019)

2. The Lernean Hydra: 2019 - a Four Elements Challenge: Fire Walk in Basildon, Rock Climbing and Caving in Cheddar, Skydiving in Beccles and the Great North Swim (postponed due to Covid-19) 3. Catching the Erymathean Boar: Three Marathons in Three Weeks (April 2018 – Brighton, London, Stirling)

3. Labour: the Stymphalian Birds - tbc

4. Labour: Taming the Cretan Bull - tbc

5. Labour: Capturing the Mares of Diomades - tbc

6. Labour: (Retrieving) the Belt of Hippolyta - tbc

7. Labour: (Obtaining) the Cattle of Geryon - tbc

8. Labour: (Stealing) the Apples of Hesperides - tbc

9. Labour: Capturing Cerberus (the three-headed Hound of Hades) - tbc

22 St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Trustees and Committee Members

The trustees of the charity, who are also the directors for the purposes of company law, during the year and, at the time of this report, are listed below:

----- Start of picture text -----
Our board of Trustees pictured in September 2019.
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Sir Andrew Cash OBE KStJ

(Chairman)

•••••

Sir Andrew joined the NHS as a fast track graduate management trainee and has been a chief executive for more than 20 years. He has worked at the local, regional and national level. He has worked by invite at the Department of Health, Whitehall on a number of occasions. He is a visiting Professor in Leadership Development at the Universities of York and Sheffield. Sir Andrew was Chief Executive of Sheffield Teaching Hospitals NHS Foundation Trust from 2004 to 2018 and is currently the part time Chief Executive of the South Yorkshire and Bassetlaw Integrated Care System. He joined the SJEHG Board as Chair in September 2018.

Mr David H Verity KStJ, MA (Oxon), MD (Lon), BM BCh, FRCOphth (Order Hospitaller)

••••

David Verity was appointed to the Board in June 2016, and became the Order's Hospitaller in September 2018. He is a surgeon at Moorfields Eye Hospital, the President of the British Oculoplastic

Surgery Society, the Treasurer for the European Society (ESOPRS), and immediate past Editor in-Chief of the international journal ‘ORBIT’. In 2015, with the ophthalmic Hospitallers of the Order, he founded the St John Ophthalmic Association (SOA), a professional organisation dedicated to the postgraduate work of SJEHG. The SOA is formed of 5 world-wide hubs, engaging medical expertise across the Priories and supporting our staff with training courses and medical exchanges. As a surgeon, he also undertakes regular working visits to our hospitals in Jerusalem and Gaza.

the board in August 2012.

Dr Maged Abu-Ramadan KStJ MD FRCSEd

•••

Hospitallers of the Order, he Dr Maged Abu-Ramadan is

founded the St John Ophthalmic a resident of Gaza, a Senior

Association (SOA), a professional Consultant Ophthalmic Surgeon,

organisation dedicated to the and the Founder and President of

postgraduate work of SJEHG. The the Palestinian Ophthalmological

SOA is formed of 5 world-wide hubs, Society. In 2005 he was made

engaging medical expertise across Mayor of Gaza. He is the Treasurer

the Priories and supporting our staff of the Middle East Africa Council

with training courses and medical of Ophthalmology, and the

exchanges. As a surgeon, he also Chairman of Coastal Municipalities

undertakes regular working visits to Water Utility. Previously, he was

our hospitals in Jerusalem and Gaza. the Palestinian Authority Director General of Hospitals General Mr Nicholas Goulding Administration and the Director

CStJ BSc FCA CTA (Fellow) ATT General of the International

(Treasurer) Cooperation Department of the •••••••• Ministry of Health. Maged became Nicholas Goulding is SJEHG’s a member of the board in April Treasurer and Secretary. He is 2013. a Chartered Accountant and Chartered Tax Adviser and is a Dr Anne Coleman OStJ MD PhD

former partner with KPMG LLP. ••• He is Honorary Treasurer of The Dr Anne L. Coleman is the HM Tower of London Chapels Hospitaller for the St John Priory Royal Foundation, The Honourable in the USA, helping to form a Company of Air Pilots, St Lawrence strong link between the Priory and with St Swithun Winchester, SJEHG. Dr Coleman is Professor Winchester Deanery Synod and of Ophthalmology at the UCLA a Governor of Lord Wandsworth Stein Eye Institute of the David College. He was first appointed to Geffen School of Medicine and

also a Professor of Epidemiology at the UCLA Fielding School of Public Health. She is Vice-Chair for Academic Affairs for the Department of Ophthalmology and Director of the SEI Center for Community Outreach and Policy. She is currently the President of American Academy of Ophthalmology and Director of the H. Dunbar Hoskins, Jr, MD Center for Quality of Eye Care, which is responsible for the patient care guidelines and public health outreach of ophthalmologists in the USA. Anne has been a member of the board since June 2014, and resigned in September 2020. She was replaced by the new US Hospitaller, David Pyott OStJ, CBE.

Ms Susan Dingwall OStJ LLM DipLP

••••••

Susan Dingwall is a partner and General Counsel of the international law firm, Norton Rose Fulbright LLP, specialising in risk and insurance issues. Prior to becoming General Counsel, she led the firm’s award winning Islamic insurance practice and is a recognised expert in her field by the leading directories. She first joined the Board in August 2011.

Council (the local authority for the City of London) in 2013 and is now the Chairman of its Finance Committee. He sits on a number of other committees within the City. He is a Liveryman of the Clothworker’s and Pattenmaker’s Companies and is a member of the Knights Templar. Jamie has been involved with the Order of St John for over 40 years as a member of the Ceremonial Staff and is currently the Sword Bearer. He joined the board in 2017.

HE Philip Hall OStJ OBE

••

Philip Hall has been British Consul General in Jerusalem since August 2017 and joined the Board of Trustees for SJEHG in September 2017. Before this, he led the Spending Review at the Foreign & Commonwealth Office. From 2012 to 2015, he headed the FCO’s Counter Proliferation Department, leading the UK Government’s work to prevent the spread of chemical, biological and nuclear weapons. He was Defence Counsellor in the UK Delegation to NATO from 2008 to 2012 and headed the FCO’s Middle East Peace Process Section from 1999-2001. He is a solicitor, completed postgraduate studies in European law and integration in Germany, and has a Masters in Public Policy from the London School of Economics. Philip Hall resigned in July 2021.

Mr Timothy Jones

•••••

Middle East Peace Process Section Tim Jones is a retired solicitor, from 1999-2001. He is a solicitor, Chair of the trustees of completed postgraduate studies homelessness charity The in European law and integration Connection at St Martins, a in Germany, and has a Masters trustee of the Safer London in Public Policy from the London charity and of the National School of Economics. Philip Hall Botanic Garden of Wales, resigned in July 2021. a director of the Sport and Recreation Alliance and a Mr Jamie Ingham Clark CStJ FCA school governor. Tim was •••••• formerly a partner in the law firm Jamie Ingham Clark is a Chartered Freshfields Bruckhaus Deringer Accountant and pursued a career LLP working on a wide range in the Lloyd’s insurance market, of corporate and commercial where he had many years board projects internationally. He was experience as either Finance or managing partner of the London Compliance Director. He was first office between 2007 and 2011 elected to the Court of Common and worked in the Madrid office

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

----- Start of picture text -----
St John employed 254 staff across our services including 157 medical, allied health and nursing professionals in 2020.
Some of our staff and Trustees are pictured in the Jerusalem Hospital gardens, September 2019.
----- End of picture text -----*

between 1994 and 2000. Upon LLP, with a practice specialising in retirement from Freshfields he banking and financial law and the became General Counsel of regulation of financial markets. He England 2015, the organising was Joint Senior Partner of the committee for the Rugby World firm from 2006 to 2010. He has Cup. Tim joined the Board in served on European Commission November 2019. consultative groups relating to financial law reform and has Mr John Macaskill OStJ represented the United Kingdom •••• in relation to international John Macaskill was a Founding law reform initiatives at the Partner and Managing Director Hague Conference on Private of Groton Partners, a Private International Law and UNIDROIT. Equity firm based in New York. Mr Mr Morton was appointed as Macaskill joined Groton Partners Acting Chairman from January in March 2005 and focused his 2018 until the appointment of Sir efforts on alternative investments, Andrew Cash in September 2018. including Private Equity. Mr He first joined the board in June Macaskill is a General Partner in 2011.

John Macaskill was a Founding Partner and Managing Director of Groton Partners, a Private Equity firm based in New York. Mr Macaskill joined Groton Partners in March 2005 and focused his efforts on alternative investments, including Private Equity. Mr Macaskill is a General Partner in a number of private equity and real estate funds and has spent the last forty years in the financial services industry in New York and London. He is a member (retired) of the Institute of Chartered Accountants of Scotland, and a Chapter Member of the Priory in the United States of the Order of St John. He joined the board in January 2018. He has been appointed as the treasurer of the Priory of the USA.

Dr David E.I. Pyott OStJ, CBE

•••

Dr David Pyott is the former Chairman and CEO of Allergan Inc. During his tenure, Allergan was transformed from a small eye care business with about $1 billion in sales to a global company, with sales over $7 billion. Dr Pyott is a member of the Board of several U.S. pharmaceutical companies, a member of the Supervisory Board of Royal Philips and Chairman of Bioniz Therapeutics. He is Deputy Chairman of the Board of Governors of London Business School, a Trustee of the California Institute of Technology, President of

Mr Guy Morton KStJ MA

•••••••••

Guy Morton is a solicitor and was, until his retirement, a partner in Freshfields Bruckhaus Deringer

the newly created Ophthalmology the Director for Industrial Foundation, successor to Technologies. He joined the the International Council of Johanniterorden in 1984 and Ophthalmology Foundation, was chairman of the Brussels President of the Advisory Board Johanniter Group from 2002 of the Foundation of the American to 2012. Since 2014, he has Academy of Ophthalmology, and is been Governing Commander of also involved on the Boards of many the Balley and is responsible for other U.S. and international eyecare international affairs. Herbert joined charities. Dr Pyott and his wife, the board in June 2014. Molly, are Members of the Priory of the USA and stalwart supporters of St John Eye Hospital. Dr Pyott Co-opted Committee joined the Board in October 2020. members who are Not trustees

Ms Nicki Shaw OStJ

••••

Mr Ken Baksh

Nicki Shaw is Chief Executive of Princess Alice Hospice. She previously worked at the British Heart Foundation, latterly as Programme Director for Prevention and Care. Her career has spanned the commercial, regulatory and voluntary sectors. She has participated in a number of national forums including the Palliative Care Funding Review and the DH Advisory Group on Health at Work. Nicki’s appointment to the board was in September 2012.

• [Investment] Ken is an investment consultant with over 40 years’ experience

Mrs Georgie Brookes MStJ

[Guild Supervisory Committee ] Georgie was Chair of SJEHG Guild and Guild Member for 20 years. Formerly at Mayfair Capital and currently Finance Manager at the Mango Tree OSP. Georgie resigned as Chair in March 2021.

Mr Mark Cannon Brookes OStJ

• [Investment]

Mr Herbert von Bose

Mark retired as an investment director of Smith & Williamson in 2017. Previously he was also Chairman of CG. Asset Management and Chairman or board member

•••

Herbert von Bose is a lawyer and has worked for the European Commission in Brussels since 1983 where he rose to become

the USA. He is a businessman and investor. He resigned from the Committee in September 2020.

of numerous other investment companies with over 56 years in the city. Mark resigned from the Investment committee in May 2020.

Mr Timothy Walker CB

Mr Thomas E.K. Cerruti Esq, OStJ

Mr Thomas E.K. Cerruti Esq, OStJ • [Audit Committee] • [Fundraising] Timothy is a retired British Civil Thomas is a lawyer, Executive Servant, formerly serving as Director of the Shiley Foundation Director General of the Health and and trustee . He is a member of the Safety Executive. Priory of the USA.

*Staff figures do not include 3 London fundraising staff.

Mrs Julia Corkey MStJ

[Guild Supervisory Committee] Julia is the incoming Chairman of the SJEHG Guild (in 2021). She was a senior British public servant for over 20 years and is currently Chief Executive of ICC Belfast, Waterfront and Ulster Halls.

KEY:

• [Board ]

• [Steering ]

• [Finance ]

• [Audit ]

• [Investment ]

Mr Kevin Custis

• [Clinical Governance ]

• [Investment ] Kevin is a registered trust and estate practitioner, Legal Executive and the chair of the London Central Branch of the Society of Trust and Estate Practitioners (STEP).

• [Fundraising, Marketing ]

• & Communication

• [Strategy & Planning ]

• [Payroll and Remuneration ]

•[Human Resources ][Honours & Awards] SOA

Mrs Anzo Francis

• [Finance] Anzo is an ICAEW Chartered Accountant and Director of Finance of Water & Sanitation for the Urban Poor.

[Guild Supervisory ]

Prior Nigel Graham Heath KStJ

• [Finance]

• Nigel is the Prior of the Priory of

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

----- Start of picture text -----
Governance The Chief Executive
Structure
Dr Ahmad Ma’ali as Nursing School Director,
CStJ PhD MPH BSN PGCE ENB, CEO infection control and clinical
•••••••••• [CEO] services coordinator, also
Dr Ahmad Ma’ali joined the gaining a master’s degree in
Hospital family in 1990 as a Public Health Management at
student nurse, successfully Al Quds University in 2003.
completing his secondment In May 2009, Dr Ma’ali made
at Greenwich University in Hospital history as the first
1996 followed by a six months Palestinian Nursing Director
postgraduate specialist at the School. In 2017, he
ophthalmic nursing course attained a PhD in advanced
at London’s Moorfields Eye Nursing practice at De Montfort
Hospital. In 1999, he was University and, after 10 years
certified with a Nurse Tutor as Director of Nursing and
Diploma by the Bolton Institute. Allied Health Professions
Thereafter, he returned to building relations with staff,
Jerusalem where he assumed students and patients, he was
Board Committees: SJEHG is a company limited SJEHG’s activities and within the role as clinic Charge Nurse appointed as an interim Joint
by guarantee in England. The its Articles of Association. New for one year, and in 2000 CEO with Peter Khoury in
Steering Order of St John is the sole Trustees are selected by the took responsibility of course September 2017. In May 2019
member of the Charity and Board to maintain an appropriate leadership at the Sir Stephen Dr Ma'ali became our first
Finance
appoints the Chairman of the balance of skills, experience and Miller School of Nursing. For Palestinian CEO.
Audit Board of Trustees. The Board diversity. Trustees are appointed nine years, he continued to act
manages the business and for a term of three years and
Investment
affairs of SJEHG and usually may be reappointed for two
Clinical Governance meets three times a year, as further terms of three years,
does the Steering Committee, but are not normally eligible
Fundraising, Marketing
with at least one meeting at for a further reappointment. In The Public Benefits from c. the teaching and training
& Communication the Hospital in Jerusalem. The July 2021, Peter Hall resigned Public Benefit SJEHG’s activities are: activities at SJEHG, which
Board reviews the performance as a Trustee and was replaced enhance the quality of service
Strategy & Planning
of SJEHG and, in particular, the by Diane Corner. Additionally, The Trustees have given due a. the provision and development delivered and increase the pool
Payroll and Remuneration performance of the hospitals three current trustees are due regard to the Charity Commission's of clinical and surgical of qualified ophthalmologists,
in Jerusalem, Gaza, Hebron to leave the Board of Trustees in General Guidance on public ophthalmic services to patients specialist nurses and allied health
Human Resources
and the Anabta and Muristan 2021/2022 after serving a nine benefit when planning the Charity's at the hospitals in Jerusalem, professionals within the region;
Honours & Awards Clinics, as well as the Mobile year term. Three new trustees activities. Our Annual Report sets Gaza and Hebron, the Anabta
Outreach Programme. The Board have been recruited to replace out our activities, achievements and Muristan Clinics and the d. the research into endemic
SOA
also considers and approves them, and will be officially and performance during the year, Mobile Outreach Programme; diseases affecting the Palestinian
Guild Supervisory the operational and capital appointed in January 2022. which are directly related to the population; and
budgets. The Board Committees An induction programme is in objects and purposes for which b. the exemption of patients'
The Committee Terms of focus in detail on their areas of place for new Trustees. The SJEHG exists. SJEHG achieves charges when the relevant e. our services enhance education
Reference were updated responsibility and report back to Board of Trustees delegates its principal objectives through the authority does not finance and employment prospects and
in 2019. the Board. The Board is aware responsibility for the daily delivery of services to members of the treatment and the patient contribute to economic growth.
of the codification of directors’ management of the Charity to the public in Jerusalem, the West is unable to pay all or part
duties under the Companies Act the Chief Executive, Dr Ahmad Bank and Gaza without regard to themselves;
2006 and takes these duties Ma’ali and the SJEHG senior ethnicity, religion, social class or
into account in consideration of management team. ability to pay.
----- End of picture text -----

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29

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Strategic Report

Strategic Vision: January 2020 to December 2020

Our three-year strategic plan 2020 - 2022 will enable us to attain our mission as a centre of excellence providing ophthalmic care of high quality to the people of the Holy Land irrespective of race, creed, social class or ability to pay. This strategy will enable us to continue Saving Sight, Changing Lives and to uphold our CARE values:

Care

Compassion

Providing eye care with empathy and willingness to promote wellbeing

Accountability

Accepting responsibility for continuous performance & improvement, embracing change & seeking new opportunities to serve

Respect

Honouring the dignity and diversity of each person

Excellence

Providing exceptionally high quality and advanced care

The strategy outlines our clear vision to work with partners to

eliminate causes of avoidable blindness in the Holy Land through five distinct strategic aims:

in research, innovation and education by sharing our knowledge on genetics research and findings from the SOA annual summit to conducting a RAAB in children. By 2022, we will produce at least 10 scientific publications and have assured that our six medical residents are successful in their in national exams.

Patient-Centered Services Putting patients first - reaching out to the most isolated and marginalized individuals in our community and ensuring quality care and patient safety.

SJEHG will build on its JCI Investing in our People re-accreditation to continually Investing in our most valuable strengthen standards and asset – our staff. Promoting protocols on quality care and local talent and supportive patient safety. We will conduct working environments regular service audits, patient whilst developing training satisfaction surveys and opportunities towards a develop pediatric services in sustainable, talented workforce. Gaza. Our priority is to establish outreach services to overcome Our staff are our most valuable permit related accessibility asset and we will continue to issues and patients located in empower and support them to more isolated communities.

outreach services to overcome Our staff are our most valuable permit related accessibility asset and we will continue to issues and patients located in empower and support them to more isolated communities. reach their full potential. We will create a culture of transparency, Excellence, Education, initiate a Hospital-wide pay scale and Innovation and ensure employees have The country’s main provider an annual development plan in of ophthalmic training for response to appraisal processes. the medical, nursing and Female staff will be encouraged allied health sector, leading to take leadership roles and on excellence in research, we will facilitate training and innovation and medical fellowship opportunities in Gaza education. and Jerusalem for corneal to oculoplastic specialisms.

We are the main provider of medical, nursing and Good Governance and allied health professionals’ Partnerships ophthalmic training in the Building international country. We will seek funding partnerships and for clinical research, and strengthening governance to achieve the American structures to mitigate risks Council of Medical Graduate and ensure best practice. Education accreditation. We will capitalise on our achievements

The hospital management will further strengthen its governance structure across its sites and continue to conduct audits to control risks and prevent any undesired outcomes. We also aim to strengthen partnerships with major donors and pertinent service providers and stakeholders such as Palestinian Ministry of Health, Afoula Hospital, as well as brokering agreements with hospitals in Israel and overseas.

Sustainability funding across patient, major Building on a decade of growth donors and Priories income. by diversifying our funding We will do this by reviewing sources so that we continue contracts with all Israeli sick to reach more patients with funds, implementing nonquality services, and ensure a clinical income generating financially secure future. projects and competing for paying customers with services We have expanded our services driven efficient hospital-wide over the past 10 years to reach processes. We aim to increase more patients and we will hospital related income from sustain these achievements 53% to 57% by 2022. by diversifying our sources of

Two Jewish Israeli trainee orthoptists receive training from our Head of Orthoptics Judith Mussallem.

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

----- Start of picture text -----
STRATEGIC VISION:
January 2020 to December 2022
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----- Start of picture text -----
Our three-year strategic plan pediatric services in Gaza. Our We aim to increase hospital
2020 - 2022 will enable us to priority is to establish outreach related income from 53% to 57%
attain our mission as a centre of services to overcome permit by 2022.
excellence providing ophthalmic related accessibility issues and
care of high quality to the people patients located in more isolated Governance and Partnership
of the Holy Land irrespective of communities. Building international partnerships
race, creed, social class or ability and strengthening governance
to pay. This strategy will enable Care for our Staff and structures to mitigate risks and
us to continue Saving Sight, Employ Caring Staff ensure best practice.
Changing Lives and to uphold Investing in our most valuable The hospital management will
our CARE values: asset – our staff. Promoting local further strengthen its governance
talent and supportive working structure across its sites and
CARE environments whilst developing continue to conduct audits to
training opportunities towards a control risks and prevent any
Compassion sustainable, talented workforce. undesired outcomes. We also
Providing eye care with empathy and Our staff are our most valuable aim to strengthen partnerships
willingness to promote wellbeing asset and we will continue to with major donors and pertinent
empower and support them to service providers and stakeholders
Accountability
reach their full potential. We will such as Palestinian Ministry of
Accepting responsibility for
create a culture of transparency, Health, Afoula Hospital, as well
continuous performance &
initiate a Hospital-wide pay scale as brokering agreements with
improvement, embracing change &
and ensure employees have Hospitals in Israel and overseas.
seeking new opportunities to serve
an annual development plan in
response to appraisal processes. Excellent Education,
Respect Female staff will be encouraged Research and Innovation
Honouring the dignity and
to take leadership roles and The country’s main provider
diversity of each person
we will facilitate training and of ophthalmic training for
fellowship opportunities in Gaza the medical, nursing and
Excellence
and Jerusalem for corneal to allied health sector, leading
Providing exceptionally high quality oculoplastic specialisms. on excellence in research,
and advanced care
innovation and medical
Sustainability education.
The strategy outlines our clear
Building on a decade of growth We are the main provider of
vision to work with partners to
by diversifying our funding medical, nursing and allied
eliminate causes of avoidable
sources so that we continue to health professionals’ ophthalmic
blindness in the Holy Land
reach more patients with quality training in the country. We will
through five distinct strategic aims:
services, and ensure a financially seek funding for clinical research,
secure future. and to achieve the American
Patient-Centered Services
We have expanded our services Council of Medical Graduate
Putting patients first - reaching over the past 10 years to reach Education accreditation. We will
out to the most isolated and
more patients and we will capitalise on our achievements in
marginalized individuals in our sustain these achievements by research, innovation and education
community and ensuring quality
diversifying our sources of funding by sharing our knowledge on
care and patient safety.
across patient, major donors and genetics research and findings
SJEHG will build on its JCI
Priories income. We will do this from the SOA annual summit to
re-accreditation to continually
by reviewing contracts with all conducting RAAB in children. By
strengthen standards and
Israeli sick funds, implementing 2022, we will produce at least
protocols on quality care and
non-clinical income generating 10 scientific publications and
patient safety. We will conduct projects and competing for paying have assured that our six medical
regular service audits, patient customers with services driven residents are successful in their in
satisfaction surveys and develop efficient hospital-wide processes. national exams.
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Strategic Report Financial Review: Achievements and Performance in 2020

The remaining 2% (2019, 2%) incoming resources related to income from investments.

primarily personnel costs which The remaining 2% (2019, 2%) makes up 57% of the total incoming resources related to cost (2019, 56%). Operating income from investments. costs were contained through the continuation of enhanced During 2020, the PA has cost controls introduced in been facing major financial earlier years as well as the difficulties that have resulted actions taken by trustees in the inability of their ministry and management to minimise of health to make sufficient, the financial impact of the regular and timely payments to pandemic. the Group, Additionally, due to the political unrest within the Costs of generating funds region, there are doubts about constituted 6% (2019, 6%) of the ability of the PA to continue total resources expended and paying the hospital on a regular is the costs of the Londonbasis. Funding this level of debt based fundraising team and the impacts on SJEHG’s cash flows Jerusalem-based fundraising and it is ameliorated to a certain and projects team in addition to extent when the European carrying out various fundraising Union pays a substantial part events. Governance costs of the PA outstanding debt. amounted to 1% (2019, 2%) of Conversely, SJEHG benefits the total resources expended from the receipt of voluntary and reflect the international income, in particular for nature of the charity’s activities restricted purposes, in advance and governance arrangements. of the related expenditure, usually for capital projects.

For the year ended 31 December 2020, incoming resources amounted to £10.7m, (2019, £12.2m) while resources expended amounted to £10.5m (2019, £12.2m). This resulted in a surplus of £0.2m (2019, £0.04m) before taking into account realised and unrealised losses on investments of £0.2m and exchange gains of £0.2m. Overall fund balances accordingly increased by £0.2m in the year.

During the year, patient-related income decreased due to the impact of the Covid-19 pandemic which imposed movement restrictions and resulted in a decline in the number of patients seen and treated by the hospital. Within voluntary income, donations from St John Priories decreased from £2.6m in 2019 to £2.1m in 2020.

Total voluntary income increased to £6.1m (2019, £5.7m) The investment portfolio is held representing 57% (2019, 46%) as a means of earning income of the incoming resources. to support operational activities Donations included £0.2m and as reserves to ensure that (2019, £0.6m) restricted for SJEHG can continue to fulfil capital projects and medical its charitable objectives, while equipment, in addition to £2.1m maintaining the real value of (2019, £2.6m) donated by the capital over the medium to long Priories of The Order of St John. term. The investment objectives Overall, the value of capital include aiming for lower volatility projects completed during the than equity markets, higher year amounted to £0.24m. diversification and only a modest exposure to illiquid assets. The Funds generated from charitable Investment Committee reviews activities (mainly patient income) the portfolio’s strategy and amounted to £4.4m and performance with the investment constituted 41% (2019, 52%) manager on a regular basis. of total incoming resources.

Expenditure on charitable activities amounted to £9.7m, being 93% (2019, 92%) total resources expended. These costs include running the hospitals in Jerusalem, Hebron and Gaza, the Anabta Clinic, the Muristan Clinic and two Mobile Outreach Units, the cost of teaching and training during the year for doctors, nurses and allied health professionals, and the running costs of the genetics laboratory and the refractive suite. The expenditure on charitable activities is

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Strategic Report Financial Review: Achievements and Performance in 2020

Reserves

A key risk which SJEHG faces continues to be financial. The position has been exacerbated by Covid-19, Brexit and the impact of the continuing reduction in value of Sterling against the Israeli Shekel, by changes to the statutory level of minimum wages in Israel, and also by the political situation in the region. SJEHG relies heavily on voluntary income received mainly from donors in the Middle East, Europe, the United Kingdom and the United States. In the current global financial situation, it remains a great challenge to continue to attract core funding from existing and new sources. The fundraising strategy includes a focus on endowment and legacy giving in order to mitigate this risk as well as a focus on major gifts for core costs.

At 31 December 2020, SJEHG had total funds of £19m (2019, £18.8m). This comprised permanent endowments of £7m (2019, £7.2m), £0.5m (2019, £0.6m) in restricted income funds, and £11.5m (2019, £11m) in unrestricted reserves, of which £5.5m (2019, £4.4m) is available to meet the normal operating needs of SJEHG.

Reserves Policy

The Board of Trustees reviews annually the need for reserves in line with the guidance issued by the Charity Commission and considers that, in the context of the political and economic situation in the region in which SJEHG operates, unrestricted reserves need to be maintained, when circumstances allow, to equate to at least six months running costs (equivalent to £6.5m) to ensure that SJEHG can continue to run efficiently with adequate working capital. It is intended to achieve this through a continuing focus on cost-cutting, revenue generation, the introduction of new sources of revenue, and enhanced fundraising activity in order to ensure financial resilience and sustainability for the future.

Liquidity is a recurring issue, especially with the prolonged payment pattern of the PA for its working capital needs. SJEHG therefore sets aside a portion of the investment portfolio as a cash deposit, in order to ensure meeting the working capital needs.

International currency exchange movements are an additional risk. It should be recognised that exchange gains do not represent realisable income which are capable of being utilised by SJEHG, as they largely reflect the translation into Sterling of the Israeli Shekel value of the Hospital premises.

Principal Risks and Uncertainties

Operationally, patient and staff access to Jerusalem is crucial to the continuation of our ability to provide eye care services in the oPt. Working in a volatile region has inherent risks. Gaza has its own risks. The situation could escalate at any time as instability and strife continue to affect

A comprehensive risk management policy is in place with a risk register of all clinical, operational, financial, external, political and governance risks. The risk register is regularly reviewed by the relevant committees and the Board, with particular focus on residual risks.

the neighbouring countries, a particular current concern.

Going Concern

Since March 2020 and the on-set of Covid-19 in Israel and the occupied Palestinian Territories (oPt), the Board of Trustees and Management have been working on flexible plans, both operational and financial, to seek to secure the continued viability of the organisation.

We currently remain confident about our future, but these are very challenging and unprecedented times for SJEHG and society in general; and are likely to remain so for quite some time to come. We plan to work closely with all our global partners and supporters to seek to ensure that we continue to serve our patients in the most efficient and safe manner.

Detailed, yet adaptable, business plans have been prepared, and financial budgets and cash flow models are aligned to those plans. These plans are clearly dependent upon a variety and number of key assumptions, some of which are inter-related. For example, national and local Government decisions (such as measures taken by Governments to mitigate the impacts of the Covid-19 global pandemic on public health), travel and border restrictions, social distancing, capacity in our hospitals, the demand from our patients, our ability (and that of the PA) to obtain funding and donations, our fixed and variable cost structure; continued financial support from Group undertakings; to note just a few. Further details of the Group's principal risks and uncertainties are set out opposite.

The plans and models have been prepared for the period to December 2022, which is a period of at least 12 months from the date of approval of the financial statements. For the Board of Trustees to have a reasonable expectation of

the Group's financial viability to December 2022, the Trustees have also identified several challenging, yet reasonably plausible, downside scenarios based on information currently identified as a result of the impact of Covid-19 (sensitivity analysis). Sensitivity analyses and modelling have been performed on the key assumption alongside the financial effects thereon.

The Trustees continue to review and will implement any possible mitigations in order to seek to reduce the financial impact of these downside scenarios – maintaining a balance between supporting the activity that is crucial to delivering the objects of the charity, whilst ensuring the long-term financial sustainability of the Group.

Under these current downside scenarios, with no further mitigations which may be available to the Group, the Trustees’ project to have sufficient liquidity through the period to December 2022.

Further details of the above are set out in Note 1 to the financial statements.

After consideration of the detailed, yet adaptable, business plans, financial budgets, cash flow modelling aligned to those plans and scenarios, and the overlaid sensitivity analyses, the Trustees consider that the Group has adequate resources to continue in operational existence for the foreseeable future, being a minimum period of at least 12-months from the date when the financial statements are approved.

Based on all of the above, the Board of Trustees are confident in the Group's ability to remain as a going concern and have, therefore, prepared the financial statements on a going concern basis of accounting.

Nevertheless, the Trustees fully acknowledge that there is a level of uncertainty, which is likely to persist for some time, given the

key assumptions and the financial modelling referred to above.

key assumptions and the financial understanding of the complexities modelling referred to above. and vulnerabilities of SJEHG's financial position. More detailed information is set Remuneration Policy out below, but the key features All roles within SJEHG are which can obscure the financial evaluated in order to determine difficulties/pressures on the where they fit on our pay scale. operating budget are– The salaries within the scale • capital donations are treated are determined by the market as income (in accordance with rates for an equivalent position. the Charities Statement of In exceptional cases, where the Recommended Accounting market information supports it, Practice), salaries may be above the top of • exchange rate variations: these the band. Each year, the payroll have recently arisen mainly from budget is reviewed, based on the depreciation of the Pound legislative, statutory and market Sterling against the operating changes, using a range of sources currency (Israeli Shekel) (which and taking account of affordability, was particularly marked in 2016, all as part of the annual budgetary when the Brexit vote resulted in process. a rapid depreciation of almost 20%, but has in fact been a Management consult with the continuous process over at least Finance, the Human Resources, the last five years), and have and the Pay and Remuneration also included a depreciation of Committees of the Board, and a the US Dollar against the Israeli pay review proposal is submitted Shekel, to the Board, which makes the • The exchange gains or losses decision on the proposal. Staff apparent from the annual results costs are set out in note 6 of the shown in the financial statements financial statements. do not represent realisable amounts which are capable of Guide to SJEHG’S being utilised by SJEHG. They are largely derived from the Finances translation into Pound Sterling of the Hospital premises with an The aim of this note is to unchanged Shekel valuation.

The aim of this note is to summarise the key points to an

Table of Adjustments 2020

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in £'000
Net incoming Resources per Statutory Financial Statements 241
Reconciling Items
Donations for Capital Projects (196)
Unrealised Losses on Investments 215
Exchange Gains (224)
Net Operating Results 36
Less: Outstanding Restricted Income (298)
Actual Net Operating Results (262)
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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Statement of Trustees' Responsibilities

and dissemination of financial statements may differ from legislation in other jurisdictions.

The Trustees (who are also directors of St John of Jerusalem Eye Hospital Group for the purposes of company law) are responsible for preparing the Trustees’ Annual Report (including the Strategic Report) and the financial statements in accordance with applicable law and regulation.

of Recommended Practice: Accounting and Reporting by Charities (2019);

• make judgments and estimates that are reasonable and prudent; • state whether applicable UK Accounting Standards, comprising FRS 102, have been followed, subject to any material departures disclosed and explained in the financial statements;

In so far as the Trustees are aware at the time of approving the Trustees’ Annual Report: (a) there is no relevant audit information of which the charitable company’s auditors are unaware; and

(b) the Trustees have taken all the steps that they ought to have taken as a trustee to make themselves aware of any relevant audit information and to establish that the charitable company's auditors are aware of that information.

Company law requires the explained in the financial Trustees to prepare financial statements; statements for each financial • prepare the financial year. Under that law the statements on the going Trustees have prepared concern basis unless it is the financial statements inappropriate to presume that in accordance with United the charitable company will Kingdom Accounting continue in business. Standards, comprising FRS The Trustees are responsible 102 “The Financial Reporting for keeping adequate Standard applicable in the UK accounting records that are and Republic of Ireland”, and sufficient to show and explain applicable law (United Kingdom the charitable company’s Generally Accepted Accounting transactions and disclose with Practice). Under company law reasonable accuracy at any the Trustees must not approve time the financial position of the financial statements unless the charitable company and they are satisfied that they the group and enable them give a true and fair view of to ensure that the financial the state of the affairs of the statements comply with the charitable company and the Companies Act 2006. group and of the incoming resources and application They are also responsible of resources, including the for safeguarding the assets income and expenditure, of the of the charitable company charitable group for that period. and the group and hence for In preparing these financial taking reasonable steps for the statements, the Trustees are prevention and detection of required to: fraud and other irregularities. The Trustees are responsible • select suitable accounting for the maintenance and policies and then apply them integrity of the charitable consistently; company’s website. Legislation • observe the methods and in the United Kingdom principles in the Statement governing the preparation

• prepare the financial to have taken as a trustee to statements on the going make themselves aware of any concern basis unless it is relevant audit information and inappropriate to presume that to establish that the charitable the charitable company will company's auditors are aware continue in business. of that information. The Trustees are responsible for keeping adequate The Trustees' Report on pages accounting records that are 2 to 39 was approved by the sufficient to show and explain Trustees and signed on their the charitable company’s behalf by transactions and disclose with reasonable accuracy at any time the financial position of the charitable company and the group and enable them to ensure that the financial Sir Andrew Cash, Chairman, statements comply with the St John of Jerusalem Eye Companies Act 2006. Hospital Group Charity no. 1139527 They are also responsible Company no. 7355619

The Trustees' Report on pages 2 to 39 was approved by the Trustees and signed on their behalf by

21 December 2021

Fundraising Statement

formally contracted them to fundraise on our behalf.

not use professional fundraisers or commercial participators in any of our activities and we are registered with the Fundraising Regulator.

SJEHG as a charity with income over £1m is required to make a statement regarding its fundraising activities in accordance with the Charities Act 2016.

Our small team of in-house registered with the Fundraising fundraising staff are fully Regulator. trained on fundraising regulations and have been No complaints were received made aware of relevant policy by SJEHG in relation to its procedures. We ensure that fundraising during the relevant we protect vulnerable persons period and, after due enquiry, from unreasonable intrusion we are not aware of any into their privacy, persistent breaches of the regulations approaches or undue pressure of the Fundraising Regulator to give by using a personal committed by SJEHG approach to fundraising. We do

Fundraising activities are carried out on behalf of SJEHG by our own in-house fundraising staff and by volunteer fundraisers. We do not consider volunteer fundraisers to be acting as legal representatives for the charity as we have not

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Stakeholder Engagement

For the 2020 financial year we are required to report on how the Board of Trustees has complied with its duty under section 172 of the UK Companies Act 2006. Section 172 requires the Trustees to have regard to the long term consequences of its decisionmaking, to the interests of key stakeholders and to the importance of maintaining high standards of conduct.

for the Trustees’ decisions. Furthermore, Trustees ensure that management operates the Hospital in a responsible manner that reflects the values of the Order of St. John.

Hospital Staff

Within the Hospital Group there are several staff committees that form the main platforms for decision making. Each of these committees has at least one Senior Management Team (SMT) representative who is in direct communication with the concerned Trustees. The Board of Trustees has 13 different specialised committees that meet regularly where SMT members are in attendance. All relevant decisions are brought to these meetings and Trustees with the staff representatives making decisions as appropriate. The Board also meets three times annually, present at Board meetings are SMT members representing the various categories of staff. Staff surveys are conducted biannually to explore staff levels of satisfaction as well as engagement in the decision-making process at the Hospital. These findings are presented at the various Board Committees for further analysis and conclusions. A good example of the Trustees’ full engagement with staff was the development of the Strategic Plan 20202022. Several workshops were held at the Hospital operational level to conduct a SWOT analysis and proposed strategic aims and objectives for the next three

In our statement of Strategic Vision on page 30 we have set out the values and strategic aims which inform the Board's decision making, reflecting the Board's commitment to the long term sustainability of the Group and to the maintenance of high standards not only in the provision of ophthalmic care and in research, but also in governance and in the way we care for our staff. Below we report on how the Trustees engage with four key groups of stakeholders. These are:

1. Staff

2. Patients

1. The Patients’ Communities 4. Donors including major donors and Priories.

The following sections outline a well-established strategy that ensures decisions made by the Board of Trustees are always well informed by our stakeholders. Communications and feedback from our stakeholders are featured in Board meetings and form a fundamental basis

years. These strategic aims were presented to the Board of Trustees who, with the SMT, conducted extensive debate and agreed a set of five strategic objectives that will shape the Hospital activities for the next three years (see page 30).

Patients

As part of our commitment to JCI accreditation, inspectors look to see that patients are engaged with on a regular basis and their suggestions for service improvements are taken on board. Patients’ views are fully appraised through a biannual survey that is conducted across the Group by our quality of care teams. Patients are asked to comment on the service that they receive as well as make recommendations for improvements and their perceived needs for additional services as appropriate. The results of these surveys are discussed at the Board of Trustees’ meetings and discussions concerning patients' expressed needs are taken by the Trustees and the SMT. Trustees also engaged in patients’ complaints where these are analysed and presented to the various concerned committees including the Clinical Governance Committee

Patients’ Communities

The Chairman and local Trustees of the Board meet with representatives from the Palestinian Ministry of Health at the ministerial level and

with the Head of UNRWA in Gaza to discuss needs of their patients and strategies that the Hospital might be able to employ to respond to such needs. The SMT is in constant dialogue and communication with representatives from the Israeli Patients’ Fund to discuss services provided by the Hospital to their patients.

These decisions are brought to the various Trustees committees for discussion. The Board of Trustees are fully aware of the considerations and decisions made at the Jerusalem community level. In this regard, we are part of the East Jerusalem Hospitals Network that meets regularly to discuss ways of enhancing the quality of care provided to patients in East Jerusalem.

Major Donors and Priories

Trustees’ have an involvement in the decision making and high-level monitoring of fundraising, project development, and marketing. They are all well informed through quarterly meetings focused on development in the aforementioned areas. The Board usually give input to any donorrequired pre-award surveys or due diligence processes that examine the capabilities, performance, and policies of the Hospital Group.

specific requirements. Our Development Team in Jerusalem is in regular contact with our institutional donors and have a stringent reporting policy for each project managed.

The fundraising Guild made up of supporters who work voluntarily to fundraise for Priories the Hospital is a vital channel through which we communicate As a foundation member of and receive feedback on our the Order of St John and work. The organisation is benefactor from most Priories considered a sub-committee of we have a distinct obligation the Fundraising Committee and to receive input and work in the Chairperson participates collaboration with the wider in committee meetings which St John family. We cater our allows us to share information reporting and engagement to across Trustees, staff and each Priory's preferences, For volunteers, which feeds into our example, St John Scotland has decision-making. Finally our sponsored both staff and the wider public donors are regularly Mobile Outreach Programme, engaged with via our bi-annual prior to which we provided Jerusalem Scene, our Annual a detailed report on current Report and our social media and future operations and the channels. Any donor is welcome budget. The Priory in the USA and encouraged to contact our sponsors staff through their Fundraising Team to discuss our Nurse Initiative and receive work. video messages from each staff member they support in thanks alongside a more detailed report. Covid-19 Various staff members also The Board of Trustees were sit on the working groups of fully involved and in agreement the Johanniter International, a with plans submitted by collaborative organisation aimed management in response to to enable European-based St Covid-19 Global Crisis. These John organisations to develop involved staff and patient safety best practice approaches to protocols that were discussed healthcare, fundraising and and approved by the clinical marketing together. Members of Trustees. Other financial and these teams meet quarterly. efficiency plans were also

The Board of Trustees were fully involved and in agreement with plans submitted by management in response to Covid-19 Global Crisis. These involved staff and patient safety protocols that were discussed and approved by the clinical Trustees. Other financial and efficiency plans were also discussed and approved by the Board of Trustees. Other stakeholders involvement included our liaison with the Israeli and Palestinian Ministries of Health in the form of Covid-19 infection prevention protocols that were updated regularly. Vaccinations of all Jerusalem staff were achieved through our partnership with the Israeli Ministry of Health in January 2021.

Other Major Donors and Stakeholders We value the feedback from our stakeholders on what they consider is the most effective use of funds and why, and we report back demonstrating the impact of this investment. Our Trusts and Foundations programme has a reporting schedule for every grant given, dependent on each stakeholders’

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

Independent Auditors' Report to the Members of St John of Jerusalem Eye Hospital Group Report on the audit of the financial statements

Opinion

group and parent charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, which includes the FRC’s Ethical Standard and we have fulfilled our other ethical responsibilities in accordance with these requirements.

In our opinion, St. John of Jerusalem Eye Hospital Group’s group financial statements and parent charitable company financial statements (the “financial statements”):

• give a true and fair view of the state of the group’s and of the parent charitable company’s affairs as at 31 December 2020 and of the group’s incoming resources and application of resources, including its income and expenditure, and of the group’s cash flows, for the year then ended; • have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards, comprising FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland”, and applicable law); and • have been prepared in accordance with the requirements of the Companies Act 2006.

Conclusions Relating To Going Concern

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 group’s and the parent charitable company’s ability to continue as a going concern for a period of at least twelve months from the date on which the financial statements are authorised for issue.

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.

We have audited the financial statements, included within the Annual Report (the “Annual Report”), which comprise: the group and charity balance sheets as at 31 December 2020; the consolidated statement of financial activities, the group income and expenditure account, and the consolidated cash flow statement for the year then ended; and the notes to the financial statements, which include a description of the significant accounting policies.

However, because not all future events or conditions can be predicted, this conclusion is not a guarantee as to the group’s and parent charitable company’s ability to continue as a going concern.

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

Basis For Opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (“ISAs (UK)”) and applicable law. Our responsibilities under ISAs (UK) are further described in the Auditors’ responsibilities for the audit of the financial statements section of our report. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Reporting On Other Information

The other information comprises all of the information in the Annual Report other than the financial statements and our auditors’ report thereon. The trustees are responsible for the other information. Our opinion on the financial statements does not cover the other information and, accordingly, we do not express an

Independence We remained independent of the

audit opinion or, except to the extent otherwise explicitly stated in this report, any form of assurance thereon.

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit, or otherwise appears to be materially misstated. If we identify an apparent material inconsistency or material misstatement, we are required to perform procedures to conclude whether there is a material misstatement of the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report based on these responsibilities.

Based on our work undertaken in the course of the audit, the Companies Act 2006 requires us also to report certain opinions and matters as described below.

Strategic Report and Trustees’ Report

In our opinion, based on the work undertaken in the course of the audit the information given in the Trustees’ Report, including the Strategic Report, for the financial year for which the financial statements are prepared is consistent with the financial statements; and the Strategic Report and the Trustees’ Report have been prepared in accordance with applicable legal requirements.

In addition, in light of the knowledge and understanding of the group and parent charitable company and their environment obtained in the course of the audit, we are required to report if we have identified any material misstatements in the Strategic Report and the Trustees’ Report. We have nothing to report in this respect.

Responsibilities for the Financial Statements and the Audit Responsibilities of the trustees for the financial statements

As explained more fully in the Statement group and parent charitable company A further description of our of Trustees’ Responsibilities, the trustees and the environment in which they responsibilities for the audit of the (who are also the directors of the operate, we identified that the principal charitable company for the purposes of risks of non-compliance with laws and FRC’s website at: www.frc.org.uk/ company law) are responsible for the regulations related to the Companies preparation of the financial statements Act 2006 and the Charities Act 2011 forms part of our auditors’ report in accordance with the applicable and relevant regulations made or framework and for being satisfied having an effect thereunder, including Use of this report that they give a true and fair view. The The Charities (Accounts and Reports) This report, including the opinions, trustees are also responsible for such Regulations 2008, and we considered has been prepared for and only for internal control as they determine is the extent to which non-compliance the charity’s members as a body in necessary to enable the preparation of might have a material effect on the financial statements that are free from financial statements. We also considered material misstatement, whether due to the direct impact of these laws and fraud or error. regulations on the financial statements. We evaluated the incentives and In preparing the financial statements, opportunities for fraudulent manipulation the trustees are responsible for of the financial statements (including assessing the group’s and parent the risk of override of controls) by the charitable company’s ability to continue trustees and those responsible for, consent in writing. as a going concern, disclosing, as or involved in, the preparation of the applicable, matters related to going underlying accounting records and concern and using the going concern financial statements and determined that basis of accounting unless the trustees the principal risks were related to the either intend to liquidate the group posting of inappropriate journal entries and parent charitable company or to to conceal misappropriation of assets. Companies Act 2006 cease operations, or have no realistic Audit procedures performed included:

A further description of our responsibilities for the audit of the financial statements is located on the FRC’s website at: www.frc.org.uk/ auditorsresponsibilities. This description forms part of our auditors’ report

This report, including the opinions, has been prepared for and only for the charity’s members as a body in accordance with Chapter 3 of Part 16 of the Companies Act 2006 and for no other purpose. We do not, in giving these opinions, accept or assume responsibility for any other purpose or to any other person to whom this report is shown or into whose hands it may come save where expressly agreed by our prior consent in writing.

In preparing the financial statements, the trustees are responsible for assessing the group’s and parent 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 group and parent charitable company or to cease operations, or have no realistic alternative but to do so.

Other required reporting

Companies Act 2006 Exception Reporting Under the Companies Act 2006 we are required to report to you if, in our opinion:

• Testing journals entries where we identified particular fraud risk criteria. • Obtaining independent confirmations of material investment valuations and cash balances at the year end.

Auditors’ responsibilities for the audit of the financial statements

• we have not obtained all the information and explanations we require for our audit; or

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 auditors’ 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.

• Testing estimates and judgements made in the preparation of the financial statements for indicators of bias.

• adequate accounting records have not been kept by the parent charitable company or returns adequate for our audit have not been received from branches not visited by us; or

• Reviewing meeting minutes, contracts and agreements.

• Holding discussions with the trustees and management to identify significant or unusual transactions and known or suspected instances of fraud or noncompliance with laws and regulations. • Assessing financial statement disclosures, and agreeing these to supporting evidence, for compliance with applicable laws and regulations.

• certain disclosures of trustees’ remuneration specified by law are not made; or

• the parent charitable company financial statements are not in agreement with the accounting records and returns.

There are inherent limitations in the audit

We have no exceptions to report arising from this responsibility.

procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in financial statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations or through collusion.

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

Andrew Lowe (Senior Statutory Auditor) For and on behalf of PricewaterhouseCoopers LLP Chartered Accountants and Statutory Auditors. London. 21 December 2021

Based on our understanding of the

40

41

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Consolidated Statement of Financial Activities for the year ended 31 December 2020

		Unrestricted	Restricted	Endowment	Total	Total
		Funds	Funds	Funds	Funds	Funds
		2020	2020	2020	2020	2019
	Notes	£000	£000	£000	£000	£000
Income and Endowments
Income from donations and legacies	3	2,680	3,466	-	6,146	5,693
Income from charitable activities	4	4,378	-	-	4,378	6,296
Income from investments	8e	58	122	-	180	225
Other Income		4	-	-	4	-
Total Income and Endowments		7,120	3,588	-	10,708	12,214
Resources Expended
Expenditure on generating funds		(586)	-	-	(586)	(728)
Expenditure on charitable activities		(6,245)	(3,478)	-	(9,723)	(11,259)
Other expenditure		(167)	-	-	(167)	(185)
Total Resources Expended	5	(6,998)	(3,478)	-	(10,476)	(12,172)
Net (losses) / gains on investments	8	(59)	-	(156)	(215)	811
Net Income		63	110	(156)	17	853
Transfers between funds	12,13	242	(242)	-	-	-
Exchange gains on overseas activities		224	-	-	224	324
Net Movement in Funds		529	(132)	(156)	241	1,177
Fund balances brought forward at 1 January		10,961	597	7,203	18,761	17,584
Fund balances carried forward at 31 December	15	11,490	465	7,047	19,002	18,761

All gains and losses recognised in the year are included in the statement of financial activities. All of the above results are derived from continuing activities.

Group Income and Expenditure Account for the year ended 31 December 2020

Group Income and Expenditure Account for the year ended 31 December 2020
	2020 2019 £000 £000
Income Expenditure	10,708 12,214 (10,476) (12,172)
Net Income	232 42

The income and expenditure account excludes the unrealised investment and exchange gains and losses shown in the Statement of Financial Activities. The accounting policies and the notes on pages 44 to 57 form part of these financial statements.

St John of Jerusalem Eye Hospital Group Financial Statements

Balance Sheets as at 31 December 2020

lance Sheets at 31 December 2020
		Group	Group	Charity	Charity
		2020	2019	2020	2019
	Notes	£000	£000	£000	£000
Fixed Assets
Tangible assets	7	5,640	6,121	7	13
Investments	8	12,661	12,662	10,434	10,715
Total Fixed Assets		18,301	18,783	10,441	10,728
Current Assets
Stocks	9	469	424	-	-
Debtors	10	2,281	2,878	132	110
Cash at bank and in hand		6,338	4,413	3,923	2,205
Total Current Assets		9,088	7,715	4,055	2,315
Creditors: Amounts falling due within
one year	11	(2,471)	(2,258)	(95)	(57)
Net Current Assets		6,617	5,457	3,960	2,258
Total Assets Less Current Liabilities		24,918	24,240	14,401	12,986
Creditors: Amounts falling due after
more than one year	11	(5,916)	(5,479)	-	-
Net Assets		19,002	18,761	14,401	12,986
The Funds of the Group and Charity
Restricted income funds	13	465	597	364	387
Endowment funds	14	7,047	7,203	7,047	7,203
Unrestricted income funds	12
Designated funds		5,640	6,121	7	13
Revaluation funds		375	467	375	467
Other general funds		5,475	4,373	6,608	4,916
Unrestricted income funds		11,490	10,961	6,990	5,396
Total Group and Charity Funds	15	19,002	18,761	14,401	12,986

The Charity's net income was £1,415,000 (2019, £1,652,000). The accounting policies and the notes on pages 42 to 57 form part of these financial statements. The financial statements on pages 42 to 57 were approved by the Trustees and signed on their behalf by:

Sir Andrew Cash Chairman, Board of Trustees 21 December 2021

Nicholas Goulding Treasurer

Company number: 7355619

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43

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Consolidated Cash Flow Statement

for the year ended 31 December 2020

		2020	2019
	Notes	£000	£000
Net cash inflow from operating activities	16	2,404	1,779
Cash flows from investing activities
Investment income	8e	180	225
Purchase of tangible fixed assets	7	(462)	(727)
Proceeds from disposal of tangible fixed assets		22	15
Purchase of fixed asset investments	8	(460)	(558)
Proceeds from sale of fixed asset investments	8	246	257
Net cash outflow from investing activities		(474)	(788)
Foreign exchange differences		(5)	(2)
Change in cash and cash equivalents in the financialyear		1,925	989
Cash at bank and in hand at 1 January		4,413	3,424
Increase in cash in the year		1,925	989
Cash at bank and in hand at 31 December		6,338	4,413

The accounting policies and the notes on pages 44 to 57 form part of these financial statements.

Notes to the Financial Statements

for the year ended 31 December 2020

1 Principal accounting policies

on consolidation to apply the Group’s accounting policies when preparing the consolidated financial statements. Transactions and balances between the Charity and its subsidiary undertakings have been eliminated from the consolidated financial statements. Balances between the companies are disclosed in the notes of the Charity's balance sheet. A separate statement of financial activities, and income and expenditure account, for the Charity is not presented because the Charity has taken advantage of the exemption afforded by section 408 of the Companies Act 2006 and Charities SORP FRS 102.

Basis of preparation

a

The Group constitutes a public benefit group as defined by FRS102. The financial statements have been prepared on the going concern basis, under the historical cost convention, except for investments which are stated at market value, with items recognised at cost or transaction value unless otherwise stated in the relevant note(s) to these financial statements. The financial statements have been prepared in accordance with the Statement of Recommended Practice: Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102) and the Companies Act 2006.

Going Concern

BACKGROUND

In assessing the going concern position of the Charity and the Group, the Board of Trustees have considered the Group’s projected activities, financial budgets, cash flows and liquidity for a period to December 2022, which is a period of at least 12 months from the date of approval of the financial statements.

These financial statements consolidate, on a line by line basis, the results and financial position of St John of Jerusalem Eye Hospital Group (the “Charity”) together with its wholly owned and controlled charitable subsidiary undertakings, St John of Jerusalem Eye Hospital and St John Eye Hospital in Jerusalem (RA) (together the “Group”). Where a subsidiary has different accounting policies to the Group, adjustments are made

Based on the Group’s cash flow projections, the Board of Trustees have adopted the going concern basis of accounting in preparing these financial statements.

IMPACT OF COVID-19

The first case of Covid-19 was confirmed in Israel on 22nd February 2020 and the first case was confirmed in the occupied Palestinian territories on 6th March 2020. The Palestinian Authority (PA) declared a state of emergency and imposed a lockdown on all Palestinians, including severe movement restrictions. Beginning the 11th March 2020, Israel began lockdown measures, including enforcing social distancing and other rules to limit the spread of infection.

The country was hit with a second Covid-19 wave in September 2020 and, as a result, the Israeli Authorities imposed a lockdown on the 18th September 2020 for 4 weeks. As for the PA, no lockdown was imposed, except for specific areas with a high incidence of Covid-19. The authorities keep all of these measures and restrictions under regular review.

On 18th December 2020, The Palestinian Authority announced a new set of strict nationwide measures aimed at slowing down the rapid spread of the Covid-19 pandemic across Palestine. This was followed by similar measures by the Israeli authorities.

The lockdown continued until 31st January 2021 after which both authorities started easing the restrictions on movements and allowed some businesses to reopen gradually. By May 2021, most of the restrictions were cancelled by the local authorities. From the beginning of August 2021, the country witnessed an increase in infected cases to reach a daily average of 3,500 cases. In early December 2021, the first confirmed cases of the Omicron variant were detected in Israel. The authorities are expected to restrict gatherings during the holidays in an effort to contain the renewed Covid-19 outbreak. Non-Israeli citizens are not allowed to enter Israel, unless they have a special entry permit from the Exceptions Committee.

The emergence of Covid-19 and reactions to it have had, and continue to have, a profound effect on domestic and global economies, organisations and society at large. As a result of all the restrictions imposed by the authorities in 2020, the Group experienced a reduction in clinical activities which resulted in a significant decline in patient related income. However, the Group was back to normal working levels and patients’ activities since the beginning of 2021. However, the PA has been facing major financial difficulties that have resulted in the inability of their ministry of health to make sufficient, regular and timely payments to the Group during 2020 and 2021. It is pleasing to note, the Group has not experienced a severe decline in voluntary income receipts and income has been within the normal average rates.

TRUSTEES’ ACTIONS

To seek to minimise the financial impact of the pandemic, the Group carried out the following actions during 2020 & 2021:

• Over 40 staff members took one month of unpaid leave during April 2020

• All staff took one month of unpaid leave (between May and August 2020)

• A reduction in variable operational costs of circa 70% was targeted

• Additional reduction in payroll costs due to postponement of recruitment (2020 & 2021)

• Reduction in non-critical operational spending and deferral of capital expenditure (2020 & 2021)

• Deferral of promotions and study/professional leave (2020 & 2021)

• An emergency appeal was launched in 2020

• All Priories of the Order of St John were requested and lobbied to increase their financial support.

As for additional and new sources of finance, the hospital received

US$150k from the Israeli Government as a grant for returning employees to work. Additionally, the hospital received US$75k from the Jerusalem Fund. Moreover, the Priories of St John have reassured the Trustees of their commitment to continue supporting the Group.

BUSINESS PLAN

In order to assess, the use of the going concern assumption, Management and the Trustee Board have produced a detailed, yet adaptable, business plan that considers projected activity, the related financial budgets, cash flows and liquidity of the Group covering the period to December 2022.

KEY ASSUMPTIONS

The business and financial plans incorporate the following key assumptions:

• National and local Government decisions, rules and advice, along with travel and border restrictions and social distancing, will be relaxed sufficiently to permit the hospitals to provide a full range of

• services so as to serve patients in the most efficient and safe manner

• There are no further impositions of closures or lockdowns, or the impact of any matter noted above, that would affect the Group’s operations

• Demand for services from patients return to a normal level

• The capacity and supply of patient services by the Group is not impacted by Covid-related matters

• Payment by the PA (directly, or indirectly via its own funding sources) of sufficient payments to the Group for patient services provided

• The achievement of a reduction in cash outflows through the restructuring of the organisation and measures planned to reduce costs during periods when activities may be limited

• The Group is able to obtain on-going voluntary and fundraising unrestricted income, in particular from the St John Priories, albeit at levels reduced from prior periods.

SENSITIVITY ANALYSIS

Management and the Trustee Board have considered the impact on projected activities, budgets, and cash flows of several challenging, yet reasonably plausible, downside scenarios such that the key assumptions are not met, or able to be met, in whole or in part. These include, for example, restrictions in supply of, or demand for, patient services; and reductions in income through voluntary income and fundraising targets not being achieved, beyond those considered in the current plans.

The Board of Trustees has also sought to identify certain mitigating actions that could be implemented in order to provide additional liquidity or reduce cash outflows so as to ensure that the Group can maintain sufficient liquidity over the period to December 2022. The success of such measures, whilst being identified and achievable based on current advice, may not necessarily provide liquidity to the degree required or within the required timescales. As such, the Board of Trustees fully acknowledge that there is a level of uncertainty, which is likely to persist for some time, given the key assumptions and the financial modelling referred to above.

CONCLUSIONS

Having assessed the combination of all these various options, the Board of Trustees has a reasonable current expectation that the Charity and the Group has adequate resources to continue in operational existence for the foreseeable future, being a period of at least 12 months from the date of approval of the financial statements. For these reasons, the Board of Trustees has adopted the going concern basis of accounting in the preparation of these financial statements. Accordingly, these financial statements do not include any adjustments to the carrying amount or classification of assets and liabilities that would result if the Charity and the Group were unable to continue as a going concern.

44

45

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements

for the year ended 31 December 2020

Principal accounting policies (continued)

j Pension and other end of service costs

b Foreign currencies

The Charity's functional and presentational currency is pounds sterling. Transactions in foreign currencies are recorded at the exchange rate ruling at the date of the transaction. Monetary assets and liabilities at the year end are translated at the rate ruling at the balance sheet date. Results of overseas operations are translated at the average rate for the period and their assets and liabilities at the balance sheet rate. All exchange differences are dealt with in the Statement of Financial Activities. Exchange differences on the translation of the assets and liabilities of overseas operations are included as Other recognised gains/(losses). All other exchange differences are included as incoming resources or resources expended as appropriate. The exchange rate of the Pounds Sterling to the Israeli Shekel at 2020 year-end was 4.3919 (2019, 4.5597), while the average rate for 2020 was 4.4131 (2019, 4.5535).

The amount charged in the Statement of Financial Activities in respect of pension costs is the contributions payable in the year on an accruals basis. Other end of service benefits are accrued as earned on an undiscounted basis.

k Rentals

The costs in respect of rentals are charged to the Statement of Financial Activities on a straight line basis over the contract period. The rental cost for the office in London occupied rent free has been computed based on an estimate of arm's length value. No charge is imputed in respect of the Hospital premises, which the Group occupied rent free until 2015, after which it has paid a nominal rent.

I Taxation

The Charity and each group entity is entitled to certain tax exemptions on income and gains from investments, and surpluses on any activities carried on in furtherance of their primary charitable objectives.

c Income recognition

Donations and other income are recognised in the financial statements on a receivable basis. Grants are recognised when the entitlement to the grant is confirmed. Legacies are recognised when the entitlement arises, being the earlier of the Group being notified of the impending distribution or the legacy being received. Donations in kind are recorded as income when the resources are received and recorded at fair value. Income from charitable activities is accounted for when earned (i.e. the service is provided to patients). Subsidies and exemptions in respect of medical services provided without charge are shown as a deduction from gross income.

m Tangible Assets and Depreciation

Cost of tangible assets includes the original purchase price of the asset and the costs attributable to bringing the asset to its working condition for its intended use.

Donated fixed assets are brought into account at an estimate of their market value at the time of acquisition and, thereafter, depreciated on the bases set out below. The costs of minor additions to fixed assets under £500 are expensed in the year in which they are incurred. Impairment reviews are only carried out if there is an indication that the recoverable amount of an asset is below its net book value.

d Medical volunteers

The value of services rendered by medical volunteers is not recognised in these financial statements. However, where doctors, nurses or other members of staff are employed by the Group but paid by third parties, the estimated market value of their services is recorded within both income (donations) and expenditure (salaries).

Depreciation on fixed assets is provided at rates estimated to write off the cost, less estimated residual value, of each asset over its expected useful life on a straight line basis, as follows:

e Resources expended and basis of allocation of costs

----- Start of picture text -----
||| |---|---| |Buildings|- 2.5% per annum| |Building improvements|- 10% per annum| |Medical equipment|- 15% per annum| |Motor vehicles|- 20% per annum| |Other equipment Fixtures|- 20% per annum| |and fittings Computer|- 6% per annum| |equipment UK office|- 33% per annum| |fixed assets|- 25% per annum|

----- End of picture text -----

Resources expended are accounted for on an accruals basis and have been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with use of resources. The irrecoverable value added tax is included with the item of expense to which it relates.

f Costs of generating funds

The holding values and estimated useful lives of assets are regularly reviewed for impairment and, where deemed appropriate, are written down.

These include the salaries and direct expenditure costs of the staff who primarily promote fundraising.

g Expenditure on charitable activities

On disposal of an item of tangible assets, the difference betweenthe disposal proceeds and its carrying amount is recognised in profit or loss within ‘Other hospital income’ in note 4.

These represent the costs of providing the medical and training services of the hospital and its clinics including both direct expenditure and the associated support costs.

h Governance costs

n Investments

These comprise costs attributable to the overall management of the Group's affairs and compliance with constitutional and statutory requirements.

Listed investments are stated at market value. Realised gains and losses on investments are calculated as the difference between the sales proceeds and their market value at the start of the period, or subsequent cost. Unrealised gains and losses represent the difference between market values at the beginning and at the end of the period. Income from fixed assets investments is recorded on an accruals basis. Market value for unlisted investments is calculated by the fund managers using underlying financial information.

i Cash flow statement exemption

The Charity has taken advantage of the exemption in FRS 102 from preparing a statement of cash flows, on the basis that it is a qualifying entity and the Group statement of cash flows included in these financial statements includes the cash flows of the Charity.

may mean that actual results ultimately differ from those estimates, and these differences may be material.The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the change takes place if the revision affects only that period, or in the period of the revision and future periods if the revision affects both current and future periods.

o Liquid resources

Liquid resources are cash, time deposits, and certificates of deposit, in addition to cash at bank and in hand held in current accounts with UK, Israeli and Palestinian Banks.

p Stocks

Valuation of stocks is determined using the "first in-first out" method and stocks are stated at the lower of cost and net realisable value.

Exchange rates are fundamental to the uncertainties. Mainly the impact of subsequent adverse movements between the exchange rates of the reporting and the operative currencies which would potentially affect, to some extent, the operating capability notwithstanding the enhanced but unrealisable balance sheet value of non UK assets.

q Funds

Unrestricted funds are funds which are generally available for the Group to carry out its charitable objectives; these include designated funds, which are amounts that have been set aside to finance fixed assets. General reserves are unrestricted funds available to be used at the discretion of the Board of Trustees for the furtherance of the charitable objectives of the Group and which have not been designated for any other purpose.

The Group provides against receivables (mainly the Palestinian Authority Debt) by making judgements based on experience regarding the level of provision required to account for potentially uncollectible receivables.

2 Legal status

Restricted funds are funds which are subject to specific conditions imposed by the donors.

The Charity was incorporated in England as a company limited by guarantee in August 2010 under registration number 7355619. It is registered as a charity under number 1139527. The registered office is at 4 Charterhouse Mews, London EC1M 6BB. It has no share capital and the liability of each member in the event of winding up is limited to £10.

Endowment funds are capital funds where the capital cannot be spent in the normal course of activities, although the income is added to restricted or unrestricted funds depending on the terms of the original endowment.

3 Income from donations and legacies

----- Start of picture text -----
|||||||| |---|---|---|---|---|---|---| |Unrestricted|Restricted|2020 Total|Unrestricted|Restricted|2019 Total| |£000|£000|£000|£000|£000|£000| |Donations|2,299|3,446|5,745|2,062|3,336|5,398| |Legacies|199|20|219|168|3|171| |Donations in kind|182|-|182|124|-|124| |2,680|3,466|6,146|2,354|3,339|5,693|

----- End of picture text -----

Transfers between funds represent tangible assets purchased with restricted donations and used for hospital operations.

r Estimates and assumptions

The preparation of financial statements in conformity with generally accepted accounting principles requires the use of estimates and assumptions that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of income and expenditure during the reporting period. Although these amounts are based on trustees' best estimates of the amount, events or actions

Donations in kind include the estimated market value of medical services donated by visiting doctors to the Jerusalem Hospital £nil (2019: £3,000), and the value of donated tangible assets and medical supplies £125,000 (2019: £73,000). Income from related parties is set out in note 19.

4 Income from charitable activities

----- Start of picture text -----
|||| |---|---|---| |2020|2019| |£000|£000| |Outpatient income|1,977|2,744| |Surgical income|3,380|3,706| |Less: Patient Relief|(1,388)|(549)| |Net patient related income|3,969|5,901| |Other hospital income|64|66| |Rental income, board and lodging|345|329| |Total other income|409|395| |Total income from charitable activities|4,378|6,296|

----- End of picture text -----

Patient Relief principally represents subsidies and exemptions to cover the value of medical services rendered when payment is waived by the Group where funding is not available from the relevant authorities and where the patients are unable to pay any balance owing. All of the above income comprises unrestricted funds.

5 Total resources expended

----- Start of picture text -----
|||||||||| |---|---|---|---|---|---|---|---|---| |Costs of|Costs of| |Generating|Generating|Charitable|Charitable|Governance|Governance| |Funds|Funds|Actvities|Actvities|Costs|Costs|Total|Total| |2020|2019|2020|2019|2020|2019|2020|2019| |£000|£000|£000|£000|£000|£000|£000|£000| |Personnel costs (note 6)|315|336|5,577|6,370|29|51|5,921|6,757| |Recruitment costs|2|10|-|-|-|53|2|63| |Medical costs|-|-|1,988|2,426|-|-|1,988|2,426| |Establishment costs|82|73|574|657|17|16|673|746| |Depreciation (note 7)|6|4|1,149|1,260|-|-|1,155|1,264| |Office expenses|26|36|173|177|3|4|202|217| |Travel and subsistence|4|55|49|108|-|-|53|163| |Marketing and publicity|115|158|-|-|-|-|115|158| |Auditors' remuneration|7|22|-|-|103|54|110|76| |Other professional fees|25|34|20|28|-|11|45|73| |Legal fees|4|-|21|18|26|12|51|30| |Finance costs|-|-|172|215|(11)|(16)|161|199| |586|728|9,723|11,259|167|185|10,476|12,172| |Support costs included above|-|-|1,253|1,439|12|63|1,265|1,502|

----- End of picture text -----

46 St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

47

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements

for the year ended 31 December 2020

Total resources expended in 2019 of £12,172,000 comprise £8,452,000 for unrestricted funds and £3,720,000 for restricted funds .

		2020 2019 £000 £000
Support costs comprise:
Personnel costs		449 472 - 53 299 340 116 127 175 180 49 108 20 28 157 194
Recruitment costs
Establishment costs
Depreciation Office expenses Travel and subsistence Other professional fees Finance costs
		1,265 1,502
Auditors' remuneration(excludingVAT): 2020 2019 £ £
External audit Other servicesprovided byexternal auditors 78,718 43,758 8,359 19,732
Sub-total Internal audit 87,077 63,490 7,313 7,935
	94,390 71,425

6 Employee information

a Number of employees

The average monthly number of employees, including part time staff calculated on a full-time equivalent basis, analysed by function during the year was:

	2020	2019
	Number	Number
Medical and nursing	168	176
Support services	47	46
Fundraising	10	10
Administration	32	36
	257	268

b Staff costs

Staff costs
	2020	2019
	£000	£000
Wages and salaries	5,248	5,999
Social security costs	402	463
Other pension costs	276	287
Other related costs	(5)	8
	5,921	6,757

c Emoluments of employees

The number of employees whose emoluments (salaries and benefits in kind) fell within the following bands were:

	2020	2019
	Number	Number
£200,001 - £210,000	-	1
£130,001 - £140,000	1	-
£110,001 - £120,000	2	-
£90,001 - £100,000	-	1
£80,001 - £90,000	1	1
£70,001 - £80,000	-	4
£60,001 - £70,000	5	1

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

d Remuneration received by key management personnel

The total remuneration received by the 10 (2019, 9) senior management personnel in managing the operations of the Group amounted to £719,000 (2019, £684,000).

e Pension costs

Pension costs comprise the contributions payable to authorised Israeli money purchase pension schemes in respect of non UK employees and a UK defined contribution retirement benefit scheme in respect of UK based employees.

End of service accrued retirement benefits for non UK employees included in wages and salaries costs are included in the Balance Sheet in Creditors: Amounts falling due within and after more than one year (note 11c).

7 Tangible assets

Tangible assets
a Group
	Buildings &	Medical	Motor	Other
	Improvements	Equipment	Vehicles	Assets	Total
Cost	£000	£000	£000	£000	£000
1 January 2020	7,110	9,127	318	2,962	19,517
Additions	176	186	36	64	462
Exchange differences	272	351	12	111	746
Disposals	-	-	(75)	-	(75)
31 December 2020	7,558	9,664	291	3,137	20,650
Accumulated Depreciation
1 January 2020	3,978	6,839	212	2,367	13,396
Charge for the year	321	634	59	141	1,155
Exchange differences	154	265	8	90	517
Disposals	-	-	(58)	-	(58)
31 December 2020	4,453	7,738	221	2,598	15,010
Net Book Value
31 December 2020	3,105	1,926	70	539	5,640
31 December 2019	3,132	2,288	106	595	6,121

Other Assets comprise fixtures and fittings, computer and office equipment.

b Charity

	Other
	Assets	Total
Cost	£000	£000
1 January 2020	68	68
Additions	-	-
31 December 2020	68	68
Accumulated Depreciation
1 January 2020	55	55
Charge for theyear	6	6
31 December 2020	61	61
Net Book Value
31 December 2020	7	7
31 December 2019	13	13

The above amounts include End of Service Benefits allowance, including in 2019 a cumulative catch-up adjustment for one employee. During the year, provident benefits and pension contributions on behalf of these staff amounted to £17,000 (2019, £12,000).

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020 4949

48

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements

for the year ended 31 December 2020

8 Investments

8 Investments

d Bank deposits

**a **	Analysis of movements (Group) Bank Listed Deposits Investments Total £000 £000 £000
	Market value at 1 January 2020 1,609 11,053 12,662 Additions 262 198 460 Withdrawals - (246) (246) Unrealised losses - (215) (215)
	Market value at 31 December 2020 1,871 10,790 12,661
	Historical cost at 31 December 2020 1,871 9,646 11,517

In 2019, unrealised gains of £811,000 comprise £269,000 for unrestricted funds and £542,000 for endowment funds.

	Listed
**b **	Analysis of movements (Charity) Investments Total
	£000 £000
	Market value at 1 January 2020 10,715 10,715 Additions 180 180 Withdrawals (246) (246) Unrealised losses (215) (215)
	Market value at 31 December 2020 10,434 10,434
	Historical cost at 31 December 2020 9,279 9,279

c Listed investments:

Analysis by category of underlying holding and location

2020 Group 2020 Charity 2019 Group £000 £000 £000	2019 Charity £000
Equity investments - UK 1,863 1,863 2,982 - Overseas 4,299 4,299 3,406 Fixed interest securities - UK 674 674 679 Property Unit Trusts - UK 1,311 1,311 1,133 Property Unit Trusts (unlisted) - Europe - - 2 Alternative Investments - UK 319 319 493 Sterling & Cash Instruments - UK 1,968 1,968 2,020 Others - Overseas 356 - 338	2,982 3,406 679 1,133 2 493 2,020 -
Market value of listed investments 10,790 10,434 11,053	10,715

At 31 December 2020, the following pooled funds represented each more than 4% of the total investment portfolio:

Group & Charity	2020 %	2019 %
Fidelity Global Dividend Fund	13.0	11.3
Trojan Income Fund	8.8	9.7
Schroder Income Fund	5.1	9.2
Aberdeen UK All Share Tracker Fund	3.1	9.0
Charities Property Fund	7.8	7..8
Vanguard S&P 500 UCITS ETF	7.0	7.8
Majedie UK Equity Fund	4.8	6.0
Property Income Trust for Charities	4.7	5.0
Schroders QEP Global Active Value Fund	-	4.9
HSBC FTSE All World Index Fund	5.6	4.9
Vontobel Fund	5.0	4.8

Bank deposits classified as investments represent deposit funds managed by investment managers.

e Income from investments

----- Start of picture text -----
2020 2019
£000 £000
Unrestricted funds 58 73
Restricted funds 122 152
180 225
----- End of picture text -----

f Investment in subsidiaries

The Charity is the controlling member of St. John of Jerusalem Eye Hospital (SJEH), a UK registered charitable company limited by guarantee (Company No.3867950 and Charity No. 1080185) and having no share capital. The liability of each member in the event of winding up is limited to £10. SJEH provides ophthalmic services through a branch in the oPt.

The Charity is also the controlling member of St. John Eye Hospital in Jerusalem (RA) (SJEHJ), an Israeli registered charitable society (No. 580040368), limited by guarantee and having no share capital. SJEHJ provides ophthalmic services from the Jerusalem Hospital and the Mobile Outreach Programme.

SJEH owns two £1 shares being all the issued shares in The St. John Eye Hospital (Palestine) Limited, which has not traded since incorporation.

The Charity owns one £1 share being all the issued shares in SJEH Trading Limited (Company No.12375269), which has not traded since incorporation.

The Charity is the controlling member of St John Ophthalmic Association Limited, a UK private company limited by guarantee (Company No.12631428) and having no share capital. The liability of each member in the event of winding up is limited to £1.

Summary financial information for the key subsidiary entities:

Summary financial information for the key subsidiary entities:
	St. John Eye	St. John of
	Hospital in	Jerusalem
	Jerusalem (RA)	Eye Hospital
	2020	2020
	£'000	£'000
Total income and endowments	6,052	3,047
Total resources expended	(7,455)	(2,550)
Net(outgoing)resources before other recognisedgains	(1,403)	497
Other recognised gains	76	147
Net movements in funds	(1,327)	644
Total assets	9,317	4,607
Total liabilities	(6,866)	(1,785)
Total funds	2,451	2,822
Restricted income funds	60	43
Designated funds	2,961	2,673
Other general funds	(570)	106
Total funds	2,451	2,822

9 Stocks

Stocks comprise hospital medical stores and supplies all owned by subsidiaries.

10 Debtors

a Amounts falling due within one year

Debtors Amounts falling due within one	year
		Group	Group	Charity	Charity
		2020	2019	2020	2019
	Note	£000	£000	£000	£000
Trade debtors		2,845	2,618	-	-
Allowance for bad debts	10 b	(1,189)	(420)	-	-
Net trade debtors		1,656	2,198	-	-
Donations receivable		488	557	83	83
Prepayments and accrued income		137	123	49	27
Total debtors		2,281	2,878	132	110

50

51

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

10 Debtors (continued)

12 Unrestricted Income Funds

b Movement in allowance for bad debts

Movement in allowance for bad debts
	Group	Group
	2020	2019
	£000	£000
1 January	420	275
Additions	1,054	505
Write off *	(290)	(369)
Exchange differences	5	9
31 December	1,189	420

• The majority of the write off relates to an agreement with UNRWA whereby the actual contractual payments are lower than the normal invoiced value of services provided to those patients. Additionally, it includes an allowance against the receivables from the Palestinian Authority

11 Creditors

• a Amounts falling due within one year

a	Amounts falling due within one year
			Group	Group	Charity	Charity
			2020	2019	2020	2019
		Note	£000	£000	£000	£000
	Trade creditors		318	388	32	27
	Retirement benefits 11 c		1,404	1,154	-	-
	Taxation and social security		80	94	4	12
	Accruals		569	526	59	18
	Deferred income 11 b		44	35	-	-
	Holiday pay accrual		56	61	-	-
			2,471	2,258	95	57
b	Deferred income

		Group	Group
		2020	2019
		£000	£000
	1 January	35	54
	Deferred income recognised	251	232
	Deferred income released	(244)	(253)
	Exchange differences	2	2
	31 December	44	35
	Deferred Income represents income received in advance from renting out some of the hospital's properties

Deferred Income represents income received in advance from renting out some of the hospital's properties in Jerusalem.

c Amounts falling due after more than one year

Group General reserves Designated funds: Tangible fixed assets Revaluation reserve Total unrestricted funds Charity General reserves Designated funds: Tangible fixed assets Revaluation reserve Total unrestricted funds Group General reserves Designated funds: Tangible fixed assets Revaluation reserve Total unrestricted funds Charity General reserves Designated funds: Tangible fixed assets Revaluation reserve Total unrestricted funds	1 January Incoming Resources Transfers Gains 31 December 2020 Resources Expended & Losses 2020 £000 £000 £000 £000 £000 £000
	4,373 6,975 (5,901) - 28 5,475 6,121 145 (1,097) 242 229 5,640 467 - - - (92) 375 10,961 7,120 (6,998) 242 165 11,490
	4,916 2,138 (464) - 18 6,608 13 - (6) - - 7 467 - - - (92) 375
	5,396 2,138 (470) - (74) 6,990
	1 January Incoming Resources Transfers Gains 31 December 2019 Resources Expended & Losses 2019 £000 £000 £000 £000 £000 £000
	2,842 8,600 (7,191) - 122 4,373 6,334 123 (1,261) 599 326 6,121 322 - - - 145 467
	9,498 8,723 (8,452) 599 593 10,961
	3,906 1,612 (605) - 3 4,916 8 10 (5) - - 13 322 - - - 145 467
	4,236 1,622 (610) - 148 5,396

Transfers represent amounts released from restricted funds for the purchase of tangible fixed assets.

Group Group Charity 2020 2019 2020 Retirement benefits £000 £000 £000 Charity 2019 £000	Group Group Charity 2020 2019 2020 Retirement benefits £000 £000 £000 Charity 2019 £000
1 January 5,479 4,805 - Additions 564 622 - Exchange differences 210 293 - Transferred to amounts falling due within one year (68) - - Payments (269) (241) - - - - - -
31 December 5,916 5,479 - -

Accrued retirement benefits mainly represents amounts payable under Israeli law when staff leave the Group's employment. Such amounts are accrued when earned, based on current monthly salaries and periods of service. The balance also includes provident schemes in respect of certain Jerusalem employees and other retirement benefit amounts payable in line with Palestinian law.

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Stat ~~ements~~ for the year ended 31 December 2020

13 Restricted Income Funds

tricted Income Funds
				Purchase
	1 January	Incoming	Charitable	of Tangible	31 December
	2020	Resources	Activities	Fixed Assets	2020
	£000	£000	£000	£000	£000
Charity
Staff sponsorship	-	797	(797)	-	-
Outreach	-	82	(82)	-	-
West Bank and Gaza Facilities	-	-	-	-	-
Other capital projects	262	26	-	(72)	216
Patient relief	1	3	(3)	-	1
Income received from endowments	-	122	(122)	-	-
Other projects	50	20	-	-	70
Others value less in each case than £25,000	74	27	(24)	-	77
Total Charity	387	1,077	(1,028)	(72)	364
Capital projects	-	170	-	(170)	-
Other projects	183	2,293	(2,429)	-	47
Others value less in each case than £25,000	27	48	(21)	-	54
Total Group	597	3,588	(3,478)	(242)	465

				Purchase
	1 January	Incoming	Charitable	of Tangible	31 December
	2019	Resources	Activities	Fixed Assets	2019
	£000	£000	£000	£000	£000
Charity
Staff sponsorship	-	734	(734)	-	-
Outreach	-	17	(17)	-	-
West Bank and Gaza Facilities	-	10	(10)	-	-
Other capital projects	330	5	-	(73)	262
Patient relief	1	9	(9)	-	1
Income received from endowments	-	152	(152)	-	-
Other projects	172	10	(132)	-	50
Others value less in each case than £25,000	7	69	(2)	-	74
Total Charity	510	1,006	(1,056)	(73)	387
Capital projects	229	480	(183)	(526)	-
Other projects	674	1,981	(2,472)	-	183
Others value less in each case than £25,000	12	24	(9)	-	27
Total Group	1,425	3,491	(3,720)	(599)	597

Charity

• Staff sponsorship represents funds received to cover or contribute to staff costs of 42 hospital staff.

• • Outreach funds cover the running costs of three outreach units.

• West Bank and Gaza facilities fund contribute to cover the operating costs of Gaza, Hebron and Anabta Clinic.

• Capital projects funds represent funds received from various UK Trusts and Middle East donors to establsih refractive suite and purchase medical equipment for the

• Patient relief funds contribute towards the treatment costs of needy patients.

• Other projects include joint teaching programmes with other medical institutions, and funds that cover the School of Nursing costs and Muristan.

Group

• Capital projects funds represent funds received from various donors to establsih refractive suite and purchase medical equipment for the Group.

• • Other projects include donations received to expand the level of operations within the Gaza hospital through the introduction of a Diabetic Retinopathy screening and epidemiological research components. Also, it includes funds received to establish a genetic research unit and a lab at the main hospital in Jerusalem as well as funds received to sustain services at the Muristan clinic in the Old City of Jerusalem.

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

14 Endowment Funds Group and Charity

Endowment Funds Group and Charity
	1 January	Investment	31 December
	~~2020~~	~~Losses~~	2020
	£000	£000	£000
American Society of St John: Walsh Bequest	519	(11)	508
Bed Endowment	4,222	(92)	4,130
Frost Charitable Trust	568	(12)	556
Frost Nursing School	537	(12)	525
~~Mr. Owen Smith Endowment~~	~~114~~	~~(2)~~	112
~~The John Swire Foundation Endowment~~	~~1,243~~	~~(27)~~	1,216
	7,203	(156)	7,047

	1 January	Investment	31 December
	~~2019~~	~~Gains~~	2019
	£000	£000	£000
American Society of St John: Walsh Bequest	480	39	519
Bed Endowment	3,904	318	4,222
Frost Charitable Trust	525	43	568
Frost Nursing School	497	40	537
~~Mr. Owen Smith Endowment~~	~~106~~	~~8~~	114
~~The John Swire Foundation Endowment~~	~~1,149~~	~~94~~	1,243
	6,661	542	7,203

These funds represent:

• The American Society of St John: Walsh Bequest: The Bequest was made in 2000 in honour of the Rev. Canon Edward West and Don Wesley Lundquist, for the endowment of 2 beds in the Children's Ward at the Hospital's facilities, maintained for the care of needy children.

• The Bed Endowment Fund: Donations to endow 37 beds between 1981-1995, with the use of income restricted to general patient care in the Hospital.

• The Frost Endowment Funds: These amounts were donated in 1989 by The Frost Charitable Trust (Mrs Sally Frost) to endow 4 beds at the hospital and the Nurses Training School.

• The Endowment of Mr Owen Smith was received in 2008 to fund professional medical training.

• The John Swire Foundation Endowment was received in 2013 to fund general operating costs.

• Investment income on endowment funds is applied in providing the on-going services covered by the endowment and is accounted for as unrestricted investment income in the Statement of Financial Activities.

Total Funds 2019 £000 6,121 12,662 5,457 (5,479) 18,761 13 10,715 2,258 12,986 15 Total Group and Charity Funds Unrestricted Unrestricted Restricted Restricted Endowment Endowment Total Funds Funds Funds Funds Funds Funds Funds a 2020 2019 2020 2019 2020 2019 2020 £000 £000 £000 £000 £000 £000 £000 Tangible assets 5,640 6,121 - - - - 5,640 Investments 5,614 5,459 - - 7,047 7,203 12,661 Net current assets 6,152 4,860 465 597 - - 6,617 Creditors: Amounts falling due after more than one year (5,916) (5,479) - - - - (5,916) 11,490 10,961 465 597 7,047 7,203 19,002 b Tangible assets 7 13 - - - - 7 Investments 3,387 3,512 - - 7,047 7,203 10,434 Net current assets 3,596 1,871 364 387 - - 3,960 6,990 5,396 364 387 7,047 7,203 14,401 Analysis by type of asset and liability (Group) Analysis by type of asset and liability (Charity)	Total Funds 2019 £000 6,121 12,662 5,457 (5,479) 18,761 13 10,715 2,258 12,986 15 Total Group and Charity Funds Unrestricted Unrestricted Restricted Restricted Endowment Endowment Total Funds Funds Funds Funds Funds Funds Funds a 2020 2019 2020 2019 2020 2019 2020 £000 £000 £000 £000 £000 £000 £000 Tangible assets 5,640 6,121 - - - - 5,640 Investments 5,614 5,459 - - 7,047 7,203 12,661 Net current assets 6,152 4,860 465 597 - - 6,617 Creditors: Amounts falling due after more than one year (5,916) (5,479) - - - - (5,916) 11,490 10,961 465 597 7,047 7,203 19,002 b Tangible assets 7 13 - - - - 7 Investments 3,387 3,512 - - 7,047 7,203 10,434 Net current assets 3,596 1,871 364 387 - - 3,960 6,990 5,396 364 387 7,047 7,203 14,401 Analysis by type of asset and liability (Group) Analysis by type of asset and liability (Charity)	Total Funds 2019 £000 6,121 12,662 5,457 (5,479) 18,761 13 10,715 2,258 12,986 15 Total Group and Charity Funds Unrestricted Unrestricted Restricted Restricted Endowment Endowment Total Funds Funds Funds Funds Funds Funds Funds a 2020 2019 2020 2019 2020 2019 2020 £000 £000 £000 £000 £000 £000 £000 Tangible assets 5,640 6,121 - - - - 5,640 Investments 5,614 5,459 - - 7,047 7,203 12,661 Net current assets 6,152 4,860 465 597 - - 6,617 Creditors: Amounts falling due after more than one year (5,916) (5,479) - - - - (5,916) 11,490 10,961 465 597 7,047 7,203 19,002 b Tangible assets 7 13 - - - - 7 Investments 3,387 3,512 - - 7,047 7,203 10,434 Net current assets 3,596 1,871 364 387 - - 3,960 6,990 5,396 364 387 7,047 7,203 14,401 Analysis by type of asset and liability (Group) Analysis by type of asset and liability (Charity)
	6,121 12,662 5,457 (5,479) Tangible assets 5,640 6,121 - - - - 5,640 Investments 5,614 5,459 - - 7,047 7,203 12,661 Net current assets 6,152 4,860 465 597 - - 6,617 Creditors: Amounts falling due after more than one year (5,916) (5,479) - - - - (5,916)
	11,490 10,961 465 597 7,047 7,203 19,002	18,761
		13 10,715 2,258
	6,990 5,396 364 387 7,047 7,203 14,401	12,986

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

16 Reconciliation of net operating income to net cash inflow from operating activities

St John of Jerusalem Eye Hospital Group Financial Statements

Notes to the Financial Statements for the year ended 31 December 2020

18 Trustees' remuneration

The trustees receive no remuneration.

	2020	2019
	£000	£000
Net incoming resources	232	42
Investment income	(180)	(225)
Gain on disposal of tangible fixed assets	(5)	(13)
Depreciation	1,155	1,264
(Increase) / decrease in stocks	(45)	108
Decrease / (increase)	597	(102)
Increase in creditors	650	705
Net cash inflow from operating activities	2,404	1,779

17 Financial instruments

	Group	Group	Charity	Charity
	2020	2019	2020	2019
	£000	£000	£000	£000
Financial assets at fair value through statement of financial activities
Investments	12,661	12,662	10,434	10,715
Financial assets that are debt instruments measured at amortised cost
Stocks	469	424	-	-
Debtors	2,281	2,878	132	110
Cash at bank and in hand	6,338	4,413	3,923	2,205
	9,088	7,715	4,055	2,315
Financial liabilities that are debt instruments measured at amortised cost
Trade creditors	318	388	32	27
Taxation and social security	80	94	4	12
Accruals	569	526	59	18
Deferred income	44	35	-	-
Holiday pay accrual	56	61	-	-
Retirement benefits	7,320	6,633	-	-
	8,387	7,737	95	57

Reimbursement of trustees' expenses for travel, accommodation and flights for 3 trustees (2019, 10) during the year amounted to £8,005 (2019, £42,929).

Donations made by trustees amounted to £48,039 (2019, £28,892).

Charity Trustee Indemnity insurance is provided at a cost of £7,754 (2019, £8,195) to cover the charity, trustees and officers against potential claims and losses.

19 Related parties transactions

The Charity is a wholly owned subsidiary of The Most Venerable Order of the Hospital of St John of Jerusalem (Charity No. 235979, Principal Office: St John House, 3 Charterhouse Mews, London, EC1M 6BB).

The Jerusalem Hospital premises occupied by the Group are owned by the Order of St John and were previously occupied rent free on a full repairing basis. During 2015, the Group signed an agreement with the Order of St John to lease the Hospital in Jerusalem and similarly the Muristan property at peppercorn rent. In the opinion of the trustees, it would be impracticable to place a value on these facilities.

The Group also occupies on a rent free basis offices in London owned by the Order of St John. The value of this facility has been estimated at £57,000 per annum based on the rents payable by the external tenants at the complex. This amount is included in the financial statements as a donation in kind.

During the year, the Chairman of the Charity, Sir Andrew Cash, was also a trustee of The Most Venerable Order of the Hospital of St John of Jerusalem.

Donations include amounts received from Priories and Establishments of the Order of St John, which are considered to be related party transactions:

Donations include amounts received from Priories and Establishments of the Order of St John	, which are considered to be	related party transactions:
	2020	2019
Priory	£000	£000
USA	1,404	1,640
England and the Islands	231	239
Scotland	99	142
New Zealand	106	214
Australia	204	162
Canada	69	168
Wales	-	25
	2,113	2,590
	~~2020~~	2019
Other Members of St. John Family	£000	£000
Johanniter Orde in Sweden	27	20
Johanniter Orde in Nederland	9	4
Johanniter Orde in Finland	-	2
The Swiss Commandery of the Order of Saint John	98	51
St John Ambulance HongKong	7	-
	141	77
	2020	2019
Donations bythe Prioryof the United States:	£000	£000
~~Hospital - General Support~~	~~1,342~~	1,303
Hospital Restricted Gifts	62	191
USAID / ASHA Hospital Restricted Grant	-	146
	~~1,404~~	1,640

~~During the year, the Charity reimbursed the Priory of England and the Islands and the Order of St John £2,925 (2019, £1,822) in respect of certa~~ in expenses incurred.

Outstanding donations from the Priories and Establishments of the Order of St John at 31 December 2020 amounted to £109,427 (2019: £441,474).

20 Contractual & designated obligations

In 2020, the Group signed an agreement with Johanniter International to administrate a grant funded by The German Federal Ministry for Economic Cooperation and Development (BMZ). It is a 3 years project that aim to prevent avoidable blindness and visual impairment in the West Bank and East Jerusalem. The total value of the grant is 1,524,623 Euros, out of which 400,000 Euros where received in 2020 and utilised 375,075 Euros during the year.

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St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

St John of Jerusalem Eye Hospital Group

Professional Advisers & Administrative Information

London & Registered Office Bankers in the occupied 4 Charterhouse Mews Palestinian territories London EC1M 6BB Bank of Palestine PLC Hebron Road Jerusalem Hospital P.O. Box 765 2 Mujir Eddin Street Bethlehem Sheikh Jarrah P.O. Box 19960 Investment Managers Jerusalem 91198 Schroders (C.I.) Limited PO Box 334, Regency Court Bankers in the UK Glategny Esplanade National Westminster Bank Plc St Peter Port 134 Aldersgate Street Guernsey GY1 3UF London EC1A 4JB

St John of Jerusalem Eye Hospital Group (a UK Company Limited by guarantee, Company number 7355619, Charity number 1139527) has two charitable subsidiary undertakings, providing ophthalmic services in the occupied Palestinian territories; St John of Jerusalem Eye Hospital (a UK Company Limited by guarantee, Company number 3867950; Charity number 1080185) and St John Eye Hospital in Jerusalem (RA) (an Israeli charitable society, registration number 580040368).

Independent Auditors Barclays Bank PLC PricewaterhouseCoopers LLP 1 Churchill Place 1 Embankment Place London E14 5HP London WC2N 6RH

----- Start of picture text -----
A child is treated for his squint at our specialist orthoptist clinic in Hebron
----- End of picture text -----

Heraldically the Arms of SJEHG are blazoned as follows: Gules a Cross Argent in the first quarter the Royal Crest proper on the Cross the outline of a pointed Ellipse fesswise Sable enclosing a Pellet conjoined to a Descrescent and an increscent Vert throughout and charged with a Maltese Cross Argent.

As a foundation of the Most Venerable Order of the Hospital of St John, the St John of Jerusalem Eye Hospital Group’s coat of arms possesses the Order’s characteristic white cross set on a red background with the Royal Crest in the top left corner. The symbol in the middle of the arms indicates the constituent entity of The Order of St John. St John of Jerusalem Eye Hospital Group's coat of arms is an emblem which is indicative of the organisation's commitment to its sight saving and life changing work. The arms are hued with the colours of the Palestinian flag, black, white, green and red, and instilled with an eye at the centre with the Amalfi Cross as its pupil. The eight points of the Amalfi Cross represent the Beatitudes from the Sermon on the Mount, and the four arms signify the Cardinal Virtues of Prudence, Justice, Temperance, and Fortitude. The iris of the eye has been created using two crescent moons, a Muslim symbol which highlights the denomination of the majority of the organisation’s patients. The iris is a brilliant green, an allusion to the region being a fertile land.

Thank You

Our vital work is reliant on voluntary income from charitable donations

St John Priory Funding 2020

£204k Australia, £69k Canada, £231k England and the Islands, £106k New Zealand £ £99k Scotland, £1.4m USA $207k Australia, $88k Canada, $349k England and the Islands, $273k New Zealand,Australia, $88k Canada, $349k England and the Islands, $273k New Zealand, $88k Canada, $349k England and the Islands, $273k New Zealand,Canada, $349k England and the Islands, $273k New Zealand, $349k England and the Islands, $273k New Zealand,England and the Islands, $273k New Zealand,$273k New Zealand,New Zealand, $232k Scotland, $1.8m USAScotland, $1.8m USA $1.8m USAUSA $

$207k Australia, $88k Canada, $349k England and the Islands, $273k New Zealand,Australia, $88k Canada, $349k England and the Islands, $273k New Zealand, $88k Canada, $349k England and the Islands, $273k New Zealand,Canada, $349k England and the Islands, $273k New Zealand, $349k England and the Islands, $273k New Zealand,England and the Islands, $273k New Zealand,$273k New Zealand,New Zealand, $232k Scotland, $1.8m USAScotland, $1.8m USA $1.8m USAUSA

Without our donors, we could not continue saving sight and changing lives. The patients and staff at SJEHG greatly appreciate the support of everyone who has given or helped in some way in 2020. The St John Priories from around the world have once again delivered much-valued assistance to SJEHG and we thank them for their continued support. We are pleased to receive the support of our Patron Lord Vestey.

We are grateful to the Guild, the St John Ophthalmic Association, the Friends of St John Society, the Alliance of the Orders of St John, St John Associations and the St John Fellowship for their on-going and crucial support.

Islamic Development Bank (IsDB) Waqfit Izz

Further Major Donors 2020:

The Altajir Trust

The John Swire 1989 Charitable Trust

The Anthony & Elizabeth Mellows Charitable Trust Arab Fund for Economic and Social Development

Julietta Khoury

The Knights Templar Timothy Mattar

Peter Ballard

The Balcome Charitable Trust

Guy Morton

The Bryan Guinness Charitable Trust

New Zealand Embassy Fund (Cairo) Representative Office of Japan to the Palestinian Authority – GGP grant

Johannes Bucher

The Cadogan Charity

Cezar Health

The R Farquar Oliver Trust Isam Salfiti

The Clothworkers' Foundation

The Edwina Mountbatten & Leonora Children's Foundation

Taawon (Welfare Association)

Faisal Husseini Foundation

The Valentine Charitable Trust

German Federal Ministry for Economic Cooperation and Development (BMZ) Hema Hindocha

The Will Charitable Trust And to all our anonymous donors

58 St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

59

St John Eye Hospital Group Trustees’ Annual Report and Financial Statements 2020

If you would like to support St John of Jerusalem Eye Hospital Group or would like more information, please contact us:

4 Charterhouse Mews, London EC1M 6BB, United Kingdom [phone] [e-mail]

2 Mujir Eddin Street Sheikh Jarrah P.O.Box 19960 Jerusalem 91198 www.stjohneyehospital.org

@stjohneyehospital

@StJohnEyeHosp @StJohnEyeHospital Printed in the UK on recycled paper