2023-03-31-accounts

Reference & admin Chair’s statement Trustees’ report Auditor’s report & financial statements New grants Mid term review .

Reference & admin Chair’s statement Trustees’ report Auditor’s report & financial statements

. New grants Mid term review

Contents

“ The relationship you have with your funder is so important and you can tell the DMT really cares about and listens to their grant holders.”

Professor Lucy Dipper, City University, London

Reference and administrative information 3 Chair’s statement 4 Trustees’ Report 8 Independent auditor’s report and 26 financial statements

	Balance sheet 33
	Statement of fnancial activities to 31 March 2023 34
	Cash fow statement 35
	Notes to the fnancial statements 36
	Comparative statement of fnancial activities to 31 March 2022 52
New grants awarded by category 2022/23 53
Mid term review 56

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Reference & admin Chair’s statement Trustees’ report Auditor’s report & financial statements New grants Mid term review .

Reference and administrative information

The Dunhill Medical Trust is a charitable company limited by guarantee registered in England Company number: 07472301 Charity number: 1140372

Trustees

Mr Michael Bellamy Professor Bernard Conway Professor Deborah Dunn-Walters Professor Carmel Hughes

Chief Executive Officer

Ms Susan Kay BA(Hons) MSc ACIB FRSA

Registered Office

Solicitors

Veale Wasbrough Vizards LLP London EC4R 9AT

Thanet House, 231–232 Strand London WC2R 1DA

Auditors

Bankers

Saffery Champness London EC4V 4BE

C Hoare & Co London EC4P 4DQ

Investment Advisors

Accountants

Moore Kingston Smith LLP London EC2A 2AP

Cambridge Associates London SW1E 6QW

Mr Dominic Jones Professor Thomas Kirkwood CBE

Mr James Lorigan Mr Eren Osman Professor Stuart Parker (until February 2023) Professor Alison Petch OBE (Chair) Mr Keith Shepherd

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Trustees’ report Auditor’s report & financial statements

Reference & admin Chair’s statement

New grants Mid term review .

Chair’s statement

When we launched our new Strategic Framework at the end of 2020, a key element was our commitment to investing in creating and sustaining the research capacity required to underpin the systemic change necessary to serve the health and social care needs of an increasingly ageing population. We acknowledge however that we are an intermediary, just one part of a wider, complex system. What we do doesn’t always directly and uniquely improve society’s understanding of ageing or make older people healthier or better supported. We aim to give our award-holders the attributes, capacity and resources to help them to achieve these aims. This goes beyond providing funding and draws on our convening power and networks to make the connections that bring ideas and research to life. It is that work that I’d like to shine a spotlight on this year.

This time last year, I reported the launch of a number of major initiatives. The first was the Commission on the Role of Housing in the Future of Care and Support with many of its recommendations reflected in the government’s Social Care Reform White Paper: People at the Heart of Care . We were therefore delighted that one of the co-chairs of the Commission, Professor Emerita Julienne

Meyer, has been appointed to Chair the Government Task Force on Older People’s Housing. We will continue to support members of the Task Force, highlighting the work of our award-holders. With older people’s housing being one of our key themes, we’ve been pleased to support a range of work in this area, for example the projects initiated as part of the Suitable Living Environments and Social Determinants schemes and the Almshouse longevity project led by Professor Ben Rickayzen at City, University of London. You can read more about all of these on our website.

The second initiative was the second phase of the Technology for an Ageing Population Panel for Innovation (TAPPI) programme. This saw us support six locality “test-bed” sites across the UK through our expert delivery partners, Housing LIN and the TEC Services Association. Each site sought to pilot and evaluate coproduced technology-based interventions to enable older people to live independently for longer in a variety of home settings. The programme has got off to a great start and you can read more in the words of the “TAPPI Champions” later in this report.

Support for Early-Career Researchers is a key strand of our capacity-building activities and 2022/23 also saw us pilot our new post-doctoral proleptic fellowship scheme. The postdoctoral career stage has long been under-resourced and we are pleased to say that, in partnership with two universities

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Trustees’ report Auditor’s report & financial statements New grants Mid term review .

Reference & admin Chair’s statement

strongly committed to ageing-related research, we were able to fund two post-doctoral fellows and support them on their path to tenured positions (we’ll be reporting on those in next year’s report and accounts). We plan to open up the scheme more widely in 2024/25. For 2023/24, we will be repeating our now-established multiple PhD studentship scheme, again in collaboration with universities with a strong commitment to ageing-related research. In addition, we will be continuing with our long-standing partnership with the British Geriatrics Society with whom we funded two new clinical research fellowships this year.

We also recognise that an academic or clinical research career might not be for everyone. Equally, we don’t want to see early career talent with understanding and expertise in the areas needed to improve healthy outcomes in later life being lost so we’ve also been providing support and information around alternative research careers. One of our most popular Early Career Researcher Network events to date has been our online seminar in which former DMT-funded PhD students spoke about the alternative careers they were pursuing in the private, public and not-for-profit sectors. We followed this up with a seminar on how researchers can present and use their transferable skills in other career paths from the newly-established Quick Switch and supported, with Zinc, in whose mission-led venture capital fund

we are invested, their new innovation fellowship scheme for postdoctoral researchers. This enables post-doctoral researchers to spend 6–9 months with entrepreneurial start-up companies.

It was hugely disappointing that the much-anticipated return of our Annual Lectures in person had to be switched to the nowfamiliar on-line format owing to the train strikes. That said, we were pleased to welcome over 150 delegates to our lunchtime seminar where I was thrilled to make two major announcements:

• that the Trust has taken its place at the centre of a collaborative hub of UK ageing research funders by being announced as the co-convenor, with UK Research and Innovation, of the revitalised UK Ageing Research Funders’ Forum

• that we’re launching the DMT Academy, an inclusive body of researchers, clinicians and third sector professionals, whose aims are to:

• › Celebrate success, achievement and ambition in ageingrelated research,

• › Encourage the key principles and behaviours we wish to encourage and uphold in ageing-related research,

• › Showcase innovative work,

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• › Facilitate better understanding and foster relationships between the academic and clinical researchers and community organisations working with older people,

• › Create a supportive place to find new collaborators, mentors and advisors and to sustain nascent networks for the longer term.

We are currently in the process of sending invitations to potential on members but, if interested, you can find out how to join our website.

Turning to more administrative matters, I want to highlight a few changes to the DMT team. We’ve been sad to see some of our long-standing Research Grants Committee members reach the end of their terms of office during this year and I’d like to thank Professors Sian Henson and Karen Lowton for their commitment and energetic support. In their places, we welcome Professor Stuart Gray and Dr Nik Rattray and, as ever, are very appreciative of their willingness to commit their valuable time and expertise voluntarily. Professor Bernie Conway also stepped down from the position of Chair of Research Grants Committee at the end of the financial year and is ably replaced by Professor Carmel Hughes. Professor Conway led the Committee through the vicissitudes of the pandemic and must be commended for that leadership which

ensured that DMT was a first-mover in announcing its package of financial support for the research community during that time.

I’m also delighted to report the addition of a new senior member of the executive team in Andy Gnaneswaran as our new Head of Impact-Led and Responsible Investment. Andy comes to us with a wealth of experience which will provide the much-needed capacity to implement our Impact Investment Policy, a key part of our strategic framework, allowing us to do more for our mission. During this year we took some important steps in becoming a member of the Charities Responsible Investment Network and a signatory to Share Action’s Long-Term Investors in People’s Health Coalition and want to build on these commitments.

On behalf of all the Board and staff I must express our sadness at the death of fellow Trustee, Professor Stuart Parker, in February this year. Stuart had been a valuable member of the Board since 2019 and served on both the Research Grants and Investment Committees with wisdom and enthusiasm. We will be making the inaugural DMT Academy Excellence Awards in his name in spring 2024.

This will be my penultimate report as Chair of the Trust. I will be handing on the baton to Professor Deborah Dunn-Walters who will take up the position following the end of my term in June

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1. Deborah has been associated with the Trust since 20 11 , having served three full terms on the Research Grants Committee, one as Chair. As a Trustee, she was part of the group that oversaw

the transition to the new Chief Executive in 2016 so is well-placed to lead the Trust into the next stage of its evolution.

Finally, my thanks must go to both staff team and my fellow Trustees for their commitment and enthusiasm throughout the year and, in particular to the staff, for their ability to constantly come up with, pursue and implement new ideas and opportunities.

Professor Alison Petch OBE

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Reference & admin Chair’s statement Trustees’ report Auditor’s report & financial statements

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The Trustees present their report for the year ended 31 March 2023.

The financial statements have been prepared in accordance with the accounting policies set out in Note 1 to the accounts and comply with the charity’s Memorandum and Articles of Association, the Companies Act 2006 and the Statement of Recommended Practice (SORP): Accounting and Reporting by Charities. Advantage has been taken of the exemptions available to small companies in the preparation of this report.

This report is a Directors’ Report as required by s417 of the Companies Act 2006.

1. Objectives and activities for the public benefit

Under the terms of the governing document, the charitable objects of the Dunhill Medical Trust are:

• the furtherance of medical knowledge and research and the publication of the useful results thereof and the provision of medical care and facilities in such manner as the Trustees shall from time to time in their absolute discretion think fit; and

• research into the care of older people and the publication of the useful results thereof and the provision of accommodation and care for older people.

The Trustees confirm that they have referred to the Charity Commission’s guidance on public benefit when reviewing the Trust’s aims and objectives in setting grant-making policy and in planning how future activities will contribute to the delivery of the aims and objectives they have set.

The work the Trust funds means that it is deeply aware of the negative impacts of inequity on health. It is therefore committed to promoting equity, diversity and inclusion in all areas of its work. It is both a Living Wage Employer and Living Wage Funder, has a flexible working policy and generous leave entitlements for staff with caring responsibilities and has adopted a diversity action plan for its Board and Committees.

2. Governance and management

2.1 Charitable purpose

The funds of the Dunhill Medical Trust originated from the Will Trust of Herbert Edward Dunhill who died in 1950. They were intended to be used for the furtherance of medical knowledge

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and research[1] , in the light of Herbert Dunhill’s own experience of 25 years of ill-health resulting from the effects of tuberculosis. In 1986, with the agreement of the Charity Commissioners, the Will Trust was reconstituted to broaden the charitable objects to include research into the care of older people and the provision of accommodation and care for older people and in 1988, the Commissioners approved a transfer of the assets to a Charity called The Dunhill Medical Trust.

In 2010 the Trustees resolved that, in line with best practice for charities with substantial assets, the Trust should become a charitable company limited by guarantee and the new corporate entity came into being on 1 April, 2011. The charitable objects remained unchanged. All Trustees of The Dunhill Medical Trust are also Directors and Members of the charitable company.

2.2 The Board of Trustees and its sub-committees

Under the Articles of Association, the Trustees are responsible for the charity, its property and funds and are appointed by the Board of Trustees. Trustees serve for four years, after which period they may be re-appointed for one further term of office, by mutual agreement.

1. The Dunhill Medical Trust promotes the highest standards of ethical practice in scientific and medical research. It does not receive or seek funds from any external body and complies fully with the Joint Protocol of Cancer Research and Universities UK on Tobacco Industry Funding to Universities (2004), as revised in 2018.

Although the Articles provide for a minimum of three trustees, no maximum number is specified to ensure the Board’s ability to have access to a wide range of expertise appropriate to the strategic development of the Trust.

Trustees’ meetings are held quarterly. The administration and management of the Trust’s business is delegated to the Chief Executive, who is supported by a Head of Communities and Governance, a Head of Research Policy and Awards, two Grants Managers and, since April 2023, a Head of Investment.

The Trust has a conflict-of-interest policy and codes of conduct for its Board and Committees and these are based on the Charity Governance Code and the Nolan Principles of Good Governance. Trustees and committee members are required to declare all relevant interests, details of which are kept in a Register of Interests which is updated regularly.

Trustees and external advisers give their time on a voluntary basis, with out-of-pocket expenses being reimbursed in line with an agreed expenses policy. Details of Trustees’ expenses and related party transactions for the year 2022/23 are disclosed in Notes 9 and 20 to the accounts. Grants to institutions and charities where Trustees or external advisers have a significant interest are noted in the list of grants awarded during the financial year (see pages 53 and 54).

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2.2.1 Grants committees

The Board of the Trust is advised by two Grants Committees: a Research Grants Committee and a Community Grants Committee. Each have delegated authority to make awards within the budgetary envelope agreed by the Board, is chaired by a suitably qualified Trustee and includes a number of external advisers with professional or academic expertise and experience appropriate to the work of the committees. The committees also advise the Board on sectoral trends and other external changes which have implications for the development of the Trust’s grant-making programmes and their funding. Being more “grant-like” in nature, the Board looks to Community Grants Committee to assess and make recommendations about social impact-led investment opportunities. It co-opts members of the Investment Committee with suitable expertise in order to assist in making such recommendations.

The Trust submits its governance and decision-making processes for the award of academic and clinical research grants to quinquennial review (Peer Review Audit) by its membership body, the Association of Medical Research Charities (AMRC) and is pleased to have been re-accredited in 2020 for a further five years. Achieving this accreditation is considered a hallmark of quality by universities, government, and funding bodies.

2.2.2 Investment Committee

Also reporting to the Board is an Investment Committee, the purpose of which is to provide advice on investment strategies appropriate to the Trust’s charitable aims, and to recommend to the Trustees any changes in investment arrangements which the Committee considers appropriate. Meeting quarterly and comprising of Trustees and external advisers with relevant professional investment/ financial expertise, it is also responsible for monitoring the performance of the Trust’s investment managers and that of their appointed professional investment consultants, Cambridge Associates.

2.3 Recruitment and training of new Trustees

The Trust has a policy and process for the appointment of trustees which is based on the Charity Commission’s requirements to demonstrate openness and good governance. Regular reviews of the skills required are carried out by the Board of Trustees to identify any gaps. Open advertisement is used to ensure that the widest possible range of potential candidates is reached, and a formal selection process followed, including interview of the shortlisted candidates and appropriate due diligence carried out to confirm eligibility to act.

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New Trustees are provided with a comprehensive induction and ongoing access to a secure area of the Trust’s website containing all key governance documents, committee papers and the Trustees’ library. All Trustees are encouraged to keep up to date with best governance practice and are supported in this through identification and provision of suitable materials and training, funded by the Trust. Following the refreshment of the Charity Governance Code in 2020, the Board of Trustees instituted an annual review of its performance against seven key pillars of good governance. It is pleased to report satisfactory performance in all areas, while identifying and accepting the need for ongoing review and improvement, particularly in the area of diversity and inclusion, a process to which it is committed and has published a Board Diversity Action Plan.

3. Grant-making policy

The main beneficiaries of the Trust’s grant-making programmes are researchers in universities, research organisations and community-led charitable and other not-for-profit organisations. The focus on understanding the mechanisms of age-related conditions and disease and improving the health and well-being of older people reflects the ongoing demographic changes towards increased life expectancy and the increasing proportion of older people in the population.

The main method by which the Trust invites grant applications is via its website at dunhillmedical.org.uk, on which its Grantmaking Policy, Research Strategy, assessment procedures and help in applying for all its funding schemes and initiatives may be found, together with the Trust’s latest annual report and details of grants awarded.

The Trust’s grant-making programmes are subject to regular review both on an ongoing-basis by the management team after completion of each award round and formally at an annual meeting of the grant-making committees and Board members to assess their effectiveness and to help inform future grant-making strategy. The process of award for the Trust’s research grant schemes is accredited by the Association of Medical Research Charities (AMRC).

The Trust is also keen to support the rigorous independent evaluation of the community-led project initiatives it funds, and its policy is to provide project funding for community organisations at their full economic cost in order to contribute to the sustainability of the organisation while ensuring that the best possible use is being made of the charitable funds at the Trustees’ disposal.

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Reference & admin Chair’s statement Trustees’ report Auditor’s report & financial statements New grants Mid term review .

4. Achievements and performance

While it might appear that the commitment to funding grant awards was substantially lower in FY 2022/23, at c. £2M, than the planned budget, this was largely the result of a re-phasing of the timing of the announcements of calls for proposals during that period. In fact, the decisions for the applications received as a result of those proposals were taken in the very early part of FY2023/24 and so the value of the grant commitment for FY2023/24 will reflect this. At the time of writing, commitments of over £3M had already been made, with a further c.£5M in the pipeline.

The theme running through the year’s work programme has been centred on creating and sustaining capacity in ageing related research and creating evidence-informed improvements to the health and social care of holder people. As set out in the Trust’s strategic framework document, published in autumn 2020, the need to invest in creating sustained capacity in academic and clinical research is essential if the required systemic change needed to improve health and social care for older people is to be achieved in the long term.

The Trust has therefore:

• remained true to its commitment to supporting its awardholders - both in re-starting their work following the effects of the COVID-19 pandemic but also in mitigating the impact of increasing costs as a result of the high inflation environment, approving an increase in the PhD stipend incorporated in its fellowship awards and project funding and responding positively to requests for additional funding for un-budgeted cost increases;

• taken the next step in rolling out its themed calls for proposals, approving three substantial new research project grants, co-led by community organisations, testing interventions to address the social determinants of a healthier later life;

• partnered with UK university institutes of healthy ageing to fund a range of PhD studentships and, importantly, piloted a prestigious post-doctoral fellowship award to support early career researchers with potential to become leaders in ageingrelated research;

• continued its commitment to, and valuable partnership with, the British Geriatrics Society and in 2022/23 co-funded two clinical research training fellowships;

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• announced that it is to co-convene a revitalised UK Ageing Research Funders’ Forum with the Medical Research Council with the objective of catalysing meaningful collaboration across research funders and to leverage more funding into ageingrelated research;

• launched “DMT Academy” . This has been created to celebrate success, achievement and ambition in ageing-related research (supported by the funding of the annual Excellence Awards), showcase and encourage the key principles and behaviours the Trust wishes to uphold in ageing-related research, facilitate better understanding and foster relationships between the academic and clinical researchers and community organisations working with older people (supported by its newlylaunched Capability Development scheme) and to create a supportive place for researchers and community organisations find new collaborators, mentors and advisors and to sustain nascent networks for the longer term.

The three-year Intergenerational Linking programme, co-funded with the National Lottery Community Fund, concluded in early 2023, with an inspirational online celebration of all it had achieved in bringing more than 400 primary school-aged children together with over 200 older people living in care-homes in a wide range of activities creating enduring intergenerational links across

England, helping to establish a culture of volunteering for life and to integrate care homes more firmly into their communities.

The Trust also made the final payment of the award it made in 2016 to the Mid and East Antrim Agewell Partnership to fund the highly successful Impact Agewell® programme. Members of the Trust’s team continue to support the charity on a collaborative steering group established to oversee its work as part of its successful selection as the Northern Ireland Demonstrator site for the EPSRC-Health Foundation’s IMPACT Programme for implementing evidence in adult social care across the UK.

At the end of FY2021/22, the Trust made its first mixed motive investment in the Zinc 2 Fund and during the last year has further expanded its relationship with Zinc by agreeing to support a number of internships in its start-up companies for PhD-qualified researchers thus providing a further tangible way to promote alternative research careers, as set out in the Trust’s plan as a signatory to the Concordat to Support the Career Development of Researchers, so that this talent in age-related research can be embedded in product and service development as well as academia and policy-making.

The Trust has also continued in its work to improve the accessibility of its website which also now plays host to the

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pages of the UK Ageing Research Funders’ Forum (UKARFF) which the Trust now co-convenes with the Medical Research Council (representing UKRI). One of the key principles underpinning the Trust’s strategic framework is the ability to grow strong networks and make connections and, as the only UK research funder with a sole focus on ageing-related research, the Trust has an important role to play in ensuring the longevity and stability of engaged, inclusive and connected networks of both research funders and researchers.

5. Financial review and investment policy

Under the terms of the Articles of Association of the charitable company, the Trustees have full powers to hold the Trust’s funds in any form of investment which they deem to be suitable in furtherance of the charitable objects. The strategic aim of the Trust is to achieve a real long term total return and to reduce risk from market turbulence.

Investment performance is monitored by the Investment Committee on an on-going basis. The Trust’s investment advisors, Cambridge Associates, provide detailed quarterly performance reports which also include any specific issues which require consideration and/ or any proposals for changes which might be made to the Trust’s portfolio and investment fund managers present to the Committee

periodically. Recommendations based on this advice are made by the Committee to the Board of Trustees, with the final approval resting with the Trustees (unless within the parameters delegated by the Trustees to the Committee).

The total funds of the charity at the year-end were represented as follows:

Fixed assets Investments: Quoted – property Quoted – equities and fxed income securities Managed balances	£M %
	0.03 0.02
	8.48 5.43
	149.41 95.67
	0.22 0.14
Bank balances	7.56 4.84
Total cash and investments Less:	165.67 106.07
Net current liabilities(excl. bank balances)	(5.89) (3.77)
Long term liabilities	(3.63) (2.32)
	156.18 100.00

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The liquidity reserve, set at around 10% of the portfolio’s value, means that the Trust believes it will be able to meet existing commitments without having to sell growth assets at short notice. For the time being, the situation will continue to be monitored carefully as there is still a good deal of uncertainty around the economic implications of the pandemic, the continuing war in Ukraine, and the persistent high level of inflation. The Board continues to take the advice of its consultants and the Investment Committee and believes it has taken the appropriate mitigating actions in response.

Publicly traded funds as at 31 March 2023 (82% of portfolio)

UK equities 12%

Trojan Ethical Income Fund

Absolute return 16%

M&G Charifund

Trojan Ethical Fund Ruffer Charity Assets Trust

Developed equity 57%

Artemis Global Select Fund Artisan Global Value Fund Blackrock ishares Developed World ex tobacco Index Fund Ownership Capital Global Equity Fund Maj Invest Global Value Equity Fund

Emerging market equity 15%

Northern Trust Emerging Markets Green Transition Fund

Stewart Investors Global Emerging Markets Sustainability Fund

During 2022/23, the value of the Trust’s investment portfolio increased by 6.2%. The 6.6% increase in value of portfolio since inception (2013/14) is now behind the Policy Benchmark of 7.4% and the currently very challenging CPI +4.5% target. Investment income received by the Trust during 2022/2023 was £2,040,358, a little less than that of the previous year (2021/22: £2,181,553,) as certain major sectors of the economy continued to suffer the impact of the pandemic and the fuel crisis. The Trust manages its portfolio for total return, however, and this is not currently expected to impact its short to medium term distribution plans.

In addition, the Trust has made commitments to a number of private equity investments (representing 5% of the portfolio value as at 31 March 2023) as part of a staged plan to commit c.10% of the portfolio to this asset class.

Cash, property and fixed income as at 31 March 2023 (13% of portfolio)

----- Start of picture text -----
Fixed income 43% Cash 26%
Colchester Global
Investors
Blackrock
ICS Sterling
Property 31%
Government Fund
Charities Property
Fund
----- End of picture text -----

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As required by the Trustee Act 2000, the Investment Policy is reviewed annually by the Investment Committee, with any subsequent changes being recommended to the Trustees for approval. The policy outlines the Trust’s current long and medium-term objectives, as well as any restrictions, and establishes the broad parameters within which fund managers are appointed. During 2021/22, the Trustees further approved an Impact Investment Policy, which sets out the intention to invest responsibly and sustainably, and in a way that does not conflict with the aims of the charity. In 2022/23 it become a member of the Charities Responsible Investment Network (CRIN) and is now a signatory to Share Action’s Long-Term Investors in People’s Health coalition.

The Trustees believe it is in the long-term financial interests of the charity and the interest of society as a whole to ensure that the risks and opportunities associated with environmental, social and governance (ESG) issues are properly managed. In doing so, the Trust sets out to:

• follow “best practice” in ESG[2] -related risk management and ensure that its fund managers take such issues fully into account in their investment processes;

• engage through its fund managers with companies, as appropriate, to try to influence and encourage improvement in practices. Other than tobacco, which is in clear conflict with the aims and reputation of the charity, no specific exclusions have been made, believing that engagement is the appropriate response as responsible investors;

• require each of its external fund managers to regularly report back on their management of environmental, social and governance risks, engagement and voting activities and to engage with them on their performance in this regard;

• Environmental, Social and Governance

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• invest in organisations and projects which support the Trust’s aims. The Trust aims to invest up to 10% of its investable assets in private equity, with a core of secondary funds and “funds of funds” to manage the initial risk and then to invest in satellite funds which are, ideally, mapped to those United Nations’ Sustainable Development Goals which are closest to the charity’s mission but not excluding those which are close to or supportive of it (wider positive health implications, prevention of ill-health and addressing social inequalities).

• A further fund of £5M has been ear-marked to invest in socalled “mixed motive” or impact-led social investments, that is, those which are mission-aligned with a higher degree of social impact but come with a higher degree of financial risk or lower return and, as such, may be more grant-like in nature. The Trust made its first commitment to such an investment in March 2022 to the Zinc 2 fund. Zinc is a mission-led pre-seed venture capital fund. One of its missions is the creation of businesses that produce research-informed products and services focused on improving later life.

The exposure of the equity element of the portfolio to fossil fuels and controversial[3] sectors is represented as follows:

----- Start of picture text -----
MSCI ACWI
FTSE
All Share
DMT portfolio
(public equities
only)
% 0 2 4 6 8 10 12 14
----- End of picture text -----

----- Start of picture text -----
Exposure to controversial sectors [3]
Exposure to fossil fuels [4]
----- End of picture text -----

1. Controversial sectors include alcohol, tobacco, gambling, weapons producers and predatory lenders

2. Fossil fuel exposure is defined as any company owning fossil fuel reserves

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The Trust as a responsible investor: fund manager dashboard (public equities only – position as at 31 March 202 3 )

1. MSCI ACWI: The index is built using MSCI’s Global Investable Market Index (GIMI) methodology, which is designed to take into account variations reflecting conditions across regions, market cap sizes, sectors, style segments and combinations. The methodology has been updated this year, with the fund and index ratings having seen a one-time downgrade as a result, so the ratings given cannot be directly compared with last year’s.

	Tobacco exclusion	ESG policy	UN PRI	Formal proxy voting	Signatory to Net Zero	Share voting	MSCI ESG
	policy in place	in place	signatory	policy in place	Asset Managers initiative	reports available	Rating5
UK equity
M&G Charifund							AA
Trojan Ethical Income Fund							AA
Developed equity
Artemis Global Select Fund							AA
Artisan Global Value Fund	No but no exposure				No – developed a climate impact		A
					reporting solution to develop a baseline
					understanding of portfolio footprint
Blackrock ishares Developed							A
World ex tobacco Index Fund
OwnershipCapital Global Equity	No but no exposure						AA
Maj Invest Global Value Equity					No – focused on developing		A
					analytical tools and engagement
Emerging market equity
Stewart Investors Global Emerging							A
Markets Sustainability Fund
Northern Trust Emerging Markets							A
Green Transition Fund
Absolute Return
Trojan Ethical Fund							AA
Ruffer Charity Assets Trust							Not available

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6. Reserves policy

The Trustees’ policy is to review reserves levels on a regular basis to ensure that there is a stable base for grants provision, in line with its plans, and to support continuing operations, while at the same time ensuring excessive funds are not accumulated.

During the year ended 31 March 2023, the Trust made grants in excess of its current year’s income, supplying the difference from its prior year balance of unrestricted income.

The Trustees have considered the reserves of the charity and conclude that there is no need for the Trust to carry free reserves. The nature of the expendable endowment fund is such that the Trustees have absolute discretion over how this is spent and can realise some of the relatively large proportion of its assets in cash or liquid equity and fixed income instruments, as needed.

At 31 March 2023 the charity does not have any free reserves, as defined by the SORP. However, the Trustees hold sufficient cash and liquid assets to cover future grant commitments and the expectation of new grants to be made in the coming year and they consider that to be a prudent way to manage reserves.

7. Risk management

The Trustees have adopted a formal risk policy and a risk

register is maintained with appropriate systems or procedures established to mitigate the risks the charity faces. An annual risk assessment for each of the principal areas of the Trust’s operations is undertaken and, in addition, the Investment and Grants Committees review risks specifically related to their areas of operation at their quarterly meetings, with any issues raised being reported to Board.

The Trust’s principal material financial risks, including foreign exchange exposures, relate to its investment portfolio and are in line with similar long-term endowment funds in the sector. Overall investment risk management is predicated on running a diversified portfolio of high-quality assets across a wide variety of asset classes and markets. In recent years, the longer-term strategic asset mix has been set by the Investment Committee, based upon principles employed by reputable investment advisors. With the appointment of investment consultants,

independent external advice on asset allocation provides another method of risk mitigation for the Trust. Individual investment mandates are awarded to specialist managers after scrutiny by both the appointed consultants and the Investment Committee.

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The current uncertain global financial markets have been kept under regular and detailed review by the Investment Committee (and will continue to be monitored on an ongoing basis). The Trustees accept that the economic outlook continues to be uncertain and may remain so for some time but consider that the Trust has protected its assets in as far as this is possible through maintaining and enhancing the diversification of its portfolio. The Board initiated a strategic review of the portfolio during 2020/21 as part of the wider strategic planning process. It took advice on how to more robustly manage environmental, social and governance (ESG) issues and sustainability, in order to reduce the risk that the Trust’s investment activities conflict with its mission. This is why responsible investing formed a key element of the Trust’s new Impact Investment Policy published during 2021/22 and was taken into account in the decision-making around the re-structure of the Trust’s portfolio during the year.

The principal risks facing the Trust are as follows:

• Significant investment losses as a result of political and economic uncertainty. While the Board is comfortable with the level of risk inherent in equity markets, it keeps its dynamic asset allocation and all its investments under close review. It ensures that individuals with relevant expertise are co-opted

on to the Investment Committee and employ the services of an independent investment advisor, Cambridge Associates.

• Poor advice regarding management of the investment portfolio by investment advisors resulting in a failure to manage for good returns and monitor outcomes is mitigated via the active role played by the Investment Committee in the monitoring and reviewing of asset performance, allocation and manager selection. The relationship with advisors is reviewed by the Committee annually, with an in-depth review and markettesting every five years.

• The reputational risk of making investments which are at odds with the Trust’s charitable objectives. There is increased attention on how endowed foundations such as the Trust invest their funds and the Trust is very conscious of its responsibilities to ensure that its investment activities are not in conflict with its charitable aims. It therefore monitors its investment managers for their active engagement in environmental, social and governance matters and considers the climate agenda and its impact on the endowment. It accepts, however, that major change such as this will take time.

• Poor grant-making would mean that the objectives of the Trust may not be advanced in line with its intent. In particular, the

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Board is concerned about the current capacity in the academic and clinical research environment to participate to the extent that it has historically in the governance and review process It is satisfied that this remains a live issue with the executive team and that the relevant Committees are keeping this under review.

• Failure of delivery partners to achieve planned outcomes.

• The new approach to supporting community programmes involves the appointment of delivery partners and providing funding to evaluate the programmes in most cases. Operational procedures have been put in place to build trusted relationships, co-produce programme plans and closely monitor programme outcomes.

• As reported in 2021/22, a specific addition was made to the risk register in respect of the impact of COVID-19. The Chief Executive and the Committees of the Board are keeping the progress of awards made prior to the pandemic under close review, as well as the financial calls being made against this commitment, although this is now a reducing risk. The Board endorsed the decision of the Research Grants Committee to encompass support for the increased costs of research arising from the inflationary environment into this fund. The Trustees’ belief is that it is important that to ensure that the investment it has already made in research and projects it had deemed

to be important are given the best chance of achieving a good outcome. The executive team remain in close contact with all award-holders to ensure they are in a position to take early action should it become apparent that the project or indeed the organisation to which the award has been made should become vulnerable and the project untenable in the longer term.

While these risks cannot be eliminated entirely, there is a raft of measures in place to mitigate them, including ensuring that the advice of suitably experienced experts and committee members is acted upon, staff development and training is kept up to date and all policies, processes and procedures are kept under regular review. In addition, the strategic framework launched in autumn 2020 identified a number of priority themes aimed to reduce the volume and wide diversity of applications and improve the success rates for applicants, whilst maintaining high quality and targeting areas of need.

In the opinion of the Trustees, the Trust has established review systems which, under normal conditions, should allow the risks identified by them to be mitigated to an acceptable level in its day-to-day operations. It is recognised that systems can only provide reasonable, but not absolute, assurance that major risks have been adequately managed.

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8. Plans for the future

The Trust will reach the mid-point of its strategic plan cycle during 2023 and so will be reviewing the progress of the array of new activities it has initiated since late 2020 to ensure that all are on track to make the difference they set out to. In particular,

• The Technology for an Ageing Population Panel for Innovation (TAPPI2) programme.

• The Commission on the Role of Housing in the Future of Care and Support. The Trust has recently agreed to work in partnership with the Centre for Ageing Better and Demos to publish recommendations for a Home Improvement Strategy.

• Continuing support of both doctoral and post-doctoral fellowship opportunities, as well as support for alternative research careers.

• Re-launch of the successful Capability Development Programme for community organisations, this time with a “research readiness component”, in partnership with Moore Kingston Smith Nonprofit Advisory and the University of Birmingham.

2022/23 also saw the launch of the Trust’s “Academy” which seeks to celebrate success, achievement and ambition in ageing-

related research, facilitating better understanding and fostering relationships between the academic and clinical researchers and community organisations working with older people and creating a supportive place to find new collaborators, mentors and advisors and to sustain nascent networks for the longer term. In addition to providing a “home” for networks and providing networking opportunities, it will also make two annual Excellence Awards for academic and clinical researchers and a Capability Development Scheme to create a cohort of research-ready community organisations. The launch of the Academy at the end of 2022/23 has received positive feedback and the Trust will be taking action to grow the community during 2023/24.

The Trust will also co-convene, with the Medical Research Council, the UK Ageing Research Funders’ Forum. This is a real opportunity to ensure that funders work together and are funding effectively, avoiding overlap and in complementary, innovate and accessible ways.

The publication of the Impact Investment Policy in late 2021 provides the Trust with the opportunity to use its endowment do more for its mission and, with the appointment of a Head of Impact-led and Responsible Investment, it now has the additional capacity to start to make progress on this challenge.

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Just after the financial year end, the Trust also made an award to the organisation Social Finance to fund a piece of research and development activity, working directly with existing organisations that have been developing innovative alternative services for older people with complex care needs e.g. dementia. The intention is to develop and prime a pipeline of potential services and approaches as well as funders and investors and define the mechanisms through which to deliver alternative approaches at scale. This will require active involvement with Social Finance as a partner and will build on the experience and knowledge developed in the team through its involvement with the Impact Agewell® programme, as well as providing vital learning for the team in approaches to provision of social finance.

Turning to governance matters, Professor Deborah Dunn-Walters will reach the end of her two terms of office as a Trustee in

September 2023. A round of open recruitment activity will take place to fill both her position, and that of Professor Stuart Parker whose sad death was announced in February 2023. The Board will also make the appointment of the Chair Elect in preparation for Professor Alison Petch’s demission in June 2024.

9. Statement of Trustees’ responsibilities

The Trustees (who are also Directors of The Dunhill Medical Trust for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the Trustees are required to:

• select suitable accounting policies and then apply them consistently

• observe the methods and principles in the Charities Statement of Recommended Practice (SORP)

• make judgments and accounting estimates that are reasonable and prudent

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• state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; and prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business.

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

company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

Approved by the Board of Trustees and signed on its behalf by:

Professor Alison Petch OBE

Chair

Date: 8 September, 2023

Insofar as the Trustees are aware:

• there is no relevant audit information of which the charitable company’s auditor is unaware

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

The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable

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Opinion

We have audited the financial statements of The Dunhill Medical Trust for the year ended 31 March 2023 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and the notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102, the Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

• give a true and fair view of the charitable company’s state of affairs as at 31 March 2023 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended;

• have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

• have been prepared in accordance with the Companies Act 2006.

Basis for opinion

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

Conclusions relating to going concern

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the

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charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

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

Other information

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

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine

whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of the audit:

• the information given in the Trustees’ Report which includes the Directors’ Report for the financial year for which the financial statements are prepared is consistent with the financial statements; and

• the Trustees’ Report which includes the Directors’ Report has been prepared in accordance with applicable legal requirements.

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Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Report.

We have nothing to report in respect of the following matters where the Companies Act 2006 requires us to report to you if, in our opinion:

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

• the financial statements are not in agreement with the accounting records and returns; or

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

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

• the trustees were not entitled to prepare the financial statements in accordance with the small companies regime and to take advantage of the small companies exemption in preparing the Trustees’ Report.

Responsibilities of trustees

As explained more fully in the Trustees’ Responsibilities Statement set out on page 24, the trustees (who are also directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error.

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

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Auditor’s responsibilities for the audit of the financial statements

We have been appointed as auditors under the Companies Act 2006 and report in accordance with regulations made under that Act.

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud.

The specific procedures for this engagement and the extent to which these are capable of detecting irregularities, including fraud are detailed below.

Identifying and assessing risks related to irregularities: We assessed the susceptibility of the charitable company’s financial statements to material misstatement and how fraud might occur, including through discussions with management, discussions within our audit team planning meeting, updating our record of internal controls and ensuring these controls operated as intended. We evaluated possible incentives and opportunities for fraudulent manipulation of the financial statements. We identified laws and regulations that are of significance in the context of the charitable company by discussions with trustees and updating our understanding of the sector in which the charitable company operates.

Laws and regulations of direct significance in the context of the charitable company include The Companies Act 2006, and guidance issued by the Charity Commission for England and Wales.

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Audit response to risks identified:

We considered the extent of compliance with these laws and regulations as part of our audit procedures on the related financial statement items including a review of financial statement disclosures. We reviewed the charitable company’s records of breaches of laws and regulations, minutes of meetings and correspondence with relevant authorities to identify potential material misstatements arising. We discussed the charitable company’s policies and procedures for compliance with laws and regulations with members of management responsible for compliance.

During the planning meeting with the audit team, the engagement partner drew attention to the key areas which might involve noncompliance with laws and regulations or fraud. We enquired of management whether they were aware of any instances of non-compliance with laws and regulations or knowledge of any actual, suspected or alleged fraud. We addressed the risk of fraud through management override of controls by testing the appropriateness of journal entries and identifying any significant transactions that were unusual or outside the normal course of business. We assessed whether judgements made in making accounting estimates gave rise to a possible indication of management bias. At the completion stage of the audit, the

engagement partner’s review included ensuring that the team had approached their work with appropriate professional scepticism and thus the capacity to identify non-compliance with laws and regulations and fraud.

There are inherent limitations in the audit procedures described above and the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely we would become aware of it. 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.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: www.frc.org.uk/ auditorsresponsibilities. This description forms part of our auditor’s report.

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Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Cara Turtington (Senior Statutory Auditor)

For and on behalf of Saffery Champness Chartered Accountants Statutory Auditors 71 Queen Victoria Street London EC4V 4BE Date 8 September 2023

Saffery Champness is eligible to act as an auditor in terms of section 1212 of the Companies Act 2006

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Balance sheet as at 31 March 2023

Fixed assets	Notes 2023 (£) 2022 (£)
Tangible assets Investments Current assets Debtors Cash at bank and in hand Creditors: due within one year Net current assets Total assets less current liabilities Creditors: due after more than one year Net assets Charity funds Endowment funds: Expendable endowment Unrestricted funds Restricted funds Total charity funds	10 20,692 45,352 11 158,088,275 148,892,666 158,108,967 148,938,018 12 525,927 440,968 7,561,616 25,458,382 8,087,543 25,899,350 13 6,421,321 7,188,580 1,666,222 18,710,770 159,775,189 167,648,788 14 3,628,009 4,813,152 156,147,180 162,835,636 17 156,137,302 162,825,759 17 - - 17 9,877 9,877 156,147,180 162,835,636

These financial statements have been prepared in accordance with the provisions applicable to companies subject to the small companies’ regime.

The notes on pages 36 to 52 form part of these accounts.

The financial statements were approved and authorised for issue by the Board.

Signed on behalf of the Board of Trustees

Professor Alison Petch OBE

Chair

The Dunhill Medical Trust

Registered charity number 1140372 Registered company number 07472301 Date: 8 September, 2023

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Statement of financial activities

Including income and expenditure account for the year ended 31 March, 2023

Notes Unrestricted Restricted Expendable endowment 2023 (£) 2022 (£)

Income and endowments from: Investment income Grants and Donations Total income and endowments Expenditure on: Raising funds Charitable activities Total expenditure Net gains / (losses) on investments Net income / (expenditure) Transfer between funds Other recognised gains / (losses): Other gains / (losses) – exchange gains Net movement in funds Reconciliation of funds: Total funds brought forward Total funds carried forward

2 2,040,358 - - 2,040,358 2,181,553 - - - - - 2,040,358 - - 2,040,358 2,181,553 3 - - (233,943) (233,943) (314,330) 4 (2,839,649) - (2,839,649) (5,475,585) (2,839,649) - (233,943) (3,073,592) (5,789,915) - - (5,594,997) (5,594,997) 9,036,433 6 (799,291) - (5,828,940) (6,628,231) 5,428,071 799,291 - (799,291) - - - - (60,226) (60,226) 195,655 - - (6,688,457) (6,688,456) 5,623,726 - 9,877 162,825,759 162,835,636 157,211,910 17 - 9,877 156,137,302 156,147,180 162,835,636

The notes on pages 36 to 52 form part of these accounts. The Statement of Financial Activities includes all gains and losses in the year. All incoming resources and resources expended relate to the charity’s one main activity, which is that of grant making. This activity is a continuing operation.

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Statement of cash flows For the year ended 31 March 2023

Statement of cash fows For the year ended 31 March 2023
		Notes 2023 (£) 2022 (£)
Cash fow from operating activities Net cash fow from operating activities Cash fow from investing activities Payments to acquire tangible fxed assets Receipts from sales of tangible fxed assets Payments to acquire fxed asset investments Receipts from sales of fxed asset investments Net cash fow from investing activities Net increase / (decrease) in cash and cash equivalents Cash and cash equivalents at 1 April 2022 Change in cash and cash equivalents due to exchange rate movements Cash and cash equivalents at 31 March 2023 Cash at bank and in hand Bank balances controlled by investment managers at year end Cash and cash equivalents at 31 March 2023 Analysis of changes in net debt Cash at bank Cash held by investment managers Total	As at 1 April 2022 25,458,382 221,735	19 (3,045,935) (2,816,912) (3,045,935) (2,816,912) - - - 254,970 (24,018,707) (58,195,208) 9,228,844 71,554,779 (14,789,863) 13,614,541 (17,835,798) 10,797,629 25,680,117 14,686,833 (60,226) 195,655 7,784,093 25,680,117 7,561,616 25,458,382 11 222,479 221,735 7,784,095 25,680,117 Cash fows Foreign exchange movements As at 31 March 2023 (17,962,042) 65,276 7,561,616 126,244 (125,502) 222,477 (17,835,798) (60,226) 7,784,093
	25,680,117

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Notes to the financial statements

~~1. Summary of signifcant accounting policies~~

(a) General information and basis of preparation

The Dunhill Medical Trust is a charitable company limited by guarantee registered in the United Kingdom. In the event of the charity being wound up, the liability in respect of the guarantee is limited to £1 per member of the charity. The address of the registered office is given in the Reference and Administrative Information at the front of the Annual Report. The nature of the charity’s operations and principal activities are the furtherance of medical knowledge and research including research into improving the health and social care of older people and the provision of accommodation and care for older people.

The charity constitutes a public benefit entity as defined by FRS 102. The financial statements have been prepared in accordance with ‘Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)’, the Financial Reporting Standard applicable in the United Kingdom and Republic

of Ireland (FRS 102), the Charities Act 2011, the Companies Act 2006 and UK Generally Accepted Practice.

The financial statements have been prepared on a going concern basis under the historical cost convention, modified to include certain items at fair value. The financial statements are prepared in sterling which is the functional currency of the charity and rounded to the nearest £1.

The significant accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all years presented unless otherwise stated.

(b) Funds

Unrestricted funds are available for use at the discretion of the trustees in furtherance of the general objectives of the charity and which have not been designated for other purposes. The charity has a single expendable endowment and the Trustees distribute the income therefrom as grants. At the Trustees’ discretion grants may also be made out of the endowment. The expendable endowment receives the gains and losses on investment and funds transferred as necessary when unrestricted expenditure is in excess of income.

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(c) Income recognition

All incoming resources are included in the Statement of Financial Activities (SOFA) when the charity is legally entitled to the income after any performance conditions have been met, the amount can be measured reliably and it is probable that the income will be received.

No amount is included in the financial statements for volunteer time in line with the SORP (FRS 102). Further detail is given in the Trustees’ Annual Report.

Investment income is earned through holding assets for investment purposes such as shares and property. It includes dividends, interest and rent. Where it is not practicable to identify investment management costs incurred within a scheme with reasonable accuracy the investment income is reported net of these costs. It is included when the amount can be measured reliably. Interest income is recognised using the effective interest method and dividend and rent income is recognised as the charity’s right to receive payment is established.

(d) Expenditure recognition

All expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related

to the category. Expenditure is recognised where there is a legal or constructive obligation to make payments to third parties, it is probable that the settlement will be required and the amount of the obligation can be measured reliably. It is categorised under the following headings:

• Costs of raising funds includes investment managers’ fees

• Expenditure on charitable activities includes grants payable to charities and institutions as well as support and governance costs

• Other expenditure represents those items not falling into the categories above

• Irrecoverable VAT is charged as an expense against the activity for which expenditure arose.

The Trust makes grants to a variety of applicants in line with their policy stated in the Trustees’ Report and on the fulfilment of certain specific conditions. The trustees approve these grants at their quarterly meetings following a rigorous assessment of the viability of the projects. The full cost of the grant commitment is recognised on approval by the trustees and, where appropriate, is recognised as a long-term liability within the financial statements. It is on this basis that they are included in the accounts and charged against income or endowment as appropriate.

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It is on this basis that they are included in the accounts and charged against income or endowment as appropriate.

(e) Support costs allocation

Support costs are those that assist the work of the charity but do not directly represent charitable activities and include office costs, governance costs, and administrative payroll costs. They are incurred directly in support of expenditure on the objects of the charity and include project management carried out at Headquarters. Where support costs cannot be directly attributed to particular headings they have been allocated to cost of raising funds and expenditure on charitable activities on a basis consistent with use of the resources. Premises overheads have been allocated on an actual basis and other overheads have been allocated on an actual basis to the relevant support expense heading. The analysis of these costs is included in note 5.

(f) Tangible fixed assets

Tangible fixed assets are stated at cost (or deemed cost) or valuation less accumulated depreciation and accumulated impairment losses. Cost includes costs directly attributable to making the asset capable of operating as intended.

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

• Leasehold property; over the life of the lease

• Fixtures and fittings; 20% reducing balance

(g) Investments

(i) Quoted securities and multi-asset funds

Quoted securities and multi-asset funds comprise publicly quoted, listed securities including shares, bonds and units. These are stated at market value at the balance sheet date. Investment shares and purchases are recognised at the date of trade.

(ii) Unquoted Investments

Unquoted investments are valued at the Trustees’ best estimate of fair value, after having taken professional advice. The principal unquoted valuations are calculated as follows:

– Unquoted hedge funds

Unquoted hedge funds are valued by reference to the fair value of the underlying securities. These valuations are provided by thirdparty hedge fund administrators.

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– Private equity funds and property funds

The vast majority of private equity and property fund investments are held through funds managed by private equity and property groups. No readily identifiable market price is available for these unquoted funds. These funds are included at the most recent valuations from their respective managers.

In a limited number of cases where information is not available as at 31 March, the most recent valuations from the managers are adjusted for cash flows and foreign exchange movements between the most recent valuation and the balance sheet date.

(v) Realised and unrealised gains and losses

Realised gains and losses represent the difference between the amount received on the sale of an investment and the original cost price, all other movements are considered to be unrealised.

(h) Debtors and creditors receivable / payable within one year

Debtors and creditors with no stated interest rate and receivable or payable within one year are recorded at transaction price. Any losses arising from impairment are recognised in expenditure.

(i) Impairment

(iii) Cash and Equivalents, Purchases and Sales for Future Settlement

Cash held within the investment portfolio purchases and sales for future settlement are stated at their fair value.

(iv) Mixed Motive investments

Mixed motive investments in the form of ordinary or preference shares are initially measured at the transaction price of those shares and subsequently at their fair value if this can be measured reliably. Where this is not possible they are measured at cost less impairment. Mixed motive investments are reviewed for impairment annually.

Assets not measured at fair value are reviewed for any indication that the asset may be impaired at each balance sheet date. If such indication exists, the recoverable amount of the asset, or the asset’s cash generating unit, is estimated and compared to the carrying amount. Where the carrying amount exceeds its recoverable amount, an impairment loss is recognised in profit or loss unless the asset is carried at a revalued amount where the impairment loss is a revaluation decrease.

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(j) Provisions

Provisions are recognised when the charity has an obligation at the balance sheet date as a result of a past event, it is probable that an outflow of economic benefits will be required in settlement and the amount can be reliably estimated.

(k) Leases

Assets acquired under finance leases are capitalised and depreciated over the shorter of the lease term and the expected useful life of the asset. Minimum lease payments are apportioned between the finance charge and the reduction of the outstanding lease liability using the effective interest method.

The related obligations, net of future finance charges, are included in creditors. Rentals payable and receivable under operating leases are charged to the SoFA on a straight line basis over the period of the lease.

(l) Foreign currency

Foreign currency transactions are initially recognised by applying to the foreign currency amount the spot exchange rate between the functional currency and the foreign currency at the date of the transaction.

Monetary assets and liabilities denominated in a foreign currency at the balance sheet date are translated using the closing rate.

(m) Employee benefits

When employees have rendered service to the charity, shortterm employee benefits to which the employees are entitled are recognised at the undiscounted amount expected to be paid in exchange for that service.

The charity provides a defined contribution to the employees’ personal pensions. Contributions are expensed as they become payable.

(n) Tax

The charity is an exempt charity within the meaning of schedule 3 of the Charities Act 2011 and is considered to pass the tests set out in Paragraph 1 Schedule 6 Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes.

(o) Going concern

The Trustees have assessed the impact on the charity of the coronavirus pandemic. Whilst the virus has affected the day to day running of the charity, the Trustees do not deem the

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pandemic to have a negative effect on the charity’s ability to operate going forward. Further, the Trustees have considered the level of funds held and the expected level of income and expenditure for 12 months from authorising these financial statements. The budgeted income and expenditure is sufficient with the level of reserves for the charity to be able to continue as a going concern.

(p) Financial instruments

The Charity has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instruments Issues’ of FRS 102 to all of its financial instruments.

Financial instruments are recognised in the Charity’s balance sheet when the Charity becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.

Financial assets

Basic financial assets, which include debtors and cash and bank balances, are measured at transaction price.

Other financial assets, including investments in equity instruments which are not subsidiaries, associates or joint ventures, are initially measured at fair value, which is normally the transaction price. Such assets are subsequently carried at fair value and the changes in fair value are recognised in net income/ (expenditure), except that investments in equity instruments that are not publicly traded and whose fair values cannot be measured reliably are measured at cost less impairment.

Impairment of financial assets

Financial assets, other than those held at fair value through income and expenditure, are assessed for indicators of impairment at each reporting date. Financial assets are impaired where there is objective evidence that, as a result of one or more events that occurred after the initial recognition of the financial asset, the estimated future cash flows have been affected.

If an asset is impaired, the impairment loss is the difference between the carrying amount and the present value of the

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estimated cash flows discounted at the asset’s original effective interest rate. The impairment loss is recognised in net income/ (expenditure) for the year.

retained but control of the asset has transferred to another party that is able to sell the asset in its entirety to unrelated third party.

Financial liabilities

If there is a decrease in the impairment loss arising from an event occurring after the impairment was recognised, the impairment is reversed. The reversal is such that the current carrying amount does not exceed what the carrying amount would have been, had the impairment not previously been recognised. The impairment reversal is recognised in net income/(expenditure) for the year.

If there is a decrease in the impairment loss arising from an event occurring after the impairment was recognised, the impairment is reversed. The reversal is such that the current carrying amount does not exceed what the carrying amount would have been, had the impairment not previously been recognised. The impairment reversal is recognised in net income/(expenditure) for the year.

Derecognition of financial assets

Financial assets are derecognised only when the contractual rights to the cash flows from the assets expire or are settled, or when the company transfers the financial assets and substantially all the risks and rewards of ownership to another entity, or if some significant risks and rewards of ownership are

Basic financial liabilities, including creditors are recognised at transaction price. Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of operations from suppliers. Amounts payable are classified as current liabilities if payment is due within one year or less or if not, they are presented as non-current liabilities.

Derecognition of financial liabilities

Financial liabilities are derecognised when the company’s contractual obligations expire or are discharged or cancelled.

(q) Critical accounting estimates and judgements

In the application of the Charity’s accounting policies, the Trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

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The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

~~2. Income from investments~~

Dividends and interest on quoted investments Rental Income Bank interest Proft of disposal of assets	2023 (£) 2022 (£) 1,912,232 2,174,102 117,555 6,104 10,571 - - 1,347 2,040,358 2,181,553

Income from investments was £1,912,232 (2022 – £2,174,102) all of which was attributable to unrestricted funds. Gains and losses on investments in the current and prior year are attributable to endowment funds.

£233,943 (2022 – £314,330) of the above costs were attributable to endowment funds.

Investment managers’ fees include only the separately identifiable direct costs relating to portfolio management and the cost of obtaining investment advice. Further indirect costs were incurred and are included within the costs of acquisition of investments or within returns on investments.

~~4. Analysis of expenditure on charitable activities~~

	2023 (£)	2022 (£)
Grants*	1,986,506	4,798,929
Support Costs	853,143	676,656
	2,839,649	5,475,585

£2,839,648 (2022 – £5,465,585) of the above costs were attributable to unrestricted funds, £Nil (2022 – £5,000) of the above costs were attributable to designated funds, and £Nil (2022 – £5,000) of the above costs were attributable to restricted funds.

~~3. Investment management costs~~

Investment managers’ fees	2023 (£) 2022 (£) 233,943 314,330 233,943 314,330

• Grant expenditure is disclosed as grants awarded less grants returned in the year as set out overleaf;

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Grants awarded Grants returned / withdrawn	2023 (£) 2022 (£) 2,166,517 4,916,304 (180,011) (117,375)
Net grant expenditure	1,986,506 4,798,929

~~5. Allocation of support costs and overheads~~

			Total	Total
	Charitable	Governance	year ended	year ended
	activities	costs	2023 (£)	2022 (£)
Unrestricted income fund
Establishment
expenses	188,713	-	188,713	151,001
Administration
expenses	520,345	76,290	596,635	459,800
Finance, legal and
professional expenses	8,963	17,928	26,891	42,143
Expendable endowment
Legal, accountancy
and audit fees	40,904	-	40,904	23,712
Total per statement
of fnancial activities
(SOFA)	758,925	94,218	853,143	676,656

Included within administration expenses above are the following staff costs:

staff costs:
Salaries and National Insurance Pension contributions	Charitable activities Governance costs Total Year ended 2023 (£) 266,875 66,719 333,594 29,903 7,476 37,379 296,778 74,195 370,973

~~5. Allocation of support costs and overheads (continued)~~

Unrestricted income fund Establishment expenses Administration expenses Finance, legal and professional expenses Expendable endowment Legal, accountancy and audit fees Total per statement of fnancial activities (SOFA)	Charitable activities Governance costs Total year ended 2022 (£) 151,001 - 151,001 395,448 64,352 459,800 37,650 4,493 42,143 10,235 13,477 23,712 594,334 82,322 676,656

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Included within administration expenses above are the following staff costs:

staff costs:
	Chibl G Tl Y
Salaries and National Insurance Pension contributions	artae activities overnance costs ota ear ended 2022 (£) 232,570 58,143 290,713 21,628 5,407 27,035 254,198 63,550 317,748

~~7. Auditor’s and accountants’ remuneration~~

Fees payable to the charity’s auditor for the audit	2023 (£) 2022 (£)
of the charity’s annual accounts Fees payable to the charity’s accountant for other services: Management accounts, book-keeping, consultancy fees and fnancial statements	17,928 17,970 40,904 23,712
	58,832 41,682

~~6. Net income / (expenditure) for the year~~

Net income / (expenditure) is stated after charging / (crediting):

	2023 (£)	2022 (£)
Depreciation of tangible fxed assets	24,660	25,293
Operating lease rentals	175,532	131,982
Losses / (gains) on fair value movement
of investments	5,594,997	(9,036,433)

~~8. Key management personnel remuneration and expenses~~

The average monthly number of employees and full time equivalent (FTE) during the year were as follows:

Charitable activities Governance	2023 Number 2023 FTE 2022 Number 2022 FTE 4 4 4 4 1 1 1 1
	5 5 5 5

The Trust considers its key management personnel to be its Chief Executive, Ms Susan Kay. The aggregate remuneration (including pension and national insurance contributions) paid to key management personnel in the year was £120,492 (2022: £111,300).

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The total amount of employee travel expenses received by key management personnel is £457 (2022: £42).

The total staff costs and employees’ benefits was as follows:

Employees' emoluments Social security Pension contributions	2023 (£) 2022 (£) 302,739 264,683 30,855 26,030 37,379 27,035 370,973 317,748

The number of employees who received total employee benefits (excluding employer pension costs) of more than £60,000 is as follows:

£60,000 – £70,000 £70,001 - £80,000 £80,001 – £90,000 £90,001 – £100,000	2023 Number 2022 Number 2 1 - - - - 1 1 3 2

~~9. Trustees’ remuneration and expenses~~

The Trustees neither received nor waived any remuneration during the year (2022: £Nil). 5 Trustees (2022: £1) were reimbursed travel expenses totalling £2,359 (2022: £488) during the year.

~~10. Fixed assets – tangible~~

Cost / valuation At 1 April 2022 Additions in the year Disposals in the year At 31 March 2023 Depreciation At 1 April 2022 Charge for the year On disposals At 31 March 2023 Net book value At 31 March 2023 At 31 March 2022	Short leasehold (£) Offce equipment (£) Total (£) 229,392 15,120 244,512 - - - - - - 229,392 15,120 244,512 192,644 6,516 199,160 22,939 1,721 24,660 - - - 215,583 8,237 223,820 13,809 6,883 20,692 36,748 8,604 45,352

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~~11. Fixed assets – investments~~

Quoted Investments (£) Balances controlled by Investment Managers (£) Investment in subsidiary (£) Total (£)

Cost or valuation At 1 April 2022 Additions Disposals Revaluation At 31 March 2023 Carrying amount At 31 March 2023 At 31 March 2022 Managed funds UK – Property fund UK investments International investments Equities and fxed interest securities UK International

148,670,931 221,735 - 148,892,666 24,018,707 744 - 24,019,451 (9,228,844) - - (9,228,844) (5,594,997) - - (5,594,998) 157,865,797 222,479 - 158,088,275 157,865,797 222,479 - 158,088,275 148,670,931 221,735 - 148,892,666 2023 (£) 2022 (£) 8,479,747 10,992,445 45,314,588 34,412,751 98,595,783 96,994,102 - 1,693,747 5,475,678 4,577,886 157,865,797 148,670,931 None of the direct holdings in equities and fxed int of the portfolio and there are no restrictions on rea Amounts committed but not yet drawn The total commitments made by the Trust at 31 Ma Of this £8,998,980 had been committed in private mixed motive investments. Of these commitments been drawn down by this date.

None of the direct holdings in equities and fixed interest securities exceed 5% of the portfolio and there are no restrictions on realisation.

The total commitments made by the Trust at 31 March 2023 totalled £9,398,980. Of this £8,998,980 had been committed in private equity and £400,000 in mixed motive investments. Of these commitments, a total of £3,131,456 had been drawn down by this date.

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~~12. Debtors~~

Trade debtors	2023 (£) 2022 (£) 9843 6623
Other debtors Accrued income	, , 63,359 80,325 452,725 354,020 525,927 440,968

~~13. Creditors: amounts due within one year~~

	2023 (£)	2022 (£)
Trade creditors	88,906	28,220
Accruals and deferred income	72,409	80,373
Other tax and social security	9,488	8,475
Committed grants	6,245,909	7,057,683
Other creditors	4,609	13,826
	6,421,321	7,188,580
~~14. Creditors: amounts due after one year~~
	2023 (£)	2022 (£)
Committed grants	3,628,009	4,813,152
	3,628,009	4,813,152

~~15. Leases~~

As a lessee Total future minimum lease

2023 (£) 2022 (£)

payments under non-cancellable operating leases are as follows: Not later than one year 53,559 167,118 Later than one year and not later than fve years - 53,559 Later than fve years - - 53,559 220,677 As a lessor 2023 (£) 2022 (£) Minimum lease receipts under non-cancellable operating leases are as follows: Not later than one year 26,036 89,266 Later than one year and not later than fve years - 26,036 Later than fve years - - 26,036 115,302

~~16. Contingent liabilities / assets~~

In the opinion of the Trustees, the charity had no contingent liabilities or assets.

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.

~~17. Reserves~~ 2023

Balance at 1 April 2022 (£) Incoming resources (£) Resources expended and gains (£) New designations and transfers (£) Balance at 31 March 2023 (£)

Unrestricted Income Fund Expendable Endowment Restricted Income Fund 2022 Unrestricted Income Fund Expendable Endowment Designated Fund Restricted Income Fund

- 2,040,358 (2,839,649) 799,290 - 162,825,759 (60,226) (5,828,940) (799,290) 156,137,302 9,877 - - - 9,877 162,835,636 1,980,132 (8,668,589) - 156,147,180 Balance at 1 April 2021 (£) Incoming resources (£) Resources expended and gains (£) New designations and transfers (£) Balance at 31 March 2022 (£) - 2,181,553 (5,465,585) 3,284,032 - 157,197,033 - 8,917,758 (3,289,032) 162,825,759 - - (5,000) 5,000 - 14,877 - (5,000) - 9,877 157,211,910 2,181,553 3,442,173 - 162,835,636

Designated Fund

In the year to 2020, the charity entered into a matched funding agreement. The funds committed under this matched funding agreement have been designated for use solely for this purpose. The matched funding agreement spans 3 years.

Restricted Income Fund

In the year to 2020, the charity entered into a matched funding agreement. The funds received under this matched funding agreement have been restricted for use solely for this purpose. The matched funding agreement spans 3 years.

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~~18. Analysis of net assets between funds~~ 2023 Unrestricted funds (£) Endowment funds (£) Restricted Funds (£) Total (£)	~~18. Analysis of net assets between funds~~ 2023 Unrestricted funds (£) Endowment funds (£) Restricted Funds (£) Total (£)
Fixed assets Cash Current assets Creditors less than one year Creditors more than one year Total 2022 Fixed assets Cash Current assets Creditors less than one year Creditors more than one year Total	- 158,108,967 - 158,108,967 9,523,402 (1,971,663) 9,877 7,561,616 525,927 - - 525,927 (6,421,321) - - (6,421,321) (3,628,009) - - (3,628,009) - 156,137,302 9,877 156,147,180 - 149,938,018 - 148,938,018 11,560,764 13,887,741 9,877 25,458,382 440,968 - - 440,968 (7,188,580) - - (7,188,580) (4,813,152) - - (4,813,152) - 162,825,759 9,877 162,835,636

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~~19. Reconciliation of net income / (expenditure) to net cash fow from operating activities~~

~~fow from operating activities~~
	2023 (£) 2022 (£)
Net income / (expenditure) for year Depreciation of tangible fxed assets (Gains) / losses on investments (Gain) / loss on disposal of tangible fxed assets (Increase) / decrease in debtors Increase / (decrease) in creditors Gain on exchange rate movements Net cash fow from operating activities	(6,688,457) 5,623,726 24,660 25,293 5,594,997 (9,036,433) - 1,153 (84,959) (38,546) (1,952,402) 803,550 60,226 (195,655) (3,045,935) (2,816,912)

~~20. Related party transactions~~

Grants paid to institutions where the Trustees or advisers of Dunhill Medical Trust have an involvement are disclosed on pages 53 and 54.

~~21. Financial instruments~~

~~21. Financial instruments~~
Financial instruments measured	2023 (£) 2022 (£)
at amortised cost Other debtors Per accounts Financial liabilities measured at amortised cost Trade creditors Committed grants Other creditors Per accounts	73,202 86,948 73,202 86,948 88,909 28,222 9,873,918 11,870,835 - - 9,962,827 11,899,057

Assets generally covered would be basic loans made, trade debtors, other debtors, cash/bank deposits.

Financial assets measured at fair value through profit and loss comprise of quoted investments, details of which are given in note 11.

Liabilities would include basic loans received, trade creditors and other creditors, such as grant recipients.

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~~22. Comparative statement of fnancial activities to 31 March 2022.~~

Including income and expenditure account for the year ended 31 March 2022

Income and endowments from Investment income Grants and Donations Total income and endowments Expenditure on: Raising funds Charitable activities Total expenditure Net gains/(losses) on investments Other gains / (losses) – exchange gains Transfer between funds Net income / (expenditure) Reconciliation of funds: Total funds brought forward Total funds carried forward	Unrestricted income Fund Restricted Expendable Endowment 2022 2,181,553 - - 2,181,553 - 0 - -
	2,181,553 0 - 2,181,553
	- - (314,330) (314,330) (5,470,585) (5,000) - (5,475,585)
	(5,470,585) (5,000) (314,330) (5,789,915) - - 9,036,433 9,036,433 - - 195,655 195,655 3,289,032 - (3,289,032) -
	(1,582,893) (5,000) 5,628,726 5,623,726
	- 14,877 157,197,033 157,211,910
	- 9,877 162,825,759 162,835,636

This information forms part of the financial statements.

The Statement of Financial Activities includes all gains and losses in the year. All incoming resources and resources expended relate to the charity’s one main activity, which is that of grant making. This activity is a continuing operation.

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New grants Mid term review .

New grants awarded 2022/2023, by category

New grants awarded 2022/2023, by category	New grants awarded 2022/2023, by category	New grants awarded 2022/2023, by category
Grants for academic and clinical researchers working in partnership with community
organisations: addressing the social determinants of health for a healthier older age1
Principal Investigator	Institution	Project	Value of award
Elizabeth Graham	Bradford Teaching Hospitals NHS	Development of methods to identify digitally excluded older people,	£412,252.54
	Foundation Trust2	and tailoring of interventions to meet their digital needs
Lucy Beishon	University of Leicester	Improving access to physical health care for older people in mental	£112,918.04
		health settings: ImPreSs-Care study
Grants for academic and clinical researchers: multiple PhD Studentship awards
Principal Investigator	Institution	Project	Value of award
Ned Jenkinson	University of Birmingham	2022–02 PhD Studentships - multiple: School of Sport, Exercise	£191,398.62
		and Rehabilitation (SportExR) DMT PhD Programme
Grants for academic and clinical researchers: personal fellowship awards co-funded
with the British Geriatrics Society (BGS)
Principal Investigator	Institution	Theme/institute	Value of award
Shiv Bhakta	University of Cambridge	CAVIAR – Calcifcation, Ageing and Vascular Imaging in the	£263,894.00
		Assessment of Risk of stroke
Marc Österdahl	King's College London	The Relationship between Menopausal Hormone Replacement	£298,670.27
		Therapy, Ageing and Future Frailty

1. A further award was made under this programme but administrative requirements were not fulfilled until after the year end so will be reported in 2023/24.

2. Professor Andrew Clegg was a member of the Research Grants Committee with an affiliation to the Bradford Teaching Hospitals NHS Foundation Trust at the time of the award, but was neither involved in the decision regarding the award of this grant nor the ranking of proposals.

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Grants for delivery partners and community-based organisations: Phase 2 of the Technology for an Ageing Population Panel for Innovation (TAPPI) programme

Innovation (TAPPI) programme
Organisation	Value of award
Co-Production Works	£118,740.00
Universityof Cambridge	£92,854.00
LB Haringey	£75,000.00
Wiltshire Council	£75,000.00
Platform HousingGroup	£75,000.00
Southend Care Limited	£74,438.00
Bield Housing& Care	£75,000.00
Pobl Group	£65,000.00

Grants for community-based organisations: #iwill Care Home FaNs intergenerational linking project[3]

	FaNs intergenerational linking project3
	Organisation	Value of award
	Global Education Derby	£5,117.00
	The St Philips Centre Limited	£5,167.00
	Leeds Development Education Centre	£5,167.00
	Enfeld Town Schools' Partnership	£5,167.00
	Windmills Foundation	£4,975.00
	Curriculum and Language Access Service(CLAS)	£4,500.00
	SensoryTrust	£5,167.00
	Diocese of Plymouth	£5,000.00
	Woven Nest Theatre	£5,167.00

Grants for community-based organisations

Organisation	Value of award
Open Age:	£15,000.00
Post-COVID online service development:
research and evaluation study

1. This programme was co-funded with the National Lottery Community Fund. These awards have been made from a prior year commitment.

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Summary of all grants awarded in financial year 2022/23

Total new grants for academic and clinical researchers	£1,279,133.47
Total new grants for community organisations/	£711,459.00
delivery partners
Total funding to support existing award-holders to complete	£174,417.55
projects delayed by restrictions related to COVID-19 or to
support un-forecast cost of living increases
Funding to support open access publication	£1,506.86
TOTAL	£2,166,516.88

----- Start of picture text -----
Success rates: awards from full applications
TAPPI locality
18%
awards
DMT-BGS
clinical doctoral 40%
fellowships
Post-doctoral
proleptic 33%
fellowships
Research project
grants theme:
addressing
20%
the social
determinants
of ageing
% 0 10 20 30 40 50 60 70 80 90 100
% of full applications
Unsuccessful applications
Successful applications
----- End of picture text -----

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The following does not form part of the report and accounts

The Trust launched its new Strategic Framework and priorities for the plan period 2020–2025 in autumn 2020. As a result of the pandemic, it was decided to delay our first call for proposals under the new framework until the spring of 2021. In the period from 1 April 2021 to 31 March 2023, over £7M in grant funding was awarded to both academic and clinical researchers, community organisations and delivery partners.

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----- Start of picture text -----
DMT spending per region: Research grants 2021–2023 DMT spending per region: Community grants 2021–2023
6
5
1 7
1
6
8
2
7
2 9
8
3
10
3
9
4
5 11
4 10
----- End of picture text -----

3. West Midlands

1. Scotland

• £599,131 £500,431

• Aberdeen University University of Edinburgh University of Strathclyde

University of Birmingham Aston University

1. South West England

2. North West England

• £48,816

University of Bristol

• £1,612,768

Bradford Teaching Hospitals

1. North East England

2. £184,454

NHS Foundation Trust

Newcastle University

• Bournemouth University Salford University

• Yorkshire and Humberside

• Manchester Metropolitan University

• £500,020

Liverpool John Moores University University of Manchester

University of Sheffield

1. East Midlands

2. £112,918

University of Leicester

1. Eastern England

2. £543,825

University of Cambridge The Open University

1. London

2. £1,300,272

King’s College London Royal College of Art Francis Crick Institute Queen Mary, University of London Imperial College London University College London

1. South East England £49,977 University of Surrey

2. West Midlands

3. Scotland

4. West Midlands 6. North East England 9. Eastern England £85,800 £5,167 £92,854 Platform Housing Group Woven Nest Theatre University of Cambridge

5. £75,000

Bield Housing & Care

Platform Housing Group Age UK Shropshire

1. Yorkshire and 10. London Humberside £297,907 £5,167 Co-Production Works Leeds Development LB Haringey Education Centre Enfield Town Schools’ Partnership 8. East Midlands Housing LIN £10,284 Open Age

2. North West England

3. £441,875

4. Wales

Windmills Foundation £65,000 £5,167 Co-Production Works Curriculum and Pobl Group Leeds Development LB Haringey Language Access Education Centre Enfield Town Schools’ 5. South West England Service (CLAS) Partnership £95,967 8. East Midlands TEC Services Association Housing LIN Wiltshire Council £10,284 Age UK Cheshire Open Age Sensory Trust Global Education Derby Age UK Lancashire Diocese of Plymouth The St Philips Centre 11. South East England Galloways Society for the Blind Lewis-Manning Hospice Limited £96,038 Care Southend Care Limited Age UK Isle of Wight Linking Lives UK

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It is still very early in the cycle. Of the 31 awards made to academic or clinical researchers, only a small number have yet been able to make reports via the Researchfish system. The following information provides some early indicators.

~~Our contribution~~

----- Start of picture text -----
5%
Total funding to support existing
award-holders to complete projects
delayed by restrictions related to
£5.8M
COVID-19 or to support un-forecast
cost of living increases
77%
Total new grants for academic
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Total new grants for academic and clinical researchers

• Supported 51 PhD studentships and post-doctoral fellowships

• Launched the DMT Academy

• Became co-convenor of the UK Ageing Research Funders’ Forum

• Hosted the Annual Lectures, kickstarter webinars and ECR network events

• Agreed support for the Zinc Innovation Fellowships to support alternative research careers

“ The DMT provides a really supportive network that makes a big difference for early career researchers like myself.”

Dr Peter Hartley, University of Cambridge

~~Our aims~~

To enable researchers and organisations to disseminate new knowledge

To enable researchers to develop careers using their expertise in ageing-related research

To assist researchers or

community organisations to become better positioned to attract mission-aligned future funding

~~Early indicators~~

From 8 awards that were able to report:

• 34 instances of dissemination to non-academic audiences, participation in expert panels, workshops and formal working groups.

• 1 person had been invited as a keynote speaker

• 2 people had received a prize for their work

• 10 journal articles and 2 conference proceedings had been published

From 4 awards that were able to report:

• 6 staff had moved to their next career destination, all of which had remained in research and 4 remained in an ageing-related field

• 1 researcher who had received a seed-funding award went on to be awarded a £0.8M grant from the BBSRC to continue the work to explore how long-lived plasma cells differ in older people compared to younger generations

• From a further 4 awards reporting, £468k of further funding has already been obtained

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“ It’s really important that we push forward with translating our discoveries into new treatments that will make a difference to people’s lives. Funding from the Dunhill Medical Trust has been vital for helping us take this project forward”

~~Our aims~~

Others seek out partnerships with DMT

~~Early indicators~~

• We have 2,207 X followers (formerly known as Twitter), up 38% on April 2021

• 159 delegates registered for the 2023 Annual Lectures

• 80 delegates registered for the ECR alternative research careers event

• More than 1100 researchers, partners and community organisations are registered for our newsletters

• We have recently entered in an agreement with the Centre for Ageing Better and Demos to work on a National Home Improvement Strategy (which will feed in to the Task Force on Older People’s Housing)

• We have been approached by Zinc to support their new innovation fellowship scheme. We are one of only two supporters, the other being NIHR

• We continue with our valuable partnerships with the British Geriatrics Society in co-funding at least one new clinical research fellowship each year. 3 Awards have been made during the plan period

Dr James Whiteford, Queen Mary, University of London

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Spotlight on development of careers in - related research age

Dr Shiv Bhakta and Dr Marc Österdahl have been awarded joint British Geriatrics Society/Dunhill Medical Trust Doctoral Training Fellowships. The Fellowships aim to support research projects that have the potential to prevent, delay or reduce future health and social care requirements and to improve older people’s quality of life. Dr Bhakta and Dr Österdahl were funded under the fourth round of the scheme, which has been running since 2019.

Dr Shiv Bhakta is a Clinical Research Training Fellow and Honorary Specialist Registrar at the Department of Clinical Neurosciences, University of Cambridge/Addenbrooke’s Hospital. Dr Bhakta’s research will explore how calcium in the carotid arteries affects the risk of a stroke reoccurrence in older people.

Dr Marc Österdahl is a Specialist Registrar in General and Geriatric Medicine at Lewisham and Greenwich NHS Trust and a Clinical Fellow at King’s College London. He will explore if there is evidence that taking menopausal hormone replacement therapy helps prevent frailty in later life.

“ I’m very grateful to the Dunhill Medical Trust and British Geriatrics Society for their support with my project. We aim to find out why some strokes happen, and if the current treatments and preventative measures can be tailored more individually this would allow older people to be healthier, and more active and independent.”

Dr Shiv Bhakta

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~~Our contribution~~

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£1.3M
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18%

Total new grants for community organisations/delivery partners

“ It helps by giving you a toolkit that enables your charity to grow, rather than just more money for projects that will ultimately end.”

AgeUK Lancashire

We partnered with Moore Kingston Smith Nonprofit Advisory to deliver the pilot Capability Development Programme for 7 community-led organisations working with older people to access a tailored programme of capability-building support, specialising in developing financial sustainability and communicating impact.

~~Our aims~~

Organisations enabled to obtain the support they need to implement evidence-based change

To assist researchers or community organisations to become better positioned to attract mission-aligned future funding

~~Early indicators~~

• The Mid and East Antrim Agewell Partnership ® were awarded funding by their local Health and Social Care Board to extend the Impact Agewell service beyond the initial pilot areas. Selected as the Northern Ireland Demonstrator site for the EPSRC-Health Foundation Funded national IMPACT programme to scale and implement change in adult social care.

• Provided funding to support the Commission on the Role for Housing in the Future of Care and Support, with the Social Care Institute for Excellence. The resulting report was reflected in the government white paper: People at the Heart of Care and one of its co-Chairs has been announced as Chair of the government’s Older People’s Housing Task Force.

• The stories on pages 62–67 provide an indication of the difference that the Technology for an Ageing Population Panel for Innovation is making.

• A community organisation (Open Age) to which DMT awarded £15k to carry out some initial work were awarded £0.5M by Innovate UK to develop their online support offer for older people.

• Following the #iWill programme’s end of programme webinar event, Public Health South West decided to do a more localised webinar to showcase Intergenerational Linking in the South with view to raising awareness and further funding.

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Spotlight on the Technology for an Ageing Population Panel for Innovation (TAPPI) programme

Chaired by Professor Roy Sandbach OBE and delivered by the Housing LIN who convened a broad panel of experts, the report of Phase 1 of this programme called for technology and digital infrastructure that could support future care needs and aid independent living for longer to be built into all new housing. The panel heard evidence from people with lived experience about the technological opportunities and barriers faced in their lives. It also captured evidence and examples of innovative practice from over 30 sector leaders on technology-based solutions across housing, health and social care.

“ I’d like technology that could give me more control and independence. That’s why I’m involved with TAPPI.”

Marilyn, retired cardiology nurse

These helped shape ten foundational “TAPPI principles” to build technology into housing in a way that improves life for older people. Working with expert partners the TEC Services Association, Housing LIN and Co-Poduction Works, the second phase of the programme, which is due to report in the latter part of 2023/24, seeks to test these principles through a Champions’ model of co-production. The Champions are based in six TAPPI testbed sites where staff and tenants have joined the Co-production Champions Group. You can read their stories, edited from the fuller versions, here.

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Marilyn’s story

Marilyn, 81 is a retired cardiology nurse, who lives at an Extra Care service in Swansea, Wales. It is a complex of 43 flats, which the housing, care and support provider, Pobl Group, are very keen to enhance their services via TAPPI, in order to promote further independence for the individuals who live there.

How could technology help you?

“I have osteoarthritis and I can no longer support my weight when I’m standing, so I’m stuck in a wheelchair. But I’m very grateful for it. It means I can get myself around and annoy people! Although I wish the battery would last longer. I could do with a lot of little buttons to help me do things in my flat. For example, my kitchen is small and there’s a door which means I can’t get in there in my wheel chair.

It means my carers have to see to my meals with is a little frustrating. I’d like to be able to do more for myself and maybe technology could help with that. It would also be nice to have a curtain switch, so I don’t have to wait for my carers to come. Reaching things and dropping them on the floor is difficult. I have a grabber and it is useful, however I

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am unable to pick things up with a smooth surface such as a TV remote control , but I’d like technology that helps me to do more things independently.

Having been used to living alone I’m finding it frustrating not being able to do things. I have to rely on my carers - I need two at once and they come at set times. For instance, I have to wait until a certain time to have my lunch. If I could just get up and on with it, I’d love that.

I’d like technology that could give me more control and independence. That’s why I’m involved with TAPPI.”

Platform Residents trying different technologies

Rosemary’s story

Rosemary, 76, lives in a retirement village in Ledbury, Herefordshire. Her flat is one of 41 in the scheme, all owned and managed by Platform Housing Group.

What are the barriers?

“My concern with technology for older people is that you can supply it, but you also need to supply someone who has the patience and time to explain how to use it. I’ve worked with computers a bit but even I struggle to remember. If you’re telling me something, I have to write it down. Trust is another big issue. I never did internet banking until Covid and then it was a case of necessity. I’m fine with it now but I’m still wary.

Technology shouldn’t take away human contact. Before I lived here, I worked as a senior warden in this building and my role was hands-on with tenants. As you get older, your world gets smaller, and I brought the world into people’s homes. I would chat with people, organise social activities and help them to do the things they love. You can also do that with technology, but it’s not the same. When we had a new alarm system installed, family members could start contacting us on an app. One daughter said to her mother, “it will save me petrol as I won’t have to drive over.”

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So, it’s not all positive.

It can be a lonely life when you’re older, though, and I sometimes use Facebook. Some people have 200-odd ‘friends’. I don’t really like that word. I’ve got 18 and I know all of them. Facebook is another way my grandchildren send me messages. I use it to stay connected with the younger generation.

I love reading, but because of my arthritis, I can’t hold a hard back book. Recently my eye was operated on for cataracts, so having a Kindle makes things easier. I can enlarge the print and I don’t have hundreds of books cluttering my small flat.

Alice and Peter’s story

Alice, 88, has lived in Scotland, Canada and southern Ireland. She brought up five daughters and used to work with disabled people, supporting them back to work. She now lives alone.

Peter, 82, lives with his wife Margaret. They have five children between them. After a stint in the army, he managed a mobile breast screening service in Edinburgh. Both Alice and Peter live in a retirement housing complex, 20 miles west of Edinburgh. The 31 apartments within the complex are owned by Bield Housing & Care.

How do you feel about technology?

Today’s technology tends to worry many older people and really it shouldn’t. Many of us have seen so much innovation in our lives. As a child, we didn’t have electricity until I was seven and my mother never overcame her fear of it. The difference now, is that technology moves a lot faster and as you get older your brain doesn’t move as fast. What we don’t understand, we fear, and I want to change that through TAPPI.”

How do you feel about technology?

Alice: I don’t have a smart phone. I’m not tech orientated at all, and I had no intention of coming on to the TAPPI project - but Peter asked me to! I do have a laptop which I only learnt to use since Covid. My tech expertise is nil. I can send emails and I go on the WH Smith website to see what the latest authors’ books are. I love reading – I used to be a proof-reader for a company that printed books. I don’t do shopping on the internet though.

Peter: I have a mobile phone and a laptop. I surf the net and google things and use it for finding holidays. But I don’t use it for

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banking. I send emails and use Zoom. I’m not very good at it, but I can do it. Alice and I both have a personal alarm. It’s a button that you can call the housing manager on in the day and the response team at night. And our flats are fitted with warden call systems.

What are the barriers?

Alice: I’m definitely fearful of technology. That’s one of the reasons I don’t do anything on it. I know someone who lost £5,000. She clicked on a link in what she thought was a bill and someone got her bank details. She did manage to get £1,000 back. You have to be careful.

Peter: Until we get the new technology in our hands and know what to do with it, we will be fearful. You have to learn to trust what you’re using. That will happen once we see the things we’ll all get to use and understand how they work.

How can any barriers be overcome?

Alice: It helps to have someone showing you how to use technology. It has to be explained in great detail. I make notes on everything. No matter where I am, I make notes. The older you get, the less your memory works the way it used to. But you have to learn to laugh at yourself rather than getting annoyed!

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Why did you get involved with TAPPI?

Alice: I was nosey! I like to know what’s going on and why. You might call it being curious. I think TAPPI will help me to find new ways of using technology. I have a daughter who is confined to a wheelchair, and I want to find out what technology I can use to support her.

Peter: Alice and I used to be involved in the Bield Improvement Group (BIG) where we’d go to Glasgow once a month to scrutinise their services. But I struggle with my knees –they affect my mobility - and I can’t walk too far. So, when TAPPI came up, it’s just down the stairs - easier than getting the train to Glasgow. I dragged Alice along with me. I like to keep myself busy. I want to open up technology for other tenants. Plus, it will keep them in their own flats for longer instead of them paying around £1,400 a week to stay in a nursing home.

Darshan’s story

Darshan Savani is TAPPI project manager in the adult’s transformation team at Haringey Council. He works closely with residents, identifying how technology can help them lead the life they want. Previously, Darshan was the council’s lead assessor for assistive technology where he evaluated people’s needs and prescribed devices.

What support do residents want?

A lot of it centres on people wanting more control over their lives so they can do the things that matter to them.

For example, some people in sheltered housing told me they want to see who is at the door before giving them access. They are fearful of bogus callers and intruders, and they want to see the caller to determine whether to let them in or not.

Lots of residents want more control over day-to-day tasks like opening their curtains and switching on lights. Two wheelchair users both told me they’d heard Alexa smart speakers can do this for them. Someone also spoke about how it’s difficult for them to open their front door and another individual said their kitchen surfaces are too high and it prevents them from preparing food

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easily. Another resident is passionate about cricket and wants some sort of tech that can help him play back the cricket scores. Several individuals find hoovering and cleaning quite difficult. They are proud of heir homes and want to keep them tidy. We spoke about robotic vacuums that sense where the furniture is and how that little bit of help could make such a big difference.

I’ve also had a number of residents express concerns around health issues. One person has their own private garden,

but they are scared to access it in case they fall. We spoke about how technology could help them become more confident out and about, so they start gardening again and visit their local community. Another individual living in sheltered housing told me about his epilepsy. He wants a device that senses if he blacks out or has a seizure and then calls for help on his behalf. Quite a few people told me it can take a long time to get a GP appointment and they want to keep track of their own health. We talked about digital health equipment that can monitor their blood pressure and blood sugar levels. Staying connected was another recuring theme. Several residents expressed that, post-Covid, lots of communal activities like coffee mornings and other get-togethers have reduced. They want to find ways of keeping connected with other residents, friends and family.

What have been the challenges?

Some residents are frustrated with the pace of the project. They feel the process is slow – in terms of procuring technology, getting a handyperson in to make adaptations and so on. But generally, people are taking it well and they’re excited about how certain devices might support them.

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Dunhill Medical Trust Thanet House, 231–232 Strand London WC2R 1DA dunhillmedical.org.uk

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