DopJSign Envdopg ID". F804C11A-C66C4B32407>BI(UFAD4028 STMARK5 O S P l T A L FOUNDATION A Future Free From The Fear Of Bowel Disease ST MARK'S HOSPITAL FOUNDATION TRUSTEES, REPORT AND FINANCIAL STATEMENTS ST FOR THE YEAR ENDED 31 MARCH 2021 CHARITY NUMBER: 1140930 COMPANY NUMBER: 07532184
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(t4FAD4028 St Mark's Hospital Foundation Tru81oo Report 2021
DopJSign Envdopg ID." F804C11A-C66C4B32407>BI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION Contents Page Trustees. Report Chairman's Statement Govemance and Management Risk and Inlemal Control Objectives and Activities for the Public Benefit Achievements and Activities 2020-2021: Fundraising Research Education Financial Review Statement of Trustees, Responsibilities Independent Audltors. Report Statement of Financial Activities Balance Sheet Statement of Cash Flows Notes to the Accounts Ref8renco and Admlnlstratlve Inforniatlon 10 12 15 18 19 22 23 24 25
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(C4FAD4028 ST MARK'S HOSpAL FOUNDATION TrUSTEES' REPORT FOR THE YEAR ENDED 31- MARCH 2021 Chairman's Statement l am extremely proud of our Foundation and St Mark's clinicians who have shown extraordinary resilience and determination supporting the NHS in its fight against coronavirus. whilst doing their utmost to ensure patlents needing complex bowelwrelated treatment are being cared for without ompromise. Clearly, the pandemic is not over but wilh the renI suc$$ of thg creation of a vaccine in record time followed by a very successful rollout in the UK, l arn cautiously optimistic we wlll slowly get back to normal, albelt a somewhat dlfferent new normal. St Mark's contlnues to remaln focused on delivering world class specialist care for patients and carrying out its mission to lead cutting edge research and educalion on a range of complex bowel issues. This past year also marked the 185" anniversary of St Mark's Hospital and the 25 anniversary of ils move lo the current site, both historic milestones worthy of recognition. However. in light of the pandemic, we chose to defer celebrations. We were very sad lo lose Paul Bouscarle. a long lime Iruslee. supporter and valued colleague of the Foundation, who died on 4th September 2021. Paul made a huge contribution lo St Mark's through his fundraising efforts and his wise advice to the Board of Tnjstees. He wll be much missed by us and of course his family. Within the span of a few weeks in early 2020. the coronavirus pandemic surprised and fundamentally changed the world we live in and lrfe as we know it. Understanding of the disease was limited and scientific guidance changed frequently, leading lo signrficanl uncertainty. In March 2020. the Northwck Park Hospital sile Iwhich includes Sl Mark's Hospital) was one of the first to receive patients critically ill with Covid-19. The impact was immediate for both clinical staff and patients of Sl Mark's. Our specialist clinicians were rapidly deployed and played a highly signrfi¢anl role Caring for patients on the quickly re-purposed Covid-19 wards and expanded Intensive Care Units. The Foundation staff quickly adapted lo supp(wt the hospitsl in many different ways without losing sile of ils main remit.. supporting the hospi181's research and education. In response lo the crisis, the Foundation team, through ils goodwll and efforts, also received some generous donations from new and existing supporters and pul these to very good use lo support the provision of urgenlty needed ilems. Amongst these were PPE venlilaled ho(xJs lor ICU staff and iPads for patienls lo communicate with their families in desperate ¢ircumstances. This last initiative was led by a team of our research felkjws who have been nationally recognised for their initiative. Throughout the year, Si Mark's has suffered from a number of waves of Covid -19 patients at Northwick Park Hospital and in response lo this, has moved some of Ihe specialist clinical services lo Ihe Central Middlesex Hospi181 site which h8s more capacity. Wherever our clinicians found Ihernselves during the18s1 year, we remained committed lo supporting the research and education programmes they continued to lead on despite all of their challenges. In this regard, the Foundation has fortunately had a very successful year and continued lo raise significant sums ol reslricled and unreslricled lunds. Tolal income for the year increased by 27./0 to £2.239,733 from £1,762,291 in 201 &20 which was remarkable given the Challenging environment for physical fundraising events. We are especially grateful lo a new donor who has made a significant contribution lo our fund raising income during the year and has indicated they will provide ongoing support. Unreslricled Reserves at year-end were £684,054. equivalent to 12 months, operating expenditure. Given the uncertain environment, my fellow Injslees and I feel this higher level of reserves as compared with the normal tsrget of 4-6 months is not unreasonable on a short-temi, temporary basis. Page 4
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(C4FAD4028 ST MARK'S HOSpAL FOUNDATION TrUSTEES' REPORT FOR THE YEAR ENDED 31- MARCH 2021 The operational resilience of the Foundation and Academic Institute staff was remarkable as they adapted to new ways of working. They quickly adjusted lo a part remote working model but al the same lime the stsff who operationally support research and educatson worked from the hospital throughout the year lo support our clinical stakeholders. The success of the innovative online course webinars which began in June 2020 and the signature Frontiers conference in November 2020 as a fully online studio level digital broadcast with an audience of over 3,0(M) were highlights of the year. From a research perspective, we continued to support many of our ongoing projects and started a range of new research. details of which are sel out later in the report. On behaw of the Board and management team. I woukj like to thank all our donors for their support. particularly in these extraordinary limes. The Four)dalion is delem)ined to continue its mission to raise funds and help cure complex bowel related diseases. Sir Thomas Troubridg8 27th September 20211 Page 5
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M1(t4FAD4028 ST MARK'S HOSpAL FOUNDATION TrUSTEES' REPORT FOR THE YEAR ENDED 31- MARCH 2021 The Trustees present their report and the audried financial stalements for the year ended 31, March 2021. Si Mark's Hospital Foundation is a company limited by guarantee. incorporated on 16 February 2011 and not having a share nd capital. It was registered as a charity with the Charity Commission for EngL4nd and Wales on 2 March 2011. The Foundation commenced operations on 1" April 2011. when the assets and operations of Sl Mark's Hospital Foundation Trust, a charty registered wlh the Charity Commission for England and Wales under Charity Number 1088119, were transferred lo the corporate charity. The Foundation is operating under exactly the same principle and objects as the unincorporated Trust and eonlinues to support St Mark's Hospital. particulady by funding research projects, as well as managing and delivering a large programme of education. enabling the dissemination of best practice in the fiekl of bowel disease at Si Mark's Hospitsl. Governance and Management effectiveness of the Foundation's extemal audit. including appointment of the Audrtors. Monthly management accounts are provided to the Trustees, giving infomiab.on on income and expenditure and budget comparisons. Trustees are apF)oinled by Ordinary Resolution or by a simple majority of all the Trustees enlilled lo attend and vole at any meeting of the Trustees. Trustees hold office until the end of the first meeting of the Trustees following the third anniversary of appointment or re8ppoinlmenl. Trustees are permilled lo sland for re-election f further terms with duration of three years each. Amongst the Trustees there is a good mix of skills with both medical and non-medical represenlalives bringing medical, business and financial expertise to the Board. There is also diversity of gender and age. Fundralsing Committge This consists of the Chairman (Trusleel, three Trustees. Ihe CEO and Fundraising Manager. The role of the Fundraising Committee is lo provide oversight of the activities of the fundraising team, and lo ensure that fundraising activity is in accordance with the strategic goals of the Board of Trustees. The Committee is the key conduit for communication and reporting beNveen the fundraising team and Ihe Board. The Board of Trustees administers St Mark's Hospital Foundation, meeting quarterly. The day-tO- day operations of the Foundation are managed by the CEO, who reports to the Board on perfonnan against the strategic plans approved by the Trustees al quarterly meetings, when reports from the Clinical Director and the Dean of the Academic Institute are also received. R&s•arch Overslght CommStta6 This committee does not have any direct Trustee represenlalion.11 consists ol the Dean of the Academic Inslilule, the Clinical Director of Si Mark's Hospital. senior consullanls and the CEO of the Foundation. The Committee reviews applications for grant funding and makes recommendalions lo the Board. The Trustees do not receive remuneration or derive any other personal benefit from the aclivilies of the Foundation. The Trustees may delegate any of their powers to a committge consisting of fv40 or more Truslees. The following committees have been established.. Risk and Internal Control The Trustees have overall responsibility for ensuring that the Foundation has an appropriate system of interr)al cor)trols. financial and otherwise. They are also responsible for safeguarding the assets of the Foundation and hence for tsking reasonable sleps for the prevention and detection of fraud and other irregularrties and to provide reassurance that: Flnance and Audit Committee This consists of the Chairman ITruslee), Treasurer (Trusteel, CEO and Accountant. Expenditure is supervised by the Committee to ensure compliance with decisions taken by the Board of Trustees. The Committee presents the draft annual budget to the Board, oversees the performance of investments. helps lo idenlrfy, evaluate and manage risks and oversees the its assels are safeguarded against unauthorised use or disposilion; Page 6
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(t4FAD4028 ST MARK'S HOSPThAL FOUNDATION TRUSTEES, REPORT FOR THE YEAR ENDED 31- MARCH 2021 {contSnuedl proper records are maintained and financial infomalion used within the Foundation or for publication is reliable., and the Foundation complies wth relevant laws and regulations. receiving UFMlates during the year on current research- and receiving updates during the year on postgraduate education. The above enables the Trustees lo satisfy As part of the Foundation's risk management themselves that the Foundation policies are being process, the Trustees acknowledge their implemented. that significant weaknesses of control responsibility for the Foundation's system of idenlified are being prompuy addressed and on the intemal controls and reviewing its effectiveness. It overall adequacy and effectiveness of the is also recognised by the Trustees that such a Foundation's system of intern81 control and risk system is designed to manage ralher than eliminale management. the risk of failure lo achieve the Foundalion's objectives and can only provide reasonable. not absolute, reassurance against material misslalemenl or loss. Objectives and Actlvities for the Publlc Benefit In line with th8 Charity Commission's guidelines on risk management, the Foundation has developed a risk register, outlining the potential risks the Foundalion could face, weighing the likelihood and potential impact of each and the current and proposed actions required lo miligale those ri$k$ a$ appropriate. The most significant risks for the Foundalion include.. ils ability lo fundraise SLrfficient unrestricted income lo cover core costs and lo generate a Surplus for Tru$lee$ to desbgnate lor resear¢h and education; the length of lime from receipt of funding to research project completion. The objecls of the Foundation. as set out in the Articles of Association, are restricted specifically lo the promotion of research into and education in disorders of the gastro-intestinal tract and pelwc floor. The policy adopled is lo provide support for research al Sl Mark's Hospital, by making grants for research projects approved by the Board of Trustees, and lo fund the Academic Instilule, postgraduate course5 and lectures and the observation of surgical procedures al Sl Mark's Hospital for medical students from around the world. A Multi-media Department. funded by the Foundation, is a valuable resource providing support for both research and education within Sl Mark's Hospital. The Trustees minimise risk lo the Foundation by: monitoring the risks by reviewing the risk register on a regular basis., setting a policy on expenditure approval. signing of cheques and the aulhorisalion of online banking transactions.. holding regu18r Trustee Meetings-, holding an Hiscox Charity Care insuran policy., receiving monthly management accounts comparing activity against budget- The Trustees refer to the guidance contained in the Charity Commission general guidan on public benefit when reviewing the aims and objectives and in planning future activities. In particular, the Trustees consider how planned activities wll eontn.bute to the aims and objectives that have been set. Pagc 7
DopJSign Envelopg ID". F804C1IA-C66C4B324D71CuFAD4O28 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) Achievements and Activities 2020-21: Overvlew Sl Mark's Hospital Foundation is dedicated lo funding healthcare research al Sl Mark's Hospital that drives clinical improvements and improves the understanding of complex bowel diseases. The Foundation also operationally facilitates the delivery of an extensive programme of education and income-generaling courses (both physical and virtuall through the Sl Mark's Ac8demic Inslitule. These are delivered by the medical staff al Sl Mark's Hospilal lo doctors and other healthcare professionals who attend in-person and virtualty from across the globe. The 2020-21 financial year started in the midst ol a global healihcare crisis. Al a local level, we fell the effects of the virus acutely as we were one of the ffirsl responders lo the Coronavirus ICovid-19} pandemic in London. However, we did not allow this lo impact our research and education activities as we adapted lo new ways of working. The Foundation showed tremendous resilience to the ever-changing nature of the pandemic over the course of the year. Developing relationships wilh new supporters was one such example that arose as a consequence of the pandemic. We are grateful for the conlribulions received from our new relationships as well as our existing Supporters to fund our search activity as well 8$ strengthen our operations. In light of the above, the pnorily for this year has been to: Support néw and 8xi$ling priority strategi¢ research proie¢ts a¢ros$ all disciplino$. somo of which have Iransfomied in importance and relovan¢e in the wake of the Coronavirus (Covid-191 pandemic., continue to execute on our projects using the existing restricted funds; enable the Surgical Robot to evolve lo a clinical delivery service managed by the hospital; adapt our Academic Education course programme from in-person lo virtual leaching., meet the changing needs of siakeholders including staff, hospilal's medicallnon-medical staff, donors and strategic supporters,. and respond to the needs of the hospital and ils staff during the Covid-19 crisis.. implement new working practices such as remote working lo protect our staff to the extent possible whilst continuing to operate wthout material disruption. Significant progress has been made over Ihe past iwelve months. The Board is confident that the actions implemented have strengthened the Foundation and wll better enable the organisation lo raise funds for high quality medical research at St Mark's Hospital. The CEO worked closely with the Research Oversight Cornmittee to agree the strategic research priorities. The Surgical Robotics Research Programme continued lo attract funding, and granis were also secured for the projects profiled in the section 'Major research projects funded from new and existing Restricted Funds, Ibelowl. Page 8
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) Impact of Covid-19 The Covid-19 pandemic forced all healthcare professionals across the county lo re-orient their activities and join the frontline lo fight the virus. Whilst this had to become the n81ion's priority, Sl Mark's clinicians remained acutely aware that the challenges for patients with bowel cancer, Inflammatory Bowel Disease and other complex bowel conditions had not gone away. And so, at the same time as uniting with their colleagues across the country, they continued lo deliver some of their core services in a different formal. such as by telephone or online video call I'telemedicine')- Our co-localion wlh Northwick Park Hospitsl meant that Sl Mark's specialist doctors and nurses were redeployed immediately in March 2020. wth many of our research fellows supporting their colleagues in intensive care for as long as three months. As the number of Covid-19 hosptslisalions reduced over th8 summer after an intense pericmy of working that involved supporting thousands of people to recover from the virus. providing conlinuily of care to our gastroenterology and colorectal patients remained a wiority. However. the scale and mode of delivery of this care was impacted. Between September and November, inleTrsive care staff had some respite, bul we knew that the wnler period was going lo be made significantly more challenging by Covid-19. From October 2020. some Sl Mark's clinical services were relocated lo Central Middlesex Hospital, which offers a clean sile for clinlcal care. This enables us to maintain outpatient and surgical care during future surges of CoMd-19. Whil$l the first few month$ of 2021 ¢oin¢ided with another surge of Covid-19. the global effort to produce a safe and effective vaccine and the efficient rolkjut of the vaccination programme in the UK marked a slgnificanl milestone in our nation's roadmap lo recovery. The first quarter of 2021 saw Sl Mark's moving lo a position of clinical and research recovery, which has been greatly assisted by the move of some clinical services to Central Middlesex Hospital,. another hospital within the London North Wesl University Healthcare Trust. We remain immensely grateful lo our supporters, both longstanding and new, who have rallied round the hospitsl with in-kind and financial donations. We are also grateful for the grants we have continued to attract for research projects that have become more important and relevant in the wake of Covid-19. Like all charities, the pandemic's impact on our tradilw)nal fundraising methods, specrfically mass participation and other community events. was significant. We thank our supporters for embracing the national calls lo partake in virtual challenges, and for also finding other innovalive ways lo support us. These efforts have not fully recovered the lost income we have experienced from traditional fundraising events not being able to go ahead as planned however donations from corporate supporters, individual donors and different types of events have more than compensated for Ihis. As the situation with the pandemic improves. the funding environment will likely remain challenging. However, wlh new ways of working wlh our various stakeholders, we are cautiously oplimislic as we look ahead to the new financial year. Research holds the promise of better futures for our patients. We therefore remain fully committed to securing funding for projects that have the potential lo improve survival and quality of life, and to delivering an ongoing extensive programme of education to share best practice in colorectal and intestin81 medicine. Page 9
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M1(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 {continued) Major research projects funded from new and existing Restricted Funds Highlighted ongoing projects Surglcal Robotles Research Programme for colotal and anorectal surgery The Foundation continued lo financially support St Mark's Hospitsl's Surgical Robotics Research Programme. The Programme is researching the polenlial of rot)lic technology lo improve the long-term health outcomes for people who require surgery for colorectal cancer and other bowel conditions, such as Inflammatory Bowel Oisease IIBDI. Since the arrival of the Da Vinci RotKJt at St Mark's in April 2018. the Sl Mark's robotic team has performed over 240 robotic coloreel81 operations on bowel cancer and IBD patients, which is a significant achievement. This is despite Ihe Da Vinci Robot not pul to use temporarily al the height of the pandemic last year. The surgical robotics platfomi has also been used by our surgical colleagues from the wider hospital's urology, gynaecology and maxillo-facial departments, albeit the main focus of the programme, unlike other UK hospitals. is colorectsl surgery. The Foundation has successfully funded the initial conlractual cosl in accordance with the lemis of the agreement. Investlgatlng and Improvlng the quallty of IBD surg•ry Eviden suggests there is variation In the delivery of IBD services and outcomes following18D surgery across IBD surgical units in England. One approach lo narrow the qu81ily gap between organisalions is to learn from those that are considered lo be Ihe highest rf0Mers. Studying high perfom)ing units for quality improvement has been well described in the lileralure. This project has identified high perfomiing units in England using outcome d818 from six IBD operations, and in4Jeplh analysis of these units has bèen performed lo understand how they achieve iheir resurts. Our leamings will be shared nationwide and have the potential lo improve surgical outcomes and reduce quality inequity between IBO surgical units across the UK through a national quality improvement programme. PERFECTS CT colonography {CTCI is an allemative lo traditional colonoscopy and can be used for frail. older and fearful patients lo identify pre-cancerous and cancerous growths. However, il is widely recognised that the accuracy levels for identifying those growths varies significantly across tho UK. from 14.kn in somo cenlres to almost 100010 at Sl Mark's Hospital. The PERFECTS research programme aims lo train radiologists practicing VC in the UK to a hwh standard of proficiency and provide professional accreditation. PERFECTS has the potential lo reduce the UK-wide variations in scan reporting of pre- cancorous and cancerous growths via CTC which is leading to missed cancers. by improving the national skill level ol radiologists practising this technique. Principles established by PERFECTS have led lo the creation of the National CT Colonography Training & AreditatIOn Programme, which aims to train, test and performance monrtor radiographers and radiologists vtho perfomi and interpret CTC. PROGRESS Bowel cancer screening and Surveillan in the UK has been carried out for many years in a slandardised way bul does not consider a patient's risk of developing bowel cancer. This means that some patients are undergoing loo many colonoscopies whereas others may nol be reIving enough surveillan. PROGRESS is Using cuttingdge molecular pathology techniques, to more accurately predict who will develop bowel c8ncer. This is wth a view lo person81ise Ire8tmenl to individual cancer risk and ensure that scarce resources are targeted more accurately lo where the needs are greatest. This is a collaborative project wilh Barts Cancer Institute and St Mary's Hospital. Our preliminary results show differen$ between polyps that became cancerous compared with those stayed benign. In addition, for the first lime. the endoscopic resuhs of a large dataset of patient5 that had colonoscopies and were followed up over a len year pericxj have been compared with the revised 2019 British Society of Gaslroenlerology guidelines. This reveals that, had these guidelines been in place in 2010, 600/0 of patients would have been discharged with no risk of colorectsl Canr$ being missed. These insights Page 10
DopJSign Envelopg ID". F804C1IA-C66C4B324D71CuFAD4O28 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) could help target resources more accurately on high risk canr patients in the future. The final research reports will be published in 2022. Precision Medicine in IBD: Can genetic clues from an inflammatory b¢)wel disease patient's gut predict whether or not they will respond to treatment? The terms personalised medicine and precision medicine are used interchangeably but they are united by a single vision." that patients with the same diagno&s do not receive the same treatment, bul the treatment that is appropriate for their disease. This palient-centred approach improves survival outcomes and health-relaled quality of life, and il also means Ihal scarce healthcare reSoUrS are directed more appropriately, helping those most in need. The need lo relieve the growing pressures on clinical services in the wake of Covid-19 has never been greater. This project is a slep towards a future where precision medicine can be realised for Crohn's disease and ulceralive colitis, the conditions colleclively known as Inflammatory Bowel Disease {IBDI. Understanding which chemicals drive inflammation in IBD may reveal predictors about which drugs patients will and will not respond lo. This means the right treatment can be started earlier and patients stsy well for longer. Our project could ad to larger trials to investigate the utility of our findings in wder clinical practice. Hlghllghts of some of thè nèw projècts started In 2020 Stratlfylng IBD patlents In accordance wlth cancer rfsk Developing new methods lo effectively stratify IBD palienls by their risk of developing cancer is an inlernalionally collaborative project that Sl Mark's Hospital is al the heart of. The primary aim of thi$ research is lo create and then clinically te$1 molecular biomarkers that a¢¢urately determine ¢ancer risk in IBD patients. Following the successful first stage funded by one of our strategic supporters the team Is discussions with International collaborators to launch the next phase of this project. The WAVE sludy Colonoscopy is one of the main investigations lo detect and prevent bowel cancer. Colonoscopy services in the UK are experiencing growing pressures.. the failure lo meet national wailing time largels is delaying procedures and bowel cancer diagnoses. In response lo the growing pressures, endoscopy units have been extending opening hours and offering weekend ProdureS,. this not sustsinable, especially in the Covid-19 era which is intensifying Ihe pressures on clinical services. In a resource- constrained environment, the endoscopy profession has lo find new ways lo improve efficiency and quality. The WAVE study is one of our responses lo this need. For the first lime, a controlled trial will compare two colonoscopy techniques {waler and waler & carbon dioxide Ihybridll lo identify which should be used lo open up the bowel wall to see the lining of the tM)wel. Understanding which technique is better al reducing pain. the procedure lime and need lo reposrtion patients, as well as being the most effective al improving the detection of pre<ancerous and cancerous growths, would help the colonoscopy procedure lo be perfomied more efficiendy potentially better tolerance and outcomes for patients. Establlshlng the Infrastructure for a new future.proof research resource al St Mark's A tissue bank facilily has recenlly been eslablished al Sl Mark's Hospital which is making il possible for the hospitsl's medical professionals to colleci fistula tissue and other samples from patients for use in future research projects. Whilst a proportion of these samples wll be frorn patients with very rare conditions, others are rare bul seen in high volume al Sl Mark's Hospital. The tissue bank represents a fUtu-pro0f research resource. Over lime, the tissue bank wll provide a rich source of dats for Sl Mark's Hospital's consultsnts and research fellows. which one wll not be able to find in any other institution in the UK in the same volume. Pagell
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) LYNCH STUDIES.. New diagnostic techniques for bowel cancer detection and prevention The Sl Mark's Lynch Syndrome Clinic is an active research department and is currently undertaking a range of projects which are being supported by a large donor. One of the projects aims to develop more lesls which facilitate the prevention and eady diagnosis of cancer in people with Lynch Syndrome ILSI. LS is a hereditsry disease which is responsible for around 1 in 30 cases of bowel cancer, often affecting multiple family members. Al present, the screening guidelines for LS patients involve the requirement of up lo 20 or more colonoscopies throughout one's lifetime. This is both invasive and resource intensive. Identifying other types of screening which are effective al diagnosing bowel cancer and pre-cancerous changes in LS patients. at a time when traditional colonoscopy Sery1$ are facing increasing pressures, will be essential going forward and can be used to supplemenl colonoscopies. During the Covbd-19 pandemic, Sl Mark's has spearheaded a national project to improve access lo colonoscopy for high risk patients by using 8 stool FIT lesl lo idenlrfy those whose need is greatest. At 8 time when access lo colonoscopy is limited, this lest is used to idenlty patients who should be priorilised. DRIVEN: Development and valldatSon of a preryoperatlve rlsk stratlftcatlon method for patlonts wlth rlght-slded bowel cancer to improve survival outcomes. Knowing, pre-operalively, whether a patient is likely lo have a good or poor prognosis wll make it possible lo tailor surgical and medical treatment lo the individual. Patients al high risk of poorer outcomes can be offered more extensive surgery, andlor chemotherapy prior lo surgery, rf appropriate. Pre•operative computed tomography ICTI scans will be revalualed applying a novel stsging method called CT TDV. Pre-operative colonoscopic biopsies will also be reassessed. Scan and biopsy results will be compared with both the operative technique perfomed and patients. survival outcomes to infom) the development and validation of a rlsk 81ralificalion method. We are collaborating with radiology and pathology colleagues at The Royal Marsden Hospital and the Inslilule of Cancer Research. Educallon Sl Mark's Academic Inslilule, which is funded by the Foundation and supported by course fees, is dedicated lo education and disserninabon of best practiee in the field of bowel disease 81 St Mark's Hospital. Drawing on the medical, surgical and nursing expertise both at the Hospital and further afield, the Academic Institute runs specialist courses attracting in excess of 1,500 practitioners from the UK and overseas. The Foundation operationally supports over 30 research fellows undertaking either MDS or PhDs. The Academic Institute supports and promotes a wbrant research ethos. Frederick Salmon founded St Mark's Hospital in 1835 as the 8enevolent Dispensary for the Relief of the Poor Afflicted with Fistula, Piles and other Diseases of the Rectum and Lower Intestines. Although the Hospital now has a far broader remil. il is fitting that Salmon's ultimate goal, benerIng the patient, remains the objective of the eduralional courses we offer today. Acadomlc Institute department staff wlthln the Foundatlon Multi-media webcast pr0ducerlaudlcWSUal c(thinalor Coursg manager Page 12
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) Course assistant Research co-ordinator Academic Instilute Course Overview As the first hospital in the wodd lo specialise in Co¢1 disease. Sl Mark's Hospital has embraced the education of others. Since the 1950's dcdors have come to Sl Mark's Hospital from all over the worfd lo leam, with many returning lo establish the specialism in their own country. The treatment of intestinal and colorectal disease has now become a speciaAy in ils right throughout the world and St Mark's The Sl Mark's Academic Institute has access lo a wealth of highty qualified and experienced stsff who have a proactive attitude to education. Courses vary in lenglh and attract a broad range of poslgraduale medical stsff. All educational courses are advertised on the inlemel and via the medical and paramedical press. We provide facilrties on all our educational courses for the disabled. Attendees. in particular for the Sl Mark's Hospital's Frontiers meeting and poslgraduale leaching courses. are from throughout the UK as well as Argentina. Australia, Austria, BelUM, Brazil. Buaria, Canada. Chile. China. Colombia, Croatia, Czech Republic, Denmark, Eire, Egypl, Finland, France, Gem)any, Greece, Hungary, Iceland, India, Israel, Italy, Japan, Kingdom of Bahrain, Korea, Macedonia. Mongolia, Nelhedands, New Zealand, Norway, Pakistan, Poland, Portugal, Russia. Saudi Arabia. Serbia, Spain. Sri Lanka. Singapore, Switzerland, Taiwan. Thailand, United Slates ol America and Uruguay. Academlc Instltutè 2020.21 This unprecedented year, dominated by the COVIO-19 pandemic, impacted the Academic Institute deeply. As tho waves of patients with COVID-19 occupied our hospilals, the need lo deal with this enormous Clinical emergency meant Ihal the delivery of education at St Mark's hospital was initially servery impacted. Slrin9enl nation81 and inlemal hospitsl restrictions were pul in place lo minimise the risk of viral transmission, hence the faCe-lface leaching of courses was suspended during this period. As national lockdowns were imposed. national and overseas visitors wore not allowed to visit our hospital. The poslgraduale room where our courses are held. became a resting area for the overworked clinical staff working in the Intensive Treatment Units in our wards. Many clinical faculty and non-clinical staff were re-deployed to areas where needed most. These restrictions affected most ol the courses originally planned and scheduled for the 2020-21.. These new challenges forced us lo think of drferent Ways lo approach the delivery of education. With the aid of technology, different online plarfomis. and collal)oralion with Sayso Medical. an extemal company, we had the opportunily lo experiment other ways to deliver education. not only lo national participants bul also lo international delegates, wlh very high standards and touching very current issues al the lime when people were most restricted in terms of travel. We delivered three virtual webinars which were very well received. With Ihis success and the challenges the COVID-19 pandemic brought lo our educational field. it was decided lo change the way we delivered our courses from fa-tO-faCe courseslevents to wrtuallonline webinars and conferences. Our first webinars were well attended. Our open day for prospective medical students on 7 July 2020 had 42 regislralions. We also had tsvo well altended gastr01nlesnaI pathology study days. This year we also launched a series of ENDOcation endoscopy leaching webinars which are very popular with regislralions reaching approximately 500 people. In this. we have had 3 ENDOcation courses including the course below. Next year we will have another 2 from the ENDOcation series. Page 13
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(t4FAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES, REPORT FOR THE YEAR ENDED 31- MARCH 2021 {continued) We were asked lo collaborate with the New Zealand's National Bowel Screening programme, the New Zealand Society of Gastro8ntorolc%Jy and Ihe New Zealand Association of General Surgeons and deliver a firsl-class course lo educate bowel endoscopists in New Zealand. This course was well attended and it has created 8 strong 8nd fruifful link with the New Zea18nd Nalior181 Bowel screening programme who are interested in future educational wllaboralion wth St Mark's. This Urse was number 3 of our ENDOcalion series. Our flagship course, 'Fronliers in Intestinal & Colorectal Disease.. was an enormous success in November 2020. The event was delivered entirely online using high quality digital streaming from our custom designed broadcast studio and very well supported through sponsorship income. 11 was very professional, highly engaging. interactive and fresh. We had 3,006 registrations, and of those, 1.960 people attended the course from 69 countries with the opportunity lo see the whole conference online after the event. We were pleased to receive extremely positive feedback from attendees on the overall delivery and content of this course. The 'Horizons in Intestinal Rehabilitation & Home Parenteral Nulrilion. course was also delivered entirely online. The attendance of this course Wds excellent: it was more than double the amount of attendees we used lo gel in the past, from around 80 attendees to 246 attendees. We had attendees joining in from all over the wodd. Changing the delivery mode of education, did not only open the opportunity lo reach participants in corners of the world before we could not reach, il also brought us the opportunity lo deliver high standard education wlh unreslricled numbers of attendees in a more sustainable formal. Courses are Charged at a standard and ¢omparable rale for educational ¢ourse$ in this field and dlscounted place are often provided for trainees. However. this year has brought about an evolution to a more sponsor led education proposition. We have been able lo offer many of our courses as free lo attend thanks to the generosity of our sponsors. Cour8• nam• and d•scrl tlon Webinars and online discussion forums, inviting the colorectal Gl community lo an interactive and engaging hour of presentations, panel discussions, live polling and Q&A: Managlng surgical risk durSng the COVID-19 era A testing timo for coloroctal cancer diagnosis- How to respond? IBD managemènt in thè COVID-19 era- Praetical issues addressed by the multidisciplinary team AbdomSnal Carg - 20 crgdlt degr99 - Unlvgrslty rnodulg ree-level module for healthcare rofessionals CT Colonography course A train the trainers course coverin various as ENDOcation end05copy Webinars Series of webinars for education in endos matters Frontiers in intestinal and colorectal disease A flagship three-day annual international conference covering a broad variety of topics. live sur lendoscop and stale of the art ke ole talks Horizons in Intestinal Rehabilitation & Home Parenteral Nutrition 2-day online course with Lectures and breakout seminars lookin9 at chronic 8nd acute intestin81 failure and home arenleral nutrition Gastrointestinal Anatomy and Physiology 20 Credit Degree - Level Module A course for healthcare professionals with an interest in caring for people with gastrointestinal conditions and diseases., ainin a universi 8ward al 20 credrts ects of virtual colonosco Page 14
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(t4FAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES, REPORT FOR THE YEAR ENDED 31- MARCH 2021 {continued) Gastrolntestlnal pathology study day Identif and re ortin on astroinleslinal Gastrolntestlnal study day for nurses osium for nurses lo increase their understandin of a varie Independent Study 20 credit degree-level university module For healthcare rofessionals lo undertake a bes ke module on a Open day for pro$p8¢tive medi¢al Students An introduction lo careers in medicine for sixth fomi students Polypectomy 2021- Webinar for NZ Bowel Screening Colon05COPiSts This webinar was made in reswnse lo requests to both Sl Marks and the New Zealand Bowel Screening Programme INBSPI and was presented in association with the NZ Society of Gaslroenlerology INZSGI and NZ Association of General Sur eons NZAGS of 8slroinleslinal lo astroinleslinal lo ic of their choice Other Notable Educational Activitles Research Cowordlnatlon The department's full-lime research eOryordin8tor supports the Research Fellows in a number of key ways, including their medical grant applications and research impacl measurement reporting. The research process can be administratively complex and we have successfully developed relationships and collaborations wlh other research inslitulions. formalised Ihe process for collectsng research metrics and developed 8 programme ol 18lks for the Research Forum. Educatlon for Internatlonal Vlsltors Most of our international visitors had to leave suddenty in March 2020 due lo the pandemic spreading around the globe. After our first lockdown, we were delighted lo welcome tsvo inlemalional observers from Korea who joined us al Sl Marks Hospital. Nurse Educatlon The gastroinleslinal care pathway and ils individual modules continue lo be successful. These modules run in conjunction with Birmingham City University. In 2020 the pathway was expanded lo include a Masters. This enables nurses to attain a post graduate eertrfieale in gastrointestinal care. Financial Review Income The Foundation received donations from a variety of sources and is not dependent on the support of any particular individu81, corporation or class of don¢x. Total income for the year was £2,239,73312019-20.. £1,762,291), an increase of 27Yo, wilh the largest driver a large unrestricted donatson. Donations (including legacy gifts} were £2,050,751 1201&20.' £1.259,1331, an increase of 63°k. The increase in donations has changed the income mix in the current year. As a resull. income from donations represented 78°A of lolal income, as shown in the chart below. Income from education courses represented only 7Yo of the lolal income as compared wth 26°/0 in the prior year, due to fewer courses held during the year. In absolute value terms income from education courses dropped by 64./, from £450,75110 £163,848. The income from legacies also dropped from 30 % in 2019-20 10 130/D in 2020-21. Legacy income can vary signrficanlly ben years due lo ils inherent nature. Page 15
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) 202fy2021 2019-2020 0.1 ix 21% 41% •Oth•r 16% Expendlture The lolal expenditure for the year was £1,499,O7212012O.. £1.811.712}. Education expenditure as a percentage of lolal expenditure has dropped by 8% as fewer courses were held during the year. The decrease in education expenditure has changed the expenditure mix in the Gurrenl year. Even though Tesearch expenditure was slightly lower in absolute terms, it made up higher Share of the lotsl expenditure, increasing from 61% of total expenditure in 2019-20 to 690/0 in 2020-21. The cost of raising funds as a perceniage of lolal expenditure increased from 110/0 10 12Vo bul decreased in absolute terms. This decrease was driven by efforts to be more cost efficient without impacting the Foundation's fundraising ability. 201fy1021 201>2020 The Trustees continued lo review the Cash held on deposit, holding sufficient short-tem) cash lo meet current obligations. Net incoming resources for the year amounted lo £740,661. Totsl funds al the end of the year were £4.022.363. compared wilh £3.281,702 in the previous period. Funds and Reserves The Trustees are satisfied that adequate funds are available in each fund. as shown in the notes to the accounts, for the Foundation lo meet tts obligations. Restricted Funds are for particular areas of research as specified by the donors. Designated Funds are Ihose funds set aside for future research or educational projects as approved by the Trustees. The Trustees have a policy of holding Reserves. Unrestricted ReseNes are required for designation to fund the future planned activity of the Foundation, including research and education projects that the Trustees may wish lo support. They are also required to provide regular cash flow to finance on-going Page 16
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) expenditure and core support costs and to protect the Foundats"on's actimties from any urrforeseen fluclualions in income. The Trustees reviewed the reserves policy in the year and agreed the policy remain tjnchanged, wth a tsrget level for unreslricled reserves equivalent to four to six fflonths, operating expendilure1£280,000 - £420,000). Unreslricled Reserves at the year-end were £684.054, equivalent lo 12 months, operating expenditure, which include the Academic Inslitule's course costs. Trustees agreed that this is reasonable level of reserves given the nrtaInty caused by COVID-19 and provides adequate contingency cover. The Foundation has forecast income and expenditure for 12 months from the date of this report, taking into consideration the likely impact of the Covid-19 pandemic on both fundraising and the Academic Instilule's expected income from c4)urses. Based on the forecast. Unrestricted ReseNes al the end of the twelve months are estimated lo come down lo the 6 monlhs expendilure level. which is the upper end of the Trustees approved reserves policy of four to six months range. Reslricled Reserves (representing funds raised for specrfic projects currentty in progress) were £2,614,273 al the year-end compared with £2,449,561 al year-end in the prior year. Investments The objective of the Foundation's treasury Fdrcy is lo produce the b8sI financial retum wthin an acceptable level of risk. The Trustees have continued the policy of holding the financial assets of the charity in fixed-tem sterling deposit accounts. The funds are deposited across several financi81 institutions and the cash position and fixed deposit returns are monitored on a regular basis. The Finance Manager reports al the regular Trustee Meetings on the perfornance of the deposils. Page 17
DopJSign Envelopg ID". F804C1IA-C66C4B324D71CuFAD4O28 ST MARK'S HOSPITAL FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31- MARCH 2021 (continued) Statement of Trustees, Responsibilities The Trustees (who are also Ihe directors of the St Mark's Hospitsl Foundation for the purposes of company lawl are responsible for preparing the Report of the Trustees and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice), including Financial Rewrting Stsndard 102 Yhe Financial Reporting Standard applicable in ihe UK and Republic of Ireland". Company law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the $18te of affairs of the charitable company and of the incoming resources and applicalion of resources, including Ihe income and expenditure, of the charitable company for that period. In preparing those financial statements. the Trustees are required lo select suitable accounting policies and then apply them consislenlty observe the methods and principles in the Charity SORP make judgements and estimates that are reasonable and prudent prepare the financial slalemenls on the going concem basis unless il is inappropriate to presume that the charitable company will continue in EMJsiness The Trustees are responsible for keeping proper accounting records which disclose with asonable accuracy at any lime the financial position of the charitable company and to 8nable them to ensure that the f1nancial stslements cornply wlh the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for takin9 reasonable steps for the prevention and detection of fraud and other irregularilies. In so far a$ the Tru$lees are aware.. there is no rel8vanl audit infomiation of which the ¢haritable companls auditors are unaware,. and the Trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and lo establish that the auditors are aware of that information. Members of the Foundation guarantee to contnbule an amounl not exceeding £110 the assets of the Foundation in the event of wnding up. The lolal number of such guarantees al 31. March 2021 was eight. The Trustees are Members of the Foundation bul this entitles them only to voting rights. The Trustees have no beneficial interest in the Foundation. AUDITORS The auditors. Knox Cropper LLP, will be proposed re-appointmenl al the f¢Nthcoming Annual General Meeting. This report has been prepared in accordance wth the special provisions of Part 15 of the Companies Act 2006 relating lo small companies. Approved by order of the board of Trustees on 27Th September 2021 and signed on ils behalf by.. Sir Chaiman Page 18
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION INDEPENDENT AUDITORS. REPORT ST FOR THE YEAR ENDED 31 MARCH 2021 Oplnlon We have audited the financial statements of St Mark's Hospital Foundation (the 'charitable company'l for the year ended 31 March 2021 which comprise the Statemenl ol Finanaal Activities, the BalanrE Sheet, Statement of Cash Flows and notes to the financial statements, including a summary of significant accounting policies. The financial reporting fr8fflework th81 h85 been applied in their prepar8tion is 8pplicable18w and Uniltrd Kingdom Accounting Stsn¢Jards, including Finantial Reporting Standard 102 The FAn8n¢i81 Reporting Standard applicable in the UK and R8publi¢ of Ireland (United Kingd Generally A¢¢epled A¢¢ounling Praclicel. In our opinion the financial statements.. give a true and fair view of the state of the charitable companys affairs as at 31 March 2021 and of ivs income and expenditure for the year then ended., have been propedy prepared in accordance with United Kingdom Generally Accepted Acojunting Practs'ce., and have been prepared in accordance with the requirements of the Companies Act 20C6. Basls of oplnlon We ¢ondu¢led our audit in accordance wth Intemational Slandards on Auditing IUKI IISAS IUKII and applicab18 law. Our restx)nsibilits'es under those standards are furth8r described in th8 Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance wilh the ethical requirements ihat are relevanl to our audit of the financial slalemenls in the UK, including the Financial Rep)rting Council's IFRCI Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit ewdenc8 we have obtained is sufficient and appropriate lo piovide a basis for our opinion. Con¢lu$lons relatlng to golng concem In auditing the financial statements, we have nCed Ihat the Iruslees, uso of Ihe going concern basis of accounting in the preparabon of the financial statements is appropriate. Based on the work we have perfomed. we have not idenlified any material uncertainties relating lo events or conditions Ihal. individually or collectively. may casl significant doubl on the charitable company's ability lo continue as 8 going concern for a period of 81 least twelve months from when the financial statements are authorised for issue. Our responsibilities and the responsibilities of th8 truste8s wth r8sp8Ct to going concern are describ8d in thg relevant sections of this report. Other information The other information comprises the infomalion induded in the annual report, other than the financial stslemenls and our auditors, report ther. The Trustees are responsible for the other infomiation. Our opinion on the financial stalements does not cover the other infomiation and. except to the extent otherwise explially stated in our reporl, we do not express any form of asSUrare condusion thereon. In connection with our audit of the finanal statements. OUT responsiknlity is to read the other information and, in doing so, consider whether the other infomation is materially inwnsislenl wth the financial slalements or our knowledge obtained in th$ audit or otherwse appears to be materially misslated. If we identify su¢h material inconsistencies or apparent material misstalements, we are required to detem)ine whether the is 8 material misstatement in the finanaal statemenis or a malerial misstatement of the other inforniation. If, based on the work we have performed, we condude that there is a material misstatement of this other information., we are required lo report that fact. We have nothing lo report in this regard. Page 19
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION INDEPENDENT AUDITORS. REPORT ST FOR THE YEAR ENDED 31 MARCH 2021 Oplnlon on other matt•rs pr•$¢rlb•d by th• Companl¢s Act 2006 In our opinion, based on the work undeken in the Course of the audit". the infomialion given in the Trustees, report, which indudes the d1ClOrS, report prepared for the purposes of company law, for the financial year for which Ihe finanaal statements are prepared is consistent wilh the finanaal statements., and the directors. report included within the Trustees. rep1 has been prepared in ar£ordan with applicable legal requirements. Matters on whlch we are requlred to report by exceptlon In the light of the knowledge antl un¢Jerstsnding ol the chaiitsble company and ils enwronmenl obtsined in the course of the audit, we have not identified material misstatements in the dire¢tors' report included within the Trustees, report. We have nothing to report in respect of the following matters where the Companies Act 2006 requires us lo report lo you if, in our opinion.. adequate accounting records have not been kept. or relums adequate for our audit have not been received from branches not visited by us.. or the financial slalemenls are not in agreement wlh the accounting records and retums., or certain disclosures ol Trustees, remuneration specified bylaw are not made,. or we h8ve nol received all the infomialion and explanalions we require for our 8udil,' or the Iruslees were nol enlilled lo Prepa the financial slatements in accordance with the sm811 companies regime and take advantage of the small companies. exempbons in preparing the trustees, report and from the requirement to prepare a strategic report. Ro8pon8ibllbtle8 of Truste¢¥ As explained more fully in the Trustees. Responsibilities Statement, the Trustees Iwho are also the directors of the charitable company lor the purposes ol company lawl are responsible for the preparation of the flnanoal slalements and for being satssfied that they give a true and fair view. and foi such internal control as the Trustees determine is necessary lo enable the pieparation of financial stalem8nts that are Ire8 from material misstat8mgnt, wh8th8r dua to fraud or error. In preparing Ihe financial stalemenis. the Truslees are responsible lor assessing tha charitabb company'5 ability lo continue as a going concern, disclosing, as applicable, matters related lo going wncern and using the goin9 concern basis of accounts'ng unless the TnJstees either intend to liquidate the CL)mpany or to ceasè operations, or have no realistsc altemaiive but lo do $0. Auditor's responsibilities for the audit of the financial Statements Our objectives are to ob18in reasonable 8ssurance about whether the financi81 stslemenls as 8 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 IUKI will aVayS detect a material misstatement when it exists. Misstalemenls can arise from fraud or error and are considered material if, indiwdually or In the aggregate, they could reasonably be expected to Influen the economic decisicS of Use taken on the basis of these financial statements. Irregulari118s, including fraud, 8re instances of rKJn<(xnpliance wlh laws 8nd regulations. We design procedures in line with our responsibilities, outlined at)ove, to detect material misststements in respect of irregularities, including fraud. The extent to which our procedures are Capab of detecting irregularilies. including fraud is detailed below.. The Charitable Company is required to comply with both company law and charity law and. based on our knowledge of ils activities, we identified that the legal requirement to accurately acwunt for restricted funds was of key significan. Page 20
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION INDEPENDENT AUDITORS. REPORT ST FOR THE YEAR ENDED 31 MARCH 2021 We gainad an understanding of how the charitable company complied with its legal and regulatory framework, in¢luding the requirement to propedy a¢counl for restri¢ted funds, through discussions with management and a review of the drUMented poliues, procedures and controls. The audit team, which is experienced in the audit of charities. considered the charitable company's susceptibility to material missiatement and how fraud may (mir. Our considerations included the risk of management override. Our approach was to check that all restricted income was property identified and separately accounted for and lo ensure that only valid and appropriate expenditure was charged lo restricted funds. This included reviewing joumal adjustments and unusual transactions. A further description of our responsitylities for the a111 of the financial ststemenis is Iwaled on the Financial Reporting Council's website at.. www.frc.o .uklauditorsres nsibilities. This description fomis part of our auditor's report. Use of th• audlt report This report is made solely lo the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our av¢Jil worf( has been undertaken, so that we might slate lo the charitable company's members those matters we are required lo stale to them in an auditor's report and for no other purpose. To the fullest extont perniiited by law. we do not accept of assume responsibility to anyone other than the charitable company and the charitable cLJmpany s members as a body. for our audit work, for this report or for the opinions we have formed. Slmon GoodrSdgo Sensor Statutory Audltor for and on behalf of Knox Cropper I Statutory Auditors 65 Lo8denhall Street London EC3A 2AD October 5, 2021 Vage21
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(t4FAD4028 ST MARK'S HOSPITAL FOUNDATION STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING THE INCOME ANO EXPENDITURE ACCOUNT) ST FOR THE YEAR ENDED 31 MARCH 2021 Note Unrestricted Designated Restricted Funds Funds Funds Total Funds 2021 Total Funds 2020 Income and Endowments Donations and Legacies Investment Income Income from Charitable Aclivilies.. Education Courses Other Incoming Resources 1,028.100 5.337 1,022,651 2,050,751 1,259,133 5,337 34,916 149.486 14.362 19,797 163.848 450,751 19,797 17,491 Total Income and Endowmonts 1.182.923 1.056.810 2,239,733 1,762,291 Expenditure Costs of Raising Funds Charitable Activities 176.818 407.360 649 177.467 200.563 902.690 1,321.605 1,611,149 11,555 Total Ex •ndltur• 584.178 11.555 903,339 1,499,072 1,811.712 Nèt Incom•l(EXnd1tura) 598.745 {11.555) 153,471 740,661 {49.4211 Transfers between funds Net Movgmgnt In Funds 12113 316,738 282.007 305.497 293.942 11,241 164,712 740,661 149,4211 Balance at 1. Aprll 2020 Balance at 31. March 2021 402.047 430,094 2,449.561 3.281.702 3,331.123 684.054 724,036 2.614.273 4.022.363 3,281,702 Page 22
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M10C4FAD4028 ST MARK'S HOSPITAL FOUNDATION BALANCE SHEET 5T AS AT 31 MARCH 2021 Note 2021 2020 Fixed Assats Tan ible Assets 1,809 1,809 Current Assets Debtors Notice deF)osits Cash al bank and in hand 10 14 14 845.657 900.000 2,436,951 4,182.608 96,316 2.900,000 719.531 3,715,847 Creditors.. Amounts falling due within one ar 160.245 435.954 Net Current Assèts 4.022.363 3.279.893 Net Assets 4,022,363 3,281,702 Funds Restricted Designated Unreslricled 13 12 2,614,273 724,036 684,054 4.022,363 2,449,561 430,094 402,047 3,281,702 Total Funds These financial statements were approved by th8 Trustees on 27th September 2021and signed on their behalf by Sir ThomasYrouYn8ge Chaimian Company Number. 07532184 Page 23
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 ST MARK'S HOSPITAL FOUNDATION STATEMENT OF CASH FLOWS ST FOR THE YEAR ENDED 31 MARCH 2021 2021 2020 Statement of Cash Flow Cash flows from operating adivities: Net Cash rovided b I used in •ratin Cash flows from investing activitses.. Dividends. interest and rents from investments Proceeds of sale of investments Net cash provided by investing activities activilies 287,917 206,532 5.337 34,916 S,337 34,916 Cash flows from flnanclng actlvltles Nel cash rovided b I used in financin activities Change In cash and cash equlvalents In the reportlng period Cash and cash equlvalents at the beglnnlng of the reporting perlod Cash and cash equivalents at the end of the reportin period 1282,5801 241,448 3,619,531 3.378,083 3,336,951 3,619,531 Reconclllatlon of Net (Expondltureinncome to Not Cash Flow from Op8ratlng Actlvltlos 2021 2020 Nel incomellexpenditur81 for the reporting per1 {as per Ihe slalemenl of financial activiliesl Adjuslmenls for.. Depreciation charge$ Losses on investments Dividends. interest and rents frcrfn investrnents Ilnueaseydecrease in debtors Decrease increase in creditors Net cash provlded b I used In operatln 740,661 149,4211 1,809 2,117 15,3371 134.9161 1749,341) 20,306 275,709 268,446 287,917 206.532 actlvltles Analysls of Cash and Cash Equivalents 2021 2020 Cash in hand Notice de osils Total cash and cash equNalents 2,436.951 719,531 900.000 2,900,000 3,336.951 3.619.531 Page 24
DopJSign Envelopg ID". F804C1IA-C66C4B324D71CuFAD4O28 ST MARK'S HOSPITAL FOUNDATION NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31" MARCH 2021 Icontinuedl ACCOUNTING POLICIES la) Basis of Preparation The financial slalemenls have been prepared in accordan with Accounting and Reporting by Charities.. Sl8temenl of Recornmended Practi applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland {FRS1021 (second edition - October 20191 and the Companies Act 2006. The charity nStItuteS a public benefit entity as defined by FRS 102. Ib) crftlcal accounting estlmates and areas of judgement Preparation of the financial statements requires the Trustees and management to make signtficanl judgements 8nd estimates. The items in th8 financial stslements vthere these judgements and eslimal8s have been made include.. Assessing the probability of receipt of legacy income.. Determining the apportionment of expenditure between the e21egories of expenditure on charitable activities. Going conc8m The Trustees have assessed whether the use of the going eoneem assumption 1$ appropriate in preparing these financial statements. The Trustees have made this assessment in respect lo a pericrtl of one year from the date of approval of these financial stalemenls. The Charity remains a going concem. promded there are sufficient Unreslricled Reserves lo meet the charity's operating expenditure for the foreseeable future. Al 31 March 2021 the charity had Ihe equivalent ofjusl over fftlve monlhs. operating expendilure in unreslricled reserves1£684,0541. Forecast cash fkjws for 12 months from the dale of this report indieale that these Unreslrieled Reserves will be sufficient to meet operating expenditure taking into account the Covid-19 pandemic. Accordingly the Truslees of the charity have concluded that there are no material uncertainties related lo events or conditions that may cast significant doubl on the ability of the charity lo continue as a going concem. The Trustees are of the opinion that the Charity wll have sufficient resources to meet its liabilities as they fall due. Id) Research Expenditure Liabilities are recognised as resources expended as soon as there is 8 leg81 or conslruclive obligation committing the charity lo the expenditure. Al expenditure is accounted for on an accnjals basis and has been dassrfied under headings that aggregate all costs relaled to the category. The expenditure is accounted for where either the Trustees have agreed lo pay without condition and the recipient has a reasonable expectslion that they will receive an award, or any condition attaching lo the expenditure is outside the control of the Foundation. Page 25
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M1(UFAD4028 ST MARK'S HOSPITAL FOUNDATION NOTES TO THE ACCOUNTS 5T FOR THE YEAR ENDED 31 MARCH 2021 (continued) ACCOUNTING POLICIES {contlnuedl 19) Tangible Fixed Assets and Depr8ciation All assets costing more than £1.000 are capitalised and all assets are valued at historic cost. Depreciation of fixed assets is calculated on cost at rates estimated to write off the assets, by equal inslalments, over their expected vlorking lives. Fixiures and fittings and office equipment are wrillen off over five years. Computers are wrillen off over three years. The modular building was depreciated over four years. ifj Incom• Research funding income is recc#Jnised in the year in which the charity receives a wrillen commilmenl from the funder. Research funding is deferred only when the charity has lo fuffil conditions before becoming entitled lo It or the donor has specified that the income has to be spent in a future period. All other incoming resources are included in the Stslemenl of Financial Activities ISOFAI when the Foundalion is legally entill8d to the income and the amount can be quantified with reasonable accuracy. Ig) Value Added Tax The Foundation registered for VAT from August 2019. Where applicable, all costs and expenditu in¢urred on trading a¢tivilie$ I ex¢lu$ive of VAT. (h) Allocatlon of Support Costs Support costs have been allocated betsveen charitable activities and fundraising. Support costs relating lo chariiable aclivilies have been apportioned based on a weighted salary P8rc8ntage basis. The alloealion of support Costs Is 8nalysed in nola 6. Costs of Ralslng Funds The cost of generating and administering voluntary income includes fundraising costs, investment managers, fees and a proportion of staff costs. u) Charltable A¢tlvltles Costs of charitable activities include grants made and an apportionment of overhead and support costs as shown in note 5. Overhead costs are apportioned based on the staff lime spent on the charitable aclivilies. (k) Funds Unrestricted ftjnds are funds which can be used at the Trustees. discretion. Restricted Funds are funds whose purposes have been reslricled by the donor. Designated Funds are unrestricted funds whith have been earmarked by the Trustees for particular purposes. Voluntary Income Unrestricted Funds Restricted Funds 2021 2020 Donations and Grants Legacies 883,462 144,638 1,028,100 877.651 145.000 1.022.651 1.761.113 289,638 2,050,751 733,813 525,320 1,259,133 Page 26
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M1(UFAD4028 ST MARK'S HOSPITAL FOUNDATION NOTES TO THE ACCOUNTS FOR THE YEAR ENDED 31°, MARCH 2021 (continued) Investment Income 2021 2020 Bank Interest 5,337 5.337 34,916 34,916 Expendituro on Raising Funds Unrestricted Funds Restricted Funds 2021 2020 Fundraising Costs Governance Costs Overheads Stsff Costs 22,809 4,323 9.666 140.020 176,818 649 23,458 4,323 9,666 140,020 177,467 30,132 5,035 10.070 155.326 200,563 649 Analysls of Charltable ActlvltS08 Oirect Expendlturo Support Costs 2021 2020 Researeh Expenditure Educalion 937,985 247,650 1,185,635 93.789 42.181 135,970 1.031,774 289,831 1.321,605 1,100,546 510,603 1,611,149 Unrestrl¢ted Deslgnaled Restrlcted Funds Funds Funds 2021 2020 Dlrectly Incurred Re<harged Salaries Equipment Expenses Salaries Courses 327.194 129,599 418,488 327,194 130,000 449,560 215.770 63,111 1.185,635 412,075 240,000 342,491 207,655 240,864 1,443,085 401 9.175 21,897 215,770 63.081 300.748 30 875,311 9,576 Support Costs Salaries Legal & Professional Audit & Accountancy Other Costs 94,442 691 3.070 8,409 106,612 27.379 121,821 691 3,070 10,388 135,970 153,169 1,405 3,560 9,930 168,064 1,979 1,979 27,379 Total Ex enditure 407,360 11,555 902,690 1,321,605 1,611,149 Page 27
DopJSign Envelopg ID". F804C1IA-C66C4B324D71CuFAD4O28 ST MARK'S HOSPITAL FOUNDATION NOTES TO THE ACCOUNTS ST FOR THE YEAR ENDED 31 MARCH 2021 Icontinuedl Expenditure Research Education Fundraising 2021 Dlrectly Incurred Re-charged Salaries Equipment Expenses Salaries Courses 327,194 130,000 426,306 54.485 327,194 130,000 449.560 215,770 63,111 1,185,635 23.254 161.285 63,111 247,650 937,985 Support Costs Salaries Legal & Professional Audit & Accountancy Other Costs Fundraisin 83.471 474 2,103 7,741 38.350 217 967 2,647 140.020 793 3,530 9,666 23,458 177,467 261,841 1,484 6,600 20,054 23,458 313,437 Costs 93,789 42,181 Total Ex endlture 1.031,774 289,831 177,467 1,499.072 Research EducatSon Fundralslng 2020 Dlrectly InGurred Re-¢harged Salaries Equipment Expenses Salaries Courses 412,075 240,000 304,455 45,379 412,075 240,000 342,491 207.655 240,864 1,443,085 38,036 162.276 240,864 441,176 1,001,909 Support Costs Salaries Legal & Professional Audit & Accountancy Other Costs Fundraisin 89.895 825 2,089 5.828 63.274 580 1,471 4.102 155,326 1,425 3.610 10,070 30,132 200,563 308,495 2,830 7,170 20,000 30.132 368,627 Costs 98.637 69,427 Total Expenditure 1,100,546 510.603 200,563 1,811,712 Page 28
DopJSign Envelopg ID." F804CIIA-Ce6C4B324D7M1(C4FAD4028 ST MARK'S HOSPITAL FOUNDATION NOTES TO THE ACCOUNTS ST FOR THE YEAR ENDED 31 MARCH 2021 {continued) Net {Expenditureylncorne 2021 2020 Net (Expendilureylncome for the year is slated after charging.. Depreciation Auditors, remuneration for audit seNices 1.809 6.600 2,117 7,170 Staff Costs 2021 2020 Directly Employed Staff- Salary Costs Social Security Costs Pension Contributions 331,198 32.129 16,197 379,524 98,087 477.611 317,925 30,768 13,500 362,193 151,770 513,963 Staff seconded from Northwest London Hospitals NHS Trust Average number of employees during the year.. Full-lime Part-lime Total emoluments for one employee fell wlhin the £60,000-£70,000 band in the year {one in 2019- 201. Totsl emoluments for one employee fell wlhin the £90,0004100,000 band in the year lone in 2019-201. The total remuneration of the three key management personnel for the year was £194,824 (£199,664 for four key personnel in 20120}. The above disclosures relate lo established posts. Staff seconded frorn Northwest London Hospitals NHS Trust are in the NHS pension scheme and the recharge includes the social security costs and employer pension Costs. Detsils of the Trustees, remuneration are dealt wth in note 15. Tanglble Assels Land and Buildings FSxtures and Fittings Software 2021 2020 Cost Brought Forward Additions Cost Carried Forward 235.(K)O 3.499 10.584 249,083 249,083 235.(M)O 3,499 10.584 249,083 249,083 Depreciation Brought Forward Charge for Year Depreciation Carried Forward Nel B(x)k Value at 31.03.21 Nel Book Valve at 31.03.20 235.000 3,499 8,775 1,809 10,584 247,274 1,809 249,083 245.157 2,117 247,274 1,809 3,926 235.CKJO 3,499 1.809 1,809 The land and buildings represent a prefabricated building funded by St Mark's Hospital Foundation which is used by Sl M8rk's Hospital. Page 29
DopJSign Envelopg ID". F804CIIA-C66C4B324D7M1(UFAD4028 INDEPENDENT AUDITORS. REPORT TO THE TRUSTEES OF ST MARK'S HOSPITAL FOUNDATION FOR THE YEAR ENDED 31 MARCH 2021 10. Debtors 2021 2020 Tax Recoverable Legacies Other Debtors 565 120,754 724,338 95.473 845,657 96.316 All amounts fall due wthin one year. 11 Credltors.. Amounts Falllng Due wlthln One Year 2021 2020 Accruals and Deferred Income Operating Lease Liability Other Creditors 36,137 86,229 240,000 109,725 124.108 160,245 435,954 12. Deslgnated Funds Balance BIF Balance CIF Income Expendlture Transfers Chairman's Action Fund Dean's Fund Nurse Education Fund Academic Inslilule Fund Seedcorn Furbd Crohn's Disease Fund Robot Fund 5,000 14,190 21,693 1.628 69,704 15,379 302.500 430,094 Trustees have designated the followng unrestricted funds.. 5,000 12,211 22,243 1,628 537,575 15,379 130,000 724,036 11.979} 1990) 1.540 18.185) 476.056 401 172,099 305,497 (11,5551 The Chairman's Action Fund finances discretionary projects. The Dean's Fund finances general research. The Nurse Educatlon Fund finances projects for sludenl nurses. The Acadernlc Institute Fund finan$ a number of projecis lo facilitate education including Ihe provision of IT facilities and online access to Ihe Academic Institute library for post-graduate students and lecturers. The Seedcorn Fund finances start-up funding education proiecls, research projects and research fellowships al Sl Mark's Hospital. The Crohn's Disease Fund finan$ research into Crohn's disease. Robot Fund for equipment rental costs. In 2019-20, the Trustees designated £302,500 of the Unreslricled Funds towards the Robot Fund. Following the renewal of the Robot programme in October 2020, referred lo in note 18, £172,099 of designated funds no longer needed for the Robot were recalled back to Unrestricted Reserves during Ihe year. Page 30
DopJSign Envelopg ID." F804CIIA-C66C4B324D7M1(C4FAD4028 INDEPENDENT ALIDITORS. REPORT TO THE TRUSTEES OF ST MARK'S HOSPITAL FOUNDATION FOR THE YEAR ENDED 31 MARCH 2021 13. Restrlcted Funds Restricted funds comprise the following unexpended balances of donations and grants given for specific purposes= Balance BIF Income Expenditure Transfers Balance CIF Stoma Care Radiology Cok)reclal Cancer Unil Cok)rectal Cancer Research Surgery Medical Nutrition Gastroenterology Sl Mark's Digital Channel Psychological Medicine Polyposis IBD Research Pouch Resear¢h Physiology COVID-19 aurdett Nurse Edu¢ation & R¢s&ar¢h Education Support Enhanced Recovery Surgical Research Flex Surgery Robotic Surgical Programme Pathology Wolfson Unrt for Endoscopy Virtual Colonoscopy Sl Marks Association Other 1,649 94,353 75.111 19,370 7,067 77,814 297 273,375 6.200 202.100 16601 (151,8581 129,4361 (4.0231 11001 {1,8001 1,186 214,070 51,875 217,447 7,067 172,511 18,048 47,801 225,581 22,210 389,821 6,001 4,752 3,487 4,109 15,598 9,563 10,303 634,928 243,737 103,054 23.750 lo.0 117,2321 15.7021 11,5101 110,2241 146,1011 160,1881 128.9281 8,875 39,311 235,805 59,096 307,084 26,129 4,752 3,283 4,323 13,626 9,653 10,303 760,505 337,754 143,143 9,695 115,988 67,381 6,115 20,251 9.215 134.281 10.1XJO 8,644 (1,2001 106.453 (106,2491 12141 2.458 502 19881 {1 47.064 (162.9491 194,0571 {169,6431 {9,6521 26.500 9,695 203,856 67,994 9,590 23,043 95,237 111,1021 613 15251 2,487 3,733 4,000 4.782 497 2020.21 2.449.561 1.056.810 903.339 11.241 2.614.273 201920 2,775,946 664,479 1,020,852 29,988 2,449,561 Transfers represent movements between reslricled fund balances, transfers from designated funds and transfers of St Mark's Academic Institute course income to cover convenors, projects. Movements between reslricled fund balances are the movement of funds not specrfically reslricled to one particular group of research or education lo support new or ongoirsg reslricled projecis. 13. Restrlcted Funds The purposes of the Funds are as follows.. Stoma Care- for research into improvement of STOMA applian( R8diology- for research & education in that dep8rtrnent Colorectal Cancer Unil- for research & education in that department Page31
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 INDEPENDENT AUDITORS. REPORT TO THE TRUSTEES OF ST MARK'S HOSPITAL FOUNDATION FOR THE YEAR ENDED 31 MARCH 2021 Restrlcted Funds {contlnued) Colorectal Cancer Researth - for research & education in that department Surgery - for clinical research in surgery Medical Nutrition - for research and education in that department Gastroenterology- for research and education in that department Sl Marf('s Digital Channel - to develop welFbased plattorm to showcase the innovative and unique attributes of Sl Mark's Hospital. Psychological Medicine - for research into patient psychology Polyposis - for research & education in the Polyposis Registry IBD Research - for research into all forms of inflammatory bowel disease Pouch Research - for research in that department Physiology -- for research in that department COVID - for procurement of PPE for Sl ma.$ medical stsff Burdett - to develop the Burdelt Nursing Scholarship Pr(N3ramme in Gastrcplnteslinal Nursing at St Mark's Hospital Nurse Education and Research - lo support training costs Education Support- to fund costs for travel and attendance at CA)nferences Enhanced Recovery- for research in Ihal department Surgical Research - for general surgical research & education Flex Surgery- minimally invasive surgical technique Robotic Surgical Programme- for equipment rental costs Pathology- for research in that department Wolfson Unit for Endoscopy - for research & education in that department Virtual Colonoscopy- for research into improvements lo eolonoseopy Procedures Sl Marks Association lo maintain and develop links between current clinic81 and academic staff of Sl Mark's Hospitsl, and those who have previously worked with the hospital 14. Analys18 of Assets and Llabllltles bètswèen Funds Unrestrlctsd Restricted and Funds Designated Funds Total 2021 Fixed Assets Current Assets.. Debtors Notice Deposits Cash al Bank and In Hand Liabilities 799,114 315,059 353.139 159,222) 1.408,090 46,543 845,657 584,941 900,000 2.083.812 2.436,951 1101.0231 (160,2451 2,614.273 4.022,363 15. Trustees, Rernuneration and Expenses No remuneration, directty or indirectly, out of the funds of the Found8tion was paid or payable for the year to any Trustee or lo any person or persons known to be connected with any of them. No expenses were reimbursed lo any Trustee other than cosls paid on behatt of the Foundalion and subsequently recovered. Page 32
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 INDEPENDENT AUDITORS. REPORT TO THE TRUSTEES OF ST MARK'S HOSPITAL FOUNDATION FOR THE YEAR ENDED 31 MARCH 2021 16. Pension Scheme The Foundation offers membership of the NEST pension scheme to its employees. matching the contributions made by the employees up lo a rnaximum of 6% of eamings. The Foundation also makes contributions into the personal pension schemes of three employees", the contribution rate for both the employee and the employer is 6.10. The London North Wesl University Healthcare NHS Tnjst is responsible for the pension liabilities of those staff that it has seconded to the Foundation and the Foundation has no liability in respect of these staff other than the annual recharge from the NHS Trust for their services. 17. Taxation Sl Mark's Hospital Foundation is a registered charity and is exempl from taxation in respect of income and capital gains lo Ihe exienl Ihal such income or gains are applied lo exclusively charitable purposes. 18. Lease Commltm•nts On 29 March 2018, the Foundation entered into an agreement wlh Intuitive Surgical Limited I"Intuitive"I to rent a surgical robot, the da Vinci Xi Surgical System Dual Console. for a period of 26 months. Under the lems of the agreement. the Foundation made rental payments aggregating £520,000 until May 2020. A moralorisjm of payments was agreed for six months whilst the Robot was not in used due to COVID-19 crisis. The Foundation has signed a new agreement for the rental of the Robot on the S" of October 2020. for 8 further 13 months. which will come lo an end in Novemb8r 2021. Total rental payTnenls for the renewal period amount lo £260,000. half of which has been recognised as an expenditure during the year and another haw is reflected as an amount due within one year in the financial slalemenls for the period endin9 31 March 2021. Following the agreement, the Foundation made the rot)ol available lo London North Wesl University Healthcare NHS Trust I"Ihe Trust") lo use in accordance with the terms of Memorandum of Understanding between the Foundation and the Trust. The Foundation also has a commitment under a lease agreement lo pay annual charges of £3,024 12020.. £4,302) on other equipment. This agreement was renewed in May 2020 for a further five years. The lotsl minimum lease payments due over the lease len.. 2021 Surglcal Robol 2021 Other 2020 Surglcal Robot 2020 Other Due Date Within 1 year Within 2-5 years 130,000 3,024 9,072 270.000 4,302 13.350 19. Rolatgd Party Transactions There were no Related Paty Transactions during the year. Page 33
DopJSign Envelopg ID". F804CIIA-C66C4B324D7MI(UFAD4028 INDEPENDENT AUDITORS. REPORT TO THE TRUSTEES OF ST MARK'S HOSPITAL FOUNDATION FOR THE YEAR ENDED 31 MARCH 2021 Reference and Administrative Infomiation Charity Number 1140930 Company Number 07532184 Registered Office and Operational Address St Mark's Hospttal, W8tford Road. Harrow HA1 3UJ Trustees The Trustees, who are also directors under company law. who served during the year and up to the dale of this report {unless slated olherwise were as follows: T. R. Troubridqe Ichairl C. Boardman P. B. Bouscarle, (Resigned 14° May 2021 } A. Lalchford S. Ralhke (Treasurer) M. Mannings G. C. Taylor 3 HR Twstee RewvsenlJlN8 Secretary M. Phutkaradze CEO J. Bacon Clinic81 Director of Sl Mark's Hospital O. Faiz Dean of the St Mark's A¢ademi¢ Institute S. Thomas1b$On Accountant M. Phutkaradze Auditors Knox Cropper LLP, Chartered Accountsnls 65 Leadenhall Slreel, London EC3A 2AD Bankers Cafcash Limited Kings Hill, Wesl Malling Kenl ME19 4TA Lloyds Bank plc 25 Moorgale. London EC2R 6AY Page 34