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UK Registered Charity No: 1145080 www.letthechildrenhear.com www.letthechildrenhear.cominfo@letthechildrenhear.com Ugandan Registered NGO No: 10054
Our vision
Improved hearing outcomes for children aged 0-16 years in developing countries.
Our Mission
To improve the hearing outcomes of children in Uganda by adopting strategies which focus on the prevention and early intervention of childhood hearing loss, to aid social integration, speech and language development and access to education. From its inception, LTCH has created a clear vision, mission, goals and set of objectives which underpin its strategy with the aim of providing a strong foundation on which the project can grow and become sustainable long term.
Our objectives
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To educate health care workers and the public about childhood hearing loss and the importance of prevention and early intervention.
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To increase the number of Health Care Workers trained in the field of Ear and Hearing Care.
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To provide an accessible ear and hearing care service for children and their families.
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To leave a legacy by integrating the service into the country’s health care system to provide for sustainability.
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To strengthen maternal and child health care to reduce the incidence and prevalence of childhood hearing loss.
Contents Welcome 3 Impact report 4 The numbers 11 Financial review 13 The Future 17 Our partners 19 Thanks, and get involved 20
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Welcome
Firstly, I would like to welcome you to our annual report for 2023.This year we have focused on strengthening of services for future sustainability by upskilling and training some of our permanent staff and audiologists.
2023 was a year in which we focused on capacity building of the infant screening programme and also to strengthen the audiology service for future sustainability.
At the beginning of 2023, we were visited in Kampala by Peter Harris from the Latter Day Saint Charities (LDSC) and Global Partners in Hearing Health (GPHH) USA.
In 2022 we worked in partnership on a screening and early intervention project and in 2023 Peter visited the clinic to see first-hand the impact of the project activities they had funded.
In the latter part of 2023, LTCH secured a second round of
funding from LDSC and GPHH. The funded project continued to focus on capacity building of hearing screening and early intervention services in health facilities in Kampala. Newborn babies and children up to the age of six years were screened in four health facilities in Kampala.
With the emphasis now being place on screening children in health facilities, the school screening project was discontinued. This adaptation to the screening project in 2023 proved to be more cost effective compared to travelling to multiple school sites to screen children.
LTCH also continued its partnership with East Africa Children's Project (EACP) who funded our speech therapy project for 2023. Additional ring- fenced funding for training, hearing screening and hearing aids was received from various UK charitable trusts.
In addition to the increase in activities aimed at the direct beneficiaries, the indirect beneficiaries
including parents and health care workers, benefitted from health education talks and training respectively.
Ongoing paediatric audiology training continued via joint clinics on Zoom with the UK volunteer audiologists mentoring the local audiologists in their clinics. This provided ongoing practical training and quality assurance of service delivery. In addition, our senior UK audiology adviser ,Pam Layton kindly agreed to go out to Kampala in November to work in the clinic and to train and upskill some of our permanent employees in screening and various aspects of audiology. The timing of her visit was very favourable as two of our audiologists were on maternity leave and appointments were in high demand.
The parental support group expanded to support more new parents whose children have been fitted with hearing aids. Some of the older children also had the opportunity to come together to
network with their hearing aid peers. The growth of project activities in 2023 and successful outcomes could not have been achieved without the commitment of the Ugandan team and UK volunteers who have worked very hard throughout the year. I would like to take this opportunity to thank them all. I would also like to say a big thank you to the LTCH board; Geoff, Paul, Elspeth, and Kevin. who have all worked hard
for the charity over the past year. Looking ahead to 2024 we are in the process of taking steps to build our UK team and recruit more trustees and team members to assist with operational activities and future growth of the charity. .
Liz Choudhury Let the Children Hear
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2023 IMPACT REPORT
Strengthening of service provision.
2023 was a year that saw
strengthening of the project activities and the Ugandan team through training and upskilling .
The project activities reached out to more than 7,800 direct beneficiaries. LTCH received a second year of funding from LDSC and GPHH USA for the Infant and Early Childhood Hearing Detection and Early Intervention Project for children 0-6 years. The second year of funding for this project commenced in November 2023 and will continue to October
2024.. It encompasses training, health education, screening, assessment , hearing aid fitting and rehabilitation.
The number of new referrals to the audiology clinic at Kisenyi Health Centre saw a 11,5% increase from 2022. 54 % of the referrals were direct and indirect beneficiaries of the US screening and early intervention
project operated in the four health facilities.
There was a reduction in lost to follow up at the audiology clinic with a 50 % reduction compared to 2022. This may be attributed to good health education talks and follow up from our screeners, audiology team members and administrative staff who
all participate in parental awareness and encouraging parents to engage with the cause and follow up of their children.
111 children were given hearing aids, of which 78 children were newly fitted compared to 54 new fittings in 2022.
Out of the 78 children that were newly fitted , 5 of these children were fitted with special bone anchored hearing aids (BAHA) which were generously donated by UK audiologists and sourced from UK hospitals.. These special hearing aids
are issued for children with conductive hearing losses who are unable to wear conventional hearing aids that transmit sound through the ear. Instead they are worn on a soft band and transmit sound via bone conductiion. LTCH is the only paediatric clinic in Uganda that supplies and fits children with BAHA;s. Most of these children have abnormalities of the outer ear and the inner ear is normal but requires supporting with bone anchored hearing aids. All 5 children have benefitted from improved speech and language development as reported from the parental feedback from home and school..
When our UK Audiology Adviser visited the clinic in November and December, she provided further training and mentorship for four of our Ugandan Audiologists. In addition, LTCH wanted to empower
and upskill some of our permanent core staff with additional audiology and screening skills. The aim of this strategy is to future proof services and to ensure clinics operate even in the absence of screeners and audiologists . This is not only beneficial for the direct beneficiaries of the services but also the staff involved who enjoy a greater level of job satisfaction and welcome such opportunities to develop additional skills for their career development.
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www.letthechildrenhear.com
UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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HEALTH EDUCATION
Increased knowledge and awareness provides better hearing outcomes for our beneficiaries
HEALTH EDUCATION
During the year, health education played an important part of our daily work. For every newborn baby and young child that was screened the accompanying parent/guardian received health education on childhood hearing loss. In addition all parents/guardians who attended the audiology clinic with their child also increased their knowledge and awareness through posters in the clinic and during consultation with the audiologist, hearing aid technician and speech therapist . This equates to more than 7,800 parents being exposed to health education relating to ear and hearing care.
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www.letthechildrenhear.com
UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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TRAINING
TRAINING
were trained in hearing screening and successfully completed the National Centre for Hearing Assessment (NCHAM) Utah, US Hearing Screening Training online course and were awarded certificates of completion.
Supervision and mentoring of the Ugandan audiologists by the UK audiology team of volunteers continued throughout the year. The majority of this training was done remotely via Zoom During the Autumn we were lucky enough to have our UK Audiology Adviser, Pam Layton visit the audiology clinic in Kampala. She provided hands on training for the 4 audiologists and some additional training for our Audiology Assistant and our Project Assistant, All staff are encouraged to participate in a mix of clinic activities. This keeps clinics running smoothly and ensures that project targets are met. On a personal level it enhances career development and job satisfaction. The Audiology Assistant received training in basic hearing testing and trouble- shooting of hearing aids. Both members of staff
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Vital component of our work –essential for capacity building of children’s hearing health care services in Uganda
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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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ACTIVITIES
TREATMENTS
In 2023 , the ear clinic was transferred and integrated into the main outpatient department of the health centre and is managed by Kampala Capital City Authority who have taken ownership of the service for future sustainability. It continues to be operated by LTCH trained nurse and provides medical treatments for common ear diseases for children and adults can also now access the service. . Data is now in the possession of the Ministry of Health, but approximately 200 children were seen and treated throughout the year.
NEWBORN HEARING SCREENING
Newborn hearing screening saw a slight fall in numbers screened. This was due to the fact that in January, we concluded the screening project for 'at risk' babies in Kawempe Hospital due to difficult screening conditions experienced by the screeners. LTCH adapted the newborn screening programme to screen babies at the following sites:
i) Screening of 6 day old babies at Kisenyi Health Centre. These babies attend for follow up health checks and immunisation. Hearing screening has been incorporated into the health checks and therefore the mothers are well motivated by the health care workers and attendance for screening is high.
ii) Screening of ‘at risk’ babies in the NICU AT St Francis Hospital Nsambya.
iii) Screening of babies 6 weeks and below at Naguru Hospital. A total of 4,656 babies were screened. Babies screened at St Francis Hospital continued to be screened by their own screeners trained by LTCH.. The loan of the screening machine was extended for another year to give the hospital more time to raise the necessary funds to purchase their own machine..
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Providing the full pathway of hearing health care for children
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www.letthechildrenhear.com
UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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Providing the full pathway of hearing health care for children
ACTIVITIES
were indirect referrals from the
EARLY INFANT HEARING SCREENING
In 2023, early infant screening continued at two hospital sites, Mulago National Referral Hospital, ENT Clinic and Naguru Hospital, Paediatric Outpatients Department. Children aged 6 weeks to 6 years were our target group of direct beneficiaries of the US funded early intervention project. However, in addition we had many indirect beneficiaries of the project. These were children who were outside the screening cohort but required referral to the audiology clinic due to parental concern regarding hearing loss. The total number of direct beneficiaries for the year was 2,052.
ASSESSMENTS & REMEDIATION
In 2023 , 357 new patients were seen in the Audiology Clinic at Kisenyi Health Centre which was a 11.5 % increase from 2022.
101 children were direct referrals from the screening project and 96
screening sites. The remaining new referrals came from other health facilities and self- referrals. 119 children were diagnosed with normal hearing and 188 children were diagnosed with permanent disabling hearing loss which is greater than 35 decibels in the better ear.
1,097 audiology appointments were completed , 357 of these were new appointments and 740 were follow up appointments. Follow up rate also improved in comparison to 2022 with a 50% reduction in lost to follow up. 78 children were newly fitted with hearing aids which included the five children who were fitted with the special bone anchored hearing aids. 33 children had their hearing aids replaced either because they lost the aid, it was faulty or child required an upgrade of hearing aid.
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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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Supporting children & their families
REHABILITATION
SPEECH THERAPY
The Speech therapy project continued to be supported by the East African Children's Project (EACP) and funding was provided for a second year. 6 children benefitted from the weekly sessions and each child had 12 individual sessions. All children who attended benefitted from better communication and listening skills and many parents reported better school performance. Speech therapy progress reports were shared by the Speech Therapist highlighting the impact of the project. In addition, beneficiary feedback was received from parents using videos and questionnaires.
SUPPORT GROUP
During 2023 the parental support group continued to support parents of children on the hearing aid programme. The Project Adviser
organised eight sessions during the year and between 9-12 parents attended each session. They continue to provide an opportunity for parents to come together and share any experiences or challenges they may have regarding managing their child's hearing impairment and hearing aids etc.. Two of the sessions involved the children, who were split into two age groups. These sessions are beneficial for all the children as they provide an excellent opportunity for socialisation with other aided children and for the younger children this can help them to comply with them wearing their hearing aid/s. The older children found the sessions very useful for networking with their hearing- impaired peer group and sharing their personal experiences of their hearing disability. In between the sessions the parents are in contact with each other through the
parents WhatsApp group. A few of the parents attend the social group regularly and are becoming strong ambassadors for the group, supporting the new parents that join. .
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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
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HIGHLIGHTS OF 2023 HIGHLIGHTS OF 2023
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UK Registered Charity No: 1145080 Ugandan Registered NGO No: 10054
info@letthechildrenhear.com
THE NUMBERS
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357 New cases seen in audiology clinic 740 Follow-up appts – in audiology clinic
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THE NUMBERS
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200 children were medically treated and managed for ear diseases
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Financial review
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2023 FINANCIAL REVIEW
Funding remains our biggest challenge
Incoming resources
| Income UK Grants US GRANT Donation –general Donations – restricted Donations - fundraiser Fundraising activities Interest |
Year ended 31 December 2023 | Year ended 31 December 2023 | Year ended 31 December 2023 | Year ended 31 December 2023 | Year ended 31 December 2022 | Year ended 31 December 2022 | Year ended 31 December 2022 | Year ended 31 December 2022 | Year ended 31 December 2022 |
|---|---|---|---|---|---|---|---|---|---|
| Total £ |
Unrestricted £ |
Restricted £ |
Total £ |
Unrestricted £ |
Restricted £ |
||||
| - | - | - | 20,000 | - | 20,000 | ||||
| 47,470 | - | 47,470 | 21,335 | - | 21,335 | ||||
| 4,899 | 4,899 | - | 3,432 | 3,432 | - | ||||
| 5,041 | - | 5,041 | 2,000 | - | 2,000 | ||||
| 8,420 | 8,420 | - | - | - | - | ||||
| 11,211 | 11,211 | - | 5,950 | 5,950 | - | ||||
| **92 ** | 92 | - | 43 | 43 | - | ||||
| 77,133 | 24,622 | 52,511 | 52,760 | 9,425 | 43,335 | ||||
| Year ended 31 December 2023 | Year ended 31 December 2022 | ||||||||
| Fundraising | Total £ |
Unrestricted £ |
Restricted £ |
Total £ |
Unrestricted £ |
Restricted £ |
|||
| General fundraising | 9,853 | 9,853 | - | 5,950 | 5,950 | - | |||
| Charities Trust | 938 | 938 | - | - | - | - | |||
| Gift Aid | - | - | - | - | - | - | |||
| Fundraising events | 420 | 420 | - | - | - | - | |||
| Miscellaneous | - | - | - | - | |||||
| 11,211 | 11,211 | - | 5,950 | 5,950 | - |
LTCH’s total income during the year was £77,133 2022: £52,760) a 46.2% Increase on 2022. Income, except for interest on funds held on deposit, was split between continuing US grant funding from The Church of LatterDay Saints, voluntary donations, a new initiative with a professional fundraiser and fund-raising activities as shown in the following table:
A further breakdown of our general fundraising activities
Our largest source of income, this year, was the continued grant from the US Church of Latter-Day Saints, organised by the Global Partnership for Hearing Health (GPHH). This continued funding allowed for the continuation of the previously expanded hearing programme in Kampala throughout 2023. General donations and fund-raising events decreased this year compared to the previous year’s income as we concentrated on securing grant funding. Except for specific funding applications, we seek to raise grant funding on an unrestricted basis, so that it may be applied where most needed.
Donations from individuals have increased by 65.5% from the level in 2022.
We benefit from Gift Aid on most of the regular donations we receive via Just Giving.
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2023 FINANCIAL REVIEW
Funding remains our biggest challenge
Resources expended
During the year, LTCH expended a total of £47,514 (2022: 47,564) very similar to the expenditure in 2021, as shown in the following table:
| Year ended 31 December 2023 | Year ended 31 December 2023 | Year ended 31 December 2023 | Year ended 31 December 2022 | Year ended 31 December 2022 | Year ended 31 December 2022 | |
|---|---|---|---|---|---|---|
| E1penditure | Total £ |
Unrestricted £ |
Restricted £ |
Total £ |
Unrestricted £ |
Restricted £ |
| Ugandan Funding1 | 36,457 | 6,450 | 30,007 | 40,445 | 8,445 | 32,000 |
| Fundraising costs | 1,805 | 1,805 | - | 90 | 90 | - |
| Administration costs | 1,317 | 1,317 | - | 2,063 | 2,063 | - |
| Trustee monitoring | 7,935 | 7,935 | 4,966 | 4,966 | - | |
| 47,514 | 17,507 | 30,007 | 47,564 | 15,564 | 32,000 |
1.Including money transfer costs
As in most previous years, the bulk of expenditure is committed directly to the project in Kampala. Funding decreased (10%) this year. This was a result of adjustments made to our programme and staffing levels, in Uganda, to suit the level of funding. Core activities funded by The Church of Latter-Day Saints remained unaffected during the year.
Trustee visit costs increased significantly (60%) as the Medical Trustees were able to return to Uganda twice in the year as opposed to the single visit made during 2022.
Administration costs decreased (35%) during the year as there was reduced expenditure on equipment during the year. We are now better placed to apply for future direct grant funding and submitted a number of grant applications throughout the year.
As a small charity run entirely by volunteers, we strive to minimise our expenditure on items other than direct project costs. Our fundraising cost solely comprised service charges for Just Giving.
Our administration costs were only £178 for insurances, internet, and bank charges.
Inspection of accounts
As our income for the year exceeded £25,000, we are required to have our accounts inspected by an independent examiner. This service has been provided on a pro bono basis.
Reserves policy
LTCH’s reserves policy is, subject to exceptional circumstances, to maintain a minimum reserve of £6,000 or three months anticipated committed expenditure, whichever is the lower. On 31 December 2023, we had unrestricted reserves of £16,388(2022: £16,296) held in a Virgin Money Interest Bearing Charity Account which is more than sufficient to cover three months of committed expenditure at current levels.
Surplus funds are held in the Virgin Charity Account and although interest rates are low, the Trustees do not consider it appropriate to invest funds where there is a risk of capital depreciation.
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2023 FINANCIAL REVIEW
Fundraising
Fundraising has again remained a challenge but has improved from the previous year. We have still been concentrating on securing grant funding and received a grant of £47,469.80 from the US Church of Latter Day Saints.
We also started using a professional fund raiser who generated £8,420.00 General Fundraising and Ring Fenced Donations, throughout the year, raised £9,415
We would like to say a massive thank you to all these super humans and organisations who have donated and fundraised for us throughout the year as this really does make a huge difference to us.
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The Future
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Summary and Future Direction
2023 has been a successful year for LTCH in Uganda as we continued to strengthen our services for the benefit of our beneficiaries. We reached out to 7,811 children. The number of target beneficiaries was lower than 2022 (13.2% ) due to the discontinuation of the school screening project. and newborn hearing screening at Kawempe Hospital
We continued to see a rise in the number of new children seen in the audiology clinic and the number of new children fitted with hearing aids. Referrals either direct or indirect from the screening sites contributed to 54% of referrals seen in the audiology clinic which clearly demonstrated the value of the screening project for both direct and indirect beneficiaries.
In 2023, LTCH formalised its partnership with Naguru China Friendship Hospital and signed a
memorandum of understanding (MOU) with the hospital. Local staff in the paediatric outpatients' department engaged well with the screeners, referring babies and children to be screened. Screening also continued at St Francis’ Hospital Nsambya, Kisenyi Health Centre and Mulago Hospital Paediatric ENT outpatients' clinic. Newborn screening at Kawempe was discontinued in February due to lack of space and difficult screening conditions for the screeners. This resulted in a slight fall (8%) in the number of newborn babies screened. In 2023.
The highlights of 2023 can be summarised as follows .The joint clinics held remotely via Zoom between UK and Ugandan Audiologists. that has enabled children with additional complex needs to be seen and managed jointly. This included the five children who had malformations of the
external ear/s and were fitted with bone anchored hearing aids (BAHA). This has led to the success of our BAHA programme in Uganda and the proficiency of our audiologists in learning how to manage these special hearing aids. The visit by Peter Harris from the US enabled us to demonstrate some of the impact and outcomes of the
early intervention project which strengthened our partnership during 2023 and beyond. Another highlight was the visit to our audiology clinic in Kampala by our UK Audiology Adviser . In addition to providing training for our audiologists , two of our permanent staff members had the opportunity to acquire additional knowledge and skills .Our Audiology Assistant received training in screening, basic hearing testing and hearing aid trouble shooting. The Project Adviser was trained in hearing screening . Both staff are now
able to provide support in the absence of screeners and audiologists to ensure clinics operate smoothly and targets are met. The other notable highlight of 2023, was the continued strengthening of the parental support group and the benefits it provided for the children and the parents.
Looking ahead to 2024, LTCH continues to explore the various options for integration and sustainability of the service in a hospital facility.
More importantly, LTCH is looking to capacity build its UK team , additional trustee/s with expertise and skills in marketing and communications, administration and finance.
Liz Choudhury Project Advisor
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Our Partners
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A big thank you to our partners
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The partnership between LTCH and Global Partnerships for Hearing Health (GPHH) and the Latter-Day Saints Charities (LDSC) continued in 2023 with further funding to continue newborn and infant screening and early intervention project.
LTCH also continued to work with the following key stakeholders in 2023 including the Ministry of Health, Kampala Capital City Authority (KCCA), Mulago Hospital , Kisenyi Health Centre, St Francis Hospital Nsambya and Naguru China Friendship Hospital, all of whom
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and supporters in 2023. Without their continued support, it would not be possible to sustain this project, hence LTCH would like to say a BIG thank you to everyone.
continued to support the project activities. East African Children's Project (EACP) continue to fund the speech therapy project in 2023.
LTCH would like to thank our volunteer audiologists in the UK who have contributed to our success in 2023. Pam Layton, Keri Abbott and Anushri Patel. They have all worked tirelessly to provide mentorship for the Audiologists in Uganda enhancing their knowledge and skills to benefit our patients and families.
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We would also like to thank all our donors, fundraisers,
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www.letthechildrenhear.com
Get involved
If you would like to…. work with us, fundraise for us or get involved please email liz@letthechildrenhear.com
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www.letthechildrenhear.com
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CHARITY COMMISSION FOR ENGLAND AND WALES Independent examinerfs report on the accounts Section A Independent Examinerfs Report Report to the trusteesl membgrs of On aOnts for the yoar ended dlOA Charity no (ff any) 114WO Set oul on pagos I report to the trustees cm my examination of the accounts of the above ¢harlty {Ihe Trusf) for the year ended 3111212023 R8sponslblllll88 and As the charlty In85 cl lh8 Tnt. you are responslble for the preparation basls of r•port of the accounts in acccdance with the requlrements of the Charits"es Acl 2011 (Ihé Arf). I report in respect of my examination of the Trust's accounts carried out under section 145 of the 2011 Act armd in carrying out my examination, I have followod the applicabl8 Directh)ns giv8n by the Charity Commisslon under se10n 145{5Xb} of the AGt I have compleled my examination. I Conf Ihal no material matters havo come to my attention ') in connectlon with the 8xamination which gives me cause to balieve that in, any material respect accountiTrJ records Vopre not kept in attordance wfth 88¢tion 130 of the Acl or the accounts do not 8ccfd wlth th8 accounling reo)rd8 Indèpendent examlnofs statemont I have c(Cem8 and have c<xne attoss no other matters In nneCtIOn with the examinatts)n to which attention should be drawn in order to enable 8 proper understanding of the aC(nts to be reach. 18 the words tho brackols if they do not ap. Slgnod: Dat•: o? Nam•: AJ &L£K R•l•vant profe10n81 quallficatlon(8) or body (If any): dress: oia Cfo . CL C IER October 2018
Section B Disclosure Onty o)mplete rf the examiner needs to hMJh1jht matters of concem (see CC32. Independent examinatM)n of charity accounts". dir8clions and guidance for examiners). Glvo here brlef dètalls of any Items that the •xamln8r wlshès to dlsclose. IER October 2018