2025-04-05-accounts

RELIEF FOUNDATION s￿en￿8 Centre University HOspital￿￿tree Lower Lane Yerpool L9 7AL Established as a Charitable Jncorporaled Organisation on 17h March 2014 Originally Eslablished under a Deed of Trust Daled 3uk March 1979 Annual Report and Accounts For year ended 5 April 2025 Registsred Charity No.1156227

CONTENTS Management and Committees Legal and Administrative information Report of the Trustees Pain Relief Foundation Aims and Policies Chronic Pain 10 Research and the Institute 11to12 Research Accommodation 12 Management Structure & Govemance 13 Risk Management & assessment 14 Trustee Recruitment 14 Advisory Sub-committees 15 Grant Making & Policies 76 Public Benefit 17 Powers of Investment & Investment Policy 18 ReseNes 19 Fundraising Regulator & our fvndraising promise 20 Donation Policy 21to22 statement of Trustee Responsibilities 23 Clinical Section & Education 24to26 Research Reports 26to29 Auditows Report 30to32 statempnt of Financial Activities 33 Balance Sheet 34to35 Cash Flow Statement 35to36 Notes fomiing part ofthe Financial Statements 37to44 Detailed statement of Financial Activities 451046

PATRONS Professor Sir Michael Bond, FRSA, FRSE, FRCPsyGh, FRCPGlas, FRCSE Darne LoTna EF Muirhead, DCVO, DBE, CStJ, FROG Mr. R. N. S. Bigland TRUSTEES Mr. D. Cain, FRSA, FIOD. MHSM, DipHSM. (Chainnan) Professor Michelle Briggs PhD RGN Miss J Daley, LLB (Hons) Professor P. Eldridge, MA, Mchir. FRCS Mr. P. Fell, MA (Cantab), FRSA (Deputy Chaimanffreasurer) Professor FranGiS McGlone BSC (Hons), PhD Dr. T Nash, MB, BS, Dobst RCOG, FRCA, FFPMRCA Mr, M. Shanna, MBBS, MD. FRCA. MSC. FFPMRCA Ms G Thompson Msc Dip AHCS MIMI Dr. J. C. Wells, MB, ChB, LRCP, MRCS, LMCC, SRCA, SIPP Dr. J. R. Wiles, MBBS. FRCA, FFPMRCA CHAJUTY MANAGER Mrs J Williams SCIENTIFIC SUB-COlkllktITTEE Dr U Allam, Bsc, MPHe, MRCP(UK)(London), PhD Dr Jamie Burgess , PhD Miss. A. Bradshaw ProfJ Carnpbell PhD Msc Bsc Cstat CPhys FRCOT FRSB Dr. N. Goodson, FRCP, PhD Dr K Heron, MSC, PhD, DClinPsych DrA Marshall MB ChB, BSC, FRCP, PhD Nr H Neiland Dr. H. Poole, PhD, GPsychol Miss. C. Staunton (Chair) EDUCATION SUB-COlItMITTEE Ms Alison Bradshaw Dr M Gupta MBBS, FRCA. FFPMRCA Dr K Matthews, Consultant Clinical Psychologist Dr K. Pushparaj MBBS, MD, FFPMRCA Dr. M. Sham7a, MBBS, FRCA, MD, FFPMRCA, Msc Mr. John Tetlow Dr. J. R. Wiles. MB, BS(Lond), FRCA (Chair) Dr. J. C. Wells, MB, ChB, LMCC, FRCA

REGISTERED OFFICE Clinical Sciences Centre University Hospital Aintree Lower Lane Liverpool L9 7AL BANKERS H.S.B.C. p.l.c., 99 -101 Lord Street, Liverpool, Merseyside. L2 6PG AIJDITOR BTMR Limited, Statutory Aud itor Century Buildings 14 St Mary's Parsonage Manchester. M3 2DF SOLICITORS John Roberts, Abensons Solicitors 102 Allerton Road, Liverpool, Merseyside. L182DG INVESTMENT ADVISORS Rathbone Investment Management Ltd., Port of Liverpool Building, Pier Head, Liverpool, Merseyside. L3 1NW

TRUSTEES, REPORT 2025 It is my pleasure as Chairman of the Pain Relief Committee on behalf of the Trustee Committee to introduce to you our Annual Report for the year ended 5th April. 2025.we are proud to have gained a reputation as Academic leaders in chronic pain research and provide facilitated support to Pain Specialists, General Practitioners, Patients and those who support them as Carers and friends. The past year has been busy with yet more achievements with our research portfolio work. and we thank our Partners in the Liverpool University particularly Professor Pete Clegg for his help and support. We are as always so engaged with our Clinical and Academic Colleagues at the Walton Centre NHS Trust and as the founder Chief Executive of that Trust l am pleased that 34 years later we continue to have excellent collaboration. Our activities extend to numerous research publications, grant applications and the ever more popular specialist Conferen￿ and education activities attracting interest in Globally and particularly in Europe. As always i want to put on record the appreciation of the Trustee Committee to Professor Andreas Goebel and Dr Andy Marshall our designated Senior Research Fellows who are leading experts and academics for the Pain Relief Foundation. The Charity is led by Julie Williams our Charity Manager who has prepared the detail of this report and continues with her small team to manage our resources and promote our interests especially promoting much needed donations, legacies and grant applications. We are particularly pleased with our profile in our social media and communications engagements. Please read this report and do not hesitate to contact us if you are able to assist, promote or othe￿iSe help us on ourjourney to advance chronic pain research We Remain strong In our Fight Agalnst Chronic Pain Despite Economic Woes Recognising the difficult economic landscape, the Pain Relief Foundation has proactively adopted a strategic approach rooted in flexibility and fiscal prudence. These strategies are crucial in ensuring th& charity can optimize its resources, maintain long-term financial stability. and continue to make a tangible impact in the field of chronic pain research. At the heart of the Pain Relief Foundation's mission lies a firm commitment to fvnding vital research. Recognising that scientific breakthroughs are the key to developing effective treatments and ultimately improving the quality of life for chronic pain sufferers, the Foundation has prioritised research support even amidst adversity. This dedicats'on has already contributed to groundbreaking discoveries and the advancement of promising research programs, offering hope for the future of pain management. Beyond simply providing funding, the Pain Relief Foundation understands the importance of nurturing talent and fostering collaboration within the pain management community. The organisation actively supports pain researchers and healthcare professionals. emerging talent. promoting collaborative projects, and facilitating the dissemination of knowledge that can directly lead to improved patient care and treatment strategies. Despite the myriad challenges facing the healthcare system and the economic uncertainties, the Pain Relief Foundation remains resolute in its determination to confront chronic pain head-on. The organisation firmly believes that continued investment in research holds the key to reducing the pain. suffering, and isolation associated with this often-overlooked condition. The Pain Relief Foundation's is entirely funded by the generosity of its supporters. The charity relies on public donations to fuel groundbreaking research and ultimately creating a world where no one has to endure the burden of chronic pain. Your support can directly contribute to finding effective treatments and improving the lives of countless individuals. With continued support and dedication, the Pain Relief Foundation is filled with optimism and determination. By embracing inclusivity. diversity. and innovation. the organisation aims to work to create a future where people with chronic pain Can live fulfilling and empowered lives. free from the limitations imposed by their condition.

What Is Chronic Pain= More Than Just a Bad Day. Pain is a universal human experien￿. Irs a vital signal, alerting us to potential harm and prompting us to tske action to protect ourselves. But what happens when pain lingers long after the initial injury has healed or when there's no Glear cause at all? This is where chronic pain comes in, transfoming from a protective mechanism into a debilitating and persistent condition. Chronic pain is defined as pain that persists for more than three months. This timeframe is crucial because it generally ex￿dS the expected healing time for most injuries or illnesses. Unlike acute pain, which serves as a warning sign and typically resolves with treatment. chronic pain becomes a complex and oflen frustrating condition that can profoundly impact a person's life. Chronic pain is more than just a prolonged case of acute pain. It's often considered a disease in itself, involving cornplex interactions between the nepious system, brain, and psychological factors. The initial cause of the pain might be a specific injury or illness, but over time, the nervous system can become hypersensitive, leading to persistent pain even when the original injury has healed. The causes of chronic pain are varied and often difficult to pinpoint. Some common contributing factors include underlying Medical Conditions: Arthritis, fibromyalgia, neuropathy, and back problems are frequently associated with chronic pain. Injuries, while most injuries heal, some can lead to chronic pain conditions, particularly if nerves are damaged. Surgery. while surgery can alleviate pain in some cases, it can also lead to chronic pain, especially if nerves ale severed or irritated during the procedure. Nerve Damage: Conditions like diabetes or shingles can damage nerves, leading to chronic pain syndromes. Unknown Causes, in some instances. the cause of chronic pain remains a mystery. adding to the frustration and complexity of the condition. The Impact of Chronlc Paln: More Than Just Physlcal Sufferlng Chronlc pain has a far-reaching impact. extending beyond physical discomfort. Common consequences include redU￿d quality of life. It can significantly limit a person's ability to perform everyday tasks. participate in social activities, and enjoy life. Chronlc pain is often accompanied by anxiety, depression, and feelings of helplessness. It can interfere with sleep, leading to fatigue and further exacerbating pain. It can put a strain on relationships with family and friends, as it can be difficult for others to understand the constant struggle of living with persistent pain, and it can be a financial burden due to medical expenses, lost wages, and disability. Seeking Help and Managing Chronlc Paln Living with chronic pain can be incredibly challenging, but it's essential to remember that help is available. A comprehensive treatment approach often involves a combination of medications such as pain relievers. antidepressants, and anticonvulsants Can help manage pain and related symptoms. Exercises and other therapies can improve strength. flexibility. and range of motion, helping to reduce pain and improve function. Cognitive behavioural therapy {CBT> and other therapies can help individuals develop coping skills to manage pain and related emotional distress. Alternative Therapies including acupuncture, massage, and yoga are some alternative therapies that May provide pain relief. Interventional Procedures such as nerve blocks, injections. and other prO￿dureS can help target specific pain sources. The lrnportance of a Muftidiscipllnary Approach Effective chronic pain management requI￿S a muEtidisciplinary approach, involving a team of healthcare professionals. including physicians, physical therapists. psychologists, and other specialists. Working with a team ensures that all aspects of the condition are addressed, leading to a more comprehensive and personalized treatment plan.

Living Well with Chronic Pain While chronic pain can be a daunting challenge. it is possible to live a fiJlfilling life despite the pain. By seeking appropriate medical care, developing coping strategies, and maintaining a positive outlook, individuals can learn to manage their pain and improve their quality of life. Remember, you're not alone, and support is available to help you navigate the journey of living with chronic pain. Chronic pain affects millions worfdwide, impacting quality of life. productivity. and overall well-being. Recognizing the profound burden of this condition. our organisations the Pain Relief Foundation and the P8in Research Institute are committed to driving change through research, education, and proactive collaboration. Our mission- to improve the lives of those living with chronic pain. not just today, but for generations to corne. The comerstone of this mission is a dedication to advanced research. By investing in the most promising scientific endeavors, the Pain Relief Foundation and Pain Research Institute aim to attract, fund, and support researchers who are focused on developing truly transformative treatments. Their approach is patient-centric, ensuring that research efforts are directly responsive to the needs of individuals struggling with chronic pain. This means focusing on science that has the potential to alleviate suffering. improve functionality, and ultimately, offer a pathway to a pain-free life. However, research alone is not enough. We recognise that pain education is equally crucial in achieving better treatment outcomes. By sharing knowledge and insights with healthcare professionals, researchers, politicians, decision-makers, and the general public, we hope to spark a ripple effect of positive change throughout society. Education empowers not only healthcare providers to deliver more effective care but also individuals to better understand and manage their own pain. The urgency of this work is undeniable. The burden of pain on our society is significant, and the need for innovative solutions is more pressing than ever. This requires a concerted effort, a collective commitment to work together, implementing new strategies and addressing the challenges head-on. The Pain Relief Foundation and Pain Research Institute are actively building bridges to facilitate this collaboration. We are working to reach more healthcare professionals than ever before, both in the UK and across the globe, providing them with essential training and information. This empowers them to offer the best possible care to individuals living with chronic pain. Furthermore, the Foundation is dedicated to building upon the work of the Pain Research Institute, advocating for the needs of people with chronic pain to be at the forefront of policy and research agendas. The Pain Relief Foundation understands that tackling human chronic pain requires not only dedicated research and compassionate care, but also a foundation built on ethical fundraising and responsible financial management. Recognising that our vital work hinges on the generosity of voluntary donations, the Foundation is deeply committed to upholding the highest standards of financial integrity and transparency. At the heart of their approach lies a deep respect for donors. The Pain Relief Foundation carefully considers its fijndraising methods, ensuring they align with ethical principles and do not place undue financial strain on contributors. Requests for donations are made respectfully. emphasising the tangible impact contributions will have on furthering the Foundation's mission to alleviate chronic pain. Donors are provided with clear and concise information outlining how their funds will be utilised and the positive outcomes achieved. This commitsnent extends beyond simply asking for support. Here at the Foundation, we exercise prudent financial managernent at every level to ma￿Mize the impact of every pound received. Expenses are meticulously reviewed and justified, ensuring they are directly related to the organisation's core mission. Investment decisions are made with a long-term perspective, prioritising the Foundation's sustainable growth and continued ability to serve those suffering from chronic pain. Transparency is paramount. We at the Foundation maintain open and ac￿Ssible financial records to foster trust and accountability among donors and the public. Regular financial reports are published and readily available, providing a clear picture of the Foundation's financial standing. Furthermore. the Foundation submits to regular external audits, guaranteeing the accuracy and integrity of its financial

reporting. This unwavering commitment to transparency builds Confiden￿ and reinfOr￿S the Foundation's dedication to responsible stewardship. The Pain Relief Foundation recognises that its sUC￿$S is inextricably linked to the invaluable contributions of its donors. Their financial support is the lifeblood of the organisation, making its vital work possible. The Foundation expresses its profound gratitude for their unwavering loyalty and commitment. In conclusion. the Foundation is steadfast in its dedication to being a responsible and accountable organisation, driven by ethical fundraising practices and prudent financial management. By adhering to these core principles. we ensure that our reSoU￿S are utilised effectively to advance its mission of alleviating human chronic pain. We remain committed to upholding these standards. building trust. and inspiring continued support for its crucial work in improving the lives of those suffering from chronic pain. This Gommitment is made possible thanks to the dedica*'on and expertise of our Board of Trustees. This skilled and capable group volunteers their time to diligently superrfise and direct the Foundation, guiding our strategic direction and ensuring financial accountability. We are immensely gratefvl for their unwavering commitment and invaluable contributions. The strength of our Board lies in its diverse composition. We are fortunate to have individuals representing a wide array of fields, each bringing their unique perspective and in-depth knowledge to the table. This includes: Medlcal Professionals: Providing invaluable expertise in pain management and research, ensuring our initiatives are grounded in the latest scientific advancements and best practices, Admlnistratlve Experts: Guiding our operational efficiency and ensuring resources are allocated effectively to achieve our strategic goals. Legal Professionals: Ensuring Complian￿ and providing guidan￿ on ethical considerations, safeguarding the integrity of our operations. Buslness Leaders: Bringing strategic business acumen to the table, helping us develop sustainable funding models and maximize the impact of our programs. Together, this collaborative Board provldes a comprehensive oversight of the Charity, ensuring that every decision is made with careful consideration and a focus on achieving tangible results. The Trustees uphold the system of continual review in all areas of importance in the scientific and adrninistrative conduct of the affairs of the Foundation. In these difficult b'mes, our reseNes can be measured as crucial and therefore, the Res8rves Policy is repeatedly monitored so that we are able to optimise the deployment of our resources, maximise their impact and ensuring we can effectively utilize our resources to their fullest potential. A key component of our financial strategy is the Investment Policy that govems the management of our reserves. The Trustees actively collaborate with the Investment Management team at Rathbones, regularly reviewing and refining the Investment Policy to achieve optimal performan￿ while adhering to ethical and responsible investment principles. Beyond financial considerations, we recognise the critical Importan￿ of risk management, Our Risk Assessment Policy is under constant scrutiny, ensuring that we proactively identify, understand, and mitigate potential risks to the charity. We are committed to implementing procedural changes as needed. This proactive approach allows us to protect our assets, safeguard our operations, and maintain the trust of our stakeholders. We believe this commitment to rigorous review and responsible stewardship is essential to ensuring the long-term sustainability and impact of our foundation, allowing us to continue supporting critical initiatives for years to come. Each year, our Trustees carefully deterrnine the budget available for research grants for the upcoming year. This decision sets the stage for our annual call for applications, which we widely disseminate

through various channels. We advertise in specialistjournals, on our website, on the dedicated research platform ResearchResearch.com, and within the University and NHS press. This multi-pronged approach aims to attract applications from the most suitably qualified researchers eager to contribute to ohronic pain research. Once applications are received, they undergo a thorough initial assessment by our dedicated Scientific Advisory Sub-comrnittee. Chaired by Dr. Caroline Staunton, this sub-committee plays a pivotal role in the entire grant allocation process. Dr. Staunton and her team are entrusted with the vital task of overseeing our research work, meticulously analysing the significant volume of scientific information submitted by applicants. The Scientific Advisory Sub-committee provides invaluable guidance to the Trustees; in identifying the most deSe￿ing applications for research grants. their expertise is essential in prioritising projects with the highest potential impact. The sub-committee ensures that each application undergoes rigorous peer review of other researchers in the field to critically evaluate the scientific merit, feasibility, and potential impact of each proposal. This process guarantees that only the most deserving projects are considered for funding. We are profoundly grateful for the extensive work carried out by the Scientific Advisory Sub-committee throughout this lengthy and demanding process. Theirexpertise. commitment to rigorous evaluation, and dedication to advancing chronic pain research are invaluable to the Foundation. Through their efforts. we are confident that we are funding the most promising research and ultimately contributing to a better quality of life for those living with chronic pain. A selection of reSea￿h reports from grants awarded by the Pain Relief Foundation can be found on our website www. ainrelieffound8tion.o .uk. Of equal importance is our programme concemed wEth the dissemination of information. equipping healthcare professionals with the latest knowledge and techniques to improve patient outcomes. This work is significantly bolstered by the Walton Centre NHS Foundation Trust for Neurology and Neurosurgery, and its associated Pain Clinic. This support enables numerous educational activities and research programs that would otherwise be impossible. We extend our sincere gratitude to the Walton Centre for their unwavering commitment. The Walton Centre Pain Clinlc, one of the largest pain centres in Europe, provides us with a resource of substantial patient population willing to participate in trials. These volunteers are essential to advancing our understanding of pain and developing innovative treatments. We are deeply indebted to all the patients who volunteer for the various research projects, both at the Walton Centre and other units supported by the Foundation. Theirwillingness to participate in clinical trials and studies is a testament to their hope for a better future. not just for themselves but for all those struggling with chronic pain. The Pain Relief Foundation is making significant strides in advancing the knowledge and skills of healthcare professionals in the treatment and management of chronic pain. Driven by the dedicated "Education Sub Comrnittee," chaired by Dr. Manohar Sharma, the Foundation has successfvlly broadened its educational activities and increased the availability of high-quality courses throughout the year. Building on the success of recent conferences. the Foundation continues to solidify its reputation for delivering exceptional educational opportunities. The "Education Sub Committee" diligently works to curate and deliver courses known for their excellence. These courses are consistently well-supported by committee members, who enthusiastically embrace the responsibility of organising and overseeing them. By providing accessible and high-quality training, the Foundation is empowering healthcare professionals to deliver more effective and compassionate care. In June we facilitated the North England Pain Group (NEPG) meeting which was attended by pain specialists from all over the north of England. Under the organisation of Dr Hemkumar Pusharaj and Dr Manohar Sharma we will run our annual workshop Clinical Management of Chronic Pain Course in November. Other workshops are currently being drafted to run thrDughout the year.

An update on these events can be found later in the report. For the final time before retirement Dr John Wiles is responsible for arranging the Annual Lecture and the Student Essay competition. The 2025 Annual Lecture 'Lostin Translation.. Enhancing quality of research to improve its use. Clinicians really need to know how dodgy basic science dat8 are as a cause of translation failure" was given to will honour the life and work of Ulf Lindblom who was Professor of Neurology at the Karolinska Institute. Stockholm, Sweden, The lecture was delivered by Professor Andrew Rice. a Glinical academic who for more than 35 years has been intrigued by the conundrum of neuropathic pain. He is Professor of Pain Research at Imperial College and the current President of the International Association for the Study of Pain (IASP). The student essay competition was again opened up to Medical, Nursing, Occupational Therapists, Psychology and Physiotherapy students. With the winners of each category presenting their essay at one of our educational meetings. Our sin￿re thanks go to Dr John Wiles for his active role over many years in coordinaling both the Lecture and Essay Competition. The work of the Foundation is a collaborative endeavour. including volunteers, staff, and external partners. This report serves as an opportunity to shine a light on these individuals and recognise the integral role they play. First and foremost, we extend our heartfelt gratitude to our volunteers. Their selfless donation of time and energy is invaluable. Without their dedication, we simply wouldn't be able to impact as many lives as we do. Our deepest gratitude also goes to our Charity Manager, Julie Williams. and her dedicated team: Lorraine Roberts, Hayley Mccullough, and Jo Stephens. They are the driving force behind our daily operations, working conscientiously throughout the year to ensure the smooth and effective execution of our projects. Financial integrity and transparency are paramount, and we are fortunate to have the expertise of Kath Johns and Emma Shepherd of 8TMR Ltd, our Ststutory Auditors. Their meticulous preparation and auditing of our accounts guarantee accountability and allow us to maintain the trust of our donors and beneficiaries, We appreciate their diligent work and commitment to upholding the highest stsndards. Finally, we extend our thanks to Joseph McLoughlin of Rathbones Investments. His expertise in managing our investment portfolio is crucial to ensuring the long-term financial stability of the Foundation, allowing us to continue supporting our programs and fulfilling our mission for years to come. The success of our foundation is a testament to the dedication and hard work of these individuals. Aims & Ob ectives The aims and objects of the Pain Relief Foundation. as set out in the Constitution, are the advancement and promotion of all forms of mèdical research and in particular the relief of human pain and all painful conditions of every type whatsoever and how5￿Ver caused and to disseminate the results of any such research throughout the world. Policies to further Alms & Ob'ectives I n pursuance of these aims and objectives, the continued policy of the Trustees is to:

Fund and enable research into the causes and optimal treatment of human chronic pain. Provide and maintain a Pain Research Institute, headed by a Professor of Pain Science, in which research and education is conducted in pursuance of the charity's objectives.

Undertake the support of the Pain Research Institute as a priority in the Pain Relief Foundation's funding programme. However, research grants will also be made available and awarded by open competition, for qualitative research projects carried out in other institutions. Support partnerships with higher education and the N.H.S directed to the understanding and treatment of human chronic pain. In particular, to provide long-term funds for the support of a Chair in Pain Science at the University of Liverpool. Support the dissemination of the results of such research throughout the world. Promote and enable education and training for doctors and other health. professionals on human chronic pain and its treatments. Provide doctors and other health professionals with an infonnation seNice on chronic pain and its treatments, in order to improve patient care. Provide an information Servi￿ to human chronic pain sufferers and patients on chronic pain conditions. This policy has remained unchanged since the last annual report. Chronic Pain Ststistics Millions of adults are living with 'Great Pain Shame,. A study found that those with an ailment that affects their day-to-day existence rarely tell others about the pain they're in. The prevalence of pain is huge. It dwarfs most other conditions. PAIN AFFECTS US ALL The Department of Health recognises chronic pain both as a long-term condition in its own right and as a component of other long-term conditions. Across the UK there are currently 14 million people living with chronic pain. HEALTH AND SOCIAL CARE 66 % of people attending A & E seeking help with pain had made 3 visits to a health care professional in the preceding weeks. 16 % of chronic pain patients feel that their chronic pain is so bad that they sometimes want to die. WELFARE AND BENEFITS Of the 14 million people living with chronic pain, 3.5 million said their pain had kept them from their usual activities, including work, on at least 14 days in the last 3 months. EMPLOYMENT The CMO report states that 25°/o of chronic pain patients lose their jobs, this contributes to 42 % in the lowest income households being more likely to report chronic pain, compared with 27 % in the highest. 410/0 of people who attended pain clinics report that their pain has prevented them from working and 130/0 have had to reduce their hours. SOCIETAL IMPACT Low back pain is ranked highest out of 291 conditions examined by the Global Burden of Disease study, ranking number 1 for years lost to disability worldwide. 10

In fact, 5 of the top 12 disabling conditions globally are persistent chronic pain conditions: low back and neck pain, migraine. arthrib's, and other musculoskeletsl conditions. This situation highlights just how much research and associated work still needs to be carried out if we are to tower above chronic pain and to ease the difficulty which it causes. The staff at the Pain Research Institute and in the other Laboratories which are funded by the Foundation, recognise that much remains to be done, and they are relentless in their efforts to solve the many problems and unexplained factors. The Pain Relief Foundation's funding has helped the Research Institute secure a firm base for an exciting and fOr￿fUl academic structure which is necessary if the Institute is to continue moving fotward with a rigorous programme of research into human chronic pain. The Pain Research Institute PRI The Pain Research Institute based within the Clinical Science Centre at University Hospital Aintree houses patient examination laboratories, research laboratories, work and study areas, a specialist pain library with several study areas and general workstations which provide researchers with access to all of the relevant pain databases and research offices, through a fast link computer hub. We are located directly adjacent to the Walton Centre NHS Foundation Trust, Liverpool. The dominating factor for our location here is because pain-related research projects often need access to a large number of patients. The Pain Clinic has a through-put of over 4500 new patients each year and access to this patient base is paramount for the Pain Research Institute to continue with their work. The symbiotic work that is carried out in liaison be￿een the two units, and the expertise that has emerged over the years, has led to the 'Walton Pain Clinic, becoming, and remaining, the largest and most successful in Europe. All patients recruited are fully infomed volunteers. Patient and Public Involvement (PPI) has always been important to the PRI. We have been holding regular PPI groups for over ten years. The PPI team consults with patients to shape all stages of research projects concerning chronic pain (with a particular focus on Complex Regional Pain Syndrome and Fibromyalgia) within the Pain Research Institute. The Pain research Institute remains a hive of activity with many current ongoing our research spans multiple fields within pain medicine, in order to deterrnine and therefore treat the underlying Cause of chronic pain. The avenues of Gurrent chronic pain research are below, showcasing the promising directions being explored to alleviate suffering and improve quality of life for those affected. Pain Immunology - We focus on the contribution of immunoglobulin G autoantibodies in causing chronic pain. Pain Management Programmes The Pain Research Institute works with the PMP Department at The Walton Centre to ensure that we continually research PM Ps to help rnake them as effective as possible. Pain lrnaging- Chronic pain leads to changes in the central nervous system that are often maladaptive - they make pain worse rather than lessen it. We have used functional MRI to explore these changes in several groups of pain patients Clinical Trials - Most researchers in the Pain Research Institute conduct clinical trials. We are engaged in both investigator-led and industry-sponsored trials that assess analgesic drugs and interventions The Pain Research Institute boasts a rich history of contribution to the field of human chronic pain, èvidenced by numerous publications in prestigious medical and scientific journals. as well as comprehensive books authored by their team of expert consultants. These publications senie as a testament to their commitment to advancing the understanding of pain mechanisms and exploring effective treatment strategies. The teams of doctors and scientists have ambitious plans for future research which, if funding can be obtained, bid fair to make substantial advances in understanding, 11

and the relief, of chronic pain which presents many psychological problems and physical conditions for the sufferer. Research Accommodation The Trustees of the Pain Relief Foundation have continued with the agreed policy that whilst continuing to retain the leasehold and ownership of the Pain Research Building in the Clinical Sciences Centre, together with the fixtures, fittings and equipment therein, they will provide the facility of the Institute, together with the fixtures and fittings, to the Department of Neurological Science, University of Liverpool, and to other such parties who are researching chronic pain, or who wish to enter into collaborative research on human chronic pain. This arrangement will ensure that research personnel supported by the Pain Relief Foundation, the University of Liverpool, the Liverpool John Moores University, and those others who are employed by another party but are working on chronic pain research under the auspices of the 'Pain Relief Foundation, Professor of Pain Science. shall be contained in the same premises and work collaboratively. This arrangement offers a more structured and controlled working area and is conducive to good working practices. The use of the premises does not create a lease but shall be treated as a Licence at Will. All of the overhead and operating costs of the Pain Research Institute premises are borne by the Pain Relief Foundation and are allocated as part of the research grants. The following 'modus operandi, was pursued during the year as in previous years..

The Pain Relief Foundation provided administration and research accommodation for the research personnel, within the Pain Research Institute. The Pain Relief Foundation provided research secretariat, and clinical research support facilities for the researcher posts from its own staff resources. The Pain Relief Foundation provided secretariat assistance to the associated research personnel, from its own employed staff. The Pain Relief Foundation discharged all costs connected with the accommodation of the Pain Research Institute and its operational facilities, including overheads, heat, light, repairs, and purchase of new equipment etc. The Pain Relief Foundation discharged all costs connected with the provision of all consurnables and computer hardware for the Professor of Pain Science and all other grant aided Researchers working in the Pain Research Institute. The Pain Relief Foundation discharged all costs connected with the provision of lecture theatre and associated facilities. Under the present structure, the Head of the Pain Research Institute is charged with porting to the Scientific Advisory Sub-comrnittee in respect of all research work carried out under the Pain Relief Foundation grant arrangements, and also on the additional research that has been made possible through the Foundation's funding and provision of accommodation. The Chair of the committee is then able to submit a concise report to the Committee of Trustees. This established pro￿dure is an essential method to evaluate and measure the success and effectiveness of the research work being conducted and to ensure that it is achieving its aims. Additionally, the head of the Pain Research Institute is invited to attend meetings of the Trustees at six monthly intervals, to answer questions on matters raised regarding current and on-going research projects and future planned developments. He also maintains a liaison with the Education Sub-comrnittee, attending their meetings in an Ex-officio capacity. 12

RESEARCH co￿RDINATIoN & EDUCATION The research co-ordination accommodation is located in the adrninistrative area and fulfills a range of functions in its operational role. It supports the Pain Research Institute in a number of fields, providing accurate sources of scientific and medical information to assist the researchers in many projects. Under the direction of the Education Sub-committee. the Education Section also undertakes the operational factors in the conduct of all postgraduate courses that are organised throughout the year, arranging the teaching serninars, overseeing the Pain Relief Foundation Annual Lecture, collating and ensuring the correct and timely marking of Student essays and organising external conferences. STRUCTURE GOVERNANCE AND MANAGEMENT Governing Document On 61h April 2014, the Pain Relief Foundation was incorporated as a Charitable Incorporated Organisation under charity number 1156227. Structure Governance & Mana ement The Pain Relief Foundation is controlled by its Constitution as a Charitable Incorporated Organisation managed by a Committee of Trustees and at their meetings the Committee regularly Gonducts an assessment and review of their number, taking into account the skill requirements of the rnembers in conducting the affairs of the Trust, and any potential retirements in the forthcoming 12 months. From this review, consideration is given to the need, if any, to recruit further Trustees. In the event that further recruitment is deemed ne￿Ssary, the Committee of Trustees will seek suitable candidates through a prO￿sS of personal contact across the Universities, the Health Service and other appropriate professional bodies associated with the charity. Details of the Trustees are shown on page two of this report. The power to appoint a new Trustee or additional Trustees of the charity is vested in the Committee of Trustees and new appointments may be made by a resolution of a meeting of that Committee. A Trustee may retire upon giving two months, notice in writing of intention to do so to each of the other Trustees. The Trust Constitution requires that the number of Trustees should not be less than three at any time, but there is no limit on the rnaximum number and Trustees are not required to retire and stand for re-election. No expenses of any type will be paid to any Trustee, nor will any Trustee be paid any remuneration or payment of any kind from the Foundation in their capacity as a Trustee. All of the Trustees will give freely of their time and act in an honorary capacity. This is confirmed in each year's Annual report & Accounts. In the period 6th April 2024 to 5th April 2025, there were no expenses of any type paid to any Trustee nor were there any Trustee in receipt of any remuneration or payment of any kind from the Foundation in their capacity as a Trustee. All of the Twstees gave freely of their time and acted in an honorary capacity. The Committee ofTrustees conducts four quarterly meetings each year atwhich they receive reports on the activities and achievernents that have occurred since the previous meeting. The meeting agendas encompass reports on the full range of activtties and srtuations including day-to-day administration, investments and reserves, cash flow and risk management. The Committee of Trustees continues to review several areas of importance in the effective management of the Foundation, The prepared 'Risk Assessmenl policy is subject to regular review to ensure that potential risks to which the Gharity may be exposed are adequately identified, assessed and mitigating steps taken. This operational area is considered to be of the greatest importance and procedural changes will be implemented if deemed appropriate. 13

Related Parties For the purposes of preparing accounts in accordance with the Statement of Recomrnended Practice for charities, in the opinion of the Trustees, the following are related parties to the Pain Relief Foundation:

The Trustees and their immediate family The National Health Service The University of Liverpool Risk Mana ement The trustees have a duty to identify and review the risks to which the charity is exposed and to ensure appropriate controls are in place to provide reasonable assurance against fraud and error. Risk Assessment The Trustees have prepared a risk assessment register in which they have recorded the details and results of an extensive study regarding the potential risks to which the charity may be exposed in the conduct of its affairs. The Trustees have satisfied themselves that through the actions they have taken, the identified risks have been reduced or eliminated, and that appropriate procedures and controls to deal with the risks are in place. so that any resulting or potential impact that the charity may experience is minimised. The risk assessment register is subject to at least an annual review and in general it is an ongoing review. Such reviews ensure that all of the procedures in place continue to be appropriate to the conduct of the charity and that it is adequate in the light of experience. Where appropriate, systems or procedures have been established and put into place so as to mitigate any risks which may arise or develop Trustee Indemni Insurance The Trustees do not contract a Trustee Group Indemnity Insuran￿ policy. Recruitment A ointment and Induction of New Trustees In selecting people to be appointed as trustees. nominations are submitted to a meeting of the Committee of Trustees, so that they each have the opportunity of evaluating the strengths of the candidate(s). In considering each nominee, the trustees take into account that person's professional qualifications or personal qualities, their commitment to promoting and furthering the aims of the Foundation, and their ability to make a contribution to the effective management of the Foundation. If the nominee is deemed acceptable, then the appointment is conducted in accordance with the established procedure of induction and training. The Chair of the committee will extend an invitation to the candidate(s) to attend an early meeting to discuss the appointment in more detail. This is followed by a further meeting with the comrnittee of trustees at which the new trustee is introduced, and a formal appointment confirmed. On appointment. the new trustee is required to sign a declaration stating thatthey comply with the formal conditions required of a Trustee and are therefore able to legally serve as a trustee. It is a requirement that a declaration of interest be rnade so that any conflicting interest is noted and registered accordingly. Should any interest be registered, then at any meeting where there is such a conflict, the Trustee will be required to withdraw and not vote on the matter. It is also declared that none of the Trustees have an interest in the phan￿a￿UtlCal industry. However, any such interest would be registered. An induction meeting is then held with the Adrninistrator who will infomi the new Trustee of their powers and responsibilities, the operational policy. the management arrangements for the charity's investment funds and the procedure of reGeiving applications for research grants and how the 14

applications are processed through selection. Other meetings are then held with the Sub- Committees at which their operational roles and powers are discussed. An induction welcome pack is provided to the new Trustee. which contains as a minimum a copy of the Constitution, a synopsis Df the Foundation Sin￿ its inception showing its achievemenls and furtherresearch targets in human chronic pain. Copies of the Trustee Committee's rneeting minutes and the meeting minutes of the Advisory Sub-committees, each covering the past 24 months, cash flow reports for the same periods, and copies of the previous two years, Annual Report and Accounts. A presentation folder is prepared containing copies of the Reserves Policy and Annual Review, Risk Assessment, Management Flow Chart, Mission Statement and Equal Opportunities Policy. In addition, a copy of the Charity Commission's publications, Education Adviso Sub-committee Appointed by the Committee of Trustees. this sub-committee is the driving force behind the Foundation's educational and informational outreach, ensuring that knowledge is not only generated but effectively disseminated to those who rttd it most. Chaired by Dr. Manohar Shanna. a distinguished Senior Pain Consultsnt within the N.H.S. and a dedicated Trustee of the Foundation. the sub-committee exempl1r￿S a unique blend of clinical insight and strategic vision. Its composition speaks volumes aboutthe depth of expertise at its disposal, including leading Neurosurgeons, Senior Pain Clinicians, and a Clinical Lecturer with a Special Interest in Pain. The primary mandate of this sub-committee is to advise the Trustees on all educational issues and to robustly develop the Pain Relief Foundation's educational footprint. This is achieved through a multi- faceted approach, encompassing: Publlcatlons: Developing and endorsing high-quality written materials. Courses & Lectures: Designing and delivering educational programmes for health professionals. Llterature & Conferences: Organising and participating in forums that foster knowledge exchange and collaboration. Bèyond direct educational programmes, the committee plays an equally crucial role in the dissemination of vital infomiation. They are specifically tasked with identifying the most appropriate methods for publishing and sharing.. Successful Research Results: Translating complex findings into accessible formats. New and Improved Treatment Methods: Providing updates on the latest advancements in pain care. Infomiatlon Leaflets for Pain Sufferers= Empowering patients by directing them to the best treatment reSoUr￿S and centres. This information is distributed through the medical press and, both the Foundation's website and the Institute's website. All of the members act in an honorary capacity. Scientific Adviso Sub-committee Tasked with advising and directs'ng the Trustees on the sensible allocation of ftjnds for selected research projects and additional applications. Leading this dists'nguished panel is Dr. Caroline staunton, a well-respected and formidable research associate whose leadership provides insightful direction to the committee's crucial work. Dr. Staunton's finn but fair approach ensures that every funding decision is considered through a lens of scientific merit. potential impact, and strategic alignment with the Foundation's mission. Her fellow committee members are meticulously recruited for their profound and in4epth knowledge of chronic pain conditions. Drawn from both local and external treatment centres. they represent the myriad disciplines involved in the comprehensive study and treatment of human pain. This diverse expertise ensures a holistic and nuanced evaluation of research proposals, encompassing the many 15

facets of pain science - from neurobiology to psychological interventions and clinical treatment modalities. Crucially, all members dedicate their time and expertise in an honorary capacity The Committee serves as an indispensable SOU￿ of information, advice, and expert opinion, particularly in its role of evaluating and prioritising the numerous funding applications for scientific research deemed worthy of support. Their rigorous assessment process is vital in identifying projects with the highest potential to yield significant breakthroughs. The Committee continues to be the source of invaluable information, advice and opinion when reporting on, and prioritising, the numerous funding applications for scientific research which were considered to be worthy of support. It also continued with the vital task of overseeing the results from the many facets of research work, assisting the Trustees in interpreting, and analysing the large volume of scientific information submitted by Research Fellows, Grant Holders. The purpose in re￿Iving and analysing these reports is to satisfy the Trustees that..

the research being fvnded is achieving the projected results to satisfactory and accepted scientific, medical and research standards. the research is likely to reach its stated aims. ethical approvals remain in place and are being followed scrupulously. research Governance is being observed at all times. quality standards are being maintained. the costs of the research are maintained within the grant limits. the research is being managed and monitored effectively. The head of the Pain Research Institute is called to attend each of the Trustee meetings to provide the Trustees with an insight into the advances and the strategic development of the research opportunities being pursued. Reports are also received from the appointed Education Advisory Sub-committee, which is principally involved in directing the Educational Meetings, Lectures, Student Essays and Patient Information issues and the Scientiffic Advisory SU￿ComMittees which undertakes the tssk of advising the Trustees on all aspects of Research and Research Grant applications. Grant Makin Polic In November each year. the Pain Relief Foundation advertises in the national medical press, to invite well established researchers and scientists to submit applications for Pain Relief Foundation grants, to carry out research projects on human chronic pain or to purchase special laboratory equipment to conduct clinical trials. The noti￿ to apply for grants is advèrtised in the selected medical journals, on the Pain Relief Foundation Website, on the NHS grant website and through other appropriate media; there is a closing date for the receipt of such applications. The advertisement states the upper (monetary) limit of grants, which may vary from year to year. On receipt of applications, the Foundation's Charity Manager ensures that all appropriate sections of the application forms which have been received are correctly completed and then arranges a meeting of the Scientific Sub-committee to present the Abstracts of the applications to the members. At this meeting, the rnembers jointly select and nominate independent and best qualified, learned medical persons who will be asked to peer review each application and to give their expert opinions. After the meeting the Charity Manager writes to the selected peer reviewers, submitting a copy of the application asking if they will provide an assessment of the proposed research, the likelihood of the work succeeding and the cost effeGtiveness of the requested budget. In addition, references are sought regarding the applicants and the outcome of previous research projects for which they have received funding frorn all sources. Vvhen all applications are complete with the peer reviews and references received, a full set of each application is submitted to each member of the Scientific Advisory Sub- Committee. for consideration and prioritisation in preparation for a selection meeting of the members. At the grant meeting, the Chairman calls the attention of the members to the received Peer Reviews and References which are referred to throughout the process of considering the most appropriate and worthy applications deserving of a grant. Each committee member delivers an opinion on the applications 16

received and scores each application between 1 and 3 with (1) being the lowest score and (3) being the highestscore. These scores are then broughttogetherwith the Peer Review scores and the applications listed in order of achievement, at which point the Chairman and the committee draw recommendations to place before the next meeting of the Trustee Committee. When the Trustee Committee receives the advice of the Scientific Advisory Sub-committee, they decide which applications, if any, will be funded in accordance with advice received. and in the light of funds available. The Trustees may recommend that an application not be ftjnded, be funded in full, or be funded at a reduced level. In the event that the Trustees are considering a number of competing recommended applications for which the Foundation's funds are inadequate to fund them all, the Trustees may invite the Chairman of the Scientific Advisory Sub-committee, together with those members of the Sub- Committee who are also Trustees, to help them priorttise the applications. Each grant is specific to the holder and ceases should the grant holder terminate their post. New rants a roved since the last re orL 1 . An application is for a 3-year prize PhD Student for a total of £74,982 submitted by Dr Fiona Watt of Imperial College London and is titled: 'Investigation of the honnonal factors undertying excess female risk forpainful osteoarthritus. 2. An application for an 12-month grant for a total of £16,625 submitted by Dr Andrew Marshall of University of Liverpool and is titled. Undery)inning Mechanisms of Developing Neuropathic Versus Non-Neuropathic Pain After Stroke 3. An application for a 12-month grant for a total of £29,969 submitted by Dr Quaslm Azlz of Queen Mary University, London and is titled 'Proof of concept assessment of the f8asibility of artificial intelligence-driven transcutaneous V8gal Nerve Stimulation (tVNS) algorithm for somatic pain,. Public Benefit In the foregoing section, the aims and objectives of the Foundation are plainly stated, and the policies adopted to deliver these aims and objectives are clearly stated. The objectives are supported by clear explanations regarding the policy of the Foundation to support the preparation and development of good quality research projects which are peer reviewed and expertly selected to develop the provision of improved treatment for the benefit of patients, easing and reducing their pain. In addition to the research Gonducted, the Foundation provides educational activities and the training of health professionals to achieve the stated aims. All of these activities are a continual matter of ongoing review by the Committee of Trustees and the Members of the Advisory Sub-committees. so that in the light of experience, adjustments which are considered appropriate are implemented quickly, to ensure that the highest quality results continue to be delivered. The development of improved patient services and treatment, as previously stated, is considered to be 8 priority issue by the Foundation, and it works symbiotically and in co-operation with the NHS and Universities to provide post-graduate scientific education in chronic pain relief. A number of postgraduate tiaining courses have been conducted each year, for the continuing education of nurse5, GPS, and for clinical pain specialists. The information service provided by the Foundation serves to infom General Practitioners and all Pain Clinicians and Consultants with up-to-date information regarding available treatments for various pain conditions. In addition, the Foundation provides an infonnation service for patients, their support carers and family members through the provision of leaflets on most chronic pain conditions. The Foundation's website also provides a vast range of guidance and support for patients and Health Professionals, and much of the advice section Contents can be downloaded for furlher ease of aC￿ss. This enables patients and carers to be empowered about their individual problems. Pain sufferers who make telephone contact with the Foundation are connected to experienced, friendly staff who are trained to sympathetically and professionally direct enquirers through to available services and advice centres. They are also able to guide sufferers into how they can avail themselves of these services and what action they can take to be refe￿ed to clinical senil￿S for pain treatment. 17

Patients also receive direct benefit through research results which lead to the development of new and improved treatments for chronic pain conditions. These results are delivered to pain treatment clinics nationally, and indeed internationally, through the dissemination of research information by the Foundation either electronically. from our website. in medical publicats'ons and by way of educational meetings for health professionals. With living with chronic pain affecting approximately 40Qh of the British population, it can be seen that the work of the Foundation provides a benefit for a huge number of people. Reports on the research work supported by the Foundation are included in later pages and give a vast amount of information on the progress that is being made with human chronic pain and you are encouraged to read this section. Volunteers The Pain Relief Foundation does not receive any funding from ￿ntral or local government, the health service, or other official bodies. Instead, the Foundation depends entirely on donations, gift aid, legacies, appeals and contributions from supportive members of the public, from generous companies and from several small trusts. There is a small level of direct fundraising activity organised and conducted by the Foundation's own staff, supported by one or bNo volunteers, an area in which we would like to grow our support. Additionally. it seeks to secure grants from trusts and the commercial sector to fund specific research projects. The Foundation is not in receipt of benefits in kind, either by way of Servi￿S, facilities, or donations-in- kind. It does, however, receive some limited benefit from the very small number of volunteers who support the fvndraising section in the organisation and conduct of small events. The Trustees recognize the intangible value of the contribution of volunteers to the charity and the Trustees are of the opinion that such income cannot be reliably ascertained. However, it is considered that such intangible income is unlikely to be material. Powers of Investment The Constitution provides the Committee of Trustees with the following powers: To administer a bank account in the name of the Foundation at such bank as the Trustees shall decide. To invest in the name of the Trustees, any monies not required for the irnrnediate purpose of the Foundation, in such securities as they may from time to time decide as if they were beneficially entitled and whether such securities shall be Trustee investments or not and shall have power from time to time to transpose such investments. That any property purchased by the Foundation shall be vested in the Trustees appointed for that purpose and the Trustees shall enter into a Deed of Trust setting forth the purposes and conditions under which they hold the said property in trust for the Foundation and shall with such consent as is by law required deal with the property so vested in them by way of sale, mortgage, charge, lease or otherwise howsoever directed by the Foundation. Investment Polic The Trustees have developed an investment policy which it believes will respond to the needs of the on-going activities of the Foundation. Sufficient funds are retained in investment that will ensure we can respond to all contingencies as they may arise. Equally important is the strategy of investing in low to rnedium risk funds that will also provide an operational income. The objective is that this investment policy will produce improved values and income, whilst at the same time safeguarding the short-term and long-term financial needs of the Foundation. The Trustees seek the advice of its Investment Advisors, Rathbone Investment Management Limited and at regular meetings with the Advisors, in-depth reviews are held into the investment portfolio that makes up the reserve fund. The investrnent decisions taken by the Trustees throughout this financial year have proved to help preserve the portfolio as much as possible in the current climate. Supported by the Advisors and 18

making several minor adjustments, for the best possible outcome the fund has this year seen an increase compared with the end of the last financial year. At a joint meeting with their Advisors, the Trustees set an investment policy of 600/0 of the funds invested into 'Equity Investments, with a view of maximising the Securtties and to invest 40°/o of the funds into 'Fixed Interest Securities,. The decision to ease the approach with fixed interest investments was a very positive decision at the commencement of the year. Mindful of the continuing uncertainty in the markets, during the year under review the Trustees gave instructions to the Portfolio Manager that the portfolio investment should be organized at 65 % of its value being in Equities and 350h of the value being in Fixed Interest stock and the investments were so arranged at the beginning of the year. Reserves Polic The strategy developed by the Trustees is to hold a level of reserves that is deemed to be appropriate from time to time, to ensure that:

The committed and planned research projects undertaken in the short, medium, and long term are sustainable. The Trustees can address any problems that arise, including the loss of any significant source of income, which might restrict the ability of the charity in carrying out its objectives. Sufficient funds are available to respond to new and important projects that are identified. The Trustees can respond to a shortfall of income in any financial year, that may occur for whatever reason, and which shall enable the research that is already authorised, to continue without a break. The cost of funding the Chair at the University of Liverpool for the 'Pain Relief Foundation Professor of Pain Science, shall be protected for a minimum forward period of 10 years from any date, by ensuring that such sums as shall be required to continue the funding for such period are kept on reser￿e. Sn setting the level of reserves, a conservative management style has been adopted that is consistent with the Trustee's responsibilities who have agreed a broad spread sector exposure to increase diversity and to regulate risk. The Trustees have established a position that the level of unrestricted reserves and investments should be adequately sufficient to respond to the above operational policy and needs. Therefore, the Trustees have agreed the following: To provide reserves to cover the estirnated costs of funding existing research, research coming on-line, overheads. research administration support, charity administration and fundraising over three years. Based on an average annual expenditure, this need is £1,270.245 To retain in investments, an amount that will enable the Trustees to respond to new and important projects that may arise. In arriving at a level of retention, consideration has been given to the fact that such projects may require funding for at least two years and possibly three years. It is considered that in view of the ongoing investment market volatility and the continuing and uncertain slow rate of recovery, together with the unsteady present uncertainties worldwide, the present level of reserves is adequate to meet these criteria. 19

Tradin Changes in the 2000 Finance Act, Chapter 17, allowed exemption to tax on charitable income from trading activities up to predetermined levels. The charity continues to carry out a very small level of incidental trading within the prescribed limits. FUNDRAISING REGULATOR FR uNUA￿SEYG REGULATOR The Pain Relief Foundation is a Member of the Fundraising Regulator (FR) and has been Sin￿ its inception in 2016, The FR is the independenl regulator of charitable fundraising and was set up following the Etherington review of fundraising self-regulation (2015) to strengthen the system of regulation and restore public trust in fundraising. The FR is open to all fundraising organisations, suppliers, and associates. Members agree to adhere to the highest standards of good practice with their fundraising, and their stated Fundraising Promise. As a Member of the FR we demonstrate Membership of the scheme by using the scheme logo on all fundraising materials. By participating in the scheme charities are advertising commitment to best fundraising practices and to giving the public the comfort of a 'safety net, provided by a robust complaints system. It is a requirement that a charity submits an annual report to the FR, advising the Board of the number of complaints received by the Charity, in relation to its Fundraising activity, by category. The report requires the charity to notify the Board of action taken to resolve any such complaints and what the outcome results are. Pain Relief Foundation is pleased to report that in the year ending 5th April 2025. no complaints had been received by the charity in the preceding 12-month period. A report to this effect was submitted to the Board of the FR as required. The Pain Relief Foundation Fundraisin Promise We are always committed to working to the highest standards of practice. We promise donors that we will comply with the FR Codes of Fundraising Practice and do all that we can to ensure that fundraisers and volunteers will at all times comply with the Codes and with this Promise. We comply with the law, health and safety and the environment. We will not put unfair pressure on anyone to donate. If you do not want to donate, we will respect your decision. We require anyone fundraising on our behalf to clearly identify themselves as one of our representatives. We are honest and open and do not make false or exaggerated claims. We do what we say we are going to do and do not pretend to do things that we cannot. We will answer any reasonable questions you have about our fundraising activities and costs. Please contact us for infomiation, visit our website or see our Annual Report. We are clear and give clear details about how you can make a gift. If you make a regular gift and you want to cancel it, we will carry out your cancellation instructions as soon as possible. We are clear about what we do and how your gift is used for the effective support of our beneficiaries. We are fair and respect the rights, privacy. and dignity of each of our supporters and beneficiaries and conform to the Data Protection Act. We will only use your personal information for the purposes stated and for which you have given your consent. If you tell us that you do not want us to contact, you in a particular way (e.g., by telephone) we wÈll not do it. We are reasonable and responsible and will be careful not to use any images or words that cause distress or offence. We make sure that our events are well run and meet health and safety and 20

environmental requirements, and we avoid causing any nuisance, damage, or disruption. We will not use excessive emotional arguments to make you feel guilty about not giving to us. We are accountable and should you be unhappy about anything we have done while fundraising, you can write to us and complain. We have a complaints prO￿dure, and we will acknowledge your complaint within 7 days and commit to dealing with the matter within 30 days. A copy of our procedure is available on request and if we are unable to resolve your complaint, we accept the authority of the FR to make a final adjudication. FUNDRAISING COMMITTEE Effective fundraising committees are vital to the life and financial well-being of organisations, and this is no different at the Pain Relief Foundation ourfundraising committee remain committed to help raise awareness and funds. The functions of the group vary but centres around infomiation, building relationships and raising money to meet the specific organisation's special or ongoing needs. The Committee is made up of Board members with special skills and contacts to serve the role and non- members made up of nurses, ex patients and people with an interest in the Foundation whom without we could not fulfil this role. The Chair of the 'Fundraising Committee, Judith Daley, who is also a Trustee will in future advise the Board of Trustees in all facets of fundraising. DONATION POLICY This policy has been set out by the Trustees of the Pain Relief Foundation. It is a public guide to how the Pain Relief Foundation makes decisions on accepting donations and the procedures they follow. The policy is aligned with the codes of Fundraising Practice published by the Institute of Fundraising. This document makes clear the Trustees, legal obloations with the regards to the acceptance and refusal of donations. It outlines the day-to-day procedures that need to be adhered to and ensures decisions are not taken on an ad-hoc basis but are in 5UPPOrt of Pain Relief Foundations strategies and objectives. Trustees, legal obligations The Trustees take overall legal responsibility for decisions relating to whether a donation can be accepted or refused. The Trustees must be able lo demonstrate that they have acted in the best interest of the Charity, The Trustees have a duty to carefully, based on evidence made available to them, whether the Charities interests will be better served by accepting or refusing the donation and to act accordingly. These judgements must not promote any Trustee or employee's personal moral agenda, or interest and the Trustees must not allow individual or collective personal, political or ethical issues, which are not directly related to interests of the Charity, to affect their judgment. Trustees must not derive any personal benefit (individually or collectively) from donations, offered to the Charity. Policy On a day-to-day basis, the Charity's board of Trustees delegates the responsibility to accept or refuse donations as follows, providing the Charity Manager is sure that any potential individual or corporate donor are supporting the charity in accordance with this policy. 21

A donation must be clearly evaluated to establish whether it would be in the best interest of the Pain Relief Foundation to ac￿pt or refuse it. The donation should contribute towards the Charity's overall strategy and plans. The Charity will not accept donations from individuals or companies whose wealth are known to result from illegal activities or where there are indications of corruption and related crime. The donorfs objectives or activities must not appear to be incornpatible with the Charity's vision, mission, and values, particularly if this risk is causing significant damage to the Charity's integrity, public image, or professional reputation. The Pain Relief Foundation will refuse donations in the following clrcumstances: Where the activities of a donor are directly contrary to the objectives or agreed policies of the Charity or the Charity suspects the gift has been donated to facilitate money laundering or other criminal activity. Where it can be clearly shown that the cost to the Charity of ac￿ptIng the donation will be greater than the donation itself, and that the acceptance of the donation will directly lead to a net decline in assets of the Charity, Where the offer of support is dependent on the fulfilment of certain conditions placed upon the Charity and any condition, A) Is in itself contrary to the objectives of the Charity B) Is regarded as needing an unreasonable level of support from the Charity especially in relation to the size or impact the donation will have on the Charity's charitable activities, C) Will divert the Charity from pursuing its current objectives, policies, or work priorlties as a necessary fulfilment of the conditions alone. The Trustees will take great care and consideration in decldlng whether to accept or refuse a donation. Donation Recognition Gift Acknowledgment & Accountability All donors will receive a personal thank you letter and receipt, regardless of gift amount. All gifts will be formally acknowledged as quickly as possible, and in any event within 5 working days. The reporting requirements of all Grant Makers will be fulfilled thoroughly, accurately and within their required timeframe. Major donors for specific projects will receive where required and appropriate regular updates on the progress of the project. Where appropriate and required the families of legacy donors will receive a report on the use of the bequeathed funds. Recognition Any donors expressed desire for anonymity will be strictly adhered to Any public recognition will only be undertaken with the Donors express permission and in compliance with data protection legislation and best practice. 22

Recognition may be tangible by way of a physical acknowledgment such as a plaque and would be pla￿d wtthin the Pain Relief Foundation. This type of recognttion would be decided by the Trustees. In general costs of recognition shall not exceed 50/0 of the gift amount. In all cases the cost of recognition shall be both reasonable and proportional. The Charity reserves the right to refuse. discontinue or remove public recognition whether tangible or intangibl8. at any time if for any reason it considers the association to be damaging to its reputation. This ¢ourso of action will be decided by the Trustees. STATEMENT OF TRUSTEES RESPONSIBILITIES The Trustees 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 AC￿pted Accounting Practice). The law applicable to charities in England and Vlales, the Charities Act 2011, Charity (Accounts and Reports) Regulations 2008 and the provision of the Constitution requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charity and of the incoming resources and application of resources, including the income and expendrture, of the charity for that period. In preparing those financial statements, the trustees are required to:_ select suitable accounting policies and then apply them consistently. observe the methods and principles in the Charity SORP. make judgments and estimates that are reasonable and prudent. prepare the financial statements on the going concern basis unless it is inappropriate to presurne that the charity will continue in business. The Trustees are responsible for keeping proper accounting records which disclose with reasonable accuracy at any time the financial position of the charity and to enable thern to ensure that the financial statements cornply with the Charities Act 2011, the Charity (Accounts and Reports) Regulations 2008 and the provisions of the constitution. They are also responsible for safeguarding the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. The Trustees present their report with the financial statements of the charity for the year ending 5th April 2025. The Trustees have adopted the provisions of Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). Approved by order of the Committee of Trustees on 2September 2025 and signed on its behalf by: Mr D Cain - Chair Date 12th September 2025 23

CLINICAL SECTION Patient & Public Information The Pain Relief Foundation (PRF) is dedicated to providing valuable resources and support to those suffering from chronic pain. Through our website and informative leaflets, the PRF offers a wide range of information and guidance to help individuals understand their pain condition and available treatments. Online Help and Advice Our website, www.painrelieffoundation.org.uk, is a comprehensive online resource for chronic pain sufferers. It offers a wealth of infonnation on various aspects of chronic pain, including its causes, symptoms, and available treatrnents. The website also features an online help and advice service, which allows users to submit their queries and receive expert guidan￿ from the PRF'S team of medical professionals. Informative Leaflets In addition to the online help and advice service, the Pain Relief Foundation provides a wide range of informative leaflets, each of which deals with a specific chronic pain condition. These leaflets have proven to be an invaluable resource for thousands of chronic pain sufferers, helping them to better understand their pain problem and the available treatment options. The leaflets are continually updated and re-written using the guidelines issued by the Centre for Health nformation Quality, ensuring that the information is accurate, up-to-date, and easy to read and understand. These are also available to download via the website and are also made available to GP surgeries. CD'S The Coping with Pain CD was one of the early self-help aids for chronic pain sufferers. With an introduction by Magnus Magnusson, it soon became part of the pain patient's medicine cupboard, Each section of the CD has been specifically designed to focus the minds of pain sufferers on ways of easing their pain through relaxation and gentle exercise. As many as 2 out of 3 people who have used it report that they have been able to improve their quality of life and find that their chronic pain problem is eased. Over 65,000 copies of the Coping with Pain CD have now been distributed through a range of outlets covering the medical field and the retail sector. Additional CD'S dealing with specific pain conditions are also available and they include: Coping with Headaches & Migraine, Feeling Good, Coping with Back Pain and Relaxation and Coping with Anxiety. Each of the CDS contains relaxation programmes that help so many sufferers to find relief. PAIN RELIEF FOUNDATION INFORMATION SCIENCES RESEARCH CO-ORDINATION & EDUCATION Introductlon The work of this department draws on the expertise of Pain Clinicians and is closely aligned with the work of the Foundation Education Sub-committee. The work of the Committee encompasses all educational courses, conferences and meetings for health care professionals and the department provides the administrative support for those developed courses and conferences plus the provision of information about chronic pain to both patients and the general public, including an online resource about hronic pain. This fvlfills the remit of the Foundation to provide such education. 24

EDUCATION Meetin s and Courses Meetings and courses which are developed and structured are aimed at all health Ca￿ professionals with the sole purpose being to educate participants about all aspects of chronic pain management the courses are initially aimed at a national level but such as the interest has grown in the treatment of chronic pain. we now attract participants from a51 over the globe. Foundation courses & lectures Organisiation is well under way for the annual Clinical Management of Chmnic Pain course, the course has a change of date this year and will Tun in November. This is a vibrant and participative clinical, hands-on course. It is a 2.5 day course aimed at Consultants, Specialist Registrars, Anesthetists, Advanced Specialist Nurses, GP'S. and Physiotherapists with some experience of pain management. This year the Gourse is under the lead of Dr Hemkumar Pusharaj, Specialist in Pain medicine and Neuromodulation at the Walton Centre NHS Foundation Trust, and Dr Manohar Sharma, Consultant in Pain Medicine, The Walton Centre NHS Foundation Trust, Liverpool with support from Dr Kerry MatthevL8, Consultant Clinical Psychologist, The Walton Centre NHS Foundation Trust, Liverpool. Each year feedback is given by the participants attended; this is read by the organisers, who take on board any suggestions and ideas to keep on improving the course so that the best education possible is provided, The course consists of a mixture of lectures, seminars, clinics. theatre sessions and a grand round. It will remain participative clinical. hands-on with the most up to date information and techniques of treating chronic pain available. The participants will also spend a day in the Pain Management Programme at Walton Centre where they see firsthand the multidisciplinary assessments and treatments that patients receive. The Foundation continued in its role of facilitating the North England Pain Group (NEPG) one-day meeting in Leeds. This year's programme was organised by Dr Angela Deeley, Consultant in Anaesthesia and Pain management at Mid Cheshire Hospitals supported by Dr Sara Slew, Walton Centre, Liverpool. The meeting covers many topical and highly relevant areas in the current practice of Pain Medicine. The 24th Pain Relief Foundation Annual Lecture took place in June and was Chaired by Dr. Chris Wells & Professor Roger Knaggs, the lecture was delivered by Professor Andrew Rice a r of Pain Research at Imperial College and the current President of the International Association for the Study of Pain (IASP). the title of the lecture was °Lost in translation, ° The evening's proceedings were to honour the life and work of Prof Ulf Lindblom, Professor of Neurology at the Karolinska Institute, Stockholm, Sweden He was a founding member and president of IASP and pioneered quantitative sensory testing We also be facilitating the 2nd Unravelling Pain rneeting: 'Management of Persistent Pain. The 'Unravelling Pain, Team is a group of pain specialists who are passionate about improving understanding of pain with the aim of changing the way people think about, talk about, and respond to persistent pain. This is a free event for people who experience persistent pain, health care professionals working with people who have persistent pain or people who know someone who has persistent pain. The aim of the meeting was to improve that understanding pain is key to living well with pain. The Foundation was approached by Dr G Baranidharan. Consultant in Anaesthesia and Pain Medicine, Leeds Teaching Hospitals NHS to facilitate the Leeds Cadaver Course, a prestigious 2- day meeting which has been running over the past 10 years. The Foundation agreed and the first meeting went with great success, and we will continue to facilitate going forward 25

The Foundation Essa Com etition The competition is run annually. The aim of this competition is to raise awareness nationally among medical undergraduates about chronic pain and the Pain Research Institute. The competition is open to multiple discipline entries Medicine and all health profession Undergraduates including occupational therapists, physiotherapist. nurses, and psychologists. The winning entries for 2024 are below: Luke Solomi, University of Plymouth - Medition in motion.. Tai Chi for chronic pain Samual Adler, U niversity of Edinburgh- The Potential Use of Electroconvulsive Therapy (ECT) in the Management of ChroniG Pain Rikata Devadas, University of Edinburgh - The Role of Lifestyle Medicine in the Management of Fibromyalgia Each winner received the winning prize of £500. their essays can be viewed on our website. Pain Relief Foundation Website The Pain Relief Foundation website, www.painrelieffoundation.org.uk, seNes as a premier online resource designed for the general public, providing vital information about chronic pain. Crucially, it acts as a trusted gateway, directing users to other specialist websites that offer good, current, medically correct, and easily understood details on specific chronic pain conditions. A key differentiator is that all recommended external sites undergo rigorous assessment by experts, ensuring the reliability and accuracy of the information presented. Furthermore, the website offers practical support through its downloadable "Dealing with Pain Series" leaflets, covering various chronic pain conditions and associated medications. Visitors can also find regularly updated, topical, and informative articles penned by staff from the Foundation, Institute, and the Walton Centre Pain team. Beyond informational resources, the site keeps users abreast of current news and fundraising events and uniquely provides an online portal for Health Professionals to register and attend relevant events or courses. WORK & STUDY AREAS The Institute continued to provide accommodation for research personnel to study their research developments and prepare research reports and applications. The accommodation is furnished and serviced, fully set out with computers workstations, and associated equipment. RESEARCH Below is a snapshot selection and brief description of research that is currently being undertaken with the support of the Pain Relief Foundation. An in-depth progress report of the research can be found on our website. www. painreleiffoundation.org.uk under the tab marked research. Grant title:, Biopsychological Prediction Models of Pain Management Programme (PMP) Outcomes for Chronic Pain. Awarded to . Dr Christopher Bmwn, Dr Jennie Day, Dr Katie Herron, Dr Selina Johnson, Dr Laura Bonnett- University Liverpool. PhD student. Andrew Pajmer 26

Overall ro ect summa This PhD project is exploring why some people with long-term (chronic) pain benefit more than others from taking part in pain management programrnes (PMPS). PMPS are the main recornmended treatment for peopEe with moderate to severe chronic pain in the UK. They can be very helpful, but they are also time-consuming, expensive, and don't work equally well for everyone. Some patients improve a lot, others see little change, and a few even get worse. This project aims to understand what helps people get the most out of these programmes - what we call 'enabling factors." It involves three studies: 1. A review of previous research to identify whal factors predict good PMP outcomes. 2. A statistical analysis using NHS patient data to build a model that could help predict who is most likely to benefit. 3. A qualitative study involving interviews and surveys to uncover personal views on what makes PMPS work well, including ideas that might not show up in quantitative data. Together, these studies aim to support future efforts to personalise PMP delivery- making sure patients get the support that's right for them at the right time. Study l - Review ofprevious research on PMP outcomes We looked at past research studies to find biological, psychological, and social factors that seem to predict how well people do emotionally after completing a PMP. Emotional well-being is a key part of recovery but often gets less attention than physical symptoms in research. Study 2- Building a prediction model using NHS data W8 are developing a prediction model using real data from patients who attended PM Ps at the Walton Centre in Liverpool. The model uses information collected before treatment (like age, health status and rnood) to try to predict who is likely to improve after•iards. Study 3 - Exploring new "enabling factors" thrnugh personal experiences This study looks at personal views and experiences of PMPS from patients and professionals. Using a method called Q-methodology, we aim to uncover which beliets, traits or behaviours people think help someone make the most of a PMP. We first interviewed a range of people - including patients, staff and a GP - to gather their thoughts. We then turned their ideas into a set of short statements about what might make PMPS work better. A different group of people is now ranking these statements in order of agreement, so we can see where there is common ground. Grant title;'Inhibition of metalloproteinases: a novel approach for the treatment of post- stroke pain., Awarded to . Dr Milena De Felice, University of Sheffield Stroke is a leading global health burden; it is the second leading cause of death and ranks third for combined death and disability. In the United Kingdom alone, there are approximately 100,000 strokes each year, with only 1 Ooh of survivors making a near-full recovery. leaving the vast majority with persistent neurological deficits (i.e., weakness, difficulty speaking or thinking) and, in approximately 30 % , debilitating chronic pain often in their arms and legs. The developed post-stroke pain makes it harder to take part in rehabilitation. disrupts sleep, contributes to low mood and anxiety, and even increases the risk of thoughts of suicide. Unfortunately. existing pain medicines often fail to provide relief or cause unwanted side effects like drowsiness, dizzines5, and nausea. 27

There is therefore an urgent need for treatments that safely and effectively alleviate post-stroke pain and improve the quality of life of stroke survivors. We have estsblished and characterised two murine models of focal cerebral ischaemia, the transient and the pemianent middle cerebral artery occlusion (MCAO), which together recapitulate most presentations of human large-vesse5 stroke. We have established that in both model, male and female develop robust thermal hyperalgesia and mechanical allodynia in the affected limbs beginning around four days post-ischaemia and persisting beyond 28 days. This mirrors the time Course and sensory profile observed clinically in post stroke pain. Building on eviden￿ that the enzymes known as matrix metalloproteinases (MMP-2, -9 and -12 in particular), contribute to tissue damage after stroke (including blood-brain barrier disruption, oedema formation and neuronal injury) and to chronic pain in other conditions, we evaluated the efficacy on MMPS inhibition in our post stroke models, independently of any neuroprotective effects. We hypothesise that ischaemic stroke induces activation of MMP-9 and MMP-12 within central nociceptive circuits, driving recruitment of key pain mediators and the emergence of chronic post stroke pain. The overall aim of this project is to define the time after the onset of stroke at which inhibition of MMP-9 and MMP-12 is still effective in providing pain relief (therapeutic window), and uncover the mechanisrns by which MMP-g and MMP-12 inhibition alleviates post stroke pain, thereby laying the groundwork for rapid clinical translation. We will achieve simultaneous inhibition of MMP-9 and MMP-12 by repurposing an existing, selective MMP-9 and MMP-12 inhibitor that is already clinically available. We will achieve this through two specific aims.. Aim 1: Role of MMP-9 and -12 in initiation and maintenance of post stroke pain We will determine the effect of MMP-9 and MMP-12 inhibition at different intervals post stroke, by measuring its efficacy on the onset and persistence of mechanical hypersensitivity. Aim 2.. Mechanisms Underlying MMP-Mediated Nociceptive Plasticity We will examine brain and spinal tissues at key times to track MMP-9 and MMP-12 activity, neuronal activity markers and pain-signaling molecules, and see how inhibition of MMP-9 and MMP-12 affects these changes. Grant Title; Perceived social threat In chronic pain Awarded to: Dr Chartotte Krahé, L werpool John Moores University Co-l.. Dr David Moore, Lmerpool John Moores Univ8rsity 1. Background and Airns The aim of this grant is to conduct two studies investigating the relationship between chronic pain and the perception of social threat. People with chronic pain often report feeling socially isolated and disconnected from others. We currently do not fully understand the pro￿sseS that cause this heightened social distress and that may keep it going. In this grant, we test whether being sensitive to social threat plays a key role. Social threat includes worrying about threats to our body (e.g. someone harming us or worsening our pain directly) or threats to how socially connected and safe we feel around others. People with chronic pain are generally more aware of threats around them, but we do not know if this also applies to social threats. Study 1." The relationship between chronic pain and perceived social threat In Study 1, we investigate social threat related to physical safety. We focus on personal space, specifically the point at which approaching footsteps are felt as uncomfortably close. We expect that 28

people with chronic pain will feel uncomfortable at an earlier point than people without pain. and we also consider whether the identity of the approaching person plays a role. Study 2." Does social exclusion exacerbate social threat and ongoing pain in chronic pain? In Study 2, we examine the impact of threats to social connectedness. We will make people feel briefly socially excluded by using a virtual ball tossing game. People with and without chronic pain will play this game with virtual players. First, they are included in the game, but then virtual players pass them the ball less and less. We study whether this brief exclusion leads to greater social threat in chronic-pain than pain-free participants, and whether it worsens in-the-moment pain (in people with chronic pain) compared to being included. Together, the two studies can help us understand pro￿sseS involved in social diSt￿sS in chronic pain and allow us to develop ways to help people with chronic pain feel safer in their social interactions. Ultimately, the findings may provide an evidence-based approach for creating safer, more supportive environments for people with chronic pain. 29

BTMR Limited statutory Auditor Century Buildings 14 Sl Mary's Parsona Mancheste( M3 20F

Rep¢)rt of the Independent Auditors to the Trustees of Pain Rellef Foundation Oplnlon We have audited the financial statement5 of The Pain Rdief Foundalion (the '¢harity') for the year ended 5 April 2025 which comprise the Statement of Financial Activilies, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including a summary of signtficanl accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards <Uniled Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements-. - give a true and fair view of the state of the charity's affairs as at 5 April 2025 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended,. - have been properly prepared in accordance with United Kingdom Generally Aceeptsd Accounting Practice., and - have been prepared in accordance with the requirements of the Charities Act 2011. Basls for opinion We conducted our audit in accordance with International Slandards on Auditing (UK) (ISAS (UK)) and applicable law. Our responsibilities under those standards are turth61 described in the Audttors, responsibilities for the audit of Ihe financial statemenls section of our report. We are independent of the charily in accordance with the ethical requirements that are ielevant to our audit of the financial statements in the UK. including the FRC'S Ethical Standard. and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate lo provide a basis for our opinion. Con¢lu$lon$ relatlng to going Concern In auditing the financial statements. we have conduded that the trustee$, use of the going o)ncem basis of accounting in the preparalion of the financial statements 18 appropriate. Based on the work we hav8 performed. VR have not identified any material Un￿rtaInlieS ￿lating to events or conditions that, indivldually or collectively, may rAst significant doubt on the charity's ability to continue as a going concem for a p8riod of at least twelve months from when the fjnancial statements are aulhorised for issue. Our responsibilities and Ihe responsibilities of Ihe Ir¢Jstees with respect to going concem are described in the relevant sections of this report. Other Infomatlon The trustees are responsible for the other infomiation. The other infomalion Comprises the information Included In Ihe Annual Report, other than Ihe financial statements and our Report of the Independent Auditors thereon. Our opinion on the financial statements does not cover the other infomiation and. ex￿pt to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion Ihereon. In connection wilh our audil of the financial statements, our responsibillty Is to read the other information and, in doing so. consider whelher the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or Otherwise appears to be materially misslaled. If we identify such material inconsistencies or apparent material misst8temenls, we are required to determine whether this gives rise to a material misstalemenl in the financial statements themselves. If. based on the work we have perfomied. we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard. MatteTS on whlch we are requlred to report by exceptlon We have nothing to report in respect of the followng matters Whe￿ the Charities {Ac¢ounts and Reports) Regulations 2008 requires us to report to you if. in our opinion.. the information given in the Report ol the Trustees is inconsistent in any material respect with the financial staternents; or - the charity has not kept adequate accounting records,. or - the financial statements are not in agreement with the accounting records and returns; or we have not received all the information and explanalions we require for our audit. Responsibilities of trustees As explained more fully in the Statement of Trustees, Responsibilities, the trustees are responsible for the preparation of the financial statements and for being satisfied Ihat they give a true and fair view, and for suth internal control as the trustees determine is necessary to enable the preparation offinancial ststements that are free from material misstatement, whelherdue to fraud or error. In preparing the finan¢ial ststements, the trustees are resportsible for assessing the charity's ability to continue as a going concern, disdosing, as applicable, matters related to going con￿rn and using the going Goncem basis of accounting unless the trustee5 etkher intend to IiqLMdate the chaiity or to ￿se operations, or have no realislic altemalive but to do so. 30

Report of the Independent Auditors to the Trustees of Pain Relief Foundation Our responsibilities for the audit of the financial statements We have been appointed as auditors under Section 144 of the Charities AGI 2011 and report in accordance with the Act and relevant regulations made or having efféct Iherèunder. Our objedives are to obtain reasonable assuran￿ about whetherthe fsnancial stalements as a whole are fre8 from material misstalement, whether due to fraud or error, and to issue a Report of the Independent Auditors that indudes our opinion. Reasonable assurance is a high level of assurance. but is not a guarantee that an audit conducted in accordance with ISAS (UK) will always deted a material misstatement when it exists. Misstslements can arise from fraud or error and are considered material if, individually or in the aggregale. they could reasonably be expected to influence the economi decisions of usèrs taken on the basis of these financial statements. The extent lo which our procedures are capable of detecting irregularities, including fraud is detailed below: Our approach lo identifying and assessing the risks of rnaterial misstatement in respect of irregularities, including fraud and non-complian￿ with laws and regulations, was as follows: - we identified the significant laws and regulations applicatde to the charity which we considered could have a di￿¢1 material effect on the financial statements or the operations of the charity. Said laws and regulalions include but are not limited to the Charities Act 2011, laxalion legislation and data protection. anli-bribery and employment legislation: the identified laws and regulations were communicated within the audit team regularly and the team remalned alert to instsnces of non-compliance throughout the audit. We assessed the susceptibility of the tharity's financial stalem8nts to material misstatement, induding obtaining an understanding of how fraud might occur. We also addressed the risk of fraud through management bias and override of controls by., - updating and reviewing our knowledge of the charity, its trustees and intemal financ4al fijnction, togetherwith their syslems and inlernal controls. This induded making enquiries of management as to their knowledge of actual, suspeGled and alleged fraud., and considering the internal controls in place to mitigate risks of fraud and non•complian¢e with laws and regulations. We concluded that whilst the Gharity had controls in place that were appropriate lo its size and the nature of ils activities, we uld not reSy on those systems and internal controls exclusively for the purposes of our audit work. We Iherefore adopted substantive and transactional approach to our audit, seeking to verify figures in the balance sheet to third party evidence and transactions within the Statement of Flnan¢ial Activities to external independent documentation., We did not review every irans8Ction. However, we adopted an approach based on tesling a sample of transactions. In choosing our sample, we tested transactions that were material in nature and in addilion a random sample of olher transaction. By choosing transactions of a material nature. our audit work is designed to detect material misstatements. The use of random lesling on other transactions is designed lo detect other irregularilies and the operation of the charity, internal control systems generally. If exceplions were noled. our audit work was expanded to test more transactions with a view lo determining whether the exception was of an isolated nature; We performed analytical PTocedures to identify any unusual or unexpected relationships; We tested journal entries lo identify unusual transactions and investigated Ihe rationale behind significant or unusual transactions. There are inherent limitations in our audit procedures described above. The more removed that laws and regulations are from financial transactions, the less likely tt is that we would become aware of non-wmpliance. Auditing standards also limit the audit procedures required to idenlify non-compliance with laws and regulations to enquiry of Ihe trustees and olher managemenl and the inspection of regulatory and legal corresponden￿, if any. Material misstatements that arise due to fraud can be harder to delect than those that arise from error as they may involve deliberale concealment or collusion. A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council's website at www.frc.org.uklauditorsresponsibilities. This description forms part of our Report of Ihe Independent Auditors. 31

Report of the Independent Auditors to the Trustses of Pain Relief Foundation Use of our report This report is made solely to Ihe charity's trustees. as a boty. in aLxordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008. Our audit work has been undertaken so that we might state to the charivs trustees those matters we are required lo stale to them in an auditors. report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other Ihan the charity and the charity's Iruslees as a body, for our audit work, for this report, or for the c¢)inions we have fo￿r￿d. trrviyz BTMR Limited Slatutory Auditor Eligible for appointment as auditor of the Charity by virtue of ils eligibrfity for appointment as an auditor under of Section 1212 of the Companies Act 2006 Century Buildings 14 St Mary's Parsonage Manchester M3 2DF Date: 32

PAIN RELIEF FOUNDATION statement of Financial Activities for the Year Ended 5 April 2025 5.4.25 Total funds 5.4.24 Total funds Unrestricted funds Restricted fund Notes INCOME AND EN DOWMENTS FROM Donations and legacies 116,590 116,590 244,998 Other trading activities Investment income 33,180 84.458 12.006 4S,186 84.458 23,443 82,422 Total 234 228 246.234 350,863 EXPENDITURE ON Ralsing funds Other trading activities Investment managernenl costs 18,064 11,794 18,064 11,794 15,977 11,716 29,858 29,858 27,693 Charitable actlvltles Research Education 324,957 11,841 336,798 5.441 471,501 Total 360,256 11.841 372,097 499,194 Net gains on investments 50,770 NET INCOMEIIEXPENDITURE) {80,390} 165 180,225 (97,561) RECONCILIATION OF FUNDS Total funds brought forward 2,790,162 2,478 2,792,640 2.890.201 TOTAL FUNDS CARRIED FORWARD 2 709 772 2 712.415 2 792 640 The notes form part of these financial statements 33

PAIN RELIEF FOUNDATION Balance Sheet 5 April 2025 5.4.25 Totsl funds 5.4.24 Total fvnds Unrestricted funds Restricted fund Notes FIXED ASSETS Tangible assets Investments 14 15 47,046 2,647 838 507 47,553 2 647.838 53,713 2,789.293 2,694,884 $07 2,695,391 2.823,006 CURRENT ASSETS Stocks Debtors Cash at bank and in hand 16 17 653 2,276 653 2,276 57.586 662 1,693 39,598 38,379 22.136 60,515 41,953 CREDITORS Amounts falling due within one year 18 (23,491) 120,0001 (43,491) {72,319) NET CURRENT ASSETS 14,888 17,024 TOTAL ASSETS LESS CURRENT LIABILITIES 2,709,772 2,643 2,712,415 2.792,640 NET ASSETS 2,709 772 2,643 2 712.415 2.792,640 FUNDS Unreslricled funds.. General fund Designated unrestri¢t8d 19 35,142 2,674,630 11,824 2,778,338 2 709 772 2.790 162 Restricted funds: Reslricled fund TOTAL FUNDS 2,712,415 2,792,640 These financial statements have been audiied under the requiiements of Section 145 of the Charities Act 2011. The financial statements were approved by the Board ofTrustees and authorised for issue on .. and were signed on its behalf by: - Chairman- Trustee The notes form part of these financial statements 34 continued.

PAIN RELIEF FOUNDATION Cash Flow Statement for the Year Ended 5 April 2025 5.4.25 5.4.24 Notes Cash flows from operating activitles Cash generated from operations Finance costs paid Tax paid (230.831) (297) 472 (216,930) (281) 5,555 Net cash used in operating activities 231 600) 222 766) Cash flovts from investing activltles Purchase of tangible fixed assets Purchase of fixed asset investments Sale of fixed asset investments Interest received Divldends re￿iVed (1.963} {61,289) 228,382 10 84,448 (533) {570,003) 546,722 82.413 Net cash provided by invesling activilies 249.588 58.608 Change in cash and cash equivalents in the reporting period Cash and cash equlvalents at the beginning of the reporting period 17,988 (184,158) 203.756 Cash and cash equlvalents at the end of thp reporting period 39,598 The notes form part of these financial statements 35

PAIN RELIEF FOUNDATION Notes to the Cash Flow Statèment for the Year Ended S April 2025 RECONCILIATION OF NET EXPENDITURE TO NET CASH FLOW FROM OPERATING ACTIVITIES 5.4.25 5.4.24 Net expenditure for the reporting period (as per the Statement of Financial Activities Adjustments for: Depreciation charges Gain on investments Interest received Finance costs Dividends received Decrease in stocks (Increase)Idecrease in debtOTS (DeGrease)fin¢rease in creditors 180,225) (97,561) 8.123 (45,638) {10) 297 184,448) 9,087 (50.770) Ig) 281 {82,413) 1111) 28,828 138 Net cash used in operations 230 831) 216.930) ANALYSIS OF CHANGES IN NET FUNDS At 6.4.24 Cash llow At 5.4.25 Net cash Cash at bank and in hand 39.598 17,988 57.586 57,686 Total 17,988 57,586 The notes form part of these financial statements 36

PAIN RELIEF FOUNDATION Notes to the Financial Statements for the Year Ended 5 April 2025 DESIGNATED FUND The designated fund represents sums set aside. out of unrestricted funds, lo meet the ongoing costs of the Ghair of Professor of Pain. 2025 2024 Investment income: Interest received Dividends Realised gains on investments sold Unrealised gain on revaluing investmenls to market value Total designated incomè Less: Realised loss on sale of investments Unrealised profiV{loss) on revaluing investments to market value 4,036 80,412 71,207 907 81,506 202,159 1SS,65S 284,572 (25,569} (11,794) (151,389) (11,716) Expenditure out ol designated funds Transfer of net expenditure lo General FurKI Net designated {expenditureVincome (103.708} 55,467 ACCOUNTING POLICIES Basis of preparlng the flnancial statements The financial statements of the charity. which is a pthlic benefit entity under FRS102, have been prepared in accordance with the Charities SORP IFRS 102) 'Accounling and Reporting by Charities.. Statement of Recommended Practice applicable to charilies preparing their acwunts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 20191,, and the Charities Act 2011. The financAal statements have been prepared under the historical cosl convent+on with the exception of Investments which are induded al market value. Income All incom8 is reeognised in the Statement of Financial Activities On￿ the charity has entitlement to the funds and it is probable that the income will be received and the amount can be measured reliably. The charity's incom8 18 made up of gifts, donations. legacies, fvndraising, sponsorship and inveslmenl incorne. Expenditure Liabilities are recognised as expenditure as soon as there is a legal or constnJctiv8 obllgation commilling the charity to that expenditure, it is probable that a transfer of economic benefrts will be required in settlement and the amount of Ihe obligation can be measured reliably. Expenditure is accounted for on an accruals basis and has been classified under headings that aggregate all costs related to the category. Where costs cannot be directly attributed to particular headings they have been allocated to activities on a basis consistent with the use of reSoUr￿s. Grants offered subject to conditions, such as duration of the granl. which have not been met at Ihe year end date are noted as a commitment but not accrued as expenditure. Allocatlon and apporttonment of costs Certain expenditure is directly attributable to specific adivities and has been included in those cost categories. Certain other c0515, which are attributable to more than one activity, are apportioned across categories on the basis of an estimate of the proportion of time spent by staff on those aclivities. Tangible fixed assets Deprecialion is provided at the following annual rates in order to write off each asset over its estimated useful life. Long leasehold Plant and machinery Fixtures and filtings Over the period of the lease 250/0 on reducing balance and 15% on cost 25 /0 on cost Expenditure on individual assets which is less than £500 is not Gapitalised. 37 continued...

PAIN RELIEF FOUNDATION Notes to the Flnancial Statements - continued forthe Year Ended 5 Aprll 202S ACCOUNTING POLICIES - continued Stocks Stocks are valued at the lower of cosl and net realisable value, after making due allowan¢e for obsolete and slow moving items. Taxation The charity 15 exempt from corporation tax on sts charitable activities. Fund accounting Unrestricted funds can be used in accordance wilh the chartlable objectives at the discretion of the trustees. ReslriGled funds can only be used for particular restricted purposes within the objecÉs of the charity. Restrictions arise when specified by the d¢Jnor or when funds are raised lor particular restricled purposes. Designated fund The Designated fund represents the investment and related income which the trustees have designated to be used specifically for fvnding the chair of the ProfessoT of Pain. Restricted fund The Restricted fund represents the Income which was made avallable for the purposes of acquiring a Tr8nscranial Magnetic Scanner and sponsorships received. The felated expendrture represenl money spent in relation to iestricled income. Hlre purchase and leasing commllments Rentals pald under operating leases are charged to the Statement of Financial Activities on a straight Ilne basls over the period of the lease. Pension costs and other post.retirement benefits The charity operates a defined contribution pension scheme. Contributions payable to the charitys pension scheme are charged to the Slatement of Financial Activities in Ihe period lo which they relate. Financial instruments Financial instruments are classified and accounted for according to the substancè of the contractual arrangement, as either financial assets. financial liabilities or equity instruments. An equity instrument is any contr8Ct that evidences a residual interest in the assets of the charity after deducting all of its liabilities. Investments Inveslments are made by the trustees acting through and on advice of professional Investment managers. The investment stralegy focuses on low to medium risk investments. Investment galns and losses Gains and losses which arise on the sale of investments during the year are temed "Realised gains and losses" Those gains and losses that arise from the disclosure of inveslments at mat*el value as at 5th April each year are lermed "Unrealised gains and losses" Governance costs Governance costs relats to the general running of the chariiy, as opposed to fvndraising or charilable activities expenditure. They include audil and legal fees. accountancy and related support cosls. Costs of generating funds The costs of fundraising events indude the costs incurred by the Charity in arranging golf days, appeals and sponsorships and are included in the SOFA on an accruals basis. Charitable activities - Grants payable Expenditure on charitable activities includes grants payable lo individuals to conduct research into pain, ils causes and relief, and to disseminate research infomation together wilh related direct costs and support costs, all of which are accounted for on an 8￿rUal5 basis. 38 continued...

PAIN RELIEF FOUNDATION Notes to the Financial Statements - continued forthe Year Ended 5 April 2025 DONATIONS AND LEGACIES 5.4.25 5.4.24 Gifts Gift aided donations Tax recovered on gift aided donations Legacies Sundry income 65,259 4,951 1,245 44,938 197 69,343 3.064 766 171.425 400 116,590 244,998 OTHER TRADING ACTIVITIES 5.4.25 5.4.24 Fundraising events Sponsorships Meeting fees Leeds Cadaver 1,205 5,535 26,440 12.008 1,804 6,200 15,439 23,443 INVESTMENT INCOME 5.4.25 5.4.24 Listed investments Deposil account interest 84,448 10 82,413 OTHER TRADING ACTIVITIES 5.4.25 5.4.24 Purchases Staff Gosts 125 15,852 18,064 15,977 INVESTMENT MANAGEMENT COSTS 5.4.25 5.4.24 Portfolio management 11.794 11.716 39 continued..

PAIN RELIEF FOUNDATION Notes to the Financial Statements - continued for the Year Ended 5 April 2025 CHARITABLE ACTIVITIES COSTS Grant funding of activities (see note 9) Support costs (see note 10) Direct Costs Totals Research Education 89.263 555 184,381 63,154 4,886 336,798 89,818 184,381 342,239 GRANTS PAYABLE 5.4.25 5.4.24 Research 184 381 304,043 10. SUPPORT COSTS Irrformation technology Govemance costs Management Finance Totals Resear Education 28,880 4,115 192 4,443 771 29,639 63,154 4,886 192 68,040 11. NET INCOMEI{EXPENDITUREI Net incomellexpenditure) Is stated after chargingl(crediting)- 5.4.25 5.4.24 Auditors, remuneration Auditors, reTnuneralion for non audit Work Depreciation - owned assets Other operating leases 5,000 3,340 8,123 5,000 3,340 9,087 5,722 12, TRUSTEES. REMUNERATION AND BENEFITS No trustees. remuneration or olher beneffits were paid for the year ended 5 April 2025 nor for the year ended 5 April 2024. Trustees. expenses There were no trustees, expenses paid for the year ended 5 April 2025 nor for the year ended 5 April 2024. 40 continued...

PAIN RELIEF FOUNDATION Notes to the Financial Statements - continued for the Year Ended 5 April 2025 13. STAFF COSTS The average number of employees for the year was 4 (2024: 4). 14. TANGIBLE FIXED ASSETS Fixtures and fittings Long leasehold Plant and machinery Totals COST At 6 April 2024 Additions 114,302 204.403 325,020 643,725 1,963 At 5 April 2025 114 302 204,403 326.983 645 688 DEPRECIATION At 6 April 2024 Charge for year 78,053 3,266 188,671 3,933 323,288 924 590,012 8,123 At 5 April 2025 81,319 192,604 324212 598 135 NET BOOK VALUE At 5 April 2025 2,771 47.553 At 5 April 2024 36.249 15,732 1,732 53.713 15. FIXED ASSET INVESTMENTS Listed investments MARKET VALUE At 6 April 2024 Additions at cost Disposals at book cost Revaluations 2,T69,293 61,289 {157,1751 25 S69} At 5 April 2025 2,647,838 NET BOOK VALUE At 5 April 2025 2,647,838 At 5 April 2024 2,789,293 Overseas investment assets amounted lo £731 ,204 (2024: £1,508,161). C05t or valuation at 5 April 2025 is represented by: Listed investments Valuation in 2025 Cost (25,569) 2 673.407 2 647 838 41 continued...

PAIN RELIEF FOUNDATION Notes to the Financial Statements - contlnued for the Year Ended 5 April 2025 16. STOCKS 5.4.25 5.4.24 Finished goods 653 662 17. DEBTORS: AMOUNTS FALLING DUE WITHIN ONE YEAR 5.4.25 5.4.24 Tax Prepayments and accrued income 1,238 1,038 927 2,276 1,693 18. CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR 5.4.25 5.4.24 Accruals and deferred income 43.491 72.319 19. MOVEMENT IN FUNDS Net movement in funds Transfers between funds At 5.4.25 At6.4.24 Unrestricted funds General fund Designated unrestricted 11,824 2,778 338 {198,682) 118292 222,000 222,000) 35,142 2,674,630 2,790.162 (80,390) 2,709,772 Restrlcted funds Restricted fund 2,478 165 2.643 TOTAL FUNDS 2 792 640 80,225) 2,712415 Net movement in funds. included in the above are as follows.. Incoming resources Resources expended Gains and losses Movement in funds Unrestricted funds General fund Designaled unrestricted 149,780 84.448 (348,462) 11,794) (198,682) 118.292 234,228 (360,256) 45,638 (80,390) Restricted funds Restricted fund 12.006 111,841) 165 TOTAL FUNDS 246.234 372.097) 80 225) 42 continued...

PAIN RELIEF FOUNDATION Notes to the Financial Ststements - continued for the Year Ended 5 April 2025 19. MOVEMENT IN FUNDS- continued Comparatives for movement In funds Net movement in funds Transfers between funds Al 5.4.24 At 6.4.23 Unrestricted funds General fund Designated unrestricted 141,987 2.722.871 (196.163) 121.467 66,000 11,824 2,778.338 2.864.858 (74,696) 2.790.162 Restrleted funds Restricted fund 25.343 (22.865) 2.478 TOTAL FUNDS 2,890,201 97.561) 2,792,640 Comparative net movement in funds, induded in the above are as follows: Incoming re50urGes Resources expended Gains and losses Movement in funds Unrestricted funds General fund Designated unrestricted 288.450 82.413 (464,613) 11,716) (196,163) 121,467 50,770 350.863 {476.329) 50.770 (74,698) Restricted funds Restricted fund {22,865> (22,8651 TOTAL FUNDS 350.863 499,194) 50,770 97,561) A current year 12 months arKJ prior year 12 months Combined posilion is as follows.. Nel movemenl in funds Transfers between funds At 5.4.25 At 6.4.23 Unreslrlctsd funds General fijnd Designated unrestricted 141.987 2,722.871 (394,845) 239 759 288,000 288,000) 35,142 2.674.630 2,864,858 (155,086) 2,709,772 Restrlcted funds Restricted fund 25.343 (22,700) 2.643 TOTAL FUNDS 2.8￿.201 177,786) 2.712.415 43 continued...

PAIN RELIEF FOUNDATION Notes to the Financial Statements - continued for the Year Ended 5 April 2025 19. MOVEMENT IN FUNDS- continued A current year 12 months and prior year 12 monlhs combined net movemenl in funds. induded in the above are as follows: Incoming resources Resources expended Gains and losses Movement in funds Unrestricted funds Genera5 fund Designated unrestricted 418,230 166,861 (813,075) 23.510) {394,845) 239 759 96.408 585,091 (836,585> 96,408 {155,086) Restricted funds Reslricled fund 12,006 (34,7Cffj) (22,700) TOTAL FUNDS 597.097 871,291) 96,408 177,786} 20. RELATED PARTY DISCLOSURES There were no related paty iransactions for the year ended 5 April 2025. 21. FINANCIAL COMMITMENTS During the year grants payable to researchers were approved in the total am¢)unt of £791,415 of whith £564,407 remains payable in resped of future p8ri0ds. 44

PAIN RELIEF FOUNDATION Detailed Statement of Financial Activities forthe Year Ended 5 April 2025 5.4.25 5.4.24 INCOME AND ENDOWMENTS Donations and legacies Gifts Gift aided donations Tax recovered on gift aided donations Legacies Sundry income 65.259 4,951 1,245 44,938 197 69,343 3.064 171,425 400 116,590 244,998 other tradlng activltles Fundraising events Sponsorships Meeting fees Leeds Cadaver 1,205 5,535 26,440 12,006 1.804 6,200 15.439 45,186 23,443 Investment income Listed inveslmenls Deposit account interest 84.448 10 82,413 82,422 Total incoming resources 246,234 350,863 EXPENDITURE Other trading activitie9 Purchases Wages Social security Pensions 125 15,250 411 191 17,272 585 207 18,064 15,977 Investment management costs Portfolio management 11,794 11,716 Charitsble activities Wages Social security Pensions Venue & meeting Costs Sundry FMS study cosls Leeds Cadaver Depreciation of tangible fixe(i assets Grants to individuals 55.351 1,966 2.083 11,812 285 49,181 1,507 1,916 8,184 818 22.640 10.198 8,123 184 381 9,087 304,043 274,199 397,376 This page does not form part of the statutory financial statements 45

PAIN RELIEF FOUNDATION Detailed Statement of Financial Activities for the Year Ended S April 2025 5.4.25 5.4.24 Support costs Management Other operating leases Ratès and water Insurance Telephone Postage and stationery Advertising Sundries Travel Computer software CTedit card charges 5,722 18,228 3.517 1.304 2.108 5.066 1.883 132 1,751 281 18,427 3,S46 753 2,308 4,442 1,457 1.765 297 32.995 39,992 Finance Bank charges 192 266 Informatlon technology Repairs and renewals 5,214 5,833 Governance costs Wages Social securily Pensions Auditors. remuneration Audilors, remuner8tion for non audit work 19,850 612 837 6,000 3.340 18,500 425 769 5,000 3,340 29,639 28,034 Total re80urces expended 372,097 499,194 Net expenditure before gains and losses 112S,863) (148,331) Reall8ed re¢ognlsed galns and losses Net investment gainsl (losses) 71,207 202.159 Net (expenditure)lincome 53.828 46

Pain Relief Foundation