## **Orthocycle Foundation** Report of the trustees for the year ending 31[st] March, 2023 The Trustees of The Orthocycle Foundation Charity present their annual report and accounts for the year ended 31[st] March 2023 and confirm they comply with the requirements of the Charities Act 2011, the trust deed and the Charities SORP (FRS 102). ## **Our Aims** - To recycle medical appliances from the UK to less developed countries - To build capacity in less developed countries by service provision and - training ## **Our Objectives** - To provide a conduit for the recycling of medical appliances in less - developed countries with the necessary infrastructure in the UK and abroad • To raise funds for the running of the operational arm of the charity - To aid capacity building in less developed countries by service - provision, teaching, training and exchange programmes - To fund educational activity compatible with the aims of Orthocycle ## **Activity** • Surgical equipment for recycling has continued to be collected throughout the year. Shipments were sent by courier to Tanzania, which included orthotic boots, knee braces and other orthotics. The cost of transport was borne by the surpluses from Orthocycle courses. The volumes that have been sent have been much larger than previous shipments, and this has consequently resulted in greater expenditure. Due to problems with distribution in Tanzania, we have set up a storage facility in Zanzibar which allows us to keep the boots in a clean, dry location, so that they can be distributed to the local hospitals as required. - Cadaveric Surgical Courses In January 2023, Orthocycle organised a series of cadaveric surgical courses at Salford University and the Manchester Surgical Skills and Simulation Centre within the medical school in Manchester. There were five courses that ran. These were Major Trauma/Major Incident Pelvic Surgery Foot and Ankle Surgery Upper Limb Surgery Rib Fracture Course These courses were organised in conjunction with a Manchester Trauma Charity, who also conducted a course on high acuity low incidence procedures. They led on the Major Trauma simulation, but Orthocycle led on the Major Incident and cadaveric components. The courses generated very positive feedback. The Trauma charity took the registration fees for the Major Trauma Course and the balance after payment of the lab fees was income for Orthocycle. ## • Forefoot Course Orthocycle organised a forefoot surgery course with Orthosolutions at Manchester Metropolitan University in May 2022. This course had mainly local faculty but with some from outside the northwest region. The delegates were junior doctors and nurses. Most of these were from the northwest region but we had delegates from all over the UK attending. The course was not very well attended by paying medical delegates, but this was the first time the course had run since COVID, and the course did not make a loss. ## • Mnazi Mmoja Hospital, Zanzibar, Tanzania. Due to the concerns raised in the previous year about operating in Tumbi Hospital in Tanzania, we did not return to Tumbi Hospital to work. We made contact with the mainland Tanzanian and Zanzibarian permanent secretary for Health at the UK/East Africa Health Summit at BMA House in May 2022. The interest from the Zanzibarian delegation was very positive, and we therefore determined to focus our attention on the Mnazi Mmoja Hospital in Zanzibar. There were two visits to Mnazi Mmoja in this financial year. One of these, in October 2022, involved a team from Manchester Royal Infirmary including three nurses, one Health Care Auxillary (HCA) and one surgeon. The nurses paid for their own flights as did the surgeon. The team took medical consumables as well as hardware to support the project. The equipment included a donated small fragment set, which was stocked with a full set of small fragment plates. There was also a full set of circular frame equipment and a stacking system to house all the components. The hospital did not have a working image intensifier, which limited the range of operations that were performed, but it was possible to perform some frame surgery and platings. We also performed some soft tissue procedures to provide skin cover of open fractures. The mission to Mnazi Mmoja was a success in providing treatments but also because of the training – both medical for the surgeons and nursing for the theatre nurses, which was very warmly received. There were some issues with the import of equipment as the revenue department at the airport responsible for customs would not accept the written letter of authority for us to bring in medical goods free of duty. This required escalation to the President of Zanzibar in order to resolve the situation and it resulted in us being unable to perform some types of surgery for three days. We met with officials from the hospital and from the Department of Health, in order to facilitate future missions. This was again very positive. A further visit to Mnazi Mmoja took place in February/March 2023. This consisted of two surgeons and one HCA. The cost of flights at that time was very high and it was not possible to fund nurses to join the mission and nurses were not able to fund themselves due to the cost. The surgeons self funded – one from the UK and one from Saudi Arabia. The HCA was mainly involved in logistical support although also worked in the operating theatre as well. We were invited to give a lecture at the hospital teaching morning and a talk on orthopaedic infection was given. The amount of orthopaedic equipment was depleted from this mission, due to the operations performed, and further supplies will be required to support further missions. • Orthocycle purchased many items of surgical equipment for future use. Some of this was orthopaedic hardware, including a power tool system made by Stryker, with associated handpieces and cables. Also purchased were portable ultrasound machines that can be used with mobile phones or iPads for providing local anaesthetic blocks for pain relief – the intent is that these will be donated during missions abroad for future use after training in their use has been provided. • The Orthocycle external fixation course was not conducted in 2022/2023. However, there were plans for the course to be executed in 2023. • The Orthocycle website has been updated. There are active Twitter postings and Linked In postings. The twitter page has been active in promoting the courses conducted in the UK as well as missions performed in other countries. ## **Future Plans** The three aims of Orthocycle have all been achieved this year and the aim for the next year is to continue with these. This means that we would like to continue recycling to Tanzania especially, as well as providing treatments abroad and providing training within the UK and abroad. The recycling of orthotic boots and braces remains a success, and this is due to the generosity of the British public who have sought out our charity to recycle their boots, knee braces and other medical equipment. The surgical equipment has been sent to Tanzania and Turkey – in response to the earthquake, and the orthotics have been shipped to Tanzania, and more importantly, are being used by patients there. There is an East African Health summit held annually at BMA House in London, and we plan to attend this again. We have since had positive feedback from the Zanzibarian Health Department and aim to maintain our involvement in Tanzania. We would like to be involved in Zanzibar and on the mainland but as we have had more engagement from Zanzibar, this will be where we concentrate our efforts. Education for doctors and nurses is one of our main objectives, and there are several further courses on the horizon, including a forefoot course, an external fixation course and a series of cadaver courses along the lines of the courses run in this financial year. The outgoings for working in Turkey were unsustainable in previous years, and this activity was not financially possible in this financial year. It is not anticipated that Orthocycle can independently fund these missions, and we will need to work with partners in order to allow these to continue. ## **Our Finances.** The initial balance was £3546.42. The final balance was £4274.89. The account remained in credit for the whole financial year. The gross income is far higher than previous years, but this is matched by similar increases in expenditure, especially for the cadaveric courses. The overall balance has been in credit, but the charity does not have a safety net or reserve in case the level of donations dips. Expenditure would have to be funded through running more courses. The principal sources of income were from the cadaveric courses, as well as individual donations from the general public within the UK. The hospitals in Tanzania have no associated costs apart from travel and accommodation for Orthocycle surgical teams. From a financial perspective, this is cost effective for the delivery of Orthocycle’s objectives. We have invested in renting a storage facility which is $150 per month. This a ## **Reserves and Financial Health** The Trustees reviewed the finances, budgets and spend against budget. The Trustees consider that the charity financial status is satisfactory. There remains stable cash flow from the general public, from courses and from the Trustees. Costs mirrored income. However, a financial reserve would be desirable. ## **Structure, Governance and Management** The charity trustees are responsible for the overall management and control of the Orthocycle Foundation Charity. All trustees give of their time freely and no remuneration or expenses were paid in the year. No person connected with a Trustee received any benefit. |**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**| |---|---|---|---|---| |**CHARITY NUMBER : 1159167 ACCOUNTS YEAR END 31 MAR 2023**||||| |||||| |||**2023**||**2022**| |**Receipts:**|**£**|**£**|**£**|**£**| |Donation,Legacies and Grants|**71,564.97**||**7,917.63**|| |||||| |**Expenditure:**||||| |Direct costs(surgeons)|6,028.90||5,516.00|| |Equipment and carriage|17,289.33||950.64|| |Speakers and materials|409.63||145.20|| |Cadaveric coursesprovision|41,098.84||737.10|| |Travel and subsistence|2,984.80||437.88|| |||||| |**Total Expenditure:**||**67,811.50**||**7,786.82**| |||||| |**Surplus/Deficit**||**3,753.47**||**130.81**| |||||| ## **Independent Examiner's Report to the Trustees of the Orthocycle Foundation** I report to the Charity trustees on my examination of the accounts of the CIO for the year ending 31" March 2023. ## **Responsibilities and basis of report** The charity's trustees are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011(‘the Act’). I report in respect of my examination of the charity's accounts carried out under section 145 of the Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act. ## **Independent examiner's statement** I confirm that I am qualified to undertake the examination because I am a member of the ACCA, which is one of the listed bodies, in section 124 of the Charities Act 2011. I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect: 1. accounting records were not kept in respect of the charity as required by section 130 of the Act; or 2. the accounts do not accord with those records I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached. ## Iqbal Chowdhury FCCA Association of Chartered Certified Accountants 16 High Holborn London WC1V 6BX Date : 10/02/2025 |**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**|**The Orthocycle Foundation**| |---|---|---|---|---| |**CHARITY NUMBER : 1159167 ACCOUNTS YEAR END 31 MAR 2023**||||| |||||| |||**2023**||**2022**| |**Receipts:**|**£**|**£**|**£**|**£**| |Donation,Legacies and Grants|**71,564.97**||**7,917.63**|| |||||| |**Expenditure:**||||| |Direct costs(surgeons)|6,028.90||5,516.00|| |Equipment and carriage|17,289.33||950.64|| |Speakers and materials|409.63||145.20|| |Cadaveric coursesprovision|41,098.84||737.10|| |Travel and subsistence|2,984.80||437.88|| |||||| |**Total Expenditure:**||**67,811.50**||**7,786.82**| |||||| |**Surplus/Deficit**||**3,753.47**||**130.81**| |||||| ## **Independent Examiner's Report to the Trustees of the Orthocycle Foundation** I report to the Charity trustees on my examination of the accounts of the CIO for the year ending 31" March 2023. ## **Responsibilities and basis of report** The charity's trustees are responsible for the preparation of the accounts in accordance with the requirements of the Charities Act 2011(‘the Act’). I report in respect of my examination of the charity's accounts carried out under section 145 of the Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act. ## **Independent examiner's statement** I confirm that I am qualified to undertake the examination because I am a member of the ACCA, which is one of the listed bodies, in section 124 of the Charities Act 2011. I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect: 1. accounting records were not kept in respect of the charity as required by section 130 of the Act; or 2. the accounts do not accord with those records I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached. ## Iqbal Chowdhury FCCA Association of Chartered Certified Accountants 16 High Holborn London WC1V 6BX Date : 10/02/2025