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Annual report and accounts 2023/24

> Investing in a healthier society

Guy's and St Thomas' Foundation Annual Report and Accounts for the year ended 31 March 2024 Company number: 93419801

Guy’s and St Thomas’ Foundation

Guy’s and St Thomas’ Foundation exists to build the foundations of a society

Annual report and accounts 2023/24

that helps everyone stay healthier for longer.

Guy’s and St Thomas’ Foundation Our Mission

For over 500 years, we’ve been a constant in London’s ever-changing landscape, at the leading edge of health.

We are rooted in the heart of a vibrant, diverse city, where health inequity is stark.

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Annual report and accounts 2023/24

Our Mission

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Our work is supported by our endowment – one of the largest among foundations in the UK – which allows us to take a long-term view while addressing the urgent health issues of today.

Guy’s and St Thomas’ Foundation

Our Mission

Across the breadth of our work, we collaborate with our communities, partners and hospitals, and use our assets to transform lives.

We invest, engage, partner and influence to tackle big health challenges from all angles.

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Annual report and accounts 2023/24

Our Mission

We are driven by a desire to increase our impact by sharing and connecting with others working on better health – because a healthier society is our collective endeavour.

Guy’s and St Thomas’ Foundation

14 Overview

Message from our Chair

" Everything that we have achieved over the last 12 months is thanks to our people and our partners."

Message from our Chief Executive

" Having seen everything we have achieved this year, I am optimistic about the Foundation’s future." 18

Our people and culture

Our people are our greatest asset. The Foundation is powered by over 150 people who work to deliver our mission helping people stay healthier for longer.

Annual report and accounts 2023/24

20 Trustees’ report

fit Our routes to impact 26 Impact on Urban Health 28 ~ ~~ ¥,—S“| Our three NHS charities 36 Our endowment 46 Our property 54 developments 56 64 83 Financial review Governance Our organisation

90 Auditor's report and financial statements

122 Appendix

Guy’s and St Thomas’ Foundation

Message from our Chair

A healthier future for all

Annual report and accounts 2023124

Guy’s and St Thomas’ Foundation

Message from our Chair

At Guy’s and St Thomas’ Foundation, we are building the foundations of a society that helps everyone stay healthier for longer. I am pleased to say as Chair, and on behalf of the Trustees, that during 2023/24 we have made significant progress towards achieving our mission in our home of Lambeth and Southwark and beyond.

Our successes this year are more important than ever because our nation’s health continues to be under threat. The cost of living crisis is exacerbating many of the social factors that lead to poor health and deepening health inequality. Financial uncertainty puts more people under pressure and squeezed household budgets dictate what we eat, the places we call home and the work we do. All of these things can have a dramatic effect on our physical and mental health.

At the same time the NHS is dealing with unprecedented demand and, due to diminished budgets, the social and care services which support health and wellbeing are having to make difficult decisions as to where to focus resources. This challenging context gives even greater urgency to our work.

This year, through our three NHS charities we continued to support patient care and the wellbeing of the incredible staff across Guy’s and St Thomas’ NHS Foundation Trust’s hospitals and community sites. We have also continued to take action through our Impact on Urban Health programmes. Working alongside communities in Lambeth and Southwark, we find and fund solutions to some of the biggest health problems found in inner cities.

" I would like to take this opportunity to pass on my sincere thanks to Paul Brown and Tom Joy who retired as Trustees during 2023/24. We are delighted to have welcomed David Bennett and Andrew Lee to the Board, who both bring a wealth of expertise and enthusiasm to the Foundation."

Annual report and accounts 2023/24

Our endowment continued to deliver good financial returns and we increasingly look to invest where we see positive health impact. We use our assets and make investments to ensure that we can continue to fund our work. This approach has also allowed us to make progress towards our ambition for a major life sciences hub in South Central London through our flagship developments at Royal Street and Snowsfields.

Everything that we have achieved over the last 12 months is thanks to our people and our partners. Therefore, our search for the Foundation’s permanent CEO to lead our talented team, and to forge ever stronger alliances for our organisation and those we seek to serve, was a key priority during 2023/24.

I would like to take this opportunity to pass on my sincere thanks to Paul Brown and Tom Joy who retired as Trustees during 2023/24. We are delighted to have welcomed David Bennett and Andrew Lee to the Board, who both bring a wealth of expertise and enthusiasm to the Foundation.

In March 2024, following a robust and highly competitive recruitment process, the Board of Trustees appointed Laurie Lee as the Foundation’s permanent CEO. At every stage, Laurie’s experience, skills and deep commitment to the values of our organisation and our mission shone through. Since joining us as Interim CEO in April 2023, Laurie has steered the Foundation through a period of significant change. Over the last 12 months we have refreshed and rebuilt the Impact on Urban Health strategy, successfully completed the first year of the Foundation’s new charities’ strategy and set out our clear commitment to Diversity, Equity and Inclusion (DEI).

Laurie’s appointment signals an exciting new chapter for us as a Foundation. With Laurie at the helm, and drawing on the expertise, energy and enthusiasm of our people and partners, I am confident we can achieve our vision of a healthier society for all.

Susanne Given Chair

Guy’s and St Thomas’ Foundation

Message from our Chief Executive

I take very seriously the responsibility of leading Guy’s and St Thomas’ Foundation. It has existed in various forms for 500 years and has a mission to ensure everyone has the same chance of a long, healthy life. It is my privilege to lead, support and challenge a talented team who work tirelessly to realise our collective vision of a society that helps everyone stay healthier for longer.

I was delighted to be appointed as the permanent CEO in March 2024, having joined the Foundation as Interim CEO in April 2023. From my very first week, it was clear to me both the urgency of our mission and the impact the Foundation is having across every area of its work.

Health problems within our local communities have continued to rise and demands on the NHS have become more acute. But we are meeting this challenge.

In total, this year we committed £37.7m to the work of our three NHS charities and Impact on Urban Health. We awarded charitable grants totalling £28.1m, together with a further £9.6m of contract and other commitments.

Highlights from our Impact on Urban Health programmes included London Mayor Sadiq Khan citing our cost-benefit analysis in his pledge to provide free school meals for all London primary school pupils for a further four years. We also launched a £3m strategic partnership with Black Thrive Global. This is a practical demonstration of our commitment to reducing the racial inequity in health outcomes in South East London.

Our three NHS charities celebrated both funding and fundraising achievements this year. Guy’s and St Thomas’ Charity invested £1.4m in a pioneering population health management hub, and Guy’s Cancer Charity funded cutting-edge equipment to deliver targeted radiotherapy to people with multiple brain tumours. Evelina London Children’s Charity raised over £100,000 through Evelina’s Incredibles, its first Christmas fundraising campaign.

This year, we have also grown our capacity to manage investments in-house. This new approach means we are better able to achieve the dual goals we set for our endowment – delivering financial returns and health impact.

" Health problems within our local communities have continued to rise and demands on the NHS have become more acute. But we are meeting this challenge."

Annual report and accounts 2023/24

Supported by the Board of Trustees, our Executive Team and brilliant colleagues across the Foundation, I have focused on delivering five key priorities during 2023/24. Each will help us to transform lives now, while taking the long-term view needed to build the foundations of a healthier, more equitable society:

Creating an inclusive, effective leadership and culture. To succeed in our mission, we need to draw on a broad range of perspectives at all levels of our organisation. Having high performing and inclusive leaders will help us to get to where we want to be. Therefore, I am delighted to have welcomed Peter Babudu to the Foundation as Executive Director of Impact on Urban Health and Emma Davies as Chief Investment Officer.

Supporting better patient care and staff wellbeing at Guy’s and St Thomas’ NHS Foundation Trust. With our new charities’ strategy in place, and thanks to our ever-growing family of donors, we proudly continued our work with the Trust to deliver better healthcare for all.

Ensuring our effectiveness and sustainability. We have improved our processes and policies to support our organisation, which has grown significantly over the last five years. We have big, long-term ambitions. To achieve impact at scale, we have built new platforms to support our people and partners and allow us to work effectively.

Making the biggest impact we can on urban health. Through Impact on Urban Health, we continued to collaborate with partners and communities to tackle health inequity in Lambeth and Southwark. During 2023/24, we took time to reflect on what we have learnt so far and refocused our efforts on tackling social factors that drive poor and inequitable health in cities.

Embedding Diversity, Equity & Inclusion. We set out to create an even more inclusive culture: one that would make everyone feel they belong and enable them to thrive. We published a revised DEI strategy and, crucially, committed to allocating resources to make sure we can do what we said we are going to do.

Having seen everything we have achieved this year, I am optimistic about the Foundation’s future. I would like to thank our amazing team, Guy’s and St. Thomas’ NHS Foundation Trust and the many partners who contribute invaluable insights and expertise to strengthen our impact.

There are undoubtedly challenges ahead but I believe that together we can do what is needed to help everyone to stay healthier, for longer.

Laurie Lee Chief Executive

Guy’s and St Thomas’ Foundation

Trustees' report

A healthier future for all

The Trustees’ annual report is approved by the Trustees of the Foundation. The strategic report, which forms part of the annual report, is approved by the Trustees in their capacity as directors in company law.

Annual report and accounts 2023124 Pi f/ 11 21

Guy’s and St Thomas’ Foundation

Achievements and performance

Summary of achievements

Our direct charitable expenditure was £37.7m. This includes £17.8m, distributed through our three NHS charities, to support the incredible NHS staff and exceptional healthcare at Guy’s and St Thomas’ NHS Foundation Trust hospitals and community services.

We generated total income of £9.3m through fundraising for our three NHS charities this year.

We also began to build our in-house capacity to deliver more fundraised income to support the work of Guy’s, St Thomas’ and Evelina London Children’s hospitals, Guy’s Cancer Centre and community services. Through our NHS charities, we funded new healthcare equipment and services for the Trust beyond what the NHS can provide. This included funding a new model of care on the neonatal ward of the Evelina London to give parents the confidence to care for their seriously ill baby. We also invested £1.4m in a population health management hub which uses data to give better access to care.

We distributed £18.8m through Impact on Urban Health – the brand for our programmatic work tackling urban health issues – to work with our partners in Lambeth, Southwark and beyond.

We established a five-year £3m strategic partnership between Impact on Urban Health and Black Thrive Global, with the clear aim of reducing the racial inequity in health outcomes in South East London. Our long-term investment in campaigning and research around free school meals continues to position us at the centre of this policy issue. Our work influenced the Mayor of London’s pledge to fund a further four years of universal free school meals in London’s primary schools during his successful 2024 re-election campaign.

We have made significant progress towards our goal of aligning our endowment with our values and our mission.

We made significant progress in our journey to insource the management of our securities portfolio. Taking control of our portfolio by moving investment decision-making in-house will allow us to deliver against our dual mandate objectives across the whole portfolio. Our aim is to invest our capital to generate financial returns as well as outcomes that are beneficial to society. Through our property portfolio we continued to make progress towards our ambition to create a world-leading life sciences district in South Central London.

Annual report and accounts 2023/24

We have invested further in the people, systems and processes needed to achieve our mission.

This year, in line with our objective to build inclusive, inspirational and effective leadership, we welcomed Peter Babudu to the Foundation as Executive Director of Impact on Urban Health and Emma Davies as Chief Investment Officer.

We also focused on what we need to do to attract and retain the best talent. We have introduced new People policies, processes and systems. This will ensure we become an employer of choice and are set up to deliver against our mission.

We continued to work hard on our organisational culture and values, so everyone who works for us, and with us, can thrive. A key part of this was the launch of an updated DEI strategy and SMART action plan to help us to build an inclusive culture where everyone feels they belong.

£9.3m

raised through fundraising for our three NHS charities

£18.8m

distributed through Impact on Urban Health

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Guy’s and St Thomas’ Foundation

Our future plans

Our ambitious plan for the Foundation

Our vision is a society that helps everyone stay healthier, for longer. We know that people’s ability to stay healthy is not equal. A range of things affect it: from the genes we are born with, to where we grow up, live and work, to our access to quality healthcare.

This is why our mission to build the foundations of a healthier society requires a diversity of approaches and perspectives, summarised below and set out in more detail in the following pages:

As a funder , collaborating with a wide range of multi-sector partners to unlock the potential of cities to be healthier;
As the charities for Guy’s and St Thomas’s NHS Foundation Trust, helping to deliver better, fairer healthcare, beyond what the NHS can provide;
As an investor , setting our endowment a dual mandate of financial returns and positive impacts in health, society and environment.

Changing systems to make them healthier is difficult. We cannot achieve it alone; we must work with others. So we collaborate with people and organisations in urban areas, NHS patients and staff, businesses and national, regional and local governments. We believe that with the right partnerships, insights and values, we can achieve ambitious goals.

In 2024/25, we have three specific priorities to set us up to achieve our goals:

Focusing on impact. Increasingly our focus is on the total long-term impact we have in the world. We want to build a healthier society for everyone. The decisions we make will be guided by a desire to have more impact, for more people and for longer. We recognise that there is a risk we spread our efforts too broadly. So, this year, we have defined more specifically the impact we want to achieve. This will also help us to identify the partners who share our goals.
Ensuring our internal operations are set-up to support our long-term goals. We have grown and changed a great deal in the last five years. Over the last year, we have taken stock on whether all of the different elements are working as well together as they need to. Therefore, one of our priorities for 2024/25 is to ensure our internal operations are set up to support our long-term goals. You can read in this report about changes we have made to the way we manage our investments. We are also changing the way we fundraise for our NHS charities and how we partner with organisations on urban health equity.
Supporting our people. We recognise that, given the different ways we approach achieving health equity, we need a strong, inclusive and collaborative culture to ensure we deliver more than the sum of our parts. A priority for us in 2024/25 is to support a unifying and inclusive culture that values diversity and helps all of our people to thrive.

Annual report and accounts 2023/24

Our goal is to leverage more resources and insights from our practical, real-world work to influence change at an even wider level. We want to drive this change across Lambeth and Southwark, where we work most intensely, and beyond.

Guy’s and St Thomas’ Foundation

Impact on Urban Health

We take a portfolio approach to achieving impact

Annual report and accounts 2023124 ¥5

£18.8m

of funding across 160 projects, working with 122 organisations

Annual report and accounts 2023/24

Our routes to impact

The places that we grow up, live and work impact how healthy we are. And, in the UK, over four in five people live in urban areas. Sitting alongside the vibrancy and diversity of cities are stark health inequalities. Discrimination and poverty mean that communities living side-by-side often experience very different health outcomes. In South East London, that particularly means racism and low incomes.

At Impact on Urban Health, we believe we can remove obstacles to good health by making urban areas healthier places for everyone to live. We do this by focusing on a few complex health issues that disproportionately impact people living in cities. We fund, and collaborate with, cross-sector partners to build health equity for people in Lambeth and Southwark, our home boroughs. In 2023/24, we committed £18.8m of funding across 160 projects, working with 122 organisations.

We developed partnerships and projects to deepen our impact and understand more about health in urban places. We committed £3m over five years to build a new strategic partnership with Black Thrive Global. We are supporting their mission to improve the lives and health outcomes of Black people living in South London and other urban places in the UK. They do this by shaping the systems that impact Black people’s lives, including the health system.

We also launched Lambeth and Southwark’s largest ever survey on health and wellbeing for our data report, ‘Health & Wellbeing in Lambeth & Southwark: Insights from Local Communities’. It was important to us that the research focused on the issues that matter to residents and that information was gathered sensitively. So we commissioned Opinium Research to survey the views of over 5,000 residents, while community researchers at ClearView Research ran focus groups and conducted in-depth interviews. The results will be published in July 2024.

During 2023/24, we took a step back to review and evolve our strategy, building on our success, learning and ambition. This resulted in a refreshed strategy and streamlined processes that will enable us, and our partners, to make further, faster, more equitable progress towards our collective mission.

We interrogated the role of power in our work, and reviewed how we work to make sure that our decisions and actions do not reinforce structural imbalances in power that negatively impact people’s health. As a result, we are making our approach to grant-making more participatory and will be taking steps to give those closest to our work more of a say in who and what we fund.

Guy’s and St Thomas’ Foundation

Impact on Urban Health

We continued to fund and work with a variety of partners. Together we develop and test ambitious projects and services, commission research, build capacity in communities, and raise voices through collaborative programmes of work that move us towards health equity.

We continue to use our evidence and influencing prowess to campaign for policy change. In 2023/24, the Mayor of London cited our work when announcing his decision to fund universal free school meals in the city’s primary schools for a second year. He also put his pledge to fund a further four years at the centre of his successful campaign for a third term as Mayor of London. We have prioritised this policy issue since 2020, investing in campaigning and research, and commissioning original economic analysis to inform and influence decision-makers.

Health effects of air pollution programme

Our health effects of air pollution programme finds equitable solutions to poor air quality in cities. This year, we continued to work with businesses, communities, campaigners, local authorities and the Government to reduce the harmful effects of air pollution on those who are most susceptible.

In total, we invested £2.0m in the programme during 2023/24. Highlights of this work included:

Publishing two new reports on the links between wood burning and air pollution, which received national and international media coverage. Our market research on wood burning was used by 18 London boroughs in campaigns designed to reduce domestic burning and improve air quality and health.
Co-funding the Healthy Air Coalition, which campaigned for cleaner air in the run-up to the London Mayoral and general elections. Activities included a roundtable attended by MPs and national media coverage calling for more funding to improve air quality.
Supporting influential think tanks, The Institute for Public Policy Research and Bright Blue, to publish reports into air pollution, which secured national media coverage. The reports have helped to build cross-party consensus on pragmatic and equitable solutions for air pollution, including around transport and wood burning.

£2.0m

total invested in the health effects of air pollution programme during 2023/24

Annual report and accounts 2023/24

Children’s mental health programme

Every child should have access to the things they need to be healthy, feel safe and reach their potential. But right now, millions of children and families are trapped in poverty – made worse by structural racism - meaning these things are out of reach. Through our children’s mental health programme, this year we continued to fund community-led, trusted partners who deliver support to children and families experiencing this distress. We also joined several coalitions and campaign partnerships calling on Government to prioritise child poverty in the run-up to the general election.

In total, we invested £2.8m in the programme during 2023/24. Highlights of the work include:

Funding the Black Child SEND report, produced by our partner Global Black Maternal Health. The report investigates the experience of Black and mixed heritage families when a child has special educational needs or disabilities. We also supported the report’s launch event which saw over 100 healthcare professionals, educators, policymakers and parents come together to demand change. As a result, Global Black Maternal Health is talking to Southwark local authority about developing new peer-led services.
Funding and contributing to The Motherhood Group’s film about unsafe maternity and mental health care for Black mums. Despite the painful reality of anti-Black racism that so many Black women experience in the healthcare system, the film launch was a celebration of community strength, Black joy, and the power of peer-led support. It has led to the commitment of several MPs to set official targets to reduce the Black maternal health gap.
Bringing together The Parent Panel, a group of parents from Lambeth and Southwark, to test how we can learn from and make decisions with parents. This work will help us to get better at involving those people most affected by the health issues we work on.

Through our children’s mental health programme, this year we continued to fund community-led, trusted partners who deliver support to children and families.

Guy’s and St Thomas’ Foundation

Impact on Urban Health

Multiple long-term conditions programme

We believe that by improving the building blocks of health - housing, work and finances - we can make a difference for people already living with, or at risk of developing, multiple long-term health conditions. We place emphasis on supporting people from minoritised communities, living on lower incomes, who face greater challenges with their health due to structural discrimination and poverty.

In total, we invested £2.2m in the programme during 2023/24. Highlights of our work included:

Launching a partnership with the Money and Pensions Service (MaPS) to explore how access to better debt advice can improve the health of minoritised people struggling with financial insecurity. Together we hope to develop a better understanding of what people need from debt advice and the value of community-based services.
Supporting the launch of the Employee Health Innovation Fund (EHIF) insights report, in partnership with the Design Council. For four years, the EHIF programme worked with seven employers to find new ways to support the health of their staff. The report explains how a design-led approach can help a range of employers develop impactful and innovative ways to improve health at work.
Leading a panel and workshop session on Housing and Health Equity at the Healthy City Design Conference, with partners Safer Renting, Kineara and the Council on Urban Initiatives. The session, run by our programme director Barbara Reichwein, explored a range of approaches tested by our partners to address the issue of inadequate, precarious housing and its effect on health.
Funding the next phase of our project Clapham Park Futures with Metropolitan Thames Valley Housing. Clapham Park social housing estate is home to 4,500 residents and is one of the largest regeneration sites in London. Clapham Park Futures works closely with residents with lived experience of unemployment, in-work poverty and ill-health to build a foundation for their vision on how to improve health and employment opportunities.

£2.2m

total invested in the multiple long-term conditions programme during 2023/24

Annual report and accounts 2023/24

Children’s health and food programme

We believe all children and young people have the right to access enough nutritious food as they grow up, no matter where they live. Working in partnership with others, our children’s health and food programme focuses on improving the accessibility of affordable, nutritious, culturally appropriate food for children and families living on low incomes in Lambeth and Southwark. We also target families experiencing the impact of structural racism in our boroughs. We share what we learn widely so the impact of our work can be sustained here and scaled across other urban areas.

In total, the programme spent £3.5m this year. Highlights from 2023/24 include:

Giving evidence at the House of Lords Select Committee on Food, Diet and Obesity. The committee invited us to share insights from our work on children’s health and food. We told a compelling story about the changes needed, locally and nationally, to improve food in the places where children live, learn, eat and meet, especially those living on low incomes.
Funding the Black Food Fund. The fund is led by people deeply connected to the local food system in Lambeth and Southwark. Facilitated by Hello Brave, the panel administers £450,000 of grant funding to support Black change-makers (e.g. food entrepreneurs, community businesses and innovators) via the Black Food Fund to improve health and food equity locally.
Hosting a delegation from the Danish Healthy Weight Alliance for a learning exchange on children’s health and food. The alliance includes the Novo Nordisk Foundation and 40 Danish health, public and private sector organisations. We know the way we talk about children’s health and food matters. Having heard about our work to reframe this narrative, the alliance is making this a key priority.
Launching a free image library for anyone talking about children’s health and food in their work, including campaigners, journalists and local authorities. This resource will help to challenge stigma and build a better understanding of children’s health and food, by showing how what surrounds us shapes us.
Working with Rice Marketing and the Greater London Authority (GLA) on the next phase of our Good Food Retail work. This project is looking at how to introduce more healthy options to convenience stores in areas of low income across London and England. In March 2024, the Deputy Chief Medical Officer visited Good Food Retail sites in Southwark. They wanted to find out more about what we’re doing and how it could work in other places.

£450k

£3.5m

of grant funding to support Black change-makers

spent on the children's health and food programme

Guy’s and St Thomas’ Foundation

Impact on Urban Health

Innovation

Our Innovation team creates the best environment for our programmes to thrive through innovative thinking and testing new ideas. The team builds partnerships with community organisations working in our boroughs and looks ahead to what urban places will look like in the future.

In 2024, we renamed our Research and Development function to Innovation to reflect its new strategy. In total, we invested £3.0m in research and development during 2023/24. Highlights of the work included:

Working with social enterprise Promising Trouble to explore how to give more households affordable, internet access. This community-centred project also looked at how digital connectivity can protect people’s physical and mental health.
Supporting the Bureau of Investigative Journalism’s Hot Homes project. This work will help us to understand how rising temperatures affect the health of people living with long-term conditions.
Funding the Council on Urban Initiatives. The project brings together academics and city leaders to develop and advocate for new ways to address complex health issues in urban places.

The team builds partnerships with community organisations working in our boroughs and looks ahead to what urban places will look like in the future.

Annual rep accounts 202312 11 ',111 1114

Guy’s and St Thomas’ Foundation

Our three NHS charities

Collectively making change

Through our three NHS charities – Guy’s & St Thomas’ Charity, Evelina London Children’s Charity and Guy’s Cancer Charity – we support Guy’s and St Thomas’ NHS Foundation Trust.

Our NHS is under unprecedented short-term pressure; demand for services is rising and there’s a backlog of people waiting for treatment. It also faces longer-term challenges, as our population ages, more people live with long-term conditions and health inequalities deepen. Our mission is to support Guy's and St Thomas' NHS Foundation Trust to deliver better, fairer, faster healthcare for all – beyond what the NHS can provide.

In 2023/34, our primary objective across our NHS Charities was to begin implementing our four-year strategy, following its agreement by our Board at the end of 2022/23. Our vision for that strategy is that every patient of Guy's and St Thomas' NHS Foundation Trust receives exceptional NHS healthcare, wherever and whenever they need it. To achieve this, we focused on project development, funding and fundraising in the following areas:

For Guy's and St Thomas' Charity:

Clinical excellence
Innovation and improvement
Staff health and wellbeing
Patient experience.

For Guy's Cancer Charity:

Early diagnosis
Precision oncology
Head and neck cancer
Personalised care.

For Evelina London Children's Charity:

Children’s Hospital programme
Innovative models of care
Supporting our local population
Developing, implementing and testing health approaches.

We also began work to deliver against priorities shared by all three charities. These are:

Investing in research and development
Creating a workforce of the future
Improving patient experience
Embedding Diversity, Equity and Inclusion
Supporting capital projects.

During 2023/24, we funded projects with a value of £17.8m. And, thanks to our incredible supporters, this year our family of charities fundraised a total of £9.3m, against our forecast of £8.0m.

Annual report and accounts 2023/24

£9.3m

fundraised by our charities

£17.8m

of projects funded in 2023/24

£3.1m ~~—_____—~~ fundraised during 2023/24 thanks to our supporters

We funded a vital piece of equipment for the community-based hepatology service for people with chronic liver disease.

£5.3m

of projects funded during 2023/24

Annual report and accounts 2023/24

Our three NHS charities

Guy's & St Thomas' Charity

Through the generosity and commitment of our supporters, Guy’s & St Thomas’ Charity fundraised a total of £3.1m during 2023/24.

Guy’s & St Thomas’ Charity supports the incredible staff and exceptional healthcare provided by Guy’s and St Thomas’ NHS Foundation Trust. During 2023/24, we funded a wide range of projects, with a value of £5.3m, to help the Trust stay one step ahead for patients and communities. Highlights include:

Investing £1.4m in a pioneering population health management hub, which will use data to improve access to care and ensure better patient experience and outcomes.
Funding a vital piece of equipment for the community-based hepatology service for people with chronic liver disease. This enables the expert team to fast-track treatment, ensuring vulnerable people get the care they need as early as possible.
A prestigious HSJ digital award being given to a project we funded at the Centre for Innovation, Transformation and Improvement. The data-led project identifies patients with higher clinical risk so they can get vital treatment sooner.
Showing our appreciation for all that the Trust does by funding the 2024 Trust Staff Awards. Held in March 2024, the Awards were the first since the pandemic and gave the dedicated Guy’s and St Thomas’ staff the opportunity to celebrate the remarkable contribution they all make.

" With the charity’s funding, we are able to make a real difference to the lives of people in the local community.”

Widening Participation Project Manager Hayley Robinson-Allen, who is leading an ambitious project to improve the prospects of young people in the local community and address under-representation in the Trust’s workforce.

Guy’s and St Thomas’ Foundation

Our three NHS charities

Guy's Cancer Charity

Thanks to our supporters, during 2023/24 Guy’s Cancer Charity fundraised a total of £4.0m.

Guy’s Cancer Charity supports Guy’s Cancer Centre to transform cancer care through the very latest developments in personalised care and precision oncology.

During 2023/24, Guy’s Cancer Charity funded a range of projects, with a value of £5.7m, to improve cancer patients’ experience and outcomes at the Trust.

Highlights from our work this year include:

Supplying machines and scalp cooling caps to help to prevent chemotherapy induced alopecia.
Providing cancer patients with advice and practical help to access financial support.
Investing in innovative equipment to deliver targeted radiotherapy to people with multiple cancerous and non-cancerous brain tumours.
Launching a patient support podcast, hosted by TV presenter Julia Bradbury who has personal experience of cancer. In the first eight weeks after it launched in January 2024, it was downloaded hundreds of times, had a listen-through rate of 98%, and received five-star reviews.

Supplying machines and scalp cooling caps to help to prevent chemotherapy induced alopecia.

£4.0m ~~as~~ fundraised during 2023/24 thanks to our supporters

Income from our Individual Giving programme has increased by 50% this financial year, and new donor acquisition has grown by 120%.

£5.7m

of projects funded during 2023/24

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Guy’s and St Thomas’ Foundation
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£2.2m fundraised during 2023/24 ~~—EEEE~~ thanks to our supporters

Our partner, Fidelity International, donated 2,000 desktop monitors to Evelina London’s IT department, saving an incredible £279,980.

£6.8m

of projects funded during 2023/24

Annual report and accounts 2023/24

Our three NHS charities

Evelina London Children's Charity

Thanks to our ever-growing family of supporters, during 2023/24 Evelina London Children’s Charity fundraised a total of £2.2m.

Evelina London Children’s Charity helps Evelina London Children's Hospital to provide compassionate, trailblazing care for children and young people and their families. During 2023/24, we funded a wide range of projects with a value of £6.8m. Highlights from our work this year include:

Enabling the delivery of innovative gene therapy to improve the vision of children with a rare form of blindness.
Funding a new model of care on the neonatal unit. The Family Integrated Care project is designed to give parents the confidence to care for their seriously ill baby. The project was among the nominees recognised at the prestigious Healthcare Honours event in November 2023.
Supporting our local community through dance therapy sessions for children with physical disabilities.
Launching a Christmas fundraising campaign, called Evelina’s Incredibles. The campaign brought our charity into people’s homes via Sky AdSmart for the first time, raising over £100,000.

“ I am proud of the care and support we provide to babies and their families. But with the charity's funding, we can do even more to give them the best possible start to their lives together.”

Jenny Michel, Neonatal Sister on Evelina London's Neonatal Intensive Care Unit

Guy’s and St Thomas’ Foundation

Arts and heritage collection

We are custodians of one of the largest collections of healthrelated arts and heritage in Europe, made up of around 4,500 works dating from the 1500s.

Art collection

We continue to use our art collection to enhance the environment and improve health outcomes for patients and staff at Guy’s and St Thomas’ NHS Foundation Trust. More than 2,000 works of art are on display at the main hospital sites and across the Trust’s community sites in South London.

This year, we have collaborated with patients and staff at the Trust on new commissions and displays of works of art in the Mary Seacole MRI Unit, the Pain Management Unit and the Young Adult Cancer wards.

We have also enriched the core collection by acquiring work by artists from communities who have historically been underrepresented within it. In 2023/24, we have added work by artists including Sunil Gupta, Lubaina Himid, Yinka Ilori, Phillip Prokopiou and Zeinab Saleh.

Heritage

This year we reached an important milestone in our work to respond to our history. In November 2023, we installed permanent historical interpretation panels alongside statues of Sir Robert Clayton and Thomas Guy at St Thomas’ and Guy’s hospitals respectively.

The statues of Guy (1644-1724) and Clayton (1629-1707) are part of our art collection. In 2020, we commissioned independent historical research which confirmed both men profited significantly from the inhumane trade of enslaved African people.

Guy, a governor of St Thomas’ Hospital, contributed to the origins of the Foundation’s endowment. His initial investment of £200,000 helped build Guy’s Hospital and set up the Foundation. Clayton was a president of St Thomas’ Hospital and donated money to the rebuilding of the hospital. He also made a significant financial contribution to our endowment.

We know many health inequalities that exist today are linked to structural racism stemming from the inhumane trade of enslaved people. We see it in our work to tackle health inequalities facing people in South London and beyond. Until now, information about Guy and Clayton only focused on their philanthropy. It did not reveal their connections to the trade of enslaved people and the origins of their wealth in racial slavery. Through this work, we have set out to acknowledge and change this.

The interpretation panels, complemented by digital interpretation materials on our website, explain the links each man had to the trade of enslaved people and to the hospitals. The interpretation text was drafted by Dr Michael Bennett and Dr Esther Brot and edited by Dr Ayshah Johnston and Professor Matthew Smith.

The interpretation was developed with oversight from an interpretation working group which included representatives from the Trust, King’s College London and Black Cultural Archives.

During 2023/24, we also worked closely with our colleagues at King’s College London on the interpretation of the monument to Thomas Guy in Guy’s Chapel.

Annual report and accounts 2023124 -rhC I"L'il Red Ri('LIIL t4vuJ and de.atli of the

Guy’s and St Thomas’ Foundation

Our routes to impact

Our endowment

Our endowment is one of our most powerful tools, operating under a dual mandate of achieving financial returns and mission aligned impact.

Annual report and accounts 2023/24

Guy’s and St Thomas’ Foundation

Our endowment

Mission-aligned investing

During 2023/24, we made significant progress in our journey to insource the management of our securities portfolio.

Taking control of our portfolio by moving investment decision-making in house will allow us to deliver against our dual mandate objectives across the whole portfolio. Our aim is to invest our capital to generate financial returns as well as outcomes that are beneficial to society. Through our property portfolio we continued to make progress towards our ambition to create a world-leading life sciences district in South Central London.

Investor engagement

We use our investor voice to share insights and to encourage businesses and fund managers to create the conditions for more equitable health, a better environment and long-term value for our portfolio.

Collaborative engagement

Through networks like Healthy Markets and the Good Work Coalition, we have influenced companies to make changes that will have a positive impact on health.

Alongside others, we have proactively engaged with Nestle regarding setting a healthy sales target and Sainsbury's to pay the real living wage. We have seen postive change as a result of our collective efforts. We have also helped to establish the Investor Coalition on Food Policy which engages with Government on policies which support a healthier, fairer and more sustainable food system. During 2023/24, we became members of Climate Action 100+ and Nature Action 100 and have begun engagements with three companies in the utility, automotive and paper industries.

Internal ownership of investment decision-making allows us to align our whole portfolio with our dual mandate objectives.

Annual report and accounts 2023/24

Climate

During 2023/24, we stepped up the monitoring of our fund managers on their climate practices. For example, we worked on a project with our advisor to survey all our managers on their carbon reduction plans, their engagement on climate change with companies they invest in and their voting records on climate resolutions. The environment is a priority outcome area under our dual mandate.

Diversity of fund managers

We have also undertaken work to better inform our understanding of the DEI policies and practices of the managers we are invested in. We track the gender and ethnic makeup of fund owners, partners and decision-makers. DEI forms a key pillar of our initial due diligence and ongoing engagement with managers.

£5.0m ~~ES~~ investment into KHP Ventures

Guy’s and St Thomas’ Foundation

Our endowment

Using our assets to transform lives

Annual report and accounts 2023/24

Our endowment is one of our most powerful tools when it comes to driving our mission and creating positive change through our dual objectives of achieving financial returns and mission-aligned impact. We use our assets to transform lives and demonstrate that investing in health is good business. This strategy allows us to take a long-term view while addressing the real and urgent health issues of today.

We have made progress with our property developments, Royal Street and Snowsfields Quarter.

During 2023/24, we made significant progress in our journey to insource the management of our securities portfolio.

Guy’s and St Thomas’ Foundation

Our endowment

The performance of our endowment was -2.0% return on gross investment assets over the financial year 2023/2024. The portfolio, excluding property, grew by 10.8% mostly driven by the liquid securities portfolio.

The illiquid portfolio delivered a small positive return. Our property portfolio was affected by the ongoing challenges that marked the UK economic landscape in 2023. Early 2024 has seen moderate positive indicators for improvement across the UK economy.

Endowment return over 1,3 and 5 years

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----- Start of picture text -----
Annualised returns over: 1 year 3 years 5 years
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Endowment return	-2.9% 3.9% 6.6%
UK Consumer price Index (CPI)	3.2% 6.7% 4.4%
Strategic Asset Allocation Benchmark (GBP)	3.5% 4.0% 5.2%

Endowment performance vs CPI

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£1,000
£900
£800
£700
£600
£500
£400
£300
£200
£100
£0
1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 2019 2021 2023
Endowment NAV (net of spending) Endowment NAV adjusted for UK RPI (CPI from 1 April 2023)
Net asset value (£ m)
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The decrease in endowment net assets before transfers for the year was £15.4m (2022/23: increase £18.9m). A total of £42.8m (2022/23: £35.8m) was released under the distribution rule and other transfers to support charitable expenditure.

Annual report and accounts 2023/24

Performance summary 1 April 2023 to 31 March 2024

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----- Start of picture text -----
Asset Class Strategic Asset Strategic Asset Allocation as at Asset Class Benchmark Allocation as at
Allocation Band (%) Allocation (%) 31 March 2024 (%) Performance (LC) Performance (LC) 31 March 2023 (%)
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Asset Class	Strategic Asset Allocation Band (%)	Strategic Asset Allocation (%)	Allocation as at 31 March 2024 (%)	Asset Class Performance (LC)	Benchmark Performance (LC)	Allocation as at 31 March 2023 (%)

Cash	0-10	1	3.8		5.3%	2.3
Fixed Income	0-10	3	2.3	3.3%	-0.0%	2.1
Liquid Credit and Private Debt	0-12	5	3.0	4.6%	7.0%	3.5
Absolute Return	0-12	6	6.8	9.0%	9.4%	6.2
Hedged Equities	5-20	10	4.4	12.0%	12.1%	4.3
Global Equities	17-35	21	26.6	21.7%	24.4%	23.8
Private Equity	8-30	14	20.8	1.5%	7.0%	18.3
Core Property	30-501	401	0.8	-11.0%	-7.7%	0.7
Composite Financial Asset Class Performance (local currency)				10.8%	13.7%
Property	30-50	40	30.9	-20.2%	-7.7%	38.3
Composite Asset Class Performance (local currency)				-1.1%	4.7%
Currency Gain or Loss				-0.8%	-1.2%
Composite Asset Class Performance (GBP)				-1.8%	3.5%
Partners Capital Fees and Other Charges				-0.1%
Return on Gross Investment Assets (GBP)				-2.0%	3.5%
Impact of Leverage				-0.9%
Return on Endowment Equity (GBP)				-2.9%

Notes:

The portfolio's financial investments into the Core Property asset class are counted towards the Property strategic asset allocation.
The above table does not show a 0.5% Multi-Asset Class position (The Master Portfolio C), held within the Permanent Endowment. The performance of this investment is included at the portfolio level.

Guy’s and St Thomas’ Foundation

Our property portfolio

Across our property portfolio, we aim to be a responsible owner, landlord and partner in developments. Our aim is to use our property assets and land to generate financial returns in a way that aligns with our mission to build the foundations of a society that helps people stay healthier for longer.

Property income remained largely consistent year on year, with occupancy averaging close to 100%, despite the economic and political instability that made 2023 a challenging year for the UK property market. The capital value of our property portfolio as of March 2024 was affected by these broader conditions.

However, the Foundation, which manages its endowment with a long-term investment horizon, expects the market and the value of its assets to recover as inflation decreases and the UK interest rate cycle stabilises. Sector analysis since the balance sheet date shows an uptick in relevant property market data, reinforcing our confidence in the long-term value of our holdings, particularly in Lambeth and Southwark. While the majority of our property assets are in London, we also own agricultural holdings across the UK.

Throughout 2023/24, we continued to embed wellbeing into our property development plans, aligning with our dual mandate to generate financial returns and positively impact both health and society.

350,000

square feet (sq.ft.) of new life science space proposed for Snowsfields Quarter development

Annual report and accounts 2023/24

Royal Street

We are working in partnership with Stanhope to progress a sustainable life science-based development at Royal Street in Waterloo.

The development will promote health and wellbeing in the built environment and provide key benefits for the local community. The site was granted full planning consent in December 2023.

Snowsfields Quarter

During 2023/24, we worked closely with our development partners Oxford Properties and Reef Group to design a new life science quarter for Snowsfields, near Guy’s Hospital in London.

The proposed development will deliver circa 350,000 square feet (sq.ft.) of new life science space with world-class lab facilities across three new buildings in a prime health innovation cluster. We aim to submit a planning application in 2024.

Our aim is to use our property assets and land to generate financial returns in a way that aligns with our mission to build the foundations of a society that helps people stay healthier for longer.

Guy’s and St Thomas’ Foundation

Financial Review

Delivering a solid financial performance

Annual report and accounts 2023/24

Fundraising and investment income in 2023/24 were both higher than in the previous year. The total reported costs also increased, reflecting investment in fundraising and the additional staff and infrastructure required to deliver our ambitious programme of activity.

While overall expenditure was slightly higher than in 2022/23, there was a reduction of £3.2m in direct charitable spending. This was in part due to the timing of an award to the Trust which was made just after the end of the financial year.

Unfavourable macro headwinds in the UK resulted in a decrease in both the gross value and the net asset value of the endowment.

Guy’s and St Thomas’ Foundation

Financial Review

Charitable expenditure

Overall direct charitable expenditure for 2023/24 was £37.7m, which is £3.2m lower than the previous year. This decrease is due to the timing of a £6m grant to the Trust. This had been planned for 2023/24 but was committed shortly after the year end and so is excluded from the annual expenditure figure.

Expenditure on Impact on Urban Health programmes has decreased to £18.8m from a peak of £24.2m in 2022/23. Of this total, £3.5m relates to our children’s health and food programme, £2.2m to our multiple long-term conditions programme, £2.0m to our health effects of air pollution programme and £2.8m to our children’s mental health programme.

Our expenditure as the charity for Guy’s and St Thomas’ NHS Foundation Trust has increased slightly to £17.8m (2022/23: £16.2m), of which £5.3m relates to Guy’s and St Thomas’ Charity, £5.7m to Guy’s Cancer Charity and £6.8m to Evelina London Children’s Charity.

The single largest recipient of funds continues to be the Trust at £16.1m or 43% of total charitable expenditure (2022/23: £16.1m or 39%). Other large grants awarded include £3.0m to Black Thrive Global, £1.1m to Partisan Community CIC, £1.0m to the Walcot Foundation and £0.9m to School Food Matters.

Fundraising

This year, fundraising income has increased to £9.3m from £8.9m in 2022/23, reflecting our ongoing investment in this area.

Direct fundraising costs have increased to £6.2m from £4.0m in 2022/23. This includes digital and marketing-related expenditure, including brand development for our three NHS charities. We expect increases in donations to lag our investment in fundraising. Allocated support and overhead costs have reduced slightly year-on-year, resulting in reported fundraising costs being £8.5m compared to £6.4m in 2022/23.

Annual report and accounts 2023/24

Endowment

The endowment’s net assets decreased by £15.4m before the transfer of £42.8m (2022/23: £35.8m) which was released to support charitable expenditure.

This compares to an increase of £18.9m in 2022/23. The net value of our endowment after the spending transfer decreased by £58.2m to £855.4m. Over the five years since March 2019, the net value has grown from £759.4m to £855.4m, while also releasing a total of £166.2m to support charitable expenditure. Direct investment management costs decreased by £1.7m to £7.0m for the year, principally because of lower performance related fees paid to Partners Capital. However, interest costs were £3.5m higher than the previous year, due to higher market rates, more than offsetting the reduction in direct costs. The addition of allocated support and interest costs brings the total reported investment costs to £16.7m for 2023/24, £2.7m higher than the previous year.

Costs

Total staff costs increased by £2.4m during 2023/24 to £13.1m (2022/23: £10.7m). This increase reflects the recruitment of additional staff required to deliver the Foundation’s ambitious programme of activity.

Other overhead costs decreased to £6.5m (2022/23: £6.9m) as a result of an increased focus on cost control. This follows several years of planned investment in the systems and infrastructure required to support the Foundation’s increased levels of activity.

£2.4m

increase in staff costs, reflecting the recruitment of additional staff to deliver our ambitions programme

Guy’s and St Thomas’ Foundation

Financial Review

Financial Position

The Foundation remains in a strong financial position.

As at 31 March 2024, the Foundation had free reserves of £12.7m (£15.2m at 31 March 2023) which are managed through a distribution account.

Financial key performance indicators (KPIs)

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----- Start of picture text -----
Measure Key performance Key indications
Charitable commitments £18.8m against a forecast A successful seventh year of programmatic activity
for Impact on Urban Health of £18.5m resulted in forecast commitments being exceeded.
programmes
Funds raised £9.3m against a forecast Another successful year of fundraising which saw
of £8.0m voluntary income exceed its forecast expectations.
Funds deployed as the charity £17.8m against a forecast Total spending on projects to benefit patients and
for Guy’s and St Thomas’ of £17.3m staff of Guy's and St Thomas' NHS Foundation Trust
NHS Foundation Trust was ahead of both forecast and of the previous year's
total of £16.2m.
Return on endowment gross -2.0% return for 2023/24 The endowment underperformed in most asset class
investment assets compared compared to benchmark benchmarks during the year. Property was particularly
to benchmark return of 3.5% impacted by both market conditions and the broader
economic environment, resulting in an overall negative
performace for 2023/24.
----- End of picture text -----

Another successful year of fundraising which saw voluntary income exceed both its target and forecast expectations.

Annual report and accounts 2023/24

Reserves policy

Total funds as at 31 March 2024 were £915.8m (2022/23: £970.9m), comprising unrestricted funds of £44.9m (2022/23: £44.0m), restricted funds of £15.5m (2022/23: £13.3m) and endowment funds of £855.4m (2022/23: £913.6m).

Total unrestricted funds increased from £44.0m to £44.9m. As at 31 March 2024, £32.2m of these funds were designated in the form of properties and other assets that are used in the provision of our charitable activities.

The remaining £12.7m (2022/23: £15.2m) of free reserves are managed through a distribution account. The Foundation does not have a specific target level of reserves because it plans the distribution of its unrestricted funds through a five-year budget, performance against which is reviewed annually. The budget is based on the distribution of all available resources projected to arise in the five-year period covered by the budget. The Foundation maintains the ability to transfer funds from the expendable endowment if necessary to meet its disbursement targets.

The Foundation has adopted a total return approach to investment for its permanent endowment funds, as disclosed in note 17 to the accounts.

£18.8m

Charitable commitments for Impact on Urban Health programmes

£17.8m

Funds deployed as the charity for Guy's and St Thomas' NHS Foundation Trust

The Foundation has adopted a total return approach to investment for its permanent endowment funds.

Guy’s and St Thomas’ Foundation

Annual report and accounts 2023/24

Our charitable expenditure in 2023/24 Total: £37,653,000

Impact on Urban Health programmes: £18,806,000

Evelina London Children's Charity: £6,804,000 By priority Guy's Cancer Charity: £5,730,000 Guy's and St Thomas' Charity and other: £5,261,000 Health Innovation Fund and other: £1,052,000 Guy’s and St Thomas’ NHS Foundation Trust: £16,059,000 Other NHS (Trusts, CCGs, GP practices etc): £193,000 Voluntary, community and social enterprises: £19,141,000 By recipient

Commercial: £1,362,000

Local authorities and other service providers: £357,000

Universities: £541,000

Guy’s and St Thomas’ Foundation

Annual report and accounts 2023/24

Five year review 2019/24 Total: £170,314,000

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----- Start of picture text -----
Impact on Urban Health
programmes: £97,846,000
Guy’s and St Thomas’ NHS
Foundation Trust: £67,870,000
By priority
Investing for Health: £1,766,000
Health Innovation Fund:
£2,832,000
Guy’s and St Thomas’ NHS
Foundation Trust: £64,028,000
Other NHS (Trusts, CCGs,
GP practices etc): £2,022,000
Voluntary, community and
social enterprises: £91,161,000£91,161,000
By recipient Commercial: £6,619,000
----- End of picture text -----

Guy’s and St Thomas’ NHS Foundation Trust: £64,028,000 Other NHS (Trusts, CCGs, GP practices etc): £2,022,000 Voluntary, community and social enterprises: £91,161,000£91,161,000 Commercial: £6,619,000 Local authorities and other service providers: £2,607,000

Universities: £3,752,000

Other: £125,000

Guy’s and St Thomas’ Foundation

Governance

Socially and strategically responsible

Annual report and accounts 2023124 65

Guy’s and St Thomas’ Foundation

Governance

Key risks and their management

We need to take risks to achieve our charitable and other goals. Effective risk management ensures we are identifying risks, mitigating them to the appropriate extent and ensuring they can be properly scrutinised within our governance processes. The Trustees believe the appropriate procedures and controls are in place to achieve this, as set out in our risk management policy. The policy defines key risks as those which are probable or very probable to occur and which have major or critical impact.

Responsibility for setting the Foundation’s risk appetite, and oversight of our risk management, sits with the Board of Trustees supported by the Finance and Audit Committee. Our risk appetite statement, risk appetite matrix and risk management policy are reviewed every three years. The Executive Team takes ownership of management of our strategic risks and all Foundation staff have a responsibility to identify and manage operational risks within their business areas. Operational risks are those risks that affect our delivery, whereas strategic risks pose a more fundamental threat to our ability to set and/or execute our overall strategy and may be internal or external.

New or changing risks, and their related actions and controls, are reviewed each month by the Executive Team. Every quarter, business areas review operational and strategic risks that relate to their area, along with their related actions and controls. We only report strategic risks and key operational risks within the annual report. Examples of the operational risks we are managing which do not meet the bar for inclusion here include business continuity, change management, compliance, cybersecurity, fraud, property development, reputation, talent management and other people-related risks. This year none of our operational risks were identified as a key risk.

The Executive Team reviews key risks quarterly. All key risks are reported to the Finance and Audit Committee on a quarterly basis. In addition, twice a year the Finance and Audit Committee reviews all strategic risks, and once a year it reviews the effectiveness of the Foundation’s risk management systems. The Board of Trustees reviews key risks twice a year and the full risk register is provided for information at each Board meeting.

Effective risk management ensures we are identifying risks, mitigating them to the appropriate extent and ensuring they can be properly scrutinised within our governance processes.

Annual report and accounts 2023/24

Key risks

1. Cost of living challenges have an increasingly negative effect on health, particularly the issues we work on.

We continue to monitor for emerging trends. We manage this both as a risk and an opportunity, as it has the potential to push health equity higher up stakeholders’ agendas. We consider the impact of cost of living challenges in our funding allocation and funding practices.

2. Likelihood of significant public sector fiscal retrenchment, including for the NHS.

Our Board of Trustees and the wider team are monitoring volatility in the environment we operate in and how this may affect the Foundation’s ability to achieve its goals. This risk is factored into the Foundation’s business planning. Our close relationship with Guy’s and St Thomas’ NHS Foundation Trust colleagues also allows us to understand how such challenges would impact on their strategic plans and to consider how we could best support them.

Strategic risks

The Foundation has also identified and is managing the following strategic risks:

1. A lack of a unifying culture across the Foundation, given its diverse activities across its directorates and brands.

We are currently undertaking a culture review to reinforce our one-organisational culture. We are also working on a number of people initiatives, such as our employee value proposition, onboarding, values and competencies frameworks and staff forum, which will support our cultural cohesion.

2. Property development opportunities face challenges in delivery, due to the complex nature of projects of this scale.

We have carefully chosen who we partner with, making sure they share our commitment to life sciences, and actively manage those projects and stakeholders.

3. There is a mismatch between spending (committed and forward expectations) and generation of returns over a rolling period.

This is mitigated by our portfolio construction and ongoing long-term financial plan, alongside frequent meetings between investment and finance teams.

4. Lack of clarity on Guy’s and St Thomas’ NHS Foundation Trust's capital ambitions inhibits our fundraised income growth ambitions.

We have implemented a new charities strategy and meet regularly with Trust personnel to manage this risk.

Guy’s and St Thomas’ Foundation

5. Our increased influencing activity draws greater reputational and regulatory scrutiny or a perception that we are party political.

We review our influencing to ensure it is in accordance with Charity Commission requirements. We have developed communications plans and reactive processes, alongside legal support, to manage this.

6. Any/perceived tensions between our heritage and our mission, in a politicised context, particularly as relates to the historic sources of wealth that have contributed to our endowment.

Cross-organisational resource, communications and legal support is in place, alongside engagement and oversight by the Board, to mitigate this risk.

7. Integration of the dual mandate framework and objectives for how we invest our endowment highlights real world challenges from wider ambitions.

We dedicate significant time and resource to understanding the investment landscape and how we might widen sourcing of fund opportunities while adhering to our dual mandate.

8. External factors impact on Guy’s and St Thomas’ NHS Foundation Trust’s ability to engage with us on long-term strategic questions, and on our ability to reinvigorate our public fundraising activities.

We mitigate this through our close working relationship with the Trust and strategy development work.

9. We spread our efforts too broadly.

We consciously work on ensuring a clear focus on our impact goals within our strategy.

We dedicate significant time and resource to understanding the investment landscape and how we might widen sourcing of fund opportunities while adhering to our dual mandate.

Annual report and accounts 2023/24

Structure, governance and management

Guy’s and St Thomas’ Foundation is an independent charitable company, registered with the Charity Commission for England and Wales, with charity number 1160316. The Foundation is registered at Companies House as a company limited by guarantee, with number 9341980.

Our registered office is The Grain House, 46 Loman Street, London SE1 0EH.

The Foundation is the Trustee of Guy’s and St Thomas’ Endowed Charity, Evelina London Children’s Charity, Guy’s Cancer Charity and Guy’s & St Thomas’ Charity, and a number of other linked charities. Unrestricted funds – and those restricted funds that are not separate charities linked to us – are part of the charitable company.

The Foundation owns 100% of the share capital of three trading subsidiary companies: GSTC Property Investments Ltd, GSTC Health Innovations Ltd and GSTC Property Developments Ltd, details of which are shown in note 10.2 to the accounts.

The charitable objects of Guy’s and St Thomas’ Foundation are any charitable purpose or purposes relating to the general or specific purposes of the Guy’s and St Thomas’ NHS Foundation Trust or the purposes of the health service (as described in section 1 of the NHS Act 2006 or any statutory modification of that section), including but without limitation by:

i) securing improvements in physical and mental health.

ii) securing improvements in the prevention, diagnosis and treatment of physical and mental illness.

iii) the promotion and protection of public health.

Funding policy

We work with many partners, funding projects and initiatives that make a positive contribution to our strategic goals, and which are in line with our charitable objects. All spend is reviewed by the Foundation against our criteria for quality and value for money. Ongoing projects are monitored to ensure they are achieving their milestones and our evaluation and learning managers support us to identify what has been achieved and can be learned from each project.

100%

The Foundation owns 100% of the share capital of three trading subsidiary companies

Guy’s and St Thomas’ Foundation

Appointment of Trustees

Since our reconstitution on 1 April 2015, Trustee appointments are made by the Trustees after open advertisement in partnership with executive recruitment firms specialising in such appointments. Guy’s and St Thomas’ NHS Foundation Trust has the right to appoint and remove one Foundation Trustee.

All Trustees are provided with a comprehensive induction covering strategy and mission, the individual strategies and aims of our different areas of operation, and legal and governance matters, including their duties and obligations as Trustees. In addition, further training is provided (either by our staff or external providers) as required, tailored to individual needs.

Trustee changes

Paul Brown stepped down from the Board on 30 April 2023 following completion of his term of office.

Tom Joy stepped down from the Board on 11 October 2023, having completed his second term of office.

David Bennett was appointed to the Board, and as Chair of the Foundation’s Investment Committee, on 12 October 2023.

Andrew Lee was appointed to the Board, and as Chair of the Foundation’s Finance and Audit Committee, on 12 October 2023.

Following the end of the 2023/24 financial year, Pamela Thomas joined the Board. Pamela was appointed as a Trustee on 10th July 2024.

Powers of investment

The Foundation’s powers of investment in its own right are principally derived from its Articles of Association and the Companies Act 2006. In exercising these powers, the Trustees must act in accordance with their duties as Foundation Trustees and as company directors as set out in the Charities Act 2011, the Charities (Protection and Social Investment) Act 2016, Charities Act 2022 and the Companies Act 2006 and as derived from case law. The Foundation’s powers of investment, in its capacity as corporate Trustee of the Guy’s and St Thomas’ Endowed Charity and the other linked charities, are principally derived from the revised Scheme approved by the Charity Commission in 2015 and the Trustee Act 2000. In exercising these powers, the Foundation must act in accordance with its duties as set out in the Scheme and the Trustee Act 2000. In each case, these powers of investment are wide, allowing the Trustees and the Foundation, in its capacity as corporate Trustee of the Endowed Foundation and the other linked charities, to invest in such stocks, funds, shares, securities or other investments as they see fit.

Annual report and accounts 2023/24

Fundraising

The Foundation’s fundraising activities have been undertaken by King’s College London (KCL) since 2012. While working in this way we have held a contract with KCL to cover these activities. In this working model, KCL reported regularly to the Foundation on fundraising activities, income, other key performance indicators and any issues arising, including complaints. These reports were discussed with KCL and at the Foundation’s Fundraising Leadership Group, which includes representatives from the Foundation, the Trust and KCL.

In November 2023, the Board agreed to insource the fundraising function within the Foundation. The partnership with KCL Fundraising and Supporter Development has been a success and generated significant income over the last four years. However, as part of our work to deliver our new charities strategy, it is the right time to insource the fundraising function to create platforms suitable for long-term success.

This change involves working with KCL colleagues to run a process of transition, with a number of KCL Fundraising colleagues being transferred to the Foundation under the Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE). This involves a consultation period, close working with KCL, and preparation at the Foundation to give our colleagues a warm welcome on 1 August 2024.

The Foundation and KCL are both registered with the Fundraising Regulator and seek to abide by best fundraising practice. The Foundation was informed of sub-contractors used by KCL for fundraising activities and KCL actively monitored them. The Foundation takes seriously the protection of vulnerable people and other members of the public from inappropriate fundraising behaviour.

Grant-making policy - Charities

Our grant-making is designed to support Guy’s and St Thomas’ NHS Foundation Trust to deliver better, fairer healthcare for all. We award grants to deliver projects that we design with Trust teams, in line with our strategy and our charitable objects. We learn from every grant we make and use that learning to inform future project development and improve decision-making.

Our grant-making is designed to support Guy’s and St Thomas’ NHS Foundation Trust to deliver better, fairer healthcare for all.

Guy’s and St Thomas’ Foundation

Grant-making policy – Impact on Urban Health

We work closely with partners to support them to develop fundraising proposals, which clearly demonstrate impact. Proposals are reviewed quarterly at the Executive Investment Committee and assessed against our objectives and Diversity, Equity and Inclusion principles.

With a focus on long-term change, the committee also considers how success will be evaluated and the potential for scalability, both in our place and in other urban areas. Once approved, we continue to support funded partners to develop and deliver those projects, using insight and learning to inform our work.

Complaints

The Foundation takes all complaints seriously and responds appropriately to issues raised.

During 2023/24, we received one fundraising complaint and three complaints relating to our Impact on Urban Health funding processes. The fundraising complaint and two of the Impact on Urban Health related complaints were upheld. In addition, we received complaints from supporters of a campaign group opposed to one of our property developments. These were not upheld. Each complaint has provided opportunities for the Foundation to learn and improve. Appropriate action was taken to address the concerns raised with the complainants and to reduce the likelihood of a reoccurrence.

Public benefit

The Trustees confirm that they have complied with the duty in section 4 of the Charities Act 2011 and that they have considered the Charity Commission’s guidance on public benefit in shaping the Foundation’s objectives and planning future activities. The Trustees are conscious of the need to ensure that the activities of the Foundation comply with the public benefit requirement, and they believe that all the charitable activities – most of which are described in this report – are for the public benefit.

Annual report and accounts 2023/24

Remuneration

The governing principles of the Foundation’s remuneration policy are to set pay levels that:

Help us to attract and retain a motivated workforce with the skills and expertise necessary for organisational effectiveness.
Are equitable, understandable and coherent across the Foundation.
Are appropriate in the context of the wider Foundation sector and the interests of the organisations we partner with and the people and communities we support.

These principles apply to all staff, including senior executives. The table below details staff compensation by salary band. It covers staff who were on payroll on 31 March 2024, and shows full-time equivalent (FTE) pay for ease of comparison. An alternative, more detailed breakdown of the remuneration of senior employees based on actual payments made appears in note 8 to the financial statements.

Salary band for staff as at 31 March 2024

Salary band	Number of staff
£20,000–£70,000	119
£70,000–£100,000	21
£100,000–£150,000	12
Over £150,000	4

All staff employed before 1 April 2023 were awarded a general pay increase of 4.5% (capped at £4,500 full time equivalent on 1 April 2023, with additional one-off payments of £1,800 or £1,200 (both FTE) for staff whose FTE salaries after the general increase on 1 April 2023 were below £50,270 or £100,000 respectively. The Foundation has been certified as a London Living Wage employer since 2016/17.

4.5%

general pay increase awarded for all staff employed before 1 April 2023

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Guy’s and St Thomas’ Foundation

Our people and culture

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Annual report and accounts 2023/24

4 new People platforms launched

of new hires recruited by the 76% People & Culture Talent team

Refreshed DEI Strategy and SMART action plan Created a values competency framework

New Wellbeing Strategy

Guy’s and St Thomas’ Foundation

Our people and culture

Our people are our greatest asset. The Foundation is powered by over 150 people who work to deliver our mission to create a healthier society for all. To propel our work forward, we must develop leadership that inspires, culture that includes and talent that transforms. Our People Strategy is centred around these three overarching pillars:

Inclusive leadership – developing inspirational and effective leadership at the Foundation.
Talent, skills and learning – becoming an employer of choice, enabling the Foundation to attract and retain the best talent.
Culture and values – creating an environment where all employees can thrive and feel they belong, and which supports us to achieve our mission.

In 2023/24, our strategic focus was on building the strong foundations needed to support a rapidly growing organisation. We identified the need to create structure and consistency in our people operations. This included the requirement to define expectations of our organisation and of our people. We have developed new and refreshed people policies, processes and procedures, including a code of conduct. Corresponding people manager training has been introduced to equip our people managers with the skills they need to support the way we work on a day-to-day basis.

Our workforce

We want the Foundation to be a place where people feel engaged and motivated and can thrive. This aspiration aligns to our core values. During 2023/24, we employed an average of 147 permanent employees and nine fixed-term employees. With the continued growth of the Foundation, we were able to fill 100% of the vacant positions we advertised. We achieved this by introducing a new talent acquisition function and centralising our recruitment activity. This has allowed us to move away from a heavy reliance on the use of recruitment consultants. 76% of hires in 2023/24 were made directly. Our average time to hire also reduced from 38 days to 30 days.

Investing in our people

To support the development and growth of our people, during 2023/24 we introduced a new learning and development strategy and carried out our first training needs analysis across the Foundation. We have produced a new training catalogue and a corresponding learning management system to support a consistent and standardised approach to employee learning. During 2023/24, our people have undertaken 339 courses and viewed 1,119 training videos on LinkedIn. Our commitment and inclusive approach to supporting the development of the skills, knowledge and experience of our people helps us to embed DEI into our current work. It will also increase our ability to reduce health inequity in the long term.

Annual report and accounts 2023/24

Our early career strategy

Central to our People Strategy this year has been our continued focus on investing in early career talent. We have refreshed our Associate Programme, including developing a pipeline of talent through the 10,000 Black Interns scheme and other apprenticeship, internship and placement programmes. A key element of our talent strategy is to nurture a diverse talent pipeline and encourage people from a range of different backgrounds into the Foundation. We regularly train and support apprentices, interns and placement students, providing skills and development opportunities, help with formal study and, in some cases, longer-term employment opportunities.

Enhancing our benefits

As a health foundation, we understand the vital importance of the wellbeing of each of our employees. This year, we developed a Wellbeing Policy to support our people and refreshed our existing benefits offering to enable every colleague to be well and keep well at work and at home.

We introduced and refreshed family policies to benefit parents and carers, including enhancements to maternity, paternity, shared parental, adoption, compassionate and family/caring leave.

Guy’s and St Thomas’ Foundation

Diversity, Equity and Inclusion

Diversity, Equity and Inclusion (DEI) is pivotal to the way we work, both internally and externally. In 2023/24, we developed our new Inclusive value to support and align with our three established Foundation values: delivery-minded, enterprising and collaborative. In autumn 2023, we launched a new DEI strategy and action plan and continued to build an inclusive culture where all our people feel that they belong, regardless of their background. For example, our voluntary employee network groups offer informal spaces for our people to share their experiences within the Foundation, which serves to create a more inclusive workplace.

To succeed as a Foundation, we need to draw on the broadest possible range of perspectives, expertise and talent at all levels of our organisation.

Of the 156 people in the Foundation at 31 March 2024, 66% were female (2022/23:71%), 31% were male (2022/23: 27%), and 1% preferred not to say (2022/23: 2%). 39% of all staff were of the Global Majority (2022/23: 38%). People of the Global Majority refers to people who are Black, African, Asian, Brown, mixed heritage or indigenous to the Global South. Our executive team is 57% female and 43% male, 43% are people of the Global Majority. 56% of our Board of Trustees are female and 44% are male and 33% are from the Global Majority.

Gender and ethnicity pay gap

While we are proud of the progress we are making in in relation to DEI, we are committed to further improving the diversity balance across our organisation. We look at, and report on, both gender and ethnicity pay practice using UK Government reporting methodology. This looks at the differences in hourly pay between men and women and between the Global Majority and white employees.

Gender pay gap

The Foundation had an average employee population of 150. While the requirement for compulsory gender pay gap reporting starts at 250 employees, we report on this data voluntarily as part of our commitment to DEI, and in our role as a Foundation addressing health inequalities.

Based on the median hourly rate of pay for men and women employees, our median gender pay gap in 2023 is 0.78% compared to 1% in the previous year.

Men Women	Median Gender Pay Gap	Median Gender Pay Gap	Median Gender Pay Gap
	People	%	Median Hourly Rate
	44 32 £31.19
	95 68 £30.95
Pay Gap	0.78%

*based on employees who have opted to disclose their gender

Annual report and accounts 2023/24

Ethnicity pay gap

Our ethnicity pay gap measures the difference between ethnic groups’ average earnings across an organisation over a period of time, regardless of role or seniority. Based on a median hourly rate of pay for white employees and employees of the Global Majority, our median ethnicity pay gap in 2023 is 1.81% compared to 0% in the previous year.

The main reason for the gap is due to compositional imbalance of ethnicity at the higher levels within the organisation; that is, there are more white colleagues than colleagues of the Global Majority employed in higher-paying positions, predominantly in senior specialist, Heads and Director roles.

		Median Ethnicity Pay Gap
	People	%	Median Hourly Rate
White	87	60	£31.42
Employees of the Global Majority	50	34	£30.86
Pay Gap			1.81%

*based on employees who have opted to disclose their gender

When deciding how to group staff for reporting purposes, we have followed government guidance for ethnicity pay gap reporting. In view of the relatively small size of some of our staff cohorts when split by ethnicity, staff have, for this purpose only, been placed into two groups, those of white ethnicity and those of the Global Majority.

Through our People Strategy, we continue to develop the necessary talent management approach to ensure we create a truly diverse workforce at all levels of the organisation. We believe that becoming more diverse, equitable and inclusive is not just the right thing to do but will help us to achieve our mission.

66%

of the 156 people in the Foundation at 31 March 2024 were female

Guy’s and St Thomas’ Foundation

Our commitment to the environment

As an independent foundation focused on building a healthier society, we believe in bold action to address climate change. We are committed to reaching net zero greenhouse gas emissions by 2050 and have made the following climate commitments:

Halving emissions across our financial investments portfolio by 2030.
Reducing exposure to fossil fuels and other investments that are not consistent with a low carbon future.
Transitioning our property portfolio to operational net zero (Scope 1 direct emissions and Scope 2 indirect emissions) by 2030.

Delivering positive outcomes for the environment is a key priority of our dual mandate. We have minimised exposure to fossil fuels within our portfolio and continue to assess investment opportunities that are focused on climate solutions.

Through Impact on Urban Health, we are raising awareness of how the climate crisis affects health in our place, and its disproportionate impact on certain groups. Our health effects of air pollution programme is building evidence and funding projects that aim to reduce and mitigate against these harmful effects.

Impact on Urban Health’s strategy on climate is built on four pillars that guide our approach, which are: to build our understanding, prioritise co-benefits, harness external energy and build equity in the sector. In 2023/24, we supported several organisations led by people of the Global Majority through our Climate, Health and Community Fund. Some of the highlights of this work included helping businesses in Lambeth and Southwark to make the switch to cargo bikes and contributing to the country’s leading campaign to retrofit buildings for improved energy efficiency.

We continue to engage with climate working groups and organisations aligned to our work, including the Institutional Investors Group on Climate Change, the Funder Commitment to Climate Change and the Lambeth Climate Partnership, of which we are a founding member.

Streamlined Energy and Carbon Reporting (SECR)

We report in line with the SECR guidance for the period covering 1 April 2023 to 31 March 2024, which considers an operational control approach for all our properties and land.

See appendix on page 124 for our report and methodology.

Annual report and accounts 2023/24

Trustees' responsibilities

The Trustees (who are also directors and members of Guy’s and St Thomas’ Foundation for the purposes of company law) are responsible for preparing the Trustees’ annual report and the financial statements in accordance with applicable law and regulations.

Company law requires the Board to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the company and of the profit or loss of the company for that period. In preparing these financial statements, the Board is required to:

Select suitable accounting policies and apply them consistently.
Make judgements and estimates that are reasonable and prudent.
State whether applicable accounting standards – including FRS 102 – have been followed, subject to any material departures disclosed and explained in the financial statements.
Follow the guidance in Statements of Recommended Practice (SORP), Accounting and Reporting by Charities.
Prepare the financial statements on a going concern basis unless it is inappropriate to presume that the charity will continue in operation.

The Trustees are responsible for keeping proper accounting records that disclose, with reasonable accuracy at any time, the financial position of the company and enable them to ensure that the financial statements comply with the Companies Act 2006, Accounting Standards and Statements of Recommended Practice and the regulations under the Charities Act 2011. They are also responsible for safeguarding the assets of the company and for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Guy’s and St Thomas’ Foundation

The Trustees of Guy’s and St Thomas’ Foundation must also act in accordance with a set of general duties, set out in section 172 of the UK Companies Act 2006. These duties are summarised as follows:

A Trustee of a charitable company must act in the way they consider, in good faith, would be most likely to promote the success of the charity’s charitable objects and, in doing so, have regard (among other matters) to the:

Likely consequences of any decisions in the long term.
Interests of the charitable company’s employees.
Need to foster the charitable company’s business relationships with suppliers, customers and others.
Impact of the charitable company’s operations on the community and environment.
Charitable company’s reputation for high standards of business conduct.
Need to act fairly between members of the charitable company.

Statement of disclosure to the auditor

So far as each of the Trustees at the date of this report is aware:

there is no relevant audit information of which the Charity's auditor is unaware; and
each Trustee has taken all the steps that they ought to have taken to make themselves aware of any relevany audit information and to establish that the auditor is aware of that information.

Auditors

Crowe U.K. LLP - Tina Allison, Audit Partner

Crowe U.K. LLP were appointed as the Foundation’s auditors in December 2022 following a competitive tender process and have expressed their willingness to continue as auditor for the following period.

Annual report and accounts 2023/24

Our organisation

Our Executive Team

Laurie Lee Chief Executive (from April 2023)

Peter Babudu Executive Director of Urban Health (from July 2023)

Catherine Cullen Executive Director of Communications and Engagement (job share)

Emma Davies Chief Investment Officer (from May 2023)

Cynthia Duodu Chief People Officer

Barbara Kasumu Executive Director of Charities

Moray McConnachie Executive Director of Operations

Gayle Willis Executive Director of Communications and Engagement (job share)

Details of our Executive Team and a full list of staff members are available on our website.

Our Trustee Board

Susanne Given (Chair from April 2023)

Sir Ron Kerr (Interim Chair from January to March 2023, Vice Chair from April 2023)

Helen Bailey

David Bennett

Dr Nikki Kanani

Yasemin Saltuk Lamy

Andrew Lee

Dr Danny Sriskandarajah

Katherine Ward

Pamela Thomas

Trustees who resigned during the period

Paul Brown (resigned April 2023)

Tom Joy (resigned October 2023)

Guy’s and St Thomas’ Foundation

Trustee biographies

Susanne Given is Chair of our Board of Trustees. Susanne specialises in digital organisational growth. She has 20+ years of experience working for fast-growing digital businesses and recognised leaders in retail, such as John Lewis, Harrods and Superdry, and currently chairs digital fashion brand HUSH UK. Susanne formerly held non-executive roles at Morrisons, Push Doctor and Deloitte. She sits on our People Committee, Investment Committee, Nomination Committee, Charities Strategy Committee and Finance and Audit Committee.

Sir Ron Kerr is Vice Chair of our Board. He was appointed as a lay member of the Council for King’s College London and Chair of NHS Providers in 2019. Prior to this, he joined Guy’s and St Thomas’ NHS Foundation Trust as Chief Executive in 2007. He stepped down in 2015 after 30 years in senior NHS leadership roles but remained with the Trust becoming special advisor to the Board. His other Chief Executive roles have included the National Care Standards Commission, United Bristol Healthcare NHS Trust and the South East London Commissioning Agency. Ron sits on our Charities Strategy Committee.

Helen Bailey is Chief Executive of the London Borough of Sutton. She is an experienced public sector leader who has worked in local government, for the Mayor of London and in HM Treasury. She has also provided strategic consultancy and advice as a consultant and is involved in two not-for-profit organisations that concern themselves with public sector leadership. Helen chairs our Impact on Urban Health Committee and sits on our Finance and Audit Committee. She is also a resident of Lambeth.

David Bennett has recently retired from a long career in financial services. He, most recently, spent 13 years at the investment consultancy, Redington. During his time there he was a senior consultant advising on a diverse portfolio of institutional investors, Head of Investment Consulting, Chair of the Investment Strategy Committee and a Board Member. His current roles include being a Trustee of the Science Museum Foundation, a Director of the John Lewis Partnership Pensions Trust and a member of the Investment Committee of the BBC Pension Scheme. David chairs our Investment Committee and sits on our Finance and Audit Committee.

Andrew Lee has held senior executive and Board positions, including Chief Executive Officer, Chief Financial Officer and Chief Security Officer, in the financial services industry for 35 years. Now retired from executive roles, he currently holds non-executive Board roles at St Andrew’s Healthcare Trust, Birmingham Assay Institution and The Scottish Building Society. Andrew chairs the Foundation’s Finance and Audit Committee and sits on our Impact on Urban Health Committee.

Yasemin Saltuk Lamy is MD, Head of Asset Allocation and Capital Solutions for British International Investment plc. She previously covered Digital Identity and Innovation at Omidyar Network and had several roles at J.P. Morgan in London across derivatives and impact investing. Yasemin earned a Master of Science with merit in financial mathematics from King’s College London. She is Vice Chair of our Investment Committee.

Annual report and accounts 2023/24

Katherine Ward is Entrepreneur in Residence in the Health Tech team at Oxford Science Enterprises. She has worked in healthcare for over 30 years. This includes 15 years in the NHS in both provider and payer roles and 11 years with UnitedHealth Group, where she was Chief Executive of UnitedHealth UK and, later, Chief Growth Officer for Optum International. Katherine chairs our People Committee.

Dr Danny Sriskandarajah took on the role of Chief Executive of the New Economics Foundation in January 2024, having previously been Chief Executive of Oxfam GB. Prior to this, he held leadership roles at CIVICUS – the global civil society alliance – the Royal Commonwealth Society, the Commonwealth Foundation and the Institute for Public Policy Research. He holds a Masters and Doctorate from Oxford University and an undergraduate degree from the University of Sydney. He is also Trustee of the Disasters Emergency Committee. Danny chairs our Charities Strategy Committee and sits on our Nomination Committee.

Dr Nikki Kanani is a respected leader in health and a practising GP in South East London. She previously held the role of Medical Director for Primary Care for NHS England and NHS Improvement, having become the first women appointed to that position. Prior to that, she was Chief Clinical Officer of NHS Bexley Clinical Commissioning Group (CCG). She currently sits on The King’s Fund General Advisory Group. Nikki sits on our Impact on Urban Health Committee.

Company Secretary Hazel Peck is a qualified solicitor and chartered company secretary. Prior to joining the Foundation, Hazel trained and spent a number of years as an associate at Hogan Lovells International LLP, a leading global corporate law firm, where she specialised in corporate finance and social enterprise. Following that, she specialised in social investment as managing director - senior legal advisor at Big Society Capital. Hazel is a Trustee of London-based children’s charity KEEN London.

Pamela Thomas is a Director in PwC’s Financial Services Advisory practice. She is an experienced international business transformation executive, with 20+ years of diversified expertise advising leaders in FTSE 100 financial institutions, energy, and the public sector on transforming their organisations. Previously she worked at Accenture and Capita leading enterprise-wide transformations for clients. She has a global perspective having worked across Europe (including Russia), Asia, the US and South Africa. Pamela holds a BA (Hons) in Political Science, an MBA and a Master’s in Strategic Financial Management.

Guy’s and St Thomas’ Foundation

Committees

Board Committees

Investment Committee

This committee takes responsibility for investment strategy and management of the Foundation’s non-programme-related assets and the investment of the assets of the Endowed Charity and other linked charities, which are held by the Foundation as sole corporate Trustee. It reports to the Board of Trustees.

The Investment Committee has two sub-committees:

Funds Committee

This committee is responsible for making investment decisions, with oversight from the Investment Committee, with a view to overseeing and guiding our work to build a portfolio of funds that generate both risk-adjusted financial returns and positively impact both health and society.

Property Committee

This committee is responsible for overseeing and guiding our major property projects and developments. It can approve certain activities up to agreed thresholds and reports to the Investment Committee. For activities above the agreed thresholds, the committee makes recommendations to the Investment Committee for approval.

Finance and Audit Committee

This committee takes responsibility for overseeing financial governance and all matters relating to internal and external audit, oversees the maintenance of an effective system of internal financial controls, management reporting and risk management, and advises the Board on governance arrangements. It reports to the Board of Trustees.

People Committee

This committee develops policy on staff remuneration, approves overall spending on staff remuneration and benefits, and monitors the composition of the Board. It also approves senior executive remuneration and terms of employment of the Chief Executive and considers succession planning and recruitment to senior management positions. It reports to the Board of Trustees.

Nomination Committee

This committee, operating under delegated authority from the Board, is responsible for the recruitment of new Trustees. Its duties include regularly reviewing the Board’s structure, size and composition and recommending any changes to the Board, and overseeing a diverse pipeline for succession. It also identifies candidates to fill Board vacancies, as and when these arise, and nominates for approval of the Board.

Annual report and accounts 2023/24

Charities Strategy Committee

This committee, operating under delegated authority from the Board, is responsible for setting the strategic direction of fundraising and fund spending, providing long-term strategic advice on all work with the Trust and NHS influencing work, and considering the strategic fit of funding and fundraising projects with a value of over £2m.

Impact on Urban Health Committee

This committee, operating under delegated authority from the Board, is responsible for providing strategic oversight and guidance to Impact on Urban Health (the programmatic area of the Foundation’s activities). The committee advises on strategic direction for cross-programmatic learning and reviews the progression of our programmes. If appropriate, this committee also recommends Impact on Urban Health funding proposals above £2m to the Board for approval.

Executive Committees

Executive Investment Committee

This committee, operating under delegated authority from the Board, is responsible for the Foundation’s activities as an independent health foundation, including spending decisions on programmatic work of up to (and including) £2m.

Charities Oversight Group

This group, operating under delegated authority from the Board, is responsible for funding and fundraising decisions of up to (and including) £2m relating to the Trust. It delegates certain funding decisions to the Trust committees, which are in the process of being reformed as the Evelina London Children’s Charity, Guy’s Cancer Charity and Guy’s & St Thomas’ Charity Expert Groups, as well as to Special Purpose Fundholders’ and the Foundation’s Chief Executive, respectively. It also takes decisions on support for the Trust in response to unforeseen needs, up to and including a value of £2m.

Guy’s and St Thomas’ Foundation

Committees

Committees to support the Trust

Evelina Children’s Fund Committee

This committee meets regularly during the year and is responsible for considering applications for funding from the Evelina Children’s Fund.

Cancer Funds Committee

This committee meets regularly during the year and is responsible for overseeing Special Purpose Funds benefiting cancer services and considering applications for funding to improve cancer care at Guy’s and St Thomas’ NHS Foundation Trust.

The Charitable Fund Committee

This committee meets regularly during the year and awards grants to improve patient care and experience and to support staff across Guy’s and St Thomas’ NHS Foundation Trust.

The Samaritan Fund Committee

This committee oversees strategy and spend for the Samaritan Special Purpose Fund, which exists to support vulnerable patients of Guy’s and St Thomas’ NHS Foundation Trust, including those in financial need.

In each case, applications to these committees are considered in light of the strategic direction set by the Charities Strategy Committee. Any applications for funding or proposals for fundraising above £500,000 are escalated for approval to the Charities Oversight Group.

Annual report and accounts 2023/24

Advisors

Auditors (statutory)

Crowe U.K. LLP, 55 Ludgate Hill, London EC4M 7JW

Auditors (internal)

KPMG LLP, 15 Canada Square, Canary Wharf, London E14 5GL

Bankers

NatWest, 91 Westminster Bridge Road, London SE1 7HT

Insurance brokers

Brunel Insurance Brokers, 40 Lime Street, London EC3M 7AW

Investment advisors

Partners Capital LLP, 5 Young Street, London W8 5EH

Property advisers

Savills, 33 Margaret Street, Marylebone, London W1G 0JD

Property managers

Savills, Wytham Court, 11 West Way, Oxford OX2 0QL

Cluttons LLP, Yarnwicke, 119-121 Cannon Street, London EC4N 5AT

CRM Students Ltd, Hanborough House, Wallbrook Court, North Hinksey Lane, Botley, Oxfordshire OX2 0QS

Lambert Smith Hampton, UK House, 180 Oxford Street, London W1D 1NN

Lawyers (charity and general legal support)

Withers LLP, 20 Old Bailey, London EC4M 7AN

Lawyers (property)

Macfarlanes LLP, 20 Cursitor Street, Holborn, London EC4A 1LT

Burges Salmon, One Glass Wharf, Bristol BS2 0ZX

Others

Newcomen Collett Foundation. The Foundation has the right to nominate a representative governor to serve on the Newcomen Collett Foundation Board of Trustees.

The Trustee’s annual report is approved by the Trustees of the Foundation. The strategic report, which forms part of the annual report, is approved by the Trustees in their capacity as directors in company law of the Foundation.

By order of the Board of Trustees.

Susanne Given

10 December 2024

Guy’s and St Thomas’ Foundation

Financial review

Auditor’s report and financial statements

Annual report and accounts 2023124 91

Guy’s and St Thomas’ Foundation

Independent auditor’s report to the members and Trustees of Guy’s and St Thomas’ Foundation

Opinion

We have audited the financial statements of Guy’s and St Thomas’ Foundation (the “charitable company”) and its subsidiaries (the “group”) for the year ended 31 March 2024 which comprise of the Consolidated Statement of Financial Activities, Consolidated Balance Sheet, Balance Sheet, Consolidated Statement of Cash Flows and notes to the financial statements, including significant accounting policies.

The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

give a true and fair view of the state of the group’s and the charitable company’s affairs as at 31 March 2024 and of the group’s incoming resources and application of resources, including its income and expenditure for the year then ended.
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice.
have been prepared in accordance with the requirements of the Companies Act 2006.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law.

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

Conclusions relating to going concern

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

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charitable company’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

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

Annual report and accounts 2023/24

Other information

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

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

the information given in the Trustees’ report, which includes the directors’ report and the strategic report prepared for the purposes of company law, for the financial year for which the financial statements are prepared is consistent with the financial statements.
the strategic report and the directors’ report included within the Trustees’ report have been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In light of the knowledge and understanding of the charitable company and their environment obtained in the course of the audit, we have not identified material misstatements in the strategic report included within the Trustees’ report.

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

the parent company has not kept adequate accounting records.
the parent company financial statements are not in agreement with the accounting records and returns.
certain disclosures of Trustees’ remuneration specified by law are not made.
we have not received all the information and explanations we require for our audit.

Guy’s and St Thomas’ Foundation

Responsibilities of Trustees

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

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

Auditor’s responsibilities for the audit of the financial statements

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

We obtained an understanding of the legal and regulatory frameworks within which the Foundation and group operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Companies Act 2006, the Charities Act 2011, together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

In addition, we considered provisions of other laws and regulations that do not have a direct effect on the financial statements but compliance with which might be fundamental to the Foundation’s and the group’s ability to operate or to avoid a material penalty. We also considered the opportunities and incentives that may exist within the charity and the group for fraud. The laws and regulations we considered in this context for the UK operations were fundraising regulations, taxation legislation, employment legislation, Health and Safety regulations and General Data Protection Regulation (GDPR).

Annual report and accounts 2023/24

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within timing and recognition of income and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management and the Finance and Audit Committee about their own identification and assessment of the risks of irregularities, sample testing on the posting of journals, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission, and reading regulatory reports and minutes of meetings of those charged with governance.

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

Use of our report

This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006.

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

Tina Allison

Senior Statutory Auditor

For and on behalf of

Crowe U.K. LLP

Statutory Auditor London

16 December 2024

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Consolidated Statement of Financial Activities

(incorporating an Income and Expenditure Account)

For the year ended 31 March 2024

Notes Income from: Investments 2 Release from endowment funds 3 Grant income 4 Donations, legacies and other 5 Total income Expenditure on: Raising funds Investment costs 6 Fundraising cost 6 Charitable activities Grants 6 Other charitable activities 6 Total expenditure 8 Net income/(expenditure) before gains and losses on investments Net gains/(losses) on revaluation and disposal of investments 10 Net income/(expenditure) Transfers between funds 18 Other recognised losses Gains/(losses) on revaluation of tangible fixed assets 9 Net movement in funds Reconciliation of funds Total funds brought forward Total funds carried forward	2024 Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000 4,291 1,194 19,034 24,519 42,600 210 (42,810) – 60 – – 60 1,549 8,054 – 9,603 48,500 9,458 (23,776) 34,182 617 – 16,091 16,708 955 7,498 – 8,453 1,572 7,498 16,091 25,161 34,023 5,985 – 40,008 8,095 1,457 – 9,552 42,118 7,440 – 49,558 43,690 14,938 16,091 74,719 4,810 (5,480) (39,867) (40,537) 3,461 – (18,378) (14,917) 8,271 (5,480) (58,245) (55,454) (7,646) 7,646 – – 303 – – 303 928 2,166 (58,245) (55,151) 43,988 13,326 913,634 970,948 44,916 15,492 855,389 915,797	2023
		Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000
		1,926 401 17,068 19,395 35,611 234 (35,845) - 189 423 – 612 2,813 6,308 – 9,121
		40,539 7,366 (18,777) 29,128
		327 – 13,666 13,993 1,715 4,646 – 6,361
		2,042 4,646 13,666 20,354
		38,748 3,242 – 41,990 8,134 2,075 – 10,209
		46,882 5,317 – 52,199
		48,924 9,963 13,666 72,553
		(8,385) (2,597) (32,443) (43,425) (3,325) – 15,474 12,149
		(11,710) (2,597) (16,969) (31,276) (4,809) 4,809 – –
		(99) – – (99)
		(16,618) 2,212 (16,969) (31,375)
		60,606 11,114 930,603 1,002,323
		43,988 13,326 913,634 970,948

There were no gains or losses apart from those recognised above. All income is derived from continuing activities.

An analysis of the movements in funds is shown in notes 15 to 17.

The notes on pages 100 to 121 form part of these financial statements.

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Consolidated balance sheet

As at 31 March 2024

			2024	2024		2023
		Unrestricted	Restricted	Endowment	Total at	Unrestricted Restricted Endowment Total at
		Funds	Funds	Funds	31 March	Funds Funds Funds 31 March
	Notes	£’000	£’000	£’000	£’000	£’000 £’000 £’000 £’000
Fixed assets
Tangible assets	9	5,188	–	–	5,188	5,040 – – 5,040
Investments	10	27,013	–	948,941	975,954	23,809 – 1,017,953 1,041,762
		32,201	–	948,941	981,142	28,849 – 1,017,953 1,046,802
Current assets
Investments	10	–	–	–	–	– – 17,767 17,767
Debtors	11	2,161	1,140	25,324	28,625	1,799 654 25,697 28,150
Inter-fund loan	12	57,500	7,500	(65,000)	-	65,000 – (65,000) –
Cash and short term deposits		7,414	21,311	30,476	59,201	3,934 24,617 3,145 31,696
		67,075	29,951	(9,200)	87,826	70,733 25,271 (18,391) 77,613
Creditors:
Amounts falling due
within one year
Grant creditors	7	27,121	6,844	–	33,965	35,651 6,708 – 42,359
Other creditors	13	9,243	3,332	11,919	24,494	6,902 3,484 22,046 32,432
		36,364	10,176	11,919	58,459	42,553 10,192 22,045 74,791
Net current assets/(liabilities)		30,711	19,775	(21,119)	29,367	28,180 15,079 (40,437) 2,822
Total assets less current
liabilities		62,912	19,775	927,822	1,010,509	57,029 15,079 977,516 1,049,624
Creditors:
Amounts falling due
after one year
Grant creditors	7	17,996	4,097	–	22,093	13,041 1,477 – 14,518
Other creditors		–	186	12,433	12,619	– 276 3,882 4,158
Private placement loan	14	–	–	60,000	60,000	– – 60,000 60,000
		17,996	4,283	72,433	94,712	13,041 1,753 63,882 78,676
Total net assets		44,916	15,492	855,389	915,797	43,988 13,326 913,634 970,948
Funds of the charity
Income funds
Unrestricted	15	44,916	–	–	44,916	43,988 – – 43,988
Restricted	16	–	15,492	–	15,492	– 13,326 – 13,326
		44,916	15,492	–	60,408	43,988 13,326 – 57,314
Capital funds
Endowment	17	–	–	855,389	855,389	– – 913,634 913,634
Total funds		44,916	15,492	855,389	915,797	43,988 13,326 913,634 970,948

The notes on pages 100 to 121 form part of these financial statements

The accounts were approved and authorised for issue by the Trustee Board on 10 December 2024.

Signed in the name and on behalf of the Trustees of Guy's and St Thomas' Foundation:

ChiorameSo Susanne Given Chair

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Balance sheet

As at 31 March 2024

			2024	2024		2023
		Unrestricted	Restricted	Endowment	Total at	Unrestricted Restricted Endowment Total at
		Funds	Funds	Funds	31 March	Funds Funds Funds 31 March
	Notes	£’000	£’000	£’000	£’000	£’000 £’000 £’000 £’000
Fixed assets
Tangible assets	9	5,188	–	–	5,188	5,040 – – 5,040
Investments	10	26,996	–	949,760	976,756	22,377 – 1,022,946 1,045,323
		32,184	–	949,760	981,944	27,417 – 1,022,946 1,050,363
Current assets
Debtors	11	2,160	1,140	8,474	11,774	1,809 655 16,229 18,693
Inter-fund loan	12	57,500	7,500	(65,000)	–	65,000 – (65,000) –
Cash and short term deposits		7,213	21,311	28,320	56,844	3,707 24,617 2,828 31,152
		66,873	29,951	(28,206)	68,618	70,516 25,272 (45,943) 49,845
Creditors:
Amounts falling due
within one year
Grant creditors	7	27,121	6,844	–	33,965	35,651 6,708 – 42,359
Other creditors	13	9,235	3,332	6,172	18,739	6,895 3,484 7,896 18,275
		36,356	10,176	6,172	52,704	42,546 10,192 7,896 60,634
Net current assets/(liabilities)		30,517	19,775	(34,378)	15,914	27,970 15,080 (53,839) (10,789)
Total assets less current
liabilities		62,701	19,775	915,382	997,858	55,387 15,080 969,107 1,039,574
Creditors:
Amounts falling due
after one year
Grant creditors	7	17,996	4,097	–	22,093	13,041 1,477 – 14,518
Other creditors		–	186	–	186	– 276 – 276
Private placement loan	14	–	–	60,000	60,000	– – 60,000 60,000
		17,996	4,283	60,000	82,279	13,041 1,753 60,000 74,794
Total net assets		44,705	15,492	855,382	915,579	42,346 13,327 909,107 964,780
Funds of the charity
Income funds
Unrestricted	15	44,705	–	–	44,705	42,346 – – 42,346
Restricted	16	–	15,492	–	15,492	– 13,327 – 13,327
		44,705	15,492	–	60,197	42,346 13,327 – 55,673
Capital funds
Endowment	17	–	–	855,382	855,382	– – 909,107 909,107
Total funds		44,705	15,492	855,382	915,579	42,346 13,327 909,107 964,780

A separate Statement of Financial Activities and Income and Expenditure Account are not presented for the Foundation itself as the Foundation has taken advantage of the exemptions afforded by section 408 of the Companies Act 2006. The net loss of the Foundation only for the year ended 31 March 2024 was £49,203,000 (2023: net loss of £35,553,000 ).

The notes on pages 100 to 121 form part of these financial statements

The accounts were approved and authorised for issue by the Trustee Board on 10 December 2024.

Signed in the name and on behalf of the Trustees of Guy's and St Thomas' Foundation:

Sie Susanne Given Chair[Chicane]

Susanne Given

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Consolidated statement of cash flows

For the year ended 31 March 2024

Cash flows from operating activities: Net cash used in operating activities Cash flows from investing activities: Rents, dividends and interest from investments Proceeds from sale of investments Purchase of investments Purchase of tangible fixed assets Net cash provided by investing activities Change in cash and cash equivalents in the reporting period Cash and cash equivalents at the beginning of the reporting period Change in cash and cash equivalents due to exchange rate movements Cash and cash equivalents at the end of the reporting period	31 March 2024 £’000 (64,548) 24,519 199,932 (131,904) (54) 92,493 27,945 31,696 (440) 59,201	31 March 2023 £’000

		(73,070)


		19,395
		193,091
		(157,466)
		(118)
		54,902

		(18,168)
		51,123
		(1,259)
		31,696

Reconciliation of net income to net cash flow from operating activities

Reconciliation of net income to net cash flow from operating activities
Net income for the reporting period Adjustments for: Depreciation charges Revaluation of fixed assets Losses/(gains) on investments Programme-related investments written off Rents, dividends and interest from investments Donated fixed assets Decrease/(increase) in debtors (Decrease)/increase in grants payable Increase/(decrease) in other creditors Net cash used in operating activities Increase in grants payable includes: Grants awarded Grants paid out Change in fair value	31 March 2024 £’000 (55,151) 201 (303) 14,435 1,552 (24,519) 8 (475) (819) 523 (64,548) 28,101 (26,101) (1,581) 419	31 March 2023 £’000
		(31,375)

		195
		-
		(12,149)
		1,265
		(19,395)
		2
		880
		6,286
		(18,779)
		(73,070)

		33008
		, (25785)
		, 937

		8,160

Analysis of changes in net debt

Cash and cash equivalents Borrowings Due after one year Total net debt	At 1 April 2023 £’000 31,696 (60,000) (28,304)	Cash flows £’000 27,945 – 27,945	FX rate movements £’000 (440) – (440)	At 31 March 2024 £’000
				59,201

				(60,000)
				(799)

The notes on pages 100 to 121 form part of these financial statements.

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

1. Accounting policies

1.1 General

The financial statements have been prepared under the historical cost convention, with the exception of: investments and works of art which are included at market value; and grant creditors payable after more than one year which are included at their present value. The financial statements have been prepared in accordance with Financial Reporting Standard 102 ("FRS 102"), the Statement of Recommended Practice for Accounting and Reporting by Charities, and applicable United Kingdom law and accounting standards. The Foundation is a Public Benefit Entity as defined by FRS 102.

The financial statements are prepared in sterling, which is the functional currency of the Foundation. Monetary amounts in these financial statements are rounded to the nearest thousand pounds.

1.2 Going concern

The Trustees have assessed whether the use of the going concern basis is appropriate and have considered (i) possible events or conditions that might cast significant doubt on the ability of the Foundation to continue as a going concern, (ii) the Foundation's forecasts and projections, and (iii) potential pressures on income. This assessment has been made for a period of at least one year from the date of approval of the financial statements. After making enquiries, the Trustees have concluded that there is a reasonable expectation that the Foundation has adequate resources to continue in operational existence for the foreseeable future. The Foundation therefore continues to adopt the going concern basis in preparing its financial statements.

1.3 Fund accounting

The Foundation maintains various types of funds and descriptions of these funds are provided in notes 15 to 18. Income and expenditure on these funds is shown separately within the Statement of Financial Activities and analysed into their main components also in notes 15 to 18.

There are three main types of funds as follows:

Unrestricted funds are expendable at the discretion of the Trustees in furtherance of the objects of the Foundation. Funds that are freely available to spend on any of the Foundation's charitable objectives are managed through a distribution account. Other funds represent the net book value of fixed assets which are used in furtherance of the Foundation's charitable objectives, including charitable property, health innovations investments, the art collection and other tangible fixed assets.
Restricted funds represent funds where the grants and donations are requested by the donor to be spent on a specific purpose.
Endowment funds are funds which are held as the long-term capital of the Foundation to provide an ongoing income to expend in furtherance of the Foundation's objects. The Foundation has two types of endowment funds; those expendable at the Trustees' discretion (expendable endowment funds) and those which must be permanently held as capital (permanent endowment funds). A total return approach to investment has been adopted for both types of endowment fund under which the funds are invested to produce an investment return without regard to whether that return is in the form of income or capital appreciation. The Foundation has developed a distribution rule which is designed to produce a consistent and sustainable amount to be transferred annually to the unrestricted fund whilst maintaining the value of the endowments in real terms over the long term (see note 3).

1.4 Critical accounting estimates and judgements

The Foundation's management is required to make judgements, estimates and assumptions that affect the application of policies and reported amounts of assets and liabilities, income and expenses. The estimates and associated assumptions are based on historical experience and various other factors that are believed to be reasonable under the circumstances. The results of the estimates and assumptions form the basis of making the judgements about carrying values of assets and liabilities that are not readily apparent from other sources. The judgements which have the most significant risk of causing a material adjustment to the carrying amount of assets and liabilities are as follows:

the valuations of investment properties, for which the Foundation's internal property team has assessed based on market knowledge and professional expertise that the valuations included in the accounts have not materially changed since the date of valuation;
the valuations of unlisted programme-related direct financial investments, which are based either on the prices achieved in the most recent fundraising, if applicable, or cost less any known impairment; and
the discount rate applied to the calculation of the present value of grant creditors payable after more than one year, for which the Foundation has assessed the most appropriate discount rate to be the interest rate of the inter-fund loan from the unrestricted fund to the endowment fund which is linked to 12 month sterling SONIA, as described more fully in note 12, as this best reflects the opportunity cost of income foregone.

100

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

1. Accounting policies (cont.)

1.5 Income

All income received or receivable are brought into account and allocated as appropriate to one of the three types of fund – unrestricted, restricted or endowment.

Donations, gifts, legacies and investment income are accounted for when received or when due and receipt is probable and measured reliably.
Dividends and interest are brought into account gross of recoverable UK and overseas taxation.
Income from grants is accounted for when the Foundation becomes entitled to receive it. Where such grants are subject to terms or conditions, income will only be recognised to the extent that the related terms and conditions have been fulfilled by the Foundation.

1.6 Expenditure

All expenditure is accounted for on an accruals basis. The majority of costs are attributable directly to specific activities. Shared costs are apportioned to activities based on an estimate of the proportion of staff time spent on each of these areas of work. Expenditure in the accounts is analysed into the following activities:

Expenditure on raising funds comprise costs incurred in managing the Foundation's investment portfolio and maintaining the Foundation's investment properties as well as amounts both charged to and directly incurred by the Foundation for fundraising services.
Grants awarded are brought into account when a constructive obligation exists for the Trustees to make the grant.
Other charitable activities relate to expenditure in support of beneficiaries which is not made as part of the normal grants programme. It includes day-to-day beneficiary expenditure incurred through special purpose funds, charitable activity funded by contractual agreements, and expenditure on maintaining and displaying the art collection.

1.7 Pension contributions and employee benefits

The cost of employer contributions to the NHS Pension Scheme and other schemes is charged to the Statement of Financial Activities.

The NHS Pension Scheme is an unfunded defined benefit scheme that covers NHS employers, GP practices and other bodies allowed under the direction of the Secretary of State. The Scheme is not designed to be run in a way that would enable employer bodies to identify their share of the underlying Scheme assets and liabilities. Therefore the Scheme is accounted for as a defined contribution scheme. Employer contributions to the NHS Scheme are based on 14.38% of gross salaries.

Termination benefits are recognised immediately as an expense when the Foundation is demonstrably committed to terminate the employment of an employee through, for example, redundancy, or to provide termination benefits.

1.8 Allocation and apportionment of costs

Staff costs are considered on a person by person basis and allocated between expense headings on the basis of an estimate of time spent on activities in each area derived from headcount. Other overheads which are not directly attributable to one particular area of activity are apportioned in the same ratios. Details of expenditure are provided in the notes to the accounts.

1.9 Tangible fixed assets

Capitalisation:

Leasehold improvements and fixtures, fittings and equipment which are capable of being used for more than one year and have a cost equal to or greater than £5,000 are capitalised.
Works of art which are included in the Foundation's art collection are capitalised without reference to a minimum cost.

Valuation:

Leasehold improvements and fixtures, fittings and equipment are included at cost less depreciation where applicable.
Works of art which are included in the Foundation's art collection are included at open market value. The entire collection was professionally valued as at 31 March 2024.

Depreciation:

Leasehold improvements and fixtures, fittings and equipment are depreciated on a straight line basis. Leasehold improvements are depreciated over 10 years or the term of the lease if shorter. Furniture and equipment is depreciated over 5 years. Computers and other IT hardware is depreciated over 3 years.
The art collection is not depreciated as the residual value of works of art is considered to be at least equal to the book value.

Impairment:

As at the balance sheet date there was no indication that the recoverable amount of any functional fixed asset was below its net book value.

101

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

1. Accounting policies (cont.)

1.10 Fixed asset investments

Property assets are included at market valuation. Investment properties are valued annually by external property valuation experts and the last full valuation was as at 31 March 2024. Where a decision to sell a property was made before the balance sheet date and offers to purchase were received subsequent to the balance sheet date, the value at which the property is included in the accounts has been adjusted to reflect the estimated net sale price achievable. The Foundation does not believe that the valuations of property assets have otherwise materially changed subsequent to the balance sheet date.
Listed investments are included in the balance sheet at market value as at 31 March 2024. Inevitably, market valuations fluctuate, sometimes significantly, over time including over the period subsequent to the balance sheet date. However, given the long-term nature of its investment portfolio, the Foundation does not believe that there has been any material permanent diminution in investment valuations subsequent to the balance sheet date.
Unlisted investments are valued with reference to the most recent valuations provided by the fund managers, all of which were as at 31 March 2024. The Foundation does not believe that there is any evidence of any material permanent reduction in these valuations subsequent to the balance sheet date.

The net gains and losses arising on revaluation and disposals throughout the year are included in the Statement of Financial Activities.

1.11 Financial instruments

Financial instruments are contracts that give rise to a financial asset in one entity and a financial liability or equity instrument of another entity. Financial instruments are classified as either basic financial instruments or other financial instruments.

Basic financial instruments are recognised in the accounts as follows:

Cash and cash equivalents, which includes cash at banks and in hand and short-term deposits with a maturity date of three months or less, are carried at the value of the cash so held.
Trade and other exchange transaction debtors and creditors receivable or payable within one year of the reporting date are initially recognised at their settlement amount and subsequently measured at the cash or other consideration expected to be paid or received.
Other debt instruments subject to a market rate of interest are initially recognised at the amount of principal advanced less material arrangement or similar fees and subsequently measured at amortised cost using the effective interest method.
Fixed asset financial investments are initially recognised at their transaction value and subsequently measured at their fair value as at the balance sheet date as described in note 1.10 above.

Other financial instruments are used as part of the Foundation's portfolio management and risk management strategy. The Foundation's use of other financial instruments during the year ended 31 March 2024 comprised forward dated contracts for the purchase and sale of foreign currencies ("forward FX contracts") which are both initially recognised and subsequently measured at their fair value in the balance sheet with gains and losses recognised in the statement of financial activities.

1.12 Grant creditors

Grant creditors are amounts committed under grant awards but not yet paid. They are non-contractual in nature and therefore not financial instruments. Grant creditors that are estimated as payable after more than one year are measured at the present value of the expected future payments discounted at a market rate of interest.

1.13 Consolidation

The consolidated financial statements include the results of the Foundation and its wholly-owned subsidiary undertakings, GSTC Health Innovations Limited, GSTC Property Investments Limited and GSTC Property Developments Ltd. The Foundation has not presented its unconsolidated income and expenditure account in accordance with the exemption under Section 408 of the Companies Act 2006.

102

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

2. Income from investments

Dividends, distributions and interest Property - rents Property - other income Interest on cash and short-term deposits	Total 2024 Funds £’000 1,113 17,549 9 5,848 24,519	Total 2023 Funds £’000
		922
		17,875
		62
		536
		19,395

3. Release from endowment funds

For disbursement under the Foundation’s distribution rule Additional disbursements Permanent endowments total return allocated to income	2024 Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000 36,481 – (36,481) – 6,119 – (6,119) – – 210 (210) – 42,600 210 (42,810) –	2023
		Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000
		35,611 – (35,611) – – – – – – 234 (234) –
		35,611 234 (35,845) –

The Foundation aims to release 4% of the value of the expendable endowment on a smoothed basis annually to the unrestricted fund for charitable and other expenditure, whilst maintaining the value of the expendable endowment in line with inflation over the long term. The actual transfer in any year will be calculated from the sum of 50% of the amount of the annual transfer from the expendable endowment to the unrestricted fund in the previous financial year adjusted for actual inflation for the year in question; plus 50% of the product of 4% times the average value of the expendable endowment over the previous three years.

During the year ended 31 March 2024, additional amounts totalling £6,119,000 were released from the endowment to support funding to Guy's and St Thomas' NHS Foundation Trust.

The Foundation aims to release approximately 4% of the value of the permanent endowments annually for charitable spending in accordance with their objects by way of transfers to appropriate restricted funds.

4. Grant income

4. Grant income
NHS Charities Together Greater London Authority National Lottery Wellcome Trust	Total 2024 Funds £’000 – 20 40 – 60	Total 2023 Funds £’000
		423
		–
		–
		189
		612

The Foundation was awarded a grant with a total value of £1,500,000 from Wellcome Trust prior to 1 April 2022, of which the conditions relating to £732,000 had been met up to 31 March 2024.

5. Income from donations, legacies and other

Donations and legacies Donations Legacies Other	Total 2024 Funds £’000 5,985 3,339 9,324 279 9,603	Total 2023 Funds £’000

		5,150
		3,707
		8,857
		264

		9,121

Contingent assets representing the net amount of pecuniary and residuary cases not included in legacy income as at 31 March 2024 were £3,199,000 (2023: £2,266,000).

103

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

6. Total expenditure

. Total expenditure
Direct expenditure Property investments Grants awarded Grants awarded Other direct Support costs Salary and other payroll Other support Depreciation Interest costs Private placement loan Other interest Change in fair value Grants creditors Direct expenditure Property investments Grants awarded Grants awarded Other direct Support costs Salary and other payroll Other support Depreciation Interest costs Private placement loan Other interest Change in fair value Grants creditors		2024
	Investments £’000	Fundraising £’000 Total raising funds £’000 Grants £’000 Other charitable activities £’000 Total charitable activities £’000 Total £’000
	5,848 1,149 – –	– 5,848 – – – 5,848 – 1,149 – – – 1,149 – – 28,101 – 28,101 28,101 6,163 6,163 – 9,552 9,552 15,715
	6,997	6,163 13,160 28,101 9,552 37,653 50,813
	2,793 914 43	1,689 4,482 6,403 2,176 8,579 13,061 575 1,489 3,564 1,211 4,775 6,264 26 69 99 33 132 201
	3,750	2,290 6,040 10,066 3,420 13,486 19,526
	2,238 3,724	– 2,238 – – – 2,238 – 3,724 – – – 3,724
	5,962	– 5,962 – – – 5,962
	–	– – (1,581) – (1,581) (1,581)
	16,709	8,453 25,162 36,586 12,972 49,558 74,720

		2023
	Investments £’000	Fundraising £’000 Total raising funds £’000 Grants £’000 Other charitable activities £’000 Total charitable activities £’000 Total £’000
	4,857 3,829 – –	– 4,857 – – – 4,857 – 3,829 – – – 3,829 – – 33,008 – 33,008 33,008 3,967 3,967 – 7,824 7,824 11,791
	8,686	3,967 12,653 33,008 7,824 40,832 53,485
	1,771 1,037 28	980 2,751 6,409 1,500 7,909 10,660 1,395 2,432 3,391 856 4,247 6,679 19 47 119 29 148 195
	2,836	2,394 5,230 9,919 2,385 12,304 17,534
	2,232 239	– 2,232 – – – 2,232 – 239 – – – 239
	2,471	– 2,471 – – – 2,471
	–	– – (937) – (937) (937)
	13,993	6,361 20,354 41,990 10,209 52,199 72,553

104

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

6. Total expenditure (cont.)

The Foundation's fundraising activities were contracted to King's College London during the years ended 31 March 2024 and 2023. Subsequent to the year end, on 31 July 2024, the contract was ended by mutual agreement and with effect from 1 August 2024 all fundraising activities are undertaken directly by the Foundation.

Total expenditure includes governance costs of £239,398 (2023: £287,662). Governance costs include auditor's remuneration of £77,825 (2023: £74,921) in respect of the external audit of the statutory accounts.

Direct charitable expenditure

Direct charitable expenditure
By activity: five-year profile Impact on Urban Health programmes Charity for Guy’s and St Thomas’ NHS Foundation Trust Investing for health Health Innovation Fund By recipient: five-year profile Guy’s and St Thomas’ NHS Foundation Trust Other organisations	Total 2020 £’000 14,323 9,898 – 1,015	Total 2021 £’000 17,637 10,905 – 458	Total 2022 £’000 22,872 13,065 1,500 156	Total 2023 £’000 24,208 16,207 266 151	Total 2024 £’000 18,806 17,795 – 1,052	Total 2020-2024 £’000

						97,846
						67,870
						1,766
						2,832
	25,236	29,000	37,593	40,832	37,653	170,314
	10,243 14,993	10,488 18,512	11,179 26,414	16,059 24,773	16,059 21,594

						64,028
						106,286
	25,236	29,000	37,593	40,832	37,653	170,314

Amounts are shown net of write backs and other adjustments.

The Health Innovation Fund represents expenditure made in accordance with the Foundation's previous strategy.

105

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

7. Grants

7.1 Grants awarded and paid

Grants awarded are brought into account when a constructive obligation exists for the Trustees to make the grant. Amounts thus committed but not yet paid are included on the balance sheet as grant creditors. Grant creditors that are estimated as payable after more than one year are measured at the present value of the expected future payments discounted at a market rate of interest, with the change in the value of the discount being included in grant expenditure (see note 6).

are measured at the present value of the expected future payments discounted at a market rate of interest, with the the discount being included in grant expenditure (see note 6).	change in the	value of
Group and Company Committed but not yet paid at 31 March 2023 Awarded Payments Fair value adjustment Grant creditors at 31 March 2024 comprises due within one year due after one year	Total 2024 Funds £'000 56,877 28,101 (26,101) 58,877 (2,819) 56,058	Total 2023 Funds £'000

		50,591
		33,008
		(25,785)
		57,814
		(937)
		56,877

	33,965	42,359
	22,093	14,518
	56,058	56,877

There were £85,000 grant creditors due more than 5 years after the balance sheet date at 31 March 2024 (2023: £nil).

106

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

7. Grants (cont.)

7.2 Grants awarded by recipient

7.2 Grants awarded by recipient
Guy’s and St Thomas’ NHS Foundation Trust Other organisations with total grants awarded greater than £250,000: Black Thrive Global Partisan Community CIC Walcot Foundation School Food Matters Shift Foundation Alexandra Rose Charity King's College London Kineara CIC Breathe Arts Health Research Purpose Europe Limited The Ubele Initiative Lambeth Council BBC Children in Need Chefs in Schools Black Thrive Lambeth Asthma and Lung UK Healing Justice London PACT Group Money and Mental Health Policy Institute Motherhood Group Parent Skills 2Go CIC Justice for Tenants Do It Now Now Oval Learning Cambridge House Southwark Council Centric Lab Food Foundation strategic partnership Marks Out Of Tenancy Sustain: The Alliance For Better Food & Farming Community Southwark Stonehaven Rooted Innovation Limited Other organisations Total grants awarded	2	024 Awarded Total £’000 15,639 3,000 1,128 1,025 911 779 650 554 483 329 300 268 250 250 – – – – – – – – – – – – – – – – – – – – 9,926 2,536 28,101	2	023
	Number 46 1 3 2 2 2 1 3 2 2 1 2 1 1 – – – – – – – – – – – – – – – – – – – – 23 61 130		Number 72 1 – – 1 – – 1 – 2 – – – – 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 1 1 1 2 26 49 147	Awarded Total £’000
				13,876

				794
				–
				–
				338
				–
				–
				344
				–
				383
				–
				–
				–
				–
				1,337
				794
				654
				647
				596
				590
				535
				489
				455
				440
				437
				370
				325
				300
				300
				297
				275
				254
				250
				250
				11,454
				7,678
				33,008

107

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

8. Staff costs

Analysis of total staff costs

==> picture [511 x 71] intentionally omitted <==

----- Start of picture text -----
2024 2023
£’000 £’000
Salaries and wages 10,749 8,810
Social security costs 1,153 908
Other pension costs 1,160 942
13,062 10,660
----- End of picture text -----

During the year, non-contractual payments of £59,000 (of which ex-gratia payments £8,000) were made to former employees, following the cessation of their employment, within the terms of standard settlement agreements. The Foundation's accounting policy is to recognise these liabilities when the settlement is agreed and there were no unpaid liabilities at the balance sheet date.

Number of employees

Pension creditor

==> picture [510 x 42] intentionally omitted <==

----- Start of picture text -----
2024 2023 2024 2023
Number Number £’000 £’000
Average monthly number of employees
in the year 147 126 Pension contributions due but not yet paid 148 120
----- End of picture text -----

Key management personnel

The total employment costs of key management personnel, who are the eleven members of the Foundation's Executive Team, during the year were £1,828,000 (2023: £1,360,000), of which £1,508,000 (2023: £1,088,000) was salaries, £187,000 (2023: £143,000) employer's National Insurance contributions and £133,000 (2023: £129,000) pension contributions.

Remuneration of higher paid employees

The following number of senior employees received salaries falling within the following ranges:

£60,001 to £70,000 £70,001 to £80,000 £80,001 to £90,000 £90,001 to £100,000 £100,001 to £110,000 £110,001 to £120,000 £120,001 to £130,000 £130,001 to £140,000 £140,001 to £150,000 £210,001 to £220,000 £230,001 to £240,000 £250,001 to £260,000 £350,001 to £350,000 £440,001 to £450,000	2024 Number 32 6 11 4 3 1 – 4 2 1 – – 1 1	2023 Number
		15
		7
		10
		3
		1
		1
		1
		1
		1
		–
		1
		1
		1
		–

No senior employee received any taxable benefits in kind in addition to their salaries as shown above.

Pension contributions for higher paid employees

The following pension contributions were made for senior employees:

==> picture [251 x 62] intentionally omitted <==

----- Start of picture text -----
Total
value of
contribution Number
£’000 of staff
Defined benefit schemes 79 6
Defined contribution schemes 574 60
----- End of picture text -----

108

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

9. Tangible fixed assets

9. Tangible fixed assets
Group and Company Cost or valuation Balance at 31 March 2023 Additions Revaluation Balance at 31 March 2024 Depreciation Balance at 31 March 2023 Charge for the year Balance at 31 March 2024 Net book value at 31 March 2024 Net book value at 31 March 2023 Original cost at 31 March 2024 Original cost at 31 March 2023	Art Collection £’000 3,615 36 303 3,954 – – – 3,954 3,615 4,821 4,785	Leasehold Improvements £’000 1,665 – – 1,665 287 169 456 1,209 1,378 1,665 1,665	Fixtures, Fittings and Equipment £’000 92 10 – 102 45 32 77 25 47 102 92	Total £’000


				5,372
				46
				303
				5,721

				332
				201
				533
				5,188
				5,040

				6,588
				6,542

109

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

10. Fixed and current asset investments (cont.)

10.1 Investments

Market Value 31 March 2023 £’000 Group Financial investments Global equity 240,508 Private equity 195,710 Absolute return 66,339 Hedged equity 56,340 Credit 37,549 Fixed income 22,285 Property funds 7,851 Multi-asset class 5,219 Forward FX contracts 883 Futures 1,234 Programme related investments 7,010 640,928 Property investments 418,601 1,059,529 Of which: Fixed assets 1,041,762 Current assets 17,767 1,059,529 Total investments include: Programme related investments Financial investments 7,010 Property investments 16,788 23,798 Market value comprises investments held in: United Kingdom Overseas Listed Unlisted of which historic cost Net gains/(losses) on revaluation and disposal of investments Realised and unrealised gains Programme related investment write downs transferred to charitable expenditure Other losses	Disposal Proceeds £’000 (131,869) (20,582) (5,409) (6,330) (12,423) - (200) (308) (3,194) (1,270) (4) (181,589) (18,343) (199,932) (182,165) (17,767) (199,932) (4) – (4)	Acquisitions at Cost £’000 95,490 32,710 – – 1,863 – 772 – – – 823 131,658 246 131,904 131,904 - 131,904 823 – 823	Net Gains (Losses) on Revaluation and Disposal £’000 43,145 1,949 5,441 6,591 1,254 696 416 709 2,357 387 (2,497) 60,448 (75,995) (15,547) (15,547) - (15,547) (2,497) 4,882 2,385 31 March 2023 £’000 487,027 572,502 1,059,529 204,470 855,059 1,059,529 593,234 31 March 2023 £’000 13,408 - (1,259) 12,149	Market Value 31 March 2024 £’000


				247,274
				209,787
				66,371
				56,601
				28,243
				22,981
				8,839
				5,620
				46
				351
				5,332
				651,445
				324,509
				975,954


				975,954
				-
				975,954



				5,332
				21,670
				27,002

				31 March 2024 £’000

				429,867
				546,087
				975,954

				199,740
				776,214
				975,954

				610,733

				31 March 2024 £’000

				(15,547)
				1,052
				(422)
				(14,917)

110

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

10. Fixed and current asset investments (cont.)

10.1 Investments

10.1 Investments
Company Financial investments Global equity Private equity Absolute return Hedged equity Credit Fixed income Property funds Multi-asset class Forward FX contracts Futures Programme related investments Property investments Total investments include: Programme related investments Financial investments Property investments Market value comprises investments held in: United Kingdom Overseas Listed Unlisted of which historic cost	Market Value 31 March 2023 £’000 240,508 195,710 66,339 56,340 37,549 22,285 7,851 5,219 883 1,234 5,578 639,496 405,827 1,045,323 5,578 16,788 22,366	Disposal Proceeds £’000 (131,869) (20,582) (5,409) (6,330) (12,423) - (200) (308) (1,270) (3,194) - (181,585) (576) (182,161) – – –	Acquisitions at Cost £’000 95,490 32,711 - - 1,863 - 772 - - - 823 131,659 - 131,659 823 – 823	Net Gains (Losses) on Revaluation and Disposal £’000 43,146 1,948 5,441 6,591 1,254 696 417 709 387 2,356 (1,086) 61,859 (79,924) (18,065) (1,086) 4,882 3,796 31 March 2023 £’000 472,821 572,502 1,045,323 204,470 840,853 1,045,323 588,650	Market Value 31 March 2024 £’000


					247,275
					209,787
					66,371
					56,601
					28,243
					22,981
					8,840
					5,620
					-
					396
					5,315
					651,429
					325,327
					976,756



					5,315
					21,670
					26,985

					31 March 2024 £’000

					430,669
					546,087
					976,756

					199,740
					777,015
					976,755

					610,705

Investments classified as current assets represented property owned by a subsidiary company which was sold to a third party on 25 May 2023. It is therefore included at 31 March 2023 at the net sales value after deducting promoter's commission, the cost of purchase of a third party's equitable interest in the property, and sales commission. This was recognised in the Statement of Financial Activities for the year ended 31 March 2023.

The Foundation has entered into commitments to invest in private equity, private debt and other funds. At 31 March 2024, outstanding commitments totalled £163,153,000 (2023: £109,081,000).

Programme related investments are investments made directly in pursuit of the Foundation's charitable purposes. The financial investments include unlisted equity, quasi-equity revenue participation and other investments.

111

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

10. Fixed and current asset investments (cont.)

10.2. Subsidiary undertakings

The Foundation owns 100% of the following subsidiary undertakings.

GSTC Property Investments Limited (registered in England and Wales number 7369879). The principal activity of this company is investment in land and buildings with long-term development potential. The company made a loss of £9,136,820 for the year ended 31 March 2024 and its net assets at that date amounted to £26,356,643. Its accounts have been consolidated into the Group accounts. The Foundation's investment in this subsidiary undertaking has been valued at the net asset value and is included in property investments in the Foundation's accounts.

GSTC Health Innovations Limited (registered in England and Wales number 6852696). The principal activities of this company are investment in healthcare technology innovations arising out of King's Health Partners (and the wider entrepreneurial community in Lambeth and Southwark) and commercialisation of these innovations. The company made a loss of £1,431,279 for the year ended 31 March 2024 and its net assets at that date amounted to £1,708,320. Its accounts have been consolidated into the Group accounts. On this basis the cost of the share capital invested is an appropriate measurement of the company's value in the Foundation's accounts.

GSTC Property Developments Ltd (registered in England and Wales number 6861110). The principal activity of the company is to undertake commercial and trading activities for the benefit of Guy's and St Thomas' Foundation or any linked charity of which the Foundation is trustee. The company made a profit of £549,502 for the year ended 31 March 2024. Its net assets at that date were £8,137. The company ceased all commercial and trading activities in March 2024 and it is not expected that any further such activities will be undertaken in the foreseeable future. The Foundation's investment in this subsidiary undertaking has therefore been valued at the original cost of the share capital purchased of £1.

112

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

11. Debtors

11. Debtors
Group Prepayments Accrued income Due from sale of investments Charitable loans Other debtors Company Prepayments Accrued income Amount due from subsidiary undertakings Due from sale of investments Charitable loans Other debtors	2024 Due within one year £’000 Due after one year £’000 Total Funds £’000 937 – 937 1,422 – 1,422 22,062 125 22,187 - 571 571 3,508 – 3,508 27,929 696 28,625 937 – 937 1,457 – 1,457 4,240 125 4,365 694 – 694 - 571 571 3,750 – 3,750 11,078 696 11,774	2023
		Due within one year £’000 Due within one year £’000 Total Funds £’000
		948 – 948 959 – 959 20,558 – 20,558 – 979 979 4,706 – 4,706
		27,171 979 28,150
		948 – 948 1,001 – 1,001 307 4,287 4,594 23 – 23 – 979 979 11,148 – 11,148
		13,427 5,266 18,693

The loans to subsidiary undertakings comprise the following:

(i) A loan of £1,448,000 to GSTC Property Investments Ltd, drawn down under a facility of £9,000,000 secured by a fixed and floating charge over the assets of that company, bearing interest at a rate of 4.5% per annum, and repayable no later than 9 December 2034 or earlier at the option of that company.

(ii) A loan of £2,805,000 to GSTC Property Investments Ltd drawn down under a facility of £30,000,000 secured by a fixed and floating charge over the assets of that company, bearing interest at a rate of 2.75% per annum, and repayable no later than 11 February 2026 or earlier at the option of that company.

12. Inter-fund loan

Within the unrestricted fund, the Foundation's policy is to closely match the total of grant liabilities and the balance on the distribution account with cash or cash equivalents. In order to enable the unrestricted fund to obtain a better return on this cash than would be available in the money market without incurring additional market risk, on 9 April 2013 the unrestricted fund lent £50,000,000 to the endowment fund for an initial term of 5 years, which was subsequently renewed. With effect from 9 April 2023 the facility was further renewed for an additional 5 years with an upper loan limit of £65,000,000 and extended to allow the restricted fund to also participate in the lending. Repayments of any amount can be requested by the unrestricted fund, the restricted fund or the endowment fund at any time. The lending funds receive interest on their loans at a rate of 12 month sterling SONIA (LIBOR prior to January 2022) + 0.8% fixed annually on the anniversary of the commencement of the loan which is paid by transfers from the endowment fund to the lending funds.

113

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

13. Other Creditors

Group Purchase creditors Accruals Deferred investment property income Tax and social security Pension creditors Other creditors Company Purchase creditors Accruals Deferred investment property income Amount due to subsidiary undertakings Tax and social security Pension creditors Other creditors	2024 Due within one year £’000 Due after one year £’000 Total Funds £’000 8,368 – 8,368 3,845 – 3,845 2,333 – 2,333 688 – 688 148 – 148 9,112 12,619 21,731 24,494 12,619 37,113 5,483 – 5,483 3,826 – 3,826 2,327 – 2,327 18 – 18 589 – 589 148 – 148 6,348 186 6,534 18,739 186 18,925	2023
		Due within one year £’000 Due within one year £’000 Total Funds £’000
		3,305 – 3,305 6,183 – 6,183 1,823 – 1,823 539 – 539 120 – 120 20,462 4,158 24,620
		32,432 4,158 36,590
		3,297 – 3,297 5,605 – 5,605 1,817 – 1,817 – – – 539 – 539 120 – 120 6,897 276 7,173
		18,275 276 18,551

Deferred investment property income represents rent received in advance of the period to which it relates and generally arises where, under the terms of a property lease, rent is due to be paid in advance at the commencement of a quarterly or half-yearly rental period. For the years ended 31 March 2024 and 2023, no income was deferred for more than six months and all amounts included in deferred income at the end of each year were released to the Statement of Financial Activities during the subsequent year.

14. Private placement loan

The private placement loan is a £60,000,000 loan advanced to the Foundation by way of a senior loan note issued on 21 December 2015. The loan bears interest at a fixed rate of 3.72% per annum and is repayable on 21 December 2045 unless previously repaid.

114

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

15. Unrestricted funds

15. Unrestricted funds
Group Programme-related investment funds Charitable property fund Health innovations investments fund Art collection fund Other tangible fixed assets fund Distribution account Company Programme-related investment funds Charitable property fund Health innovations investments fund Art collection fund Tangible fixed assets fund Distribution account Group Programme-related investment funds Charitable property fund Health innovations investments fund Art collection fund Other tangible fixed assets fund Distribution account Company Programme-related investment funds Charitable property fund Health innovations investments fund Art collection fund Other tangible fixed assets fund Distribution account	Balance 1 April 2023 £’000 16,788 7,010 23,798 3,615 1,425 15,150 43,988 16,788 5,227 22,015 3,615 1,425 15,291 42,346 Balance 31 March 2022 £’000 19,868 7,320 27,188 3,709 1,507 28,202 60,606 19,868 5,554 25,422 3,709 1,507 27,962 58,600	Income £’000 – – – – – 48,500 48,500 – – – – – 48,506 48,506 Income £’000 – – – – – 40,539 40,539 – – – – – 40,552 40,552	Expenditure £’000 – – – – – (43,690) (43,690) – – – – – (43,633) (43,633) Expenditure £’000 – – – – – (48,924) (48,924) – – – – – (48,752) (48,752)	Transfers £’000 – 775 775 36 (191) (8,266) (7,646) – 963 963 36 (191) (8,454) (7,646) Transfers £’000 – (4,390) (4,390) 5 (82) (342) (4,809) – – – 5 (82) (4,732) (4,809)	Gains and Losses £’000 4,882 (2,454) 2,428 303 - 1,033 3,764 4,882 (875) 4,007 303 – 822 5,132 Gains and Losses £’000 (3,080) 4,080 1,000 (99) – (4,325) (3,424) (3,080) (327) (3,407) (99) – 261 (3,245)	Balance 31 March 2024 £’000


						21,670
						5,331
						27,001
						3,954
						1,234
						12,727
						44,916



						21,670
						5,315
						26,985
						3,954
						1,234
						12,532
						44,705

						Balance 31 March 2023 £’000


						16,788
						7,010
						23,798
						3,615
						1,425
						15,150
						43,988


						16,788
						5,227
						22,015
						3,615
						1,425
						15,291
						42,346

The distribution account represents the free reserves of the Foundation. Other funds represent the net book value of fixed assets which are used in furtherance of the Foundation’s charitable objectives.

115

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

16. Restricted funds

Group and Company Evelina London Children's Charity funds Guy's Cancer Charity funds Other Restricted funds St Thomas' Lupus Trust Fund LFRUPA Nelson Piercy legacy Loach legacy Samaritan Fund St John's Hospital Sorab Lam Fund Next Generation Nightingale Fund Mark Ward Stroke Unit Hunt Legacy for Dialysis Machines Other funds Unapportioned costs Change in fair value - grants creditors Group and Company Evelina London Children's Charity funds Guy's Cancer Charity funds Other Restricted funds St Thomas' Lupus Trust Fund NHS Charities Long COVID grant LFRUPA Long COVID Research Samaritan Fund Next Generation Nightingale Fund Hunt Legacy for Dialysis Machines Sorab Lam Fund St John's Hospital Cardiac Intervention Research Fund Other funds Unapportioned costs	Balance 1 April 2023 £’000 6,497 3,189 923 277 – – 235 118 121 194 15 135 1,622 13,326 – – 13,326 Balance 1 April 2022 £’000 3,773 2,898 1,139 – 322 172 226 231 200 87 114 18 1,934 11,114 – 11,114	Income £’000 2,241 4,147 418 78 250 190 122 9 29 – 112 – 668 8,264 1,194 – 9,458 Income £’000 3,063 2,451 134 423 30 99 134 – – 34 – 100 898 7,366 – 7,366	Expenditure £’000 (3,840) (2,217) (64) 16 – – (222) 25 – (47) (5) (29) (388) (6,771) (8,717) 550 (14,938) Expenditure £’000 (552) (2,160) (350) – (75) – (125) (37) (65) – 4 (1) (1,062) (4,423) (5,540) (9,963)	Transfers £’000 (214) 295 – – – – (26) – – – – – 68 123 7,523 – 7,646 Transfers £’000 213 – – – – – – – – – – – (944) (731) 5,540 4,809	Balance 31 March 2024 £’000

					4,684
					5,414

					1,277
					371
					250
					190
					109
					152
					150
					147
					122
					106
					1,970
					14,942
					–
					550
					15,492

					Balance 31 March 2023 £’000

					6,497
					3,189

					923
					423
					277
					271
					235
					194
					135
					121
					118
					117
					826
					13,326
					–
					13,326

A full list of all financial transactions on restricted funds is available on request from the Foundation. There were no other gains or losses.

116

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Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

16. Restricted funds (cont.)

Details of material funds at 31 March 2024:

Name of fund	Description of the nature and purpose of each fund
The Evelina Children's	For the benefit of the health and wellbeing of children and families accessing children's services
Hospital Appeal	at the Guy's and St Thomas' NHS Foundation Trust.
Integrated Cancer Centre Fund	To support the new Integrated Cancer Centre.
St Thomas' Lupus Trust Fund	To support lupus research andpatient care.
LFRUPA	To benefit the Lane-Fox Respiratory Unit.
Nelson Piercy legacy	To support the TAVI team within the Cardiology department.
Loach legacy	Restricted legacy for vascular surgery/research
Samaritan Fund	To benefitpatients in need of financial and other assistance.
St John's Hospital	To benefit the St. John's Institute of Dermatology.
Sorab Lam Fund	To support a bursary for MBBS students in need
Next Generation Nightingale Fund	To support the Next Generation Nightingale Project.
Mark Ward Stroke Unit	To support Mark Ward
Hunt Legacy for Dialysis Machines	To support Hunt Legacy for Dialysis Machines.

17. Endowment funds

17. Endowment funds
Group Permanent endowments Guy’s and St Thomas’ Samaritan Fund The Leak Trust The Guy’s and St Thomas’ Patients Amenities Fund S J Lam Legacy Fund Dr Reginald Curle Trust Expendable endowment General fund Company Permanent endowments Guy’s and St Thomas’ Samaritan Fund The Leak Trust The Guy’s and St Thomas’ Patients Amenities Fund S J Lam Legacy Fund Dr Reginald Curle Trust Expendable endowment General fund	Balance at 31 March 2023 £’000 1,619 1,263 1,173 752 443 5,250 908,384 913,634 1,619 1,263 1,173 752 443 5,250 903,857 909,107	Income £’000 (65) (51) (47) (18) (30) (211) (23,565) (23,776) (65) (51) (47) (18) (30) (211) (14,734) (14,945)	Expenditure £’000 (12) (9) (9) (3) (5) (38) (16,053) (16,091) (12) (9) (9) (3) (5) (38) (16,438) (16,476)	Transfers £’000 – – – – – – – – – – – – – – – –	Gains and Losses £’000 219 171 158 61 100 709 (19,087) (18,378) 219 171 158 61 100 709 (23,013) (22,304)	Balance at 31 March 2024 £’000


						1,761
						1,374
						1,275
						792
						508
						5,710

						849,679
						855,389


						1,761
						1,374
						1,275
						792
						508
						5,710

						849,672
						855,382

117

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

17. Endowment funds (cont.)

Group Permanent endowments Guy’s and St Thomas’ Samaritan Fund The Leak Trust The Guy’s and St Thomas’ Patients Amenities Fund S J Lam Legacy Fund Dr Reginald Curle Trust Expendable endowment General fund Company Permanent endowments Guy’s and St Thomas’ Samaritan Fund The Leak Trust The Guy’s and St Thomas’ Patients Amenities Fund S J Lam Legacy Fund Dr Reginald Curle Trust Expendable endowment General fund	Balance 1 April 2022 £’000 1,804 1,407 1,306 838 494 5,849 924,754 930,603 1,804 1,407 1,306 838 494 5,849 924,769 930,618	Income £’000 (72) (56) (52) (33) (20) (233) (18,544) (18,777) (72) (56) (52) (33) (20) (233) (18,345) (18,578)	Expenditure £’000 (12) (9) (9) (6) (3) (39) (13,627) (13,666) (12) (9) (9) (6) (3) (39) (12,997) (13,036)	Transfers £’000 – – – – – – – – – – – – – – – –	Gains and Losses £’000 (101) (79) (72) (47) (28) (327) 15,801 15,474 (101) (79) (72) (47) (28) (327) 10,430 10,103	Balance 31 March 2023 £’000


						1,619
						1,263
						1,173
						752
						443
						5,250

						908,384
						913,634


						1,619
						1,263
						1,173
						752
						443
						5,250

						903,857
						909,107

In October 2014 the Trustees resolved (i) to adopt a total return approach to investment to the five permanent endowment funds shown above pursuant to the power contained in the Charities Act 2011, and (ii) that the provisions in the Charities (Total Return) Regulations 2013 would regulate the Trustees’ use of the total return approach on an ongoing basis. The Foundation received advice from its legal advisors Withers LLP with regard to the use of the power. Consequently, effective from 1 January 2015, these funds are invested to maximise total return and the Foundation aims to release 4% of their value annually for charitable spending in accordance with their objects by way of transfers of portions of the unapplied total return to income of appropriate restricted funds. Until the power to make transfers is exercised, the unapplied total return remains invested as part of the relevant permanent endowment.

The table below sets out the dates that the values of the initial endowments (or the valuations at the nearest dates for which the information is available) were established. The total value of the gift components was £2,329,000. The initial values of the unapplied total return (in practice, the capital profits arising from the investment of the endowments) were established as at 31 December 2015.

Guy’s and St Thomas’ Samaritan Fund	31 March 2004
The Leak Trust	31 March 1998
The Guy’s and St Thomas’ Patients Amenities Fund	31 March 2001
S J Lam Legacy Fund	31 March 2013
Dr Reginald Curle Trust	31 March 1998

118

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

17. Endowment funds (cont.)

The note below shows the opening unapplied total return and fund transfer in the year.

Permanent endowments – statement of total return

Permanent endowments – statement of total return
Group and Company At 1 April 2023 Gift components of the permanent endowments Unapplied total return Movements during the period Investment return Realised and unrealised losses Allocated to income during the period Net movements during the period At 31 March 2024 Gift components of the permanent endowments Unapplied total return Balance at 31 March 2024	Trust for investment £’000 2,329 – 2,329 – – – – 2,329 – 2,329	Unapplied total return £’000 – 2,921 2,921 709 709 (249) 460 – 3,381 3,381	Total endowments £’000

			2,329
			2,921
			5,250


			709
			709
			(249)
			460

			2,329
			3,381
			5,710

Details of material funds at 31 March 2024:

Name of fund	Description of the nature and purpose of each fund
Guy’s and St Thomas’	For the relief of patients and former patients of the hospitals operated by the Guy's and St Thomas' NHS Foundation
Samaritan Fund	Trust,preference being given to those in need of financial assistance.
The Leak Trust	For medical research.
Guy’s and St Thomas’ Patients	For the benefit of in or out patients who are or have been treated at hospitals operated by the Guy’s and St Thomas’
Amenities Fund	NHS Foundation Trust.
S J Lam Legacy Fund	Toprovide bursaries for medical students.
Dr Reginald Curle Trust	For providing extra comforts for the patients at hospitals operated by the Guy’s and St Thomas’ NHS Foundation Trust;
	and for theprovision of accommodation for the use of relations.
General Fund	No restrictions on expenditure of income. Capital may be expended at Trustees’ discretion.

18. Gross transfers between funds

Group and Company Restricted funds net support costs Other transfers	2024 Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000 (7,523) 7,523 – – (123) 123 – – (7,646) 7,646 – –	2023
		Unrestricted Funds £’000 Restricted Funds £’000 Endowment Funds £’000 Total Funds £’000
		(5,540) 5,540 – – 731 (731) – –
		(4,809) 4,809 – –

The transfer from unrestricted to restricted funds of £7,523,000 (2023: £5,540,000) represents the balance of the support costs incurred by the Foundation in administering the restricted funds after taking account of the interest income earned on restricted fund cash balances.

Other transfers comprise the transfer of £300,000 (2023: £nil) from unrestricted funds to support the activities of a restricted fund, partly offset by the transfer to unrestricted funds of £177,000 (2023: £731,000) restricted donations for which no appropriate special purpose fund currently exists to support unrestricted grants which have objects that are aligned to the original restriction.

119

Guy’s and St Thomas’ Foundation

Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

19. Trustee and connected person transactions

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----- Start of picture text -----
Trustee expenses reimbursed Trustees’ indemnity insurance
2024 2023 2024 2023
£ £ £’000 £’000
Travel and subsistence 0 0 Trustees’ and officers’ liability 40 29
2024 2023
Number Number
Number of Trustees receiving reimbursement 0 0
----- End of picture text -----

Trustees’ remuneration

No person received remuneration as a Trustee of Guy’s and St Thomas’ Foundation in either the current year or the previous year.

Transactions with Trustees or connected persons

During the year ended 31 March 2024 none of the Trustees, key members of the Foundation's management or parties related to them has undertaken any transactions with Guy's and St Thomas' Foundation, except for:

Dr. Danny Sriskandarajah , a Trustee, is the Chief Executive of the New Economics Foundation. During the year, Guy's and St Thomas' Foundation made a charitable contract totalling £93,000 to that organisation. The contract was awarded through the Foundation's normal charitable contract-making process, and Dr. Danny Sriskandarajah had no direct involvement.

Barbara Kasumu, a key member of the Foundation's management, is related to the director of Inclusive Boards Ltd. During the year, Guy's and St Thomas' Foundation contracted with that company for the provision of the service for the value of £77,000. These contracts were concluded on an arm's length basis, and Barbara Kasumu had no direct involvement in the procurement.

Number of Trustees

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----- Start of picture text -----
2024 2023
Number Number
Total number of Trustees 9 9
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19.1. Other related parties

The Foundation owns 100% of the share capital of the following subsidiary companies, in which it had the following transactions:

GSTC Property Investments Ltd

The Foundation was owed £4,253,000 at 31 March 2024 (2023: £4,253,000), repayable as detailed in note 11. The Foundation earned interest and service charge of £178,000 for the year end 31 March 2024 (2023: £246,000). The Foundation received £8,972,000 donation during the year ended 31 March 2024 (2023: £nil).

GSTC Health Innovations Ltd

The Foundation was owed £861 at 31 March 2024 (2023: £12,000), repayable on demand.

The Foundation earned service charge of £9,000 for the year end 31 March 2024 (2022: £12,000). The Foundation received £nil donation during the year ended 31 March 2024 (2023: £nil).

GSTC Property Developments Ltd

The Foundation was owed £nil at 31 March 2024 (2023: £296,000).

The Foundation earned interest and service charge of £11,000 for the year end 31 March 2024 (2023: £20,000). The Foundation received £nil donation during the year ended 31 March 2024 (2023: £nil).

20. Capital commitments

There was no capital expenditure contracted or provided for at 31 March 2024 (2023: £nil).

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Company number: 9341980

Registered Charity number: 1160316

Annual report and accounts 2023/24

Notes to the financial statements

21. Operating leases

21.1 Operating lease income

The Foundation generates income from leasing out space within its investment properties. The future minimum lease payments receivable under non-cancellable operating leases are

21.2 Operating lease commitments

The Foundation leases office space. The total future minimum lease payments under non-cancellable operating leases are:

Group and Company Within one year After one year but within five years After five years	2024 £’000 9,065 19,796 196,504 225,365	2023 £’000 9,050 23,863 196,054 228,967 Group and Company Within one year After one year but within five years After five years	2024 £’000 896 3,586 2,054 6,536	2023 £’000

				896
				3,586
				2,951
				7,433

22. Contingent liabilities

As described in note 7, grants awarded are brought into account when a constructive obligation exists for the Trustees to make the grant. The majority of grants are made without substantive conditions and so are recognised in their entirety even if the term of the grant extends for more than one year. However, a minority of grants are subject to substantive conditions which are within the Foundation’s control such that the Foundation retains the discretion not to make future payments. As a constructive obligation for these payments does not exist, their value is not recognised as a liability in the balance sheet. The total value of these conditional payments at 31 March 2024 was £1,133,000 (2023: £2,454,000).

Expenditure on charitable activity funded by contracted agreements is recognised on accruals basis in accordance with an estimate of the amount of work performed under the terms of the contract during the reporting period. As there is no constructive obligation for the balance of the amounts contracted for, their value is not recognised as a liability in the balance sheet. The total value of these amounts contracted for but not recognised at 31 March 2024 was £4,382,000 (2023: £8,084,000).

The Foundation recovers part of the VAT incurred on investment advisory costs in accordance with its longstanding interpretation of applicable VAT legislation. A recent court decision involving an unrelated third party has created some uncertainty regarding this interpretation. Although the Foundation remains confident that the court’s decision does not apply to the Foundation’s circumstances, it is possible although not probable that a further determination may result in the Foundation being required to repay any VAT recovered on this basis over the preceding four years. As at 31 March 2024 the total amount of VAT that would be repayable was £164,000 (2023: £106,000).

23. Company limited by guarantee

The Foundation is a company limited by guarantee of members and does not have a share capital. The liability of members is limited to £1.

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Financial review Appendix

122

Annual report and accounts 2023124 123

Guy’s and St Thomas’ Foundation

Appendix: Energy usage

This appendix relates to the section on our commitment to the environment on page 80. It provides an overview of the methodology used to report on our impact in line with Streamlined Energy and Carbon Reporting (SECR) guidance, as well as charts and tables displaying our Energy usage.

Reporting methodology

The Foundation is committed to complying with all environmental legislation. The Foundation has met SECR requirements by disclosing purchased electricity, natural gas and fuels used in personal/hire cars for business use. This includes fuel for which the organisation reimburses its employees following claims for business mileage. The Foundation also provided data on the use of refrigerants where this is in its operational control.

In accordance with SECR guidance, which states that “the party responsible for the consumption of Energy should take responsibility for reporting of it under this legislation”, all direct tenant consumption was excluded from this report.

Below is a detailed description of how data was collated:

Electricity: Data was obtained from manual meter readings and invoices. This year, more invoice data was received for Car Park C & Arches, so estimations were required for only two months. Consumption in common areas of 92-95 Snowsfields was estimated in the same way as for 2022/23, using the actual data provided in 2021/22.
Natural gas: Data was obtained from manual meter readings. This year, consumption during the 18 days in June that Francis House remained in the Foundation’s operational control was estimated.
Fuels:
Company vehicles: The Foundation does not have any company vehicles.
Business travel: The Foundation used the total expensed mileage for employee vehicles, along with records of flights, train, taxi, bus and hotel stays.
Refrigerants: The Foundation provided the details of the refrigerants used and losses were estimated.

Data analysis

The Foundation used the following data analysis techniques:

Analysis of monthly consumption trends and year-on-year variances.
Comparison of consumption between data sources.
Investigation of anomalies to identify root cause.
Communication with client and property managers to contextualise observed data trends.

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Annual report and accounts 2023/24

Greenhouse gas emissions

The Foundation adopted an operational control approach and calculated the Scope 1 and 2 greenhouse gas (GHG) emissions. Partial Scope 3 GHG emissions are also included in this year’s reporting, in line with the increased scope in last year’s reporting to include business travel by flights, train, taxi and bus, and hotel stays. The Foundation has calculated emissions from the following Energy sources:

Scope 1: natural gas and refrigerants.
Scope 2: purchased electricity.
Scope 3: business travel (employee vehicles, flights, train, taxi, bus and hotel stays).

The methodology used to calculate emissions followed the guidance from the revised edition of the GHG Protocol Corporate Accounting and the Reporting Standard, the GHG Protocol Scope 2 Guidance, the GHG Protocol Scope 3 guidance, and the UK Government Guidance on SECR. All scopes of GHG emissions were calculated using each period’s conversion factors from the Department for Energy Security and Net Zero (DESNZ; formerly BEIS) and the Department for Environment, Food and Rural Affairs (DEFRA) UK Government Conversion Factors for GHG reporting.

The Foundation reports Scope 2 GHG emissions using location-based and market-based emissions factors. Location-based emissions reflect the average emissions intensity of grids on which energy consumption occurs. Scope 2 market-based GHG emissions were calculated using a zero-emissions factor for the Renewable Energy Guarantees of Origin (REGO) backed electricity supplies, which applied to electricity purchased from 1 April 2023 to 31 March 2024. There was no on-site renewable energy generation to account for in the period covered in this report. AIB European Residual Mixes factors were used for the remaining Scope 2 market-based emissions in 2019. GHG emissions were calculated for all types of business travel provided, not only expensed mileage.

The Foundation applied a standardised intensity ratio to allow easier comparison between yearly results, expressed as kgCO2e emissions per net lettable floor area (sq. ft).

Energy and GHG emissions

The Foundation’s Energy consumption within the SECR boundaries is detailed in Table 1 and Graph 1. The total Energy consumption in 2023/24 was 1,331,617 kWh , which was 16% lower compared to the 2021/22 baseline and 17% lower compared to 2022/23.

In comparison to 2022/23, a 7% decrease was observed in natural gas consumption during the reporting period, although a 5% increase was observed compared to baseline. In 2023/24, electricity consumption decreased by 31% compared to 2022/23 and 38% compared to baseline.

125

Guy’s and St Thomas’ Foundation

Appendix: Energy usage

As illustrated in Graph 2 , natural gas remains the largest source of Energy consumption for the Foundation, accounting for 64% of total consumption during the last year, while electricity represents the remaining 33% . Orchard Lisle and Iris Brook Houses have 88 gas boilers which contribute to the high proportion of natural gas emissions.

No refrigerant top-up or replacement was reported this year, although the Foundation replaced 1.52 kg in 2023/24.

As shown in Table 2 , in 2023/24 the Foundation’s total GHG emissions, including partial Scope 3 emissions, accounted for 275 tCO2e (location-based) and 190 tCO2e (market-based). Year-on-year, Scope 1 emissions decreased by 7% , but increased by 5% compared to baseline.

Scope 2 emissions (location-based) showed a decrease of 27% year-on-year, and a decrease of 37% compared to baseline. Scope 2 market-based emissions were reported for the second time in 2023/24 and reduced by 72% year-on-year, which reflected the impact of certified renewable Energy contract purchases.

Scope 3 emissions (business travel) totalled 23 tCO2e in 2023/24, reflecting an increase of 96% year-on-year, due to increased travel by rail, air and bus, and hotel stays. The significant increase compared to baseline year, reported at 0 tCO2e, is due to the expansion of the reporting scope for business travel, which previously only included personal car usage.

The intensity metric in Table 3 allows for a standardised comparison of Energy efficiency performance over time. The kgCO2e emissions per net lettable floor area (location-based) have decreased by 13% in comparison to 2022/23 and 10% compared to the baseline. The key drivers of these reductions are:

Change in operational control from landlord to tenant at one commercial property and exclusion from the report from 19 June 2023 onwards, resulting in reduced total GHG emissions.
Monitoring and intervention on unauthorised appliance use in student accommodation.

The kgCO2e emissions per net lettable floor area (market-based) have decreased by 17% in comparison to 2022/23 and were not previously reported in baseline year. The key drivers of this reduction are:

Renewable backed electricity purchased for four residential properties and one commercial property contributing to a decrease in market-based GHG emissions.
The emissions factor for UK electricity (location-based) and gas increased in 2023 compared to 2022 but decreased compared to 2021.

After a review of the approach to scoping boundaries and intensity calculations, one property was excluded, and the intensity metric was calculated on landlord floorspace only. The previous year's calculations were amended to reflect this.

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Annual report and accounts 2023/24

Table 1: Energy consumption (kWh)

Energy Source	FY 2021/22	FY 2022/23	FY 2023/24	% Change (23/24 vs 22/23)	% Change (23/24 vs 21/22)
Natural Gas	809,945	916,021	852,651	-7%	5%
Electricity	767,464	694,311	478,964	-31%	-38%
Business Travel - Cars	242	439	2	-100%	-99%
Total	1,577,651	1,610,771	1,331,617	-17%	-16%

Graph 1: Year-on-year comparison of Energy consumption (kWh)

1,000,000 900,000 800,000 700,000 600,000 50,0000 400,000 300,000 200,000 100,000 0

==> picture [186 x 271] intentionally omitted <==

==> picture [186 x 230] intentionally omitted <==

Natural gas

Electricity

FY 2021/22

FY 2022/23 FY 2023/24

127

Guy’s and St Thomas’ Foundation

Appendix: Energy usage

Graph 2: Energy breakdown by Energy source (%)

Electricity Natural Gas

Energy consumption FY2023/24

==> picture [328 x 114] intentionally omitted <==

----- Start of picture text -----
64%
----- End of picture text -----

==> picture [76 x 29] intentionally omitted <==

----- Start of picture text -----
33%
----- End of picture text -----

Table 2: GHG emissions (tCO2e)

==> picture [509 x 37] intentionally omitted <==

----- Start of picture text -----
% Change % Change
(23/24 vs (23/24 vs
Scope FY 2021/22 FY 2022/23 FY 2023/24 22/23) 21/22)
----- End of picture text -----

Scope 1	148	167	156	-7%	5%
Scope 2 (location-based)	158	137	99	-27%	-37%
Scope 2 (market-based)	Not reported	50	14	-72%	–
Scope 3 (business travel)	0	12	23	96%	–
Total (location-based)	306	316	275	-13%	-10%
Total (market-based)	Not reported	229	190	-17%	–

Table 3: Intensity metric (kgCO2e/sq.ft)

Scope	FY 2021/22	FY 2022/23	FY 2023/24	% Change (23/24 vs 22/23)	% Change (23/24 vs 21/22)
Scope 1	1.2	1.3	1.2	-7%	5%
Scope 2 (location-based)	1.2	1.1	0.8	-27%	-37%
Scope 2 (market-based)	Not reported	0.4	0.1	-72%	–
Scope 3 (business travel)	0	0.1	0.2	96%	–
Total (location-based)	2.4	2.5	2.2	-13%	-10%
Total (market-based)	Not reported	1.8	1.5	-17%	–

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Annual report and accounts 2023/24

Energy usage

We have further developed a draft Environmental, Social and Governance (ESG) strategy for our property portfolio. This will support the achievement of our objectives, with key performance indicators and case studies where applicable, tracked within our sustainability accounts.

Energy efficiency actions

In line with our commitment to put sustainability at the heart of our operations, the Foundation has implemented several initiatives in 2023/24 to improve Energy efficiency and reduce the associated GHG emissions.

Initiatives across multiple assets included:

Metering feasibility and data rationalisation study completed across Scope 1 & 2 sites, resulting in industry flow updates to change Meter Serial Numbers (MSNs) on the central electricity database.
Implementation of minimum sustainable refurbishment standards.

Orchard Lisle House and Iris Brook House

Installation of 83 electricity meters completed.
Onboarding of the 83 new meters onto Save Energy Online (SEO) platform completed for monitoring.
All heating turned off in empty rooms as soon as the student checks out.
Monthly invoice monitoring and investigation of consumption spikes.
Boiler temperature reduced to the minimum legal level.
Regular unauthorised appliance checks for safety and Energy consumption.
For Iris Brook House, new double-glazed windows were installed to replace the poorly insulated and aged timber single-glazed windows. This has reduced heating emissions due to increased thermal efficiency.

Residential block management

Heating and ventilation system upgrades completed on an ad-hoc basis for vacant units.

129

Guy’s and St Thomas’ Foundation

The Grain House 46 Loman Street London SE1 0EH

gsttfoundation.org.uk @GSTTFoundation

Registered Charity No. 1160316. Company limited by guarantee. Registered in England and Wales No. 9341980.

Investing in a healthier society

2024-03-31-accounts

> Investing in a healthier society

that helps everyone stay healthier for longer.

Our Mission

Our Mission

Our Mission

Contents

14 Overview

Message from our Chair

Message from our Chief Executive

Company information

Our people and culture

A healthier future for all

Message from our Chair

Message from our Chief Executive

A healthier future for all

Achievements and performance

Summary of achievements

We generated total income of £9.3m through fundraising for our three NHS charities this year.

We distributed £18.8m through Impact on Urban Health – the brand for our programmatic work tackling urban health issues – to work with our partners in Lambeth, Southwark and beyond.

We have made significant progress towards our goal of aligning our endowment with our values and our mission.

We have invested further in the people, systems and processes needed to achieve our mission.

£9.3m

£18.8m

Our future plans

Our ambitious plan for the Foundation

This is why our mission to build the foundations of a healthier society requires a diversity of approaches and perspectives, summarised below and set out in more detail in the following pages:

Impact on Urban Health

We take a portfolio approach to achieving impact

Our routes to impact

Impact on Urban Health

Health effects of air pollution programme

Children’s mental health programme

Impact on Urban Health

Multiple long-term conditions programme

Children’s health and food programme

Impact on Urban Health

Innovation

Our three NHS charities

Collectively making change

For Guy's and St Thomas' Charity:

For Guy's Cancer Charity:

For Evelina London Children's Charity:

We also began work to deliver against priorities shared by all three charities. These are:

£9.3m

£17.8m

Our three NHS charities

Guy's & St Thomas' Charity

Through the generosity and commitment of our supporters, Guy’s & St Thomas’ Charity fundraised a total of £3.1m during 2023/24.

Our three NHS charities

Guy's Cancer Charity

Thanks to our supporters, during 2023/24 Guy’s Cancer Charity fundraised a total of £4.0m.

Highlights from our work this year include:

Our three NHS charities

Evelina London Children's Charity

Thanks to our ever-growing family of supporters, during 2023/24 Evelina London Children’s Charity fundraised a total of £2.2m.

Arts and heritage collection

Art collection

We continue to use our art collection to enhance the environment and improve health outcomes for patients and staff at Guy’s and St Thomas’ NHS Foundation Trust. More than 2,000 works of art are on display at the main hospital sites and across the Trust’s community sites in South London.

Heritage

This year we reached an important milestone in our work to respond to our history. In November 2023, we installed permanent historical interpretation panels alongside statues of Sir Robert Clayton and Thomas Guy at St Thomas’ and Guy’s hospitals respectively.

Our endowment

Our endowment

Mission-aligned investing

During 2023/24, we made significant progress in our journey to insource the management of our securities portfolio.

Investor engagement

Collaborative engagement

Climate

Diversity of fund managers

Using our assets to transform lives

Our endowment

The performance of our endowment was -2.0% return on gross investment assets over the financial year 2023/2024. The portfolio, excluding property, grew by 10.8% mostly driven by the liquid securities portfolio.

Endowment return over 1,3 and 5 years

Endowment performance vs CPI

Performance summary 1 April 2023 to 31 March 2024

Our property portfolio

350,000

Royal Street

We are working in partnership with Stanhope to progress a sustainable life science-based development at Royal Street in Waterloo.

Snowsfields Quarter