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2024-03-31-accounts

The Royal National Orthopaedic Hospital Charity

2023|24

Charitable Incorporated Organisation Charity Number: 1166129

Contents

Page 3 Reference and administratve details
Page 4 Welcome from the Chair and Chief Executve
Page 6 Our partner
Page 7 What we do
Page 20 Future plans
Page 23 Financial review
Page 26 Governance
Page 30 Statement of Trustees' responsibilites
Page 31 Independent Auditor's report to the Board of Trustees
Page 35 Statement of fnancial actvites
Page 36 Balance sheet
Page 37 Cash fow statement
Page 38 Notes to the fnancial statements

2

Reference and administrative details

Registered address:

Royal National Orthopaedic Hospital NHS Trust Brockley Hill Stanmore Middlesex HA7 4LP Tel: 020 8909 5362

Trustees:

Dorothy Dalton, Chair (to 4 July 2023) Richard Jones, Chair (from 5 July 2023)

Sarah Bedingfield Shutt

Kathryn Hardwidge

Robert Hurd

Anju Jaggi

Advisors:

Fund manager Cazenove Capital 1 London Wall Place London EC2Y 5AU

Bankers Barclays Bank PLC 1 Churchill Place London E14 5HP

Elizabeth Klein (to 4 September 2023)

Matthew Lee

Richard Linskell

John Magnier

Professor John Skinner (from 28 November 2023)

Hitesh Thakrar

Independent auditor Moore Kingston Smith LLP 9 Appold Street London EC2A 2AP

Solicitor Withers LLP 20 Old Bailey London EC4M 7AN

Key management personnel:

Rosie Stolarski, Chief Executive

Carol Corney-Brotherston, Head of Finance

June Heath, Head of Marketing and Communications (from January 2024)

Alice Smith, Head of Fundraising (from August 2023)

3

Welcome from the Chair and Chief Executive

RNOH Charity serves to strengthen and support the patients, staff, research and infrastructure that help place the Royal National Orthopaedic Hospital (RNOH) at the forefront of orthopaedic care and neuro-musculoskeletal medicine. Our mission is to help RNOH offer the best patient treatment, to enhance the hospital staff experience, contribute funding towards pioneering clinical research and elevate the hospital facilities beyond the limitations of an NHS budget.

Richard Jones Chair

Rosie Stolarski Chief Executive

Transformation through targeted investment

Through strategic funding initiatives, the Charity has become a catalyst for change within the hospital community, positively impacting patients and their families. By allocating resources to crucial projects and fostering inclusivity and support, the Charity helps to create a high-quality environment for patients and those who help them.

The collaborative partnership between the Charity and RNOH spans both the Stanmore and Bolsover Street sites, enabling the hospital's world-class teams of clinicians and researchers to access essential equipment, deliver comprehensive rehabilitation programmes and drive forward innovative research initiatives. Notably, RNOH has emerged not only as a centre of excellence for surgical procedures and rehabilitation but also as a global leader in translational research, forging partnerships with such esteemed institutions as University College Hospital London and the Royal Free Hospital.

This year, the Charity's investments have been key to enabling the acquisition of transformative equipment, as well as advancing cutting-edge research projects, and we are pleased to report the progression of fundraising for the key targets of the last 12 months.

One of the largest projects for our Charity this year has been a grant of more than £820,000 towards enhanced equipment in the new Centenary Theatres Block at Stanmore. The grant had incredible impact and, thanks to the funding of equipment by the Charity, the theatres budget could stretch further to include energy and cost-saving enhancements. Building on the ambitions of the previous year, we are pleased to report that fundraising for the refurbishment of the day-room at the Spinal Cord Injury Centre in Stanmore is almost complete.

The funding priority of a new high-rise scanner is still a focus for 2024|25, while the new ultrasound scanner

4

Welcome from the Chair and Chief Executive

for the Spinal Cord Injury Centre has been installed and the purchase of the new Lyra Gait Trainer is now fully funded.

With the spotlight on mental health having never been stronger, we were also delighted to have supported the CCOPER research to completion: the Collaborative Care in Orthopaedic Rehabilitation Project, to assess the potential for cross-departmental treatment models between musculoskeletal and mental health teams. In addition, the Charity directed funds towards ground-breaking projects examining the effect of exercise initiatives on joint and muscle conditions in those with and without prosthetic limbs, and research towards the advancement of 3D-printed patientspecific instruments for implant positioning.

Committed staff at RNOH are on the frontline, effecting profound changes in the lives of patients. The funds raised by the Charity serve as a lifeline, strengthening the essential services provided by the hospital and offering invaluable support to both patients and staff alike.

Improving the patient and staff experience of RNOH is one of the Charity’s main aims. The Charity continued to fund the role of the Staff Wellbeing Lead to December 2023, with the crucial part it plays in both the mental healthcare and comfort of staff on and off-duty. Similarly, the Volunteer Service continues to thrive, supporting the hospital across the site. Volunteers help ward and administration teams, provide the patient trolley service, organise visiting rounds from the Service’s dedicated Pets as Therapy dogs, brighten wards with seasonal celebrations, operate the patient buggy transport service and arrange the walking aid recycling project.

Planning ahead

The progression of robust Charity infrastructure continued throughout the year. We will maintain focus on the development and scaling up of capabilities so that our ambitious long-term targets, including raising sustainable unrestricted income, remain aligned with the Trust's vision for the future; together transforming lives through pioneering treatment and research.

at the Charity and we have already seen an uplift in fundraising and communications strategy and action.

We are pleased to share news that our Impossible Possible campaign will continue as a fundraising brand of the Charity to foster unrestricted giving activity. The campaign raises awareness of our mission and highlights how RNOH helps transform patients’ lives when they face complex orthopaedic conditions but how extra investment is required in order for RNOH to remain extraordinary.

Our sincere thanks

We are immensely grateful for the continuing support of HRH Princess Eugenie as our Royal Patron. Her championing of our cause inspires so many others to support the Charity.

We extend our sincere thanks to the staff and Trustees of the Charity, whose tireless efforts and unwavering commitment propel our organisation forward.

In addition, we express heartfelt gratitude to every member of the RNOH team, including the dedicated NHS professionals who are the driving force behind every patient success story, medical innovation and painstaking procedure.

Our utmost appreciation must of course go to our steadfast supporters, whose determination and boundless generosity have a tremendously positive impact on patient outcomes at RNOH. Their commitment serves as an inspiration to us all.

With the invaluable help of everyone connected to the Charity, we eagerly anticipate the opportunity to raise more funds, undertake exciting projects and explore new possibilities for people facing complex musculoskeletal conditions, now and in the future. Together, we can continue to make a meaningful difference in the lives of those we serve.

The Charity team has been bolstered by the appointment of three new staff members: a Head of Fundraising, one Fundraising Administrator and a Head of Marketing and Communications. These developments are in line with our focus on continuity

5

Our partner

RNOH's vision is to continuously strengthen its status as the UK’s leading specialist orthopaedic hospital, enhancing its international profile for outstanding patient care, research and education.

RNOH Charity is independent of RNOH. The Charity’s mission is to strengthen and support the people, research and infrastructure that make RNOH one of the world’s best orthopaedic hospitals.

15,255 inpatients 149,042 outpatients

"At RNOH, we’re proud to be the UK’s leading orthopaedic hospital, offering a comprehensive range of neuro-musculoskeletal (MSK) healthcare services. From acute spinal injuries to complex bone tumours, orthopaedic medicine, and MSK pain management, our specialist care treats both adults and children. Moreover, through partnership working at a local level we extend our reach by providing direct access to local community services via our Enfield MSK Community Health Hub.

Our partnership with RNOH Charity is paramount. Together, we strive to elevate the patient and staff experience at RNOH. Charitable contributions enable us to go above and beyond NHS funding, enhancing care and resources, such as specialist equipment.

From the opening of the new Centenary Theatres to supporting the Spinal Cord Injury Centre and our research teams, the Charity's support is invaluable. As we pursue ambitious development plans, our partnership remains crucial in delivering the highest standard of care and support to our patients and staff."

2023|24 attendance:

120,618 outpatient attendances at the Stanmore site

28,105 outpatient attendances at the Bolsover Street site

319 outpatient attendances at other locations

Prof. Paul Fish Chief Executive, RNOH NHS Trust

6

What we do

Strategic objectives

RNOH Charity supports RNOH NHS Trust by raising and awarding funds to RNOH. The Charity has set itself ambitious targets in order to fulfil its vision. They are as follows:

Enhancing the patient experience

Each patient deserves the best possible experience at RNOH and our aim is to ensure everyone receives outstanding care. We will work with the hospital to identify areas that would benefit from improvement, as well as undertake our own research to identify any gaps. We will endeavour to ensure that the patient journey is of the highest quality.

Improving the staff experience

An important part of our mission is to help RNOH in its endeavours to provide a working environment that raises staff morale, aids in staff retention and helps achieve patient satisfaction. We will work closely with the hospital to identify any root cause issues and develop a robust programme to create collaborative team working.

Creating a world-class facility

Following the success of our significant contribution to the Centenary Theatres complex, we aim to continue to be a key funder of equipment and hospital developments on-site to provide the best environment for patients and staff.

Investing in medical research

RNOH has always been a centre of excellence for orthopaedic research and education in the UK. It has a long tradition of translational research, implant development and teaching in collaboration with University College London and other partners. We aim to provide the best facilities for musculoskeletal specialists and researchers to help strengthen RNOH’s world-leading position.

7

What we do

A year in numbers

Income

Expenditure

Total grant programme of £1,254,000 by objective:

£214,000

Donations received (major donors, ward and general donations, collections, Gift Aid, gifts in kind, etc.)

£241,000 Grants received (includes grants from NHS Charities Together)

£371,000 Transfer of assets from Skeletal Cancer Trust

£53,000 Legacies received

£187, 000 Investment income

£178,000 Enhancing the patient experience

£18,000 Improving the staff experience

£227, 000 Investing in medical research

£820,000 Creating a world-class facility

£11,000

Activities undertaken directly (funds spent directly by wards and departments)

Income and grants over the past five years

Income from fundraising activity over the last five years amounted to £4,551,000 whilst grants awarded totalled £4,695,000.

----- Start of picture text -----
£594,000
£382,000
£1,019,000
£ 1,242,000
£1,317,000
£1,576,000
£742,000
£241,000
£879,000
£1,254,000
Income from fundraising activity Grants awarded
2019|20
2020|21
2021|22
2022|23
2023|24
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8

What we do

Grant-giving

RNOH Charity is proud to have awarded more than £4.6 million in grants to RNOH in the last five years (between 2019|20 and 2023|24).

We continue to focus on funding key projects that help provide the best patient experience, enhance staff wellbeing, contribute to cutting-edge equipment and support pioneering research.

The cost-of-living crisis continues to be felt across the NHS, both for staff and hospital facilities. Through initiatives such as the greener energy and waste management practices installed in the new Centenary Theatres Block, efforts are being made to contain costs but our grant-giving continues to strengthen RNOH to create the best patient experience and support staff as much as possible.

In addition, whilst this report covers the last year specifically, the long-term benefit of some of our previous grants continues to be experienced by both patients and staff alike.

During 2023|24, we awarded a total of 24 grants, amounting to £1,329,000 alongside £11,000 provided directly to wards and departments. Grants undrawn and written back in year amounted to £86,000, giving a total grant programme of £1,254,000.

The next few pages aim to give insight into some of the 2023|24 funding RNOH Charity has provided, as well as that from previous years, which has benefitted patients and staff.

The new ultrasound scanner at the Spinal Cord Injury Centre

9

What we do

Enhancing the patient experience

Every patient deserves the best possible experience at RNOH and to receive outstanding care. We continue to work with the hospital to identify areas that require improvement and endeavour to ensure the patient journey is of the highest quality.

In recent years, RNOH Charity has made significant, prominent long-term investments in projects, the benefits of which continue to be felt by patients in their overall improved experience of the hospital environment. These include the contribution to the new Centenary Theatres Block (see page 13) and the refurbishment of valued on-site family accommodation. The Charity has also continued to fund the hospital’s patient packs, ensuring all

visitors have comprehensive information and support resources during their treatment and rehabilitation at RNOH.

This year, RNOH Charity has also funded several smaller-scale grants, which nevertheless still enable positive change and make a huge difference for patients. These include:

Ultrasound machine

Family accommodation block

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Grant amount Date awarded
£30,250 June 2023
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Grant amount Date awarded
£70,500 Dec 2023
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An ultrasound machine dedicated to the Spinal Cord Injury Centre (SCIC) was purchased thanks to a contribution from the Kusuma Trust. The scanner produces high-quality, detailed images for clinicians and allows patients faster access to treatment.

RNOH patients come from all over the UK to access its specialist care but the accommodation offered for families was not ideally fit for purpose. The Charity grant funded a complete refit of all 16 rooms, the communal kitchen and laundry area. This is the first refurbishment of the family accommodation block in more than 15 years.

"Without the new ultrasound, I would be in a queue. Accessible for everyone without the waiting times and making a difference to everyone who needs it – thank you to RNOH Charity." SCIC ultrasound patient

RNOH patients

10

What we do

Enhancing the patient experience

The Volunteer Service

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Grant amount Date awarded
£73,911 Summer 2023
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Over the last nine years, RNOH’s successful Volunteer Service has grown and this year, the number of volunteers within the Trust has reached the highest it has been since COVID-19, with an additional 44 people on board.

Following nine years of fully funding the service at c. £825,000, RNOH Charity will continue to invest in and part-fund the Volunteer Service to January 2025 with another £51,000, bringing the total to c. £876,000.

This includes supporting the roles that keep the service running successfully, such as its Involvement Lead, Volunteers Co-ordinator and an administrator, as well as its operating costs and patient buggy maintenance.

The team of trained, supervised volunteers is made up primarily of current and former RNOH patients, and members of the local community.

Their main responsibilities are: to assist, escort and direct patients and visitors; to provide information about the hospital’s facilities and services; to collect and deliver medicines for patients; and to provide administrative assistance to hospital departments.

Volunteers also simply act as a friendly and reassuring ear, which helps to alleviate anxiety amongst patients and their relatives.

The service has developed into a thriving, innovative operation that supports many aspects of the hospital’s work. The following services benefit either hundreds of patients or smaller numbers of the most vulnerable:

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Volunteer drivers for the
patient buggy service
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Part of RNOH’s most vital volunteering help is the buggy service for patients and their visitors. Prior to launching this service in 2016, disabled and elderly patients often had to make long, tiring journeys either on foot or in their wheelchairs, across our very large Stanmore site. It is roughly a mile in length, covering hilly and bumpy terrain.

The buggy service quickly became indispensable and supports at least half of all patients on our main site. The dedicated team of 10 permanent and seven standby drivers operates in all weathers. They carried 21,000 passengers in 2023|24 and in April 2024, reached the milestone of 150,000 passengers transported since the service began.

11

What we do

Improving the staff experience

RNOH Charity funds projects and activities that enable RNOH to retain its outstanding staff, be recognised as a good place to work and offer opportunities for staff celebration and structured wellbeing programmes.

RNOH Charity has continued to fund a number of different programmes designed to recognise and reward hospital staff for the exceptional work that they undertake for the benefit of patients. These included: the annual Staff Achievement Awards, staff training, conference support and discounted gym membership.

Staff Wellbeing Lead

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Grant amount Date awarded
£13,804 July 2023
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RNOH Charity continued to fund the Staff Wellbeing Lead to December 2023, in addition to its previous support of the Wellbeing Hub. These are both crucial elements of RNOH’s programme of looking after its staff, with a total £145,305 in funding from the Charity over recent years. The Staff Wellbeing Lead’s work includes managing the Wellbeing Channel, which offers 24/7 online resources for staff to make sure that there is reliable information easily at hand for anyone who needs support. The Staff Wellbeing Lead also carries out important outreach to staff, connecting face-to-face during their working day and encouraging them to focus on their own self-care and wellbeing, as well as that of their teams.

This year, RNOH celebrated International Nurses’ Day with funding from RNOH Charity. Colleagues celebrated each other and championed the diversity of the hospital teams, who come from all over the world. In addition, the annual RNOH Staff Achievement Awards took place in Stanmore in February 2024. The Charity was proud to support the event, which also saw the launch of our new short film, produced to showcase the work of the Charity and the hospital. Our sincere thanks were extended to our Charity Patron, HRH Princess Eugenie, for her role in the creation of the film, which will help broaden the reach of our mission and our impact.

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The Staff Wellbeing Hub International Nurses' Day The RNOH Staff Achievement
celebrations Awards
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12

What we do

World-class facility

RNOH Charity aims to be a key funder of cutting-edge equipment and RNOH on-site developments in order to provide the best environment and facilities for patients. Strategic investments from the Charity in some of the larger items of equipment for the hospital have a long-term benefit for patients and staff.

Centenary Theatres Block

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Grant amount Date awarded
£822,962 July 2023
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One of the largest projects for the Charity this year was a significant contribution to the new Centenary Theatres Block at Stanmore. Named for the 100th anniversary of the hospital at the site, the project includes four new theatres, bringing the total to 14, with each now featuring enhanced equipment thanks to the Charity grant.

Incorporating space from the previous heli-pad at RNOH, the new theatres were constructed primarily to increase the hospital’s capacity for patient care and to improve the usability of facilities for patients and staff.

The enhanced complex opened in October and is now fully operational. Being able to invest in new equipment and realise additional plans using funds provided by the Charity has been a real advantage to the project. Staff have been able to grow the case-load, reduce waiting times for treatment and carry out more of the hospital’s specialist work. For staff, the new unit means more space to work and a brighter environment.

Before COVID-19, RNOH was already planning to expand its surgical services to meet the increasing demand for orthopaedic treatment but, with the interruption, waiting lists rose and patient care was affected. Fortunately, the success of the development has enabled the hospital to clear some of the build-up faster, not only at RNOH but also across NHS North Central London.

The improved theatre complex means RNOH is now able to treat around 800 additional patients a year across a mix of orthopaedic sub-specialities, primarily spinal, sarcoma and joint reconstruction. Many of the cases can be long, complex procedures that can take an entire theatre session each so the extra capacity was clearly much needed and very welcome.

Specifically, the grant has helped to fund cutting-edge medical devices, including monitors, ultrasound, X-rays and anaesthetic machines. However, this financial contribution also enabled the team to achieve more than they had ever imagined. With the Charity helping to fund surgical equipment, additional development of the block became possible and the complex now benefits from solar panels to reduce costs and energy wastage, while an energy-efficient ultra clean ventilation canopy has been installed and the water treatment plant is optimised for energy usage.

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Mark Ashwell,
Theatre Manager
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The new Centenary Theatres Block

13

What we do

Investing in medical research

Pioneering research and innovation is a key component of RNOH’s vision to be a world-leading orthopaedic hospital with the best patient care and staff experience in the NHS. RNOH Charity supports its ground-breaking research projects, including investigations into musculoskeletal as well as neuro-musculoskeletal conditions, rehabilitation, peripheral nerve injury repair, sarcoma detection and surgical treatments.

RNOH Charity has supported the following:

Exercise for Science 3D-printed patient-specific instruments

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Grant amount Date awarded
£205,304 Nov 2023
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Grant amount Date awarded
£110,000 Aug 2021
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We are extremely grateful to the Rosetrees Trust, Stoneygate Trust and Arthroplasty for Arthritis Charity for supporting research into 3D-printed patient-specific instruments (PSI) for implant positioning in hip replacements.

Thanks to a generous contribution from Arthroplasty for Arthritis Charity, RNOH's Professor Alister Hart and his team have been able to undertake 3D MRI research into the benefits and risks of popular national programmes such as Couch to 5K.

PSI help guide the positioning of implants during surgery, the success of which is dependent upon absolute precision. PSI are also far less expensive than the robotic alternative, at £100-£200 per case when printed and sterilised on-site, yet they are not widely in use. This research will study 80 patients undergoing primary hip replacement and, for the first time, assess how accurate PSI are. The hope is that patients and hospitals will benefit enormously and extend the use of PSI to similar work in other areas of orthopaedic surgery.

The advantages of regular exercise are well known but the team is seeking to understand the impact initiatives like this have on joint and muscle condition in people with and without prosthetic limbs, before and after training. Findings should enhance understanding of the effect of running on musculoskeletal health and the motivations behind participation in exercise of this type. The grant’s impact should be substantial, given the widespread interest in such programmes.

14

What we do

Investing in medical research

Collaborative Care in Orthopaedic Rehabilitation (CCOPER)

Institute of Healthcare Engineering Summer Studentships

Grant amount Date awarded £92,463 Oct 2020

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Grant amount Date awarded
£18,925 May 2023
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Around a third of the UK population live with a musculoskeletal condition and it’s believed that one in every six adults in England meets the criteria for the diagnosis of a mental health condition. RNOH researchers therefore set out to assess the potential for collaborative care models between musculoskeletal and mental health teams.

The Charity was delighted to award grants to support RNOH’s Research and Innovation Centre. The hospital was able to host the UCL Bioengineering Masters Summer School, an eight-week project to boost the next generation of PhD students starting out in orthopaedic medicine, co-funded by UCL.

Psychiatry already plays an important role in hospitals and is used to assess and manage coexisting mental health disorders. However, this approach is traditionally reactive. As two of the largest health burdens, the combination of both a musculoskeletal and a mental health disorder can cause a greater risk of poor clinical outcomes.

The RNOH trial looked at the potential for proactive support, using the collaborative care model developed in the US in the 1990s and already successfully deployed in diabetes, kidney and cancer care, after evidence revealed that people with orthopaedic conditions reported more mental health concerns than those without. The Charity has been pleased to support the research to conclusion across 2023|24. Findings have already been published in the British Medical Journal with the goal of disseminating the results beyond RNOH for the benefit of patients across the UK.

15

What we do

The healing journey with art

The Stanmore Building at RNOH is home to a collection of inspirational art. Studies have shown that art in healthcare environments provides significant benefits for patients, families and staff, offering a place to reflect away from the busy clinical setting during challenging times.

The atrium houses a beautifully crafted installation, Tribe, which hangs majestically from the ceiling and incorporates 50 colourful heads modelled on RNOH patients, staff and supporters. We are also privileged to display precious artwork on the wards, while the reception area of each floor exhibits pieces on generous loan for the fourth consecutive year from

celebrated gallery Hauser & Wirth, personally curated with the hospital community in mind by gallery director and Charity Patron, HRH Princess Eugenie.

In total, 20 pieces are on display, including works by Mark Wallinger, Martin Creed, Bharti Kher and the late Dame Phyllida Barlow.

"Studies show that art in healthcare environments has a number of positive therapeutic and medical outcomes for patients. These include a reduction in stress, depression and anxiety, reduced blood pressure, lowered pain intensity, and a reduced intake of medication."

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Rosie Stolarski,
Chief Executive, RNOH Charity
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Artwork on display inside The Stanmore Building

16

What we do

Fundraising

We are deeply grateful for the support of our donors, volunteers and other contributors. Their continued generosity means we are able to have such a meaningful impact on the staff and patients at RNOH. In the 2023|24 financial year, the Charity’s total voluntary income was £879,000, with fundraising expenditure amounting to £384,000. Key sources of income during 2023|24 include grant-making trusts, community fundraising, general donations and the transfer of assets from the Skeletal Cancer Trust.

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£241k
£371k
£53k
£214k
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Skeletal Cancer Trust

This year, we were honoured to announce that the charitable organisation Skeletal Cancer Trust (SCT) has joined RNOH Charity.

Based at RNOH since the early 1990s, SCT was originally set up to fund hair-pieces for young patients undergoing chemotherapy, whose options at that time were limited. The organisation grew over the next three decades into a charity aimed at supporting the advancement of sarcoma research, raising awareness of bone cancer and providing the best possible support at each stage of their treatment for patients and their families.

This important work will now continue under the care of RNOH Charity. With their complementary ambitions, the two are ideally placed to join forces and build on SCT’s achievements.

Grants

RNOH Charity received a total of £241,000 from grant-making trusts (including NHS Charities Together), including: £40,000 from ALBORADA Trust to support the purchase of a Lyra Gait Trainer; £30,000 from Garfield Weston towards our Spinal Cord Injury Centre Day-Room Refurbishment project; and £25,250 from Kusuma Trust UK to purchase a GE LOGIQ P9 ultrasound machine. Funding was also received from Rosetrees Trust, Stoneygate Trust and Arthroplasty for Arthritis to support 3D MRI muscle health research, with a further contribution from them for 3D-printed patient-specific instrument research.

Legacies

The Charity continues to actively promote legacygiving, which enables our grant-giving programme to develop further. This year we gratefully received £53,000 in legacies from former patients who were appreciative of the treatment received at RNOH.

Donations and community fundraising

Incredible support from more than 40 fundraisers in 2023|24 helped raise £94,000 through community fundraising. From marathons to bungee jumps, head shaves to cycle challenges, our supporters went above and beyond to support the vital work of RNOH Charity.

£371,000 was transferred from SCT to RNOH Charity this financial year and will be used to further SCT’s valuable drive to help sarcoma-related projects.

RNOH Consultant Orthopaedic Surgeon Professor John Skinner, who specialises in sarcoma as well as hip and knee replacement surgery, has taken up a position on the Board of Trustees at RNOH Charity. Professor Skinner is also a member of the RNOH Trust Board.

The launch of our Impossible Possible campaign in 2023 helped to drive general donations throughout 2023|24. In addition, RNOH Charity Ambassador David Holmes launched an appeal to raise funds to support our Spinal Cord Injury Centre Day-Room Refurbishment project. In total, the Charity received £57,000 from general donations. Other donations included individual giving, corporate donations, major donors and gifts in kind, amounting to £63,000.

17

What we do

Our amazing individual fundraisers

A dedicated group of supporters, many of whom are former patients, have raised vital funds for RNOH Charity. Here are some of the wonderful highlights.

London Landmarks Half Marathon

Together with family and friends, James Bilham completed the London Landmarks Half Marathon, raising an incredible £3,133. James, who took part in the event in his wheelchair, said: "I am so grateful for the support that everyone at RNOH gave me in the early days of my rehabilitation and something I will come to rely on again in the future; and also for RNOH Charity for its support with funding the hospital’s work so people like me can get a second chance at life."

Becky's two-tunnel run

After being diagnosed with a rare bone tumour as a teenager and then again with a second tumour in 2022, Becky Farrell showed us anything was possible when she completed the Bath Two Tunnels Half Marathon, raising a tremendous £2,537. Becky said: “At 16 years old, when I just wanted to be out enjoying life with my friends, instead I was in a lot of pain with reduced mobility, which at some points meant I couldn’t even walk to the bottom of my street without a stick. Although the recovery was not easy, the specialist knowledge, facilities and care that RNOH provided me made my time as an in-patient as comfortable as possible and allowed me to have my life back.”

18

What we do

Our amazing individual fundraisers

Superhero Sean

12-year-old Sean and his family joined hundreds of people with disabilities to take part in the Superhero Series in Windsor, raising an amazing £689. Sean was diagnosed with hypermobility in 2023 and has been receiving support from RNOH to learn about his disability and ways to manage it. Sean’s mother, Rebecca, said: “Sean’s hypermobility has meant he has had to limit a lot of the things he loves, such as bike rides, scootering and football. He can suffer from multiple dislocations a day and it became particularly worse when he started secondary school this year."

Cardiff Christmas concert for RNOH Charity

Patient Philippa Tredget held a Christmas concert in Cardiff, raising £650. Philippa said: “We've chosen RNOH Charity because I had scoliosis surgery at the hospital in 2006 and I wanted to say thank you to the hospital for all I've been able to achieve – I've run marathons and climbed mountains, and worked some pretty physical jobs, none of which would have been possible without the surgery. It's also a great opportunity to help improve the facilities for future patients."

Bungee jumper Henry

We had our first ever bungee jump for RNOH Charity, with supporter Henry Wood taking on a 300-ft jump to raise over £2,000. Henry chose to fundraise for RNOH Charity after his five-year-old daughter, Sienna, was treated for hip dysplasia as a baby, undergoing surgery twice and spending 12 weeks in a body cast. The family have also supported us in previous years, with Henry’s wife Charlotte taking part in challenge events.

19

Future plans

Our strategic priorities and objectives for 2024|25 build upon those we achieved last year and include:

All are enablers to the delivery of our key strategic objectives.

Transforming the patient experience and improving staff wellbeing

Creating a world-class facility

Providing Funding state-of-the-art ground-breaking equipment medical research

20

Future plans

Looking ahead, as we endeavour to develop the Charity’s infrastructure, we look forward to working in close alignment with RNOH to ensure patients receive the best treatment, care and facilities.

Projects in the pipeline include the following:

Each of these projects will have significant benefit for patients across a breadth of conditions that RNOH supports, in line with RNOH Charity’s strategic funding objectives.

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The Lyra Gait Trainer
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21

Future plans

The HiRise scanner

Demand for the hospital's services has grown rapidly, exceeding the capacity of the hospital’s current cone beam computed tomography (CBCT) scanner, which is becoming out-of-date, expensive to maintain and limited in what it can do. We are working to help the hospital buy a new, hi-tech CBCT digital X-ray scanner.

Called a Curvebeam HiRise, the scanner the hospital requires can take detailed 3D X-ray images of joints and limbs in natural standing positions. This allows more accurate diagnosis than traditional X-rays or other scans and would help particularly with the kind of complex surgery that RNOH carries out.

Uniquely, the Curvebeam HiRise covers feet, knees and hips, meaning more patients and consultants can benefit from the same machine. The new scanner will also shorten waiting times for scans, enable better diagnosis and treatment planning, and improve national and international research.

Refurbishing the Spinal Cord Injury Centre day-room

The Spinal Cord Injury Centre is a specialist facility at Stanmore where patients with a life-changing spinal cord injury are treated and rehabilitated. While the garden outside the day-room has been transformed by Horatio’s Garden, with support from RNOH Charity funding, the day-room itself is dated, clinical and unappealing.

The Charity wants to enable the hospital to refurbish the area based on patients’ feedback – into a relaxing, pleasant space in which they can spend time with family and friends and forget they are in a hospital. The refurbishment and transformation of the day-room will provide an aesthetically pleasing area. Patients will be able to have meals together and socialise for peer support. In addition, the space would be able to be adapted for daytime and weekend activities. Family and friends will be encouraged to join these sessions so that patients are able to spend time with them in a welcoming environment.

The Curvebeam HiRise scanner

Above: The SCIC day-room today Below: How the day-room could look

22

Financial review

Overview

The Charity has continued to develop its infrastructure during this financial year, with investment in staff to enable the scaling up of fundraising and brand awareness activities for the longer term. This was also a year of substantial charitable activity, with the notable grant award of £823k towards enhanced equipment for the new Centenary Theatres Block. As a result, the net assets of the Charity at 31 March 2024 were £3.4m (2022|23 £4.0m), a decrease of £0.6m.

The net expenditure for the year was bolstered by investment gains of £226k as the investment portfolio experienced strong gains in quarter four.

Income

Expenditure

Expenditure during 2023|24 amounted to £1.9m (2022|23 £809k), £1.1m more than the previous year. The increase was driven by growth in the annual grant programme of £1.0m, with grants and direct ward and department expenditure totalling £1.3m (2022|23 £241k). The majority of grants in year were awarded from restricted funds.

The Charity’s overall operating costs remain consistent with the previous year as active management of expenditure continues. Fundraising spend, inclusive of apportioned support and governance costs, is £48k higher than the prior year at £384k (2022|23 £336k) as the Charity strives to build on its fundraising capacity to fulfil the objective of increased sustainable unrestricted income.

Total income in 2023|24, including fundraising and investment income, was £1.1m (2022|23 £940k).

Fundraising income was £879k (2022|23 £742k), a £137k increase.

Income was supported by the transfer of funds from the Skeletal Cancer Trust, as its important work in relation to sarcoma continues under the care of RNOH Charity. Income from grants also increased in year, with funding for equipment, refurbishment projects and research.

Income received through legacies was notably lower in the year, with the emphasis on increasing sustainable unrestricted income from other sources remaining a key target for the future.

Investment income of £187k was £11k less than the prior year (2022|23 £198k) as a result of investment redemptions to fund the equipment for the Centenary Theatres Block.

Continuing to develop a robust fundraising function, expand fundraising activities and generate sustainable income is vitally important and remains a key part of the strategic plan for 2024|25 and beyond.

23

Financial review

Investment policy and performance

The Charity holds investments of £4.5m, which are available for investment over the long term. The majority of these assets will be invested to generate returns to supplement external sources of funding such as donations, grants and funds from other charitable activities. Furthermore, returns from the investment portfolio provide a buffer against adverse future experience and provide additional funding for future charitable projects.

The Charity’s investments are split into a smaller shortterm component and a larger long-term investment:

The Charity’s assets are invested in the Charity Sustainable Multi-Asset Fund and the JP Morgan Sterling Liquidity Fund, through the investment manager’s cash administration service. Both are pooled funds and, given the size of the Charity’s portfolio, the Finance and Audit Committee accepts that the Charity will be subject to the investment manager’s ethical policy.

The Sustainable Multi-Asset Fund, managed by Cazenove Capital, generated a return of +10.2% over the 12-month period to 31 March 2024. The fund outperformed the peer group, ARC Steady Growth (+9.3%) and the long-term objective of CPI +4% (+6.7%). Strong returns from the core direct equity strategy were the primary driver of returns over the year.

Since launch (1 August 2018), the fund has returned +6.4% per annum with circa 70% of the volatility of global equities.

Investments – Environmental, Social and Governance (ESG)

The Cazenove Charity Sustainable Multi-Asset Fund is an actively-managed investment fund which incorporates ESG views as part of their investment process. The Fund has a responsible investment policy and aims to have a positive impact across environmental, social and governance factors. The Fund invests in companies that create a measurable positive impact for people and planet. Cazenove Capital report on the underlying impact of all investments held in the fund (not just equities) on an annual basis. 27% of the portfolio is contributing to solutions by supporting the United Nations (UN) Sustainable Development Goals (SDGs), as assessed under the Impact Management Projects’ (IMP) framework.

The Fund will not invest in companies which fail to meet the responsible investment criteria, defined as companies involved in the following activities: armaments, tobacco, fossil fuels, gambling, alcohol, predatory lending activities, and pornography, based on revenue tolerances. There is a zero tolerance to controversial weaponry.

The Board of Trustees has delegated investment decisions and review of investment manager performance to the Finance and Audit Committee. The Committee receives quarterly reports, while nominated Trustees and the CEO meet with the investment manager on a quarterly basis.

24

Financial review

Reserves

As part of effective financial management, we hold reserves to ensure we can manage:

Financial impact of risk . There are a range of risks we face, including the risk of an unforeseen drop in income, as well as a reduction in the value of our investments.

Working capital . A significant proportion of our reserves is represented by investments and therefore we need to ensure we retain sufficient working capital to be able to meet approved grants given to RNOH, as well as guarantee that operations can continue over the short term and commitments can be met.

The Trustee Board believes it is prudent to hold a level of free reserves to enable the Charity to take advantage of opportunities as they present themselves and to have sufficient working capital to maintain the fundraising, support and governance operations of the Charity. This will allow the Charity to respond in a considered way to an adverse change in circumstances, giving sufficient time to enable emerging circumstances to be assessed and appropriate plans developed and implemented, without requiring a crisis response.

Having carefully considered the best interests of the Charity and its beneficiaries, in light of the uncertainty in financial markets and the cost of living crisis, the Trustee Board believes that it is appropriate to aim to hold the following general reserves: a short-term reserve of £550k with a target in the longer term of £750k.

for, in relation to a specific appeal, event, etc. As at 31 March 2024, restricted funds amounted to £2.7m and consisted of 74 separate funds.

Unrestricted funds are expendable at the discretion of the Trustees for general charitable purpose and include the following as at 31 March 2024:

The short-term reserve parameter was set to take into account an approximate annual level of unrestricted operating costs of £400k-£500k, with a contingency to allow for uncertainty in investment markets and other unforeseen events. In response to the impact that the cost of living crisis and other social and economic events have had on voluntary income levels, operating costs have been tightly controlled and minimised wherever possible. As a result, the approximate level of unrestricted operating costs is currently lower, at c. £400k.

Whilst this is currently the case, the Trustees consider £550k to be the appropriate target to allow for the expenditure required in future years to continue to build on the infrastructure and staffing of the Charity.

Going concern

Any free reserves held by the Charity over and above this amount, which are not expected to be used in the short term, will be made available by the Trustee Board for grants to benefit RNOH patients. If free reserves fall below this level, the Trustee Board will consider whether this is due to short-term circumstances or a longer-term reason, and will review its expenditure and fundraising plans accordingly.

The Board formally reviews the reserves policy annually and the reserve level quarterly to ensure that the arrangements continue to be appropriate.

The Charity holds both restricted and unrestricted reserves totalling £3.4m.

Restricted funds consist of unexpended income where the donor has defined what the funds should be used

The Trustees have reviewed the financial position of the Charity, including its forecast cash flows, liquidity position and existing and potential funding commitments for the forthcoming year. Budget and forecast projections are considered on a fund-byfund basis to ensure that adequate unrestricted funds remain. The Charity will only commit to charitable activities and any other major projects as long as it is confident that it is able to meet its obligations. The Trustees believe that there are adequate resources to continue in operation for the foreseeable future, for a period of at least 12 months from the approval of the financial statements, and that it is appropriate to continue to adopt the going concern basis of accounting when preparing its annual report and financial statements.

25

Governance

Constitution

The Trustees derive their authority, powers and scope from the Constitution duly created when the Charity became a Charitable Incorporated Organisation (CIO) that is fully independent of NHS legislation (registered charity number 1166129). The objects of the CIO are for the public benefit to advance any charitable purpose or purposes relating to: the general or specific purposes of the Royal National Orthopaedic Hospital NHS Trust or its successor from time to time; or any other part of the National Health Service associated with RNOH.

The Trustees

The Charity currently has 10 Trustees to oversee the governance arrangements. The Board normally meets quarterly, with two additional away days per year for strategy and planning. There is a Finance and Audit Committee and a Grants Committee, which normally meet quarterly. The Charity is managed on a day-to-day basis by the Chief Executive. To facilitate operations, the Trustees have delegated day-to-day activities for operational matters including fundraising, finance and operations to the Chief Executive and the senior management team.

Appointment, induction and training of Trustees

Related parties and co-operation with other organisations

None of the Charity Trustees received remuneration or other benefit from their work with the Charity. Any related party transactions are disclosed on an annual basis, as well as any conflicts of interest.

Further details of related party transactions are detailed in note 14.1 of the financial statements.

Equality, diversity and inclusion

RNOH Charity wholeheartedly supports the principles of equality, diversity and inclusion in employment. We aim to create, value and encourage diversity and we recognise that talent and potential are distributed across the population. Not only are there moral and social reasons for promoting equality of opportunity, it is in the best interest of this Charity to recruit and develop the best people for our jobs from as wide and diverse a pool of talent as possible.

A comprehensive policy is in place which demonstrates our commitment to challenge and eliminate discrimination and to promote equality and diversity amongst our workforce and Trustees.

Trustees are engaged via an external recruitment agency. New Trustees undergo a period of induction organised by the Charity, which includes training on charity finances and grant-giving. As well as the induction, Trustees are briefed on their duties and legal obligation under charity law, the Charity’s governing document, any related Charity Commission guidance, the Charity’s latest activity, future plans and recent financial performance. New Trustees will also meet key employees, RNOH Executive Directors and key clinicians.

26

Governance

Pay policy

Having a consistent and robust method for assessing and comparing the value of different jobs is vital to achieving equal pay. Our remuneration policy aims to provide a fair basis for the Charity to operate its grading and pay structure.

The Finance and Audit Committee annually reviews the remuneration policy, the remuneration ratio and provides scrutiny to remuneration decisions. Salaries are benchmarked prior to appointment against relevant sectors or the wider not-for-profit sector and then every three years thereafter.

Risk management

The risk register is designed to identify key risks and existing controls. A current score is allocated based on the impact and likelihood of each risk causing a loss to the Charity.

The Trustees have given consideration to the major risks to which the Charity is exposed and are satisfied that the systems and procedures to manage them are in place.

The Charity also reviews salaries on an annual basis, in light of relevant market indices, to establish whether an annual incremental increase is appropriate.

Environmental, Social and Governance

The Charity is based on the RNOH Trust site and as such, endeavours to operate with due consideration of RNOH’s Sustainability Policy.

The Charity’s operations are largely paperless and the purchase of single-use plastic is actively discouraged, both internally and wherever possible through the grant programme.

Carbon emissions are minimised through hybrid working, reduced travel, and car-sharing where possible.

In addition, the Charity grant for the Centenary Theatres Block enabled the introduction of anaesthetic procedures that eliminated the use of nitrous oxide and minimised the need for desflurane, as recommended by NICE, both contributing to the net zero targets within the Trust’s sustainability and green agenda.

27

Governance

Risk management

The major risks identified are summarised in the table below:

Risk Risk summary Mitgaton
• Loss of key income source • Identfy major dependencies and consider
Fundraising • Dependency on income source diversifcaton plans
income
volatlity		 • Competton for funds
• Economic downturn leads to
reducton in income		 • Establish pipelines for key income streams
• Recruit specialist staf/interim consultants
• Implement key performance indicator reportng
• Inability to raise unrestricted funds
at a sufcient level to ensure • Development of infrastructure and planned
reserves policy met fundraising actvites to appropriately support
Financial and
liquidity risk		 • Difculty meetng the operatonal
costs of the Charity
• Inability to develop and commit to		 fundraising ambitons
• Regular review and monitoring of reserves
policy and reserves level
longer-term funding aspiratons • Scrutny of cash fow and fund projectons
• Reputatonal risk of any of • Implement additonal reportng as necessary
the above
• Unforeseen severe adverse
investment conditons • Regular performance monitoring reports
• Financial loss through lack of and meetngs
Investment risk investment advice
• Cash fow difcultes arising from		 • Specialist investment expertse on the
Trustee Board
lack of liquidity • Detailed cash fow projectons allowing for
• Being a forced seller of investment considered redemptons
assets in tmes of volatlity
• Lack of agreed funding priorites • Contnue to maintain close working
impactng fundraising actvites relatonships with RNOH executve team,
Strategic risk • Project delays and impact
on budgets		 clinicians and grantees
• Grant funding applicatons appropriately
• Inability to maximise strategic endorsed prior to submission to relevant
impact Commitee/Board

28

Governance

Fundraising governance

The charitable sector is always under scrutiny over its approach to raising funds and communicating with potential supporters. We are aware of the need to protect vulnerable persons in any fundraising we undertake and are continually taking steps to ensure our fundraising approach takes this into account. We continually review our methods of fundraising and communications to ensure that our approaches are appropriate, that we provide our supporters with the very best donor care, and that we are compliant with both best practice and legislation.

Public benefit

The Charity confirms that the Trustees have complied with their duty to have due regard to the guidance on public benefit requirement published by the Charity Commission under the Charities Act 2011 in exercising its powers or duties.

The fundraising work of the Charity builds upon the grant-giving, providing the RNOH NHS Trust with additional resources and support, enabling a higher standard of patient care to members of the public attending the hospital.

Fundraising disclosure

The following fundraising disclosure covers the period for the year ended 31 March 2024.

1. Fundraising methods and processes

The Charity seeks support from individuals, charitable trusts and corporate organisations. The Charity’s objectives and targets are clear and set out the urgent and compelling causes against which to fundraise to support the Royal National Orthopaedic Hospital.

c. Fundraising conforming to recognised standards: The Charity is a member of the Institute of Fundraising, and adheres to the Fundraising Codes of Conduct. It is also a paid member of the Fundraising Regulator. The Charity team stays up-to-date with any changes in standards as set for the sector by the Institute of Fundraising and other guidance bodies, such as NCVO, ACEVO, ICO and the Charity Commission.

The Charity reports on fundraising performance every quarter to the Board of Trustees, working to an agreed and transparent return on investment. The Charity works to an agreed fundraising budget with clear objectives to raise unrestricted and restricted income. All donors' wishes are adhered to, and the Charity operates with complete transparency for beneficiaries and our donors.

f. Protection of the public, including vulnerable people, from unreasonably intrusive or persistent fundraising approaches, and undue pressure to donate: The Charity treats its donors and beneficiaries with great respect. The Charity is fully GDPRcompliant, and its website has the appropriate privacy notices as required by law. Each time supporters are contacted by email, by post or by telephone, the Charity offers unsubscribe options or the opportunity to opt-out of specific types of communication with the Charity.

2. Use of third-party fundraisers

29

Statement of Trustees' responsibilities

The Trustees are responsible for preparing the Trustees’ Annual Report and the financial statements in accordance with applicable law and regulations. Charity law requires the Trustees to prepare financial statements for each financial year.

Under that law they are required to prepare the financial statements in accordance with UK Accounting Standards and applicable law (UK Generally Accepted Accounting Practice), including FRS 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland. Under charity law the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the Charity and of the excess of expenditure over income for that year.

In preparing these financial statements, the Trustees are required to:

The Trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the Charity’s transactions and disclose with reasonable accuracy at any time the financial position of the Charity and enable them to ensure that the financial statements comply with the Charities Act 2011. They have general responsibility for taking such steps as are reasonably open to them to safeguard the assets of the Charity and to prevent and detect fraud and other irregularities. The Trustees are responsible for the maintenance and integrity of the corporate and financial information included on the Charity’s website. Legislation in the UK governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

In addition, the Trustees confirm that they are satisfied that the content of the annual review in pages 3 to 29 of this document meets the requirements of the Trustees’ Annual Report under charity law. They also confirm that the financial statements have been prepared in accordance with the accounting policies set out in the notes to the accounts and comply with the Charity’s governing document, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with FRS 102, The Financial Reporting Standard applicable in the UK and Republic of Ireland published on 31 January 2022.

Each of the persons who is a Trustee at the date of approval of this report confirms that:

This report was approved and authorised for issue by the Board of Trustees on 9 July 2024 and signed on its behalf by:

Richard Jones Chair

Date: 9 July 2024

30

Independent Auditor's report to the Trustees of the Royal National Orthopaedic Hospital Charity

Opinion

We have audited the financial statements of Royal National Orthopaedic Hospital Charity for the year ended 31 March 2024 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement 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 FRS 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:

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 Charity 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 Charity’s ability to continue as a going concern for a period of at least 12 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.

Other information

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The Trustees are responsible for the other information contained within the annual report. 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 course of 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 there is 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.

31

Independent Auditor's report to the Trustees of the Royal National Orthopaedic Hospital Charity

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters where the Charities Act 2011 requires us to report to you if, in our opinion:

Responsibilities of the Trustees

As explained more fully in the Trustees’ responsibilities statement set out on page 30, the Trustees 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 Charity’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 Charity or to cease operations, or have no realistic alternative but to do so.

Auditor’s Responsibilities for the audit of the financial statements

We have been appointed as auditor under section 144 of the Charities Act 2011 and report in accordance with regulations made under section 154 of that Act.

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 aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit. We also:

32

Independent Auditor's report to the Trustees of the Royal National Orthopaedic Hospital Charity

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

Explanation as to what extent the audit was considered capable of detecting irregularities, including fraud

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.

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the Charity.

Our approach was as follows:

33

Independent Auditor's report to the Trustees of the Royal National Orthopaedic Hospital Charity

There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in the financial statements. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

Use of our report

This report is made solely to the Charity's Trustees, as a body, in accordance with Chapter 3 of Part 8 of the Charities Act 2011. Our audit work has been undertaken so that we might state to the Charity’s Trustees 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 any party other than the Charity and Charity's Trustees as a body, for our audit work, for this report, or for the opinion we have formed.

Luke Holt (Senior Statutory Auditor) For and on behalf of Moore Kingston Smith LLP, Statutory auditor

Date

9 Appold Street London EC2A 2AP

Moore Kingston Smith LLP is eligible to act as auditor in terms of Section 1212 of the Companies Act 2006.

34

Statement of financial activities for the year ended 31 March 2024

Unrestricted Restricted 2024 Unrestricted Restricted 2023
funds funds Total funds funds Total
Notes £’000 £’000 £’000 £’000 £’000 £’000
Income
Voluntary income 2.1
207		 672 879 426 316 742
Investment income 3.1
29		 158 187 37 161 198
Total income 236 830 1,066
463		 477 940
Expenditure
Cost of raising funds:
Voluntary fundraising costs 287 97 384 246 90 336
Investment management costs 20 25 45 29 18 47
Total cost of raising funds 4.1 307 122 429
275		 108 383
Expenditure on charitable actvites 5.1
106		 1,351 1,457 89 337 426
Total expenditure 413 1,473 1,886
364		 445 809
Net gains/(losses) on investments 8.2
32		 194 226 (45) (247) (292)
Net (expenditure)/income (145) (449) (594)
54		 (215) (161)
Transfer between funds 11.1
-
-
-		 (60) 60 -
Net movement in funds (145) (449) (594)
(6)		 (155) (161)
Reconciliaton of Funds
Funds brought forward at 1 April 808 3,157 3,965 814 3,312 4,126
Funds carried forward at 31 March 663 2,708 3,371
808		 3,157 3,965

During the year, no operations have been either discontinued or acquired by RNOH Charity.

The notes on pages 38 to 53 form part of these accounts.

35

Balance sheet as at 31 March 2024

Unrestricted Restricted 2024
2023
funds funds Total Total
Notes £’000 £’000 £’000 £’000
Fixed assets
Intangible assets 8.1
2		 10 12 19
Tangible assets 8.1
-		 2 2 3
Investments 8.2
688		 3,807 4,495 5,262
Debtors - non-current 9.1
-		 9 9 5
Total fxed assets 690 3,828 4,518 5,289
Current assets
Debtors - current 9.1
58		 69 127 90
Cash at bank and in hand 65 - 65 121
Total current assets 123 69 192 211
Creditors: amounts falling 10.1
(150)		 (1,022) (1,172) (1,283)
due within one year
Net current liabilites (27) (953) (980) (1,072)
Total assets less current liabilites 663 2,875 3,538 4,217
Creditors: amounts falling due afer more than one year 10.2
-		 (167) (167) (252)
Net assets 663 2,708 3,371 3,965
Reserves
General funds 432 - 432 580
Designated funds 231 - 231 228
Unrestricted funds 11.1
663		 - 663 808
Restricted funds 11.1
-		 2,708 2,708 3,157
Total funds 663 2,708 3,371 3,965

The notes on pages 38 to 53 form part of these accounts. Approved and authorised by the Trustees and signed on their behalf by:

Richard Jones Matthew Lee Chair Trustee Date: 9 July 2024 Date: 9 July 2024

36

Cash flow statement for the year ended 31 March 2024

Cash fows from operatng actvites:
Net cash used in operatng actvites
Cash fows from investng actvites:
Income from investments
Payments to acquire tangible and intangible fxed assets
Receipts from sale of investment assets
Payments to acquire investment assets
Net cash provided by investng actvites
Change in cash and cash equivalents in the reportng year
Cash and cash equivalents at the beginning of the reportng year
Cash and cash equivalents at the end of the reportng year
Reconciliaton of net cash used in operatng actvites
Net expenditure for the period
Adjustments for:
(Gain)/losses on revaluaton of investment assets
Depreciaton and amortsaton
Investment income
(Increase)/decrease in debtors
Decrease in creditors
Cash outlow from operatng actvites
Analysis of cash, cash equivalents and net debts
Cash at bank and in hand
Opening balance
Cash fows
Closing balance		 2024
2023
Total
Total
£’000
£’000
(1,241)
(624)
195
196
(3)
(21)
1,958
130
(965)
(200)
1,185
105
(56)
(519)
121
640
65
121
(594)
(161)
(226)
292
8
2
(187)
(198)
(49)
66
(193)
(625)
(1,241)
(624)
121
640
(56)
(519)
65
121

37

Notes to the financial statements

Accounting policies

1.1 Basis of preparation

These financial statements have been prepared under the historic cost convention, with the exception of investments, which are included at market value.

The financial statements have been prepared in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102). The Charity is a public benefit entity for the purpose of FRS 102 and therefore the Charity also prepared its financial statements in accordance with the Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (The FRS 102 Charities SORP) and the Charities Act 2011.

The financial statements are prepared in sterling, which is the functional currency of the Charity.

Monetary amounts in these financial statements are rounded to the nearest one thousand.

The significant accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all years presented unless otherwise stated.

1.2 Going concern basis

The Trustees have considered the Charity’s forecasts and projections and have concluded that there is a reasonable expectation that the Charity has adequate resources to continue in operation for the foreseeable future.

Whilst the Charity’s investment portfolio is susceptible to movements in investment values, it still has sufficient liquidity through existing cash facilities to meet its grant commitment obligations. The Charity therefore continues to adopt the going concern basis in preparing the financial statements.

The Trustees have assessed whether the use of the going concern basis is appropriate and have considered possible events or conditions that might cast significant doubt on the ability of the Charity to continue as a going concern. The Trustees have made this assessment for a period of at least one year from the date of approval of the financial statements.

1.3 Income

a) Recognition

38

Notes to the financial statements

b) Donated services and facilities

1.4 Expenditure

All expenditure is accounted for on an accruals basis. All expenditure is recognised once there is a legal or constructive obligation to make a payment to a third party.

Where possible, all costs are directly attributed to an expenditure category.

a) Cost of raising funds

The costs of raising funds are the costs associated with generating income for RNOH Charity.

b) Expenditure on charitable activities

This includes grants payable and other directly associated support costs. Grants payable are primarily payments to RNOH, in furtherance of the Charity’s objectives. Grants are accounted for on an accruals basis where the conditions for their payment have been met or where a third party has a reasonable expectation that they will receive the grant and where the liability can be reasonably quantified. Where grants do not have substantive review conditions, the total amount is included within expenditure in the period committed.

c) Support costs

Support costs, which include governance costs, that relate to more than one expenditure category are apportioned based on estimates of staff time spent on each area.

d) Irrecoverable VAT

Irrecoverable VAT is charged against the expenditure category for which it was incurred.

1.5 Fund structure

Restricted funds are those for which a legal restriction exists over its use and related income is restricted to the purpose of the fund.

Unrestricted funds are those funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Charity. They comprise general funds, where there are no constraints on use, and designated funds which have been set aside by the Trustees, to ensure due regard to donors' wishes.

The major funds held within these categories are disclosed in note 11.1.

39

Notes to the financial statements

1.6 Pension contributions

The cost of employer contributions to the NHS Pension Scheme and the Defined Contribution Scheme, is charged to the Statement of Financial Activities.

Certain past and present employees are covered by the provisions of the NHS Pensions Scheme. Details of benefits payable under these provisions can be found on the NHS Pensions website (www.nhsbsa.nhs.uk/nhs-pensions). The Scheme is an unfunded, defined benefit scheme, preparing its own statements, that covers NHS employers, general practices and other bodies allowed under the direction of the Secretary of State, in England and Wales. The Scheme is not designed to be run in a way that would enable NHS bodies to identify their share of the underlying Scheme assets and liabilities. Therefore, the Scheme is accounted for as if it were a defined contributions scheme: the cost to an NHS body of participating in the Scheme is taken as equal to the contributions payable to the Scheme.

Applicable rates for employee contributions for the NHS Pension Scheme ranged from 6.1% to 13.5% for both 2023|24 and 2022|23. Employer contributions were 14.38% for both 2023|24 and 2022|23.

Employees employed after 2018 can choose to belong to a Defined Contribution Work Place Pension Scheme. Applicable rates were 4% and 5% respectively for employee and employer contributions for both 2023|24 and 2022|23.

1.7 Investments

Investments are stated at market value at the balance sheet date and asset purchases and sales are recognised at the date of trade. Unrealised and realised gains and losses on investment assets are recorded in the Statement of Financial Activities as they arise.

1.8 Financial instruments

The Charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

1.9 Cash and cash equivalents

Cash at bank and cash in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

1.10 Taxation

As a registered charity, income and gains are exempt from Corporation Tax to the extent that they are applied to the charitable objects of the Charity.

40

Notes to the financial statements

1.11 Critical accounting estimates and areas of judgement

In preparing financial statements, it is necessary to make certain judgements and assumptions that affect the amount recognised in the financial statements.

Accounting estimates and judgements are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

The key judgements and estimates are:

1.12 Fixed assets

Tangible assets are included in the balance sheet at cost less accumulated depreciation. Depreciation is charged on a straight-line basis to support costs over the estimated useful life of three years for IT and five years for fixtures, fittings and equipment.

Intangible assets are included in the balance sheet at cost less accumulated amortisation. Amortisation is charged on a straight-line basis to support costs over the estimated useful life of three years.

The capitalisation threshold for all fixed assets is £1k.

41

Notes to the financial statements

2.1 Voluntary income

2.1 Voluntary income
Unrestricted Restricted Total Funds Unrestricted Restricted Total Funds
funds funds 2024 funds funds 2023
£’000 £’000 £’000 £’000 £’000 £’000
Donatons 140 59 199 94 138 232
Grants 9 230 239 2 136 138
Legacies 43 10 53 315 10 325
Gifs in kind 15 -
15		 15 -
15
NHS Charites Together grants - 2 2 -
32		 32
Skeletal Cancer Trust transfer - 371 371 -
-
-
207 672
879		 426 316 742

In June 2023, the Trustees of Skeletal Cancer Trust (SCT) resolved to transfer the assets of SCT to RNOH Charity, to be held and applied by RNOH Charity for the charitable purposes of SCT. In December 2023, the net assets, representing cash of £371k, were transferred to RNOH Charity. The funds are held in a special purpose fund restricted to the purposes of SCT, see note 11.1. RNOH Charity agreed to undertake and discharge any remaining liabilities of SCT of which there was one grant commitment of £33.5k that is included within the cost of charitable activities.

3.1 Investment income

Unrestricted RestrictedTotal Funds RestrictedTotal Funds Unrestricted Restricted Total Funds Restricted Total Funds
funds funds 2024 funds funds 2023
£’000 £’000 £’000 £’000 £’000 £’000
Interest income -
2		 2 -
-		 -
Dividend income 29 156 185 37 161 198
29 158 187
37		 161 198

42

Notes to the financial statements

4.1 Cost of raising funds

4.1 Cost of raising funds
Unrestricted RestrictedTotal Funds Unrestricted Restricted Total Funds
funds funds 2024 funds funds 2023
£’000 £’000 £’000 £’000 £’000
£’000
Voluntary fundraising costs
Fundraising staf costs 50 29 79 49 37
86
Apportonment of staf costs 60 26 86 45 18
63
Other direct costs 147 18 165 122 11
133
Apportonment of overheads 30 24 54
30		 24
54
Total cost of voluntary fundraising 287 97 384
246		 90
336
Investment management costs
Apportonment of staf costs 11 11 22
18		 2
20
Other direct costs 1 8 9 2 8
10
Apportonment of overheads 8 6 14 9 8
17
Total investment management costs 20 25 45
29		 18
47
Total cost of raising funds 307 122 429
275		 108
383

5.1 Expenditure on charitable activities

Unrestricted Restricted Total Funds Unrestricted Restricted Total Funds
funds funds 2024 funds funds 2023
£’000 £’000
£’000		 £’000 £’000
£’000
Grant funded actvity 106 1,223
1,329
25		 185
210
Actvites undertaken directly -
11
11		 -
56
56
Total grant programme 106 1,234
1,340
25		 241
266
Grants undrawn, writen back or returned (69) (17) (86) (9) (16) (25)
Total grant programme 37 1,217
1,254
16		 225 241
afer reversal of prior years' grants
Apportonment of staf costs 26 100
126
27		 73
100
Apportonment of overheads 43 34
77
46		 39
85
Net grant expenditure 106 1,351
1,457
89		 337 426

The total grant programme of £1.254m includes £823k towards equipping the new Centenary Theatre complex. Activities undertaken directly are funds spent directly by wards and departments.

Grants undrawn, written back or returned reflect an underspend across various projects. Although RNOH Charity maintains regular contact with grantholders, there are occasions where planned expenditure is not achievable and the related grant commitment is reversed.

43

Notes to the financial statements

5.2 Total grant programme summary

5.2 Total grant programme summary
Unrestricted Restricted Total Funds
funds funds 2024
£’000 £’000
£’000
Improving the staf experience
Staf Wellbeing Lead -
14		 14
Staf Achievement Awards 3 -
3
Internatonal Nurses' Day celebraton -
1
1
Conferences, training and development -
1
1
Other grants and writebacks (1) -
(1)
Actvites undertaken directly -
4
4
Total 2 20
22
Enhancing the patent experience
Volunteer service 67 7
74
Refurbishment of family accommodaton -
70
70
Ultrasound machine -
30
30
Support for Horato's Garden -
7
7
Other grants and writebacks 2 (5)
(3)
Actvites undertaken directly -
4
4
Total 69 113
182
Investng in medical research
3D Printed Patent-Specifc Instruments (PSI) for Implant
Positoning in Total Hip Replacement -
205
205
Biobank assistant -
34
34
Summer studentship programme -
19
19
Publicatons -
7
7
Other grants and writebacks (31)
(7)
(38)
Actvites undertaken directly -
3
3
Total (31)
261		 230
Creatng a world-class facility
Theatre complex equipment - 823
823
Other grants and writebacks (3)
-
(3)
Total (3)
823		 820
Total grant programme
afer reversal of prior years' grants		 37 1,217 1,254

44

Notes to the financial statements

6.1 Cost allocation

Where possible, costs have been directly allocated to one of the above categories.

The remainder, relating to general office costs and governance costs, have been apportioned based on estimates of time spent on activity in each area.

Apportioned overheads include governance costs of £36.4k (2022|23 £38.1k) which includes external audit fees of £17.8k (2022|23 £17.4k).

7.1 Analysis of staff costs

Salaries and wages
Social security costs
Pension costs
Total
Average number of full-tme equivalents
Average head count		 2024
2023
Total
Total
£’000
£’000
267
229
22
19
24
21
313
269
5
5
6
6

7.2 Pension contributions for higher paid employees

Pension contributions of £13k were made for one employee earning over £60,000 per annum .

7.3 Higher paid employees

The following number of employees received emoluments falling within the ranges indicated:

2024 2023
£80,000 - £89,999 - 1
£90,000 - £99,999 1 -

Key management personnel, the senior management team of four, received aggregate employee benefits of £224k (2022|23 team of three, £199k).

45

Notes to the financial statements

8.1 Intangible and tangible fixed assets

Intangible Assets Software
£'000		 Total
£'000
Cost:
Balance at 31 March 2023 21 21
Additons - -
Balance at 31 March 2024 21 21
Accumulated amortsaton:
Balance at 31 March 2023 2 2
Charge for the year 7 7
Balance at 31 March 2024 9 9
Net book value at:
31 March 2024 12 12
31 March 2023 19 19
Tangible Assets IT
equipment		 Fixtures, fittings and
equipment		 Total
Cost: £'000 £'000 £'000
Balance at 31 March 2023 2 1 3
Additons - - -
Balance at 31 March 2024 2 1 3
Accumulated depreciaton:
Balance at 31 March 2023 - - -
Charge for the year 1 - 1
Balance at 31 March 2024 1 - 1
Net book value at:
31 March 2024 1 1 2
31 March 2023 2 1 3

46

Notes to the financial statements

8.2 Investments

8.2Investments
Cazenove Charity Sustainable Mult-Asset Fund
JP Morgan Liquidity Fund
Cash held for investment
Year ended 31 March 2023		 Market
value at
Net gain/
31 March
Additons
Proceeds
(loss) on
2023
at cost
of disposal
revaluaton
£’000
£’000
£’000
£’000
4,620
-
(627)
194
642
965
(1,340)
32		 Market
value at
31 March
2024
£'000
4,187
299
5,262
965
(1,967)
226		 4,486
5,484
200
(130)
(292)		 9
4,495
5,262

The historical cost of the investment as at 31 March 2024 was £4.487m (2023 £5.717m).

The net gain on revaluation comprised; unrealised gain of £278k (2023 losses of £293k) and realised losses of £52k (2023 gains of £1k).

9.1 Debtors

Non-current
Other debtors
Current
Other debtors
Prepayments
Accrued income		 2024
2023
£’000
£’000
Total
Total
9
5
17
14
31
21
79
55
127
90

10.1 Creditors: amounts falling due within one year

General creditors
Accruals
Other taxaton and social security
Grant commitments (see note 10.3)
Deferred income		 2024
2023
£’000
£’000
Total
Total
4
22
25
28
9
5
1,121
1,226
13
2
1,172
1,283

47

Notes to the financial statements

10.2 Creditors: amounts falling due after more than one year

2024 2023
£’000 £’000
Total Total
Grant commitments (see note 10.3) 167
252
10.3 Grant commitments
2024 2023
£’000 £’000
Total Total
Grant commitments as at 1 April 1,478
1,997
Commitments awarded in year 1,329
210
Commitments expended in year (1,433)
(704)
Grants undrawn, writen back or returned (86)
(25)
Grant commitments as at 31 March 1,288
1,478

Grant commitments comprise a number of grant awards to RNOH where the Trustees have committed to expenditure and costs are expected to fall due in future years.

48

Notes to the financial statements

11.1 Analysis of funds

Restricted funds
Skeletal Cancer Trust Fund
The London Irish Ward Fund
Hardship Fund
Independent Living Unit Fund
Pharmacy Department Fund
Foot & Ankle Research & Educaton Fund
Spinal Surgery – Educaton & Research Fund
Radiology Department Fund
Funds £50k - £100k
- Research (3)
- Wards/departments (2)
- Fundraising (5)
Others, up to £50k
- Research (13)
- Wards/departments (26)
- Fundraising (16)
- 3D MRI Muscle Health & Patent-Specifc
Implant Research Fund
Total restricted funds
Unrestricted funds
General funds
Designated funds
- Hospital Redevelopment Fund
- Sarcoma Fund
Total designated funds
Total unrestricted funds
Total funds		 1 April

Gains/
31 March
2023
Income Expenditure
(losses)
Transfers
2024
£’000
£’000
£’000
£’000
£’000
£’000
-
380
(52)
35
-
363
342
-
-
-
-
342
217
15
(16)
21
-
237
96
9
(14)
17
83
191
156
16
(16)
15
-
171
153
11
(17)
15
-
162
120
8
(12)
11
-
127
96
8
(12)
9
-
101
188
12
(40)
16
-
176
148
11
(21)
14
5
157
1,008
183
(884)
1
-
308
108
7
(14)
10
(2)
109
265
22
(107)
17
-
197
305
26
(63)
13
(86)
195
(45)
122
(205)
-
-
(128)
3,157
830
(1,473)
194
-
2,708
580
233
(413)
32
-
432
228
-
-
-
-
228
-
3
-
-
-
3
228
3
-
-
-
231
808
236
(413)
32
-
663
3,965
1,066
(1,886)
226
-
3,371

Transfers between funds represent income which has been reclassified to ensure donations are used in accordance with donors' wishes.

The 3D MRI Muscle Health and Patient-Specific Implant Fund balance represents confirmed funding, yet to be received, from three specific grant-making trusts. In accordance with the funders’ agreement, the pledged income will be received over the next 18 months.

As a result of fund value changes in the year, the funds included in each of the value ranges above are not consistent to the prior year.

49

Notes to the financial statements

11.2 Details of significant funds

Restricted funds

Name of fund Skeletal Cancer Trust Fund

The London Irish Ward Fund

Hardship Fund

Independent Living Unit Fund

Nature and purpose of fund

For the benefit of RNOH patients diagnosed with bone and soft tissue tumours.

For the London Irish Ward (from the London Irish Ward Appeal).

To assist RNOH staff who are experiencing financial difficulty.

Funding for the new Independent Living Unit.

Pharmacy Department

Foot & Ankle Research & Education Fund

For pharmacy education and training, workforce development and patient benefit.

To improve the service of the Foot & Ankle Unit.

Spinal Surgery – Education & Research

Radiology Department Fund

For the furtherance of spinal surgery education and research at RNOH.

To support staff and patients in the Radiology Department.

3D MRI Muscle Health and Patient-Specific Implant Research Fund

For 3D MRI muscle health research and patient-specific implant projects.

Designated funds

The designated funds relate to legacies received in 2021|22 and 2023|24 respectively. Funds will be utilised in accordance with the legators' wishes, at an appropriate time for the most suitable project.

50

Notes to the financial statements

11.3 2022|23 comparatives

|11.32022|23 comparatves|| |---|---| |Restricted funds
General Redevelopment Appeal
The London Irish Ward Fund
Hardship Fund
Pharmacy Department
Foot & Ankle Research & Educaton Fund
Spinal Surgery – Educaton & Research
Funds £50k - £100k
- Research (3)
- Wards/departments (4)
- Fundraising (4)
Others, up to £50k
- Research (12)
- Wards/departments (28)
- Fundraising (20)
- Other
- 3D MRI Muscle Health Research Fund
- EOSedge Scanner Fund
Total restricted funds
Unrestricted funds
- General funds
- Designated legacy fund (1)
Total unrestricted funds
Total funds|1 April

Gains/
31 March
2022
Income Expenditure
(losses)
Transfers
2023
£’000
£’000
£’000
£’000
£’000
£’000
963
62
(62)
(73)
-
890
342
-
-
-
-
342
236
12
(13)
(18)
-
217
161
18
(11)
(12)
-
156
168
9
(11)
(13)
-
153
130
8
(8)
(10)
-
120
217
11
(24)
(16)
-
188
401
28
(77)
(30)
-
322
340
20
(36)
(24)
-
300
167
7
(59)
(11)
-
104
210
27
(34)
(16)
1
188
253
43
(55)
(18)
(1)
222
60
1
(55)
(6)
-
-
(175)
130
-
-
-
(45)
(161)
101
-
-
60
-| ||3,312
477
(445)
(247)
60
3,157| ||586
463
(364)
(45)
(60)
580
228
-
-
-
-
228| ||814
463
(364)
(45)
(60)
808| ||4,126
940
(809)
(292)
- 3,965|

51

Notes to the financial statements

12.1 Analysis of net assets between funds – 2024

12.1Analysis of net assets between funds – 2024
2024
Unrestricted Restricted Total
funds funds Funds
£’000 £’000 £’000
Total fxed assets 690 3,828 4,518
Current assets 123 69 192
Current liabilites (150) (1,022) (1,172)
Creditors: amounts falling due afer more than one year - (167) (167)
663 2,708 3,371
12.2Analysis of net assets between funds – 2023
2023
Unrestricted Restricted Total
funds funds Funds
£’000 £’000 £’000
Total fxed assets 1,041 4,248 5,289
Current assets 144 67 211
Current liabilites (371) (912) (1,283)
Creditors: amounts falling due afer more than one year (6) (246) (252)
808 3,157 3,965

52

Notes to the financial statements

13.1 Trustee remuneration

None of the Trustees received remuneration for their services to the Charity (2022|23 £nil) and no Trustees were reimbursed for expenses incurred during 2023|24 (2022|23 £nil).

RNOH Charity paid for course attendance for one Trustee of £468 (2022|23 £nil).

14.1 Related party transactions

The total amount of related party donations made without conditions during the year was £1,003 (2022|23 £nil).

During the year, the total grant programme in support of RNOH was £1.254m (2022|23 £241k).

One Trustee is employed by RNOH and was part of the team who were awarded a grant during 2020|21 of £92,464. The remaining grant balance of £4,160 was spent during the year. RNOH Charity also paid £694 towards some of the Trustee's travel and accommodation costs in relation to attendance and speaking at conferences. For both, standard procedure was followed and the Trustee was not involved in the approval process.

The Charity benefits from the use of an office and IT services at no charge. These have been accounted for as gifts in kind (see note 2.1).

RNOH staff and finance systems were utilised for six months of 2022|23 at a cost of £28,100. This administrative support ceased in October 2022.

There are no other related party transactions which require disclosure in the year (2022|23 £nil).

53

2023|24

Charitable Incorporated Organisation Charity Number: 1166129