OpenCharities

This text was generated using OCR and may contain errors. Check the original PDF to see the document submitted to the regulator.

2023-03-31-accounts

Action Against Age-Related Macular Degeneration

Report and Accounts for year ended 31[st] March 2023

Registered office:

3 Queen Square, London, WC1N 3AR. Registered Charity Numbers: England and Wales: 1170224

Scotland: SC048549

1

Table of Contents

TRUSTEES AND ADVISERS ......................................................................................................................................... 3 REPORT OF THE TRUSTEES FOR THE PERIOD ENDED 31ST MARCH 2023 ................................................................... 4 INDEPENDENT AUDITOR’S REPORT ......................................................................................................................... 14 STATEMENT OF FINANCIAL ACTIVITIES ................................................................................................................... 17 BALANCE SHEET ...................................................................................................................................................... 18 STATEMENTS OF CASH FLOW ................................................................................................................................. 19 NOTES TO THE ACCOUNTS ...................................................................................................................................... 20

2

Trustees and Advisers

Trustees

Auditor

Crowe U.K. LLP, St Bride’s House, 10 Salisbury Square, London EC4Y 8EH

Legal Adviser

BPE Solicitors LLP, St James House, St James Square, Cheltenham, GL50 3PR

Banker

Barclays Bank PLC, 1 Churchill Place, London, E14 5HP

3

Report of the Trustees for the period ended 31st March 2023

The Trustees present their report with the accounts of Action Against Age-Related Macular Degeneration (‘AAAMD’) for the period ended 31[st] March 2023.

AAAMD is a charitable incorporated organisation (CIO), registered charity 1170224 in England and Wales and SC048549 in Scotland.

AAAMD has two subsidiaries. Foresight Research Limited (a trading Private limited company incorporated in the UK on 13th June 2019, Company registration number: 12048839) and Foresight Research Scotland Limited (a dormant Private limited company incorporated in Scotland on 14th June 2019 company registration number: 633501). They each have allocated shares of £100, which is unpaid as of 31[st] March 2023.

The Charity accounts comply with the Statement of Recommended Practice (SORP) issued in 2015, other current statutory requirements, and the requirements of the Trust Deed.

The information set out on page 3 also forms part of this report.

Structure, Governance and Management

The charity was incorporated as a Foundation model constitution Charitable Incorporated Organisation on 16[th] November 2016. This was amended to an Association model constitution on 21[st] September 2018 and included provisions for the appointment of two additional Trustees bringing the maximum number of Trustees allowed to eight.

At 31[st] March 2023 the Trustee board is now comprised of seven people. There are three representatives of our ‘Governing Charities’: sight loss charities that founded AAAMD and continue driving our mission. These are Greg Allen, interim CEO of Blind Veterans UK, Craig Spalding, CEO of Sight Scotland Veterans and Cathy Yelf, CEO of Macular Society.

In addition, AAAMD has four Independent Trustees. Rob Bryan – the Chair of the Trustees and equity partner at BPE Solicitors LLP; Mark O’Donnell – CEO of Age Scotland; Dr Ton Rijnders – Consultant in pharmaceutical industry and life sciences based in The Netherlands; Dr Ian Campbell, OBE, - Special Projects Executive Director, KAUST (King Abdullah University of Science and Technology).

Apart from the First Charity Trustees (each representing one of our Governing Charities) every Trustee is appointed for a term of two years by a resolution passed at a properly convened meeting of the Trustees. In selecting individuals for appointment as Trustees, the Trustees regard the skills, knowledge and experience needed for the effective administration of AAAMD. On or before his or her first appointment the new Trustee is provided with:

4

Their induction also includes the review and completion of the Register of Interests declaration form.

On 31[st] March 2023 AAAMD employed two staff members: Dr Wen Hwa Lee as Chief Executive Officer and Chief Scientist and Joanna Zapisek as Head of Operations. AAAMD also uses the services of consultants Dr Jesse Coker (as Science and Strategy Associate) and Dr Ellie Williams (as Public and Patient Involvement and Engagement Co-ordinator). In addition, Ms Nupur Patel (as an independent consulting accountant) is the Finance Manager. Until February 2023, Ms Patel was also Head of Finance at Blind Veterans UK, from which she led the pro bono finance services kindly provided by Blind Veterans UK to AAAMD. Other specialist consultants are used as and when necessary.

The remuneration of key management personnel is benchmarked against market rates for similar sized organisations. Salaries and fees reflect the responsibilities and experience of the relevant team member, and any increases are approved by the Board.

Objectives and Activities

The main objective of AAAMD is for the public benefit, the advancement of health by research into the nature, causes, diagnosis, prevention, treatment, and cure of age-related macular degeneration (‘AMD’), including but not limited to the development of research into practical application for the prevention, treatment, and cure of AMD.

AAAMD’s mission is to create convenient, affordable, and accessible solutions that stop AMD in its early stages before it causes sight loss.

AMD destroys central vision, leaving a person unable to read, drive, or recognise faces. It can lead to poorer general health and is often associated with falls, and has a significant impact on mental health, including social isolation, loneliness, and depression.

AMD is one of the leading causes of blindness in the world. Around 10 million people have late-stage AMD globally. It is the most common cause of sight loss in the developed world. With world populations ageing, AMD cases are expected to double by 2040.

To date in the UK, only patients with the wet form of AMD (around 1 in every 10 people diagnosed with AMD) can be treated with regular injections of a drug into the eye – although it is difficult to predict for how long each patient will respond to the drug. As of January 2023, there are no treatments for the remaining patients with the dry form of AMD, nor are there any approved medicines to stop early AMD from progressing into late stages.

With an increasing ageing patient population, the time to act is now to find a convenient, affordable, and accessible solution that can be used by all so no patient is left behind.

Although the late forms of AMD are well-characterised, the underlying causes of AMD are still unknown. Recent discoveries from basic science suggest that there might be multiple causes or even sub-types of AMD, and the mechanisms in early and late stages of AMD may well be different.

AAAMD is working with multiple stakeholders to increase investments and drive research to bring interventions for early AMD. This includes both traditional sectors such as academia, pharmaceutics, clinicians, policy makers and regulators, as well as emerging sectors such as the data and analytics industry.

5

In summary, AAAMD acts as:

Assessment of public benefit

The Trustees have complied with the duty in Part 1 Chapter 1 s4 of the Charities Act 2011 to have due regard to public benefit guidance published by the Charity Commission. The main objective of AAAMD is for the public to benefit through the advancement of health by research.

AMD is one of the leading causes of blindness in the world. It is estimated that in the UK alone there are more than 685,000 people with significant sight loss as a consequence of late-stage AMD. With an ageing population, it is anticipated that the number of people losing sight due to AMD will increase. This will have an associated increase of the burden on healthcare, social care and related economic effects. Currently, there is only one known treatment option, which is only suitable for a very small proportion of patients and only at the late stages of the wet form of the disease.

The public benefit derived from stopping this sight loss epidemic would be a major accomplishment.

The Trustees continue to focus the Charity’s aims and objectives and plan future activities to further the possibility of achievement of this public benefit.

Achievements and Performance

During the period to 31st March 2023, AAAMD has continued driving initiatives started in previous years as well as engaging in new initiatives – all aligned with our strategy set out in 2019, focused on the [1] pharmacological approach to prevent or stop progression of early AMD, including repurposing initiatives and [2] enabling discovery of biomarkers of AMD disease progression, through data aggregation initiatives.

Summary of strategy:

6

1. Pharmacological approach to prevent or stop progression of early AMD

Repurposing

AAAMD’s strategy includes the focus on drug repurposing research to determine whether any existing medicines for other conditions might also be effective in AMD – more specifically in either preventing or slowing progression of AMD.

Drug repurposing (also called drug repositioning, reprofiling or retasking) is a strategy that identifies new uses for approved or investigational drugs outside the scope of the original medical indication. This is possible because human biology is built on a network of biological pathways and, rather frequently, a single pathway can be involved in more than one disease manifestation – thus if one drug can modulate a pathway for one disease, it can potentially have effects on other diseases.

Advantages of repurposing include the ability to fast-track the very costly earlier stages of drug discovery (financially and timewise), as well as tapping into drugs which are already proven to be safe and, in some cases, off-patent which might facilitate quicker and cheaper access.

In collaboration with University of Birmingham’s Real World Evidence group (an academic research team of leading epidemiologists, data scientists and clinicians), we have identified certain drugs which might be protective against AMD. However, since the exploratory ‘signal generation’ protocol relies on pharmacovigilance data, the results need to be experimentally verified before we can confidently share the precise results publicly.

As such, we have reviewed our pharmacoepidemiology results and taking into account existing model systems presently available, we have designed experiments to help us confirm our earlier findings.

Under a Cooperative Research and Development Agreement (CRADA, Agreement Ref. No. C-047-2023), the National Eye Institute (NEI)[1] and AAAMD will collaborate to evaluate drug candidates that have been identified using AAAMD’s in silico pharmaco-epidemiology screen for drugs with the potential to effectively treat AMD including dry AMD and Geographic Atrophy (GA). Pre-clinical studies will be conducted to explore the drug candidates using NEI’s 2-D AMD-like model system. This collaboration aims to evaluate molecular pathways and mechanisms in preventing, delaying the onset, or arresting progression of AMD.

The experiments will start to be conducted in 2023 and we will aim to report the findings in due course.

1 The National Eye Institute is part of the U.S. National Institutes of Health, a public agency of the U.S. Department of Health and Human Services. The mission of NEI is “to eliminate vision loss and improve quality of life through vision research.”

7

2. Data Initiatives

In contrast with late stages of AMD, earlier AMD is more difficult to classify, as there are conflicting views on features used for existing classification. Moreover, most of classification relies heavily on fundus photography, and presence and features of drusen (small yellow deposits of fatty proteins/ lipids that accumulate under the retina).

The existence of Optical Coherence Tomography (OCT) scanners and their fast-paced technological evolution has recently led to rapidly decreasing costs and higher data quality.

In addition to flat images from fundus photography (surface of retina), OCT scans generate 3D volumes, microscopically imaging many layers of cell underneath the surface of the retina.

Taken together, these digital datasets present an unprecedented opportunity to add completely new dimensions in the search for novel markers of early AMD.

Additionally, potential new markers might also offer ways to track progression towards the sight loss stages – which we can use and work together with in defining clinical endpoints for early AMD. This would ultimately help researchers to quickly and efficiently determine the effectiveness of any new treatment.

AAAMD has been working with various partners aiming at making anonymised, large-scale ophthalmic data available for patient-focussed research, under transparent and ethical governance on the use of such data.

a. Building platforms to provide safe, ethical, and open access of ophthalmic data

Clinical trials in age-related/ neurodegenerative conditions are especially challenging as models can’t overcome the time component. Therefore, there is a need to identify early and predictive markers of disease progression. Fortunately, recent advances have enabled quick, cheap, and convenient non-invasive ophthalmic imaging of live human eyes, at microscopic level. Aggregating and making content-rich and high-quality data accessible to researchers is therefore imperative to progress both clinical development and understanding of all stages of the disease to enable earlier identification and interception.

In addition to our continuing involvement at UK ophthalmic imaging bioresource initiatives (INSIGHT Hub and SCONe), we developed and implemented the Foresight initiative to address the remaining gap of community-level, sub- clinical and early-stage data.

8

----- Start of picture text -----
Foresight
----- End of picture text -----

Foresight Research Limited (‘Foresight”) is a first-in-class, charity-led, prospective, consented, patient-first digital health initiative that seeks to aggregate fragmented community level ophthalmological data into a centralised, easy-to-use data resource to spark innovation in oculomics[2] .

The primary objective of Foresight is to enable - through ophthalmic and retinal imaging and linked data - better prevention, earlier detection, and improved treatment of diseases. The Foresight research programme will speed up the discovery of new methods of early disease detection, and the evaluation of new diagnostic tools to help identify and treat diseases early when outcomes are usually better.

To achieve these objectives, Foresight aims to recruit up to 500,000 adults, aged 40 and over, from across the UK to create a diverse and inclusive cohort of people who have consented to participate in the research. In addition to being asked to provide their personal ophthalmic imaging data and complete questionnaires on recruitment, participants will be asked for permission to link their ophthalmic imaging data to other health-relevant data, and for re-contact about taking part in further research studies.

In order to cater to contractual requirements of researchers in different sectors, and its own sustainability, Foresight was implemented as a wholly owned trading subsidiary of AAAMD. During its initial stage, Foresight is being supported by a grant from AAAMD (as a sub-grant from the USA based BrightFocus Foundation), and a Programme Related Investment (PRI; defined under the Charity Commission’s guidance CC14).

With committed funding, Foresight started operations on October 2022 and is now developing all the technological and ethics frameworks, and initiating discussions with

2 'Oculomics' - the association of ophthalmic biomarkers with systemic health and disease - offer a unique opportunity to further our understanding of eye-body relationships and support the development of novel diagnostic and prognostic tools through non-invasive means. (‘Oculomics’ first appeared in a paper entitled Insights into Systemic Disease through Retinal Imaging-Based Oculomics, published in February 2020).

9

delivery partners.

Foresight is intended to be both a prospective observational cohort and a platform for future discovery and translational research studies, with participant consent for linkage to other datasets and re-contact. Foresight will build on our national strengths and complement existing prospective cohort resources and translational research efforts in the UK.

Building this large resource with linkage, feedback and re-contact will facilitate a new generation of discovery and translational research – alongside other UK national initiatives, such as the INSIGHT Hub and Our Future Health. Together we expect to enable our complementary data to be used to advance the development and testing of early diagnostic technologies and preventive (or ‘personalised precision health’) interventions.

Equality, Diversity and Inclusion statement.

AAAMD is committed to treating all people equally and with respect irrespective of their age, disability, gender, gender reassignment, marriage or civil partnership, pregnancy or maternity, race, religion or belief, sex, or sexual orientation.

Our aim is to achieve a more equitable, diverse, and inclusive workforce by ensuring equality, diversity and inclusion (EDI) is reflected in our values and embedded in our activities and individual behaviours. We expect all of our third-party suppliers and partners to commit to treating their workforce with dignity and respect.

We aim to design our research activities specifically to encourage and support participation from participants that are historically underrepresented in and apprehensive about biomedical research, or who face barriers to participation for other reasons.

AAAMD recognises its legal obligations under the Equality Act 2010, Human Rights Act 1998 and The UN Convention on The Rights of Persons with Disabilities, ratified in 2009. AAAMD commits on continuously monitor our operations to make sure that equality, diversity, and inclusion is effectively integrated and implemented. We will review our EDI policy on annual basis.

Financial Review

2022/2023 year consolidated accounts include the AAAAMD’s subsidiary Foresight Research Limited.

During the year end 31st March 2023 AAAMD obtained income totalling £354,134 (£350,457 in 2021/22) of which £205,246 has been obtained as unrestricted and £148,888 as restricted funds.

The unrestricted funding (£205,246) included:

10

The restricted funding (£148,888) included:

The total AAAMD expenditure was £267,194, which is slightly lower compared to the last year (2021/2022) expenditure of £305,729. Total Group (including Foresight) expenditure was £356,206.

We are immensely grateful to all the funding bodies noted above. Their contributions had a considerable impact on AAAMD operations in 2022/2023 and on our work towards AAAMD’s aims. We were successful in reaching all internal targets set up under funding agreements and we hope that the collaborations that we were part of in 2022/2023 will lead to further support for AAAMD in 2023/2024.

The AAAMD team was also aided in its work with pro-bono assistance from the Governing Charities (Blind Veterans UK, the Macular Society, Sight Scotland Veterans) in areas including finance, fundraising, marketing, communications, office space and IT. The Trustees are grateful for this continued support and spirit of collaboration, and joint work towards addressing unmet needs in AMD.

AAAMD had no fundraising activities requiring disclosure under S162A of the Charities Act 2011.

Reserve Policy

At 31st March 2023 total charity funds were £465,323 (Group, including Foresight): £376,311). This comprises of £102,572 as restricted and £362,752 (Group, including Foresight): £273,739) as unrestricted liquid reserves. AAAMD’s reserve policy is set at six months of expected core cost expenditure. For 2022/2023 this has been calculated at £138,000 (£200,000 in 2021/2022). Current free reserves are above the six months target for core cost expenditure in 2023/2024. This is due to the unused remaining funds received from the Governing Charities and collaboration with the Macular Society and SSV mentioned above.

Cash reserves are currently held with Barclays Bank PLC.

The AAAMD Board and its Audit & Risk Committee regularly reviews the AAAMD Budget and a sensitivity analysis on expected income and costs. A going concern analysis, which included variations to both income and cost expectations, concluded that AAAMD was in a position to continue as a going concern. AAAMD has at least 12 months of resources to continue to operate in line with actual and budgeted income and costs.

11

Principle Risks and Uncertainties

The Trustees regularly review and discuss the AAAMD Risk Register. The main areas of risk and how the Trustees are managing them are as follows:

1. Failure to achieve key objective of at least a therapeutic drug entering clinical trials by 2028

The promising results of our Repurposing workstream will now be tested by AAAMD’s collaborators at the National Eye Institute (part of the U.S. National Institutes of Health, a public agency of the U.S. Department of Health and Human Services; see Achievements and Performance 1.a.i) once the contract is finalised. The Trustees and the AAAMD’s Scientific Advisory Board meet on a regular basis to review scientific progress and possible new developments in the eye care sector to make sure that AAAMD remains focussed on its mission.

2. Reputational damage

Since its formation, AAAMD has established good governance policies and guidance supported by written Standard Operating Procedures. These cover a wide range of issues and help to maintain clear communications with all stakeholders.

Similar processes have been developed by Foresight. The AAAMD Trustees receive regular reports on Foresight’s key developments, one of the Trustees (AAAMD Designated Director) is a member of the Foresight Board. The AAAMD Director’s presence is compulsory at Foresight Board Meetings.

3. The failure to secure long-term financial sustainability to cover core costs, research project and trading subsidiary funding.

AAAMD has been successful in securing funding for the initial stages of its Foresight trading subsidiary operations. The risk of securing core funds remains high, and Trustees and management team review the funding strategy on a regular basis.

However, with Foresight being set up to execute the data initiatives work stream from the main AAAMD strategy and being able to open up alternative funding sources (e.g., through provision of services or PRI), we believe that the AAAMD Group’s financial sustainability will become stronger in the coming years.

During the setting-up of Foresight the AAAMD Trustees and the AAAMD Audit and Risk Committee members will continue to monitor and to support AAAMD activities and financial situation.

12

Statement of Trustees’ Responsibilities

The Trustees are responsible for preparing the Trustees’ Report and the financial statements in accordance with applicable law and regulations.

Charity law requires the Trustees to prepare financial statements for each financial period in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards) and applicable law.

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 its net incoming/outgoing resources for that period. In preparing these financial statements, the trustees are required to:

The Trustees are responsible for keeping proper 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 are also responsible for safeguarding the assets of the Charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Auditor

Crowe U.K. LLP has indicated its willingness to be reappointed as statutory auditor for the next financial year.

Approved by the Trustees and signed on their behalf by

Trustee

Date:

13

Independent Auditor’s Report to the Trustees of Action Against AgeRelated Macular Degeneration

Opinion

We have audited the financial statements of Action Against Age-Related Macular Degeneration (‘the charity’) for the year ended 31st March 2023 which comprise the statement of financial activities, balance sheet, 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 Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

• give a true and fair view of the state of the charity’s affairs as at 31st March 2023 and of its income and expenditure, for the year then ended;

• have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

• have been prepared in accordance with the requirements of the Charities Act 2011 and the Charities and Trustee Investment (Scotland) Act 2005 and Regulations 6 and 8 of the Charities Accounts (Scotland) Regulations 2006 (amended).

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

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

We have nothing to report in this regard.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters in relation to which the Charities (Accounts and Reports) Regulations 2008 and the Charities Accounts (Scotland) Regulations 2006 requires us to report to you if, in our opinion:

14

Responsibilities of trustees

As explained more fully in the trustees’ responsibilities statement set out on page 12, 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 parent 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 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and report in accordance with the Acts and relevant regulations made or having effect thereunder.

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

Details of the extent to which the audit was considered capable of detecting irregularities, including fraud and non-compliance with laws and regulations are set out below.

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

Extent to which the audit was considered capable of detecting irregularities, including fraud

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, and discussed these between our audit team members. We then designed and performed audit procedures responsive to those risks, including obtaining audit evidence sufficient and appropriate to provide a basis for our opinion.

We obtained an understanding of the legal and regulatory frameworks within which the charity operates, focusing on those laws and regulations that have a direct effect on the determination of material amounts and disclosures in the financial statements. The laws and regulations we considered in this context were the Charities Act 2011 and The Charities and Trustee Investment (Scotland) Act 2005 together with the Charities SORP (FRS 102). We assessed the required compliance with these laws and regulations as part of our audit procedures on the related financial statement items.

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

Auditing standards limit the required audit procedures to identify non-compliance with these laws and regulations to enquiry of the Trustees and other management and inspection of regulatory and legal correspondence, if any.

We identified the greatest risk of material impact on the financial statements from irregularities, including fraud, to be within recognition of grant income and expenditure and the override of controls by management. Our audit procedures to respond to these risks included enquiries of management

15

about their own identification and assessment of the risks of irregularities, testing the posting of journals, reviewing accounting estimates for biases, reviewing regulatory correspondence with the Charity Commission, and reading minutes of meetings of those charged with governance

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non- compliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it. In addition, as with any audit, there remained a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non- compliance with all laws and regulations.

Use of our report

This report is made solely to the charity’s trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008 and Regulation 10 of the Charities Accounts (Scotland) Regulations 2006. 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 anyone other than the charity and the charity’s trustees as a body, for our audit work, for this report, or for the opinions we have formed.

Crowe U.K. LLP

Statutory Auditor London

13 December 2023

Crowe U.K. LLP is eligible for appointment as auditor of the charity by virtue of its eligibility for appointment as auditor of a company under section 1212 of the Companies Act 2006.

Crowe U.K. LLP is eligible for appointment as auditor of the charity under regulation 10(2) of the Charities Accounts (Scotland) Regulations by virtue of its eligibility under section 1212 of the Companies Act 2006.

16

Consolidated Statement of Financial Activities

Notes
Income from:
Donations and Grants
Donations
2
Grants
2
Total income and endowments
Expenditure on:
Charitable activities
3
Raising funds
3
Total expenditure
Net income / (expenditure)
Net movement in funds
Reconciliation of funds
Total funds brought forward
Total funds carried forward
9		 Restricted
Funds
Unrestricted
Fund
2023
Group
2022
Group
£
£
£
£
-
5,246
5,246
82,183
148,888
200,000
348,888
268,274
148,888
205,246
354,134
350,457
77,915
189,279
267,194
305,729
-
89,012
89,012
-
77,915
278,291
356,206
305,729
70,973
(73,045)
(2,072)
44,728
70,973
(73,045)
(2,072)
44,728
31,599
346,784
378,383
333,655
102,572
273,739
376,311
378,383

All the Charity’s activities above arise from continuing operations.

The charity had income of £354,134 and charitable expenditure of £267,194, resulting in a net surplus of £86,940 for the year. There were no recognised gains or losses in the current or prior year, other than those shown above.

17

Balance Sheet

Note
Current Assets
Debtors
6
Cash at Bank
Current liabilities
Creditors
7
Net Current Assets
Creditors: Amounts falling due after
more than 1 year
8
Net Assets
Funds for the Charity
Represented by:
Restricted Funds
Unrestricted funds
9
Total Charity Funds		 Charity
Group
Charity & Group
2023
2023
2022
£
£
£
14,071
12,420
54,219
476,995
772,798
384,289
491,066
785,218
438,508
25,743
48,452
60,125
-
-
-
465,323
736,766
378,383
-
360,455
-
465,323
376,311
378,383
102,572
102,572
31,599
362,751
273,739
346,784
465,323
376,311
378,383

Approved by the Trustees and authorised for issue on and signed on their behalf by:

Trustee

__ Date

18

Consolidated Statements of Cash Flow

Notes
Cash flow from operating activities:
Net cash (used in) / provided by operating activities
(Table A)
Cashflow from Financing Activities
Cashflow from new borrowings
Change in cash and cash equivalent in reporting period
Cash and cash equivalent at the beginning of the reporting period
(Table B)
Cash and cash equivalent at the beginning of the reporting period
(Table B)
Table A
Net expenditure for the reporting period (as per the statement of
financial activities)
Adjustment for:
Decrease / (increase) in debtors
(Decrease) / Increase in creditors < 1 year
Increase in provisions – interest payable
Net cash (outflow) / inflow from charitable activities
Table B
Analysis of cash and cash equivalent
Cash at bank at start of the reporting period
Net cash (outflow) / inflow
Cash at bank, at end of the reporting period
Table C- Group
As at 1 April 2022
Cashflows
Analysis of changes in net debt
£
£
Cash
384,289
388,509
Loan falling due after more than one year
-
(350,000)
384,289
38,509		 Group
2023
Group
2022
£
£
38,509
87,818
350,000
-
388,509
87,818
384,289
296,471
772,798
384,289
Group
2023
Group
2022
£
£
(2,072)
44,728
41,799
81,039
(11,673)
(37,949)
10,455
-
38,509
87,818
384,289
296,471
388,509
87,818
772,798
384,289
As at 1 March 2023
£
772,798
(350,000)
422,798

19

Notes to the Accounts

1. ACCOUNTING POLICIES

a) Company status

AAAMD is a charitable incorporated organisation (CIO), registered charity 1170224 in England and Wales and SC048549 in Scotland. The members of the CIO are the Trustees as mentioned on page 3. In the event of the charity being wound up, the members of the CIO have no liability to contribute to its assets and no personal responsibility for settling its debts and liabilities. AAAMD meets the definition of a public benefit entity under FRS102.

AAAMD has one dormant subsidiary; Foresight Research Scotland Limited (Private limited company incorporated in Scotland on 14th June 2019 company registration number: 633501).

Foresight Research Limited is also a subsidiary of AAAMD (Private limited company incorporated in the UK on 13th June 2019. Company registration number: 12048839). It became active on 1st October 2022.

They each have allocated shares of £100 which is unpaid as at 31st March 2023.

b) Basis of Preparation

The accounts (financial statements) have been prepared in accordance with the Charities SORP (FRS102) applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland and the Charities Act 2011 the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006.

c)

Income

Donated Goods and Services

Donated services and facilities are included as income (with an equivalent amount in expenditure) at the estimated value to the charity where this is reasonably quantifiable, measurable and material. Donations are recognised when receivable. Grants

Grant income is recognised in full when the charity becomes entitled to the income, it is probable that the income will be received and the amount can be measured reliably. Where the grant is not performance related this is on notification of the grant award. Where related to performance grants are accounted for as the charity earns the right to consideration by its performance. Where the grant is received in advance of performance, its recognition is deferred and included in creditors. Where entitlement occurs before the grant is received, it is accrued in debtors.

d) Expenditure

All expenditures accounted for on an accrual basis and has been classified under heading that aggregate all costs related to that category.

Support and Governance costs

This comprises of all costs associated with the initial set up and general running of the organisation, including providing administrative, financial services and legal services. Irrecoverable VAT is included with the item of expenses to which it relates and is charged to the Statement of Financial Activities.

20

Charitable Activities

The expenditure relating to any research projects and raising awareness through marketing has been allocated here.

e) Financial Instruments

AAAMD holds only financial assets and liabilities of a kind that qualify as basic financial instruments. These financial instruments are recognised initially at their transaction values and measured subsequently at their settlement values.

Financial assets held at amortised cost comprise cash at bank and in hand, together with trade and other debtors. Financial liabilities held at amortised cost comprise bank loans and overdraft, trade and other creditors.

f)

Going concern

The Trustees have a reasonable expectation that the charity has adequate resources to continue its activities for the foreseeable future. Accordingly, having considered the risks as set out within the Trustee’s annual report they continue to adopt the going concern basis in preparing the financial statements.

g) Critical accounting judgements and key sources of estimation uncertainty

In the view of the Trustees the treatment of the Performance Related Investment represents the key area of estimation at the balance sheet date which might result in a material adjustment to their carrying amounts in the next financial year. Further information is included in note 8, the full amounts received to date has been recognised as a liability (along with accrued interest), and the financial statements have been prepared on the basis that the full amount due under the agreement will be repaid. The term (and so implied interest rate) is based on the expected term by reference to forecasts produced by management and is reviewed at the end of each accounting period.

2. INCOME

Unrestricted
Donations
This includes gift in kind of £3,840 (2022: £7,680)
Grants:
Sight Scotland Veterans
The Macular Society
Garfield Weston Foundation
Restricted
Grants:
Clothworkers' Foundation
University Birmingham NHS Foundation trust (INSIGHT Award)
UK SPINE KE Award
BrightFocus
Total Income		 Group 2023
Group 2022
£
£
5,246
82,183
100,000
73,000
100,000
-
-
25,000
205,246
180,183
-
50,000
46,395
94,227
-
26,047
102,493
-
148,888
170,274
354,134
350,457

Note:

Clothworkers' Foundation: £250,000 has been received to-date (£50,000 in the year 2021/22) as restricted income towards AAAMD’s strategy involving validating existing data and creating a larger-scale data-driven project using participant’s data and artificial intelligence for diagnosis of early AMD. £31.6k was carried forward as unused

21

funds in 21/22 that has now been fully utilised.

University Birmingham NHS Foundation trust (INSIGHT Award): The final amount of £46,395 was received in 2022/23 (£94,227 was receivable in 2021/22) making the total received to date of £293,090 as restricted income (from a possible Award of £296,236) for generation of project deliverables by AAAMD as a partner in INSIGHT – Health Data Research Hub for Eye Health.

UK SPINE KE: £26,047 been received in the year 2021/22 as part of the total award of £46,900 towards the Pharmaco-epidemiology for discovery of targets and modulating strategies to protect against age-related macular degeneration project.

Sight Scotland Veterans grant: This represents the second of three annual unrestricted financial contributions payable from Sight Scotland Veterans following the signing on 30th September 2021 of the Amendment to the Collaboration Agreement dated 8th February 2018 (total commitment of £250,000 payable by June 2024). Macular Society grant: This represents the first of three annual unrestricted financial contributions payable from Macular Society following the signing on 29th September 2022 of the Amendment to the Collaboration Agreement dated 8th February 2018 (total commitment of £300,000 payable by June 2024).

Garfield Weston Foundation: Grant of £25,000 was received on 1[st] July 2021, this was restricted to core costs. Donations in 2021/22 included £73,000 received from the Macular Society (who are also one of the founding members) for the purposes of facilitating or funding AAAMD’s mission to create convenient, affordable and accessible solutions that stop age-related macular degeneration in its early stages before it causes sight loss. BrightFocus: Total award of USD 250,000 has been granted for creating Foresight: Charity-led big data resource for discovery of novel biomarkers for multiple conditions using eye scans. The award will be paid over two years of which 50% has been received in 2022/23.

3. EXPENDITURE AND COST ALLOCATIONS

Costs are allocated based on time spent on charitable activities or support and governance. For the period to 31st March 2023 costs allocated to each activity were as follows:

Charitable Activities and Raising
Funds
Programme costs
Conference and research projects
Total		 Staff
Other
Support*
Group
Total
Group
Total
costs
costs
costs
2023
2022
£
£
£
£
£**
179,036
46,074
130,996
356,106
305,629
-
100
-
100
100
179,036
46,174
130,996
356,206
305,729

Note: Other costs includes grants paid/payable of £42,045 for the INSIGHT project.

*Support and Governance
Staff, consultants and expenses
Insurance
Legal & Professional
Audit, Tax and Accountancy services
Other administrative expenses		 Staff
costs
Other
costs
Group
Total
2023
Group
Total
2022
£
£
£
£
87,115
-
87,115
41,670
-
2,494
2,494
3,505
-
1,462
1,462
3,838
-
12,908
12,908
6,935
-
27,017
27,017
4,807
87,115
43,881
130,996
60,755

BASIS OF ALLOCATION

BASIS OF ALLOCATION
Support & Charitable
Governance Costs Activities
% %
Initial set up costs (Foresight) 20 80
Trustees 100 -
Staff Costs (excluding consultants) 5 95
Chief Operating Officer (COO) 90 10
Consultants (excluding COO) 75 25

22

Scientific & Strategic Consultant - 100
Head of Operations (HoO) 70 30
Insurance 100 -
General Legal & professional 35 65
Services of BPE & Crowe 10 90
Launch, marketing, annual conference and research projects - 100
Audit, tax and accountancy services 100 -

Charity

Charity
Charitable Activities
Programme costs
Annual conference and research
projects
Total
*Support and Governance
Staff, consultants and expenses
Insurance
Legal & Professional
Audit, Tax and Accountancy
services
Other administrative expenses		 Staff Costs
£
179,036
-		 Other
Support &
Governance
Costs
Total
Total
*
2023
2022
£
£
£
£**

46,074
41,984
267,094
305,629

100
-
100
100
179,036
46,174
41,984
267,194
305,729
Staff Costs
Other
Total
Total
costs
costs
2023
2022
£
£
£
£
13,712
-
13,712
41,670
2,022
2,022
3,506
1,409
1,409
3,838
8,394
8,394
6,935
16,447
16,447
4,807
13,712
28,272
41,984
60,755

4. EMPLOYEE INFORMATION AND STAFF COSTS

a) The average headcount

The average number of staff employed by the group is 3 (2022: 1). The services of a part-time COO (April-June 22) and other advisory roles were also provided by externally contracted consultants or recruited though the founder charities and recharged accordingly.

b) Expenditure included the following staff and related costs:

Wages and salaries
Social security
Employer’s pension costs
Other Compensation
Consultancy costs		 Group
2023
Group
2022
£
£
192,917
135,000
23,788
17,410
10,442
6,750
2,500
-
25,452
34,366
255,099
193,526

The following number of individuals received emoluments in excess of £60,000 (as consolidated salary for the group) during the year.

23

2023 2022
No. No.
Employee(s) received emoluments within the band £140,001 to £150,000 1 -
Employee(s) received emoluments within the band £130,001 to £140,000 - 1

c) Remuneration and expenses

emuneration and expenses
No of Trustee Group 2023
£
Remuneration 1 12,500
Reimbursement of expenses 2 2,093

Remuneration of £12,500 was made to Mark O’Donnell for his services as chair to Foresight Research Limited. There were no reimbursement of expenses or remuneration to trustees in 2022.

d) Donations of services

As at 31st March 2023 AAAMD received accountancy services pro bono estimated at £3,840 from Blind Veterans UK (2022: £7,680). This has been reflected in the Statement of Financial Activities.

e) Key Management personnel

AAAMD considers its management personnel to be the three Governing Charity Trustees, four Independent Trustees, Chief Executive and the Head of Operations. Foresight Research limited consider its management personnel to be the four Directors and the Head of Operations. The total costs incurred in relation to key management personnel during the year were £234,770 (2022 £175,279).

5. GOVERNANCE (INCLUDED WITHIN SUPPORT COSTS)

Auditor’s remuneration (including VAT):
Statutory audit
VAT /tax advice		 Group
2023
Group
2022
£
£
10,200
6,900
4,632
-
14,832
6,900

6. DEBTORS

Other debtors
Accrued income (Grants)
VAT Receivable
Prepayments		 Charity
2023
Group
2023
Charity &
Group
2022
£
£
£
14,071
10,991
2,386
-
-
51,833
-
336
-
-
1,093
-
14,071
12,420
54,219

24

7. CREDITORS: AMOUNTS FALLING DUE WITHIN ONE YEAR

Charity Group Charity &
2023 2023 Group
2022
£ £ £
Amounts due to subsidiary undertakings 620 - -
Other Taxation and Social Security 3,491 9,590 5,810
Pension contributions 1,518 3,114 1,013
Accruals 20,114 23,248 53,302
Other Creditors 12,500
25,743 48,452 60,125
. CREDITORS: AMOUNT FALLUNG DUE AFTER MORE THAN ONE YEAR
Charity Group Charity &
2023 2023 Group
2022
£ £ £
Loan - 360,455 -

8. CREDITORS: AMOUNT FALLUNG DUE AFTER MORE THAN ONE YEAR

Foresight Research Limited (the Company) has secured a committed loan facility of £1,000,000 from several charities in a form of a Programme Related Investment (PRI). As at the end of March 2023, the Company had received £350,000.

This loan is unsecured with no fixed repayment schedule or end date, and it is not repayable on demand. For illustration purposes, the PRI loan interest is charged at 9.1% per annum, see above Note to the Accounts Accounting Policies 1. G).

At the year end, Foresight Research Limited had a loan outstanding totalling £360,455, inclusive of the interest charged to date.

Repayments are expected to commence in the year ending March 2026. The repayment amounts will be determined by the Directors after considering the cash flow requirements of the Company. The repayment amounts will be between the minimum repayment level of 2% of Company revenues, up to a maximum repayment level of 50% of the Company’s post-tax profit.

The total amount repayable will not exceed 1.78 times Loans advanced - e.g., if £1m of Loan advanced, a maximum of £1.78m will be repayable.

Estimated repayment schedule
Amounts falling due <1 year
Amounts falling due 1-5 years
Amount falling due > 5 years
Total		 £
-
404,000
1,376,000
1,780,000

Note : A Programme Related Investment is an asset held by a charity that provides investment funding to individuals or organisations in order to directly further the charitable purposes of the investing charity; any financial return obtained is not a primary reason for making the investment. A Programme Related Investment is made exclusively to further the charitable aims of the investing charity by funding specific activities or related tangible fixed assets of a third party which, in turn, contribute to the investor’s own charitable purposes.

25

9.1 MOVEMENT IN FUNDS AS AT 31 MARCH 2023 - CHARITY

Restricted funds
Clothworkers' Foundation
University Birmingham NHS Foundation
trust (INSIGHT Award)
BrightFocus
Unrestricted funds
Total funds		 At 31 March 2022
Income
Expenditure
At 31 March
2023
31,599
-
(31,599)
-
-
46,316
(46,316)
-
-
102,572
-
102,572
346,784
205,246
(189,279)
362,752
378,383
354,134
(267,194)
465,323

9.2 MOVEMENT IN FUNDS AS AT 31 MARCH 2023 - GROUP

Restricted funds
Clothworkers' Foundation
University Birmingham NHS Foundation
trust (INSIGHT Award)
BrightFocus
Unrestricted funds
Total funds		 At 31 March 2022
Income
Expenditure
At 31
March
2023
31,599
-
(31,599)
-
-
46,316
(46,316)
-
-
102,572
-
102,572
346,784
205,246
(278,291)
273,739
378,383
354,134
(356,206)
376,311

Description of each of the restricted funds are included under note 2

10. MOVEMENT IN FUNDS AS AT 31 MARCH 2022 – CHARITY & GROUP

At 31 March
2021		 Income Expenditure At 31 March
2022
Restricted funds
Grants 100,406 170,274 (239,081) 31,599
Unrestricted funds 233,249 180,183 (66,648) 346,784
Total funds 333,655 350,457 (305,729) 378,383

11. RELATED PARTY TRANSACTIONS

During the year the following transactions took place between AAAMD and its founding charities which are related by virtue of the CEO of each founding charity sitting on the board.

Balance owed Recharges Balance owed
by/ (to) related from Payments Payments by/ (to) related
parties at 31 Related made received parties at 31
March 2022 parties March 2023
£ £ £ £

26

Blind Veterans UK (2,275) (1,735) 4,010 - - (2,275) -

During the year, the charity also received £100,000 (2021/22 £73,000) from Sight Scotland Veterans and £100,000 from Macular Society. This represents the second and first (respectively) instalment of three annual unrestricted financial contributions (totalling £250,000 from Sight Scotland Veterans and £300,000 from Macular Society) payable by March 2024 following the amendment to the Collaboration Agreement dated 8th February 2018.

Other related party transactions:

Foresight Research Ltd received £350,000 representing 35% of the total £1 million payable for the Programme Related Investment.

The charity incurred and paid £17,138 of costs of service with BPE Solicitors (2022: £5,904) for legal & professional services rendered. Trustee and Chairman Rob Bryan is an equity partner of BPE Solicitors (April-October 2022) and also a non-executive director and Company Secretary of Open Data Institute (ODI). The charity incurred costs of £62,091 which has been paid to ODI during the year (£21,846 was accrued in 2021/22).

12. COMPARATIVE STATEMENT OF FINANCIAL ACTIVITIES

Statement of Financial Activities for year ended 31 March 2022 Statement of Financial Activities for year ended 31 March 2022
Restricted
Funds
Unrestricted
Fund
2022
Charity &
Group
£
£
£
-
82,183
82,183
170,274
98,000
268,274
170,274
180,183
350,457
239,081
66,648
305,729
239,081
66,648
305,729
(68,807)
113,535
44,728
(68,807)
113,535
44,728
100,406
233,249
333,655		 2021
Charity &
Group
£
15,742
195,540
211,282
312,738
312,738
(101,456)
(101,456)
435,111

27

28 Action Against AMD