**Charity numbers: 1183175 & SC049746**
## **NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT AND FINANCIAL STATEMENTS**
**FOR THE YEAR ENDED 31 DECEMBER 2024**
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **CONTENTS**
||Page|
|---|---|
|**Reference and administrative details of the Charity, its Trustees and**||
|**advisers**|**1**|
|**Trustees' report**|**2 -19**|
|**Independent auditors' report on the financial statements**|**20 - 23**|
|**Statement of financial activities**|**24**|
|**Balance sheet**|**25**|
|**Statement of cash flows**|**26**|
|**Notes to the financial statements**|**27 -48**|
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS FOR THE YEAR ENDED 31 DECEMBER 2024**
|**Trustees**|Rajeevendra Kumar Mahapatra, Chair
Nicholas Reid, Treasurer
Dr Raj Armanani (elected 29 September 2024)
Prof Antoni Tuck Yin Chan, Trustee
Jo Davies (elected 29 September 2024)
Rachel Davis
Gillian Eames,Trustee(re-elected 29 September 2024)|
|---|---|
||Paul Curry, Trustee
Poppy Hocken, Trustee (retired 29 September 2024)
Claire Jeffries, Trustee
Dr Lesley Jane Kay, Trustee (re-elected 29 September 2024)
Hannah Elizabeth Bruce, Trustee (retired 29 September 2024)
Prof Hasan Imam Syed Tahir,Trustee|
||Alexia Katherine Dreese Granatt,Trustee|
|**Charity registered**
**numbers**
1183175 and SC049746
**Principal office**
Unit 6
Cambridge Court
210 Shepherds Bush Road
London
W6 7NJ
**Independent**
**auditors**
BKL Audit LLP
35 Ballards Lane
London
N3 1XW
**Bankers**
Barclays Bank UK Plc
1 Churchill Place
London
E14 5HP||
Page 1
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
The Trustees present their annual report together with the audited financial statements of the National Axial Spondyloarthritis Society for the year 1 January 2024 to 31 December 2024.
## **Objectives and activities**
NASS’ vision is as follows:
“ _The future we want to create is one where every person with axial spondyloarthritis (axial SpA) has timely and effective diagnosis, treatment and care, is empowered to make informed health choices and feels part of a supportive community.”_
NASS seeks to do this by:
- providing information to the general public about axial SpA, and advice to people living with the condition, their families, carers, service-providers and employers
- advocating to ensure that every person with axial SpA has timely and effective diagnosis, treatment and care
- funding and disseminating research and analysis to advance scientific understanding of the condition and its effective treatment.
In setting objectives and planning for activities, the Trustees have given due consideration to general guidance published by the Charity Commission relating to public benefit, including the guidance 'Public benefit: running a charity (PB2)'.
## **a. Strategies for achieving objectives**
In accordance with the provisions set out in its Constitution, the Trustees have adopted the following strategy for the period 2020 – 2024 to meet NASS’ principal objects:
To ensure that people with axial SpA receive timely diagnosis, effective treatment and care
- Maintain pressure at national level to ensure effective and widespread implementation of the NICE Guideline and Quality Standard for axial SpA
- Continue to run an All Party Parliamentary Group on Axial Spondyloarthritis
- Undertake Parliamentary work in the devolved nations
- Develop and publish a Gold Standard time to diagnosis route map
- Commission research on the economic consequences of a delay to diagnosis
- Create impactful ways to engage primary care professionals and those in appropriate secondary care services to ensure that they identify and refer patients who may have axial SpA
- Form an alliance to protect NHS hydrotherapy services
- Develop a primary care clinical champions programme
- Continue to work in partnership with medical bodies
- Support rheumatology and other services to test approaches to improving diagnosis and treatment and spread the learning across the UK
- Expand the _Aspiring to Excellence_ healthcare improvement programme
- Ensure that patient values and needs underpin NHS service delivery
- Disseminate learning from _Aspiring to Excellence_
- Raise awareness among those working in emergency care and NHS 111
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
To empower, inform and inspire people affected by axial SpA
- Ensure that everyone affected by axial SpA has access to personalised support and the best information about the condition
- Extend personalised support through NASS’ Helpline service, and reliable and user-friendly information resources for everyone affected by axial SpA
- Promote physical activity, and support and motivate people to exercise
- Support and develop the NASS branch network to continue to ensure people can access regular group, physiotherapy led exercise sessions
- Support and motivate people to confidently and safely exercise independently
- Ensure that everyone affected by axial SpA has the skills, confidence and knowledge they need to manage their condition optimally
- Develop a self-management pilot programme and roll it out
To foster a connected and supportive community, raising axial SpA awareness everyday, everywhere
- Conduct public awareness campaigns using various methods and channels to try and increase knowledge. Chiefly this activity will include:
- Using case studies of people living with axial SpA to generate media coverage
- Encouraging our members and supporters to become advocates for NASS and campaigners for improvements in axial care
- Online and social media campaigns to create interest and inform the public
- Using related national and international awareness days
- Create an active community of NASS members and supporters who work together
- Make more use of online tools for streaming events, conversations and debates, to encourage participation and engagement
- Increase our online supporter numbers through social media promotion, listening, and outreach to potential supporters
- Encourage members and supporters to take up fundraising activity for NASS, whether largescale challenge events or activity such as raffles and coffee mornings
- Ensure that people know what NASS stands for, the changes that we are seeking to bring about, and how we operate
- Offer thought leadership and op-ed pieces from the CEO, Chair and other key colleagues to professional and trade outlets and to mainstream health outlets
- Use social media listening techniques to reach out to people talking about axial SpA, making them aware of NASS and its resources
- Develop annual membership campaigns to increase the number of members and membership revenue
- Seek outreach opportunities through external events outside of the sector at which NASS can contribute and have visibility.
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## **NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **b. Activities undertaken to achieve objectives and achievements**
The charity fulfils its objectives by:
- Providing information to people living with axial SpA
- Supporting people through a Helpline service and welfare benefits advice
- Providing a wide range of self-management resources, including webinars, videos and online meetings
- Supporting our network of local branches which are led by volunteers and provide regular group physiotherapy sessions
- Campaigning amongst policy makers, Parliamentarians and health service leaders
- Providing expert quality improvement support to rheumatology teams and primary care professionals who are working to reduce diagnostic delay and improve the quality of care
- Raising public awareness of the condition and of NASS
- Supporting research studies
- Contributing to public consultations relating to musculoskeletal health and the management of spondyloarthritis.
## **c. Volunteers**
NASS is heavily dependent on 250 volunteer members who provide support at branch level. Volunteer members are unpaid and NASS’ accounts do not reflect the value to NASS of the many hours work provided free to us. The Trustees are fully conscious of this value and recognise that the work of NASS would be considerably curtailed without the support provided by volunteer members.
Our NASS branches offer regular, physiotherapist-led group exercise for anyone living with axial SpA. They are subcommittees of NASS and are led by a committee usually comprising a Chair, Treasurer and Secretary. We support our branches with a suite of resources, regular promotion of their activities, online meetings and a named member of staff who is available Monday to Friday to help with any problems or issues.
## **d. Main activities undertaken to further the charity’s purpose for the public benefit**
NASS provides public benefit by:
- working with statutory bodies and others that provide for the treatment and welfare of people affected by axial SpA
- educating people affected by axial SpA, as well as healthcare professionals and the public, on the condition and best management
- helping people reach their potential and live their best lives
- promoting research into the management and cure of axial SpA and its causes
- disseminating the results of research related to axial SpA.
In so doing, NASS improves the lives of those affected by axial SpA, particularly in relation to their ability to contribute positively to the prosperity of their communities and the country as a whole.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **Achievements and performance**
## **a. Summary**
2024 was an impactful year for NASS. Despite having a reduced workforce (11.1 whole time equivalents), our activities, visibility and influence continued to be strong:
- We supported 5700 people living with axial SpA through our Helpline
- We helped people to access £1,400,000 of welfare benefits
- Since we launched our self-management programme in 2020, our webinars have had 433,000 views, we have partnered with 53 rheumatology departments to run online sessions and had more than 650 attendees at our online peer support meet ups
- Our awareness campaign has now reached 6 million people since its launch in June 2021, and 35,000 people have completed our online symptom checker
- The data from our ongoing patient survey indicate a reduction in the time to diagnosis at UK level to 7 ½ years
- Our membership increased by 6%
- We held a policy roundtable to explore opportunities to promote axial SpA in the context of the new government’s proposed NHS 10-year plan, and supported a Westminster Hall debate on musculoskeletal (MSK) health and work
- In Wales, we worked with the MSK clinical lead, MSK Strategic Network Manager and Rheumatology Lead and are a member of the Low Back Pain Pathway group
- We responded to numerous consultations including the new government’s 10-year strategy, NHS Wales MSK Strategy, Personal Independence Payments, the NHS Constitution consultation, and we supported BSR’s Homecare Campaign
- We delivered education sessions to a wide range of healthcare professionals and continued to run our quality improvement initiative with rheumatology departments
- We had 68 branches meeting face to face for gym and/or hydrotherapy sessions, and created a NASS Affiliated Group programme.
## **b. Key performance indicators**
Performance against key indicators was as follows:
- **Fundraising ratio:** every £1 spent on income generation activities raised £5.79 in income
- **% of expenditure on charitable activities:** 70% of our expenditure was directly related to charitable activities
- **total annual value of successful benefit applications for our members.** We helped members to secure £1,400,000 of welfare support payments
- **Numbers of people reached through our self-management programme:** 102,915
- **Helpline requests processed within two working days** : 97% (target is 95%).
## **c. Review of activities**
## **Reducing diagnostic delay**
In 2020, respondents to our national consultation process – healthcare professionals (HCPs), professional bodies and patients – agreed that it should be possible for every person experiencing symptoms of axial spondyloarthritis (axial SpA) to receive a diagnosis within one year of symptom onset. 2021 we published a route map to achieve a Gold Standard time of one year.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
Starting from a current baseline average of 8.5 years, the achievement of this goal will require transformational change. This includes a significant increase in awareness of the condition among HCPs and the general public, a critical mass of clinical leaders who will improve health care performance in axial SpA, the widespread use of technology to ensure that axial SpA is higher within clinical reasoning and to support diagnosis, the routine use of pathways to ensure that patients are referred directly to rheumatology for assessment, and consistent use of agreed national protocols for imaging.
Above all, to attain such a dramatic change in time to diagnosis we must win hearts and minds, build a social movement of people who want to work with us to create change, and demonstrate proof of concept for our ideas.
2024 was the third full year of implementation of our route map.
## Making the case for change
We continued to make the case for change through research and audit:
- We submitted journal articles on our economic modelling, work in primary care and the first three phases of the public awareness campaign, and presented our work at UK and international conferences.
- In 2022 we established a UK-wide patient-completed survey of time to diagnosis in axial SpA, which includes patients diagnosed since January 2021. By the end of 2024, 57 NHS Trusts and Health Boards had signed up to the survey (up from 39), submitting data for 600 patients. The data indicate a potential trend of reduced time to diagnosis in 2024
- We supported the trialling of the PRIMIS primary care pop-up alert, and one of our Champions in Primary Care worked with Ardens to refresh the MSK template. Another worked with Fourteen Fish which manages the appraisal process for GP trainees. Our Champions presented at five UK conferences and training events.
- We launched the second round of our Changemaker awards to recognise the work of HCPs who are working alongside NASS to reduce the time to diagnosis. We released four podcast episodes / blogs on the campaign work focused on primary care, uveitis, inflammatory bowel disease and MRI respectively, and ran 12 national and regional HCP peer to peer network events.
We strengthened our educational work with healthcare professionals:
- We continued to run a Peer to Peer HCP Network, providing monthly webinars and an opportunity to share ideas and issues.
- We delivered bespoke education sessions in collaboration with groups such as the Royal College of Chiropractors, Physio First and MIMS. We also delivered locality peer to peer meetings for HCPs.
- We conducted a consultation with our closest HCPs to gauge the level of support they were able to provide to NASS, and also what support they needed from NASS.
We brought these results to the attention of Parliamentarians, policymakers and healthcare professionals:
- We supported a Westminster Hall debate on musculoskeletal (MSK) health and work.
- We convened a Parliamentary roundtable meeting to explore opportunities for axial SpA in the context of the incoming government’s 10 NHS Plan for England.
- In Wales, we worked with the MSK clinical lead, MSK Strategic Network Manager and Rheumatology Lead and are a member of the Low Back Pain Pathway group.
- We presented our work at regional SpA Academies, regional rheumatology networks, the British
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
Society for Spondyloarthritis annual scientific meeting, the British Society for Rheumatology conference, the International Congress on Spondyloarthritides and the European Alliance of Associations in Rheumatology (EULAR) conference.
## Raising public awareness about early diagnosis
Raising public awareness about axial SpA and inflammatory back pain is key to earlier diagnosis. We continued to run a national social media campaign featuring case studies of people living with axial SpA.
In addition, we launched a six-week public awareness campaign in Belfast, reaching almost 1,000,000 people through our social media campaign including 81% of 18-40 year olds, with almost 400 people completing the symptom checker. We then embedded the new collateral used for Belfast in the next phase of our national awareness campaign, reaching over 1,200,000 people in four months.
Since our awareness raising campaigns began in June 2021, we have reached 5 million people. Crucially, more than 35,000 people have completed our online symptom checker and started their journey to diagnosis.
## We are seeing indications of a reductions in the time to diagnosis at UK level
The latest data from our ongoing patient survey indicate that in 2024 the average time to diagnosis from our participating sites has reduced to 7 ½ years. This suggests that our campaign, and the collective efforts of the HCPs working us, is having an impact at national level.
## **Improving healthcare quality across the patient pathway**
In 2019 we established the _Aspiring to Excellence_ programme. In partnership with the NHS Transformation Unit, we teach rheumatology teams the fundamentals of healthcare quality improvement and, through learning sessions, coaching and webinars, we encourage participating teams to share their experiences and data.
In 2024, cohorts three and four continued with their projects, alongside learning sessions, webinars and coaching from our partners at NHS Transformation Unit. We welcomed the National Clinical Director for MSK with NHS England, and the NHS Executive MSK Lead (Wales) to our Celebration Event which showcased the work of the teams and our Champions in Primary Care. We showcased all of the projects on our website and several of the teams also presented their work at the British Society of Rheumatology conference and at the British Society for Spondyloarthritis Annual Scientific Meeting.
In 2023 we began an ambitious long-term initiative to create a Gold Standard in Treatment and Care for Axial SpA. In 2024, we appointed leads to the workstreams, both lived experience and HCPs. We issued a call for evidence from people with axial SpA and HCPs, encouraging them to share their positive experiences of treatment and care and examples of best practice and novel interventions. This included a targeted campaign for those with lived experience, and a variety of ways to respond for all parts of the community including online surveys and interviews.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **Helping people to live well with axial SpA**
Axial SpA is a condition that requires a great deal of information, support and guidance for people to manage their symptoms effectively and ensure optimal long-term outcomes. There are few formal patient education programmes for axial SpA and many people report feeling isolated and have never met anyone else with the condition. NHS backlogs and the rheumatology workforce crisis are such that this need is ongoing.
## Helpline
We supported 5,700 enquiries in 2024, a 14% increase on 2023. This seems to be related in part to NHS staffing shortages and the workload in rheumatology departments, with callers reporting long waits for appointments and calls to department helplines resulting in a lack of response. Additionally, our self-management programme has increased our visibility and encouraged people to be in contact.
The NASS Helpline is often the only place people can turn to for help and support and we responded to 85% of queries within 1 working day and a total of 97% within 2 working days. The worsening economic situation has also led to more people seeking our help with disability benefits. We supported 299 people with claims which we predict will result in people receiving £1.4 million in disability benefits.
## NASS Branches
We have 68 branches meeting face to face for gym and/or hydrotherapy sessions. We are very pleased to report that 39 of these branches are able to offer hydrotherapy. Nine currently offer online sessions, including our all-UK online branch.
We created a NASS Affiliated Group programme. Our branches are sub-committees of NASS and are structured so that a committee of volunteers run the branch and manage the finances. This structure did not suit everyone and therefore we introduced NASS Affiliated Groups so we could bring in groups who run differently but still offer regular affordable exercises sessions targeted at people with axial SpA. We currently have two affiliated groups and hope to be able to expand this further.
Overall, branches are in a relatively stable situation. Most that were working to return to operation post-COVID are now back and, for the most part, services are running smoothly. While low numbers may be a challenge with some branches, in other areas there are now waiting lists, especially for hydrotherapy.
We supported all branches in logistical conversations with hospitals, health professionals and venues and with promotion of their branch.
## - Supported self management programme
We support people through education and empowerment, and by creating a supportive community, we aim to reduce the isolation of people with axial SpA.
In developing our self-management work, we held consultations with patients and healthcare professionals, which identified that our supported self-management programme should: empower patients with axial SpA to live well with their condition; be co-designed with people living with axial SpA and healthcare professionals; be easily accessible; reduce isolation; and leave a legacy.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## Our supported self-management programme comprises:
- Regional online sessions in partnership with local NHS rheumatology teams
- _My AS, My Life_ live webinars
-
- _Your SpAce_ videos, downloadable resources, and online peer support meetups
In 2024, we ran eight online sessions in partnership with 26 NHS rheumatology departments, reaching 236 people living with axial SpA. We commenced regional pilots in Northern Ireland, Wales, and England with support from The National Lottery Community Fund.
We ran seven webinar sessions with over 50,000 views. The _My AS, My Life_ webpages were visited nearly 18,000 times. We continued to get excellent engagement with the live sessions, and the video library is an excellent resource to signpost people to. Sessions covered: information about the condition; tips for daily life with axial SpA; exercise taster sessions; research into exercise; getting the most out of medical appointments; travelling; university life; work; and medication during pregnancy.
We launched two new _Your SpAce_ modules on making medication decisions and navigating appointments. _Your SpAce_ is aimed at people at the start of their axial SpA journey, as well as those who are struggling, and people who feel isolated. It was developed in collaboration with people with axial SpA and HCPs. The new modules comprise eight videos and five downloadable resources. In 2024, we sent promotional packs to 99 rheumatology departments containing posters to display in clinics and promotional postcards to hand to patients.
In 2024, the _Your SpAce_ videos were watched 11,000 times and webpages visited 23,000 times.
We presented the results of the first three _Your SpAce_ modules at EULAR Congress in Vienna and it was awarded best abstract in the People with Arthritis and Rheumatism in Europe Category.
As part of _Your SpAce_ we developed a safe space for people to meet and share experiences and ask questions through our online meetups. In 2024, we ran 10 on-line meetups, with 366 attendees. We presented the results at the BSR Conference in an oral abstract presentation.
Since the Self-management Programme started in 2020, to the end of 2024 we:
- Ran 131 live-streamed webinars with over 433,000 views
- Ran 63 online self-management sessions in partnership with 53 rheumatology departments, reaching 1640 people living with axial SpA
- Created 22 _Your SpAce_ videos with 22,720 views and 44,973 webpage visits
- Ran 22 _Your SpAce_ meetups with 663 attendees.
## Information provision
193 packs of guidebooks were sent to NHS Hospitals in 2024 (up from 122 in 2023) comprising over 10,500 information guides. Our guides and the additional posters and flyers we provide are an important introduction both to axial SpA and to NASS for people diagnosed with the condition. We continued to update the website information on a rolling basis.
## **Raising the profile of axial SpA within Government**
In 2019 we worked with Parliamentarians to create an All Party Parliamentary Group (APPG) on axial SpA with the aim of providing national level oversight of the implementation of NICE Guideline 65 concerning the diagnosis and treatment of spondyloarthritis. In 2024 we put the APPG meetings
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## **NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
on hold, partly for financial reasons and partly because of the inevitable turbulence created by the General Election.
Nevertheless, we supported a Westminster Hall debate on employment and MSK health and held a policy roundtable to explore opportunities to promote axial SpA in the context of the new government’s proposed NHS 10-year plan in England.
In Wales we worked with the MSK clinical lead, MSK Strategic Network Manager and Rheumatology Lead and are a member of the Low Back Pain Pathway group.
## **Social media**
We continued to reach and engage broader audiences on social media, creating a sense of community and sharing stories about people’s experiences of life with axial SpA. We supported World AS Day, World Arthritis Day, Bone and Joint week and Pride Month.
Following cost reduction measures in 2023, we operated without any communications staff in 2024. Consequently, we lost followers on some channels, although we were able to grow our followers on Facebook and YouTube, as follows:
- **Facebook:** Our reach was 4.9 million, covering organic and paid for social activity (up from 4.1 million in 2023). There were 55,000 visits to our page (a 33% increase on 2023).
- **Instagram:** we reached 209,000 profiles with our content (down from 588,800 in 2023), which led to 6,900 visits to our profile and 715 new followers.
- **YouTube:** the NASS YouTube channel increased subscribers by 1397, and our videos received 106,100 views (down from 127,000 in 2023)
- **LinkedIn** : the NASS LinkedIn page had a reach 60,000 (similar to 2023) and 480 new followers (down from 565 people in 2023)
- **Twitter (X):** changes to X resulted in us losing access to channel analytics.
- **Website performance:** The NASS website had 473,000 views and 113,000 users (down from 124,400 in 2023).
## **Membership**
Our members are the lifeblood of NASS. Membership increased by 6% in 2024 from 4,100 to 4,324 with re-engagement with lapsed members and the implementation of a membership retention plan. We improved the welcome pack and offered exclusive content including two new members only webinars, with 400 attendees in total.
## **d. Factors relevant to achieve objectives**
Our income was higher in 2024 than 2023 (despite one pharmaceutical partner ending their support) and our expenditure reduced, reflecting the impact of the cost reduction measures put in place in 2023. As a consequence, our overall financial position stabilised.
We continue to have excellent relationships with a wide range of healthcare professionals, professional bodies, health consortia and other charities, all of which has enriched our work and strengthened its impact.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **e. Fundraising activities and income generation**
## **Raising funds for NASS**
Thank you to everyone who supported us in 2024 by donating or fundraising. We don’t receive public funding and couldn’t do our work without the generosity of our supporters. The money we raise ensures that we’re here to transform axial SpA diagnosis and care, and offer practical support and advice to anyone affected by the condition.
At the national level we met 92.7% of our total income budgeted target and our income in 2024 amounted to £874,158 (£873,253 in 2023). Income at branch levels amounted to £179,640 in 2024 (£154,399 in 2023)
In 2024 our income generation activities included:
- **Community and events fundraising:** In 2024, 44 people raised money for NASS by organising an event in their community or through birthday fundraising, 72 fundraisers took on challenge events (running, swimming, walking etc.), and 42 people joined one of our fundraising events (Stretch-tember, Walk Your AS Off and Winter Walks). Collectively, these activities raised £98,811 including Gift Aid. We would like to express our sincere gratitude to each individual fundraiser who dedicated their time and effort to support our cause. We would also like to thank the corporate companies who took part in our first ever Football Tournament that raised £13,000.
- **Donations and individual giving:** In 2024 we had 174 regular donors, 326 people supported us through our Winter Appeal. 215 people donated to NASS for the first time.
- **Corporate Donations:** We extend our thanks to the corporate companies that have generously supported us through direct donations and matched donations. Your support is invaluable in helping us continue our mission.
- Barclays PLC
- BioScript Sterling Limited
- Deutsche Bank AG
- Google LLC
- Microsoft Corporation
- Reed Exhibitions Limited
- RELX PLC
- Robert W. Baird & Co. Incorporated
- Sipped Coffee Ltd
- Sony Interactive Entertainment
- The Capital Group Companies, Inc.
- The Estée Lauder Companies Inc.
- **Trust fundraising:** We would like to thank the following grant-making organisations that supported us, collectively giving £82,760:
- The Bernadette Charitable Trust
- The Charity of Stella Symons
- The Joan Ainslie Charitable Trust
- `o` Marsh Christian Trust
- The Simon Gibson Charitable Trust
- `o` Masonic Charitable Foundation
- The G C Gibson Charitable Trust
- The Chamifealion Charitable Trust
- The Hospital Saturday Fund
- `o` Souter Charitable Trust
- The National Lottery Wales
- `o` The National Lottery England `o` The National Lottery Northern Ireland
- The Mary Homfray Charitable Trust
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
- _**Legacies:**_ In 2024, we received 12 legacies totalling £102,838, for which we are deeply grateful. These generous gifts make a lasting difference to people affected by axial SpA.
- _**Investments:**_ Our residential properties generated £34,450 of rental income, and cash savings generated £6,904 of interest income.
- **Funding from pharmaceutical companies:**
We would also like to thank the following companies that supported us in 2024:
- AbbVie Ltd £30,637
- `o` Biogen Idec Ltd £30,000 `o` Eli Lilly and Company £30,000 `o` UCB Pharma Ltd £243,646.
Any relationship NASS has with a pharmaceutical company is underpinned by the following principles:
- **Independence** – The independence of NASS must not be compromised by the relationship with an external organisation or by the agreed working arrangements. The financial benefit must be made available for the support of our charitable activities without restriction. We will not allow funders to influence our campaigning, policymaking, research or fundraising for their own purposes. We will ensure our editorial independence is maintained and all information produced by NASS will be based on the latest evidence, informed by our Medical Advisory Board.
- **Transparency** – Any relationship with an external organisation is not an endorsement of their product or organisation and will be made transparent to our members, supporters, staff and the general public including in our annual Report and Accounts. All partnerships will be governed by a written agreement which will detail requirements and expectations from each party.
- **Benefit for those living with axial SpA** – Any relationship formed with an external organisation must be positive for NASS members and people living with axial SpA and in furtherance of our charitable aims.
- **Regulation and good practice** – All funders must comply with all relevant laws and regulations, as well as good practice. This includes full compliance with the Association of the British Pharmaceutical Industry's Code of Practice.
- **Use of NASS logo** - our logo may only be used following written approval from NASS. We may use a funder's mark where relevant to the relationship including in webinars, event banners, on our website or on press releases where appropriate. The use of a funder’s trademark will have no impact on the independence of the charity.
- **Sharing expertise and knowledge** - We will work with funders to share non-product expertise and knowledge. This may include participation in networking events and meetings
- **Privacy policy** - In line with our privacy policy NASS will not, under any circumstances, share the personal data of any of our service users or supporters with a pharmaceutical company.
- **Alignment with our strategy and values** - Any collaboration or cooperation with pharmaceutical companies will be assessed against the ethics, desirability and practicality in relation to the overall plans and work of NASS.
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## **NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **Fundraising responsibly**
We rely on the generosity of our donors and fundraisers to do our life-changing work and have processes and policies in place to ensure that we fundraise responsibly.
- We are a member of the Fundraising Regulator and pay an annual levy
- We are transparent about our fundraising and treat donors and fundraisers respectfully and fairly
- We provide personal stewardship to anyone who is taking part in a fundraising activity for us; this includes ensuring people are aware of the risks of taking part in activities
- We explain how to opt out of communications and people are easily able to unsubscribe from emails
- We adhere to data-protection legislation and provide information on our website about our data-privacy policy, and how to opt-out of communications
- We take all reasonable steps to opt-people out of communications if they request to no longer hear from us
- We respond quickly and efficiently to any complaints about fundraising. We received no complaints in 2024
- We mitigate the risk of not reaching our fundraising targets by reviewing management accounts monthly, monitoring income levels, and reforecasting. We take appropriate actions if fundraising income falls below anticipated levels.
- We are registered with Hammersmith and Fulham Council as a Small Society Lottery under Paragraph 42 of Part 5 of Schedule 11 to the Gambling Act 2005. During the year, we ran three fundraising raffles (Valentine's, Summer and Festive), which collectively raised £6,198.50, of which £3,733.50 was retained as unrestricted income to fund our charitable activities. The remainder covered prizes and administrative costs associated with running the lottery.
## **f. Investment policy and performance**
To minimise the risk of potential loss of funds and maintain financial security, a portion of our funds is held in cash within a reputable bank.
Additionally, the charity has made strategic investments in two properties we own which provide a consistent and reliable source of income for our charitable initiatives.
All investments are carried at market value.
## **Financial review**
The year saw a modest increase in total income to £1,053,798 (2023: £1,027,652) and a reduction in total expenditure to £1,090,496 (2023: £1,158,200), narrowing the deficit to £36,698 (2023: £140,980). This improvement reflects the continued impact of the cost control measures introduced in 2023 and demonstrates a more sustainable trajectory as we head into the 2025– 2029 strategic period.
## **a. Going concern**
After making appropriate enquiries, the Trustees have a reasonable expectation that the Charity has adequate resources to continue in operational existence for the foreseeable future. For this
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
reason, they continue to adopt the going concern basis in preparing the financial statements. Further details regarding the adoption of the going concern basis can be found in the accounting policies.
The charity's trustees closely monitor its reserves. To ensure adequate cash reserves, the Board of Trustees decided to take out a loan against the properties owned by NASS. The loan increased the charity's liquidity and its free cash reserves.
## **b. Reserves policy**
The charity's funds at the end of the reporting period are as follows: Unrestricted funds: £691,070 Restricted grants: £78,832 Branch funds: £231,873
NASS holds two investment properties valued at £655,000 which are not used for direct charitable purposes but from which NASS derives rental income. These properties have an associated bank loan with total outstanding balance of £295,395 (45% LTV), of which £27,950 is due within 12 months.
Our readily available unrestricted reserves ("free reserves") amount to £331,465 (2023: £372,950), which represented seven months of actual operating costs.
This is calculated by taking our unrestricted funds (£691,070) and deducting the net book value of our investment properties after accounting for associated loans (£655,000 - £295,395 = £359,605). NASS must raise income each year from voluntary sources and total income is likely to fluctuate from year to year. As a general policy, we aim to hold 6-9 months of free reserves. This working capital protects the continuity of our core work, that is, work not funded through restricted income. Core work includes our information and support service, awareness raising, campaigning and policy influencing, and the work of our branches across the UK. We have chosen a reserves level of 6-9 months having considered the level of predictability in our income sources and the extent to which our cost base is flexible or committed. Our largest income sources (legacies and grant funding from pharmaceutical companies) come at irregular intervals, and the majority of our costs are committed, principally in the form of the staff who deliver our charitable objectives.
## **c. Material investments policy**
The Charity holds two properties that are rented out to private tenants. Properties were chosen as a reliable source of income for the Charity and the expected income is set at £34,000 per annum. Both properties are let to private tenants.
## **d. Principal risks and uncertainties**
The Trustees have adopted appropriate policies necessary to limit or mitigate the risks faced by NASS. The principal risks are:
- Loss of income: NASS seeks to broaden and expand its income from all sources. Nevertheless, NASS is dependent upon voluntary income, both at branch level and at national level, and aims to increase its membership locally and nationally
- Loss of reputation: NASS seeks at all times to maintain its independent viewpoint. Grants from
Page 14
## **NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
- pharmaceutical companies are strictly controlled so as to ensure that our independence is not compromised
- Loss of staff: NASS has a reward strategy to ensure that the charity is able to recruit and retain high quality staff. It also has a set of HR policies to provide the appropriate framing for all HR matters.
In the course of 2024, one pharmaceutical partner discontinued their funding. All remaining relationships were reviewed to ensure continued alignment with NASS’s policy on independence, transparency and public benefit. The Trustees are satisfied that editorial oversight, campaigning priorities and policy engagement activities remained wholly independent and were not influenced by any external funding arrangement
NASS has a safeguarding policy and set of procedures applicable to beneficiaries, staff, trustees and volunteers. Staff are trained in safeguarding and NASS branches have a training resource. The safeguarding policy and procedures are reviewed on an annual basis.
## **e. Financial risk management objectives and policies**
Effective management of financial risk is a high priority. Given the importance of accurate financial projections and reporting, we have taken a comprehensive approach to ensure that we consistently maintain a high standard in all aspects of financial management. It includes implementing robust budgeting and costing methods, adhering to donor imposed restrictions, maintaining strong financial systems and controls, regular reporting and ensuring adequate reserves and cash flow management. We also conduct regular audits and financial reviews to maintain transparency and accountability. We have a range of policies and procedures to achieve these objectives. We employ processes and controls to guarantee accurate financial forecasting and reporting. We follow a welldefined procedure for expenditure approval, ensuring that any spending is fully authorised, and documented accordingly. Furthermore, we take great care to keep detailed records of all restricted funds, which helps to ensure complete transparency and accountability in their utilisation.
Collaborative budgeting methods are also used to ensure our financial management practices are practical and efficient. These policies and practices reflect our commitment to sound financial management, compliance, transparency, and accountability.
## **f. Principal funding**
In 2024 NASS received its funding from various sources, with a notable distinction between income generated at the national level (83%) and that at the branch level and designated for their specific use (17%). 89% of branch income came from subscriptions, 3% from donations and legacies and 7% from fundraising activities.
At the national level, our income for 2024 was diversified across various categories. The majority of our funding originated from grants provided by pharmaceutical companies (38%), designated for specific projects (restricted), along with a contribution towards general operational expenses. Other sources of income were as follows:
- Donations: 22%
- Fundraising: 14%
- Membership subscriptions: 10%
- Legacies: 12%
- Investments 5%
Page 15
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **Structure, governance and management**
## **a. Constitution**
The charity is a Charitable Incorporated Organisation and was registered with the Charity Commission in April 2019. The rules and regulations of the CIO are set out in its Constitution, adopted by the Board of Trustees on 14 September 2019.
## **b. Methods of appointment or election of Trustees**
The governing body of NASS is a Board of Trustees consisting of elected Trustees. Only members of NASS may be appointed as Trustees and the maximum number is twelve.
At every annual general meeting of the members of NASS, one third of the charity trustees shall retire from office. The charity trustees to retire by rotation shall be those who have been longest in office since their last appointment or reappointment. If any trustees were last appointed or reappointed on the same day those to retire shall (unless they otherwise agree among themselves) be determined by lot. The vacancies so arising may be filled by the decision of the members at the annual general meeting; any vacancies not filled at the annual general meeting may be filled by the charity trustees. Such persons shall retire at the conclusion of the next annual general meeting after the date of their appointment, and shall not be counted for the purpose of determining which of the charity trustees is to retire by rotation at that meeting.
The members or the charity trustees may at any time decide to appoint a new charity trustee, whether in place of a charity trustee who has retired or been removed in accordance with clause 15 (Retirement and removal of charity trustees), or as an additional charity trustee, provided that the limit specified on the number of charity trustees would not as a result be exceeded.
The Chair and Treasurer are approved by the Board and selected from among the trustee group. Their term of office as Chair and Treasurer is consistent with their term of office as a trustee. In advance of each AGM members of NASS are widely encouraged to nominate a fellow member as Trustee.
On appointment, new trustees are asked to spend a half day in the NASS central office for a briefing with the Chief Executive and staff to understand how the society works. Formal training is provided when required.
## **c. Organisational structure and decision-making policies**
The Trustees meet quarterly to review matters of policy and to make appropriate judgements, directions and decisions on CIO issues. Trustees delegate authority on some matters to a Finance and General Purposes Committee consisting of the Chair, the Treasurer, up to three appointed Trustees and the Chief Executive and Head of Finance and Administration. This Committee meets four times per year. NASS also has a Medical Advisory Board which acts in advisory capacity only. Day to day management of NASS is undertaken by the Chief Executive and their staff. The trustees consider the Chief Executive and management team as comprising the key management personnel of the charity in charge of directing and running and operating the charity on a day to day basis.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
## **d. Policies adopted for the induction and training of Trustees**
All new trustees receive an induction programme which includes the organisation’s structure, scheme of delegation, NASS constitution, strategic plan, business plan and budget, trustee code of conduct and CC3, _The Essential Trustee_ . Periodic training is provided (e.g. how to read management accounts).
## **e. Pay policy for key management personnel**
Every three years we commission external HR consultants to undertake independent benchmarking of all roles. The last review was in November 2022. Our medium term aim is to pay at the midpoint. The pay of the Chief Executive is reviewed annually by the trustees.
## **f. Related party relationships**
There are no related party relationships. NASS is a member of various umbrella groups, including the Arthritis and Musculoskeletal Alliance, The Axial SpA International Federation, National Voices, the National Council for Voluntary Organisations, the Disability Benefits Consortium and the Prescription Charge Coalition and The Alliance (Scotland). Our membership of these bodies does not impact on the operating policies adopted by the charity.
## **g. Financial risk management**
Further to the risks identified above, in 2025 trustees will be asked to approve an updated risk management strategy.
## **h. Trustees' indemnities**
NASS holds Trustee Indemnity insurance through Markel UK, providing cover with a limit of 1 million pounds against any wrongful act claim made against a Trustee.
## **Plans for future periods**
- In November 2024 the Board approved a strategy covering 2025 – 2029 with five long-term goals:
- _**To ensure that people with axial SpA are diagnosed within twelve months of symptom onset**_
- _**To create and embed a gold standard approach to treatment and care, integrating patient and clinical perspectives**_
- _**To support and empower people to live well with axial SpA and feel part of a supportive community**_
- _**To influence, advocate and educate for axial SpA**_
- _**To ensure that NASS is able to deliver its ambitious programmes**_
Page 17
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
Our priority areas for 2025 are:
- Hold a Parliamentary event to launch two national improvement goals on the time to diagnosis, announce the recipients of the second round of Changemakers and launch the Faces of Axial SpA campaign
- Publish a time to diagnosis ‘playbook’ and launch a call for expressions of interest to develop a place-based intervention in 2025 – 2026
- Publish four scientific manuscripts
- Design and begin implementation of a research study to track the journeys to diagnosis of a sample of the 36,000 people who have completed the symptom checker
- Continue to recruit to the time to diagnosis audit
- Support the rollout of the PRIMIS pop-up tool.
- Complete cohorts three and four of Aspiring to Excellence
- Design and deliver a consensus development process to develop a set of proposed statements that describe a gold standard approach to treatment and care, and run a consultation process on the draft standard
- Publish a gold standard that covers the treatment pathway.
- Extend our self-management work through three projects and build an academic partnership to strengthen our evaluation approach and data
- Sustain our Helpline and Information Service at current levels
- Grow our membership by 6%, improve the members area of the website and offer more exclusive member webinars
- Support NASS branches including information sharing across the network.
- Support primary care education, continue to run a peer to peer network and deliver education sessions to a range of HCPs
- Consider creating an alumni programme for HCPs involved our work
- Support the work of the Wales MSK Strategic Network
- Deliver a programme of parliamentary influencing in England on diagnosis times and the wider issues around MSK programmes
- Make preparations for the 50th anniversary of NASS in 2026.
- Strengthen fundraising capability and capacity by investing in the Dataro machine learning fundraising software and recruiting a digital fundraising marketeer
- Pilot work to identify the growth potential in corporate fundraising
- Pilot a corporate membership scheme
- Undertake a governance review at Board level.
## **Statement of Trustees' responsibilities**
The Trustees are responsible for preparing the Trustees' report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).
The law applicable to charities in England & Wales and Scotland requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the Charity and of its incoming resources and application of resources, including its income and expenditure, for that period. In preparing these financial statements, the Trustees are required to:
- select suitable accounting policies and then apply them consistently
- observe the methods and principles of the Charities SORP (FRS 102)
- make judgments and accounting estimates that are reasonable and prudent
- state whether applicable UK Accounting Standards (FRS 102) have been followed, subject to any material departures disclosed and explained in the financial statements
- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the Charity will continue in business.
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **TRUSTEES' REPORT (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2024**
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, the Charity (Accounts and Reports) Regulations 2008, the Charities and Trustee Investment (Scotland) Act 2005, the Charities Accounts (Scotland) Regulations 2006 (as amended) and the provisions of the Memorandum of Association. 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.
## **Disclosure of information to auditors**
Each of the persons who are Trustees at the time when this Trustees' report is approved has confirmed that:
- so far as that Trustee is aware, there is no relevant audit information of which the charity's auditors are unaware, and
- that Trustee has taken all the steps that ought to have been taken as a Trustee in order to be aware of any relevant audit information and to establish that the charity's auditors are aware of that information.
## **Auditors**
The auditors, BKL Audit LLP, have indicated their willingness to continue in office. The designated Trustees will propose a motion reappointing the auditors at a meeting of the Trustees.
Approved by order of the members of the board of Trustees and signed on their behalf by:
Rajeevendra Kumar Mahapatra
Date: 18/07/2025
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**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **Opinion**
We have audited the financial statements of National Axial Spondyloarthritis Society (the 'Charity') for the year ended 31 December 2024 which comprise the Statement of financial activities, the Balance sheet, the Statement of cash flows and the related notes, including a summary of 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 31 December 2024 and of its incoming resources and application of resources, including its income and expenditure for the year then ended
- have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice, and
- have been prepared in accordance with Accounting and Reporting by Charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and in other respects the requirements of the Charities Act 2011.
## **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 Auditors' 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 United Kingdom, including the Financial Reporting Council'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 twelve months from when the financial statements are authorised for issue.
Our responsibilities and the responsibilities of the Trustees with respect to going concern are described in the relevant sections of this report.
Page 20
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY (CONTINUED)**
## **Other information**
The other information comprises the information included in the Annual report other than the financial statements and our Auditors' 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 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 where the Charities (Accounts and Reports) Regulations 2008 and the Charities Accounts (Scotland) Regulations 2006 (as amended) require us to report to you if in our opinion:
- the information given in the Trustees’ Report is inconsistent in any material respect with the financial statements; or
- sufficient accounting records have not been kept; or
- the financial statements are not on agreement with the accounting records and returns; or
- we have not received all the information and explanations we require for our audit.
## **Responsibilities of trustees**
As explained more fully in the Trustees' responsibilities statement, the Trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for 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.
## **Auditors' responsibilities for the audit of the financial statements**
We have been appointed as auditor under section 144 of the Charities Act 2011 and section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and under the Companies Act 2006 and report in accordance with the Acts and relevant regulations made or having effect thereunder.
Page 21
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY (CONTINUED)**
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 Auditors' report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.
Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:
- Enquiring of management around actual and potential litigation and claims
- Reviewing board meeting minutes of meetings of those charged with governance
- Reviewing financial statement disclosures and testing to supporting documentation to assess compliance with applicable laws and regulations
- Performing audit work over the risk of management override of controls, including testing of journal entries and other adjustments for appropriateness, evaluating the business rationale of significant transactions outside the normal course of business and reviewing accounting estimates for bias.
Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. This risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.
As part of an audit in accordance with ISAs (UK), we exercise professional judgement and maintain professional scepticism throughout the audit. We also:
- Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control
- Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion of the effectiveness of the charity's internal control
- Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Trustees
- Conclude on the appropriateness of the Trustees' use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the charity's ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our Auditors' Report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our Auditors' Report. However, future events or conditions may cause the charity to cease to continue as a going concern.
- Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation
Page 22
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY (CONTINUED)**
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.
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 Auditors' report.
## **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 in accordance with 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 Auditors' 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 its trustees, as a body, for our audit work, for this report, or for the opinions we have formed.
## BKL Audit LLP
## **BKL Audit LLP**
35 Ballards Lane
London
N3 1XW
Date:
BKL Audit LLP are eligible to act as auditors in terms of section 1212 of the Companies Act 2006.
Page 23
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 DECEMBER 2024**
|**Note**
**Income from:**
Donations and legacies
3
Other trading activities
4
Investments
5
Other income
6
**Total income**
**Expenditure on:**
Raising funds
7
Charitable activities
9
**Total expenditure**
**Net**
**(expenditure)/income**
**before net losses on**
**investments**
Net losses on
investments
**Net**
**(expenditure)/income**
Transfers between
funds
19
**Net movement in**
**funds**
**Reconciliation of**
**funds:**
Total funds brought
forward
Net movement in funds
**Total funds carried**
**forward**|**Restricted**
**funds -**
**Branches**
**2024**
**£**
**166,681**
**12,165**
**-**
**794**
**179,640**
**315**
**187,752**
**188,067**
**(8,427)**
**-**
**(8,427)**
**(2,890)**
**(11,317)**
**243,190**
**(11,317)**
**231,873**|**Restricted**
**funds - All**
**other**
**2024**
**£**
**356,992**
**-**
**-**
**-**
**356,992**
**-**
**341,021**
**341,021**
**15,971**
**-**
**15,971**
**99**
**16,070**
**62,762**
**16,070**
**78,832**|**Unrestricted**
**funds**
**2024**
**£**
**350,642**
**125,170**
**41,354**
**-**
**517,166**
**150,867**
**410,541**
**561,408**
**(44,242)**
**-**
**(44,242)**
**2,791**
**(41,451)**
**732,521**
**(41,451)**
**691,070**|**Total**
**funds**
**2024**
**£**
**874,315**
**137,335**
**41,354**
**794**
**1,053,798**
**151,182**
**939,314**
**1,090,496**
**(36,698)**
**-**
**(36,698)**
**-**
**(36,698)**
**1,038,473**
**(36,698)**
**1,001,775**|_Total_
_funds_
_2023_
_£_
_868,724_
_99,270_
_35,625_
_24,033_
_1,027,652_
_123,807_
_1,034,393_
_1,158,200_
_(130,548)_
_(10,432)_
_(140,980)_
_-_
_(140,980)_
_1,179,453_
_(140,980)_
_1,038,473_|
|---|---|---|---|---|---|
The Statement of Financial Activities includes all gains and losses recognised in the year.
The notes on pages 27 to 48 form part of these financial statements.
Page 24
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **BALANCE SHEET AS AT 31 DECEMBER 2024**
|**Note**
**Fixed assets**
Investment property
15
**Current assets**
Debtors
16
Cash at bank and in hand
Creditors: amounts falling due within one
year
17
**Net current assets**
**Total assets less current liabilities**
Creditors: amounts falling due after more
than one year
18
**Total net assets**
**Charity funds**
Restricted funds - Branches
19
Restricted funds - All other
19
Unrestricted funds
19
**Total funds**|**39,832**
**640,653**
**680,485**
**(66,265)**|**2024**
**£**
**655,000**
**655,000**
**614,220**
**1,269,220**
**(267,445)**
**1,001,775**
**231,873**
**78,832**
**691,070**
**1,001,775**|_38,565_
_802,951_
_841,516_
_(162,614)_|_2023_
_£_
_655,000_
_655,000_
_678,902_
_1,333,902_
_(295,429)_
_1,038,473_
_243,190_
_62,762_
_732,521_
_1,038,473_|
|---|---|---|---|---|
The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by:
................................................ **Rajeevendra Kumar Mahapatra** (Chair of Trustees) Date: 18/07/2025
The notes on pages 27 to 48 form part of these financial statements.
Page 25
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2024**
|**Cash flows from operating activities**
Net cash used in operating activities
**Cash flows from investing activities**
Dividends, interests and rents from investments
Proceeds from sale of investments
**Net cash provided by investing activities**
**Change in cash and cash equivalents in the year**
Cash and cash equivalents at the beginning of the year
**Cash and cash equivalents at the end of the year**
The notes on pages27to48form part of these financial statements|**2024**
**£**
**(203,652)**
**41,354**
**-**
**41,354**
**(162,298)**
**802,951**
**640,653**|_2023_
_£_
_99,248_|
|---|---|---|
|||_35,625_
_11,568_|
|||**47,193**|
|||**146,441**
_656,510_|
||||
|||_802,951_|
||||
Page 26
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **1. General information**
The National Axial Spondyloarthritis Society is a CIO incorporated under articles of association dated 29th April 2019 in England & Wales with charity registration number 1183175. It was subsequently registered with the Scottish Charity Regulator on 19th November 2019 with Scottish charity registration number SC049746.
## **2. Accounting policies**
## **2.1 Basis of preparation of financial statements**
The financial statements have been prepared in accordance with the Charities SORP (FRS 102) - Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019), the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006 (as amended).
National Axial Spondyloarthritis Society meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy.
## **2.2 Income**
All income is recognised once the Charity has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.
The recognition of income from legacies is dependent on establishing entitlement, the probability of receipt and the ability to estimate with sufficient accuracy the amount receivable. Evidence of entitlement to a legacy exists when the Charity has sufficient evidence that a gift has been left to them (through knowledge of the existence of a valid will and the death of the benefactor) and the executor is satisfied that the property in question will not be required to satisfy claims in the estate. Receipt of a legacy must be recognised when it is probable that it will be received and the fair value of the amount receivable, which will generally be the expected cash amount to be distributed to the Charity, can be reliably measured.
Grants are included in the Statement of financial activities on a receivable basis. The balance of income received for specific purposes but not expended during the period is shown in the relevant funds on the Balance sheet. Where income is received in advance of entitlement of receipt, its recognition is deferred and included in creditors as deferred income. Where entitlement occurs before income is received, the income is accrued.
Income tax recoverable in relation to investment income is recognised at the time the investment income is receivable.
Other income is recognised in the period in which it is receivable and to the extent the goods have been provided or on completion of the service.
Page 27
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **2. Accounting policies (continued)**
## **2.3 Expenditure**
Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use.
Expenditure on raising funds includes all expenditure incurred by the Charity to raise funds for its charitable purposes and includes costs of all fundraising activities events and non-charitable trading.
Expenditure on charitable activities is incurred on directly undertaking the activities which further the Charity's objectives, as well as any associated support costs.
Grants payable are charged in the year when the offer is made except in those cases where the offer is conditional, such grants being recognised as expenditure when the conditions attaching are fulfilled. Grants offered subject to conditions which have not been met at the year end are noted as a commitment, but not accrued as expenditure.
All expenditure is inclusive of irrecoverable VAT.
## **2.4 Interest receivable**
Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the Charity; this is normally upon notification of the interest paid or payable by the institution with whom the funds are deposited.
## **2.5 Debtors**
Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.
## **2.6 Cash at bank and in hand**
Cash at bank and 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.
Page 28
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **2. Accounting policies (continued)**
## **2.7 Liabilities and provisions**
Liabilities are recognised when there is an obligation at the Balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably.
Liabilities are recognised at the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.
Provisions are measured at the best estimate of the amounts required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, discounted at the pre-tax discount rate that reflects the risks specific to the liability. The unwinding of the discount is recognised in the Statement of financial activities as a finance cost.
## **2.8 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 with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method.
## **2.9 Fund accounting**
General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Charity and which have not been designated for other purposes.
Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Charity for particular purposes. The costs of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements. Due to the significant nature of branches on the accounts, the Restricted branch fund is displayed separately throughout the accounts.
Investment income, gains and losses are allocated to the appropriate fund.
## **3. Income from donations and legacies**
|Donations
Legacies
Charity grants
Subscriptions|**Restricted**
**Funds -**
**Branches**
**2024**
**£**
6,016
-
-
160,665
166,681|**Restricted**
**funds - All**
**other**
**2024**
**Unrestricted**
**funds**
**2024**
**£**
**£**
48,992
139,920
-
102,838
308,000
24,000
-
83,884
356,992
350,642|**Total**
**funds**
**2024**
**£**
**194,928**
**102,838**
**332,000**
**244,549**|
|---|---|---|---|
||||**874,315**|
Page 29
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **3. Income from donations and legacies (continued)**
|Donations
Legacies
Charity grants
Subscriptions|_Restricted_
_Funds -_
_Branches_
_2023_
_£_
_12,393_
_1,000_
_-_
_129,551_
_142,944_|_Restricted_
_funds - All_
_other_
_2023_
_£_
_9,500_
_100_
_356,456_
_-_
_366,056_|_Unrestricted_
_funds_
_2023_
_£_
_137,086_
_78,343_
_63,288_
_81,007_
_359,724_|_Total_
_funds_
_2023_
_£_
_158,979_
_79,443_
_419,744_
_210,558_|
|---|---|---|---|---|
|||||_868,724_|
Charity grants includes Pharmaceutical Industry grants of £334,000 (2023: £419,744).
## **4. Income from other trading activities**
## **Income from fundraising events**
|Fundraising events
Fundraising events|**Restricted**
**Funds -**
**Branches**
**2024**
**Unrestricted**
**funds**
**2024**
**£**
**£**
12,165
125,170
_Restricted_
_Funds -_
_Branches_
_2023_
_Unrestricted_
_funds_
_2023_
_£_
_£_
_9,767_
_89,503_|**Total**
**funds**
**2024**
**£**
**137,335**|
|---|---|---|
|||_Total_
_funds_
_2023_
_£_
_99,270_|
Page 30
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **5. Investment income**
|Rental income
Bank Interest
Rental income
Bank Interest|**Unrestricted**
**funds**
**2024**
**£**
34,450
6,904
41,354
_Restricted_
_funds -_
_Branches_
_2023_
_Unrestricted_
_funds_
_2023_
_£_
_£_
_-_
_31,985_
_156_
_3,484_
_156_
_35,469_|**Total**
**funds**
**2024**
**£**
**34,450**
**6,904**|
|---|---|---|
|||**41,354**|
|||_Total_
_funds_
_2023_
_£_
_31,985_
_3,640_|
|||_35,625_|
## **6. Other incoming resources**
|Other Income
_Restricted_
_Funds -_
_Branches_
_2023_
_£_
Other Income
_1,532_|**Restricted**
**Funds -**
**Branches**
**2024**
**£**
794
_Unrestricted_
_funds_
_2023_
_£_
_22,501_|**Total**
**funds**
**2024**
**£**
**794**|
|---|---|---|
|||_Total_
_funds_
_2023_
_£_
_24,033_|
Page 31
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **7. Expenditure on raising funds**
## **Fundraising trading expenses**
|Expenditure on raising donations and legacies
Staging fundraising events
Fundraising for membership
Staff remuneration
General fundraising expenditure
Allocated centrally incurred fundraising and governance
costs
Expenditure on raising donations and legacies
Staging fundraising events
Fundraising for membership
Staff remuneration
General fundraising expenditure
Allocated centrally incurred fundraising and governance
costs|**Restricted**
**funds -**
**Branches**
**2024**
**Unrestricted**
**funds**
**2024**
**£**
**£**
-
4,024
315
8,606
-
956
-
71,460
-
38,726
-
27,095
315
150,867
_Restricted_
_funds -_
_Branches_
_2023_
_Unrestricted_
_funds_
_2023_
_£_
_£_
_-_
_7,444_
_718_
_2,235_
_-_
_936_
_-_
_66,281_
_-_
_21,964_
_-_
_24,229_
_718_
_123,089_|**Total**
**funds**
**2024**
**£**
**4,024**
**8,921**
**956**
**71,460**
**38,726**
**27,095**|
|---|---|---|
|||**151,182**|
|||_Total_
_funds_
_2023_
_£_
_7,444_
_2,953_
_936_
_66,281_
_21,964_
_24,229_|
|||_123,807_|
Page 32
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **8. Analysis of grants**
|Grants, Empower, Inform and Inspire
Grants, A Connected and Supportive Community
Grants, Empower, Inform and Inspire|**Grants to**
**Institutions**
**2024**
**£**
-
_Grants to_
_Institutions_
_2023_
_£_
_1,003_
_-_
_1,003_|**Grants to**
**Individuals**
**2024**
**£**
250
_Grants to_
_Individuals_
_2023_
_£_
_179_
_300_
_479_|**Total**
**funds**
**2024**
**£**
**250**|
|---|---|---|---|
||||_Total_
_funds_
_2023_
_£_
_1,182_
_300_|
||||_1,482_|
## **9. Analysis of expenditure on charitable activities**
## **Summary by fund type**
|Every Patient Every Time
A Connected and Supportive Community
Empower, Inform and Inspire|**Restricted**
**funds -**
**Branches**
**2024**
**£**
-
187,752
-
187,752|**Restricted**
**funds - All**
**other**
**2024**
**Unrestricted**
**funds**
**2024**
**£**
**£**
293,178
158,474
-
56,643
47,843
195,424
341,021
410,541|**Total**
**2024**
**£**
**451,652**
**244,395**
**243,267**|
|---|---|---|---|
||||**939,314**|
Page 33
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **9. Analysis of expenditure on charitable activities (continued)**
## **Summary by fund type (continued)**
|Every Patient Every Time
A Connected and Supportive Community
Empower, Inform and Inspire|_Restricted_
_Funds -_
_Branches_
_2023_
_£_
_-_
_151,884_
_-_
_151,884_|_Restricted_
_funds - All_
_other_
_2023_
_£_
_345,248_
_64,676_
_45,590_
_455,514_|_Unrestricted_
_funds_
_2023_
_£_
_189,381_
_63,291_
_174,323_
_426,995_|_Total_
_2023_
_£_
_534,629_
_279,851_
_219,913_|
|---|---|---|---|---|
|||||_1,034,393_|
## **10. Analysis of expenditure by activities**
|Every Patient Every Time
A Connected and Supportive Community
Empower, Inform and Inspire|**Activities**
**undertaken**
**directly**
**2024**
**£**
351,814
229,288
181,724
762,826|**Grant**
**funding of**
**activities**
**2024**
**£**
-
-
250
250|**Support**
**costs**
**2024**
**£**
99,838
15,107
61,293
176,238|**Total**
**funds**
**2024**
**£**
**451,652**
**244,395**
**243,267**|
|---|---|---|---|---|
|||||**939,314**|
|Every Patient Every Time
A Connected and Supportive Community
Empower, Inform and Inspire|_Activities_
_undertaken_
_directly_
_2023_
_£_
_445,170_
_263,757_
_161,836_
_870,763_|_Grant_
_funding of_
_activities_
_2023_
_£_
_-_
_1,182_
_300_
_1,482_|_Support_
_costs_
_2023_
_£_
_89,459_
_14,912_
_57,777_
_162,148_|_Total_
_funds_
_2023_
_£_
_534,629_
_279,851_
_219,913_|
|---|---|---|---|---|
|||||_1,034,393_|
Page 34
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **10. Analysis of expenditure by activities (continued)**
## **Analysis of direct costs**
|Staff costs
Other staff costs
Courier & distribution of materials
Literature, brochures and information
Promotion of activities and materials
Organising professional events
External technical providers
Attending professional events
Branch network expenditure
Staff costs
Other staff costs
Courier & distribution of materials
Literature, brochures & information
Promotion of activities and materials
Organising professional events
External technical providers
Attending professional events
Branch network expenditure|**Every**
**Patient**
**Every Time**
**2024**
**£**
262,810
7,387
2,518
4,738
5,957
23,503
28,721
16,180
-
351,814
_Every_
_Patient_
_Every Time_
_2023_
_£_
_235,262_
_10,045_
_1,835_
_7,494_
_2,348_
_99,275_
_87,237_
_1,674_
_-_
_445,170_|**A**
**Connected**
**and**
**Supportive**
**Community**
**2024**
**£**
33,780
978
4,155
4,184
-
-
-
-
186,191
229,288
_A Connected_
_and_
_Supportive_
_Community_
_2023_
_£_
_40,892_
_1,264_
_3,791_
_4,500_
_54,797_
_6,219_
_2,391_
_-_
_149,903_
_263,757_|**Empower,**
**Inform and**
**Inspire**
**2024**
**£**
164,094
420
1,808
14,356
562
484
-
-
-
181,724
_Empower,_
_Inform and_
_Inspire_
_2023_
_£_
_152,275_
_804_
_2,841_
_4,590_
_808_
_343_
_175_
_-_
_-_
_161,836_|**Total**
**funds**
**2024**
**£**
**460,684**
**8,785**
**8,481**
**23,278**
**6,519**
**23,987**
**28,721**
**16,180**
**186,191**|
|---|---|---|---|---|
|||||**762,826**|
|||||_Total_
_funds_
_2023_
_£_
_428,429_
_12,113_
_8,467_
_16,584_
_57,953_
_105,837_
_89,803_
_1,674_
_149,903_|
|||||_870,763_|
Page 35
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **10. Analysis of expenditure by activities (continued)**
## **Analysis of support costs**
|Staff costs
Other staff costs
Premises costs
Travel & accomodation expenses
IT and Communications
Office costs
Insurance, legal & professional
Other support costs
Bank charges & interest
Governance costs|**Every**
**Patient**
**Every Time**
**2024**
**£**
35,738
5,055
13,474
1,389
12,124
2,179
10,043
545
12,998
6,293
99,838|**A**
**Connected**
**and**
**Supportive**
**Community**
**2024**
**£**
4,594
1,385
1,733
178
1,558
280
1,291
1,631
1,672
785
15,107|**Empower,**
**Inform and**
**Inspire**
**2024**
**£**
22,314
2,231
8,413
867
7,570
1,360
6,270
341
8,116
3,811
61,293|**Total**
**funds**
**2024**
**£**
**62,646**
**8,671**
**23,620**
**2,434**
**21,252**
**3,819**
**17,604**
**2,517**
**22,786**
**10,889**|
|---|---|---|---|---|
|||||**176,238**|
Page 36
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **10. Analysis of expenditure by activities (continued)**
## **Analysis of support costs (continued)**
|_Every_
_Patient_
_Every Time_
_2023_
_A Connected_
_and_
_Supportive_
_Community_
_2023_
_£_
_£_
Staff costs
_38,666_
_6,444_
Depreciation
_159_
_27_
Other staff costs
_1,996_
_333_
Premises costs
_7,239_
_1,206_
Travel & accomodation expenses
_796_
_133_
IT and communications
_12,425_
_2,071_
Office costs
_2,409_
_402_
Insurance, legal & professional
_11,910_
_1,985_
Other support costs
_669_
_112_
Bank charges & interest
_7,427_
_1,238_
Governance costs
_5,763_
_961_
_89,459_
_14,912_
**11.**
**Auditors' remuneration**
Fees payable to the Charity's auditor for the audit of the Charity's annual
accounts
Fees payable to the Charity's auditor in respect of:
All non-audit services not included above|_Empower,_
_Inform and_
_Inspire_
_2023_
_£_
_24,972_
_103_
_1,290_
_4,674_
_514_
_8,025_
_1,556_
_7,692_
_432_
_4,797_
_3,722_
_57,777_
**2024**
**£**
**10,500**
**3,500**|_Total_
_funds_
_2023_
_£_
_70,082_
_289_
_3,619_
_13,119_
_1,443_
_22,521_
_4,367_
_21,587_
_1,213_
_13,462_
_10,446_|
|---|---|---|
|||_162,148_|
|||_2023_
_£_
_9,000_
_3,000_|
Page 37
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **12. Staff costs**
|Wages and salaries
Social security costs
Contribution to defined contribution pension schemes|**2024**
**£**
**432,110**
**42,183**
**58,754**
**533,047**|_2023_
_£_
_409,135_
_39,509_
_60,339_|
|---|---|---|
||||
|||_508,983_|
The average number of persons employed by the Charity during the year was as follows:
||**2024**|_2023_|
|---|---|---|
||**No.**|_No._|
|Employees|**12**|_12_|
The number of employees whose employee benefits (excluding employer pension costs) exceeded £60,000 was:
|||**2024**|_2023_|
|---|---|---|---|
|||**No.**|_No._|
|In the band £100,001|- £110,000|**1**|_1_|
Key management personnel consists of the CEO, Head of Information and Support Services, Head of Policy and Health Services and the Head of Finance and Administration. The total employee remuneration and benefits of the key management personnel of the Charity were £288,381 (2023: £259,185).
## **13. Trustees' remuneration and expenses**
During the year, no Trustees received any remuneration or other benefits _(2023 - £NIL)_ .
During the year ended 31 December 2024, expenses totalling _£_ 58.95 were reimbursed or paid directly to 1 Trustee _(2023 - £103.99 to 1 Trustee)_ . Expenses in both years related to travel expenses.
Page 38
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
|**14.**
**Tangible fixed assets**
**Cost or valuation**
At 1 January 2024
At 31 December 2024
**Depreciation**
At 1 January 2024
At 31 December 2024
**Net book value**
At 31 December 2024
_At 31 December 2023_
**15.**
**Investment property**
**Valuation**
At 1 January 2024
At 31 December 2024|**Office**
**equipment**
**£**
**18,073**|
|---|---|
||**18,073**|
||**18,073**|
||**18,073**|
||**-**|
||_-_|
||**Freehold**
**investment**
**property**
**£**
**655,000**|
||**655,000**|
Investment property comprises residential flats let. The fair value of the investment property has been arrived at on the basis of a valuation carried out by an independent valuer with reference to market evidence of transaction prices for similar properties and a formal valuation made post the year end. The valuation was made on an open market value basis.
Page 39
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **16. Debtors**
|**Due within one year**
Trade debtors
Other debtors
Prepayments and accrued income|**2024**
**£**
**13,404**
**13,129**
**13,299**
**39,832**|_2023_
_£_
_21,057_
_6,410_
_11,098_|
|---|---|---|
||||
|||_38,565_|
## **17. Creditors: Amounts falling due within one year**
|Bank loans
Trade creditors
Other taxation and social security
Accruals and deferred income|**2024**
**£**
**27,950**
**19,876**
**4,659**
**13,780**
**66,265**|_2023_
_£_
_3,532_
_97,757_
_5,557_
_55,768_|
|---|---|---|
||||
|||_162,614_|
## **18. Creditors: Amounts falling due after more than one year**
||**2024**|_2023_|
|---|---|---|
||**£**|_£_|
|Bank loans|**267,445**|_295,429_|
## **19. Statement of funds**
## **Statement of funds - current year**
||||||**Balance at**|
|---|---|---|---|---|---|
||**Balance at 1**||||**31**|
||**January**|||**Transfers**|**December**|
||**2024**|**Income**|**Expenditure**|**in/out**|**2024**|
||**£**|**£**|**£**|**£**|**£**|
|**Unrestricted funds**||||||
|General Funds - all funds|**732,521**|**517,166**|**(561,408)**|**2,791**|**691,070**|
Page 40
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **19. Statement of funds (continued)**
## **Restricted Funds - Branches**
|**Restricted Funds - Branches**||||||
|---|---|---|---|---|---|
|Branches
**Restricted funds - All other**
Branch Development Fund
Fergus Rogers Fund
Aspiring to Excellence
Cimzia Select Programme
Ophthalmology /
Gastroenterology project
Self Management Programme
Gold Standard Delay to
Diagnosis
APPG
Round Table
Health Inequalities
**Total of funds**|**243,190**
**Balance at 1**
**January**
**2024**
**£**
**10,740**
**1,752**
**8,611**
**150**
**18**
**18,072**
**13,271**
**688**
**7,110**
**2,350**
**62,762**
**1,038,473**|**179,640**
**Income**
**£**
**-**
**-**
**96,000**
**-**
**-**
**48,992**
**212,000**
**-**
**-**
**-**
**356,992**
**1,053,798**|**(188,067)**
**Expenditure**
**£**
**(842)**
**(250)**
**(96,670)**
**-**
**-**
**(46,750)**
**(188,440)**
**(736)**
**(7,110)**
**(223)**
**(341,021)**
**(1,090,496)**|**(2,890)**
**Transfers**
**in/out**
**£**
**111**
**-**
**-**
**(60)**
**-**
**-**
**-**
**48**
**-**
**-**
**99**
**-**|**231,873**|
||||||**Balance at**
**31**
**December**
**2024**
**£**
**10,009**
**1,502**
**7,941**
**90**
**18**
**20,314**
**36,831**
**-**
**-**
**2,127**|
||||||**78,832**|
||||||**1,001,775**|
Page 41
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **19. Statement of funds (continued)**
## Branch Network Funds
The Branch Network Funds support the local activities of NASS Branches, which offer regular physiotherapy or hydrotherapy sessions led by qualified instructors. Each Branch raises its funds and decides how to utilise them for specific activities. In the event of a branch ceasing operations, any remaining funds will be reclassified as unrestricted funds. A portion of these funds may be directed into the Branch Development Fund, to support our branches' continuous growth and development.
## Branch Development Fund
The Branch Development Fund is created through donations from local NASS Branches. It aims to ensure the establishment and promotion of all Branches, and it provides start-up grants to new Branches and funds for ordering promotional materials such as posters and leaflets.
## Fergus Rogers Fund
The Fergus Rogers Fund was established in memory of Fergus Rogers to assist people with axial SpA in purchasing specific items that can improve their quality of life. It is used to provide support for those in financial need to obtain essential items recommended by their healthcare professionals.
## Aspiring to Excellence Fund
The Aspiring to Excellence Fund supports a multi-year quality improvement program to transform healthcare for people with axial SpA. The fund facilitates strategic partnerships between NASS, BRITSpA, and the NHS transformation unit, bringing together rheumatology teams and service improvement experts. It is utilised for various activities, including recruitment to the program, learning sessions, online coaching, podcasts, and the development of an audit tool to track the time to diagnosis.
## Ophthalmology / Gastroenterology Project Fund
The Ophthalmology/Gastroenterology Project Fund supports the Gold Standard time to diagnosis program and its efforts to improve the identification and referral of suspected axial SpA in Ophthalmology and Gastroenterology. It finances the involvement of clinical associates from both specialities in gathering intelligence and understanding the current landscape. Additionally, the fund covers the development of educational materials, audits, posters, surveys, and policy reports.
## The Self-Management Programme
The Self-Management Fund covers the costs of NASS's Supported Self-Management Program, which equips people with axial SpA with the skills and tools to manage their symptoms confidently. It supports various aspects of the program, including online resources, self-management sessions, and regional events held in conjunction with local NHS rheumatology departments.
## Delay to Diagnosis - Gold Standard Fund
The Delay to Diagnosis - Gold Standard Fund is utilised to implement The Gold Standard Time to Diagnosis program for axial SpA. It supports various activities such as producing campaign impact reports, conducting economic analysis, delivering landscape reports, reviewing the use of MRI in diagnosis, and running public awareness campaigns.
Page 42
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **19. Statement of funds (continued)**
## APPG (All Party Parliamentary Group) for Axial Spondyloarthritis Fund
The APPG Fund is established to oversee the implementation of the National Institute for Health and Care Excellence (NICE) guidelines for Spondyloarthritis and its Quality Standard. It supports the functioning of the parliamentary group. It is used to conduct meetings, national inquiries, and parliamentary receptions to engage with MPs on axial SpA NHS services.
## NASS Voices
The NASS Voices Fund supported regional events to facilitate interactions between local people with axial SpA and their rheumatology healthcare professionals. It helped cover the costs of venue payments and other expenses for organising these events. This fund was closed in 2023.
## Round Table
The Round Table Fund supported wider policy work and national discussions on axial SpA in the UK. Although there was no activity in 2022, the fund was carried forward to continue its purpose in 2023. The Round Table meeting took place in 2024 and the fund has since been closed.
## Health Inequalities Fund
The Health Inequalities Fund finances a qualitative study focusing on people's experiences with axial SpA through the lens of sex, gender, and gender identity. It covers expenses related to recruitment for focus groups and data collection.
## Cimzia
The fund's purpose is to provide one-year free NASS membership for eligible patients living with axial spondyloarthritis.
Page 43
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **19. Statement of funds (continued)**
|_Balance at_
_1 January_
_2023_
_£_
_Income_
_£_
**Unrestricted**
**funds**
General Funds -
all funds
_770,477_
_507,197_
**Restricted**
**Funds -**
**Branches**
Branches
_265,269_
_154,399_
_Balance at_
_1 January_
_2023_
_£_
_Income_
_£_
**Restricted**
**funds - All**
**other**
Branch
Development
Fund
_7,992_
_-_
Fergus Rogers
Fund
_2,052_
_-_
Aspiring to
Excellence
_42,234_
_121,000_
Cimzia Select
Programme
_150_
_-_
Ophthalmology /
Gastroenterolog
y project
_855_
_-_
Self
Management
Programme
_21,067_
_40,962_
Gold Standard
Delay to
Diagnosis
_35,316_
_177,694_
APPG
_517_
_26,400_
NASS Voices
_3,493_
_-_
**Statement of funds - prior year**|_Expenditure_
_£_
_(550,084)_
_(152,602)_
_Expenditure_
_£_
_(1,335)_
_(300)_
_(154,623)_
_-_
_(837)_
_(43,957)_
_(199,739)_
_(26,229)_
_(9,113)_|_Transfers_
_in/out_
_£_
_15,363_
_(23,876)_
_Transfers_
_in/out_
_£_
_4,083_
_-_
_-_
_-_
_-_
_-_
_-_
_-_
_5,620_|_Gains/_
_(Losses)_
_£_
_(10,432)_
_-_
_Gains/_
_(Losses)_
_£_
_-_
_-_
_-_
_-_
_-_
_-_
_-_
_-_
_-_|_Balance at_
_31_
_December_
_2023_
_£_
_732,521_|
|---|---|---|---|---|
|||||_243,190_|
|||||_Balance at_
_31_
_December_
_2023_
_£_
_10,740_
_1,752_
_8,611_
_150_
_18_
_18,072_
_13,271_
_688_
_-_|
Page 44
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **19. Statement of funds (continued)**
## **Statement of funds - prior year (continued)**
|Round Table
Health
Inequalities
**Total of funds**|_Balance at_
_1 January_
_2023_
_£_
_11,900_
_18,131_
_143,707_
_1,179,453_|_Income_
_£_
_-_
_-_
_366,056_
_1,027,652_|_Expenditure_
_£_
_(3,600)_
_(15,781)_
_(455,514)_
_(1,158,200)_|_Transfers_
_in/out_
_£_
_(1,190)_
_-_
_8,513_
_-_|_Gains/_
_(Losses)_
_£_
_-_
_-_
_-_
_(10,432)_|_Balance at_
_31_
_December_
_2023_
_£_
_7,110_
_2,350_|
|---|---|---|---|---|---|---|
|||||||_62,762_|
|||||||_1,038,473_|
Page 45
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **20. Summary of funds**
## **Summary of funds - current year**
|General funds
Restricted funds-Branches
Restricted funds|**Balance at 1**
**January**
**2024**
**£**
**732,521**
**243,190**
**62,762**
**1,038,473**|**Income**
**£**
**517,166**
**179,640**
**356,992**
**1,053,798**|**Expenditure**
**£**
**(561,408)**
**(188,067)**
**(341,021)**
**(1,090,496)**|**Transfers**
**in/out**
**£**
**2,791**
**(2,890)**
**99**
**-**|**Balance at**
**31**
**December**
**2024**
**£**
**691,070**
**231,873**
**78,832**|
|---|---|---|---|---|---|
||||||**1,001,775**|
## **Summary of funds - prior year**
|General funds
Restricted
Funds-
Branches
Restricted funds|_Balance at_
_1 January_
_2023_
_£_
_770,477_
_265,269_
_143,707_
_1,179,453_|_Income_
_£_
_507,197_
_154,399_
_366,056_
_1,027,652_|_Expenditure_
_£_
_(550,084)_
_(152,602)_
_(455,514)_
_(1,158,200)_|_Transfers_
_in/out_
_£_
_15,363_
_(23,876)_
_8,513_
_-_|_Gains/_
_(Losses)_
_£_
_(10,432)_
_-_
_-_
_(10,432)_|_Balance at_
_31_
_December_
_2023_
_£_
_732,521_
_243,190_
_62,762_|
|---|---|---|---|---|---|---|
|||||||_1,038,473_|
## **21. Analysis of net assets between funds Analysis of net assets between funds - current period**
|Investment property
Current assets
Creditors due within one year
Creditors due in more than one year
**Total**|**Restricted**
**Funds -**
**Branches**
**2024**
**£**
-
231,873
-
-
231,873|**Restricted**
**funds - All**
**other**
**2024**
**Unrestricted**
**funds**
**2024**
**£**
**£**
-
655,000
78,832
369,780
-
(66,265)
-
(267,445)
78,832
691,070|**Total**
**funds**
**2024**
**£**
**655,000**
**680,485**
**(66,265)**
**(267,445)**|
|---|---|---|---|
||||**1,001,775**|
Page 46
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **21. Analysis of net assets between funds (continued)**
## **Analysis of net assets between funds - prior period**
|Investment property
Current assets
Creditors due within one year
Creditors due in more than one year
**Total**|_Restricted_
_funds -_
_Branches_
_2023_
_£_
_-_
_243,190_
_-_
_-_
_243,190_|_Restricted_
_funds - All_
_other_
_2023_
_£_
_-_
_62,762_
_-_
_-_
_62,762_|_Unrestricted_
_funds_
_2023_
_£_
_655,000_
_535,564_
_(162,614)_
_(295,429)_
_732,521_|_Total_
_funds_
_2023_
_£_
_655,000_
_841,516_
_(162,614)_
_(295,429)_
_1,038,473_|
|---|---|---|---|---|
## **22. Reconciliation of net movement in funds to net cash flow from operating activities**
|Net expenditure for the period (as per Statement of Financial Activities)
**Adjustments for:**
Depreciation charges
(Gains)/losses on investments
Dividends, interests and rents from investments
Decrease/(increase) in debtors
Increase/(decrease) in creditors
**Net cash provided by/(used in) operating activities**
**23.**
**Analysis of cash and cash equivalents**
Cash in hand
**Total cash and cash equivalents**|**2024**
**£**
**(36,698)**
**-**
**-**
**(41,354)**
**(1,267)**
**(124,333)**
**(203,652)**
**2024**
**£**
**640,653**
**640,653**|_2023_
_£_
_(140,980)_
_332_
_10,432_
_(35,625)_
_3,899_
_261,190_
_99,248_
_2023_
_£_
_802,951_
_802,951_|
|---|---|---|
Page 47
**NATIONAL AXIAL SPONDYLOARTHRITIS SOCIETY**
## **NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2024**
## **24. Analysis of changes in net debt**
|Cash at bank and in hand
Debt due within 1 year
Debt due after 1 year|**At 1**
**January**
**2024**
**£**
**802,951**
**(3,532)**
**(295,429)**
**503,990**|**Cash flows**
**£**
**(162,298)**
**(24,418)**
**27,984**
**(158,732)**|**At 31**
**December**
**2024**
**£**
**640,653**
**(27,950)**
**(267,445)**
**345,258**|
|---|---|---|---|
Page 48
## NASS Annual Report and Accounts YE2024
Final Audit Report 2025-07-25
Created: 2025-07-21 By: Jessica Eades (Jessica.Eades@bkl.co.uk) Status: Signed Transaction ID: CBJCHBCAABAAl4OYFnCwwxiNNwPqvVD6Ty-N7YRUw0Bb
## "NASS Annual Report and Accounts YE2024" History
## Document created by Jessica Eades (Jessica.Eades@bkl.co.uk)
2025-07-21 - 10:38:25 AM GMT- IP address: 31.121.171.20
Document emailed to ian.saunderson@bkl.co.uk for signature
2025-07-21 - 10:44:47 AM GMT
## Email viewed by ian.saunderson@bkl.co.uk
2025-07-25 - 2:01:14 PM GMT- IP address: 104.47.11.254
- Signer ian.saunderson@bkl.co.uk entered name at signing as BKL Audit LLP
2025-07-25 - 2:02:35 PM GMT- IP address: 31.121.171.20
## Document e-signed by BKL Audit LLP (ian.saunderson@bkl.co.uk)
Signature Date: 2025-07-25 - 2:02:37 PM GMT - Time Source: server- IP address: 31.121.171.20
## Agreement completed.
2025-07-25 - 2:02:37 PM GMT