2023-03-31-accounts

Crynpany Règistration nurnber.. 10887014 lE￿lartd and Wales) Charlty nwnber: 1194431 HEALTH DATA RESEARCH UK (a company limited by guarantee) ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 MARCH 2023 "ACTr14L TRN* 2911 Ir2023 COMPANIES H(XJSE

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HEALTH DATA RESEARCH UK ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENOED 31 MARCH 2023 CONTENTS Paees Leeal and Adminlstrativè Information Tru5tee'< Report IndependentAuditorfs Report 38 Statement of Financial Aalvltles 41 Balance Sheei 42 Statement of cash flows 43 Notes to the Financial Stattmtnts 44

HEALTH DATA RESEARCH UK LEGAL AND ADMINISTRATIVE INFORMATION FOR THE YEAR ENDED 31 MARCH 2023 Trustees and Direclafs Or Graham Spittle. C8É. Chair- resigned 26.07.2023 Dame Julie Moore. Chair- appointed 26.07.2023 Professor Sir Alex Markham, resigned as Chair of Audit and Risk Committee 15.12.2022. completed tenure as trustee 8.11.2023 Professor Sir James Smith completed tenure as trustee 8.11.2023 Profe550r Dame Janet Thomton completed tenure as trustee 8.11.2023 Prole550r Sarah Harper CBE, resigned as Chair of Nominations Committee 15.12.2022 Lord James O'Shaughnessy- reappointed 1.12.2022 William Boa. resigned as Chair of Remuneration Committee and appointed Chair of Audit and Risk Committee 15.12.2022 Altson Wilcox- appointed 22.09.2022, appointed Chair of Nominations Committee 15.12.2022 Dr Andrew Elder- appointed 22.09.2022, appointed Chair of Remuneration Cornmittee 15.12.2022 Professor The Lord Ara Darzi- appointed 22.09.2022 Dr Claire 8ithell- appointed 22.09.2022 Sir Mark Walport- appointed 22.09.2022 Dr Claire Newland- appointed 15.12.2022 Ed05a Odara - resigned 31.01.2023 Patsy Wilkinson- appointed S.10.2023 Company registered number 10887014 Registered office Wellcome Trust Gibbs Buildin 215 Ev5ton Road London NWI 2BE Principal operatin8 offi¢e 215 Euston Road London NWI 2BE Auditor Haysmacintyre LLP 10 Queen Street Place London EC4R IAG Company secretary Elemental Company Secretary Limited Bankers Natwest 250 8ishopsgate London EC2M 4AA Solic•tors Bird & Bird LLP 12 New Fetter Lane Lorhdon EC4A IJP

HEALTH DATA RESEARCH UK LEGAL AND ADMINISTRATIVE INFORMATION FOR THE YEAR ENDED 31 MARCH 2023 Foreword The Trustee5 are pleased to present their Strategrc ￿port for Health Data Research UK I"HDR UK". the "Company-, the -Institute"I for the year ended 31 March 2023. The Trustees continue to present the Compan￿5 inforrnation in line with the Charitie5 SORP, previously chosen as the best representation of the Company's circumstances and how to dtsclose its activities. This report provides a review of the activitie5 and business for HOR UX and outlines its development and performance for the financial year, the financial position at the end of the year and an outline of bts plans. The report also destribe5 how the risks facing HDR UK are managed. Overview At the start of this financial year, HDR UK was in ihe middle of an in-depth review by ils main funders to asse55 ts first five years since it was established in 2018 and consider proposed plans for a further five years. Following completion of the tn-depth international Teview, the Institute wa5 judged as iniemationally competitive and leading edge in most areas. The International Panel chaired by Dame Muffy Calder concluded that= "HDR UK had made impressive progress. establishing btself as an international leader in the health data research field. "HDR UK'S distinctive success and service to the community. playing a unique convening role was commendable.- "The cohesive interaction of infrastructure and research has enabled 5ignrfKant pro8ress." "HDR UK has developed a highly successful. world leading national resource. promoting collaborative team scien￿ and tackling important challenge5 in health data science.. With this very rk)sitr¥e review of the institute's achievements. our core funders- nine of the largest government and charity research funders in ihe UK- awarded us £71.3 rnillbon for the years 2023 to 2028. This increase in funding for the next fNe year5 places the institute in prime posrtion to build on it5 5ucce$5. In 2022-23 the institute also announced HDR Global. a new partnership programme to share data science approaches to better collaborate and help address major public heafth challenges in low- and middle-incorne countries. It is a partnership with The Global Heahh Network ITGHNI and its network of partner organi5atiDns in Africa, Asia and South America to support health data science studies across a wide range of disease areas and health challenges, to improve health outcomes for all. HDR Global will a5SiSt with sharing data 5tience skills and connecting best practice across this network to enable trustworthy use of data in regions and comrnunities where evidence to tackle threats to public health is lacking. The Digital Innovation Hub IDIHI Progiamme ended in March 2023 having achieved a step change in improving the quality of research-ready data and making it easier for researchers to discover. as well as developing services to support the effective and trustworthy use of that data.

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Alongside the data curation and service5 provided by the Health Data Research Hubs set up under this programme, the Innovation Gateway has improved discoverability of data assets and the UK Health Data Research Alliance ha5 achieved consensus and convergence in key areas of data custodianship. As ihe OIH Pro8ramme funding ends. HDR UK and NH5 En8land have announced a joint workplan to continue working together on many of the areas started in the DIH Programme which are bein8 coritinued through the NHS England Data for R&D programme. In April 2023, twelve Core furbded Directorf5 Innovation Fun(J projects were launched with the objective of propelling the Institute's progress towards ao2 èttivity. With a total budget of £2.5 million allocated across the HOR community, the projetts accelerated activrty across the Driver Programmes, Trust and Transparencv. Capacity Buildin& and the Trials workstream. In another development. a programme of rapid research projects was set up at the beginning of 2023 to examine how to ease winter pressures faced by the NHS. The 16 research projects. funded by ihe National Institute for Health and Care Research INIHRI. used data4rNen approaches to pin-point pressures in the health care system. understand their causes and develop ways to overcome or avoid them. The projecis include studies aiming to ease pressures on emergency seNices by usin8 hospital data to speed up patient flow through and out of emergency departments. as well as a projert using an analysis approach called 'machine learnin￿ to predict peaks of infection with the common bu& Respiratory Synrytial Viru5 IRSVI. that can cause sèrious illness in young children and put pressure on paediatric intensNe care units. Other projects will investigate the impact of cold and damp homes on people's health with the aim of informing policies to protect the most VLblnerable and avoid knock-on impacts on the NHS. The results of these rapid projects will be published from Summer 2023. These achievements, and those highlighted in this report below. are a result of the commitment and dedication of the marhy teèms across HDR UK'S distributed national Institute. our partners and our patient and public advisors. It is a testament to theirfocus on ourvalues of transpa￿nc¥. optimism, respect, courage and humility that we have made such progress. As we transition to our future strategy. we look forward to working with our partners and community. strengthening our connections and to focus on delivering novel insights and innovative data research and services to enable discoveries that improve people's lives.

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Strategic Report Business and acrivity review HOR UK is the national rnsir(ute for heatth data that includes England. Scotland. Wale5 and Northern Ireland with a mission to unite the UK'S health data to enable discoveries ihat improve people's lives. Our 20-year vision is for large scale data and advanced analytics to benefit every patient interaction, tlinitèl trial and biomedical discovery and to enhance public health. In 2022123 the Institute updated it$ 5-year strate8y and underwent a rigorous international assessment exercise which concluded that the Instrtute was very well positioned to deliver its mission over the next five years. To achieve this mission our trate ic delive lan published in March 2023 sets-out th￿e long-ierm goal5= I. ACCELERATE By implementing a nalional research data strate8y and assembling infrastructure and ser¥ices aligned to research and innovation needs y valuing people with diverse perspectives and skills. committed to open and team 5cien¢e to advance scientific discoveries and deliver Palieni and public benefit By building and maintaining critical partnerships, aligning incentives and reducing iornplexity across a fragmented landscape to streamline health data science TRUSTWORTHY DATA USE 2, EMPOWER RESEARCHERS . PROMOTE PARTNERSHIPS We continue to deliver this plan with Ouf inclusrve, team-oriented One Institute ethos- bringing together experts across the UK to collaboraie and achieve more together than they would alone- all built upon values of transparency. optimisrn, respect. courage. and humility. Achievements and Performance During the year, we worked acr05S the Institute and with our partners to review our impact to date and to develop a strategy for the futLbre five years12023-20281. Thi5 work formed part of. our five- ear uin uennial, review by our core funders and. following si8nrft£ant collaboration with colleagues aCfOSS academia, healthcare. charities. industry and patient groups. we published an overview of our impact and future strategy in February 2022. Further details of the future strategy are outlined in the Plans for Future Periods section of this report. This report provides the highlights of key achievements and performance across HDA UK duTin8 2022123 and includes work that HDR UK has led and activitie5 that HDR UK has enabled and delivered in partnership. Accelerating the pace and scale of health and biomedical data science Natiortol Research Priorities HDR UK'5 Six National Research Prioritie5 on Applied Analytrcs, Human Phenome, Understandbng Causes of Disease. Clinical Trials Improving Public Health and Better Care have produced UK-wide research that no single research organisation could achieve alone. Highlights of HDR UK'S research impact during the year are provided below. Further examples can be viewed on our website.

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Applied Analyti¢s- Making text data in health records more useable for research Bean et al. 20231 While electronic heahh records attempt to capture data in a standardised format, clinical letters remain the primary way of recording and sharing medical inforniation. However. thi5 unstructured text is difficult to analyse at scale and can only be converted to standardised clinical codes manually. This means that valuable data are not accessible for many studie5, limiting new ￿searCh insights. The Cogstack project. supported by HDR UK. uses natural language protessing algorithms io automate the conversion from free text to clinital codes. This was successfully applied to the record5 of over a million patients at King's College H05Pital, revealing patterns in the age of disease onset. sex differences and comorbidtties. This approach could allow the large-scale anatysis of historical text data. making it re5earch-ready for studies into rnylti-morbidity. The Human Phenome- Milestone of l(M)O definitions for health conditions To make large-scale health data useable for research. computer progrèms need to bdentify traits. also known as phenotypes, from complex records that are not standardised. Researchers create definitions of each phenotype, which might be a combination of clinical code5. that the pro8rarns search for in the health record. The HDR LIK National Phenotype Library is the first national platfomi that allow5 researchers to store and f reelv share these definilions. The Library now has over l.IXKJ phenotypes available to use. which are helping to improve research efficiency and accuracy. For example. this has helped to identify over 10.OCKJ COVID-19 death5 thal were previously unattributed, ￿cOgnise the higher risk of dyinglrom COVID-19 for people with cardiovascular diseases and accelerate ￿crUItMent to clinical trials by proattrvety identifying eligible people. Understanding the Causes of Disease- How genetics make us chemically unique Isurendran et al. 20221 Every one of u5 15 unique, right down to the chemicals that circulate in our bloodstream. This v8riation makes it difficult to understand how these molecules Influen￿ the risk of disease and how diseases alier this chemical fingerprint. Compounds produced by the body'5 metabolism. called meialxllites, are particularly interesting a5 they can reveal changes in key mechanisms. A study supported by HDR UK combined multiple datasets from the HDR UK Multi-omics Consortium and UK Biobank to analyse over 9LK) metabolites in the blood of almost 20,000 people. The study, the largest of its kind. identified thousands of relationships between genetic variations and metabolites. This reveals how metabolites are controlled, their relevance io health and the connection to rare genetic variants. These results could help to tailor treatments to individual patients based on their risk of a(fverse effects from certain drugs. Better Care- Recommendations for implementing learning health systems (Hardie et al. 20221 The health and care 5V5tem in the UK faces 518nificant pressures, which will require adapting and reshapin8 care to meet future health need5. An alternative approach to'tOP-down' national policy changes is enabling providers to internally drtve improvement5 throuBh a le3rning health system ILHSI. An LHS takes a systematic approach to iteratively introduce improvements usinB data and evidence from routine care. The final report produced by HDR UK'S Better Care Catalyst Pro8ramme's Policy and Insights workstream set out the challenges and opportunities for implementing LH55 in the UK. Thi5 extensive work was based on a survey of over Ilj) expert stakeholders. interview5. a literature review and real-world case studie5. The authors identified a gap between the promise and practice of LHSS and made recommendations for policymakers and organisational leaders to advance implementation. These fell into four key areas- learning from data, harnessing technoloey. nurturing learning communities and implementing service improvements.

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Publ•¢ Health- Impaci of the pandemic on cancer diagnosis (Greene et al. 2022 The COVID-19 pandemtc Severely di5rupled cancer 5creenin8 pro8rammes and presentations to primary care. While several studies examined the resulting impact on cancer mortality. most hèd limited data on incidence. stage and healthcare pathways to diagnosis. To assess the Situation at a populatKJn level, a collaboration led by the Swansea University HDR UK team used the SAIL Databank to study Welsh cancer clinKal records. An analysis of colorectal. non-small-cell lung and female breast cancers revealed that diagnoses decreased by 15 per tent overall in 2020 compared to 2019. Colo￿tt31 and female b￿ast cancers detected through annual 5creenin8 fell by 13 per cent and 48 per cent, re5peciivety, while non-small.cell lung cancer diagnose5 at emergency presentatton increased by vp to 16 per cent. The stud￿5 authors suggest that heahh service5 must continue optimising cancer screening programmes and transfomiing cancer services and primary care referrals to mIt￿ate the impact of the pandemic. Better. F¥5ter and More Efficient Clinical Trials- Est•blishing the quality of real-world data for clinical trials (Murra et al. 20221 Existing healthcare data, like GP notes. prescriptions and hospital data. can help to make clinical trials more efficient. However, only a￿￿t fwe per cent of UK-based randomised clinical triak5 obtained routinely collected data. It can be difficult for trial sponsors to incorporate this information a5 they must Show that the data used are reliable, complete and relevant. To help overcome some of these barriers. a report by HDR UK'S Healthcare Systems Data for Clinical Trials COlla￿rative Gmup set out a process to establish the provenance (the origins and production methods) and integrity Ithe accuracy and reliabilityl of real-world data. The report demonsir8ted this process for two important NHS Digital datasets that are commonly requested by trialli5ts. The authors calle(l on data collators to systematically assess and record the provenance and integrity of each routinely collected dataset to increase their use in clinical trials. Doto ond Connectivity Notionol Core Study HDR UK continued its joint leadership of the Data and ConnectNity National Core Study INCSI with the Office for National Siaiistics. The programme works with partners to make COVIO-19-relevant data more readilv avail3ble for research. Over the pasi year, the Data and Conneaivity NCS has continued to inform the UK'5 decision-making on COVIO-19 and it5 ensuing irnpact on healthcare. In January 2023. HDR UK announced sixteen rapid research projects to study how to ease winter pressures on the NHS. The project5, designed to run for just three month5. aim to publish results later this year so that thev can inform policy for future winters. This approach applie5 lessons from the pandemic, driving research that generates results quickly and directly impacts clinical care. The EAVE 11 study continued to yield valuable insights. using patient data to track the COVID-19 pandemic and vaccine effectiveness across Scotland. A study published as a pre-print in March 2023 used electronic health records to estimate that over 90.wo adults in Scotland experienced lonE COVID. Thi5 15 likety to be an underestimate, as On￿ some people with long COVID may have visited their doctor and self-reptrrted surveys suggest a hi8her rate. However, this work is a basis for the next step in the project to predict long COVID from routinely collected data ljeffre et al. 2023

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDEO 31 MARCH 2023 Another EAVE 11 analysis showed that the Omitrorh variant was associated with a lower risk of pregnancy complication5 than Delta. This finding will help to inform public health measures to prevent infection in pregnant women (Stock et al. 20221. Research published in September 2022 found that the risk of vascular events. Such as stroke, deep vein thromb05is and myocardial infarction. is higher for up to 49 weeks after a COVID-19 diagnosis. The study analysed records from 48 million adults in England and Wales, finding an estimated 10,500 excess vascular event$ after COVIO-19 diagnoses. These result5 5UBgest thai people at high risk of vascular events should be gbven preventive therapies after Seve￿ COVID-19 (Kni ht et 31. 20221. As well as yielding new scientific research. the Data and ConnectiVTty NCS has continued to bring iogether key partners. For example, the 'One Wales. initiative united teams across the country to respond to the pandemic led by the Swansea Unwersity HDR UK team. Through thi5 partnership. the Data and Connectivtty NCS supported the SAIL Databank to gather dozens of new data assets. The results from this collaboration led to informing Welsh policy decision5 on 5UPPOrt for people shieldin& reopening schools. vaccination gap5 in ethnic minorities and risks to care worker5. The collaboration wrth SAIL a150 helps research beyond COVID-19. For example. a study supported by HDR UK showed that home a(laptation5 helped to reduce the risk of falls. UsinB SAIL to study over 600.OLKI older people in Wales, this w8S the first study to look at fall prevention on a large scale. This provided evidence of the effectiveness of services that identify people at risk of falling and deliver interyentions IHollin hurst et al. 2022 ICODA- A 9lobol heolth dotu response to COVID-19 Work undertaken by HDR UK in convening the Internattonal COVID-19 Data Alliance IICODAI. which wa5 announced in June 2020 came to conclusion in this period. wrih all of the driver projerts completing successfully by October 2022. The ICODA Trnitiative. funded by the COVID-19 Therapeutics Accelerator. a large- scale initiative supported by the Bill & Melinda Gates Foundation and Minderoo Foundation and other donors, had twelve driver projects- specific research questions bringing together 3 range of datasets for analysis. Across the twelve ICODA driver project5 we had an active cohort of 135 researther5 from 19 countries working in our trusted research environment. the ICODA Workbench. Thr5 provided thern with a wide range of analytical tools. wrapped with rigorous data governance processes and a mechanism to share meta data for further secondary research use through our ICODA Gateway. Our researchers worked with a broad range of data types includin8 data from health systems. clTrnic31 trials, electrontc hea￿h records. populalion data, hospital admissions, birth and vaccine data. Over 40 ublications to date have been generated by our project leam5 and all of our olicies and rocesses enericised and ublished such that others are able to use them in future. The ICODA researchers remèin active as part of a Global health data Scien￿ community of practice. Driver Project IPOP which worked on understanding the change5 in preierm birth and stillbirth duTinE COVID-19 lockdowns using interrupted time series and meta-analyses with harmonized data from 52 million births in 26 countries. They showed small reductions in PTB in the first. second and third months of lockdown, but not in the fourth month of lockdown. although there were some between-country difference5 after the first month. M. Azad et al Nature Hum n Behaviour Feb 23 Driver Projecl REHCORD which worked on understanding the Impact of COVID-19 on health Service delivery and institutional mortality across multiple countries used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in 10 low to middle income settings. Despite efforts to

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 maintain health services, disruptions of varying magnitude and duration were fftlind in every country. with i)0 clear paiterns by £uuntry income group or pandemic intensrty. They found that often the disruplions in healih services preceded COVID-19 waves. IC. ArsenaLblt. Nature Medicine, Mar 221. Following on from ICODA. HDR Global was launched during 2022-23- part of a five way ecosystem partnership between The Global Health Network and regional partners in Brazil. Africa and Bangladesh. Funded by the Bill & Melinda Gates Foundation. this new programme seeks to enable trustworthy data access, re-use and analysis in regions, communities and areas of global healih challenge, where evtdence to tackle threats to public health is lackine and builds on HDR UK'S mission and expertise. io

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 BHF Doto Science Centre Launched in January 2020 as a partnership between HDR UK and the British Heart Foundation, the BHF Data Science Centre enables responsible. ethical research that combines the power of advanced analytic methods with the UK'S large-stale and diverse cardiovascular data. The work of the BHF Data Science Centre has grown substantially over the year. with the leadership team in place and good progress being rnade across all thematic and disease areas. Following on from Ihe launch in May 2022 of the Diabetes Data Science Catalyst- a strategic partnership with Diabetes UK and the 8HF- we have used this successful model to from a partnership with the Stroke Association and the BHF in the development of the Stroke Dai3 Science Caialy5t_ We also established our Public Advisory Group IPAGI comprises 17 public contributor5 from diverse backgrounds who serve as public contributors. Throughout the Year, their invaluable coritributions have had a significant impact on various aspects of our work. including our Patient and Public Irbvolvement and Enga8ement strategy. The PAG convenes quarterly and has been instrumental in ensuring that our work remains patient-centric and relevant to the public. Key achievements made this year include= Working with Swansea University IUKSeRP and SAIL Dat8bankl to establish a cardiovascular and diabetes research cohort trusted research environment TRE to link individual disease-ba5ed cohorts with other types of health data in a safe and seeure environment. to better understand the causes and consequences of disease. Through the cVD-COVIO-UKICOVID-IMPA￿ consortium supporting three NIHR-funded research ects to ra idl res nd to and inform lic by pin-poinling pressure5 in the health care system. understand their causes and develop ways to overcome or avoid them. ro Awarded EHDEN fundin for CVD-COVID-UK COVID-IMPACT consortium to map data onto the Observational Medical Outcome Partnership IOMOPI common data model. to drive standardisation and interoperability of data-driven research internationallv. Awarded funding, following a competitive funding call, to 13 data Science research project5 focusing on COVID- 19 and its links to cardiovascular disease and diabetes. Key research outputs from the centre during the year included= A stud in Nature Medicine showing a reduction in the number of people starting lo take blood pressure lowering and cholesterol lowering medication in the first half of 2021 compared with the same time period in 2019. They estimated that rf left untreated this could lead to more ihan 13,(M)O additional cardiovascular events. A stud ublished in Circulation showing COVID-19 infertion during the first wave of the ￿ndeMiC Iso prior to vaccines being availablel resulted in an increased risk of bli)od clois for at least 49 weeks post infection in England and Wales li

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Assembly of a UK-wide data infrastructure and services for health research UK Heolth Doto Reseorch Allionce Convened by HOR UK, the Alliance is a non-for-profit assocration of leading health data providers. custodians and curaiors. Alliance members are dedicatetl io improving human health by maximising the potential of fflultiple forms of data to accelerate progress in biomedicine, health and care through development and adoption of standards, polKies, and best practice. During 2022123 the Alliance ha5 continued to grow with 75 data custodian members as at March 2023. We have welcomed new members as diverse as Cancer Research UK. the Royal Marsden NHS Foundation Trust. UK Longitudinal Linkage Collaboration, Northern Care Alliance, Gloucestershire Hospitals NHS Foundation Trust Grampian Data Safe Haven. and National Pathology Imaging Co-operative. Three partitular areas of focus for the year have been= Tackling the challenge of simplifytng and streamlining data access governance processes. Supporting adoption of the ObseThational Medical Outcomes Partnership Common Data Model IOMOP CDMI in collaboration with the European Health Data Evidence Network IEHDENI Increasing dNeT5ity in data by addressing the challenges and opportunities in the use of data reporting ethnicity. The Pan-UK Data Governance Steering Group is a working Group of the Alliance representing data custodians and policymakers across the four nations. The Steering Group is focused on simplifying and Sireamlining dat access governance processes. The group is cross-sector. including representatives from the health research and administrative research communities. By bringing together cross-secloral expertise we can learn from one another and start to f3tilitate alignment between processes for accessing administrative data. health and care service data and Siu(Iy daia, utilising previous work where possible. Members of the pan-UK Data Governance Steering Group are committed to meaningful public. patient and prartitioner involvement and engagement IPPIEI to enable us to build governance models on a foundation of deserved public trust. To date, three 'Action Forces, have been set up to take foNard priority areas of.. mappine data govern3nce processes.. developing a Trusted Research Environment lalso known a5 Secure Data Environments) Legal Toolkit- and 'Five Safes, Form adoption and training. The Alliance is undertaking a number of activtties to support the adoption of data standards in the UK health data ecosystem. In particular, we are focusing on OMOP CDM developed by the Observational Heahh Data Sciences and Informaiics IOHDSII consortium. Supporting data custodians in transforming their data a55ets to the OMOP CDM. enables the data sets they routinely collect to be leveraged for research. and combined and federated with other data sets. Our work in this area has been accelerated through our collaboration with the EHDEN consortium to support UK data custodians in trènsforming their ¢Jata to the OMOP CDM. Five new UK datè partners have joined ihe iniliative with our sUPPOrt during 2022123. positioning the UK in the vanguard of European countries adopting OMOP. We are now working with partners including NHS England to understand the adoption of OMOP and other standards across the UK- what data has and has not been transformed to OMOP.. the impact and applications of that work. Ihe barriers to the adoption of stanilards, and what support is needed io overcome them. 12

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Diversity in data is a cross-cutting theme which align5 With HDR UK'S diversity and inclusion policy. While there are many different aspects to consider within the diversity data field, during 2022123 an Alliance working group has been locused on challenEes and opportunitie5 ITI the use of daia reporting ethnicity The Alliance has highlighted the need to address concerns around quality of data and missing samples that can hinder the reliabilrty of scientific insights. The leadership of the working groLbP ha5 drafted a set of retommendations to improve the capturing and recording of ethnicity data in the UK. based on community feedback and input received. These recommendations will be plrblished in the coming months. Looking to the future, Alliance baseline funding ha5 been secured through HDR UK core fundtn& enabling it to continue to maximise trustworthy use of health daia by working across ihe entire UK 'ecosystem' and connecting with relevant international developments. The Alliance will be strengthened further by bringing together national decision makers and regulatory bodies. industry associations and research funders who have not yet had a direct role in the Alliance. but who are critical to ensvring development ol an efficient health data infrastructure ecosystem. These changes are bekng made after consuhation with existing members and other stakeholders and will help shape the legacy of the investment from the Industrial Strategy Challenge Fund IISCFI Data to Early Diagnosis and Precision Medicine Challenge that led to the creation of the Alliance as part of the Di8ltal Innovation Hub programme which ran from 2018-2023. 13

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Heolth Doto Reseorch Innovorion Go£ewoy The Health Data Research Innovation Gatewa Ithe 'Gateway'l was established in 2020 and 15 the UK'S on unified platform to search, discover and request access to health datasets for research and innovation. To date, over 8C¥) datasets descriptions from 70+ data custodians have been mède available on the Gateway. alongside over 4,OCKI other health data resources including publications. data uses. tools and educational courses. The Gateway fomis an entire ecosystem for fostering the curation. quality improvement, access, and ethical use of health data. To date. the Gateway hos over 2.000 registered users from 3cross the health data community who made more than 11.OCKI searches in 2022. The Gateway. through its provision of a Sin le data access re uest rocess (built around the Five Safes Framework), has also enabled 250+ data acce55 enquTrries and over 70 full data access requests. Throughout 2022. a broad range of health data assets continued to be added to the Gateway. Over 1000 phenotypes a￿ now contained within the Health Data Research UK Pheno e Librar making it the largest national resource for information. tools and phenotyping algorithrns io allow researchers to harness data held in Electronic Health Records. The library is also integrated with heakh dataset information aeross the Gateway, allowing Users to refine iheir search results further. In add>tion, more data sources have been added to the Cohort Oiscove tool including population scale data from Scotland. To date. 19 Gateway datasets covering over 5 milliorb subjects atross the UK are now available for researchers to discover usbng Cohort Discovery. The tool, delivered in partnership with CO-CONNEcf and funded by UK Research and Innovation, enable5 researchers to search by specific population criteria across multiple datasets, widening the data discovery capabilities of the Gateway even further and facililatin8 a faster pathway to impactful researth. Improvements were also made to features and services on the Gateway throughout 2022 to enhance user experience further. including= The Gatewa Data Use Re ister launched in January 2022. aims to improve transparency in the use of health data for research and innovation and provide a best prartice example of how information about approved data uses is shared and managed. This new feature describes how Gateway datasets are being used. by who and for what purpose. The register will also support researchers in identifying how datasets listed on the Gateway are already being used to help inform theiT data requesi choices, whilst the public and funding bodie5 fflight search the register to understand how the data is beinB Used in research. More than IOOJ data use5 have been Up￿aded to the Gateway since its release in early 2022. In addition. a data use re ister wid et (developed in September 20221 Provides increased accessibility and transparency of data uses published on ihe Gateway by enabling a clear and direct connection from data custodian websites to relevant Gateway data uses. May 2022 saw the launch of a Federated Metadala Automation sewvice. Th>$ service allows data custodians the option to synchronise their metadata catalogue directly with the Gateway so that data descriptions are automatically pulled through land continuously updatedl when onboarding datasets. An editable version of the Five Safes Data Access Request form was launched in July 2022 allowing data custodians to select additional questions and tailor gurflance to better suit their application requirements. Improvements to the design of the search results page now provide users with more information about health datasets up front. including when the metadata was last updated. typical time to access and completeness of the dataset metadata. Search and fblter preferences can now be saved and access to the Cohort Discove tool and Data Utili Wizard can now be performed directty from the search page. 14

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR TrIE YEAR ENDED 31 MARCH 2023 Nearly three years after its creaiion, the Gateway is a recognised platform for researcher5 to discover and request access to UK health datasets. offering a simplrfied and standardised approach to data access management and supporting transparency and trustworthiness in the use of health data for research. In order to continuousty meet the emerging needs of Gateway user5, key focus areas for 2023124 will include convening an open-source technology ec05V5tem community to Co-create and share solutions, develop standards. enhance search capability, and support interoperability. maintainability and scalability. Heolth Datu Re5eurch Hubs The Health Data Research Hubs provide 3 rich toolkit of healthcare datasets. infrastrurture and capabilitie5 that enable users to identify, access. understand and use data to improve people's lives. Woiking in partnership with HDR UK, each Hub is the product of strong collaboration between fhe NHS. academia, industry and the public and forms an integral part of the vibrant UK research data ecosvstewn. Our network of Hubs 15 pioneering and informing the development of health data research in the UK. and globally. and is demonstratin8 how insights from data are improvin8 people's lives. 2022123 has been a year of transition for the hubs established a5 part of the Industrial Strategy Challenge Fund as the Digital Innovation Hub programme drew to a close and the NHS England Data for Research and Development programme launched. The Hubs have benefiled from having a focu5 on sustainabilsty from the outset and all Hubs have continued to operate beyond the ISCF funding period. with a variety of models for long-lerm legacy. NHS Di8iTrials and Discover-NOW (London Secure Data Environment ISDEII are directly involved in the NHS England Data for R&0 programme. PIONEER is collaboiaiing closefy wtih the West Midlands SDE DATAQAN, INSIGHT and Gut Reaction have all changed host organisations are pursuing mixed sources of fvnding including grants, research collaboiations and service contracts with industry and other users. 8REATHE. OATA-CAN and PIONEER are also 5UPPOrting HOR UK'S research Driver Programmes from April 2023. The two newer VKRI Medical Research Council IMRCI funded Hubs- Alleviate Ipainl and DATAMIND (mental healihl- have developed at pace. benefitting from being part of an established H4Jb network. Alleviate is working with HDR UK to cieate an online. safe. platform as a key resource for the national pain research communities. Creating this hub will enable researcher5 to tackle the challenge5 in understanding the complexty an(1 unpredI￿abl1ltV of pain. It will also reveal new and improved treatments across diverse chronic and debilitaling pain conditions. DATAMINO makes the most of the UK'S rich mental health (lata to enable coordinated research, with the aim of improving live5 by Iransforming mental health research in the UK by providing a central. integrated data infrastrvctufe with findable, accessible. interoperable. and reusable IFAIRI mental health data sels. Dat3 from diverse sources, underpinned by expertb5e and innovation, by principles of responsible use, and by public participation, lor use across universilies. the NHS. the tharitable sertor, policy makers. antj industry. In partnership with charity MQ-. Transfomiing Mental Health. the hub supports the development of the public's invofvement in mental health research to ensure that valuable contribution5 are included from those with lived experience. The hub also works alongside MQ to build ￿paCrty and strengthen expertise in this increasingly important area of research through the charitrfs data science conferences and skills development workshops. 15

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 ￿RCH 2023 The DARE UK (Doto ondAnolytlCs Research Environments UKI progrofflmp DARE UK Data and Arbal tics Research Environments UK is a UK Research and Innovation UKRI programme which aims to design and deliver a more joined-up, efficient and irusiworthy nation31 data research infrastructure. This is to support Safe and secure cross-domain ana￿SiS of sensitwe daia at scale for public good. The DARE UK programme is funded through the UXRI Di ital Research Infrastructure portfolio and is one of several iTrve51ments as part of this portfolio. Phase l of ihe DARE UK programme. which is planned from July 2021 until March 2024. 15 jointly led by HDR UK and ADR UK IAdmini5trative Data Research UK). Phase l is an extensive listening exercise with stakeholders across the UK. including researchers. technologists, the public and others. The goal has been to understand, through open dialogue. what is needed to enable MO￿ efficient, coordinated ènd trustworthy data research using sensitive dala. The aim is to ensure that subsequent phases of DARE UK work to address the needs of the UK in makin8 the best use of sensitive data at scale for public benefit. In 2022, 3 key achievement of the programme was the publishing of a set of 31 recommendations based on the stakeholder engagement and extensNe listenrng exercise across the UK, with this document capturing and framing the key challenges within the sensitwe data research landscape. This was delivered via a programme of engagement including over 60 hour5 of interviews and over 30 hours of workshops with more than 500 individuals including researchers. technologistg. private sector representatives. members of the public and others. The final recommendations can be found here and were published at the end of August 2022. FeedinB inio the recommendation5 was the work of 9 Sprint Exemplar Projects kicked off in january 2022 through the DARE UK programme. funded by UKRI with a total award of over £2 million. to develop potential use cases. demonstrate the technology and explore best practice for the governance, ethical and public engagement and involvement aspects of developing a more coordinated data research infrastructure. The Sprint Exemplar Pcojerts ran for eight months until August 2022- further (letails on the portfolio of projects and their output5 can be found here. Alongside this work the programme delivered. in collaboration with Kohlrabi Consultin a UK-wide public dialogue lo explore views regarding what a more joined-up, eff icient and iiustworthy national data research infrastructure should look like. A series of deliberative workshops was held with 44 members of the public from across England, Northern Ireland, Scotland and Wales in january and February 2022. The workshops e¥plored issues related to data security, access and actredilalion. trustworthiness and more. The final ie ort published in May 2022, presents a set of six recommendations for the trustworthy handling and use of sensitive data in Tesearch. In the latter half of the 2022123 firbancial year, p05t-August and the publishing of the initial recommendations, the programme's focus shifted towards refining the roadmap for the second half of Phase I ISeptember'22 - March .241 and securing sign off from DARE UK Programme Board for this plan of action. The DARE UK Programme Board off icially approved the roadmap in September .22 with minor adjustments, as well a5 three primary outputs or milestones io be delbvered a5 part of this plan.. Milestone l.- An architectural blueprint for a federated network of Trijsted Research Environments ITREI Milestone 2.. A model for delivering the architettural vision defined in Milestone I Milestone 3: A business case and funding model underpinning Milestones l and 2 These are key outwts to delNered by the end of Phase l of the DARE UK programme by March .24. 16

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 As part of this effort. a portfolio of DrNer Prosects was competitively selected to play a leading role in informinB the design of different components of what will be a UK-wide network of tiusted research environments (TRES). These 5 Driver Project5 were funded through UKRI wtth a total award of over £2.5 milliorb as part of the DARE UK programme, in several thematit 3reas of focus relevant to the programme and directly linked to the recommendations la5 above) that emerged as part of the first half of Phase l. The Driver Projects kicked off in Februèry 2023 and are funded to run until October 2023- further details on the portfolio of projects and their work can be found here. Finally, the DARE UK Delivery Team have begun the initial drafting of an architectural blueprint for a federated network of Trusted Research Environments (TRES) in early 2023 with a target for an initial draft to be published and open for public comment in April 2023. DARE UK has embedded Public Involvement and Engagement IPIEI in all asperts of programme ideation, strategy and delivery. In the period in review. DARÉ UK has held a series of public consultations, landscape review surveys, and community-wide interactions across the sensitive data research landscape, which have informed the development of the initial draft of the DARE UK Federated Archilecture Blueprint. whose initial public consultaiion has just been concluded. 8y inviting members of the public to join the prograrnme's decisNJn-making Ix)ards and provide feedback throughout delivery, DARE UK has sustained its commriment to transparency and accountability while demonstrating trustworthiness and promoting a community-led delivery approach. DARE UK'S cornfflitment to meaningful public participation is ￿flected in its strategic efforts to understand publTrc interests and concerns in sensltive data management. As such, public Voice is integral in the delivery of all programme activities. 17

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 In March 2022 a series of six virtual worksho was held to seek further input and feedback on a set of emerging recommendations shaped around six thematic areas of focus in the context of a coordinated national data research infrastructu￿. The input from the workshops has informed the further development of the recommendations. The findings of DARE UK Phase l activities are now bein8 incorporated into a fin¢Jin8s report- a draft version of which went out to public consultation in July 2022 with a comprehensive set of retommendations for the delivery of a toordinaied national data research infrastructure. The final report is due to be published at the end of August 2022. Working in partnership as One Institute HDR UK is a multi-disciplinary. geographically distri1￿ted. UK-wide Institute of over 1500 researchers across

39 organisations. During the year. the Institute has engagetl a broader UK and increasingly global community spannin8 the National Health Service INHSI, research institutes. industry. charilie5, government and regulators with >500 organisations collaborating on programmes of health data research initiated and enabled by the Institute. Communications and engagement The HDR UK Communications and Policy Team ha5 buili upon the successes of the previous year and delivered on increasing HDR UK'S reach through working with the media. strategic communications campaigns, events nd communicating impact on HDR UK digital channels. HDR UK'5 digital channe15 continue to go from Strength to strength. Between l April 2022 and 31 March 2023. the HDR UK website receNed a total of 754.069 views from 283,584 users. The HDR UK website links to the Alliance webslte, the HDR UK Futures training plarform and the Gateway to provide users with a clear route to discover more detailed. tailored infonnation in response to their user need. Social media has seen significant growth over the year. At present (June 20231, HDR UK has over 11,9 followers on Twitter, an increase of over 20CM) from the previous report, while Linkedln has seen the largest increase up io 10,600 from 4,5rx). The monthty institute new51etter. HIVE. a150 continues to pTovi(le a concise update on key attivities and (leveloprnents acr055 the organisation to over 6.500 people. The Black Internship Programme was one of the major projerts supported by the communications team this year. HDR UK successfully attracted many talenied Black data scientists to apply for the programme and partnered with community TV stations and healthcare podcasts to enable the interns to share their story globally. further promoting the programme. The team's work generated over ISO,IXXI impressions across HDR UK social media channeL% and 14,000 views to the prograrnrne information. Coverage was secured on NHS England and Genomics podcast5. as well a5 The Toda Show and Salam Britain for TV. which greatly boosted the programme's reach. In recognition of ihese achievements, HDR UK were awarded first place in the Best diversit cate 2023 of the Cor Comms Ma azine annual awards. and inclLt5ion The team also launched a hiEhty successful strategic communications campaign ahead of World Mental Health Day on 10 October. Running from 28 September to 14 October, the Oata Soves Lives." Mental Health campaign focused on the important role that data has in reducing mental health care inequalities. During the campaign 18

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 the team delivered." a dedicated web hub, written content, Co-designed infographics- partnerships with mental healih charities to feature HDR UK-funded researchers on their podcasts. social media content, press, and public engagemeni events. From inception to delivery. the whole campaign was informed by people with lived experience of mental health tondition5 and their loved ones. HDR UK'S annual scientrfic conference in December 2022- Data for Global Health and Societ celebrated the global health data ￿VOlUtIOn with talks from 1rbternat￿n3l7Y leading figures across the health data research sector, interattive panel discu55ions and opportunities for collaboration and networking. The 2022 conference was intended to be a hybrid event in 8imiingham. but Lrnfortunate a national train strike was announced which meant that the conference had to be delivered virtually. Oespite the significant logistical challenges thi5 presented. the conference was very successful with 878 attendees on the day. In January 2023, HDR UK announced 16 projerts funded through Data and Connectivity in partnership wilh NIHR that aimed to tackle winter pressures facing the NHS throu8h the use heafth dats research and workin8 alongside policy analysts. As the challen8es facing the NHS were of high media promirbence, the communications team seized the opportunity to promote HOR UK'5 work through national coverage. A briefing was held with the Science Media Centre-'How can data science help alleviate the NHS winter crisis?'_ and the story was covered both in print and online across major national news publications including the Telegraph, Daily Mail, and more. 19

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENOED 31 PIARCH 2023 Patient and Public Involvement and Engagement HDR UK has shown leadership Jeross the secror in demonstrating tranSp3￿nCY and trustworthiness to the public by embedding Patient and Public Involvement and Engagement IPPIEI artivities in governance, infrastructure developments. and research. HDR UK'S innovative approaches to bringing public views to the forefront of health data science have shaped our priorities and delivered tools to foster inclusiveness in this field. A prime example of thi5 15 the introduction of standards aimed at ensuring clear communication of data access procedures with mernbers of the public. These measures were deemed instrumental in promoting understanding and trust between stakeholders and the widercommunity. During the year. we held a campaign to recruit new members to our Public Atlviso Board IPABI. whith provides strate8ic guidance to HDR UK. Nine new members were appointed. inclucsing a Chair and a Deputy Chair, bringing new voices and expertise to our governance strurture. We hugely benefitted from the work of our PAB. along with the significant contribution of numerous public members inVo￿ed in PPIE activities atross the Institute, including HDR UK Voices British Heart Foundation'5 IBHFI Public Advisory Group. and OARE UK'S Programme Board and Public Advisory Groups. They all made a si8nrficant impact and ensured our work was driven by delivering benefits to pat*nts ènd the public_ The range of PPIE activrties they have been involved in over ihe 202212023 year include= Leading the work behind the Data Saves Lives.. Mental Health campaign arbd promoting patients and PLtblic's participation in related engagement acrNities Participating in the plannin& delivery, and evaluation of our 2022 Scientific Conference Shaping the PAB recruitment by encoura in involvefflent arbd parttcipaiing in the process, from shortlisting to induction sessions Supporting the Public En ement in Data Research Initiative by drafting shaping the New Families 'Your data in artion, pilot campaign Enhancing the Clarity and accessibility of HOR UK PPIE web e and Voices communications, as well as providing guidance on all public-facing BHF Data Science Centre's outputs Advancing the Par) UK Data Governance Steerin Grou .5 rn155ion of 5trearnlining the access and use of health data for research processes by contributing to each of the action forces, mission Informing our PPIE Honoraria and Ex enses Poli and laying the foundations for the development of our future engagement sirategv Co-developing ￿SUrVe s for UnstTuctUTed Data and Personal Monitoring Data, ensuring their accessibilitv and inclusivity. Co-authoring publications pertainin8 to Cardiovascular Priorities for Unstrvctured Data Reviewing and providing approval for applications within our CVD COVID IMPACT Consortium Co-piesenting BHF Data Science Centre monthty webinars, as well as national webinars focused on PPIE in Data Intense Research Informing the COVID-19 fundin ortunit call launcheil by the BHF Data Science Centre to encoura8e data-led research In cafdiovascular disease andlor dbabetes and the illtera(lion with COVID- 19 ood ractice standard5 and Deliberating on core DARE UK'S programme decisions and outcomes, as well as collaborating with researchers and industry experts to fulfil the prograrnme's overarching goal Informing the development of recommendations for the trustworthy handling and use of sensitive data in research incorporaied into the DARE UK programme strategy 20

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Impacting the conduct and outcomes of the DARE UK S recently started Driver Pro ects Participating in the DARE UK-led stakeholder roundtable to assess the need for an independent, UK- wide coordinating function for PIE in the UK sensitive data research landscape. rint Exem lar Pro ert5 and tontributing to the Proactively 8etting invofved to help shape our strategy for HDR UK'S next five years. including having a public advisor as a co-lead for our PPIE approach Key members of funding andlor review panels, including the Health Data Research HLJb Milestones, Data and Connectivity Rapid Funding Calls and ihe Grand Challenges ICODA COVID-19 Data Science Shaping the direction of COVID-19-specific research and communicatrons. and providing their valuable insights to HDR UK'5 COVID-19 res onse includin8 through regular reports to SAGE Making recommendatlons lo the Goldacre Review on the need for meaningful PPIE in the efficient and safe use of health data for research Leading on the development of uidance for Alliance and wider health data organisations Co-developing uidance includin tem 13tes for blic involvement in fundin adapted used beyond HDR UK and sector-wide organisations Aunning our #AtoZHealthData twitter tam n to raise awareness and understanding of health dat science whilst engagin8 ihe wider public ublic involvement in data access rocesses acr055 the calls which can be HDR UK learning- attracting and developing talent Over the past year. the HDR LIK Talent and Training team has taken major steps towards our goal of building a vibrant and diverse health data science workforce and responding to the UK'S health data science skills shortage. HDR UK Futures The online learning environment Health Oata Research Futures now has over 10,OJO users and houses IO0+ CPD accredited bite-sized videos organised into 13 learning pathways on topics such as Artbficial Intelligence for Clinicians, Privacy Enhancing Tethnologies and Bringing Software as a Me(lical Device to Market. More learning pathways are currently in development including on PPIE for clinical trials. developed in partnership with Centre for Trials Excellence Cardiff University and HDR UK North, Learning Health Systems, Wlth University of Manchester as part of the Better Care programme. and Research Software EnEineering. This year saw the first meeting of the Talent & Training Advisory Group, comprising individuals representinB our key sectors and stakeholder groups to help prioritise resource and provide feedback on training activity. Workshops ond webinors A successful serie5 of workshop5 and webinars have taken place this year. A series of four webinars on Bringing Software as a Medical Oevice to Market attracted over 4LKJ attendees. seeing many new interactions wbth industry and workshops on the same topic are in development for later in 2023. other workshops include an Introduction to R workshop with Kings College London, Health Information Engineering and Data Wrangling wilh University of Manchester and a bespoke workshop on Machine Learning delivered for the CPRD team at the MHRA, which is currently being adapted into an online self-directed course. This year we piloted recovering some training costs by charging for attendance. whilst ringfencing free spaces for members of the Alliance, Alumni Network and HDR UK Global. An invitation to tender has been published for freelance trainers and educators to help us develop our trainine programmes moving foTward. 21

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Outreoch Our career outreach efforts have Continued overthe past year, including a Researcher Roadshow delivered in partnership with UKRI and then NHS England which attraded over 250 attendees and featured inspiring career talks from speakers workirb8 in a range of health data science roles. Our Alumni network continues to grow and currently has 350 members and recently ran successful CV workshops and recruitment event. Our online reach continue5 to grow with our monthly training newsletter ama55in8 almost 20(Kl subscribers and our HDR UK Learning Twitter account has over 7CKtJ followers. Our careers pages continue io be among the most Vlslted on the website and we are currently carrying out 3 redesign of our pages to make them more streamlined. We are working through our Technician Commitment action plan. carrying out various initiative5 to empower and support the careers of technologists in the HDR UK central team and wider community. Partnership5 We continue to work in partnership with organisations spanning the heahh data science ecosystem. After consultation wTrth Analystx on skills gaps we provided them with bite_siied videos and recentty attended their key partner event. We delivered three workshops to the NHS Digital Leadership Programme on Trust & Transparency, PPIE and ED&I. We sit on NHSX'S Developing Data and Analysis as a Profession Board. Turing's Data Skills Taskforce and are partnering wilh the Medical Schools Council, Health Education England and NH5 Education Scotland to carry out a survey of UK medical school staff and students on the teaching of data science in the current UK medical school currbculum_ Results of the survey will be analysed by an intem hired a5 part of the Black Internship Programme 2023. Mosters Scholorships Applications are currently open for our new masterfs degree scholarships. jointly funded by HDR UK, Diabetes UK and Alzheimer's Research UK. The scholarships pay £IO.(KKJ towards the deg￿e programme and allow students to carry out a research project in one of these disease areas. The scholarship5 offer the insights, knowledge, experience and qualrficaiions students need to enier a field that pmvides many great career opportunities. HDR UK/Turing Wellcome Phoprogromme Our PhD programme goes from strength to strength with our newest cohort soon to be defining their PhD proposals to fellow academics and a panel of patients and the public. We have delivered deep-dive immersion weeks for internal and external PhD students on fairness in healthcare modelling and structural causal modelling. Later this summer students have been invited to a residential summer school in collaboration with Roche on single-cell anatysis. They will have ihe opportunity to learn from the scientists as well as well as an exclusive opportunity io apply for an internship wrth Roche. Biomedicol Vocation Scholorships We are now welcoming our second cohort of scholars to host or8anisations acr0$5 the UK. Funded by the Wellcome Tru51, Ihe scholar5hip5 pay for undergraduale sludents in quantitative disciplines to get a taster of health data research as well as their expenses. Applicants from an underrepresented background were prioritised and supported throughout the application process. These placements have inspired some of our first cohort to change their final year module5 and also helped one student secure a placement as a health data analyst. Building diversity in dot(J science We hosted our first in-person closing ceremony at the Wellcome Collection for the Health Data Science Black Internship Programme in September last year, welcornin8 both interns and host organisations to celebrate the interns, achievements. The winning group of the technical challenge presented their work and interns also 22

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 shared their experiences of the programme. Almost half of our 2022 interns attended a non-Russell Group university. with over 60% being women and 25 being first generation university students. Our he8lth programme forthis year attracted over 660 applicants. wrth 95 successful interns joining 54 h05t organisations this summer. We will be launching the pro8Tamme this summer with an in-per50n opening teremony in Birmingham. Plans for f uture periods The year 2023124 will mark the start of HOR UK'5 next five-year strateBy. with our core funders- nine of the largest government and charity research funders in the UK- having awarded us £71.3 million for the years 2023 to 2028. While the institute'5 long-term mission to unite the UK'S data to make discoveries that improve people's lives remains unchanged. we will follow a refreshed plan to increase the speed, scale and quality of health data science and $0 enable new discoveries. The next 12 months will See us start work on our three strategic goals.. Accelerate trustworthy data use by implementin8 a national research data strategy and assemblin8 infrastructure and servtces ali8ned to research and innovation needs. 2. Empower researcher5 by valuing people with diverse perspective5 and skills. committed to open and team science to advance scientrfic discoveries and delNer patient and public benef it 3. Promote partnerships by I￿lIding and maintaining critical partnership5. aliEninB incentives and reducing complexity across a fragmented land5(ape to streamline health data science For example. we will form UK-wide, collaboratNe research programmes to drive forward the use of large datasets in different areas.. from cancer and heart disease to respiratory disease. from the use of medicines to looking at social and environmental impacls on health. The current fragmentation and lack of standardisation in the data will be t3ekled by working with manv different or8anisations, bLJilding capabilities and supporting real team science. Patients and the public will continue to be involved throughout the Institute's work- ensuring that access to data for research 15 enabled by trustworthy. safe and secure systems and generates public benefit. Some early developments will include unveiling a new action plan that outlines how HDR UK will support the vital work and careers of technologists within the health data research sector. This is part of our response a5 5ignatoTies of the Technician Commtiment and recognises that technologists play an invèluable role in driving innovation and advancing scientific research. A £0.5 million pound InVe￿ment in daia-driven approaches to tackle stroke is to be anwjounced. The Stroke Data Science Catalyst will be led from the BHF Data sc￿nCe Centre at HDR UK. More than 1.3 million people in Ihe UK have had a stroke. which can have devastating consequences for patients and their families. This new initiative aims to Speed up the search for better stroke prevention. treatments and care by enabling researchers to securely access. link and analyse existing UK health data. Professor Cathie Sudlow, Chief Scientist at HDR UK. is to carry out an independent review of the UK'S ability to use data to improve health care. The review. which will report in late 2023. has been commissioned by Professor Sir Chri5 Whitly, the Chief Medical Officer for England. Or Timothy Ferris, NHS England's National Dirertor of Transformation. ènd the UK'S National Statistician Professor Sir lan Diamond. The review, entitled 23

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Uniting Het71th Doto in the UK, will assess the flows of health-relevant data across the four nations of the UK. offeriri¥ an opportunity for policy makers to evaluate how data can be better managed to improve the public'5 health. while maintaining privacy and public trust. Patient groups are being consulted and will be actively involved throughout the process. Financial review Funding Our funds 5VPPOrt lon8-term scientific and research studbe5, training and Trnfrastructure that contribute to data science at scale. support our One Institute approach and deliver long-temi impact for the health of patients and populations across the UK. HOR UK'S actTrvity across our strategic priorrty areas has continued to generate sEnrficant interest from funders. Corefunding Our fundeis have jointly invested in Health Data Research UK= the Medical Research Council IMRCI.. the health research deparrments of England, Scotland, Wales and Northern Ireland INational Institute for Health Research INIHRI, Chief Scientist Office ICSOI, Health and Care Research Wales, HSC Research and Development respectively). the Economic and Social Research Council IESRCI. the Engineering and Physical Sciences Research Council IEPSRCI. Wellcome IQQI ontyl. Cancer Research UK lQQ2 only). and The British Heart Foundation I"Core Funders'l. In 2022123. the Core Funders aEreed in principle to provide £71.3m funding io HDR UK in the 5 years to March 2028. In line with the Charities SORP IFR51021 the full amount of Core funding has been recognised in 2023 12022.. £33ml. In respect of existing core-funding the Company incurred expert(Jiture on staffin& grants and other costs of £17.7m12022= £13.3ml. Restrictedfunding Restrirted fynding is received primarFly in respect of HDR UK'S Infrastructure and Services and Research Driver Programme strategic areas, along with our partnership pr(erammes. UK Research and Innovation'5 Industrial Strategy chaI￿nge Fund in support of the Digital Innovation Hub Pro8rarnme12023= £1.9m. 2022: £5.7ml UK National Core Studies= Data & Connectivity programme funding to support the five National Core Studies established by ihe govemment to answer key research questions on COVID-1912023.. £5.1m, 2022- £10_2ml Medical Research Council funding in respect of capttal investment$12023-. £1.3m. 2022= £0.8ml COVID-19 Therapevtics Accelerator funding in support of the Internation31 Covid-19 Data Alliance and data analysis Workbench12023.. £1.3m, 2022 £3.5ml HDR Global Ecosystem funding12023.. £2.Om, 2022.. £0.Om} BHF- Oata Science Centre established to carry out research using heamh dèta into the causes, prevention. and treatment of all diseases of the heart and circulation12023-. £8.5m, 2022.. £9.4ml DARE- The UK Trusted and Connected Data and Analytics Research Environments programme aiming to deliver a national federated digital infrastructure12023.. £1.9m. 2022.. £1.Iml Other charitable expenditure is funded by otherfunders, or through cost sharing with HDR UK'5 collaborative partners. 24

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Grants HDR UK provides long-term awards to research organisation5 Wlth a track record of excellence in health data sciente. Substontive Site5, Notionol Priorities ond Health Doto Reseorch Hubs HDR UK has provided £32.4m funding in the 5 years to March 2023 to the eight HDR UK Substantive Sites. Each Substantive Site has a co-ordinaiing research organisation IROI and a variable number ol a550ciate ROS. The co- ordin3ting RO is accountable to SLbb-contract with rts associate ROS to ensure delivery of the Institute's objectives. The Substantive Sites are HDR UK Cambridge (Sanger Institute- University of Cambridge, European Bioinformatics Institute), HDR UK London IUCL.. QMUL. LSHTM. Imperial College, Kin85 College) HDR UK Midlands. University Hosprtals Bimiingham NHS Foundation Trust= University of BimiinBham. University of Leicesler. University of Nottingham, University of Warwick HDR UK Oxford Iuniversity of Oxford) HDR UK Scotland (University of Edinburgh.. Universities of Glasgow, St Andrew5. Aberdeen. Strathclyde, Dundeel HOR UK Wale5 & Northern Ireland (University of Swansea= Queen's University 8elfastl, From April 2020- HDR UK North Iuniversity of Liverpool.. Bradford Teaching Hospitals NH5 Foundation Trust, County Durham and Darlington NHS Foundation Trust. Lancaster UnNersity, The Leeds Teaching Hospitals NHS Trust. University of Leeds. LNerpool University Hospitals NHS Trust. University of Mènchester, Northern Health Science Alliance. Newcastle upon Tyne Hospitals NHS Foundation Trusls, Newcastle University, 5alford Royal Foundation Trust. UnNersity of Sheffield. South Yorkshire and Bassetlaw Integrated Care System. Wirral University Hospital NHS Foundation Trust) From April 2021> HOR UK South-west (University of Bristol; University of Bath) Each site contritNJtes to one or more of HDR UK'S six National Research Priorities and participates in HDR UK'S national implementation projects. These projects are embedded in the national research priorities and delivered by teams across four. five or six site5 to delNer research which no single institution would be able to achieve. HDR UK has also supported the establishment of two Heath Oata Research Hubs, PIONEER and NHS Digitrials. In 2023 HDR UK funded £10.2m site and national implementation project expenditvre12022: £9.2ml. £472k Health Data Research Hub expenditure was funded12022.' £1.5m}. Troining Progrommes HDR UK has agreements in principle to provide £6rn fundin8 in the period to 2027128 in relation to the HDR UK- Turing Welltome PhD Programme in Health Data Science. and to provide £2m funding in the period to October 2023 in relation to the HDR UK Masters pro8rammes. In 2023 HDR UK funded £l.Im PhD Programme expenditure12022- £417kl and £719k Masters programmes expenditure12022- £971kl. Ivotionol Core Studies.- i)uto & Connectivity Progromme As part of the National CO￿ Studies= Data & Connectivity programme. in 2023 HDR UK provided £2.Im12022'. £5.Iml grant funding to five partners to deliver streamlined access to a variety of health and administration data via five secure Trusted Research Environments across the four nations.. OpenSAFELY. SAIL DatabanL 25

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Scotland National Data safe Haven and Northern Ireland Honest Broker Setvice. £1.3m was spent on Turing co- funded projects12022.. £0.7ml and a further £1.6m was spent on additional aclivitie5 Wlth partner organi5ations and cohorts (Outbreak Data Analysis Platform. Intensive Care National Audit and Research Centre, REACT Imperial and scaled up acute admissions activity across 8 partnersl12022= £1.Sml. Reserves Policy The Core Funders are committed to funding costs incur￿￿ by the Institute, with regular funding throughout each financial year. By the nature of thi5 model. there is no need for significant re5erve5. However, the Trustees are satisfied that there are Sufficient arran8ernent5 for ihe provision of funding for the Cornpany to continue to operate for the foreseeable future. This is based on the requirement for the Company to present forecasts to the end of the current funding period so that comfort can be gained that all anticipated costs are manageable with agreed fundin8. As at 31 March 2023 total unrestricted reserves were £60.66m12022- £20.Oml and total restricted reserves were £25.4m12022: £12ml. Under the term5 of HDR UK'S existing fundin& amounts are not permitted to be set aside for general unrestricted reserves. the value of ￿n￿stricted ￿seFve$ is the balance of core funds not yet spent. Risk management FIDR UK'S vision and strategy are ambitious and there are risks that may impact OUT ability to successfully achieve our ambition. HOR UK con5ider5 risk mana8ement to be fundamental to good managernent pTaclice and a Significant aspect of good charity governance. HDR UK'S risk management policies and processes make the effectNe management of risk an integral part of day- to4ay operations at HDR UK and provide a frarnework to.. Define risk governance Identify key risks Asses5 risks • Develop mitigating Strategies and actions Monitor and review risk activities • Communicate and fem)rt risks Risk management is an ongoing and dynamrc process and HDR UK regularly reviews the risks we face and mitigatiorb Strategies_ HDR UK has a Risk Register. which is structured in line with Charity Commission guidance. The Risk ReBiSter is reviewed and updated by the Executive Committee monthly. reviewed and discussed by Audit & Risk Committee IARCI quarterly and reviewed by the full Board quarterly. As a charity. the Board of HDR UK are responsible for total risk e¥p05ure. These risk management processes are part of our IS090JI certrfied quality management system. A principol concern for HDR UK 15 ongoing 5U5tainable fundin8. HDR UK ￿ mana8in8 this through ongoin8 engagement with funders. in particular with our core funders as part of our five-year quinquennial review. HDR UK has a written guarantee from MRC for future funding at a sustainable level. 26

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Structure, Governance and Management Status HDR UK is registered as a Company limited by guarantee,. incorF)orated in ju￿ 2017. and a registered charity, registered 12 May 2021 (charity number 11944311. The Board of Trustees govern the Company in accordance with its Memorandum and Articles of Association. The Trustees have the benefit of a qualifying third-party indemnity provision as defined by section 234 of the Companies Act 2006. Recruitment of Trustees The Board makes Trustee appointments for terms of three years, with an extension of up to two further terms. All Trustees give of their time free￿. wrth the Chair recetving a remuneration which was paid during the year. Details of Trustee expenses and related party transactions are disclosed in note 17 to the accounts. New Trustees are appointed through an open public appointment process, depending on the experience and key skills needed. New Trustees are recommended by the NOMInat￿n$ Committee and are formally appointed in accordance with the Articles. Training and Induction On appointment, new Trustees follow a formal induction prograrnme, which includes initial meetings with the Chair and the Trustee. Provision of training via an online learning system an(1 the provision of key governance documentation. Ongoing tratning is provided for Trustees as relevant throughout their term. Training has been provided to ensure Trustees are aware of their responsibilities as both company directors and charity trustees. Organisational structure The Board provides leadership anil governance to the HDR UK. This is a strategic role that involves ensuring oversight. compliance and performance management. The Board meets at least four limes per year. Day-to-day responsibility for the running of HDR UK is delegated to the Director. The Director is sUPPOrted by an executive management team which contains the Jppropriate range of skills to ensure competent management of HDR VK. HDR UK hos three 8oord Committees: The Audit and Risk Committee is responsible for advising the Board on financial management and reporting, the relationship with external auditors and risk management. Professor Sir Alex Markham stepped down a5 Chair of the Audit and Risk Committee on 15 December 2022 and William Boa was appointed as Chair. The Nominations Committee is responsible for advising the Board on Board recruitment and skills requirement. Professor Sarah Harper CBE stepped down as Chair of the Nominations Committee and Alison Wilcox was appointed a5 Chair. The Remuneration Committee is responsible for advising the Board on the remuneration of the Institute's key management personnel in the context of appropriate comparators and sector benchmarks. William Boa stepped down a5 Chair of the Remuneration Committee on 15 December 2022 and Dr Andrew Elder was appointed as Chair. 27

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Trustees, Duty to promote the success of the Charity- Section 172 Statement Section 1721"s.172-1 of the Companies Act 2006 requires the Twstee5 of Health Oata Research UK (the -ChariW or"HDR UK-I to att in a way that they ￿nSider promotes. in good fèith. the success of HDR UK for the benefit of its members as a whole. In doing this. s.172 requires Trustees to have ￿gard, amongst other matters. to the.. lal likely consequences of any decisions in the long term- Ibl interests of HDA UK'S employees.. Icl need to foster HDR UK'5 bu5ines5 relationshLP5 with suppliers. customer5. and other5.. Idl impatt of HOR UK'S operations OA the community the environment- lel desirability of the Charity in maintainin8 a feputation for hi8h Standards of business conduct.. and If) need to att lairly as between members of HDR UK. The Trustee5 Qf HDR UK fully embrace and support these reporting requirements. The Tru5tee5 receive regular training on their obligations and have access to advice from the Head of Legèl. Trust and Ethics and from the Company Secretary when required. By havin8 a 8ood governance framework and procedures in place. the Tru5tee5 ensure that their deasion making is open and transparenL dea510115 are sustainable in the long term and do not disproportionately affect any single stakeholder 8roup. We set out below how HDR UK has cortsit1ered the matters found in s.172. First, we explain some of the key decisions taken by the Trustees over the past year and how srakeholdef inierests were considered over the course of decision-making, in line with HDR UK'S values. Then we outlsne how we engage with our stakeholders generally and the influence that such en838ements have on our decision makin8. Xey decisions of 2022 to 2023 Transition to the fiT ear stiate The Trustees continually review HDR UK'S strategy. A5 part of thi5. thÈ Tru5tÈes consider HDR UK'S business plan for the ¢omin8 year, its buil8et and the impact that decisions will have in the long terni. In considering the long-term success of HDR UK. the Trustees engaged with various stakeholders to create an ambitious new strate8y for the next five years. starting in 2023. The strategy set5 Qut an innovative proKramme to increase the scale, quality. speed and irnpact of insights derived from health data research in the UK and internationally. By 2028, the Institute will be well positioned to move forward to the next stage of its 20-year vrsion'for lar8e-5cale data and advanced analytics to benefit every pat￿ent interaction. clinical trial. and biomedical discovery and to enhance public health., and io be at the Cent￿ of a global. collaborative ne￿Ork of health data suence. In 2022 to 2023, HDR UK has fotustd on the transition to itsfuture fivÈ-year strategy. particularly on three integrated areas of activity to delNer this ambitiort indudin8= 111 Atcderate Trustworthy Data Use- 121 Empower Researchers.. and131 Prornote Partnerships. HDR UK will continue to work with its partners and funders towards its future wsion. The breadth of support for HDR Uws vision and strategy is ¢le3rly demonstrated by letters of sUPPOrt received dLtring HOR UK'S stakeholder engagement process. By bringing togeiher diverse health data science. HDR UK will advance research discoveries and ac(eleiète insi8hts that benefit patients and the public across the UX and global￿. 28

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Patient and Public Invol¥ement anil En emeflt The involvement and engagement of patients and the public in governante. infrastructure devÈlopments. and research ensures HDR iJK's work 15 inclusive. trustworthy* and drr¥en by deliverin8 public benefits. HDR UK is committed to raising awarene55 of health data researth and working with patients antl the publicto ensure their voices Shape the access and use of health data for research that improves people'5 live5 and delivers benefits for all. By providing opportunities suth as joining HDR UK'S Publit Athisory Board Ofpart￿1patlngIfi campaigns like Dtrro5ove live5.' MentolHeolth. patients and the public makes a significant impact on HDR UK'S work and contribute to the advancement of its mission. HDR UK involve5 and engages patients and the pvblic through ¥arityJs means. including: Seekin8 advice frcrfn the Public Advisory 8oard and implementin8 the feedback received Conductin8 publi£ consultations io gather diverse perspectives on health data research matters OrÈ3nisin8 accessible and inclusive public events to raise awareness of health data and encourage involvement in related research Creating Opportunities to shapin8 health data research. from design to dissemination and evaluation stages Sharing relevant information and updates through webpa8e. s¢xial media. and newsletters. 3. Cham ionin Divers in Data S¢ien The 8oard is committed to developing an inclusive eulfvre that promotes tliveryity. Opportunities have been provided to those frorn 50cio-econornic backgrounds that are currently underrepresented within health data science. Irs re5pon5e to the significant underrepresentation ol Black people in data science, HDR UK launched a Black Internship Programme with intems marched to data roles in Alliance partner organisations. The Black Internship programme is currently in its third year. HDR UK is pleased that many candidates went on to secure roles in the field. Open di5CUS5ions about issues faced in the workplace have fed into HOR UK'S strategy. To support HDR UK'S agenda, HDR UK is lookin8 to Continue to attract and retain Peop￿ from dwerse batkgrounds. This ￿infOr£e5 HDR UK'S open and honest pproach to communicating ￿th its people on matters of 8ender and ethnioty. The businesse5 goals will be tracked on a frequent basis. Stakeholder Engagement We set out below how we engagè with our key Stakeh￿derS= Thè Public and PztTrtnts En The public and patients are critical to HDR UK. HDR UK aims to work in partnersh4P With the public and patients to ensure trznsparenty to build trusttvorthine55 in datè initiètive5. em HDR UK'5 innovative approach to bring public views in quickty and effectively ha5 shaped research and improved outcomes with thousands of patients and members ol the public contributing to HDR UK'S work. How this en ement infl d 8oard discu and decisi makin HDR UK has widened its public engagemenl and reach through social media. press campaign5. and events. showcasing the benefits and impact of data. Insights are regularly shared with the Board through quartedy Ml packs. 29

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 IAARCH 2023 Funde En HDR UK liaised and interarted with its lundets to understartd those aspects which a￿ upperm05t on their agÈndas. ement this en ernent influenced Board di5CUS5ions and decision makin Insights are regularly shared with the Board thtough quarterly Mana8ement Information packs. Trustees and members of the executive regularly seek and re¥iew feedback from funders. which directly feed into Board discussions and inform strategic decision making. Employees ernent 8y engaging with its peDple. HDR UK will achieve it5 aim of advancing ￿earch discoveries and accelerating insights that benefit parients ané the public across the UK and globally. HDR UK'S employees are a sttong and talented group of people who work wlth skill and enthusiasm. We seek regvlar feedback throu6h staff surveys to assess employee en8agemenL reduce employee attrition and build stronger teams. ement influenced Board discussions and deo ion makin Understanding staff sentiment help5 HDR UK to understand how to improve its relationship with employees. HDR UK continues to build a working environment that advantes equity, d￿erSIty and indusion. Partnerships and Suppliers HDR UK'S partnerships have continued to grow and flourish durin8 the year which demonstrate5 the value of combining expertise to deliver further and faster on joint ambFbons. HDR UK partners with variov5 institutes to further advance its health research to improve patient care. How this en ernent influenced 8oèrd discussions and decision m3kin Members of the executive regularly seek leedback from Partners and Suppliers. which feed into Board di5CU55ions and inform 5tra¢egic decision making. Wider Comrnunlty HDR Ufs solutions direcdy and indirectly impatr a whole host of stakeholders includin8 patients and public. data custodian5 and rèsÈarchets.' By operating responsibty and 5UStainably. HDR UK increases accessibility to its services which is core to it5 purpose. How this en ement influenced 8oard discv55ion5 and decision m The work of HDR UK is cenired around medical innovation for the benefit of all.. Uniting health data by bringing treether the UK'S datasets and making them safely and securely discoverable and accessible for research through the UK Health Data Alliance and Innovation Gatewayi in a way that earns the trust of patients and the public. Improving health data by providing tools. methods. hubs, and national expertise in health data quality improvement lor researchers and innovators. Enabling research and innovation that has a 13r8e-scale impact, demonsiratin8 novel approaches to health data use. and establishin8 an expert group of national research leaders in health data 50ence. kin 30

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 The Trustees arE mindful of the impaci that the busines5 and solutions have on the witler cornmuriity. HDR UK'S science strategy is centred on prioritisinÈ area5 that will have the maximum impact forthe health of pabents and populations across the UK. Relationships with other organisations A nLbmber of Trustees. key management or their close famity member5 hold Posit￿￿5 in other organisations wilh which HDR UK has significant relationships: Organisation Medical Research Council Ipart of UK Research and Innovationl Relationship to HDR UK UK Research and Innovation is a memberofthe Company. UKRI brings together the seven researth touncils. Innovate UK and Research England. UKRI provides funding grants to the Company through the Medical Research Council and Innovate UK. Trustee involvement Dr Graham SpTrttle is a Council Member of the Medical Research Council Innovate UK (part of UK Research and Innovation) Professor Sir James smith's spouse was former￿ Executive Chair of the Medical Research Council from April 2018 to January 2022 Alex Markham is Non-Executive Director of Inftovate UK, Medicines Discovery Catapult Claire Newland is the Medical Research Council Director of Policy. Ethics & Governance Emily Jefferson is a Mernber of the Longitudinal Population Studies Strategic Advisory Panel. MRC and a Member ofthe MRC Lorhgitudinal Population Studies Task and Finish Group Cathie Sudlow is Deputy Chair of the MRC Data Science Advisory Gmup Professor Sir James Smith was a Director of Genome Research Limited until july 21. Genome Research Limited Co-ordinatin8 Research Organisation of the HDR UK CaMbr￿ge Substantive Site and lead for HDR UK'S Understanding the Causes of Disease nat￿)nal research priority. 31

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Genome Research Limited is a wholly owned subsidiary of the Wellcome Trust. Genome Research Limited is the recipient of Core funded grants. Wellcome Trust Welltome Trust provide5 funding grants to the company directly for the HOR UKTuring Wellcome PHD Programme in Health Data science. through UKRI as a core funder and through the Covbd-19 Therapeutics Attelerètor. HDR UK is also a Tenant of the Wellcome trust Co-ordinating Research Organisation of the HDR UK Scotland Substantr¥e Site and lea for HDR UK'S Applied Analytics national research pr￿rIty. James Smith was the Direttor of Science for the Wellcome trust, resigned May 21 The University of Edinburgh An(Jrew Morrrs is Vice Principal nd Professor of Medicine at The University of Edinburgh Graham Spittle is Dean of Innovation Lead organisation for BREATHE - Health Data Research Hub for Respiratory Health. BREATHE is a member of the UK Health Data Research Alliance and a represented on the Alliance Council Cathie Sudlow is Professor of Neurology and Clinical Epidemiology at the University of Edinburgh The University of Edinburgh is the recipient of grants through Core funds. the Data and Connectivitv- National CO￿ Studies programme, and The Alan Turing Institute HDR UK D&C Funding Call. Scoitish Government members are represented on the Alliance Council. NHS Scotland and Public Health Scotland are Alliance member organisations. Scottish Government Andrew Morris is Chair of the Scottish Government Standing Committee on Pandemics and of the Scott15h Governmenl COVIO- 19 CMOadvisoryGroup. Scottish Government members are the recipients of grant funding through the Data and ConnectNity= National Core Studies Programme. 32

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Imperial College Healthcare NHS Imperial College Healthcare NHS Trust Trust is an Alliance member and is represented on the Alliance Council. Department of Heamh and Social care 15 a funder for the Winter Pressures fund. Ara Darzi is Consultant Surgeon at Imperial College Healthcare NHS Trust. Department of Health & Social Care Ara Darzi 15 a Member of the Recovery. Resilience and Growth Oversight Group IRRGI, Department of Heahh & Social Ca University of Oxford QResearch is a nol-for-profit collaboration between the University of Oxford and EMIS. QResearch is an Alliance member and 15 represented on the Alliance Council. Sarah Harper 15 PTofe550r of Geronto108V. Throughout 2022123. Trudie Lang IHDR UK'S Global Researth Director) has been secon(led to HDR UK from Oxford universitv. This relationship ended 31 Mav 2023. The University of Oxford 15 the to- ordinating Research Organisation of the HDR UK Oxford Substantive Site. The University of Oxford is the recipient of grant5 through Core funds and the Data and Connectivity.. National Core Studies programrne. A grant agreement wa5 signed between HDR UK and the University of Oxford Ispecifically the Centre for Tropical Medicine and Global Heakhl. taking effect I July 2022 and lasting S years. This is a grant from the Bill & Melind8 Gates Foundation, with Oxford acting as lead and HDR UK as a partner in this arrangement li.e. funds flow from 8MGF to Oxford to HDR UK) NHS Digital Recently merged with NHS England. sitting Wlthin the Transformation Directorate. NHS England are represented on the Alliance Council Imperial College London is part of the HDR UK London Substantive Stle. Alex Markham, Andrew Morri5, David Seymour and Cathie Smith are members of NHS Digital. Research Advisory Group Imperial College London Ara Darzi is Paul Hamlyn Chair & Co-oirector of Institute of Global Health Innovation. Imperial College London. 33

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 MARCH 2023 Impefial College London is a recipient of grant funding through the Data and Connectivity= National Core Studies Programme and the recipient of Core funding via University College London as part ofthe HDR UK London Substantive Site James O'Shaughnes5y is Visitirbg Professor at Institute of Global Health Innovation, Imperial College London. Mark Walport is Honorary Distinguished Professor of Medicirbe. Imperial College London and Chair, Imperrdl College Health Partners. Cathie Sudlow 15 3 Member of the External Advisory Board. UKRI CDT in Al for Healthcare, Imperial College London Mark Walport is Chair of Imperial College Academic Health Sciences Centre Partnership Board Imperial College Academic Health Sciences Centre Partnership Board Imperial College Healthcare NHS Trust 15 an Alliance member and is represented on the Alliance Council. Research Daia Scotland are an Alliance member have a representative on the Alliance Council. Research Data Scotland Board Andrew Morris was in altendance at Research Data Scotland Board NIHR NIHR Clinical Research Neiwork and NIHR Bioresource are both Alliance members and have representative within the Alliance Council Cathie Sudlow is a Member of the UK Government Clinical Research Recovery. Resilience and Growth Programme Data and Digital Subgroup. UK Governwnent, NHS TransformatKJn Directorate, NIHR Emily Jefferson's academic ppoirttment is at UnNer5ity of Dundee University of Dundee Research Organisation within HDR UK Substantive Site and lead for the Alleviate Hub In accordance with ihe Institute's policy. Trustees are required to disclose all relevant inte￿st5 and register them with the Chair of Trustees and to withdraw from decisions where a conflict of Inte￿St arises. HDR VK'S register of interests 15 published on the website= htt www.hdruk.ac.uk -content load5 2022 08 HDR- UK-Re Jster-of-Interests-07 22. df. Full details of Related Party Transactions are included at note 17 of the financial statements. 34

HEALTH DATA RESEARCH UK TRUSTEES, REPORT FOR THE YEAR ENDED 31 ￿RCH 2023 Objectives and activity Objectives HDR UK'S marn objertives, as set out in the Articles of L$sociat￿Tr. are al to improve, protect. preseNe and advance the health of the public in particular but without limitation through the use of heahh data science by= the development and applicalion of biomedical and health data research. the development of the tools. technologies, skills and partnerships required to transform health informatics research and innovation- the sharing of infomiation in order to advance the understandin& prevention, diagnosis and treatment of disease5 to achieve better health outtomes for the benefit of the public.. and bl the advancement of medical and health research, in particular but without limitation by undertakin8, promoting, disseminating and improving research into biomedical and health informatics. Aims, objective and strategy to achieve HDR UK'S objective HDR UK ha5 been established to work with a wide range of heafth data from the NHS. universitie5. reseèrch institutes and charities, and Inc￿3$inglY from wearables. and private companies. Over the next 5 years, health research dataset5. participants and vses will grow rapidly HDR UK will position the UK to lead health data science internationally with our national. pan-sector approach. Our strategy will be delivered via the infrastructure we have started to create. Public benefit The Trustees have referred to the guidance contained on the Charity Commi5SlOn'S general guidance on public benefit and consider HDR UK to be a public benefrt entity. Going Concern HDR UK has committed funding in place to cover lis activities until 31 March 2023 and has a written guarantee from MRC for future fundin8 at a sustainable level. A grant award letter from MRC UK to HDR UK for £71.3m was signed 5 April 2023. The Trustees have therefore been able to sat15fy themselves that the Company is able to continue as a going concern. Streamline Energy and Carbon Reporting The 2018 Streamlined Energy and Carbon Re￿rtIng Regulations. imposed by the 2019 SECR regulations, require large unquoted companies to include energy and carbon informalion within theirtrustees, report. for any period beginning on or after l April 2019. HDR UK did not consume more than 40,(KMI kwh of energy in this reporting peTiod, therefore it has qualified as low energy user and is exempt from reporting under the streamlined Energy and Carbon Reporting ISECRI. 35

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Audit information The Trustees who were in office at the date of approval of these financial statements have confirmed that, a5 far as they can reasonably ensure. èll relevant audit information has been provided to the auditors,. and the Trustees have taken all the steps that they ought to have taken as trustees in order to make themselves aware of any relevant audit information and to establhsh that the Company's auditois are aware of that information. statement of Tru5tees' Responsibilities The Trustees Iwho are also dirertors of HDRUK for the purposes of company lawl are ￿spOnSible for preparing the Trustees, rep)rt and the financial statements in accordance with applicable law and Unrted Kingdom Actounting Standards (United Kingdom General￿ Accepted Accounting Practice). Cornpbny law requires the Tw5tees to prepare financial statements for each financial year. Under company law the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charrtable company and of the incoming resources and application of resources. inclLtdin@ the income and expenditure. of the charitable company for that period. In preparirtg these finartcial statements, the Trustees are required to.. select suitable accounting policies and then apply them consistently. observe the methods and principle5 in the Charities SORP: make judgmenis and accounting estimates that are reasonable and prudent. slate whether applicable UK Attounting Standar(Js have bèen followed. subject to any material departures disclosed and explained in the financial statements- and prepare the financial statements on the going concern basis unless bt is inappropriate to presume that the charitable company will continue in operation. The Trustees are res￿nsIble for keeping adequate accounting records that are sufficient to show and explain the charitable company's transauions and disclose with reasonable accuracy at any time the financial p051tion of the charitable comparhy and enable thewn to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking re350nable steps for the prevention and detection of fraud and other bffegularities. The Trustees are responsible for the maintenance and intègrity of the corporate and financial information included on the charitable company's website. Legislation in the United Kingdorn governing the preparation and dissemination of financial statements may differ from legislaiion in other jurisdictions. So far as each of the Trustees Is aware at the time the report is approved-. there 15 no relevant audit information of which the company'5 auditors are unaware- the Trustees have taken all steps that they ou8ht to have taken to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information.. and there were no 5eriou5 incidents during the previous financial year that should have been reported to the Charity Commission but were not. 36

HEALTH DATA RESEARCH UK TRUSTEES. REPORT FOR THE YEAR ENDED 31 MARCH 2023 Approv31 This Tru5tees' report includingthe Strategic rep)rt was approved by the Board ofTrustee5 on 10 November 2023 and signed on their behalf by: JHl/e Mooke Dame Julie Moore Chair of the Board of Trustees 37

HEALTH DATA RESEARCH UK INOEPENDENT AUDITOR'S REPORT FOR THE YEAR ENDED 31 PIARCH 2023 Opinion We have audited the financial statements of Heath Oata Research UK for the year ended 31 March 2023 which comprise the Statement of Financial Attivities. Balante sheet. the statement of cash flows and the related notes to the financtal statements, 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 Finonciol Reporting Standardapplicoble in the UKond Republic of Irelond Iunited Kingdom Generalty Accepted Accounting Practice). In our opinion, the financial statements= give a true and fair view of the state of the charitable company's affairs as at 31 Mafth 2023 and of the charitable company's nei movement in funds, including the income and expenditure. for the year then ended- have been properly prepared in accordance with United Kingdom Generalty Accepted Accounting Prartice.. and have been prepared in accordance with the requirements of the Companie5 Act 2CI)6. Basis for opinion We conducted our audit in accordan￿ with International Standards on Auditing IUKI IISAS IUKII 8nd applicable law. Our responsibilities under those standards are further described in the Auditorfs responsibilities forthe audit of the financial statements section of our report. We are independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC'S Ethical Standard, and we have fulfilled our other eihical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained 15 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 trustee5' Use of the going concern basis of accouniing in the preparation of the financial siatements is appropriate. Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that. individualty or collectively. may Cast signrfitant doubt on the chariiable company's ability to continue as a 8oin8 concern for a period of at least twefve months from when the financial statement5 are authori5ed for issue. Our responsibilities and the responsibilities of the trustees with respert to going concern are described in the relevant sections of this report. Other information The trustees are re5pon5ible for the other informatiorb. The other information comprises the information included in the Trustees, Annual Report Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly state(l in our re￿rt, we do not exp￿55 any form of assurance conclusion thereon. In connection with our audit of the financial statements, our responsibility is to read the other information and. in doinB so, consider whether the other information is materially inconsistent with the financ¢al statements, or our knowledge obtained in the audit or otherwise appearsto be materially misstated. If we identify such material 38

HEALTH DATA RESEARCH UK INOEPENDENT AUDITOR'S REPORT FOR THE YEAR ENDED 31 MARCH 2023 inconsistencies or apparent material misstatement5. we are required to determine whether there is a material misstatement in the finantial statements or a material misstatement of the other information. If. based on the work we have performed. we conclude that there is a material mi5Statement of thi5 oiheT information, we are required to report that fact. We have nothing to report in this ￿83rd. Opinions on other matter5 prescribed by the Companie5 Act 2006 In our opinion, based on the work undertaken in the course of the audit.. the information given in the Trustees. Annual Report (which include5 the strategic report and the diiectors, report Prepared for the purposes of company lawl for the financial yearfor which the fi'nantial statements are prepared is consistent with the financial statements,. and the strategic report and the directors, report included within the Trustees, Annual Report have been prepared in accordance with applicable legal requirements. Matter5 on which we are required to report by exception In the light of the knowledge an(1 understanding of the charitable company and its environment obtained in the course of the audit, we have not Klentrfie(I material misstatements In the Trustees, Annual Report (which incorporates the strategic report and the directors. reportl. We have nothing to report in respect of ihe following matters in relation to which the Companies Act 2006 requires us to report to you if. in our opinion.. adequate accounting records have not been kept by the charitable company- or the charitable company financial statements are not in agreement with ihe accounting records and returns: or certain disclosur￿ of trustees. remuneration Specif￿ by law are not made- or we have not received all the information and eyplanations we require for our audit. Responsibilities of trustees for the financial statements As explained more fulty in the trustees, responsibilities statement set out on page 28. the trustees (who are also the director5 of the charitable company for ihe purpose5 of company lawl are responsible for the preparation of the financial statemen1$ and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the trustees are responsible for assessing the charitable company's ability to continue as a going concern. disclosing, as applicable. matters related to going concern and using the going concern basis of accounting unle55 the trustees either intend to liquidate the charitable company or to cease operations. or have no ￿￿11StiC alternative but to do so. Auditor's responsibilities for the audit of the financial statements Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material mi5Statement, whether due to fraud or error. and to issue an auditorfs rew)rt that includes our opinion. Reasonable assurance is a high level of assurance. but is not a guarantee that an auLlii conducted in accordance with ISAS IUKI will alway5 detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered maierial if. individually or in the a￿regate, they could reasonabty be expected to influence the economic decision5 of users taken on the basis of these financial statements. Irregularities. including fraud. are instances of non-cornpliance with laws and regulation5. We design procedures in line wilh our responsibilitie5, Outlined above, to detett material misstatements in respect of irreBularities. 39

HEALTH DATA RESEARCH UK INDEPENDENT AUDITOR'S REPORT FOR THE YEAR ENDED 31 MARCH 2023 including fraud. The extent to which our procedures are capable of detecting irregularrties. including frautl 15 detailed below- Based on our understandin8 of the charitable company and the environment in which it operates, we identified that the principal risks of non-compliance with laws and ￿gUlationS related to Charity and Company Law applicable in England and Wales. and we considered the extent to which non-compliance might have a material effect on the financial statements. We also considered those laws and regulatlons that have a direct impact on the preparation of the financial Statements such as the Companies Act 2￿6 and the Charities Act 2011, and consider other factor5 such as payroll tax and income tax. We evaluated management's incentives and opportLtnities for fraudulent manipulation of the financial statements linclu(Jing the risk of override of controls). and determine(J that the principal risks were related to posting inappropriate journal entries to revenue and management bias in actounting estimaies. Audit procedure5 performed by the engagement team included= Inspectin8 correspondence with regulators and tax authorities- Discussions with marbaBement including consideration of known or suspected instances of non- compliance with laws. regulation and fraud.. Evaluatin8 management's controls designed to prevent and detect irregu￿rities,. Identifying and testing journals using data analytics software- and Challenging assumptions an(J judgements made by management in their critical accounting estimates Because of the inherent limitations of an audit. there is a risk that we will not detect all irregularities, including those lea(Jing to a material misstaternent 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 siaiements, as we will be less likely to become aware of Trnstances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion. 0miss￿jn or misrepresentation. A further description of our responsibilities for the audit of the financial statement$ 15 located on the Financial Reporting Council's website at= www.frc.o auditors￿$ onsibilities. This description form5 part of our auditorfs report. Use of our report This report is made solely to the ch8ritable company's members. as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an Auditor's report and for no other purpose. To the fullest extent permitted by law. we do not actept or assume responsibility to anyone other than the charitable company and the charitable company's members, as a LN)dy, for our audit work. for thi5 report. or for the opinions we have formed. Kathryn Burton Isenior Statutory Auditor) For and on behalf of Haysm3¢intyre LLP, Statutory Auditor 10 Queen Street Place London EC4R IAG Date.. 15111/2023 40

HEALTH DATA RESEARCH UK STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 MARCH 2023 Total Tot•1 ZO22 Funds Funds Incorne fraffl= tk*nations 58.327 27.292 85,619 64.637 Investments Other in¢ome 15 Total income $8,328 27.295 85,623 64,652 Empendiiure on: Research 17.651 13.9)0 31,551 32,9￿) Tffjal e¥penthiure 17.651 I3.￿10 31.551 32. Net incomellexpenth"turel beforetranslefs 40.677 13.395 54.072 31.752 Transfers between Funds 12 13 Net movement in 13.408 S4.072 31,752 Rtconciliation ¢>f lullds rotal funds brouzht foTh¥ard 11.980 31,980 229 Total fuThSs carried forward .664 25.388 B6,052 31.981 All of the above results are from continuing activitie5. The notes on pa8e5 44 to 63 form part of these finantial statements. 41

HEALTH DATA RESEARCH UK BALANCE SHEET AS AT 31 MARCH 2023 Company Registration Number: 10887014 (England and Wales) Registered Charity Number: 1194431 2022 £'OLXJ £'tyJo HXED ASSETS Intanwble assets Tangible a55ets 76 123 140 199 CURRENT A55ET5 Debtors 87.221 33.175 Cash at bank and in hand Is 8.146 14.619 95.367 47.794 CREDITORS.. arnount5. wiihin cffje year io 19.4551 116.012 NET CURRENT ASSETSI ILIABILITIESI 85,912 31.980 NEf ASSErsi ILIABIUTIESI 36,052 31.980 CHARITY FUNDS Unrestrirted funds 12 20,000 Restricted 12 25.388 11,980 TOTAL FUNDS 86.052 31.980 The financial statements were approved by the Board of Trustees and authorised for issue on 10 November 2023 and are signed on its behalf bv.. JHlie Mooke Dame Juliè Moore Chair of the 8oard of Trustees The note5 On page5 44 to 63 form part ofthese financial statements. 42

HEALTH DATA RESEARCH UK STATEMENT OF CASH FLOWS FOR YEAR ENDED 31 MARCH 2023 2023 2012 Notes Cash fftow5 fr(MTh operatinE acti¥ities Net cash wtflow prothded by operatingattmties 14 16.4251 17.99LI Cash flows Ifom inves1f￿a((l￿1Eles Interest received Purchase of tsngible and intaneible fixed asstts 1511 11191 1481 11191 Chanee in ￿5h and c•5h eq¥r¥ilent5 in theyear 16.4731 18,1111 Cash and ca5hequivalents brought forward 14,619 22,730 Cash ahd tash equi¥alents carried fon¥ard Is 8.146 14.619 A net debt reconciliation note has not been presented as the charity has no debt. The notes on pages 44 to 63 foim part of these financial statements. 43

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 Auounting wlice5 1.1 General information Health Data Research is a Charity and company limited by 8uarantee and is registered in England and Wales. The gistered gflice and the address of the principal place of business is Welkome Trust. Gibb5 Buildill8, 215 Euston Road. London. NWI 2BE. 1.2 8asi5 01 preparation of financial statefflents The financial statements have been prep3red in accordance with the Charities SORP IFRS 1021 Accounting and Reporting by Charities: Statement of Recommended Practi￿ applicable to charities prepwin8 their accounts in accordance with the Finantial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021 (effective I January 20191. the Financial Reporting Standard applicable in the UK and Republic of Ireland IFRS 1021 and the Companies Act 2￿)6. Health Oata Research UK meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initièlly reeognised at historical tost or transaction value unless otherwise stated in the relEvant accounting policy. 1.3 Fund accountib General funds are unrestrirted fuftds wh¥ch are available foruse at the discretion of the Trustees in furtherance of th* general objedives of the Company and whith have not been designated for other purpose5. Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised bythe Company for particular purposes. The costsof raisingand admini5teringsuch funds a￿ charged a8ainst the specific fund. The aim and use of each restricted fund 15 set out in the notes to the financial statements (Note 131. Inyestmeni income, gains and losses are allocated to the appropriate funds. 1.4 Income All income is recognised once the Company has entitlement to the incorne. it is probable that the income will be received, and the amount of income receivable can be measured reliably. Income from 8rants containin8 performan￿ conditions is recognised as performance occurs. with all funding received irn advance or in arrears of performance deferred or accrved accordingly. Oiherwise income 15 recoBni5ed in full as soon as any other relevant conditions are sat15fied. On receipt. donated profe5si0nal services and donated facilities are recognised on the basis of the value of the gift to the Company which is the amount the Company would have been willing to pay to obtain servKes or facilities of equivalernt economic benefit on the open market. a corresponding amount is then recognised in e¥penditure in the period ol receipt. Income tax recoverable in relation to investment income is recognised at the time the investment incorne 15 receivable. Other income 15 recognised in the period in which tt Is receivable and to the extent the goods have beEn provided or on completion of the ser¥ice. 44

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 Accounting poll¢es Iconiinuedl 1.6 Expenditure Expenditure is reco8nised once there is a le8al or constn&rtNe obligation to transfereconomic benefit to a third party, it is piobable that a transfer ol economic benefits will be reouireij in settlement and the amount of the obligation can be measured reliably. Expenditure is classifietl by acbvity and is analysed between 8rant fundin8 and the c05t of activ*tie5 performed direttly by HDR UK togeiher with the associated support Costs including governance costs. The staff cost element ol support cosis is attributed to grani making actNities in proportion togrant expenditure and dirert expenditu￿. Irrecoverable VAT is charged as a tost 38aihst the activity for which the expenditure was incurred. Govemance costs are those incurred in ronneuion with administration ot the Company and compliance with constitutional and staruwry requirements. Grants payable are charged in the year when the offer is made except in ihose cases where the offer is conditional, such grants being recognised as expenditure when the tondifions attaching afft fvlfilled. Grants offered subject to condition5 which have not been met at the year-end are noted as a comrnitment. but not accrued as expenditure. 1.7 Goln8 concern The Trustees have a reasonable eXpe￿atiOn that the Company has adequate resou¥ces to continue in operational existente for the foreseeable futvre. For thi5 reason they continue to adopt the going concern basis In preparin8 the financial statements. 1.8 IntanBlble fmed assets and amortisatioft Intsngible assets costing El,CKQ or morè a￿ capitali5ed and recognised when luture economic benefits are probable, and the cost or value of the assets tan be measured reliably. Intangible assets are initially recognised at cost and are subsequently measured at C05t net of amortisalion and any provision for impairment. Costs relating to assets developed internally are capitalised in accordance with ihe reqU1￿ments of FRS 102. Amortlsation is provided on intangible fixed assets at rate5 calculated to write off the cost of each asset. less their estimated residual value. on a straight-lint basis over theirexperted useful lives.. Purchased software litenses The contractual period Oeveloped software Straight line over 3- 5 years Websites Strajght line over 3- 5 years A full year of amortl53tion 15 tharged in the year when the assei is ready for use and no amortisation is char8ed in the vear of disposal. The carying values of intangible h.xed assets are wiewed for Impairment when events or changes in circumstances indicate that the carrying amount may not be recoverable. Shortfalls between the carrying value and retoverable amounts are reco8nised as impairments. Impairment 1055es are recognised in the statement of financial artivities ineorporattng rncL7me and expendtture account. 45

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 l. Attowiting policies Itontinued) 1.9 Tangible fixed a55et5 and depreciation All assets costing more than £l.(IJO are capitali5ed. Tangible fixed a55ets are carried at C05t, net of depreciation and any provision for impairment. Depreciation is prov¢ded at rate5 calculated to write off the c05t of fixed a55ets, less their estimated residual value. on a strai8ht-line basis over their experted useful lives= Short-term leasehold improvements Leasehold period Office equipment S years Computer equipment 5 years A full year of depreciation is tharged in the year when the asset is ready for use and no depreciation is char8ed in the year of disposal. A review for impairment of a fixeij asset Is carned out If events or changes in circumstances indicate that the tarrying value of any asser may nor be iecoverable. ShortFalls between the carrying value ol fixed assets and their recoverable amounts are recognised as impairments. Impairment losses are recognised in the statement or rinancial actlvities intorporating income and expenditure attount. 1.10 Operatint leases Rents payable under operating leases are tharged to the ststÈmÈnt of financial actr¥ities incorporatin8 incorre and expenditure account on a straight-line basis over the lease of the term. 1.11 Interest receival Interest on funds held on deposit is included when receNable and the amount can be measured reliably by the Cowpany,. this is normally upon notification of the interest paid or payable by the bank. 1.12 Oebtors 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. 1.13 Cash at bank and in hand Cosh at bank and in hand indutles cash and shtyt term highty I￿Uld investments wilh a short maturity of three months or less from the date of acquisitson or opening of the deposit or similar account. 1.14 Liabilit￿$ and provisions abilities are reco8nised when there is an obligation at the balance sheet date as a result of a past event. it is probable thar a trarbsfer of economic benefit will be required in settlement. and the amount ol the settlement can be estimated reliably. Liabilrties are recognised at the amount the Company antitipates tt will pay to settle the debt or the amount it ha5 recesved as advanced payrnents for the good5 or Services it must provide. Provisions are measured at the best estimate ol the amourtts requ¢red to settle the obligation. Where the effect ol the time value ol money is significant, discount rate is applied. The discount rate that reflects the risk speofic to the liability. The unwinding of the discount is recognised within interest payable and similar charges. 46

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 l. Attounting policies Itontinuedl 1.15 Flnancial instrumenis The Company only has financial assets and ffinancial liabilitie5 of a kind that qualrfy as basic financial instruments. Basic financial instruments a￿ initially reco8nised at transaction value and subsequently at amortised cost using the effective interest method. less any impairment losses. 1.16 Critical ¥counting jydgements and estimates The preparation of the finanoal statements requires managemènt to make jud8ements. estimates and assumptions that affert the amounts reported for assets and liabilitie5 a5 at the balanee sheet dale and the amounts reported for revenues and expenses durin8 the year. However. the nature of estimation means that attual outcomes could differ from those estimates. 47

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 ANALYSIS OF EXPENDITURE Dirert Gr￿￿ Support Total Tot•1 2022 olartbvth5 2023 Charitable attivities Research 9,918 19.892 1.742 31.SS2 32,900 Total 2023 9.918 19.892 1.742 31.5S2 32,900 Support Costs Staff Premises and Total Total st5 2023 2012 Charitable artivities Research 1.226 2S7 259 I,742 2,709 Total 2023 1.226 257 259 1.742 2.709 HOR UK has one w of artNity. &Jpport costs have been alTrrxaied io that c4ie acbvity. Governan￿ cost5 are ificluded within support cost& Support Costs related to grani fundmz actNitie5 i￿l￿ded in totsl 5YPP¢Xt C95t5 abDveare £790k. 48

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 ANALYSIS OF ExpeNDITURf - Pr￿r year Gr4Wbt I￿&￿8 ola¢ti¥ilies Suppwt rosts Total Total 2021 2022 Charitablè artivities Research 10.354 19.837 32.9C(I 27,389 Total 2022 10.354 19.837 2.709 32,900 27,389 Support Costs Staff Pr*isesand her Total 2022 Total 2021 Charitable attivilies Research 1.814 171 724 2.709 1.374 Total 2022 1.814 171 724 2.709 1,374 HOR UK has one type of actNrty. 5upwrtcosts ha¥e been all￿ted to thator aciv4ity. Go¥ern3nce costs are induded within support cost5. Support costs retsied io 8rantfundmB arti￿tres I￿￿ded in totsl 5UPPQrt(Q5ts above are £J.198k. GOVERNANCE COSTS Total 2023 Toial 2022 Chair remuneration Reimbursement of Trustee & Direttor Expenses Audit lee includinÉ VAT Non-audit services includin8 VAT Legal fees Board costs 16 16 25 20 125 107 172 153 49

HEALTH OATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 GRANTS PAYABLE o￿anIs•ll0￿ Total 2023 Total 20Z2 UniversityColleÉe London Universit¥OI Edinburgh Genome Research bmited Swansea University Universityof Oxford Universityof Birmingham Universityof Liverpool Universityof Bristol Scottish G¢Jvernment Imperial Cdle8e ol scie￿e, Te£h1￿￿￿aThd MEdicint Other 3.075 2,857 2,239 2,038 1,920 1.533 1,184 976 646 459 2.966 2.478 2,657 1.437 2,081 2.805 1.224 575 606 1.067 918 3.988 19,893 19,836 The above are the contracting ofganisations. Our research locations are.. HDR UK Cambridge. HDR UK London. HDR UK Midlands. HDR UK North. HDR UK Oxlord. HDR UK Scoiland. HDR UK South-west. and HOR VK Wales & Northern Ireland. Our Health Data fiesearth Hubs are.. BREATHE. DATA-CAN. Discover-NOW. Gut Reattion. IN51GHT. PIONEER. NHS Di8iTrials. BHF Data Science Centre, OATAMIND. and Alleviate. Ourtrainin8 locations (Masters and PhDI are- Belfast, Bimiin8ham. Bristol, Cambridge. Edinburgh. Exeter, Leeds, London, Manchester and Oxford. The full list of fund reopients is listed ￿ ourwebsite". hrt wwnM.hdruk.ac.u abou locations STAFF COSTS Total 2023 Total 2022 E'fyJD Staff costs were as follows.. Staff wage5 and 5alarie5 Social security costs Other pension costs APprentI￿h1￿ Leyy 5.317 659 4.738 571 473 522 19 6.517 S,783 Not included in staff cosis were rethar8ed seconded salary costs amvunfin8 to £1,106k12022. £765kl and temporary staff costs of £921k12022.. E936kl_ Including costs incurred from recharged salary costs charged by third parties. the total compensation ol key management personnel was 2023.. £866k12022.. £639kl. Termination payments were made to the value of £15k12022'. nill. These were the result of redundancy and settlement paymenls. 50

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 STAFF COSTS Icontlnuedl The averaBe number of persons ernployed by the Company durin8 the yearw35 as follow5.. 2013 No. 2022 87 74 The number of members of staff whose emoluments. including benefits in kind. amounted to over £60,000 were as follows.. 2023 No. 2022 No. £flJ,(KQ- £70,OiX) £70.(K)1- £80.0(KI £80.￿l- £90.OCXJ E90.001- £IOO,OC#J ioo.ooi- £iio.ctsJ £110.001- £120,CO) E120,001- £130,C E130.001- E140.LKK) E140.001- E150.C(Q £150.001- E160.LN)O £160.CQD. E170.(KK) 14 li io 28 Dvring rhe year, Or Graham Spittle. a Trustee. received remuneration for his Services as Chair of E16.43012022.. £16.430115ee note 31. During the period, no other Trustees have been paid any remuneration or ceived any benefit5 irs kind12022.. nill. Trustees hwe been reimbursed for expenses incvrred to the total value of £668 durin8 the year. TAXATION The Company applied to the Charity Commission for ￿gIStratIon as a UK charity. All of the Company's income and gains have been applied to charitable attivities and. as such. no corporation tax liability ha5 been induded in these financial statements. The relevant exemptions are induded ai CTA 2010, Part 11, Chapter 2. 51

HEALTH DATA RESEARCH VK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 INTANGIBLE FIXED ASSETS Total Intangibles At l April 2022 Additions Disposals 358 27 11791 At 31 March 2023 206 Total IntanBibles AmortI￿￿On At l April 2022 Cha¥8e lor the year Disposals 282 34 11601 At 31 March 2023 156 Carrying amount At 31 Marth 2023 50 Al 31 Marth 2022 76 At 31 Marth 2023. thevalue of capital commitments for intangible fixed assets £nil12022= £nill. 52

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 TANG18LE FIXED ￿SET5 Leaseh(Ad Cumputei equipment ewipmeni Total rotyj Cost At l April 2022 Additions 25 62 146 233 24 24 Disposals Iiii 1421 1531 At 31 March 2023 25 51 128 204 Depreclatlon At l April 2022 Charge for the year Disposals 25 26 13 iii 35 1321 22 125 At 31 March 2023 25 32 57 114 Net book value At 31 Marth 2023 19 71 90 Al 31 March 2022 37 86 123 At 31 March 2023, the value ol capital commitment5 tangible fixed assets was £nil12022-. £nill. 53

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 DE8TOR5 2023 2022 Trade debtors Prepayments and accwed income Grants Receivable 4.819 28,339 16 83.979 3.241 87,221 33.174 The increase in accrued ¢ncome is lar8ety due to the QQ2 core award of £71.3m, whith has been recognised irt full but not yet invoiced. io. CREDITORS: Amounts faling due t￿thin one year 2023 2021 Trade creditors Accruals and deferred income Isee below) Accruals for grant payables Other treditors 8.591 454 2.277 1.493 12.012 230 165 245 9,455 16.012 Deferred income Oeferred income at l April 2022 Resources deferred during the year Amounts released Irom pr￿louS years 1271 14.052 27 114.0521 Oeferred incorne at 31 March 2023 No income has been deferred in 2023. In 2022 £26.727 ¥ias deferred as arnounts received were not utili5ed in the period. ii. FINANCIAL INSTRUMENTS 2023 2022 Financial assets measured at amtsrtised cost 95,368 47,793 Financial liabilities me35vred at amort15ed cost 9.455 16,012 Financial assets measured at amortised cost comprise cash. trade debtors and other debtors. Financial liabiSitie5 rnea5ured at amortised cost comprise trade creditors, other tsxation and Social security, other creditor5 and accruals. 54

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 12. STATEMENT OF FUND5 Mtr•ement wb Balance * i bncome April 2022 ExpEnthtyr Tr4Tr5fer5 Oetween Funds Balance at 31 Marth 20za £'ooo Totil Unrestrthd Re51rithed Core lunds-restricted Data & Conned￿lIV mat￿nal Core Study". Pha5ei HDR GlobalGraThl DAAE Phase Ib Diral Research InfrasirvctureAw•rd Turin8Oaia & coDnetsi￿tyj0Mrt Call proje(ts wellcome Trust PhD Prcframme Inscience Wintertyessutes pro8ramn BHF 05C Cardiova5cuLir and Oiabete5 CohtytsTRE world CLèss Labs 22123 Capital ebik Grani DkibetesData ScnceCatalys1 A11eviaie Hub Datsmknd Hub DAAE UK- Dthtr Proiert". FX VITTCons0rtium TuriD8WelkoMeTru51 Pho Pro8ram 8iomedlcal vacati￿ Schdarship Health Foundation 8ttter Care Ca0￿$t DARE UK- DrNei Projea. ￿TRE InternaiK)Aal cow￿￿9 Data Alliancel"ICODA"I & GRnd 20XXKI 58.328 (J7,6511 60.664 I3.1￿• J3.IXO 14.9651 1,982 1,975 1.192 ii.Th)01 953 19J71 106 7BY 385 3LYJ 48 43 28 26 1.270 Capital InvE5tment Pro8ramme (Phase 21 ICOOA& Gbbal tr¢eallh Nerwcrk.. PLifflningGrar CO-CONNECT DARE UK-Drwer Pvoieu. $4CRO DARE Phase I 018it3iinnovaiion Hub Pro8ramme.' Phe3 Population Reseawch UK Diiitallnnovation Hub ProwammE klanaBtrr•bt world Class Labs zoni Briiish Heart Foundat￿Th Data S¢wKeCÈntf Data & ConnettNily14atHJnal C¢)oSludy." Phaseo Total Resrrlcted Totsl of Fynd5 19 64 83 349 1.578 281 15 {6821 160 7.774 11.979 31.979 17J97 85M5 ij 35.388 86.052 Trdnsfers between funds are as*t trnnslers of E13k. 55

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 12. STATEMENT OF FUND51continued) Details of restritted lunds are as follows". Fund Core fvnds- restricted Data & Connectivity National Qjre Study.. Phase I Purpose Of the total core funds awarded to HDR UK £13m are restricted to specific To continue to respond to emerging COVID-19 research priorities, mappin8 key data sets required by the National Core Studie5. NIHR UPH Studies and SAGE sub-groups to allow search which can inform policy and operational decision making across the UK. To furthEr develop the data infrastructure and services across the UK to alsow faster access to hi8h priority health. administrative. molecular. and behavioural data asset5 for searchers workin8 on the most important COVID-related studies. ensuring priority research questions can be answered efficiently. in a transparent and trustworthy way. To strengthen and extend the existing national Trusted Research Environments ITREI and UK Health Data Research Innovation Gateway infrastwC￿re through inclusive four nations approach ensurin8 the priority datasets for COVID-19 researth are findable. accessible. inter-operable and reusable IFAIRI. To enable the expan5iors arsd directional lead of The Global Health Network to shift to Global South countries and facilitate the expansion ol a network ol data analysis scieAce led b stientssts from low- and middle-income countries. To scope out the delivery of è national federatetl digital research infrastructure to establish the next generation ol secure. flexible and interoperable environments for connectin8 and analysing complex and sensitive multi- disciplinary data at UK scale. ro rarnme5. HOR Global Grant DARE- Phases l and Ib. Data and Analytics Research Environmer+ts UK Digital Research Infrastructure Award Turin8 Data and Connectivity Joint Call projects Wellcome Trust PhD Prograrnme in Science Winter Pressures Capital lunding to support the development of the Health Data Research Innovation Gateway and associaied infrastructure serwi£es. To fund Oata and Connectivity joint call projects_ To deliver the HDR UK-Turing Wellcome PhD Programme in Health Data Science For the fundin& delivery and rnana8ement of the Data Science to inform NHS com ound winter ressure olicy To fjifil the secure and efficient data storage. linkage. sharin8 and analysis requirements of UK-wide disease-speofic cohorts, with an initial focus on cardiovascular and diabetes ohorts To support HDR UK'S capitsl in¥e5tments programme and assets. ro ramme BHF DSC Cardiovascular and Oiabetes Cohorrs TRE Wodd Class Labs 22123 Capital Block Grant Diabetes Data Science Catalyst Cdlaboration between the BHF Data Science Centre and Diabete5 UK to enhance our knowledge of the links be￿een diabete5 and cardiovascular disease, facilitate a deeper understartdin8 of the causes and progression of diaberes as a major cardiovascular risk factor- and drNe improvements in treatment and prevention of diabetes. with associated redurtions in cardiovascular disease. Collaboration with the Universityof Dundee to develop the ￿￿e¥late Hub and to integrate the Hub as a Health Data Research hub participating in the Hubs Network. Collaboration with the University of Swansea to develop the Datamind Hub and to integrate the Hub as a Health Data Research hub part4CiPatin in the Hub5 Network. To develop an exemplar frarnework and reference implementation for federated analytic queries. leviate Hub Datamind Hub DARE UK- Driver Project.. FX (Delivering a federèted network of TRES to enable sale analyts'csl 56

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 VITh Con50rtium Understsndin8 Mechanisms ofThrombosis and Thrombocytopenia in COVID-19 and with SARS-CoV2 Vaccines To deliver the HDR UK- Turin8 Wellcome Pho Programme in Health Oata Soenee Turing Wellcome Trust PhD Pro ramme Biomedical Vacation 5cholèrshi Health Foundation.. Better Care Catalyst Programme International COVIO-19 Data Alliance I"ICODA-I & Grand Challenges DARE UK- Driver Project.. SATRE (Standardised Architecture for Trust Research Environments) Capital Investment Prograrnme Phase 2 To provide 30 Wellcome Biomedical Vacation scholarships12020-20241. To 5UPPOrt the Better Care programme catalyst projects, providing exemplar outputs for use of data-drbven analyts'cs in clinical ractice. To deliver the Intemational Covid-19 Data Alliance and data analysi5 Workbench to 5UPPOrt the rapid developmentof insights and treatments to combatthe global efferts gf COVID-19. To develop a reference specification for TRES. informed by existing open-source TRE implementations. the TRE comrnuntty. and patients and the public. To support HDR UK'S capital investment programme irt". HDR UK Gateway dataset5.' to ensure Alliance rnembers datasers are onboarded to make them discoverable and accessible through the Gateway foT use in scientific research and innovation projects." Trusted Research Environments.. to enhance and provide access to Trusted Research Environment capability for turrent and future Alliante members (including HDR UK sites)., Gateway Technology Partnership.. To accelerate the development of a common access point for health data a5set5 acr05S the UK: Infrastrutture sprints= to develop So1￿10n5 on curation. data linkage and federated analytics.. 5. Collaboration solutions". technology and on-line capabilities that will enable HDR UK tooperate effioentlyand effectively a5 One Institute acr055 all priorities. sites and with partners_ ICODA & Global Health Network.. Planning Grant CO-CONNECT- Covid Curated and Open aNaly5is aNd rEsearCh plaTforrn DARE UK- Orivef Projeci.. SACRO ISemi-Automated Checking of Research Outputsl Oigital Innovation Hub Prograrnme: Phase 3 To enable the expansion of the ICODA workbenth for COVID data analysis to low- and middle-income country partners To build the data irtfrastructure to ensu￿ researchers have the necessary information to answer fundamental questions arthJnd how immunity may help prevent future spread of the virus Spreads in sthoolsand workplaces. how besttotreat it in hospitals. and generally how long smmunity lasts. To provide a cOhe￿nt intellectual framework encompassing the latest theoretical advantes to create resources inclutling practical guidelines for choices about OSDC in rart8e ol iechnical and procedural environments. To supporr business development of the Health Data Research Hubs, support the work of the UK Health Data Research ￿liance ano the UK Health Data Research Innovation Gaieway. To supporr the developrnent of Population Research UK. a research initiative that that rnaximise5 the insights. innovation5 and researth efficiency of the UK'5 woild leading social and biomedical data assets. including Longitudinal Population Studies. To support the development of the Oigital Innovation Hub Prograrnme under the life Sciences Industrial Strategy To 5UPPOrt HOR UK'S capital investments programme and assets. in particular those relating to the national COVID-19 re5pon5e. To deliver the 8HF Data Science Centre for cardiovascular health Population Research VK Oigital Innovation Hub Pro ramme Management World aass Labs 20121 British Heart Foundation Data Science Centre 57

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 Data & Conneciivilv National Core Study.. Phase O To support and accelerate research on COVID-19, 5UPPOrting the other five National Core Studies into key research questions by enabling streamlined. safe and responsible access to rdevant dataset5 relevant for the pandemic. To support the 8etter Care programme tatalyst projects. providin8 exemplar outputs for use of data-driven analyDC5 in clinical practice. To deliver the Internarional Covid-19 Data Alliance and data analysis Workbench to support the rapid development of insight5 and treatments to combat the 8lobal effects of COV1￿19. To enable the expansion of the ICODA workbench for COVID dats analysi5 to low and middle income country partne To support HDR capital investments programme and assets, in particular those relatin8 fo the national COVID-19 response. To support the development of Population Researth UK. a research initiative that that maximises the insights. innovations and research effiaenry of the UK'S world leading social and biomedical data assets. including Longitudinal Population Studie5. To support and accelerate researth on COVID-19. 5UPPOrting the other five National Core Studies into key research questions by enabling streamlined. safe and responsible access to relevant datasets relevant for the pandemic. To continue to respond to emerging COVID-19 research priorities. rnappin8 key data set5 required by the National CO￿ Studies, NIHR UPH Studies and SAGE sub-groups to allow researth whith tan inform poliry and operational decision making across the UK. To further develop the data infrastrurture and services acros5 the UK to allow faster acce5S to high priority health. administrative. molecular. and behavioural data assets for researthers working on the most important COVID-related studies, ensuring priority research qvestion5 can be answered efficiently, in a transparent and trustworthy way. To sirengthen and extend the existin8 national Trusted Research Environments ITREI and UK Health Data Research Innovation Gateway infrastructure through inclusive four nations approath ensuring the priority datasets for COVIO-19 research are findable. actessible, inier-operable and reusable IFAIRI. To scope out the delivery of a national federated di8iral research infrastructure to establish the next generation of secure. flexible and interoperable environments for connectin8 and analysing complex and sensitive multi- disciplinary data at UK scale. To build the data infrastructure to ensure researchers have the nece55ary information to answer fundamental questions around how immunity may help prevent future spread of theviru5 spreads in schoolsandworkplaces. howbest to treat it in h05Plta15. and 8enerallv how long immunity lasts. Capital funding to support the development of the Health Data Research Innovation Gèteway and associated infrastructure service5. To support HDR UK'S tapital investment5 programme and assets. Health Foundation.. Better Care Catalyst Programme Intefnarional COVID-19 Data Alliance I-ICODA-I & Grand Challenge5 ICODA & Global Healrh Ne￿Ork.. Planning Grant World Class Labs 20121 Population Research UK Data & Connectivity National Core Study.. Phase O Data & Connectivity National Core Study.. Phase I DARE- Data and Analytics Research Environments UK CO-CONNECT- Covid Cvrated 2nd Open aNalysis aNd rEsearCh plaTform Di&tal Research Infrastructure Award World Cla55 Lab5 22123 Capital Block Grant Oiabetes Daia Science Catalyst To enhance knowledge of the links between diabetes and cardiovascular disease., facilitate a deeper understanding of the cause5 and progression of diabetes as a major cardiovascular risk fèctor." and drive irnprovements in treatment and prevention of diabetes. with associated reductions in cardiovas￿lar disease_ To fvlfil the secure antl eFfiaent data storage. linkage. sharing and analysis requirements of UK-wide disease-specific cohorts. with an initial focus on cardiovascular and diabetes cohorts. BHF DSC Cardiovascular and Diabetes Cohorts Trusted Research Environment Vr￿ Consortium unders￿ndIng Methanisms ofThrombosis and Thfombocytopenia in COVID-19 and with 5ARS-CoV2 Vaccines 58

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 DARE UK- Driver Project.. SATRE (Standardised Architecture fgr Trust Research Environrnentsl DARE UK- Driver Piojert". SACRO ISemi-Automated Checking of Research Outputs) DARE UK- Driver Project.. FX IOeliverinB a federated network of TRES to enable sale analytlC51 Alleviale Hub To develop a reference 5pecifiration for TRES. informed by existing open 50urce TRE implementations, the TRE community. and patients and the public. To provide a coherent intellertual framework encompa$5ing the latest theoretical advances to ueate resources including practical 8uidelines for choices about OSDC in a range ot technical and procedural enviconments. To develop an exemplar frarnework and reference irnplernentation for federated analyknc queries. Collaboration with the University of Dundeeto developthe Aleviate Hub and to integrate the Hub as a Health Data Research hub participating in the Hubs Network. Collaboration with the University of Swansea to develop the Datamind Hub and to integfate the Hub as a Health Data Research hub participating in the Hubs Network. Datamind Hub 59

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 12. STATEMENT OF FUNOS Iconiinuedl STATEMENT OF FUNDS- prior yew 8aknce Mo¥emeni in fund5 Tièn5fers Bttwetn Fund5 Ba￿lIce ot l Zoii Icoffle Éxpenthiiure 31 PA•rrh 2022 UThresirfrted RstliCt¢d Dyital Innovation Hub Proxramme Mana8ernent Dqital Innovation Hub Progrnmme Phase 3 Cawtal Investment PrDErammePha5e 2 Brltish Heart FowndaivJn Data kience Centre wellcomeTrust PhD ProRrèmw Health Foundation- eellercare ICOtsA& Grand Challenees ICOOA& Glotsal Trlealth Neiwork WJnrMni Worfd Cla55 Labs 20121 pOpu￿tron Re5earth UK Daia & Conneitfvfty Phaseo Data & Connertrdity Phase I DAAÉ Phase I CI>CONNEcr a3￿2 113.3201 20,C•JI 1,114 Z81 I,S78 19 13.0401 17641 7BJ 9.357 18731 8,482 191 76 2569 971 176 1,370 19711 15 461 1557 11.5571 (8.6)1 17011 349 Total of funds 229 1319J)I 31.980 Transfers be￿een funds are fixed asset transfers of £4(

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 13. ANALYSIS OF NET A5SET5 BETWEEN FUNDS Analysis ol net funds- ¢urreTht ye Unrestricted Funds 2023 Resiricted Funds 2023 Total Funds 2023 Intangible fixed assets Tangible fixed 35sets Current assets Creditors due within one year 90 67.029 16,5061 28.338 12.9491 95.367 19.4551 Total of funds 60.663 25.389 86.052 Analysis of net funds- prior year UnTestr•cted F￿ndS 2022 Restrirted Funds 2022 Totsi Funds 202Z £'cKID Intangible fixed assets Tan8ible fixed a55etS Current a5set5 Crediiors due within one year 76 123 27.515 17.7141 76 123 47,794 116.0121 20.279 18,2981 Total of funds 20.1 11.981 31,981 14. RECONCILIATION OF NET MOVEMENT IN FUNDS TO NET CASH FLOW FROM OPERATING ACTtVlTIES 2023 2022 Net income for the year la5 per Statèment of financial Activities) 54.072 31,752 Adlustment lor: Depreciation and amortisation ch3r8es Disposals Net bank interest Decrease / lincrea5el in debtors IDecreasel/increase In creditors 69 41 105 IS4.0471 16,5571 128,2371 111.6111 Net cash provided by operating activities 16.4251 17,9911 61

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 ANALYSIS OF CASH ANO CASH EQUIVALENTS 2023 2022 Cash at bank and in hand 8.146 14.619 8.146 14.619 16. OPERATING LEASE COMMITMENTS At 31 March the tolal of the CompanVs future minimum lease payments under non-cancellable operating leases was.. 2023 2022 £'ooo Amoynts payable.. In le5S than I year In two to five years Total 17. RELATED PARTY TRANSACTION5 In the tourse of the year 2023. HDRUK reteived grants of £25,195k12022.. £45.504kl from The Medical Research Council (part of UK Re5earth znd Innovation). £345k w35 owed to HDR UK at 31 Marth 202312022.. £4.502kl. UX Research and Innovation IUKRII is a foundin8 member of the Companv. Over the courseol the year the organisation received grants of £79Sk12022.. £191kl and incurred othtrexpenditure of £153k12022.. £IIOkl in relation to Wellcome Trust. Wellcome Trust provides fundin8 gonts to the company directly for the HDR UX Turtsng Wellcome PHD Prr¢ramrne in Health Oata saence. through UKRI as a core funder and through the c￿ld-19 Therapeutics Accelerator. HOR UK is also a Tenant of the Wellcome trust. During the year the Company received grarbts of E2LM)k 12022.. nil) from Swansea UnNersity and incurred expenditure of £3.149k12022-. £1.391kl as grants Payable and £341k as other expenditure. HOR UK owed £928k as at 31 March 2023. Cathie Sudlow. Chief Scientist. Deputy Direttor of HDR UK and Director of the BHF Data Science Centre. is Chair of the Strategic Adwsory 8oard, DATAMIND at the Swansea University 3nd partners. Over the financial year the company incurred grant payable expenditure of £1.156k12022.. 390kl towards Imperial . College London. Mark Walport. a member of the trustee board. is Honorary Distinguished Professor of Medicine and Chair of tko Imper4al College Academic Health So"entes Centre Partnership 8oaid. Throvghout the year the company incurred grant payable expenditure of £1.284k 12022.. E429kl to Scottish 80vernment. £165k was owed at 31 March 202312022= £194kl. And￿W Morris is Chaic of The Scottish Govefnment COVID-19 CMO advisory Group and Chair of the Scottish Government Standing Committee on Pandemics. During the year. the institution incvrred other expenditure of £78012022. nil) to Thrive Woddwide UK Ltd. Alison Hopkinson. Chief Operating Officer and Oirettor of Delivery. is the 5PQU5e of the Dirertor and Shareholder Thrive Wofldwide UK Ltd. During the financial year 22123 the Company inCUr￿d expenditure of £3,148k12022.. £393kl a5 grants Payable and £1.354k as other expenditure to the University of Edinburgh. £105k was owed at 31 March 2023. Professor Andrew Morris, the Director of HDR UK is Vice Pfincipal and Professor of Medicine at The University ol Edinbur8h. 62

HEALTH DATA RESEARCH UK NOTES TO THE FINANCIAL STATEMENTS FOR YEAR ENDED 31 MARCH 2023 17. RELATED PARTY TRAN5AcfioNS (continued) During the year, Dr Graham SkNtUe. a Trustee. was paid £16.43012022.. £16.4301 foi his services as chair. During the year. trustee5 weie reirnbursed expenses amovntin8 to £66812022.. £nill 18. COMPARATIVE STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITURE ACCOUNT- Pfbor Year Unrestricted Funds Restricted Funds Total 2022 Incorne from: Oonations Investments Other incorne 33.041 31,596 64,636 li 15 Total incorne 33,052 31,60) 64.652 Empenditure on.. Chariiable activities Research 13.320 19.580 32.9C4) Total Expenditure 13.320 19.$80 32,900 Net incomellexpendilurel before transfers 19.732 12.020 31,752 Trzn51ers between Fund5 40 1401 P4et movernent kn fvnds 19.772 11,980 31,752 Recon¢tliation of funds Total funds brought forward 229 229 Total funds carried fo￿ard 20.001 11.980 31.981 63