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2024-06-30-accounts

CHARITY REGISTRATION NUMBER: 1194581

CLEFT

Independently examined accounts 30 June 2024

CLEFT

Financial statements

Year ended 30 June 2024

Page
Trustees' annual report 1
Independent examiner's report to the trustees 155
Statement of financial activities 16
Balance sheet 17
Notes to the financial statements 18

CLEFT

Trustees' annual report

Year ended 30 June 2024

The trustees present their report and the unaudited financial statements of the charity for the year ended 30 June 2024.

The financial statements have been prepared in accordance with the accounting policies set out in notes to the accounts and comply with the charity's governing document, the Charities Act 2011 and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland published in October 2019.

Reference and administrative details

Registered charity name CLEFT Charity registration number 1194581 Principal office 10a Warren Estate Lordship Road Writtle Chelmsford CM1 3WT

The trustees

As part of a planned programme of staged turnover of trustees, there have been a number of resignations and we are currently advertising for three new trustee posts.

The trustees who served during the year and at the date of approval were as follows:

B Sommerlad (Chairman) R Allan E Anderson M Fell T Goodacre T Morris S Novintan (Appointed 19/02/2024) M Pinkstone B Richard D Sainsbury R Slator J Baldwin (Resigned 19/07/2023) M Dwyer (Resigned 08/07/2024) M Gwyther (Resigned 12/06/2024) N Hay (Resigned 13/06/2024) Y Kahn-Pascual (Resigned 02/01/2024) K Knowles (Resigned 07/05/2024) R Walker (Resigned 12/09/2023)

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Treasurer W Smith (Appointed 01/07/2023)
Executive Officer M Baldwin
Deputy Operations Officer E De'ath (Appointed 01/11/2023)
Independent examiner L Thurston FCCA
Lovewell Blake LLP
Chartered accountants
First Floor Suite
2 Hillside Business Park
Bury St Edmunds
IP32 7EA
Bankers Barclays Bank PLC
North Herts and Welwyn Group
Hitchin

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Objectives and activities

Our Mission

CLEFT is a charity focused on providing permanent, sustainable, ways to improve cleft care in both the UK and overseas.

Supporting a variety of projects, we are helping to improve the lives of people born with clefts in many ways. Broadly speaking, our help can be described in two categories:

Research Projects

A core principle of CLEFT is to invest in research projects that study the causes and treatment of clefts. When it comes to clefts, there is still so much that is unknown. The progression of knowledge and understanding of clefts is therefore a key component in improving the methods used by surgeons, speech therapists and other medical professionals to treat and provide quality, long-term care for all people born with clefts, both in the UK and overseas.

Overseas Projects

CLEFT works with local surgeons and other specialists in several lower income countries to help them develop high quality, multidisciplinary cleft centres. We do this by visiting and working with local teams regularly, helping to provide education and training, and donating much-needed equipment.

Our visits are by selected UK cleft specialists who are invited by the local team to visit, primarily for teaching, collaboration and support.

We help to establish cleft centres in teaching hospitals so that the next generation of specialists will also benefit. Once twinning relationships are built, opportunities for overseas clinicians are created to visit the UK to further their training.

Our goal is to support local teams so that children born with clefts in these countries will have the same opportunities of having quality cleft care as those in the UK.

Public Benefit

The trustees confirm that they have paid due regard to the Charity Commission guidance on public benefit.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Achievements and performance

CLEFT Funded Research Projects

Previously funded research projects

The committee reviews all funded projects three times a year with brief written updates from the researchers at each meeting of the Research Steering Committee.

In July 2023, with the agreement of the researcher, it was agreed that the previously funded project 'Analysis of North Thames Cleft Q data' - was not going to proceed. At least partly because of staff changes following the Covid pandemic, it was decided that it was not going to be possible to find a researcher to analyse the data for this project. This project is therefore no longer supported by the charity.

In March 2024, in the routine review of projects, two previously funded projects were discussed. Of these, one (CLEFT 2018/03 - 'Do audio-visual aids improve the experience of patients undergoing an alveolar bone graft?') continues to progress steadily, albeit slowly, and one (CLEFT 2020/02 - 'A study on the long-term effect of vomerine flap closure of the hard palate at lip repair on appearance, dental arch relationship and growth of the upper jaw, speech, hearing and psychosocial outcome in in patients born with cleft lip and palate') is still awaiting the outcome of an application for ethical approval.

One further project: (CLEFT 2020/01 - 'An Investigation of the Anatomy and Function of the Superior/Transverse Component of the Palato-Pharyngeus Muscle') has been revised by the researchers and was resubmitted to the committee in the 2023 Call for Applications for research funding. This project was recommended for funding by the Research Steering Committee (RSC) but was 4th in the rankings of the projects assessed. It was not funded due to lack of sufficient available funds for all the recommended applications (see below).

Funded Research Projects 2021-23

Following recommendation by the RSC, the Trustees agreed to fund project CLEFT 2022/01 - 'Speech outcomes following orticochea pharyngoplasty in patients with cleft and non-cleft velopharyngeal dysfunction'. The project has progressed satisfactorily, though more slowly than anticipated.

CLEFT 2023/01 - 'Understanding the impact of the COVID-19 pandemic on the early speech and language development of children born with cleft lip and/or palate' (Bristol). This project has been successfully completed and a final report submitted, both written and financial. The project resulted in presentations at national and international conferences. A paper is due to be submitted for publication. The full aims of the project could not be achieved due to a smaller than expected data sample.

CLEFT 2023/02 - 'Development of an automatic scoring software tool utilising artificial intelligence to measure a cleft aesthetic outcome for children born with a complete unilateral cleft lip' (Birmingham). This project has progressed satisfactorily though not exactly as planned. The researchers requested that the funding for a two-year part-time researcher be converted to funding for a one-year full time researcher at no additional cost. This was approved. The project has been presented at a national conference.

CLEFT 2023/03 - 'Eye-tracking - A first step towards an automated measure of success in cleft lip surgery' (Newcastle). This project has progressed slowly. An initial paper submitted for publication was rejected and is being rewritten as two papers describing methodology and results separately. Further data is also being gathered at a conference in June 2024. The project has been presented at an international conference.

Call for Research applications 2023

Six applications were received. It was generally felt that the applications were of a higher standard than the previous year.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Four applications were recommended for funding by the RSC. However, there were limited funds available for funding research projects, and the Trustees were able only to confirm funding for the highest scoring project: CLEFT 2024/01 - 'Hearing status in newborns with an orofacial cleft and its relationship with speech at age 5: a study analysing linked national datasets.' (CRANE / London). This project was due to start in April 2024.

The second highest scoring project was titled 'Does maternal diet influence cleft sub-type?' (Manchester). The researcher accepted the offer from the charity to try to find funding from elsewhere. Applications have been made to other funders (one has been rejected), and this is still ongoing.

Two of the applications were not recommended for funding by the RSC. Feedback to the researchers was provided.

Research Webinars

Following the Awayday in 2023, it was suggested that an online meeting be held to investigate how the charity could best support researchers in the field of cleft lip and palate. This was discussed on several occasions. During these discussions the plan changed to one of holding webinars in the lead-up to the Craniofacial Society of Great Britain and Ireland (CFSGBI) Annual Conference in April 2024. A research webinar was held on 21st March 2024, with presentations by members of the RSC. It was chaired by Yvonne Wren. Feedback was positive and there is a plan to repeat these webinars next year.

CLEFT Funded International Projects

The year July 2023 - June 2024 has seen continued activity involving travel that was interrupted substantially during the Covid pandemic. Alongside visits involving linked teams, the Committee has met to discuss future strategic partnerships, and especially the vision for twinning units in the UK with appropriately chosen units in low- and middle- income countries. There have also been constructive discussions with a Canadian based charity, Transforming Faces, to explore possible collaborative work in in some fashion in future years.

Bangladesh

CLEFT funded teams returned to Bangladesh to support the collaboration in August 2023, and February 2024. The August 2023 visit was primarily focused on dento-alveolar teaching and development, following a specific request for such support by the team in Dhaka. The February 2024 visit was more general, although had very worthwhile interactions with the speech and language therapist team. These visits were funded by a large, restricted donation from 2023 as well as website restricted donations.

It has not been possible to advance the embryonic development of the centres envisioned for Khulna and Mymensingh, but as the situation within Bangladesh changes, it is hoped that future work alongside the political authorities might facilitate this.

In May 2024, the Chairman and two Trustees joined a meeting at the House of Lords with the High Commissioner of Bangladesh in London.

- Sulaimania, the semi autonomous Kurdish Region of Iraq

In November 2023, the Chairman visited Sulaimania, to both teach and support, as well as inaugurate the new operating microscope and C-arm for speech investigation that had been bought with funds given by a private donor to CLEFT. The Chairman participated in the opening of the new cleft centre, joined in a cleft conference, saw patients, and operated with the Sulaimania team. Also on the visit was a journalist colleague from the Daily Telegraph who subsequently wrote a substantial piece for the newspaper related to the work.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Egypt

CLEFT has a long-standing relationship with the cleft centre in Sohag, Egypt. The Chairman spent a few days in Sohag in February 2024 together with an orthodontist to work with the team and collaborate in a workshop. Both then returned to Cairo to join the Chair of the International Steering Committee and one of the committee members in participating in the 2nd Egyptian Cleft Association Conference, at which over 75 participants had received travel grant support from CLEFT to attend.

The conference highlighted the complexity in developing comprehensive cleft care in Egypt but was productive both educationally for all participants as well as in strategic direction setting. CLEFT additionally provided over 200 participants with operative training videos after the conference.

Gaza

A visit to Gaza by the Chairman as well as the Chair of the International Steering Committee and one of its members (Ghassan Abu Sitta) had been scheduled for 23rd October 2023. The events in Israel of October 7th and subsequent war in Gaza have prevented any plans for such a development visit for the foreseeable future. However, the links remain and will be explored regularly once the military action has ceased and reconstruction begins.

Nepal

The continued link between the Newcastle Cleft team and a centre in Kathmandu, Nepal took a considerable leap forward with the visit in October 2023 of a team of seven clinicians to the Nepalese centre. Teaching and clinical support was undertaken in speech and language therapy, nursing/ feeding, clinical psychology, dental care and surgical management. Very good feedback was received on all fronts, as well as excellent material for future publicity. The link has continued with tele-medical support, and future visits will be scheduled when requested/indicated, as well as support for Nepali clinicians to receive further development as identified by both parties.

Philippines

In February 2024, CLEFT funded a ten-day visit by two speech and language therapists from the Birmingham team to join Khurram Khan, a member of the International Steering Committee, (who was supported by another charity) to develop the partnership with a burgeoning cleft team in Davao, a large island in south Philippines. The visit was very successful in both teaching and fostering sustainable partnership between clinicians and will continue with tele-medicine and additional in person bilateral visits in due course.

Other links

CLEFT retains links with centres in Sri Lanka and Uganda.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

CLEFT Committee Updates

Fundraising committee

The Fundraising Committee is now over three years old and continues to support regular fundraising events, independent events and raise CLEFT's national profile at every opportunity.

The strategy it adopted last year was two-fold:

Corporate and Major Donor Committee

The Corporate and Major Donors Committee (CMD) continued to strive to raise finances last year, via a few different avenues. These included attempting to implement a series of Breakfast Interviews by CMD Chair and trustee, Matthew Gwyther, to invite potential donors to. Building relationships with companies who may make CLEFT their charity of the year. Also, reaching out to influential celebrities with links to the countries CLEFT supports.

However, as a newly formed and therefore yet not fully resourced committee, in a difficult corporate and economic climate where discretionary philanthropy is under pressure, it did not achieve the success it desired and has yet to secure any large donations.

Our existing corporate relationships were maintained this year with Emirates Airlines who donate the air fares for our trips to Bangladesh, Canva who provide a free not for profit subscription to their editing platform and DLA piper who provide use of their offices and refreshments for the CLEFT annual awayday.

Trainee Section

The CLEFT Trainee Section has completed its first full financial year since it was founded at the beginning of 2022. It aims to unite trainees of all disciplines who are passionate about improving global cleft care. It is currently chaired by trustee, Shonnelly Novintan, and consists of trainees in plastic surgery, orthodontics, dentistry, speech and language therapy and psychology. This year it has developed in the following areas:

A Restructure of the section

The Trainee Section has gone through a major restructuring, previously having had two Co-Chairs who managed three departments (events, research and education). It now has a more flattened hierarchy of one Chair and the core committee. This has been found to be a much more effective way of engaging and managing trainees. Once more established and these departments naturally form, reverting to the original structure will be taken under consideration. Furthermore, trainees are now expected to sign an annual volunteer contract, where they commit to undertaking two tasks during their annual term.

Growth

The trainee section has had four resignations this year and gained two members. The current eight members of the committee are very engaged, and the size of the committee is now very manageable. Recruitment has been paused until December 2024.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Raising Awareness and Outreach

As a part of the action points from the CLEFT Away Day, outreach events are deemed as a priority of the Trainee Section going forwards. These are events where trainees go to academic communities (often alma mater but can be local institutions) and talk about CLEFT and career building. So far, two outreach events have been held (at Anglia Ruskin University and Imperial College London). Awareness of CLEFT has also been raised by a series of articles in the European Dental Students Association (EDSA) journal and a guest appearance of Marie Pinkstone (Vice Chair of CLEFT) on the Giving Voice Podcast. Marie Pinkstone has also attended the University College London Student Careers Day to talk about speech and language therapy careers in cleft, international opportunities and CLEFT.

Fundraising

The Trainee Section has participated in four fundraising events: The Dorney Duathlon, Ford Ride-London 2024, Imperial College of Medicine Musical and EDSA Smiles for Miles campaign, raising nearly £3,000.

'Meet the Surgeons' Video:

The aim of this project was to raise awareness of the surgeons involved in CLEFT. These have been posted on CLEFT social media platforms and the CLEFT website.

Cleft Education Videos

This is a video series aimed at trainees who have an interest in cleft lip and palate with the objective of making the speciality more accessible. All six episodes are written with one episode filmed, ready to share. This project was presented at the CFSGBI conference and was well received.

Barrier to cleft training project

This project interviewed cleft surgeons around the country about barriers that exist in cleft training. It was presented at the CFSGBI and was well received. It is due to be published soon.

Student Section

In its third year the Student Section has continued to work towards its original aims of fundraising for CLEFT and raising awareness of the charity. In addition to this, one of the prime focuses this year was also to improve collaboration amongst the student groups and within the wider CLEFT charity.

This year the Student Section has recruited just under forty new ambassadors across fifteen universities and has raised a total of £2,350. This was through a variety of individual and group events ranging from bake sales, running events, quizzes and conference/ large event support. It has maintained strong international links with the Charles University in Prague which is hoped to continue into the coming years.

This year the section has faced challenges with recruitment and engagement of the student ambassadors and so utilised the CLEFT Away Day to strategise on how this can be approached. Despite the numbers and total fundraising amount being lower than the previous year, the Student Section central team are very proud of the hard work and dedication the student ambassadors have put in over the past year.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Financial Review

The Statement of Financial Activities provides detail to CLEFT's income and expenditure for the year.

During the year ended 30th June 2024, the charity's total income reached £248,844 which was 29% below the prior year £349,078.

Total Expenditure during the year was £306,960 up 182% on the prior year (£167,537) and included £292,311 for support costs, grants and awards to existing and new international and research projects, that are central to the objects of the charity.

As at the yearend date expenditure exceeded income by £57,030.

Reserves Policy

It is the policy of the charity to maintain sufficient funds to cover all agreed future commitments and at a level which considers inflation. Our funds are separated into three distinct fund types:

Restricted Funds

Restricted funds are funds subject to specific projects or areas of work, which may be declared by the donor(s) or with their authority (e.g. in a public appeal), but still within the wider objects of the charity.

Unrestricted Funds

All other funds generated from the fundraising activities, events and advertising less all the associated expenditure constitute the unrestricted funds of the charity and as such are freely available to spend on any of the charity's purposes.

Designated Funds

Designated funds are part of the unrestricted funds which trustees have earmarked for a particular project or use, without restricting or committing the funds legally. The designation may be cancelled by the trustees if they later decide that the charity should not proceed or continue with the use or project for which the funds were designated.

Levels of Reserves

As of 30th June 2024, CLEFT was holding funds of £444,782 of which £102,677 are restricted funds. Of the remaining £342,105 unrestricted funds, £205,332 are designated funds allocated for current and planned projects.

CLEFT's reserves policy is to hold six months core operating costs in reserve to guard against fluctuations in income. At the end of the 2023/24 financial year the trustees deemed six months' support costs to be £37,200.

On 30th June 2024, CLEFT was holding £136,773 free reserves, well above the level required for the charities reserve policy.

These reserves are intended to drive our expansion plans for CLEFT's reach and the trustees will be looking to allocate these available funds towards new projects in the coming year.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Plans for future periods

CLEFT Funded Research Projects

Research Steering Committee Support

During 2023, the Research Steering Committee (RSC) received two requests for support from other groups. The first request was from the Trainee Section of the charity to ask if members of the RSC would be willing to act as mentors for trainee research projects. The suggestion was that trainee research projects be vetted by the Chair of the Trainee section first. Only then might the RSC be approached with a request for someone to support the trainee. The support would involve giving advice on the project proposal, and on writing up any outcomes from the research. The RSC unanimously agreed this was a good idea. The suggestion has subsequently been endorsed by the Trustees. The initiative will be reviewed in a year's time.

The second request came from the Cleft and Craniofacial Conditions Clinical Studies Group (CSG) and their associated Early Career Research Group (ECRG). The CSG was originally funded for administrative support from the National Institute for Health and Care Research (NIHR) by The Scar Free Foundation and the Craniofacial Society of Great Britain and Ireland (CFSGBI). Neither of these organisations wished to continue funding the CSG.

The CSG approached the RSC to see if support might be available from CLEFT. Although the RSC were extremely supportive of the continuation of the CSG and ECRG, there were mixed views on whether it is appropriate for the charity to provide funds for administrative support. The RSC did not support funding faceto-face educational meetings of the ECRG with funding for speakers.

This request was passed back to the Trustees for a final decision, and it was agreed that funding would be provided to support high quality research in cleft care.

Podcasts

One of the themes of the 2024 Awayday was how to raise the profile of CLEFT. One suggestion was that the charity could host a series of podcasts which would be available on social media platforms. The RSC were supportive of this as an idea, and agreed they would be willing to be approached to participate in discussions or activities for said podcasts.

Future funding for research projects

A further Call for Applications for funding for research projects related to cleft lip and palate will be made from 1st July 2024, with a closing date of 30th September 2024. Applications may be made for funding of individual projects up to £50k.

CLEFT Funded International Projects

Bangladesh

A visit by the Chairman to include filming of work for promotional purposes is planned in August 2024. A cohort of the Bangladesh team plan to visit Great Ormond Street Hospital in October 2024 and will then be able to take back their learnings. February 2025 will see the annual team-teaching visit take place, and based on the needs of the clinicians a schedule will be devised nearer to the time. These visits are being funded by a large, restricted donation from 2022 as well as website restricted donations.

The semi-autonomous Kurdish Region of Iraq

The continued collaboration with the team in this area of Iraq with a troubled past has been particularly encouraging and a future return visit is planned for November 2024. The schedule will be based on the needs of the clinicians nearer to the time.

Egypt

The Chairman will be continuing the collaboration with a visit to the cleft centre in Sohag, Egypt in December 2024. The schedule will be based on the needs of the clinicians nearer to the time.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Mozambique

The potential link between the Birmingham cleft team and a collaborative unit in Mozambique has led to a planned visit in December 2024 led by International Steering Committee member and cleft surgeon, Khurram Khan, alongside two speech and language therapists, an oral and maxillofacial colleague and a nurse specialist. This nation has considerable needs, and the partnership is being developed in direct response to requests for support on a sustainable basis.

Strategic direction

Future plans for twinning units (possibly with one or two alongside Transforming Faces' work) are being explored and will be subjected to newly defined and more closely monitored budgeting when being considered for submission to the Trustee Board for approval.

CLEFT Committee Plans

Fundraising Committee

Reflecting on the results of the twelve-month campaign of Fundraising Committee events last year, it has been decided rather than running monthly campaigns it would seem sensible to focus on winter and summer fundraising. Winter : Wine Tasting, Online Quiz, Give It Up/Take It Up Summer : Online Quiz, CLEFT BBQ.

To increase levels of fundraising support, the Fundraising Committee is currently following up with ten new people who have shown an interest in CLEFT fundraising; offering those who do not wish to commit to being full committee members the opportunity to commit to just fundraising, as either a Summer Squad member or a Winter Warrior.

Corporate and Major Donor Committee

The committee is considering various options to increase its success in the coming twelve months. Funding has been provided by a member of the committee to complete a charity fundraising audit, to help develop the diversity of CLEFT income streams. The committee is also looking into ways that CLEFT can increase its public awareness using the mainstream media, ensuring the key ethos of the charity is highlighted to donors who are sympathetic to international comprehensive cleft care in low resource countries.

Trainee Section

Outreach

The Trainee Section plans to increase CLEFT's presence via outreach events, with a specific goal of having a multidisciplinary outreach event where multiple trainees will attend. A provisional event is organised later this year, as well as an international Outreach Event in Budapest.

Research

A research project investigating the exposure of cleft medicine in the dental undergraduate curriculum is planned to start next year.

Collaboration with Student Section

The Trainee Section plans to support a 'Handover Day' and to build regional groups of trainees and students.

Student Section

The underlying aims of the Student Section remain the same, to continue to:

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

The Student Section hopes to increase recruitment numbers (particularly increasing the multidisciplinary spread of teams) and improve the engagement of the ambassadors. With plans for a joint conference/ induction with the Trainee Section, and a restructure of the Student Section (to a more regional approach) it is hoped that better links will be forged with local units and trainees, forming small supportive CLEFT bubbles across the UK and therefore helping the Student Section reach its aims.

Structure, governance and management

Governing Document

CLEFT is a Charitable Incorporated Organisation and a charity registered in effect from 25 May 2021. The charity is constituted and governed by trustees under the terms of its memorandum and articles of association.

The current board of trustees and the changes which have occurred since the previous annual report are as stated in the reference and administrative details for these accounts.

Organisational Structure

The trustees are responsible for the governance of the charity. Initial appointment of trustees is made either through a nomination by a member of the charity or via an advertised recruitment process. All trustees hold office for three years, subject to reappointment. The trustees convened for six meetings during the year, to discuss fundraising, allocation of funds and strategy for the charity.

The charity has a Research Steering Committee of medical and scientific advisers and an International Steering Committee which considers submitted projects and makes recommendations to the trustees.

During the year, the following members served on the steering groups:

Members of the Research Steering Committee:

Name Position
Rona Slator Chair of the Research Steering Committee
Emily Anderson Clinical Geneticist, Vice-Chair of the Research Steering Committee
Norman Hay Consultant Orthodontist
Prof Phil Stanier Professor of Craniofacial Biology and Genetics, University College
London
Raouf Chorbachi Audiological Physician, Great Ormond Street Hospital
Fiona Gilchrist Senior Lecturer & Hon. Consultant in Paed. Dentistry
Stephanie van Eeden Lead Specialist Speech and Language Therapist
Yvonne Wren Chief Investigator of the Cleft Collective
Helen Robson Lead Nurse Cleft Lip and Palate
Sophie Butterworth Plastic Surgical Trainee
Ambika Chadha Oral and maxillo-facial surgeon
Gillian McCarthy External Engagement Officer, CLAPA
Jenny Cropper Clinical Psychologist
Hannah Lane Clinical SLT, Doncaster and Bassetlaw
Julie Davies Clinical SLT and Heath Psychologist, Manchester

Resigned from Research Steering Committee

Name Position Malcolm Birch July 2023 Martyn Cobourne September 2023 Paul Morris December 2023

Non-voting Members of Research Steering Committee

Name Position

Mark Dwyer CLEFT Trustee Brian Sommerlad Consultant Plastic Surgeon and Chair of the Committee and of CLEFT

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

New members joined

Name Position Jenny Cropper July 2023 Hannah Lane December 2023 Julie Davies December 2023

Members of International Steering Committee:

Name Position
Brian Sommerlad Consultant plastic surgeon, Chair of CLEFT
Tim Goodacre Retired plastic surgeon, Vice-Chair of the International
Steering Committee
Marie Pinkstone Speech and Language Therapist, Great Ormond Street Hospital
Debbie Sell Senior Research Fellow/ Speech and Language Therapist, Great
Ormond Street Hospital
Bruce Richard Consultant cleft surgeon (retired)
Raouf Chorbachi Audiological Physician, Great Ormond Street Hospital
Justhna Motlib Radiographer, University College London Hospital
Matt Fell Plastic Surgeon Trainee
David Sainsbury Cleft Surgeon, Newcastle upon Tyne
Richard Allan CLEFT Trustee
Paul Whittaker Film maker
Chris Hill Consultant Plastic and Reconstructive Surgeon
Mahen Bulumulla Accountant
Kate le Marechal Consultant Clinical Psychologist
David Orr Consultant Plastic Surgeon
Triona Sweeney Speech and Language Therapist, Dublin
Neil Brierley Cleft surgical trainee, Newcastle
Khurram Khan Consultant Plastic Surgeon, Birmingham
Jonathan Syme-Grant Consultant Cleft Surgeon
Adrian Sugar Retired Consultant in Cleft and Maxillofacial Surgery
Patricia Rorison Consultant plastic surgeon
Liz Grant Professor of Global Health
Helen Robson Lead Nurse Cleft Lip and Palate
Chloe Rolland Consultant Orthodontist
Ghassan Abu-Sittah Consultant Plastic Surgeon
Rowan Griffiths Photographer
New members joined in 2023
Name Position
Rowan Griffiths January 2024

Risk Management

The Trustees have examined the major strategic business and operation risks which the Charity faces and confirm that systems are in place to enable regular reports to be produced so that necessary steps can be taken to lessen these risks.

True and Fair Override

The financial statements have been prepared to give a 'true and fair' view and have departed from the Charities (Accounts and Reports) Regulations 2008 only to the extent required to provide a 'true and fair view'. This departure has involved following the Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland issued in October 2019 rather than the Accounting and Reporting by Charities: Statement of Recommended Practice effective from 1 April 2005 which has since been withdrawn.

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CLEFT

Trustees' annual report (continued)

Year ended 30 June 2024

Independent Examiner Reappointment

A resolution to appoint L Thurston of Lovewell Blake LLP as independent examiner will be proposed at the next Annual General Meeting.

The trustees' annual report was approved on .............................. and signed on behalf of the board of trustees 10/10/2024 by:

B Sommerlad (Chairman) Trustee

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CLEFT

Independent examiner's report to the trustees of CLEFT

Year ended 30 June 2024

I report to the charity trustees on my examination of the financial statements of the charity for the year ended 30 June 2024 which comprise the statement of financial activities, balance sheet and the related notes.

Responsibilities and basis of report

As the charity's trustees you are responsible for the preparation of the financial statements in accordance with the requirements of the Charities Act 2011 (‘the Act’).

I report in respect of my examination of the charity's financial statements carried out under section 145 of the Act and in carrying out my examination I have followed all the applicable Directions given by the Charity Commission under section 145(5)(b) of the Act.

Independent examiner's statement

I have completed my examination. I confirm that no material matters have come to my attention in connection with the examination giving me cause to believe that in any material respect:

  1. accounting records were not kept in respect of the charity as required by section 130 of the Act; or

  2. the financial statements do not accord with those records; or

  3. the financial statements do not comply with the applicable requirements concerning the form and content of accounts set out in the Charities (Accounts and Reports) Regulations 2008 other than any requirement that the accounts give a ‘true and fair' view which is not a matter considered as part of an independent examination.

I have no concerns and have come across no other matters in connection with the examination to which attention should be drawn in this report in order to enable a proper understanding of the accounts to be reached.

Your attention is drawn to the fact that the Charity has prepared the accounts (financial statements) in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) in preference to the Accounting and Reporting by Charities: Statement of Recommended Practice issued on 1 April 2005 which is referred to in the extant regulations but has since been withdrawn.

I understand that this has been done in order for the accounts to provide a true and fair view in accordance with the Generally Accepted Accounting Practice effective for reporting periods beginning on or after 1 January 2015.

L Thurston FCCA Independent Examiner

Lovewell Blake LLP Chartered accountants First Floor Suite 2 Hillside Business Park Bury St Edmunds IP32 7EA 10/10/2024

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CLEFT

Statement of financial activities

Year ended 30 June 2024

2024 2023
Unrestricted Restricted
funds funds Total funds Total funds
Note £ £ £ £
Income and endowments
Donations and legacies 4 194,178 2,122 196,300 231,242
Other trading activities 5 47,280 47,280 116,513
Investment income 6 5,264 5,264 1,148
Other income 7 175
------------------------------- ---------------------- ------------------------------- -------------------------------
Total income 246,722 2,122 248,844 349,078
=============================== ====================== =============================== ===============================
Expenditure
Raising funds
Costs of raising donations and
legacies 8 14,649 14,649 25,758
Charitable activities 9 137,790 154,521 292,311 141,779
------------------------------- ------------------------------- ------------------------------- -------------------------------
Total expenditure 152,439 154,521 306,960 167,537
=============================== =============================== =============================== ===============================
------------------------------- ------------------------------- ------------------------------- -------------------------------
Net (expenditure)/income and net
movement in funds 94,283 (152,399) (58,116) 181,541
=============================== =============================== =============================== ===============================
Reconciliation of funds
Total funds brought forward 247,822 255,076 502,898 321,357
------------------------------- ------------------------------- ------------------------------- -------------------------------
Total funds carried forward 342,105 102,677 444,782 502,898
=============================== =============================== =============================== ===============================

The statement of financial activities includes all gains and losses recognised in the year. All income and expenditure derive from continuing activities.

The notes on pages 18 to 28 form part of these financial statements.

- 16 -

CLEFT

Balance sheet

30 June 2024

2024 2023
Note £ £ £ £
Fixed assets
Tangible fixed assets 12 919 1,161
Current assets
Debtors 13 572 1,198
Cash at bank and in hand 445,877 503,780
------------------------------- -------------------------------
446,449 504,978
Creditors: Amounts falling due within
one year 14 (2,586) (3,241)
------------------------------- -------------------------------
Net current assets 443,863 501,737
------------------------------- -------------------------------
Total assets less current liabilities 444,782 502,898
------------------------------- -------------------------------
Net assets 444,782 502,898
=============================== ===============================
Funds of the charity
Restricted funds 102,677 255,076
Unrestricted funds 342,105 247,822
------------------------------- -------------------------------
Total charity funds 15 444,782
===============================
502,898
===============================

These financial statements were approved by the board of trustees and authorised for issue on ........................, and are signed on behalf of the board by: 10/10/2024

B Sommerlad (Chairman) Trustee

The notes on pages 18 to 28 form part of these financial statements.

- 17 -

CLEFT

Notes to the financial statements

Year ended 30 June 2024

1. General information

The charity is a registered Charitable Incorporated Organisation in England and Wales. The address of the principal office is 10a Warren Estate, Lordship Road, Writtle, Chelmsford, CM1 3WT.

2. Statement of compliance

The charity constitutes a public benefit entity as defined by FRS 102. The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland issued in October 2019, the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland (FRS 102), the Charities Act 2011 and UK Generally Accepted Accounting Practice.

The financial statements have been prepared to give a 'true and fair' view and have departed from the Charities (Accounts and Reports) Regulations 2008 only to the extent required to provide a 'true and fair view'. This departure has involved following the Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland issued in October 2019 rather than the Accounting and Reporting by Charities: Statement of Recommended Practice effective from 1 April 2005 which has since been withdrawn.

3. Accounting policies

Basis of preparation

The financial statements have been prepared on the historical cost basis, as modified by the revaluation of certain financial assets and liabilities and investment properties measured at fair value through income or expenditure.

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

Going concern

The accounts have been prepared on a going concern basis as the trustees believe that no material uncertainties exist. The trustees have considered the level of funds held and the expected level of income and expenditure for 12 months from authorising these financial statements. The budgeted income and expenditure is sufficient for the charity to be able to continue as a going concern.

Income tax

The activities of CLEFT are exempt from United Kingdom Income and Corporation taxation, provided that the income is applied to charitable purposes.

- 18 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

3. Accounting policies (continued)

Fund accounting

Restricted Funds:

The restricted funds are funds subject to specific projects or areas of work, which may be declared by the donor(s) or with their authority (eg in a public appeal), but still within the wider objects of the charity.

Designated Funds:

Designated funds are part of the unrestricted funds which trustees have earmarked for a particular project or use, without restricting or committing the funds legally. The designation may be cancelled by the trustees if they later decide that the charity should not proceed or continue with the use or project for which the funds were designated.

Unrestricted Funds:

All other funds generated from the fundraising activities, events and advertising less all the associated expenditure constitute the unrestricted funds of the charity and as such are freely available to spend on any of the charity's purposes.

Income

All income is included in the statement of financial activities when entitlement has passed to the charity, it is probable that the economic benefits associated with the transaction will flow to the charity and the amount can be reliably measured. The following specific policies are applied to particular categories of income:

Expenditure

Expenditure is recognised on an accruals basis as a liability is incurred. Expenditure includes any VAT which cannot be fully recovered, and is classified under headings of the statement of financial activities to which it relates:

Operating leases

Lease payments are recognised as an expense over the lease term on a straight-line basis. The aggregate benefit of lease incentives is recognised as a reduction to expense over the lease term, on a straight-line basis.

- 19 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

3. Accounting policies (continued)

Tangible assets

Tangible assets are initially recorded at cost, and subsequently stated at cost less any accumulated depreciation and impairment losses. Any tangible assets carried at revalued amounts are recorded at the fair value at the date of revaluation less any subsequent accumulated depreciation and subsequent accumulated impairment losses.

An increase in the carrying amount of an asset as a result of a revaluation, is recognised in other recognised gains and losses, unless it reverses a charge for impairment that has previously been recognised as expenditure within the statement of financial activities. A decrease in the carrying amount of an asset as a result of revaluation, is recognised in other recognised gains and losses, except to which it offsets any previous revaluation gain, in which case the loss is shown within other recognised gains and losses on the statement of financial activities.

Depreciation

Depreciation is calculated so as to write off the cost or valuation of an asset, less its residual value, over the useful economic life of that asset as follows:

Computer equipment - 20% straight line

Financial instruments

A financial asset or a financial liability is recognised only when the entity becomes a party to the contractual provisions of the instrument.

Basic financial instruments are initially recognised at the amount receivable or payable including any related transaction costs, unless the arrangement constitutes a financing transaction, where it is recognised at the present value of the future payments discounted at a market rate of interest for a similar debt instrument.

Current assets and current liabilities are subsequently measured at the cash or other consideration expected to be paid or received and not discounted.

Debt instruments are subsequently measured at amortised cost.

4. Donations and legacies

Unrestricted Restricted Total Funds
Funds Funds 2024
£ £ £
Donations
Donations 194,178 2,122 196,300
=============================== ====================== ===============================
Unrestricted Restricted Total Funds
Funds Funds 2023
£ £ £
Donations
Donations 81,242 150,000 231,242
========================== =============================== ===============================

- 20 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

5. Other trading activities

Unrestricted Restricted Total Funds
Funds Funds 2024
£ £ £
Fundraising events 47,280 47,280
========================== ============= ==========================
Unrestricted Restricted Total Funds
Funds Funds 2023
£ £ £
Fundraising events 1,253 115,260 116,513
====================== =============================== ===============================
6. Investment income
Unrestricted Total Funds Unrestricted Total Funds
Funds 2024 Funds 2023
£ £ £ £
Interest income 5,264 5,264 1,148 1,148
====================== ====================== ====================== ======================
7. Other income
Unrestricted Total Funds Unrestricted Total Funds
Funds 2024 Funds 2023
£ £ £ £
Compensation received 175 175
============= ============= ============= =============
8. Costs of raising donations and legacies
Unrestricted Total Funds Unrestricted Total Funds
Funds 2024 Funds 2023
£ £ £ £
Event costs 7,500 7,500 14,078 14,078
Fundraising costs 7,149 7,149 11,680 11,680
-------------------------- -------------------------- -------------------------- --------------------------
14,649 14,649 25,758 25,758
========================== ========================== ========================== ==========================

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CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

9. Expenditure on charitable activities

Unrestricted Restricted Total Funds
Funds Funds 2024
£ £ £
Research grants 15,002 15,002
Overseas projects 8,985 144,574 153,559
Support costs 113,803 9,947 123,750
------------------------------- ------------------------------- -------------------------------
137,790 154,521 292,311
=============================== =============================== ===============================
Unrestricted Restricted Total Funds
Funds Funds 2023
£ £ £
Research grants 27,949 27,949
Overseas projects 16,644 26,284 42,928
Support costs 70,902 70,902
------------------------------- -------------------------- -------------------------------
115,495 26,284 141,779
=============================== ========================== ===============================
Analysis of support costs
2024 2023
£ £
Salaries 61,588 38,834
Pension costs 1,186 535
Bank charges 621 298
National travel 849 404
International travel 28,686 6,252
Membership fees 759 614
IT and website fees 9,707 9,535
Printing, postage and stationery 1,716 2,341
Storage 1,849
Advertising and promotions 9,301 692
Consultancy and specialist staff support 2,431 5,671
Depreciation 242 51
Insurance 881 1,659
Independent examination fees 2,178 2,100
Legal and professional fees 1,756 1,916
------------------------------- --------------------------
123,750 70,902
=============================== ==========================

- 22 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

10. Staff costs

The total staff costs and employee benefit for the reporting period are analysed as follows:

2024 2023
£ £
Wages and salaries 61,588 38,834
Pension costs 1,186 535
-------------------------- --------------------------
62,774 39,369
========================== ==========================

The average head count of employees during the year was 3 (2023: 2).

No employee received employee benefits of more than £60,000 during the year.

The key management personnel of the charity comprise the trustees and senior management team as listed on the reference and administration details page of these accounts. The total value of remuneration and benefits received by Key Management Personnel was £45,003 (2023: £25,902).

11. Trustee remuneration and expenses

The trustees were neither entitled to, nor received, any remuneration from the charity during the year. Three trustees received reimbursed expenditure totalling £14,127 (2023: two trustees £2,476) during the year.

12. Tangible fixed assets

Equipment
£
Cost
At 1 July 2023 and 30 June 2024 1,212
======================
Depreciation
At 1 July 2023 51
Charge for the year 242
----------------------
At 30 June 2024 293
======================
Carrying amount
At 30 June 2024 919
======================
At 30 June 2023 1,161
======================
Debtors
2024 2023
£ £
Other debtors 572 1,198
============= ======================

13. Debtors

- 23 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

14. Creditors: Amounts falling due within one year

2024 2023
£ £
Trade creditors 162 96
Accruals and deferred income 2,178 2,100
Social security and other taxes 1,045
Other creditors 246
---------------------- ----------------------
2,586 3,241
====================== ======================

- 24 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

15. Analysis of charitable funds

Year ended 30 June 2024

At 30 Jun
At 1 Apr 2023 Income Expenditure Transfers 2024
£ £ £ £ £
Restricted Funds
Palate Muscle Anatomy (Nth
Thames) 16,100 16,100
Bangladesh - Private Donor
Project 103,095 1,321 (20,080) 84,336
Kurdistan - Private Donor
Project 135,881 (133,640) 2,241
Mozambique - Private Donor
Project 801 (801)
------------------------------- ---------------------- ------------------------------- ------------- -------------------------------
255,076 2,122 (154,521) 102,677
=============================== ====================== =============================== ============= ===============================
Designated funds
Vomerine Flap Closure 20,000 2,000 22,000
The impact of COVID on
Speech 17,567 3,008 (18,009) 2,566
Alveolar Bone Graft 3,498 3,498
North Thames CLEFT Q Data
(Nth Thames) 1,215 (1,215)
Bangladesh multi-disciplinary
cleft centre 5,402 (5,402)
Orticochea Pharyngoplasty
(Nth Thames) 27,186 (1,000) 26,186
Eye Tracking to measure
success in surgery 14,984 14,984
Egypt project 10,000 (7,763) 2,237
Kurdistan project 2,074 (1,139) 935
Mozambique project 10,936 (4,626) 6,310
Nepal project 20,966 (18,076) 2,890
Philippines project 2,828 (3,718) 890
Development of Automatic
Scoring Tool 24,941 24,941 (24,941) 24,941
Newborn orofacial cleft
analysis 48,785 48,785
Research project 50,000 50,000
------------------------------- ------------------------------- -------------------------- ------------- -------------------------------
114,793 175,538 (85,889) 890 205,332
=============================== =============================== ========================== ============= ===============================
Unrestricted funds
General funds 133,029
===============================
71,184
==========================
(66,550)
==========================
(890)
=============
136,773
===============================

- 25 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

Year ended 30 June 2023

At 30 Jun
At 1 Apr 2022 Income Expenditure Transfers 2023
£ £ £ £ £
Restricted Funds
Palate Muscle Anatomy (Nth
Thames) 16,100 16,100
Bangladesh - Private Donor
Project 115,260 (12,165) 103,095
Kurdistan - Private Donor
Project 150,000 (14,119) 135,881
-------------------------- ------------------------------- -------------------------- ------------- -------------------------------
16,100 265,260 (26,284) 255,076
========================== =============================== ========================== ============= ===============================
Designated funds
Vomerine Flap Closure 20,000 20,000
The impact of COVID on
Speech 20,575 (3,008) 17,567
Speech therapy for cleft
speech characteristics project 16,500 (16,500)
Alveolar Bone Graft 3,498 3,498
North Thames CLEFT Q Data
(Nth Thames) 1,215 1,215
Bangladesh multi-disciplinary
cleft centre 28,000 (22,598) 5,402
Orticochea Pharyngoplasty
(Nth Thames) 27,186 27,186
Eye Tracking to measure
success in surgery 14,984 14,984
Kurdistan project 935 (935)
Mozambique project 816 (816)
Nepal project 1,988 (1,988)
Development of Auto Scoring
Tool 49,882 (24,941) 24,941
------------------------------- -------------------------- -------------------------- ------------- -------------------------------
131,958 53,621 (70,786) 114,793
=============================== ========================== ========================== ============= ===============================
Unrestricted funds
General funds 173,299
===============================
30,917
==========================
(70,467)
==========================

=============
133,029
===============================

Purpose of Restricted Funds

Palate Muscle Anatomy (Nth Thames): Following a review of the donation from the unincorporated entity, this restricted fund relates to amounts restricted for a reassessment of the function of the muscles of the soft palate in speech and their importance in cleft palate surgery.

Bangladesh - Private Donor Project: To provide services for purposes defined by the income provider.

Kurdistan - Private Donor Project: To provide surgical equipment to hospitals in Kurdistan.

Mozambique - Private Donor Project: To provide services for purposes defined by the income provider.

- 26 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

Purpose of Designated Funds:

Vomerine Flap Closure: Following a review of the donation from the unincorporated entity, this designated fund is for a study on the long-term effect of vomerine flap closure of the hard palate at lip repair on appearance. Dental arch relationship and growth of the upper jaw, speech, hearing and psychosocial outcome in patients born with cleft lip and palate.

The impact of COVID on Speech: Designing robust single case studies to provide an evidence base speech therapy for cleft speech characteristics.

Alveolar Bone Graft: Do audio-visual aids improve the experience of patients undergoing an alveolar bone graft.

Orticochea Pharyngoplasty (Nth Thames): A research project to assess how effective orticochoea pharyngoplasty is in improving speech in children with both cleft and non-cleft velopharyngeal dysfunction.

Eye Tracking to measure success in surgery: A research project to assess using eye tracking to measure success in surgery.

Egypt project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Kurdistan project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Mozambique project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Nepal project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Development of Auto Scoring Tool: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Newborn orofacial cleft analysis: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

Research project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

The following designated projects have been completed:

North Thames CLEFT Q Data (Nth Thames): Analysis of North Thames Cleft Q data.

Bangladesh multi-disciplinary cleft centre: Support of the multi-disciplinary cleft centre in Bangladesh.

Philippines project: A designated project to improve the reach of the charity as outlined in the objectives of the charity.

- 27 -

CLEFT

Notes to the financial statements (continued)

Year ended 30 June 2024

16. Analysis of net assets between funds

General Designated Restricted Total
Funds Funds Funds Funds
30 June 2024 £ £ £ £
Tangible fixed assets 919 919
Current assets 138,440 205,332 102,677 446,449
Current liabilities (2,586) (2,586)
------------------------------- ------------------------------- ------------------------------- -------------------------------
Net Assets 136,773 205,332 102,677 444,782
=============================== =============================== =============================== ===============================
General Designated Restricted Total
Funds Funds Funds Funds
30 June 2023 £ £ £ £
Tangible fixed assets 1,162 1,162
Current assets 135,108 114,793 255,076 504,977
Current liabilities (3,241) (3,241)
------------------------------- ------------------------------- ------------------------------- -------------------------------
Net Assets 133,029 114,793 255,076 502,898
=============================== =============================== =============================== ===============================

17. Operating lease commitments

The total future minimum lease payments under non-cancellable operating leases are as follows:

2023 2022
£ £
Due within 1 year: Website lease and
servicing 1,868
======================
1,868
======================

18. Related parties

M Baldwin is the executive officer and related to the former trustee J Baldwin. During the year M Baldwin received salary and expense reimbursements totalling £39,256 (2023: £27,536). CLEFT owed no money to M Baldwin at the year end date.

Other than those elsewhere disclosed in the accounts, there were no other related party transactions in the year.

- 28 -