Charity Number. 1194851 THE SPINE FOUNDATION UNAUDITED TRUSTEES, REPORT AND FINANCIAL sfATEMENTS FOR THE YEAR ENOED 31 DECEMBER 2025 THE SPINE FOUNDATION CONTENrs Page Legal and admlnlstratlve detalls Trustees, report 2-8 Independent examlnerfs report 9-10 Statement of flnancial activltles li Balance sheet 12 Notes to the flnanclal statements 13-17 THE SPINE FOUNDATION LEGAL AND ADMINISTRATIVE DEfAILS FOR THE YEAR ENDED 31 DECEMBER 2025 Trustees Dr Vivek Mehta Dr Kavita Poplv Prashant Brijmohansin8h Dr Richard Mark Langford Raghav Mehta Charlty reglstered number 1194851 Re8Sstered address 20 Hlllcrest Road Lou8hton IGIO 4QQ Independent Examlners Sterllngs Ltd Lawford House Albert Place London N3 IOA Bankers Metro 8ank One Southampton Row London WCIB SHA THE SPINE FOUNDATION TRUSTEES. REPORT FOR THE YEAR ENDED 31 DECEMBER 2025 The Trustees are pleased to present their annual Trustees, Report together with the financial statements of The Spine Foundation for the year l January 2025 to 31 December 2025. The financial 5tatement5 comply with the Charities Act 2011. the Trust Deed, and Accountlng and Reporting by Charities: Statement of Recommended Practice appllcable to charities preparing their accounts in accordance with Financlal Reporting Standard appllcable in the UK and Republic of Ireland IFRS1021 leffective l January 20191. Oblectlves and Actlvltles Constltutlon and objects The foundation Is a charltable company limited by guarantee. It is entered on the Central Register of Charltle5 under number 1194851. The 8overnin8 instrument Is the Trust Deed dated 18 June 2021. The objects of the charlty are: The charSty alms to promote educatlon In fleld of back paln to allow the health care profe5slonals to galn competencies to manage these conditions. We especlally aim to promote education in neuromodulatlon to deliver 5tandard5 in trainin8 across the world. This is done by creating a bursary scheme for candidates acr055 the world who are keen to develop their education with neuromodulation. The Charity supports 2 educational pro8rams In neuromodulation. l. Executlve Educatlon Program in Neurornodulatlon IEEPIN) Clty St Georges, Unlverslty of London EEPIN is a university-based certificate course, the first step towards a rTreuromodulation career. This foundation program designed for "Team Neuromodulatlon" Is delivered online and can also be viewed asynchronously on City university 'Media Space. platform, allowinB exceptional flexibility and access worldwide. EEPIN underpins standardized, unbiased education under strict university governance to protett and promote the safe practices In the speclality. The candidate experiences live online teachlng sessions, video lectures, interactlve octivities and case- based discussions from the International faculiy whilst re¢eivln8 personal support from a dedicated "Learning Team. based at City University and Barts Neuromodulotion Centre. Structure The 2 -day online program, spreading over I week, draws expert15e from Key Opinion Leaders IKOL51, displaying reciprocated didactic lectures with clinical discussions and case studies. Program schedule- Monday, TiJe5day 10..00-17..00 pm IGMTI 2nd week of June THE SPINE FOUNDATION TRUSTEES, REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2025 The program aims to prepare candidates with the fundamentals of neuromodulation assessed via multiple choice question5 leading towards a certificate from the City University, London. Learnlng Objectives of the program The programme aims to cover the following key topics on the fundamentals of neuromodulation with the potential to incorporate further novel advancements in the field.. Indication5 of nevromodulètlon- current and emerging Physlcs of waveform and implication5 in neuromodulatlon Patient selection and Multldisciplinary IMDTI approach Procedural ski115 including videos for SCS, DRG, ONS, PNS and DBS Mechanism of actlon of current waveforms and their evidence in clinical practice Current neuromodulation devices and available technologv Peripheral nerve stimulatlon and Indications Non-lnvasive neuromodulation Headache and neuromodulation Deep brain stimulation and indlcatlons Raéiofrequency evidence and emerging indlcations Intrathecal drug delivery therapy and it5 Indications How to set up a neuromodulation servlce How to implement best clinical practice based on evidence Managlng conflict of interest within neuromodulation industry Who Is thls program for7 This program Is aimed for "Team neuromodulatlon. comprising Physicians, Cllnical Nurse Specialists, Physiotherapists, Industry Representatives, Field Clinlcal Engineers and Allied Health Professionals. Essentially, a candidate who would like to be part of the neuromodulation team, seeking a formal career in neuromodulation with university certiflcatlon. Recommended ell8lblllty: Dortors: Experience in Pain medicine, Neurosurgery, Spinal surgery, or Neuromodulation Nurses, Physiotherapist. Allied healthcare professlonals. Industry representatl¥es and Fleld Clinical Engineers in neuromodulation.. Undergraduate degree and statement of purpose with ability to demonstrate interest in neuromodulation 2. Post Graduate Certlflcate (PG Cert} In Neuromodulatlon and Pain Management, Queen Mary University of London THE SPINE FOUNDATION TRUSTEES, REPORT (contlnuedl FOR THE YEAR ENDED 31 DECEMBER 2025 Programme overwiew PG Cert In Neuromodulation and Pain mana8ement, Queen Mary University London, is a universlty based, unique, fully online accredltatlon throu8h one academlc year on part time basis. The certification offers a totsl of 60 credits. 4 x 15 credits each module. The modular nature of the program 15 designed to provide structured knowled8e, ranglng from basic sclence to clinical appllcatlon in line with best available evidence. The certification is deslgned for Doctors. Clinlcal Nurse specia115t5 and Fleld Clinical Engineers wlth cllnical and academic aspirations. The online modular programme Is designed to fit around one's professional commltments. The qualification is served in one academic year through part-time study wlth both synchronou5 and asynchronous learnin8. Structure The modular nature of the programme180 hours of didactlc teachlngl is deslgned to fit withln the needs of candidates in full-time employment. The candldate wi15 receive the tau8ht element of the modules in three-day blocks. Two modules per semester wlth each module being approxlmately four to six weeks apart. Semester I modules: Module I (October): Anatoniyi Pathophysiology, Physics, Waveform5 includlng emer8lng technology and Ima8ing relevant to neuromodulation Module 2 (Novemberl: Patient care, Indications, Procedural skills, Perloperative Complicatlons and Troubleshooting Semester 2 modules: Module 3 1Febiuaryl: Devices and available technology- CLbrrent evidence and rationale selection Module 4 (March).. Deep brain stimulation/lntra thecal pumpl cancer pain management, Pefipheral stimulation & Miscellaneou5 THE SPINE FOUNDATION TRUSTEES, REPORT Icontinuedl FOR THE YEAR ENDED 31 DECEMBER 2025 Assessment The candidates are a55essed on submitted written assignments 2500 words for each module with 50% pass marks. A dedicated online mentorship session will be provided halfway through the module submlssion to assist throu8h the assignment preparation. Who is thi5 program for? This program is aimed for Physlcians, Clinical Nurse Specialists and Field Cllnical Engineers who are seekin8 a fom)al career in neuromodulation wlth university qualiflcation. Recommended ellglb115ty crlterla Dortors: Experience in Pain mediclne, Neurosur8ery, Spinal surgery or Neuromodulation Cllnical Nurse Speclallsts In neuromodulatlon: Under8raduate degree and statement of purpose with abllity to demonstrate significant interest and career aspiration in neuromodulation Our partners The charrty has been working in c105e contact wlth major industry partners In neuro modulation who are commStted to support education for physicians, nurses and field clinical engineers to ensure standards of education in the field. The key partners who supported the imltatlve by donatlng unrestricted education grants are: Abbott Medtronic 805ton Scienlific Saluda Mainstay Medical Neuromodulation Education Women in Neuromodulation Trustees The Trustees who have setved during the period and slnce the period end are set out on page l. THE SPINE FOUNDATION TRUSTEE5' REPORT {continued) FOR THE YEAR ENDED 31 DECEMBER 2025 Grant Maklng polScv The Spine Foundation has established it5 grant makin8 pollcy to achieve its objects for the public beneflt. The Foundation's aim Is to Improve education in neuromi)dulation by 8iving the power of education to physicians, nurses and field cllnical en8ineers so they can benefit the patient. The beneflclarles of our grant making programme are ultlmately the paln suffers and those at risk of developing intractable neuropathic pain In the future. Knowledge and education in neuromodulatlon also have the potential to relieve the huge burden of care often faced by the families of sufferer5. Our research and educational programmes fund doctors, nurses and field cllnical en8ineers who use these funds in their work to enhance treatment care for 5ufferer5 from intractable neuropathic paln and related conditions. Any private benefit received by physicians, instltutions and healthcare bodies is purely incidental to the objects of our work. The Splne Foundation invite5 applications for bursary grants from candidates by advertislng in the speciallst press, journa15 and educational meetings. Eligibility is restricted to applicants having an expertise in the field to ensure high quality results. Applicants submit a summary of their proposals to the trustees in a specific format, includin8 their CV and statement of purpose. The application5 are revlewed by the trustee board against a crlterlon established by our charity objectives. A revlew of our achlevements and performance.. How our bur53ry programmes dellvered publlc beneflt. The benefits of the Spine Foundation's work are the education of future physicians, nurses and field clinlcal engineers, the dissemination of these findin8S, the knowled8e to understand and hame55 development of new theraples wlth the goal belng to assist sufferers, their carers and familie5. The tru5tee5 are pleased that the achievements and performance of the Spine Foundation, as set out below, demonstrate concrete progress. rtification in neuromodulatlon and ain mana ement.. In 2024-25 18 candidates IUK, India, Ireland, Slngapore. USI received a £89,650 In bursary support to obtain post graduate qualification in neuromodulation. THE SPINE FOUNDATION TRUSTEES, REPORT Icontinuedl FOR THE YEAR ENDED 31 DECEMBER 2025 Public Benefit We have referred to the guidance contained in the Charity Commission's general guidance on public beneflt when reviewing our aims and objectives and in planning our future activities. In particular, the Trustees conslder how such planned activities will contribsjte to the aims and objectives of the Spine Foundation. Flnanclal revlew The income of the foundation during the year has come from the charitable donatlon. The deficlt for the year amounted to £75,61112024- surplus- £178,608). Reserves pollcv Following the initial injection of major funds, the Trust reseNe will be malntalned in order to generate future income whlch will be avallable for distribution by 8rant5 each year. The accumulated reseThes at the end of the year amounted to £134,35212024- £209.9631. Rlsk mana8em¢nl The Trustees have conducted a review of the major risk5 to which the charlty Is exposed. Future plans The SpSne Foundation 15 now prop05in8 to fund 2-year clinical fellowships in neuromodulation in assoclatlon with Barts Neuromodulation Centre, St Bartholome￿5 Hospital London and Medical Training Initiatlve Scheme. Faculty of Pain Mediclne and Royal College of Anaesthesia, UK. Plans are to create a vSsiting fellowship specifically for the developing world that wlll allow the candldates to 8aln hands-on experience In neuromodulation by loinlng the affiliated centres. This wlll provide unsurpa55ed professlonal development opportunlties to the candidate enabling investment in a range of new initiatives that would enable personal development and skill mi¥. The candldates will be provided a Vlsitlng Fellowshlp Certlflcate, followlng successful fellowship program. THE SPINE FOUNDATION TRUSTEES, REPORT (continued) FOR THE YEAR ENDED 31 DECEMBER 2025 Trustees, responsibilities statement The Trustees are responsible for preparing the Trustees, Report and the financial statement5 in accordance with applicable law and United Kingdom Accounting Standards Iunited Klngdom Generally Accepted Accounting Practice). The law applicable to charities in England and Wales requires the Trustees to prepare financial statements for each financial year. which glve a true and falr view of the state of affalrs of the charity and of the incominB resources and application of resource5, includin8 the Income and expenéiture, of the charity for that period. In preparing these financial statements, the Trustees are required to: Select sultable accountlng pollcies and then apply them con5iStentlvi Observe the methods ané principles in the Charities SORP- Make ludgements and accountln8 estimates that are reasonable and prudent: State whether applicable accounting standards have been followed, subject to any materlal departure5 that must be disclosed and explained in the financlal statement5,' and Prepare the financial statements on the 8olng concern basi5 unless It is inappropriate to presume that the charlty will contlnue in operation. The Trustees are responslble for keeping adequate accounting records that are sufflcient to show and explain the charity's transactions and disclose with reasonable accurocy at any tlme the financlal posltlon of the charltv and enable them to ensure that the finartclal statements comply wlth the Charltles Act 2011. They are also responslble for 5afeguardlng the assets of the charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. Thls report Was approved by the Trustees on and si8ned on their behalf by.. Drvlvek Mehta Chairman and Trustee THE SPINE FOUNDATION INDEPENDENT EXAMINER'S REPORT FOR THE YEAR ENDED 31 DECEMBER 2025 Independent exarninerfs report to the Trustees of The spine Foundatlon. We report to the Trustees on our examination of the financial statements of The Spine Foundation for the year ended 31 December 2025 which comprise the Statement of Financial Activities, the Balance Sheet and related notes Set out on pages 13 to 17. This report is made solely to the charity's Trustees, as a body. in accordance with section 145 of the Charities Act 2011. Our work has been undertaken 50 that we might state to the charitVs Trustees those matters we are requlred to state to them in this report and for no other purpose. To the fullest extent permitted by law, we do not accept or a55ume responsibility to anyone other than the charity and the charity's Trustees as a body, for our work, for this report, or for the oplnlon5 we have formed. Responslbllltles and basls of report A5 the Trustee5 of the charitable company you are responsSble for the preparatlon of the financial statements in accordance with the requirements of the Charities Act 2011 (the 2011 Actl. Having Satisfied ourselves that the financial statements of the charitable trust are not required to be audited under the Act and are eligible for independent examination, we report in respect of our examinatlon of the charltable trust's financial Statements carried out under section 145 of the Charities Act 2011 (the 2011 Act) and In carryln8 Out our examination we have followed all the applicable directions Biven by the Charlty Commi55ion under section 14515llbl of the 2011 Act. An Independent examination does not involve gathering all the evldence that would be reqUI￿d In an audit and consequently does not cover all the matters that an auditor conslders in giving their opinion on the financial statement5. The planning and conduct of an audlt 80 beyond the limlted assurance that an Independent examination can provide. Consequently we express no opinion as to whether the financlal statements present a 'true and falr, view and our report Is limited to those specific matters Set out in the independent examinerfs statement. Independent examlnerfs ststement We have completed our examination. We confirm that no material matter5 have come to our attention in connection with the examination, giving us cause to believe that in any material respect.. Accounting records were not kept in respect of the charitable trust as required by section 130 of the 2011 Act,. or the financial statements do not accord with those records; or the financial statements do not comply with the accounting requirements set out in the charities (Accounts and Reports) Regulations 2008, other than any requirement that the financial statements give a 'trLfre and fair view, which is not a matter considered as part of an independent examination,. or THE SPINE FOUNDATION INDEPENDENT EXAMINER'S REPORT {contlnued) FOR THE YEAR ENDED 31 DECEMBER 2025 the financial statements have not been prepared In accordance with the methods and principles of the Statement of Recommended Practice for accounting artd reporting by charities applicable to charities preparing their accounts in accordance with the Flnancial Reporting Standard appllcable in the UK and Republlc of Ireland IFRS 1021. We have no concerns and have come across no other matters In connection wlth the examination to which attention should be drawn in thls report in order to enoble a Proper understanding of the financlal statements to be reathed. Gary Moss FCA Isenlor Statutory Audltor) For and on behalf of Sterllngs Ltd Chartered Accountants ststutory Audltor Lawford Hous• Albert Pl?ce London N3 IQA Dated: -io- THE SPINE FOUNDATION STATEMEMf OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 DECEMBER 2025 Unrestricted Fund$ 2025 Unrestrlcted Funds 2024 Note Income from: Donations recelved 70,OIX) 246.928 Total income 70,0(XJ 246.928 Expendlture on: Charitable activities Grants payable Costs of generatin8 funds Management costs Governance 189,6501 146,2581 19,7031 154,2181 114,1021 Total expendlture 1145,6111 168,3201 14et Incomellexpendlture) before other re¢o8nl$ed galns and losses 175,6111 178,608 Total funds carrled fO￿ard 175,6111 178,608 The notes on pages 13 to 17 form part of these flnancial statements. -li- THE SPINE FOUNDATION BALANCE SHEEr FOR THE YEAR ENDED 31 DECEMBER 2025 2025 2024 Note Current assets Cash at bank and in hand 138,972 216,623 138,972 216,623 Credltors: amounts fallin8 due wlthln one year 14,4401 16.6601 Nel current assèts 134,532 209.963 Nel assets 134.532 209,963 Charlty fund$ Unrestricted funds 134,532 209,963 Totsl funds 134,532 209,963 The flnanclal statements were approved by the trustees o and signed on their behalf by: Dr Vlvek Chalrman and Trustee The notes on page$ 13 to 17 form pan of these linènclal siatements. -12- THE SPINE FOUNDATION NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2025 l. Accountlng policles 1.1 Basis of preparation of financial statements The financial 5tatement5 have been prepared in accordance with Accountin8 and Reporting by Charities.. Statement of recommended Prattice applicable to charities preparing their accounts In accordance with the Financial Reporting Standard applicable in the UK and Republlc of Ireland IFR51021 (effective l January 20191 i55ued by the Charity Commission - (Charitie5 SORP IFRS1021, the Financial Reporting Standard applicable in the UK and Republlc of Ireland IFRS1021 and the Charltles Act 2011. The Spine Foundation constitutes a public benefit entity as defined by FRS102. The flnancial statements are prepared under the historical cost conventlon. The flnanclal statement5 are presented in pound5 SterlinBi which Is also the functional currency of the trust. Roundin8 of amounts shown in the financial Statements is to nearest pound. 1.2 Going concern The Trustee5 consider that there are no material uncertainties about the Trusvs ability to continue as a goin8 concern. With respect to the next reporting period, the most slgnlficant areas of uncertainty that affect the carrying value of assets held by the Trust are the level of investment returns ané the performance of investment markets. 1.3 Fund accountin8 General funds are unrestricted funds whlch are avallable for use at the directlon of the Trustees in furtherance of the general objective5 of the charlty and which have not been de51Bnated for other purpose5. Unrealised 8ains and1055e5 on Investments are shown in the headin8'GainllLossl on revaluation of listed Investments, in the Statement of Financial Activities. 1.4 Incomlng resources All income is recognised once the charlty has entitlement to the income, it is probable that the Income will be received, and the amount of income receivable can be measured reliably. Investment income, donations and other incoming resources are recognised on a receivable bas15. -13- THE SPINE FOUNDATION NOTES TO THE FINANCIAL STATEMENTS (continued FOR THE YEAR ENDED 31 DECEMBER 2025 1.6 Expenditure Exper)diture is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it IS Probable that a transfer Df economic benefTts will be required in settlement and the amount of the obllgation can be me05ured reliably. Expenditure is classified by actlvlty. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a sin8le activity are allocated directly to that activity. Shared costs which contribute to more than one activlty and support costs which are not attributed to a single activity are apportloned between those activities on a basis consistent wlth the use of resources. Investment management Costs relate to the cost incurred for the administration of the Trust's investment portfolio. Governance costs are those Incurred In connection with administratlon of the charlty and compliance with constitutlonal and statutory requirements. Grants payable are charged In the year when the offer is made except In those cases where the offer is condltional, such 8rants being recognised as expenditure when the conditions attachin8 are fulfilled. Grants offered subject to conditlons which have not been met at the perlod end are noted as a commitment but not accrued a5 expenditure. 1,7 Interest receivable Interest on funds held on deposlt Is included when receivable and the amount can be measured reliably by the charity. This is normally upon notiflcation of the interest paid or payable by the bank. 1.8 Debtors Other debtors a￿ recognlsed at the settlement amount. Prepayments are valued at the amount prepaid net of any trade discounts due. 1.9 Cash at bank and in hand Cash at bank and in hand includes cash and Short term highly liquid investments with a short maturity of three months or less from the date of acquisitlon or opening of the deposit or similar account. -14- THE SPINE FOUNDATION NOTES TO THE FINANCIAL STATEMENTS Icontlnued) FOR THE YEAR ENDED 31 DECEMBER 2025 1,10 Liabilitles and provisions Liabilltles are recognised when there is an obligation at the Balance sheet date as a result of a past event, it is probable that a transfer of economlc benefit will be required in settlement and the amount of the settlement can be estimated reliably. Liabilities are reco8nised at the amount ihat the charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide. Provisions are measured at the best estimate of the amount5 required to settle the obligation. Where the effect of the time value of money is material, the provision is based on the present value of those amounts, dlscounted at the pre-tax dlscount rate that reflects the risks specific to the Ilabllity. The unwSndlng of the dlscount Is recognised within interest payable and similar charges. 1,11 General informatlon The foundatlon is a charitable trust operating in England and Wales. It Is also registered wlth the Charities Commlsslon. The Trust's re8lstered address is: 20 Hillcrest Road, Lou8hton, IGIO 4QQ. 1.12 Judgements In the application of the Trust's accounting policies which are described above, management Is required to make judgement, estlmates and assumptlons about the carrying value of assets and liabilities that are not readily apparent from other sources. The estimates and underlyin8 assumptions are based on judgement and experience together with any other factors that are considered to be relevant. Actual results may differ from these est5mates. Estimates and any underlying assumptlons used are reviewed on a continuin8 basis. Revision5 to accounting estimates are recognised in the period in which the estimate is revlsed if the revision affects only that period, or in the period of the revls5on and future periods if the revision affects both the current period and subsequent periods. 2. Income from charltable actlvltles Unrestrfcted funds 2025 Unrestrfcted funds 2024 Donations received 70,000 246,928 70,000 246,928 The aggregate amount of donations received without condition5 from the trustees during the period amounted to Enil12024 £Nill. -15- THE SPINE FOUNDATION NOTES TO THE FINANCIAL STATEMENTS (continuedl FOR THE YEAR ENDED 31 DECEMBER 2025 3. Analysls of grants The total number of Indlvidual grants awarded in the furtherance of the charrvs objectives wa5 2 12024.. 01. In accordance with section 16.25 of the Charities SORP the Trust claims exemption from namin8 the recipients of the grants durinB the lifetime of the settlors of the Trust. 4. Governance costs Unrestrlcted funds 2025 Vnrestrlrted funds 2024 Other office costs Legal and professional fees Independent examlnels fees 7,483 2,002 2.220 2,700 9,703 14,102 5. Analysls ol resources expended bv expendlture type Total Z025 Total 2024 Charitable actlvltles Costs of generating funds 89,650 55,961 68,320 145,611 68,320 6. Net in¢omin8 resourcesl (resources expended) 2025 2024 This is stated after charging: Independent examinels remuneratlon 2.220 2,700 During the year no Trustee received any remuneration12024'. Nill. During the year no Trustee received any benefits in kind12024-. Nil) During the year Trustees received reimbursement of expenses of £20,96112024'. £9,302) During the year no staff were employed apart from the Trustee5 and no remuneration was paid. The Trustees are also the key management personnel of the Trust. -16- THE SPINE FOUNDATION NOTES TO THE FINANCIALSTATEMENTS (contlnued) FOR THE YEAR ENDED 31 DECEMBER 2025 7. Cred5tors: Amounts falllng due wlthln one year 2025 2024 Accruals 4,440 6,660 8. Summaryolfunds Brought forward Incomlng resources Resources expended Carrled forward General funds 208,963 70,￿￿ 145,611 133,352 General funds: These are donatlons recelvable 8enerated for the objects of the charlty wlthout further specified purpose and are avallable as general funds. 9. APB Ethlcal StaNlard relevant clr¢umstances In common wlth many buslne55es of our slze and nature we use our independent examlners to asslst with the preparatlon of the flnanclal statements. 10. Related party tran5actlons Durin8 the year there were no related party transactlons which require disclosure. -17-