The Royal College of Pathologists Pathology the science behind the cure Annual report and financial statements For the year ended 30 June 2023 Registered charity number 261035 The Royal Collage of Pathok418ts 6 Alie Stre8t, London. E18QT, UK Tel.. 020 74S16700. www.rcpath.org The Royal Collage of Pathologists Index to the financial statements Pa Report of the trustees Report of the audltors 15- 18 Consolldated statement of financlal actlvltles 19 Consolidated and College balance sheets 20 Consolldated statement of cash flows 21 Accountlng pollcles 22-24 Not8S to the financlal statements 24-36 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 The Trustee Board are pleased to present their report together with the financial statements of the College for the year ended 30 June 2023. Objectlves & activities The College's mission is to promote excellence in the practlce of pathology and maintsin standards through training, assessments, examinatlons and professlonal development, to the benefit of th8 public. The trustees have complied with the duty in the Charities Act 2011 to have due regard lo guidance published by the Charity Commission, including publlc benefit guidance. Pathology is the science at the heart of modem medicine, vital for the understanding. diagnosis and planning clinical management of disease. 950/0 of patients will have a pathologist involved their healthcare journey. (hlfps."//wMv.england.nhs.uk/wp- contenVuploadsf20t410Vpalhol-dig-first.pdO Pathologists study the causes of disease and the ways In whlch dlsease pro￿sseS affect our bodies. Recognising the patterns that disease takes allows us to understand whavs at the root of a problem, enabllng accurate diagnosis. Following up thls understanding helps treatments to be devised and preventative measure5 to be put in place. Much of pathology goes on behind the scenes which may account for the fact that many people are almost unaware of its ongoing and vital contributions to modern medicine. Wilhout the work of pathologists there would be no evidence to support the diag.-?sis and clinical management of disease, and improving or even maintaining the quality of medical care would be Impossible. The College's unique role ensures that high quallty standards of knowledge and expertise are maintained in all areas relating to pathology. The College ensures that pathologists are qualified and up to date In their practice by.. Setting standards for education and training in pathology. Examining against these standards. Providing a leading continuing professional development programme. Running scientific seminars, webinars and expert workshops on a national and regional basls. The College looks after the interests of patients by- Producing guldelines and other documents that set standards of best practice. Making our case to parliamentarians through the Heamh Committee, All Party Heatth Groups. individual ministers and civil servants to raise awareness of the role pathology plays in providing safe patlent care. Ensuring lay representation on all designated College committees. Working with organisations such as Lab Tests On-Llne and Labs Are Vital as a resource for patients to provide infomiation about the range of clinical tests that are used in their diagnosis and treatment. Page 1 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Objectives & activltles (contlnued) The College helps in the searGh for cures to disease by committing to strengthening the research base of the specialty. This is achleved through: Supportlng fellows and trainees who undertake researGh activities as part of their day- to4ay work. Awardlng bursarles and prizes for research. The College has a public engagement programme whose aims include inspiring secondary school students to leam about scSence through an innovative and creatSve programme focusing on health and disease. The goals of this programme are to: Increase interest In p8thology as a career option. Raise awareness of pathology and its crucial role in treating and curlng dlsease. Contrlbute to the wider initiative of engagin9 the publlc In contemporary science. Support the teaching of science in secondary schools. Change attitudes towards science, in particular pathology. Actlvltles To achieve our objectlves the College has undertaken slgnlficant actlvltles during the year under review: Tralnlng, examlnatlons and assessm•nts: Settlng the standards for training in pathology through the provision of medical, cllnlcal science and veterinary pathology curricula. Administering medical pathology tralning through College Specialist Training Committees, who advise and provide guidance on all major issu8s relating to speclalist training in pathology. Managing the development. Implementatlon and evaluation of workplace-based assessments for medical tralnees and advislng on the development of workplace- based assessments for clinical sdence trainees. Registering and monitoring Specialty Registrars for the duration of their training and recommending them for the award of a Certificate of Completion of Training (CCT) to the General Medical Council (GMC). Providing electronic training portfolios to allow registered tralnees to record thelr progress in training. Development, Implementatlon and delivery of the FRCPath Part 1 and Part 2 examinations in the 17 pathology specialties, as well as the Certlficale and Diploma examin8tions and the Stage A and Stage C BMS examinations. Ensuring that curricula, assessments and examinalions are approved by the appropriate regulator, and that transitional arrangements are in place where these change slgnlficantly. P8ge 2 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Actlvltles (contlnued) Recommending to the GMC whether or not the training andlor quallflcations and experience of pathologlsts applylng to the Speciallst Reglster under the Certificate of Equivalence of Specialist Registration (CESR) rules is equivalent in content and duration to that required for a Certificate of Completion of Training. Management of the review and approval of 8pplications for Fellowship by published works. Supporting training and continuing professional development through the provision of the Pathology Portal. Supporting the provislon and promotion of pathology In undergraduate and foundation training. Patlent safety Support pathologists and their t8ams to improv8 safety and qualty of care. Encourdge shared18arning to advance patient safety and quality improvement. Professlonal guldellnes and practlce Deliver a leading contlnulng professional development scheme and user friendly online CPD and revalidation portfolio for members. Supporting the Professlonal Conduct Committee to deal with revalidation queries and concerns about professional performanc8 in all disciplines of pathology. Delivering invited r8views of pathology services for healthcare organisations and providing formal advice on professional performance in pathology. Supporting the ongoing oversight of, and governance for, extemal quality assessment stakeholders. Providing guidance and support to members and tralnees on patient safety and quality improvement methodologies includlng clinical audit and dèlivering continuous quality improvement awareness months. Ensuring pathology input into guidelines and standards produced by natlonal bodies. Continued membership of the Intemational Collaboration on Cancer Reporting to support the production of Common and intemationally validated and evidence-based pathology datasets for cancer reporting for use throughout the world. The production of hlgh-quality evidence based clinical guidelines in pathology to accredited standards. Hosting webinars for new guidance documents to support pathologist understanding and apply them in practice. Commerclal fundraising The provision of consultancy services to providers or cornmissioners where an authoritative independent review is required on the provlsion of high-quallty pathology services, under the trading name RCPath Consultlng. The provision of high quality conference and meeting facilities and catering s8rvices to external clients utilising College rooms when not used for our own purposes, und8r the trading name Events@No6. Page 3 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Activities (continued) Workforce Maintaining standards in pathology by reviewing and approving consultant level job descriptlons and overseeing the College's statutory role in consultant advisory appointment committees {AAC's). Collecting data from direct surveys and the outcomes of appointments to enable the College to define the workforce required to deliver high quality patient centred pathology seNices throughout the UK. Providing data to enable the College to have a clear voice on pathology workforce planning. Conferences and academlc actlvltles Management and development of the programme of in-house symposia and online webinars deslgned to keep partlclpants up to date with current thinking and practice in the pathology dtsciplines, Advl80ry commlttees Much of the work of the College is achieved through the College's committee structure reportlng to Council. These activities provide professional advice and guidance through specialty advlsory committees, intercollegiate and Joint committees. Committees deal with generic matters crossing all pathology speclaltles whll$t tha specialty advisory committees advise on specialty specific matters such as hi51opathology and microbiology, etc. Establishment of a ne￿Ork of lay advisors lo input into specifi'c committees. Regional councils for Northern Ireland, Scotland and Wa18s maintain valuabl8 regional and local influence and insight. Committees that report to the Trustee Board include Councll. Nominations Committee, Governance Committse and the Remuneration Commlttee. Communlcatlons Production of the quarterly publication The Bulletin" dlstrlbuted to members and subscribers. Production of a range of publications and guidelines on best practlce In pathology. Production of the monthly President's e-newsletter for members. Development and maintenance of the College's web site, Including the members, area. Engagement with politicians. civil servants and other key Stakeholders across the UK to raise awareness and understanding of the value of pathology and the role of the College. Responding lo parliamentary questions and consultations. Identifying opportunities to promote the work of the College via the media and improve the understanding of pathology. Provldlng a professional point of contact for all medla enquirfes. Delivering the College's publlc eng8gement programme, including National Pathology Week. Managing grant schemes and awards. Page 4 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Activities (contlnued) International development Providing support for the work of the Intemational Committee. chaired by th8 Clinlcal Director of International Activities. and the International Regional Advisors and Country Advisors. Supporting current international medical graduates through provision of the College sponsorshlp scheme and Medical Training Initiative. and the Intemational Tralnee Support Scheme. Supporting future intemational pathologlsts throughout their careers through the provision of the International Pathology School. Providing support for examinations and candidates based outside of the UK, Providing support for refugee pathologists in the UK. Providing resources for members and healthcare workers in regions affected by challenge and conflict. Fostering intemational strategic partnerships, collaborations and allian￿S through the development of Memorandums of Understanding and delivering the work agreed. Delivering International Pathology Day annually. Advocatlng and promoting the role of the College intemationally, including through the dellvery of projects. Supporting the professional development of international members and trainees, Raising awaren8ss and understanding about the role and contribution of pathology to global health. Equallty, dlverslty and Incluslon {EDI) Hosting regular meetings of the EDI Ne￿Ork to ensure EDI is embadded in all the College does. Developing an action plan to increase diversity and ensure inclusion. Progressing work to initiate a survey of member characteristics and barriers to engagement to better inform the College's policies and procedures. Hosting events to ralse awareness of EDI matters and generate discussion. Volunteers Many members give their time freely to help the College achieve Its objects by attending committee meetings, sitting on working parties, acting as examiners, commenting on reports, acting in a local liaison capacity, assisting with the public engagement programme, or undertaking some other tssk or function on behalf of the College. The Trustee Board Is greatly indebted to these indivlduals for their commitment and support. Achievements & performance The College produ￿$ a full Annual Report, which should be consulted for an analysis of the achievements and perft)rmance of the College for the year to 30th June 2023. Page 5 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Investment performance During the year the College tendered its investm8nt management arrangements which resulted in switching th& portfolio from Canaccord to CCLA Investment Management. The switch took place in December 2022. UK markets had a mixed performance from July to December. The market started the year strongly, but then declined in the latter part due to a number of factors, including concerns about the global economSc slowdown and geopolitiC81 uncertainty. Inflation has remained high during the year with the Bank of England raising interest rates in an effort to combat inflationary pressurès. The total retum from the COIF Charities Ethical Investment Fund over the slx-month perlod ended on 30 June 2023 was +1.70/0. Wlthin equitles, which make up the majority of the portfollo, the Fund's retums were strong in absolute terms but lagged tha equlty market as a whole. This reflected the fact that as a diversified portfolio, the Fund's allocation to the handful of technology stocks which accounted for almost all of the market's total returns is lower than the dominant share these companies represent in the market as a whole. Elsewhere, some of the Fund's healthcare stocks had a weak period, although those focusing on medlcal technology and surgical devices continued to perform well. Conversety, the Fund's avoidance of traditional energy companies was supportive of relative returns at time when that sector underperfomied the rest of the market. Bond markets deliveréd n6gative retums over the period, so it was helpful to relative perfonnance that the Fund has a lower allocation to fixed interest than Ihe comparator benchmark. The Fund's fixed interest holdings also perfomied better than the bond market as a whole. In other asset classes, rising bond ylelds continued to depress valuatlons for some holdings in infrastructure, contractual income and other altemative assets although not on the damaging scale seen in the second half of 2022. Financlal review The income of the College amounted to £9.44Mn, with expenditure of £9.41Mn. Subscriptions continue to be the largest source of income amounting to £4Mn. Income from postgraduate education and examinations has increased to £2.4 milllon, with expenditure on thls activity of £2.7 million. The number of candidates sitting College examlnations has increased generating both Ihe incr8as8d revenue and increased costs. The income from trading. undertaken through the wholly owned subsidiary company. has been remarkable. The Events@No6 conference cenlre has experienced a significant increase in turnover as demand for meeting space has exceeded all expectations. Income from RCPath Consulting has also performed well, and the combination of these has meant a healthy surplus for this actlvlty. During the year we secured a tenant for the 5th floor of the Alie Street premises which is generating much needed rental income. and the income from bank deposits and the College's investment portfolio have improved over the prior year wlth the increase in interest rates. Pagè 6 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Flnanclal revlew (contlnued) Whilst the foregoing is good news. our costs have increased over the prior year. Inflationary pressures have meant that the running costs assoclated wlth all College actlvitles have gone up. The Interest payable on the mortgage loan has increased as UK base rates have moved from their historic lows last year. To counter this the trustee board will be looking at ways to reduce costs and generating additional income in the new financial year. As stated in this report, the College ralses funds by subscriptions, examlnatlon fees, grants and trading through the College's subsidiary. The College does not seek donations from the general public, and so no fundraiser or commercial participator is employed or engaged by the College. No voluntary schemes for fundraising have been joined and no fundralslng complaints have been received. The College's subsidiary Incurred deficits in commencing to trade. and was further hit by Covid disruption which severely restricted holding events over an exlended period. The subsidiary started the year with a deficit of £420k and due to exceptional trading a profit of £230k reduced the deficit to £190k. The company is expected to reverse the remalning deficit over the next 1-2 years. Reserves The Trustee Board has established a reserves policy, whereby the unrestricted funds not committed or invested in tangible fixed assets or designated for specific purposes {th8 Yree reserv&s') held by the College, should normally be sufflcient to allow the College to operate without income for up to 15 months. This level of reserves is essential, because our income is nol guaranteed and can be subject to significant fluctuations year on year. The College's reserves ensure that short temi changes In revenue wlll not materially affect the College's activitles, secures the long temi funding of the College and enables the College to meet its duties under statute and its Royal Charter to promote standards ofeducation and pradice of pathology. Thls level of reserves would also enable the College to address any unforeseeable ad-hoc expenditure arising from topical issues in pathology, which the College feels should be addressed. At 30th June 2023 the level of free reserves of £6.63 million equated to 8.7 months of unrestricted expenditure. The total amount of restricted funds at 30 June 2023 amounted to £1.99 million. Total College funds amounted to £38.2 million. Golng concern The trustees have reviewed the financial position and financial forecasts, taking into account the levels of investment reserves and cash. and the systems of financial control and risk management. As a result of this review. the trustees believe that they are well placed to manage operational and financial risks successfully. Accordingly, the trustees consider that the College has adequate resources to continue in operational existence for the foreseeable future. They continue to support the going Concern basis in accounting and in preparing the annual financial accounts. Page 7 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 The Trustee Board has adopted an ethical investment policy precluding investment In fossll fuel. tobacco, mining or armament companies. The portfolio is managed by an investment man8gement company. The total rotum approach where income and capital gains are considered in aggregate is adopted, including for those investments relating to restricted funds. Risk management The principal risks faced by the College are detailed below. together with the steps taken to mltigate against them. Risk NHS Trusts and other employers of pathologists may not release them lo devote to College dutles. A wide range of work, ultimately for the benefit of the NHS, is undertaken by pathologists for the College. Miti ation Trustee revlew of the volunteer model. Member engagement proposition Is being drawn up explaining the value of the College and encouraging people to become involved. Additionally, members may not feel that the College is relevant to their practice and may not volunteer for College roles or stand for election to College posts. Encouraging meetings to take place electronically or in hybrid style using available technologies. General economic conditions, including high rates of general cost inflation, higher bank base rates and utility costs increasing faster than inflation will lead to signtficant financial pressures on the College, with a deflclt projected for the n8Xt few years. Monthly management accounts produced comparing actual against budget to inform trustees of the up to date position. Review of College activities to see if additional income can be generated from sources other than subscriptions and examination fees. Review of activities to see if some could be paused whilst cost ressures are ex erienced. A technology Iransformation project is under way for the database and website systems, which is incorporating a review of all business processes. Technology risks, includlng reliance on the College database, which is used by many departments across several different functions. A review of IT infrastructure took place In early 2022. and new cloud hosting arrangements have b88n put in place. We have implemented recommendations relating to Cyber risks. Auditors A resolution will be proposed at the Annual General Meeting that Begbies be re-appointed as auditors to the College for the ensulng year. Page 8 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Investment pollcy and objectives The Trustee Board's investment policy is to maximise th8 return on inv8Stm8nts taklng the medium to long-term view wlth a moderate level of risk. The capital value of the portfolio should be protected in line with the objective of generating an annual rate of retum of inflation, as defi'ned by the Consumer Price Index (CPI). plus 4 /0 over a 5-year basis after expenses. The Trustee Board may invest funds of the College In such stocks, funds, shares, or securities and other investments within the United Kingdom or elsewhere as the Board sees fit, provided that the Board is satisfied that such investment is not speculative and will not expose such monies and other investments to undue risk. Deslgnated funds Deslgnated funds are funds set aslde by the Trustee Board out of unrestricted general funds for specific future purposes or projects and are excluded from th8 valu8 of th8 College's free reserves. An explanation of the College's designated funds is given in note 20 to these accounts. The total of designat8d funds at 30 June 2023 amounted to £29.5 mlllion. Plans for future perlods Trustees have agreed a strategy for 2021-24 that has 5 aims, In addition to Ihese alms the College will be working on a carbon reduction plan and on producing a net zero strategy for consideration by trustees. Strateglc alm 1 services. to support all members through the dellvery of hlgh-quality member This will be achleved by: Supportlng current members in their continulng education by offering guidance and support. Encouraging future m8mbers by fostering their interest in a career in pathology and supporting career development. Promoting and encouraglng inclusivlty and diverslty throughout our membership, the wider profession and our work. Advancing knowledge in pathology through the dellvery of a range of resources to support continuing professional development for all our members. Implementing the use of lechnology that widens and improves Consistency of access to services for members. Strateglc aim 2- develop and maintain high standards of educalion. training and research across all pathology specialties. This will b8 achieved by.. Provlding curricula, assessments and examinations for professional groups, ensuring thal they meet the future requirements for the profession. Po98 9 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Plans for future periods (contlnued) Optimising the efficiency of the examlnation process by developing centralised systems and providing enhanced support to examiners. Increasing intemational participation In College examinatlons. Encouraglng and supporting our members and trainees to undertake and publish highquality research to advance the practlce of pathology. Strategic aim 3 - promote excellence and advan¢e knowledge in pathology practice across all specialties. This will be achieved by: Advocating for a propedy resourced, supported and sustainable pathology workforce. Continuing lo develop excellent continuous professional development recording and support seNices. Delivering high-quality resources to benefit pathology practice. Developing a robust framework for governance and overslght of external quality assurance to ensure high standards. Promoting environmental sustainability in pathology and the ways in which we work. Supporting future innovation and delivery of digital resources in pathology. Strategic aim 4 - increase the College's influence through a clear, coherent. professlonal voice. This will be achieved by.. Promoting the College as a vital contributor to health policy and decision making. Influencing policy lo advance patient care and safety. Championing the College as the leading medical royal college in genomics services. Promoting pathology to th8 wider health professionals and the public to enhance our capacity and influence policy. Strategic aim 5- resource the future development of the College. We will achieve this by: Increaslng and developing new sources of income to support the work of the College. Delivering effective management of member services and providing an excellent place to work, Building corporate membership that benefits the College and its member partners. Structure, Governance & Management The College of Pathologists was founded on 21 June 1962 and was incorporated under Royal Charter on 28 February 1970 and registered as a Charltable Trust on 28 April 1970. The College is govemed by Its Royal Charter, Ordinances and By-laws, the "governing documents.. Pag8 10 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Structure, Governance & Management (continued) The Trustee Board is r8sponsible for the structure, governance and management of the College, including financial matters. Members of the Board are the trustees of the College. Committees reporting to the Trustee Board Include the Council, Governance Committee, Nominations Committee and Remuneration Committee. Council is responsible for the dinical, educational and professional functions of the College. Council has sub committees, including speclalty and standing advisory committees, examinations and training commlttees, and regional counclls. The trustees who served during the year are set out below. They comprise the 7 honorary offic8rs, the chairs of each of the regional councils for Northem Ireland, Scotland and Wales, and 3 lay trustees. Trustees are elected or appointed for a three-year temi of office after whlch they may serve again only after a one-year gap, unless elected to another honorary officer role. The Treasur8r, R8gistrar and lay trustees can s8rv8 for two consecutive three- year terms of offlce. The honorary officers are elected by the fellows and diplomate members as a whole from amongst the fellows. The chairs of the regional councils are elected by the fellows and dlplomate members in thal region from amongst the fellows resident within the particular region. The three lay trustees are appointed following a process which includes advertising these positions, completion of an application form. shortlisting against the requirements contained in the role description and person specification, and a panel interview. Trustees take decisions In the best interests of the College as a whole. They operate in accordance with a code of conduct that makes explicit reference to objectivity in decision- making. A register of interests is maintained in respect of each member of the Trustee Board and Council. On appointment to office trustees receive an induction pack and are invited lo attend the annual induction training meeting. The Trustee Board approves the College's annual budget and forward plan. Once approved. the implementation ofthe plan is delegated to the stsff, who have the authority to work within the parameters set by the Board. Decisions of a strategic nature, or items out with the agreed budget and plan, must be referred to the Board. The College wholly owns a subsidiary company, RCPath Trading Llmited, whlch undertakes certain trading activities. The directors of the company are the College's President, Treasurer, Chief ExecutiV8, and an independent director appointed by the College's Trustee Board. The Trustee Board requir88 that the taxable profits of the company be paid to the College under gift aid. Responslbllltles of the trustees The trustees are responsible for preparing the report of the trustees and the financial slatements in accordance with applicable law and Unlted Kingdom Accounting Standards (United Kingdom 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 give a true and fair view of the state of affairs of the College and of the incoming resources and application of resources of the College for that period. In preparing these financial statem8nts. the trustees are required to: Pag¢ 11 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Structure, Governance & Management (continued) Select suitable accounting policies and then apply them consistenlly: Observe the methods and princlpals of the Statement of Recommended Practice {Charities SORP)., Made judgements and estimates that are reasonable and prudent., State whether applicable accounting Standards have been followed, subject to any material departures disdosed and explained In the financlal statements. and Prepare the financial statements on the going concern basis unless It Is Inapproprfate to presume that the College will continue in operation. The trustees are responslble for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the College and enable them to ensure that the financial statements comply with the Charities Act 2011, the Charities SORP (FRS 102) and the provisions of the Royal Charter, Ordinances and By-Laws. They are also responsible for safeguardlng the assets of the College and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. The trustees are responsible for the maintenance and integrlty of the College and financial information included on the College's website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from18gislation in other jurisdictions. -.nanagem•nt p•rsonn•l r•muneratlon The trustees consider the Trustee Board and the senior management team comprise the key management personnel ofthe charity in charge of directing and controlling, running and operating the College on a day to day basis. All trustees give of thelr time freely and no trustee received remuneration in the year. Details of trustees, expenses are disclosed in note 6 to the accounts. The pay of all stsff, including the senior stsff. Is reviewed annually by the remuneration committee. Pay is benchmarked against the medlan of the range for similar roles in similar sized organisations in the London not for profit sector. Remuneration Is based upon eight pay bands each with five pay points. Staff progress up the pay scale on successful completion of an annual performance review. The senior management team meet annually to review and agree perfomiance review summaries for all staff, and the remuneration committee reviews and ratifies this decision, The remun8ration committee reviews the perfomiance reviews for all of the members of the senior management team and agrees their progression up the pay scale. No employee of the College or of its contractors Is pald below the London living wage. Statement of dlsclosure to auditor So far as the trustees are aware. there is no relevant audit Infomiation of which the College's auditors are unaware. Addiuonally. the trustees have taken all the sleps they ought to have taken as trustees in order to make Ihemselves aware of any relevant audit information and to estsblish that the College's auditors are aware of that information. Pagg 12 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Reference & admlnlstratlve detalls Trustees Those who served as trustees during the year were as follows: Dr John Ashcroft Treasurer (appointed 17 Novembar 2022) Dr Andy Boon Treasurer (demitted office 17 November 2022) Prof Sarah Coupland Vlce President Dr Bernie Croal Chair, Scotland reglonal councll Prof Angharad Davies Vice President Ms Jill Gauntlett Lay Trustee (demitted office 31 December 2022) Dr Anu Gunavardhan ChaSr, Wales regional council (appointed 17 November 2022) Dr Anita Hlll Co-opted Trustee Prof Peter Johnston Vlce President Dr Jonathan Kell Chalr. Wales reglonal councll (demitted office 17 November 2022) Dr Elijah Matovu Co-opted Trustee Dr Gareth McKe8man Chair, Northern Ireland regional council Dr Stephen Morley Assistant Registrar Prof Mike Osborn President Dr Lance Sandle Registrar Mr Robert Smith Lay Trustee & Chair of Trustee Board Mr Vlncent Voon Lay Trustee Senlor Staff Daniel Ross Joanne Brinklow Diane Gaston Nigel Pollard Katherlne Timms Chief Executive Director of Learning Director of Communications Director of Corporate SeNices Director of Professional Practlce Prlnclpal Office The Royal College of Pathologists, 6 Alie Street, London E18QT. Telephone: 020 74516700 E-mail: info@rcpath.org Website.. www.rcpath.org Reglstered charlty number 261035 In England & Wales Company registration number RC000127 Page13 The Royal College of Pathologists Report of the trustees for the year ended 30 June 2023 Reference & administrative detalls (continued) Professlonal advlsors to the College Auditors Begbies. 9 Bonhlll Street, London EC2A 4DJ. Taxatlon advlsoys Crowe, 55 Ludgate Hill, London EC4M 7JW. Property advlsors CBRE, Henrietta House, Henrietta Place, London W1G ON8, Solicitors Womble Bond Dickinson. 4 More London Riverside, London SE12AU. Investment Canaccord Ganuity, 41 Lothbury, London EC2R 7AE. (to 9 December 2022) managers CCLA, One Angel Lane, London EC4R 3AB {from 9 December 2022) Bankors HSBC, 69 Pall Mall, St. James's, London SW1Y 5EY. Approved by the Trustee Board and signed on their behalf by.. k/ Professor Mlke Osbom Presldent 3 August 2023 Pag6 14 Independent auditor's report to the trustees of The Royal College of Pathologists Oplnlon We have audited the financial statements of The Royal College of Pathologists (the 'charity') for the year ended 30 June 2023 which comprise the Consolidated Statement of Financial Activities, the Consolidated and College Balance Sheets, the Consolidated Statement of Cash Flows and notes to the financial statements, including a summary of significant accountlng policies. The financial reporting framework that has been applied in their preparation is applicable lawand United Kingdom Accounting Standards, including Flnancial Reporting Stsndard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland {United Kingdom Generally Accepted Accounting Practice). In our opinion the financial statements: Glve a true and fair view of the stste of the parent charity and Its subsidiary undertaking's affairs as at 30 June 2023 and of their incoming resources and application of resources, for the year then ended.. have been properly prepared In accordance with United Klngdom Generally Accepted Accounting Practice; have been prepared in accordance with the requirements of the Charitles Act 2011. Basls for oplnlon We conducted our audit in accordance with International Standards on Auditing {UK) {ISAs (UK)) and applicable law. Our responsibilities under those standards are further discussed in the auditor's responsibilities for the financial statements section of our report. We are Independent of the charity in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK. including the FRC'S Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with thes8 requirements. We belleve that the audit evidence we have obtained is sufficlent and appropriate to provide a basis for our opinion. Concluslons relatlng to golng concern In auditing the financial slatemgnts, we have concluded that the directors, use of the going concem basis of accounting in the preparation of the financial statements Is appropriate. Based on the work we have performèd, we have not IdentSfled any material uncertainties r8latin9 to events or conditions that, individually or collectlvely, may cast slgnlficant doubl on the company's abillty to conllnue as a going concem for a period of al least twelve months from when th8 fSnanclal statements ar8 authoris8d for issue. Our responsibilities and the responsibilities of Ihe directors wth resp8Ct to going concem are d6scrlbed In the relevant sectlons of this report. Othor Inforniatlon The trustees are responsible for the other informatlon. The other information comprises the report of the trustees. Our opinion on the financial statements does not cover the other infomiation and, except to the extent otherwise explicitly stated in our report, we do not exprass any form of assurancè conclusion thereon. Pa9e 15 Independent auditor's report to the trustees of The Royal College of Pathologists In connection with our audit of the financial statements, our responsibllity is to read the other information and, in doing so, consider wh8ther the other infomiation is materially inconsistent with the financial stslements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify suGh material inconsistencies or apparent material misstatements. we are required to determin8 whether there Is a material misstatement in the financial statements or a material misstatement ofthe other infomiation. If based on the work we have performed, we conclude that there is a material misstatement of this other infonnation, we are required to report that fact. We have nothing to report In thls regard. Matt•rs on whlch we are requlred to report by exceptlon In the light of the knowledge and understanding of the charity and its Énvironment obtain6d In the course of the audit. we have not identified any materlal mlsstatements in the report of the Irustees. We have nothing to report in respect ofthe following matters in relation to which the Charities (Accounts and Reports) Regulations 2008 require us to report to you If, in our opinion., The Snforrnatlon given in the twstees, report 15 inconsistent in any material respect with the financial statements., or Suffici&nt accounting records have not been kept. or The financial statements are not in agreement with the accounting records; or We have not received all the information and explanations we require for our audit. Rgsponslbllltles of truste•s As explained more fully in the trustees, responsibilities statement, the trustees are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such intemal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstat8ment, whether due to fraud or error. In preparlng the financlal statements, the trustees are responsible for assessing the charty's ability to continue as a going concern. disclosing, as applicable, matters relatin9 to going conc8rn and using the going concern basis of accounting unless the trustees either intend to cease operations, or have no realistic alt8rnative but to do so. Audltor's responslbllltles for the audit of the financlal statements We have been appointed as auditors under section 151 of the Charities Act 2011 and report in accordance with the Act and relevant regulations made or havlng effect Ihereunder. Page 16 Independent auditor's report to the trustees of The Royal College of Pathologists Our objectives are to obtaln reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditorfs report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted In accordance with ISAS (UK) will always detect a material misstatement when it exists, Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to Influence the economlc decislons of users taken on the basis of these financial statements. Extent to which the audit was capable of detectlng Irregularities, including fraud Irregularities, including fraud, are instances of non-compliance with laws and regulations. W8 design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, Including fraud. The extent to which our procedures are capable of detecting irregularities. including fraud is detailed below: Agreement of the financlal slatement disclosures to underlying supportlng documentation., Enquiries and confirmation of manag8m8nt and the trustees as to their identification of any non-compliance with laws or regulations, or any actual or potential claims., Review of minutes of Board meetlngs throughout the perlod. Incorporating unpredictability into the nature, timing andlor extent of testing. Evaluation of the selection and application of the accounting policies chosen by Ihe charity., In relation to the risk of management override of internal controls, by undertaking procedures to review journal entries and evaluating whether there was evSdence of bias that repr8sented a risk of material misstatement due to fraud; and We assessed the susceptibility of the charity's financial statements to material misstatement. including how fraud might occur by considering the key risks impacting the financial statements. Our audit procedures were designed to respond to risks of material misstatement in the financlal statements. recognising that the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by. for example. forgery. misrepresentations or through collusion. There are inherent limitations in the audit procedures performed and the further removed non to not cash flow from oporatlng actlvltl•s 2023 2022 Net Incom¢ll•xp•ndhure) fi>r th• y•ar la8 per the 8tat•m•nl of flnanclal a¢tlvhl•81 Adjustments for.. Depreclalion charges IGainsylosses on investments DSvidends and interest {InGrga5elldecrease in stoGks {InGr8aseydecrease in debtor InGreasel{dgcreasel In creditors 256.973 1536,4751 697.950 1232.1041 {167.9171 1,603 (155,0501 {28,084} 687.635 1,035,948 179.4771 14111 1326,2281 594,067 Not cash providod by I lusgd in) ¢Jp•r•ting *ctlvltl•s 373,371 1.375.059 2. Analysls of Gash and GJsh equlvalents 2023 2022 Change In year Cash at bank COIF Charfty Deposll Fund Cash at broker 3,207,779 4,000,000 7.066,834 13,859,055) 4,000,000 1132,3281 132,328 Tolal cash and cash equSval6nts 7.207.779 7,199.162 8,617 Analysls of Ghanges in n¢t dobt 2023 Cash flows 2022 Cash COIF Charlty Deposlt Fund Cash al broker Loans falling due wilhln one year Loans falling due more than one year 3,207.779 4,1)00.000 13,859,055) 4.000.000 1132,3281 95,338 365,466 469.421 7,066,834 132,328 1291,2501 8 322,957 1.415,045 1195,9121 7,957.491 945,624 Page 21 Th• Royal College of Pathologlsts Notes to the Flnanelal Statements as at 30 June 2023 1. kGounting pollcles {al B•¥ls of preparatlon The flnanclal statements have been prepared In accordance the Ststemenl of Recommended Practlc6.' Accounting ond Reportlng by Charitl8s prèparfng thelr accounts In accordance with th& Financlal Reportlng Standard appllcabl8 In th6 UK and Republlc of Ireland IFRS 1021 and tho Flnanoial R&portlng Stsndard applScable in th8 UK and Republlc of Ireland IFRS 1021 and the Charfjtles AGt 2011 and UK Generally Acceptod Pra¢liGe. {bl Publ1¢ b•n•tit antty The College meets the definltion of 8 public benefit enllly under FRS 102. (¢1 Golng concern The trustees consider that thgrg aro Tr) material uncertalntles about the Colleg8'¥ ablllty to contlnu& 8$ a golng c￿)Com. The Iruslees do not consider that ther8 ai8 any sources of 8stimallon uncertainty at the ￿portIng dale thal hav& a $1gnificanl risk of cousing a material adjustment to the caryng 8mounls of assets and Ilabililies Wrthin the next reporting perlod. {dl Group flnanclal statomonts Thg flnancial $tstgmgnl$ consolldale the results of the College antl Ils wholly owned 8ub8ldlary, RCPath Tradlng Limited. on a Ilne by Ilne basls. (el Income Income is Included on a rècelvable basls. Income from subscrSptlons, trainee registration and fees for partS¢ipation in the contlnuing professional devglopmonl Scheme are recognised in the accountlng period lo which the services covered by those lees relate. Fees received in advanBe are accounted for as defgrred income within creditors. Incomo from gxaminalions and conferences & academlc aclfvilles are included in the accounllng pe￿0d In whlch thg pxaminslion or conferenc8 takes pLgce. {n Exp•ndlturo and IrroCOVorablo VAT Expendlture Ss recognlsed once thoro is a legal or constructlve obllgatlon to make a Po￿nent to a thlrd party. It is pTobabl8 that $8lllemenl will be requlred and the amount of the obl￿allOn can be mea8ured reliably. Expendllure on charllable a¢￿vItIeS Sncludes the costs of delivering examlnati¢)ns, tralnlng and educallonal actlvltles undertaken lo further the purposes of the College and Iholr asswl8ted support costs. Irrecoverable VAT Is charged as a cost agalnsl the aclivlly for whi¢h the exp8ndlture was in¢urrgd. Igl Alloc•tion of support costs Resources expended are allocated to the particular actlvlty %there the cost rel8tos directly to that activity. However, the cost of overall dlrècllon and admlnislr8tion of each acllvily, comprising the Salary and overhoad costs of the central function,18 apporuonod, bas&d on staff numbors engaged in each acllvlty. Govornance costs are apportionod on the semg bas1$. (h} Forelgn curreTrcle8 Transacllons denomlnated In forelgn currencles are Iran$laled inlo sterling al the rate of exchange prevailing al the me of the Iransaclion. 111 Oporatlng loa808 Instslrn8nts under operallng lease commllments arfslng In lh8 ygar ara included In the Slalem8nt of FinanGial Actlvllles for the year in which they arise. Page 22 Th• Royal Colleg• of Pathologists Notes to the Flnancial Statements a$ at 30 Junè 2023 lil Tanglbl• flx•d assots and doproclatlon Tangible fSxed 88sels costing rnore than £2.500 are capilalised. Depr8cialKJn is charged on fixed issel$ 01 rates calculated lo off their cost evenly as follows.. Freehokl buildings over SO years to residual value Land not dfrprgciatod F￿t￿re8. flttings and office equipment over 3 to 5 years Computer syslems and software over 2 to 5 years The College has aijopl8d an accounting pollcy of capitslising borrowing costs that are dlrectly attributable to the conslwctlon of the new building. From tho dale of occupat￿)n of the premlses in November 2019 interost h8s been charged lo th& Slalemenl of Financial Activities. As explained in note 14, herltage 8s8ets have not been ¢apiiali$¢d or depr$ciat¢d as no reliable value ¢an be attribul8d. Ik) Stocks These are Staled al the lower of cost and not roalisablo value. 111 Funds •¢¢ountlng Funds h8ld by the Collgge are.. Unrestrtcfed g8n6r81 fvnds - thèse are fvntJ$ whith can be used in •ccordan¢e wllh the ¢haritsble objects 8t the d58cret￿n of the Tru81ee 808rd. Unrestricted Designoted funds - these are funds sel asSde by the Trustee Board out of unreslricled general ftJnd$ for speciflc future purposes or projects. Restricted funds - these are funds that can only bo used for particular reslricled purposes within the objects of the Colleg8. Restrfcllons arfsa when specified by th6 donor of where funds are raised for particular reslricled purposes. Further explanation of the nature and purpose of each fund is included in the notes lo the accounts. (m) Pen8lon schèmos The College partlclpates in 2 pension schemes.- Ihg defined bengfil schemo, operated by SAUL {Superannualion Arrangemgnls of the Univershy of London) and the defined contribution scheme operated by Royal London. For SAUL, the actuarfal valuatlon applles lo SAUL 8$ a whole and does not Idenlwy surpluses or deficlts appllcable to Indlvldual employ8ts. As a wholg. Ihg market value of SAUL'S assets al 31 March 2020 was £3,612 mSlllon representlng 940% of the Ilabililies. Thg market value of SAUL'S assets al 30 April 2021 was £4.369 rnillion repres8n￿ng 109.kn of the estimated liabllllles. 11 Is not possible to Identify an individual Employerfs share of the undedwng assgls and Ilabllilles of SAUL. Thè College accounts for its partlclpallon In SAUL as If il were a d8flned conlribullon scheme and penslon costs are based on the amounts actually paid li.e. Gash amounts) in accordance paragraphs 28.11 of FRS 102. Although there was a Technlcal Provlslons deflcil al 31 March 2020, allowlng for post valuatlon expèrlen¢o 10 30 Apdl 2020, SAUL had a Technl¢al Provlsrons surplu8. Therefore no deflcll contributions were requlred followtng the 2020 valu8tlon and Ih6re Is no defined benefit liabllbly 11.e. the present value of any deflGII contrfbullons due to SAUL) to be r&cognlsed by the College. For the Royal London scheme, the pension charoe represents the contrlbulk>ns payable by the College. Inl R•••aTch grant$ Grants payable and re￿1vable are recognised In the statement of flnancl81 actlvblles In the period lo whlch the grant relates and ￿ere condllions relating to the grant have boen full61￿d. (ol T•rmlnatlon payments Temiination pa￿rnents are recognlsed In the Ststemenl ol Financial Activities when incufted. (pl Flx•d asset Inv•stm•nts Flxed asset Investments are incIL￿ed at thpir fair valugs {markg1 valug) at the balance shoel dats. Any gain or loss on r8valualion is lak8n lo th8 Statement of Flnanclal Actlvllles. Pag& 23 Tho Royal College of Pathologlsts Notes to the Flnanclal Statements as at 30 June 2023 (q) Debtors Trade and other debtors are recogni8ed at the settlemgnt amount du6 after any trade discount offered. Prepayments are valued at the amount prepaid net of any trada discounts due. {r) Cash at bank and In hand Cash al bank and cash In hand Includes cash and short term highly liquld Investments with a short malunty of three months or less from the dale of acqulslllon or opening of the deposit or 8lmllar account. Cash balancgs include amoun18 held by way of rent deposits from tenants. (sl Cr•dltors and pMv181on8 Creditors and provisions are recognlsed where the charity has a prosgnl obligallon resultlng from a past event that w511 probably result In the transfer of funds lo a third party and th8 8mounl due 10 Settle the obligation can be measured or esllmated rellably. Creéltors and provisions are nomially rgcognised al thelr settlement amount after albwing for any Ir8de dlscounls due. The charity only has financlal a$$els and flnanclal liabilities of a kind that quallfy as basic financial instruments. 2. Tradlng In¢ome and expondbturo RCPalh Trading Limited The College owns 1001)/o of RCPath Tradln9 Llmlled (Company number 045352961. The main activities of th• company are lo undertake va￿oU$ IradSng activllies of the College. The company supplles eonsultancy services under the trading name of RCPalh consuttlng, and operates a commercial conference centre oallèd Events@No6 at the Coll8g8's Ali8 Slreel premises. The latter operation commenced in January 2019 and has made some losses to date in il's start-up situation. It will donate fvture taxable profits to the COll￿e under gSft ald. Tiading results exlracled from its audiled accounts are as follows.. 2023 2022 Profft & Lo88 account Tumov81 1,799,202 934,310 {1.569,5201 1910,501} 229.682 23.809 Cost of Sales and admln181rallve expenses Nel profit Payable under gift ald to The Royal College of PatholcN3ists Profft retained In RCPalh Tradlng Llmited 229,682 23,809 Balance Sheet 2023 2022 Debtors Cash at bank 266.923 61,386 259,$50 244,495 328.309 504,045 (425.7401 {330.3371 Creditors.. amounts falllng due wtthln one ￿ar Net current assets {97,4311 173,708 {92,369} (593,1901 1189.8001 1419.482) Cr6dilor8.' amounts falling du& after more than one year Nel 8S8ets I Illabllltl681 Share capllal Profit end Ioss account 100 100 1189,9001 1419.5821 Capllal and resgrves al 30 June 1189,8001 1419,4821 The College has agreed a formal loan to financialty support Its trading subsidiary company's losses during the Start-up phase of its conference eentre Operat￿n8. The108n is for a perfod of up to 10 years. Th8 College purchased £86,00212022 - £32,933) of seNicfrs from its wholly owned subsidiary during the year and re¢elved a payment of £234,44212022 - £17,500) towards the cost of shared overheads. Interest on the loan amounting lo £10.266 {2022 - £10,419} was payable by the subsidiary company to thè College. In accordance with the SORP, these tr8n8actlon8 have been removed on consolid8tlon. In addltlon. the College pabd £57,28212022- £116,626) of salaries relating to staff employed by the subsldiary company that were recharged In full. Pag? 24 Tho Royal Collogo of Pathologl8t$ Notes to Ihe Flnanclal Statements as at 30 June 2023 3. Detall&d comparJtlv•$ for th• $tat•m•nt of flnanclal actfvitles In 2022 UnreStr￿ted Unreslricled General Deslgnaled Funds Fund8 Tot81 R68trtcted Funds Fund8 30 Jung 2022 Income from: Donation$ &1gga¢i8s Charilablg octivitl95 588 588 Subscripllons Poslgraduatg gducation & examIna￿on6 Pathology portal Inlemalksnal development Conferences & academlc acllvllles Professlonal standards Research Communlcafjon8 & publlc engagèmènt Tradlng activllies Inveslmonts 3.974,297 1,981,094 3,974.297 1.994.594 500,000 45,239 190,467 57,844 40.000 115 13,500 500,000 10,021 35,218 190,467 57,844 40.000 115 901,377 901,377 77,614 1,863 79.477 other 65,253 65.253 Total Income 7.283.867 565.384 7,849,251 Exp•ndltur• on: R8islng funds Trading activities Investment management fees Charitsblg activiti99 1,350.735 41.682 1,154 50,297 1,402,186 41,682 Poslgraduale educatlon & examlnatSons Pathology portal Inlarnallonal devèlopmont Conferences & academic 8clivilies Professional pract¢ce Workforce Communications & publlc eng8gemenl Advlsory commlttees Total •xpendlture 2.202,566 2.202,566 160,987 359,539 415,176 734,713 378,239 1.218.610 436.080 160,987 16.342 24,668 343,197 390,508 726.945 378,239 1.217.789 436.080 7,768 821 7,087,741 8,922 253,115 7,349,778 Included In the above expendlture Is £121,623 relatlng lo non-recurrent IT costs. Not Incomo 1 {•xpendlturo} b•for• n•t galn$ on Investments Net galns on Investments Nèt Incomè I lexpendlturel Transf9rs b9twogn funds 196,126 1874,9641 1678.838} {129,7531 1808.5911 {8,9221 312,269 499,473 1160.9841 11,035.948 151.285 1536,475} 1,000 18.922) 128,753 N•t mov•m•nt In funds 119.831 152.285 {536.4751 Recon¢lllallon of funds: Total funds brought forward Total funds c•rrl•d forw•rd 7,596,098 29,436.817 1.458.634 38,491,549 6,787,507 29,556,648 1,610.919 37,955,074 Pag8 25 Thè Royal Collego of Pathologists Not•s to the Flnanclal Statements as at 30 June 2023 4. In¢om• from investments 2023 2022 Bank d8poslt Interest Income from listed investments Incom8 from Investment prop8rtles 31,351 106,483 30,083 5.633 55,209 18,635 167,917 79,477 S. Donatlons & Legacles 2023 2022 College memb6rs 588 588 588 588 6. Staff co$t$, trustee remuneratlon and expenses. and the cost of key management personnèl 2023 2022 The total cost of salaries and wages were Salaries and wages Redundancy and lerminalion costs Social security Gosls Pension contrlbulions 3,121,715 15,131 343.794 416,538 2,644,301 21.500 280,500 337.846 3,897,178 3,284,147 The redundancy end temiin8tlon costs wfjrg sellled and paid at tha baLgnce sheet date. The number of employees whose emoluments excee¢Jed £60.000 in the year was as folbws: 2023 No. 2022 No. £60,001- £70,000 £70,001- £80,000 £80,001- £90,000 £130,001- £140.000 Conlrfbutions wera madè to a definèd benefit penslon 8cheme amountSng to £122,09812022- £74,969) in respect of the staff noted above. The key management personnel of the charfty comprfse the Iwsloos. thg Chief Executive and the 4 {2022 - 41 other senlor managers. The lot81 employee remuneration of the key managgment personnel amounted lo £617.88012022 - £578.7611. The charlty trustees were not paKI or recelved any other bgnefils from employment wlth the charity in the year 12022 - £Nill- No charity Iruslee received payrnent for professional or other sermces supplied to the Gharity {2022- £Nil). Travel, 8ubslstenGe 8nd accommodallon costs incurred amounting lo £45.53212022- £20,719) were relmbursg(110 14 (2022- 131 members of the Trustee Board. Detalls of the transactions with the trading subsldlary are Includod in note 2. Durlng the year there We￿ no other related party Iran8acllons12022- £Nill. Page 26 The Royal College of Pathologists Notes to the Flnanclal Statements as at 30 June 2023 7. Stsff numb•rs The average number of employ868 {head count based on number of 81aff employed) durlng the year wa8 as follows.. 2023 2022 No. No. 23.3 19.9 Postgraduate educ8tion & examinatlons Conferences & academlc activlties Professlonal practlce Advisory committees Communications & publlc relatlons Workforce Education centre Internallonal development 11.8 17.5 15.4 75.1 63.9 The averag8 number of full lime equivalent employees during the year was 69.5 58.8 . Total expendlture (Current year) Direct Cost8 Staff Costs Support Costs Total 2023 Total 2022 Tradlng aclivili8s & educatlon centre Investment management Other Poslgraduatg education & examinations Pathology Portal Intemalional development Conferences & 8c8demlc actlvrf(les Professional practi¢e Workforce CommunIc8￿on8 & publlc engagement Advlsory committees Total for the year ended 30 June 2023 1,048,402 16,876 46,193 773,375 89,106 31,097 14.366 59,432 2,065 190,657 82,614 57,282 673,558 1.779,242 16,876 228.630 2.704.046 164.162 426,579 506,448 1,058,787 424,860 1,508,455 597,252 1,402,186 41,682 182.437 787,083 1,143,588 75.056 190.340 279.562 694,038 258,795 877,006 321,511 2.202,566 160,987 359.539 415.176 734,713 378,239 1,218,610 436,080 205,142 212,520 305,317 164,000 440,792 193,127 2,354,183 3,897,178 3,163,976 9,415,337 7,349,778 8. Totsl expendlturn IPrlor year) Dlrect Costs staff Costs Support Costs Totsl 2022 Tradlng acllvlties & educatlon centre Investmenl management Poslgiaduate education & examinations Pathology Portal Inlemational development Conferences & academic activities Professionol practice Workforce CommunScÈllon$ & publ1¢ engagement Advlsory ¢ommlttees Total for the year ended 30 June 2022 777,538 41,682 541,110 124,248 16,346 8.350 25,373 {20) 104.024 17,559 116,626 508.022 1.402.186 41.682 2.202.566 160,987 359.539 415,176 734,713 378,239 1,218,610 436,080 981.890 36,739 179,417 258,415 479.587 242.108 749,401 239,964 679.566 163,776 148.411 229.753 136,151 365,185 178,557 1.656,210 3,284.147 2,409,421 7.349,778 Govemance costs are contained within support costs and are not shown separately. They comprfse th• 8xptsnditur8 in relation lo the trustee board of £12,75712022 - £12,437), trusl8e recruitment costs of £34.87212022- £NIII, legal and Professional costs of £12,269 (2022 - £21,453) and the auditors r8munerallon as detalled in note 9. Page 27 The Royal College of Pathologl$ts Notes to the Flnanclal Statements as at 30 June 2023 9. Nat Ineomlng r•sourc•s for the year 2023 2022 Thls is ststed after charging.. Depreclatlon Audllols remuneratlon - exlemal audlt Audllols remuneration - subsldiary company Audltor's remuneration - payroll bureau servlces Trustee Ilabllily indemnlty insurance 697.950 8,604 2,308 8,833 1,000 687,635 7,993 1,250 5.912 752 10. Penslons The College participales in 2 pension schemes: the defined benefit scheme, operated by SAUL Isuperannuatlon Arrangements of the University of London) and the defined contribution sch6me, operated by Royal London. SAUL scheme The College partlclpales In the Superannuatlon A¥Tangements of th8 Untverslty of London I'SAUL'I, which is a Gentralised defined ben8fi1 scheme withln the UnSled Kingdom and was contracted-out of the SecorKI Stale Pension (prior to April 20161 SAUL Is an In¢Jependenlly-manag8d pension scheme for the non-academlc stsff of over 50 ¢olleges and In$￿tutIonS wlth links lo hlgher education. Penslon benefits accrued within SAUL currently build up on 8 Career Average Revalued Eamings I'CARE") ba$ls. The College is not expeGled to be118ble lo SAUL for any other current partSclpating gmployerfs obligatlons under the Rules of SAUL, bul in the event of an In$olvency of any partlcipatlng employer wllhin SAUL, an amount of any pensSon shortfall Iwhlch cannot otherwlse be recovered) In respect of that employer, may be spread across the remaining partlcipating employeTS and reflected In the next a¢luarlal valuallon. Fundlng Policy SAUL'S ststutory funding oblecllve Is to have suffi'cient and appropriate assets lo meet the costs inGurred by the Trustee in paying SAUL'S benefits as they fall due {the 'Technical Provisions"). The Trustee adopts assumptions which, taken as a whole. are Intendetl to be suffi'ciently prudent for pensions and benefits already in payment to contlnue lo be pald and for the commllments which arise from Members, a¢crued penslon rlghts lo be met. The Technlcal Provlslons assumptlons Include approprlal& marglns lo allow fcf the possibility of events turning out worse than expected. However, the funding method and assumptions do not completely remove tho risk that the T¢Ghni¢al Provislons could be insufficient lo provlde benefits in th¢ future. A fonmal actuarial valualion of SAUL is &?rried out every three years by a professionally qualified and Independent actU8ry. The last actuarial valuation was carried out with an effectlve dale of 31 March 2020. Infom)al reviews of SAUL'S posillon, refleollng Ghanges in rnarkel condition$, cash flow Snformation and new a¢orual of benelts, are carried out beknn formal valuations. The fvnding prfnclple8 were agreed ty the Trustee and Employors in June 2021 and ar8 due to be rev￿Wed agaln at SAUL'$ next fomial valuation in 2023. At the 31 March 2020 valuatlon SAUL was 94Yo funded on ils TechnlGal Provisions basis. Howev9r.market movements followlng the valuatlon dale were pOsI￿ve and the Trustee5 and the Employers agreed to allow for post-valuation experience up lo 30 Aprfl 2021. As SAUL was In surplus on Ils TechniGal Provlslons basls at that date, no deficit Gonlributions werg requlred. However, the The TTusl8e and Empknyers hAve 8gr6ed that the ongolng Employers, ¢ontrlbulions will inGreasg from a rate of 16Q/o of CARE salaries lo 19¥0 of CARE salarles from 1 April 2022 and to 21 Yo of CARE salarles from 1 January 2023. Should thg College leave the SAUL scheme this could trigger a debt. Royal London sch•m• The College operates a defined contrfbutlon scheme for staff other than $enlor m8nag6r8 who Jolned the College after 1 Aprfl 2021. The assets of the scheme are held separately from those of the College In an Independently admlnlslered f￿nd wlth Royal London. The pension cost charged represents the ¢onlrlbulions payable und•r the scheme by the College to the fund. The College has no liability under the scheme other than for payment of thes8 contribulions. Paga 28 The Royal College of Pathologlsts Notes to the Flnanclal Statements as at 30 June 2023 11. Allocatlon of Cost8 Support CO818 as per note 8 above, can be broken down by activity, as follows.. Infomialion Finance technology & HR Secretariat (Current yearl Premise8 Total Postgraduate education & examinations Inlemalional development Conferences & 8C8demic activitie5 Professional practice Workforce Communicallons & publlc engagement Trading acllvilies & educatlon centre Aévisory commillees Other 138,455 42,186 36,236 58,411 31,910 90.437 16,225 37,859 285,675 84,552 72,544 117,072 64,540 181,111 32,520 67,574 51,968 15,381 13,197 21,297 11,741 32,947 5,916 12,287 310,985 63,023 90,543 108.537 55.809 136.297 618,897 75.407 182.437 787,083 205,142 212,520 30S,317 164,000 440,792 673,558 193,127 182,437 Total 6UPPOrt costs year end8d 30 Jun& 2023 3,163,976 Informallon technology Flnance & HR Secretarlat IPrfor year) Premlses Tolal Poslgraduale education & examinations Internallonal development Conferences & academic activities Professlonal practice Workforce Communications & public gngaggmont Trading acliviliès & education centre Advisory ¢ommlttees Total support costs year ended 30 June 2022 164.891 50.210 43.080 69.521 38,326 107,551 19,312 44,862 70,617 21,503 18,449 29,774 16,414 46,060 8,270 19,213 34,846 10,611 9,104 14,692 8.099 22.728 4,081 9,481 409,212 81,452 77.778 115,766 73,312 188,846 476,359 105,001 679,666 163,776 148,411 229.753 136.151 365.185 508,022 178,557 2,409.421 Included In Informallon technology costs aljove, as all¢xatgd auoss the varfous departments, 1$ an amount of £121,623 In relation lo non-recurrenl IT costs. The basis of aliocalion of support costs 1$ as follm: Infoimatlon technology costs have been allocated on the basis of the number of computers used by ga¢h departmgnt. Fln8nce costs and s8crelarlat costs have been allocated on the basls of the headcount. Premlses costs have been allocated on the basis of Ihg usage of floor areas. Saiary cosls a5 per note 8 above Can be fvrth&r analysed as follows: Dir8clly HR. Payroll Attrfbutable &IT (Currgnt yèar) Finance Secretariat Premises Total Postgraduaie educallon & examlnatlons DlgStal educalknn prolecl Inl8rnalional development Conferences & academic activities Professlonal pradiGe Woikforc8 CommunOc8lion$ & publk enga9gmgnt Trading activitie$ & eduGation ￿ntre Advisory committees Total salary Gosts year ended 30 June 2023 754,982 75.056 112.151 200,934 499.584 179.378 605,067 35,385 205,024 148.121 132,150 69,302 39,033 1.143,588 75,056 190,340 279,562 694,038 258.795 877,006 57.282 321,511 29.402 30,458 75,352 30,525 104,430 8,274 44,184 26,786 26.503 65.530 26,884 92,100 7,481 39.717 14,079 13,860 34,269 14.079 48,239 3,929 20,845 7.922 7,807 19,303 7,929 27,170 2,213 11,741 3,897,178 Page 29 The Royal College of Pathologlsts Note$ lo the Flnancial Statements as at 30 Jun• 2023 11. Allocatlon of c¢yJts l¢0ntlnU￿) Directly HR, Payyoll A￿bu￿ble &IT (Prfor year) Finance S8cr8lariat Premises Total Postgraduate eduG9tion & examlnatlo Digital education project Inlernalion81 development Conferences & academic aclivities Profe$sion81 practice Workforce Communications & publio engagemer Tradlng actlvities & eduGalion Gonlre Advisory commillees Tolal salary costs year ended 30 June 2022 659,724 36,739 106,112 174,455 342,374 167,078 536.927 89.568 153,332 118,107 111,987 72,385 19,687 981,890 36.739 179,417 258,415 479,587 242,108 749,401 116,626 239.964 25,972 30,643 51,050 27.574 79.167 10.441 31.187 25,935 29.261 47.342 26,056 73,254 9,151 30,416 16,825 18,911 30,519 16.825 47.213 5,869 19,694 4,573 5,145 8,302 4.575 12.840 1.597 5,355 3,284,147 The basls of allocalion of salary costs is as follows.. Infomialion technology costs have been allocated on the basis of the number of computers u88d by each departmenl. FSnance c051s. $ecret8rfat costs, premlses costs and HR & payroll costs have been allocated on the basls of the headcount. 12. Taxatlon As a reglstered charity tho College 15 gX•mPt from corporatlon lax slnce all income is applled for charllable purpo$e$. 13. Tanglblo flx•d ass•ts Consdthted and College Computer Systems & Softwar• Fixtures, Fitt4'ngs & Equbpmenl Fr••hold Propety Total Cost or valuatlon At 1 July 2022 Additions Di6P06als 38.841,116 135,6981 1.270,168 8,222 197.4011 917,607 40.828.891 44.298 16,822 51.377) 1148.7781 AI 30 June 2023 38,605,418 1,180.989 910.S28 40,696.935 Dapr6clatbn At 1 July 2022 Providad In year Dlsposals 1.205.417 372,108 1.097.676 158,298 197.4011 748,382 167,544 51,377 3.051,475 697,950 1148.7781 At 30 June 2023 1,S77,525 1,158.573 864.549 3,600,647 Nèt b(￿k va￿e at 30 June 2023 37,027,893 22.416 45,979 37,096.268 Not bocA¢ value al 30 June 2022 37.435,699 172,492 169,225 37.777.416 In addition lo the capitallsed fixed assets held for the CharilVs own use. th8 College also has a numb8r of assets on trust for retention In perpelulty as a pemanenl record of the College's history. These comprise a uniqu8 collgclion of paintings depicting the col￿ge.8 20 Presidents since its founding in 1962. together with a library coll¢clion and other artefacts whose Intrinsic value 1$ also bound up with Ihg Collfjge's history. These are irreplaceab19 originals to which no reliable ￿st or valut can be attributed and accordlngly these assets have not been capilalised in the flnancial statements. Page 30 The Royal College of Pathologlsls Notes to the Flnanclal Statements as at 30 June 2023 14. Inve8tm•nts Consolldated 2023 2022 College 2023 2022 Market value al 1 July 2022 Additions at cost Disposals al market value Net gain on revaluation Market value al 30 June 2023 5.233.165 6,294,112 5.233.265 6.294,212 4,737,135 1,382,358 4,737,135 1,382,358 14.814.418> 11,407,357) (4,814.4181 11,407.3571 232,104 11,035,948) 232,104 11,035.9481 5,387.986 5,233,165 5.388,086 5.233,265 Hlstorical cost al 30 June 2023 5,360,425 4,671,934 5,360,525 4,672.034 Investments at market value comprfsed,. Llsled Investment trusts and unlt trusts Investment property Listed equity shares Flxed Interest securille$ Cash held by investment manager awaiting reinveslmenl Unlisted inve$tmgnls 4,702.165 685,821 3.915,142 4.702.165 698,112 685,821 280,594 206,989 132,328 3.915,142 698.112 280.594 206,989 132,328 100 100 Market value a8 8t 30 June 2023 5.387,986 5.233,165 5.388.086 5,233,265 Durlng the year the College tendered Its investment management arrangements. The result of th1818 that wllh effect from December 2022 CCLA Investment Management were appolnled. The Collego rlow has a single investment holding In the CCLA COIF Ethical Investmènt Fund. Thè inveslrnenl in Ihls fund gives the Co118ge greater access to diversification rather than dirgct holdlThJs. Thg invgstmgnl prop8ty 1$ valued by rfrffrrence lo the marftgt value of similar propgrties in tho dovglopment. Wh￿h, In th8 oplnlon of the Trustees, Is the falr value al 30 June 2Li23. Unllsled Investments 8t cost comprlse.. 2023 2022 RCPalh Tradlng Llmlled - 100 ordlnary shar68 of £1 e8th 100 100 100 100 The College owns 100•h of the ordlnary share capSts1 of RCPath Tradlng Llmlled, company number 4535296, whlch has L*en consolldaled as a subsldlary undartaklng Ihroughoul. The reglslér8d address of the company18 6 Alle Streot. London El 8QT. Flsrther details of th8 investment pollcy and oblecllves are contalned In the Inveslm8nt policy Section of the roport of the Trustees. 15. 8tock8 Consolldated and College 2023 2022 M8morabSlla for resale 2.886 4,489 2,886 4,489 Page 31 The Royal College of Pathologists Notes lo the Flnanclal Statements as at 30 June 2022 16. D•btor¥ Consolidated 2023 2022 College 2023 2022 Trade debtors Prepayments and accrued Income Other debtors Amounts due from subsldlary undertaking 284.365 99.702 574,676 294,458 175,928 333.307 24.442 99.702 567,676 92,369 34,909 175,928 333.307 593.189 958.743 803,693 784,189 1,137,333 The ar￿UTht du8 from the subsidkqry undertaking of £92.3691s due •fter more than on? year. 17. Credltor8 Con801idaled 2023 2022 Collegg 2023 2022 Amounts falling due wilhln one year Deferred Income (Dole 18) Trade Creditors Other Gredilors Taxation and so¢l8l $gcurty Accruals Bank Loan 3,124,839 365,693 202,572 91,687 503.441 195.912 3,378,715 319,435 129,804 81,780 406,582 291,250 3.006,192 61.001 202,571 91,687 501,041 195,912 3.244,738 126.789 129,804 81,780 402,868 291,250 4.484.144 4,607,566 4,058,404 4,277,229 Amounts falling due after more than one year Consolidated and College Bank loan - amount dug betwgen 2 end S years Bank loan - amount due after 5 years 2023 2022 912.166 7,045,325 1,240,642 7,082,315 7,957,491 8,322,957 The loan is a commercial mortgage loan secured by a first legal charge over the land and bullding owned by the College at 6 Alie Street. Interest Is tharged 8t 1.50A above base rate. 18. Deferred Income Consolidated 2023 2022 College 2023 2022 Balance at 1 Juty 2022 Amount released to Incomlng resources Amount deferred in the year 3,378,715 2,777,290 3,244,738 2,746,855 13.341.155) 12,765,730) {3,244.7381 {2,746,8551 3.087.279 3.367,155 3,006,192 3,244,738 Balance as at 30 June 2023 3.124,839 3,378,715 3.006,192 3,244.738 Deferred income compris85 incom8 from subscription$. tralnee reglslrallon, examinations, conferences and contlnulng professional d8v8lopment, received in advan￿, that wlll form part of incoming resources durfng the followlng financlal ye8r. The College was in recelpt of £500.000 of statutory funding for the year12022- £500.000) by w8y of grants for speclflc projects. All conditions relating lo thes& grants have been met in full. Page 32 Tho Royal College of Pathologlsts Notes to the Financlal Statements as at 30 June 2023 19. Mov•monts In Fund$ Icurrenl yearl Balance at 1 July 2022 Incoming Resourcos Outgoing R6￿UrceS Transfers Gains and Losses Balance at 30 June 2023 Re$trl¢ted funds Research Pool Fund Oliver Memorial Fund 8hagwan Slngh Fund Flynn Fund Kohn Memorial Fund Developmental Pathology Fund Intoma￿O￿al Challenge Events Fund Public Engagomenl Fund Furness Prize Fund Summer School Fund William Tong Memorlal Fund Pathology Portal Fund MTI Fund Arise Project Fund Galea Prize Fund Undergraduate P8lhology Fund Covid Port81 Fund Ghan8 Project Fund 22.289 121,978 62.912 165,655 29,831 19,462 22,733 2,531 159 35.040 2,689 941.899 50,297 51,391 5,006 37,047 40.000 22,387 132,330 68,865 163.904 34,521 22,166 22,832 2.249 3.217 1,162 2,302 588 319 99 17,0251 121 {12,0811 {251 14,160 4.793 8,028 4.127 2,385 {293} {1591 110.5271 12501 {164,162 15.127 11 506.012 220 222 22 162 175 12.293 542,040 1,000 40,640 2.450 1,283,749 50.517 49,104 5,028 37,209 40.175 7,635 1.985.761 {2,5091 14.658} 1201,6911 1,610,919 1.000 33,493 Unrestrlcted Funds Designated funds Propety Fund Cancer Reporting Fund EQA Fund SuslaSnablllly Fund Premises Matketing Fund 60th Anniversary Fund Examlnatlons Development Fund TechTh)logy Transformation Fund Major Repairs Fund Corporate M&mbershlp Fund Geneial Unrestr￿ted fund 28,821.494 31,298 50.000 52.997 28,874,491 22.935 18,363) 150.0001 50,000 13,3691 136.4401 18,0001 46.631 36.440 10,000 100,000 400,000 100.000 7.416 6,787,507 2.000 100,000 341.932 125,000 7.416 6.705,881 158,068) 25.000 8,898,166 19,099,406) 9,440,206 {9,415,3371 178,9971 198,611 Total Funds 37,955,074 232,104 38,212.047 The transfer from the de81gnated propety fund Is $0 as to m81ntsln the balance on the fund belng equal to Ihe net book value of tho land and bulldlngs less the capltal ou18tandSng on the mortgage loan. The transfer lo the summer Schools fund represents the Colleg8'$ share of the funding for thi$ aclivlly to match Ihal made by other Indl%Adu81 pathoksgy a8sociation$ who jointly Nn thi$ event. During the year the trustees resolv8d lo r￿desIgnate tho balancg on the EQA fund to establish th8 sustainability fund. Page 33 The Royal College of Pathologlsts Notes to the Flnanclal Statements as at 30 June 2023 19. Mov•monts In Funds {Prlor period) Balance al 1 July 2021 Incomlng Resources Outgoing Resources Transfers Galns and Losses Balance at 30 June 2022 R•strlcted funds Research Pool Fund Olivor Memorial Fund 8hagwan Singh Fund Flynn Fund Kohn Memorial Fund Developmental Pathology Fund Medkal Examiner Training Fund E.leaming Project Fund International Challenge Events Fund Publlc Engagement Fund Fumess Prize Fund Summer School Fund Willlam Tong Memorlal Fund P8thology Portal Fund MTI Fund Arisg Project Fund Gale8 Prize Fund Undergraduate Pathology Fund Cgvid Portal Fund Ghana Project Fund 22,278 164,215 88.486 240,056 41,290 26,050 24,617 SO,271 22,721 2,530 359 20,529 2,688 602,560 SO,271 57,682 5.003 37.028 11 543 157 643 22,289 121,978 62.912 165,655 29.831 19.462 {6211 142.1591 125.7311 {75.0441 111,4601 {6.5901 51 26 12 124,668} 150.297} 22,733 2.531 159 35,040 2.689 941,899 50,297 51,391 5,006 37,047 40,000 12001 13.511 1,000 500,326 26 30 (160,987) 16.321) 19 40,000 10.021 110,0211 {253,115) 1.458,634 585,384 1.000 {160,9841 1,610,919 Unr•s¢rict•d Funds Property Fund Cancer Reporting Fund EQA Fund Pr•mls8s Marketing Fund 60th Anniversary FLtnd ExÈmlnAlens Development Fund T&chn(Aogy Transformalion Fund Major Repalr3 Fund Corporatè M•mbarshlp Fund Genoral unreslrictsd fund 28,692,741 39,066 50,000 37,594 10,000 100,000 400,000 100,000 7,416 7,596,098 128,753 28.821,494 31,298 50,000 36.440 10,000 11)O,QOO 400,000 100,000 7,416 6,787,507 17.768} 11.1541 7,283,867 17.087,741} 1129,7531 1874.9641 17.349,7781 11,035,948) 37,955,074 Total Fund• 38,491.549 7.849,251 20. R•8trlctèd and dè8lgnatod fund8 Th8 Research P¢)ol Fund was eslabllshed Sn 1995 to promote r8saarch In pathology. The Ollv8r Memorial Fund was eslabllshed lo perpeluale the nam6 of Percy Lane Ollvei, by providing an annual national award for service lo b1¢￿￿ Iran$fusion, and for the furtherance of knowbdge relating to the princlples and practices of blood transfuslon. The Bhaowan Singh Fund w8$ establishe(J in 1982 to Sponsor occaslonal vI85ls between the UK and Malaysia, lo promote MalayEian p8thology. The Flynn Fund was established in 1998 to fund an annual le¢lur8 in clinical biochemlstry. A number of bursaries are awarded lo Iraln88s lo attend the scienlrfic m881ing where thè lecture Is delfvered. In th8 College's 60th annlver88ry ￿ar a Flynn Lecture is being hold in each nation of the UK, supported by th8 fund. The Kohn Memorfal Fund was estsblished in 1987 to fund an annual18Cture malnly in cllnlcal bio¢hgmi$try. The Devek)pmental Pathology Fund was estsblished in July 2004 as 8 gift from the Developmèntal Pathology Soclety lo fund an occasion81 named 'Emerf lecture in pa$dialric pathology. The Medlcal Examlnor Tralnlng Fund was estsbllshed by grant in ald from the Departm8nt of Health IEngLgnd) lo support th6 dtvèl¢)pment of a46arning m8terlals and face to fece Irolnlng for medical examlners of th8 caus8 ol death. Page 34 The Royal Coll•g• of Pathologlsts Noles to the Flnan¢lal Slaternents as at 30 June 2023 20. Rostrlcted and deslgnated funds Icontlnuedl The E-198ming Project Fund was eslablishad to fund the provision of electronic learning for pathology consultants and troinees, and was supported by grant in aid from 6leaming for Healthcare, fomerly part of Health Education England. The Pathology Portal Fund was establlshed by grant in aid from Health Education England lo develop and implement a cornpetencg based model of learning support on a digilal platform for pathology whSch would include digilisatlon of examlnations. The International Challenge Evènts Fund was est8blished lo raS80 funds for the College's Inl8rnaliono1 dev8lopment projects. The Publlc Engagement fund was established by way of a prize awarded by The Royal Society lo Dr Suzy Lishman for her work on bghalf of the Co118ge on public engaggment and is availab16 for the College's publlc engagement work. The Furness Prize lund was established in 2010 to fund an annLtal prlze In science communication in relat￿n to pathology. The Summer School Fund was established to collect and 8dminlsler the funds lo run the annual pathology summer school. whlch Ss funded and run In assoclats'on with a number of pathobgy specialist soclelles. The William Tong M9morial Fund w8S established by way of donations from Ihg family and friends of the late Willi¥m Tong to provide an annual prize lo a trainee in virology on the basis of a piece of work submilled as a poster. The MTI Fund was est*bli$hed by grant in aid from the Wesl London Cancer Alliance lo deliver trainirbg opportunities across London for intemalKJnal medical graduates in hislopathology 8s part of the medlcal tralnlng in1118tive. The Arlse Project Fund was established by Grant in Ald from the European Union lo fund the College's Involvement in a mulli-partner resear¢h project lo share and sprèad best practice Sn n6wbom 8creenlng, dlagnosls and Irgalmenl of Sickle Cell Dlseas8,18adlng lo Improvements In overall dl8ea8e outcome. The undergraduate pathology fund was establlshed to create undftrgradual8 and foundatlon taster evonts and materials lo support r8cruitmanl in pathology, and to provide bursaries under th* m8dlc81 elective scheme. The Galoa Prize Fund was eslabllshèd by way of glft from Metabolic Support UK to fund 8n annual prfze lo encourage research Into a therapy that VAII amelloral8 and In future help find a cure for metabollc dlsorders and Inherlled rare condltlons. The Covld Portal Fund was eslabllshgd lo fund a rosgarch project to interrogate the Covld post-mortem portal to provide leamlng from the pandemic which will bg diS￿minated by way of leanlng materials, webinars or scigntrfic papers. The Ghana Prolecl Fund was eslabllshed by Grant In Ald from The Tropical Health and EdUcat￿n Tru81 to produce webinars to support the new pathology curricul? of the Faculty of Pathology of the College of Physlclans of Ghana. The designgled property fund was estsbllshed lo hold the net book vahje of the College's functlonal promSses al Alie Street less the amount of the capital sum oulslanding on the mortgage loan. The deslgnateil cancer reporting fund was e8labli8hed to fund the College's shore of the commitment to the Inlemalional Collaboration on Cancer Reportlng, whos¢ aims arg to pursue global harmonisation of cancer dat8sets for pathology reportin9. The ICCR ha$ been incorporated as a not for profil organlsalion and the Collogg is a foundatK¥n mfrmber. The deslgnated EQA fund w88 èslabli8hed lo fund inlllal expendlture on Inlerprgtive EQA and technical EQA monlloring 8yslem8. The designal8d sustsinablllty fund was 8Stablish8d to support the Collég6's project to dellver and Impbment a ¢arbon reduction roadmap and nèt Zero stralogy. and to b8 available for goneral sustalnability initiatives. The doslgnated preml$es markellng fvnd was eslabllshed for expendlture on the marketing of the facllllles al Ali• Street that wlll generate revenue for tha Col*6 In subsequ8nt years. The designated 60th anniversary fund was established to fund activllles a$socl8ted wllh the 60th annlver8ary of the founding of the College, which will be on 21st June 2022. The desrgnaled examinations developmonl fund was estsbllshed lo fund the devebpmenl of the digilisalion of College 8xamln8tlons. The designated technology Iransformats'on lund was gslablished to fund the replacement of the College's central d8tabase system, which is an enterprise widè system incoiporallng membershlp, finance, examinations. training, CPD. ￿ljemIC symposla, and a dyn8mic Ilnk that integrates to the College ￿bsIte. The d881gnaled mathor repalrs fund wa8 established to create 8 Slnklng fund for the iepalr and replacement of major piecgs of plant ond equlpmenl wilhln the College's premisès al Aliè Street. The designated corporate membeiship lund was estsbll8hed lo fund tho d8velopm8nt and expansion of the Coll8g8'S corporate membership scheme. Page 35 The Royal College of Pathologlsts Notes to the Flnancial Statements as at 30 June 2023 21. Analysls of group ng1 as¥•ts be¢w•gn fund¥ {Curront y•arl Consolldatèd Tangible flxed assets Investments Net current assets Long term Total General unreslricled Designated Restricted 68,394 37,027,894 5.018.238 1,619,251 450,C(12 1,616,011 6,705.881 {7,957,4911 29.S20.405 1,985,761 369.750 N81 a88818 as at 30 June 2023 37,096.288 5,387,986 3,685,264 17,957,491} 38,212,047 21. Analysls of group ngl a¥¥gt• b•tw•on funds (Curront y•arl . Colleg• Tanglble fixed assets Investments Net CUT￿nI assets Long temi Ilabllltles Total General unrestricted Deslgnaled Reslricled 68,394 37,027,894 5,018,336 1.809.051 450,002 1,616,011 6.895,781 17,957,491) 29.520,405 1,985,761 369,750 Nel asset8 as at 30 June 2023 37,096.288 5.388.086 3,875,064 17,957,491138.401,947 21. Anatysls of group n•t a•s•ts be1w￿n fund¥ {Prlor y•arl - Con$olldatsd Tanglble fixed assets Investments Net current as$ets Long term Total General unreslrlcted Designated Restricted 341,716 37,435,700 4.836,767 1,609,024 443,905 1,214,521 6,787,507 18,322,957129,556,648 1,610,919 396,398 Net assets as al 30 June 2022 37.777,416 5,233,165 3.267,450 {8.322,957) 37,955,074 21. Analysis of group not ass•t# b•tw••n funds (Prior yaarl - Colleg• Tangible fixed assets Investments Nel current Long tenn assets Total General unre8lrfcled Deslgnated R6slricled 341,716 4.836.867 37,43S,700 2.028,507 443,905 1,214,521 7,207.090 (8,322,957} 29,556,648 1,610,919 396,398 Nel assets as at 30 June 2022 37,777,416 5,233,265 3,686,933 (8,322.957138.374,657 22. Prn$entatlonal currency The presentational currency is Steding. Page 36 The Royal College of Pathologists Pathology.. the science behind the cure Annual report 2022-2023 ## **Annual report 2022–2023** ## **Section 1** 1. Introduction: Supported pathologists. A stronger profession. Better care. 2. Welcome from the President. 3. Message from the Registrar. RCPath 1 AR Final ## **Introduction** ## **Supported pathologists. A stronger profession. Better care.** The Royal College of Pathologists is proud to support pathologists at every stage of their career. Over 125 trainees attended our 2022 New Trainees’ Welcome Day webinars where they were given information on all the ways we can support them through their training. The webinar included practical advice on how to use our Learning Environment for Pathology Trainees (LEPT) system and our exams process. We provided 29 educational events to support our members’ continuing professional development. This included webinars on how to implement our updated datasets and study days to discuss clinical cases. We increased the number of hybrid events to ensure members have equal opportunity to access learning opportunities regardless of where they live. 7 events were recorded and made available to watch on our website, providing greater flexibility for our members. We are committed to building a supportive and inclusive membership framework and shaping equitable and inclusive pathology practice. The College has formed a working group to examine the impact of gender-affirming hormone therapies on laboratory reference ranges and provide guidance on the interpretation of results, ensuring safe and equitable healthcare provision for transgender individuals. The clinical guidance we create, endorse and publish provides care standards and recommendations for healthcare professionals to optimise patient care. In late 2022, we published 2 multi-agency guidelines on ethical issues in prenatal genetic testing and genetic testing in childhood. The guidelines include examples of difficult ethical issues faced by patients. They aid decision-making by suggesting possible approaches to these challenges and key points both professionals and patients should consider. These represent just some of our work and initiatives from this year. Below you can read more about how we have worked this year to deliver for our members. RCPath 2 AR Final ## **Welcome from the President** Welcome to this year’s annual report. It has been a busy and productive year for us, and this report will give you a sense of what we have achieved for you as well as our future direction. This is the last annual report of my presidency. My presidency was marked by the COVID pandemic. We were also saddened by the death of Her Majesty Queen Elizabeth II, our patron. Coming out of the pandemic, the College renewed its focus on our members, with our highly successful ‘Your College, Your Profession’ national member engagement tour. The outcomes from this tour are shaping the future work of the College and how we meet the needs of our members. Our commitment to advocating for pathology, our members and their patients can be seen through the formation of our All-Party Parliamentary Group for Diagnostics this year, working with the Royal College of Radiologists. Diagnostic services are changing and are more in demand than ever. This group gives us a voice at the heart of debates, it provides a link between parliament, our members and their patients. None of our achievements, nor any of our work, would be possible without the effort and support of College staff, lay people and the huge number of members who work tirelessly to facilitate all we do. I would like to personally thank everyone involved in the College, in whatever function, for all your help and support. Without you, the College would not exist. Thank you. ## **Professor Mike Osborn** ## **President** RCPath 3 AR Final ## **Message from the Registrar** Over the last year, we have concentrated our efforts on delivering core activities that support pathology, our members and patients, at local, national and international levels. We worked with the Institute of Biomedical Science and the Association for Clinical Biochemistry and Laboratory Medicine to establish new guidance around tests that are delivered outside of laboratories. As a coalition, we also raised concerns about direct patient access to test results. There is a real risk that patients will access test results that are non-standardised, unexplained and uninterpreted. This work will improve the quality of data and information given to patients. The Pathology Portal, our online learning resource hosted by Health Education England, continues to grow in all specialties, with access being extended to our international members. The launch of our second virtual resources series in collaboration with the Ghana College of Physicians and Surgeons provides opportunities for continued professional development. This educational series will benefit both members and patients. We have trained nearly 2,500 medical examiners and over 600 medical examiner officers. This is an important step towards improving patient care and safety. It helps families where the cause of death of loved ones or post-operative care raises questions which can now be answered. Reflecting society at large, we work increasingly on equality, diversity and inclusion issues. We look to not only improve our diversity in all aspects with members, staff and the public, but also to improve workplace experiences and aspirations. Our strategy will evolve in response to the changes our members and healthcare faces. We look forward to working with you. ## **Dr Lance Sandle** ## **Registrar** RCPath 4 AR Final ## **Section 2** 1. Our progress in numbers 2. What we’ve achieved for our members RCPath 5 AR Final ## **Our progress in numbers** 218 new fellows welcomed across the College’s admission ceremonies in September 2022 and February 2023 149 new specialty registrars registered with the College 73 Certificate of Completion of Training (CCT) recommendations to the GMC 25 Certificate of Eligibility for Specialist Registration (CESR) evaluations ## **Guidelines and audits** 12 NICE-accredited guidelines were published 19 audits were published 27 audits were submitted to the audit certification scheme 167 NICE consultations were responded to 351 job descriptions were reviewed and approved 222 College assessors attended advisory appointment committees in England, Wales and Northern Ireland ## **Continuing professional development** 2,092 CPD returns were processed 5,303 people used our CPD portfolio 172 events were accredited for CPD 29,000 hours of CPD logged ## **Learning Environment for Pathology Trainees (LEPT)** 421 Multi-source feedback assessments were created 551 Annual review of competence progression (ARCPs) were created RCPath 6 AR Final 12,941 Workplace-based assessments were used in those ARCPs 219 Specialty ARCP outcome forms were created ## **What we’ve achieved for our members** ## Key achievement 1: Pension reform success With others, we successfully campaigned for NHS pension reform. We took every opportunity to show how flaws in the scheme were contributing to the pathology workforce crisis. The changes will help retain experienced pathologists. ## Key achievement 2: 46% increase in exam candidates We ran 58 exams for 2,277 FRCPath, Diploma, Certificate and Biomedical Scientist examination candidates. ## Key achievement 3: Progress in digital services We moved to a fully online experience for trainees tracking their annual review and competence progression through the LEPT system. The launch of this functionality will eradicate the need for paper copies. RCPath AR Final 7 ## **Section 3: Supported pathologists** From launching new educational platforms and resources to setting up international exam centres, we invest in you. ## **Investing in your career** The College continued to focus on making exams accessible for candidates globally. We collaborated with the Faculty of Pathology at the Royal College of Physicians of Ireland to set up exam centres in Ireland for FRCPath Part 2 exams in histopathology and haematology. This has made it easier for Irish candidates to sit exams as they no longer need to travel to the UK with their microscopes. We have also been able to accommodate more overseas candidates in the exam centres in Ireland as there are more options for obtaining visas. ## **Making opportunity fairer** The Medical and Dental Recruitment and Selection (MDRS) Recruitment Group changed their 2023 recruitment process after we made them aware of how changes to their recruitment timeline would be detrimental to diagnostic neurology and paediatric pathology recruitment. Following our intervention, we published advice to specialty trainees around exam timings and we now have a seat on the MDRS Recruitment Group so we will be part of any future discussions and decisions about postgraduate medical recruitment. We launched a range of LEPT instructional videos – both for trainees and those who support trainees. The videos help users to use the LEPT system to its full potential and functionality updates have improved users’ experiences and almost eliminated the need for paper copies. RCPath 8 AR Final ## **Stronger connections** We recruited 35 new country advisors across all 6 international regions. Country advisors are the link between our international members and the College. They reach out to members to get their views on regional issues and challenges, which drive the direction of our work and our priorities for that region. This has resulted in the launch of international pathology school events across various regions and the signing of 8 Memorandums of Understanding (MoUs). Outcomes from these MoUs include exams being hosted in Egypt, United Arab Emirates and Jordan, the revision of curricula and train-the-trainer and examiner training events in Nigeria. “It is a pleasure and a privilege to be the Lead Examiner of the Cairo FRCPath Examination Centre on behalf of the College, facilitating the opportunity for overseas students to take the exam in a location and environment closer to home. In addition, candidates get to visit lands that have a lot to offer in terms of culture and history, further enriching the candidates’ experience at personal and professional levels. I received an email from one of the candidates from Malaysia who sat the Exam in Cairo in January 2023, which reflects the multitude of benefits of overseas centres. The candidate wrote “I wandered off from a small country of mine to Cairo alone, and was initially slightly worried of how things will turn out. But everything was very well taken care of, from the delivery of pre-examination guidance, microscope checks, concise briefings, to the rotations chaperoned by the examination invigilators. No matter how the results turn out to be, I am glad that I had the opportunity to come to Cairo for this examination.” – Professor Mona El-Bahrawy, President of the Egyptian Committee for Pathology Training and Past-Immediate Country Advisor for Egypt ## **Making ourselves heard** Regional surgeries took place across the UK, providing opportunities for members in those regions to discuss areas of concerns that they wanted their representatives to bring to the attention of College Council. This surgery approach enables Council to be made aware of the issues our front-line members are facing. Members told us of their challenges, such as difficulties in filling vacancies in remote and rural areas, and current shortage of expert RCPath 9 AR Final neonatal pathologists in Bristol. The College has used its workforce data to show regional gaps in particular pathology specialties, responding to numerous consultations and appearing on various media channels, such as BBC 4’s File on Four and Sky News. We are now working with NHS England on the shortages in perinatal and paediatric pathologists. The College President and Vice President for Learning have approached the Medical Schools Council about the lack of pathology in undergraduate curricula and its effect on pathology recruitment. ## **Pathology Portal – innovation in knowledge-sharing** We launched the Pathology Portal in August 2022 – the culmination of a project that involved international pathologists, colleagues from other professional bodies and the Technology Enhanced Learning Team from NHS England. “I wish the Pathology Portal had been available when I was preparing for exams. There’s an abundance of well-annotated images, scanned slides, and helpful Q&As. It's brilliant to see integration of different pathology specialties, with the common goal of teaching the next wave of pathologists. I have recommended it to every trainee I’ve meet, and consultants as well.” Dr Nataliya Piletska, ST5 Histopathologist The Portal is free for all to use and focuses on delivering engaging and quality-assured learning resources. Its development and testing involved trainers and learners who would be using the Portal to create simple ways to upload content and access a wide range of media including video, audio, text, data, image and whole slide images, with annotation functions. - Our content includes nearly 5,000 cases and tutorials along with quizzes, podcasts and assessments. - 90% of Pathology Portal content is 5/5 star rated by users. RCPath 10 AR Final - The content has been accessed on average 7,000 times per month since the launch in August 2022. In response to feedback from the Portal community, we streamlined access through our website and produced demos and how-to guides. Access to the Portal has been expanded to our international members, and we worked with international regional advisors to promote the Portal and provide additional support. We collaborated with the Trainees’ Advisory Committee to spread awareness among trainees in different specialties. The Portal saw a spike in use and new users during the recent examination period, with the number of launches doubling and the number of people requesting access increasing by 45% on the previous month. “The neuropathology content provided is top-notch, covering a wide range of topics with clarity and depth. Self-assessment tools are available to track progress and identify areas that need further review. The broad range of content and user-friendly interface make it a valuable asset for all aspiring neuropathologists.” Dr Joseph Yates, Diagnostic Neuropathology SpR We review all feedback and requests for new content, working with a team of editors and international faculties to ensure content is available for everyone regardless of their career stage. We are delighted by the success of the Portal so far and continue to add new content and cover more specialties to better support the pathology workforce. - By the Pathology Portal team RCPath 11 AR Final ## **Section 3: A stronger profession** Through our work in parliament, the devolved nations and through the media, we have campaigned for change and raised pathology’s profile. ## **Campaigning for change** Following our campaign work highlighting chronic workforce shortages, in April 2023, NHS England announced a new drive to ensure cancer patients received test results within 10 days of referral. We have long lobbied for improvements in digital pathology and infrastructure. Our response to this initiative and the additional support announced for pathology services was quoted across various news outlets, including the Independent, Daily Mail and The Herald. “We welcome the announcement of support for pathology services which will help our members provide the quicker diagnoses that patients need. Pathologists have long asked for improvements in digital pathology and infrastructure to help them provide better patient care. We fully support this initiative and the fresh focus on pathology it will provide which, we hope, make a real difference to patients.” The long-awaited long-term NHS workforce plan was published at the end of June by NHS England and the Department of Health and Social Care. We campaigned and lobbied for its publication following continued delays, joining with other royal colleges and healthcare organisations. College President Professor Mike Osborn was interviewed by Sky News on the day of publication to give our initial response to the plan. We have campaigned for the removal of the cap on medical school training places for several years and we were pleased to see an increase in training places has been included in the plan. We welcome the 3-pronged approach of training, retention and reform. All these elements are vital, as is a long-term commitment to the plan if the real promise of this announcement is to be fulfilled. RCPath 12 AR Final ## **Planning for the future** The 8% increase in excess deaths in 2022 meant pathologists were unable to keep up with demand for post mortems. Our President was interviewed by Sky News where he used our workforce data to show shortages of pathologists to perform post mortems. He highlighted the issue of post mortems falling outside of NHS work, with pathologists having to prioritise them between their NHS work. Using workforce data from our members that showed the ongoing shortages in allergy consultants, we created briefings for MPs, other parliamentarians and policymakers prior to a debate on allergy services. Evidence from our report into shortages in allergy consultants was cited by Karin Smyth MP in a Houses of Parliament debate during Allergy Awareness Week, with a call for a fully funded workplace plan for the NHS that will meet increasing demand on allergy services. In Northern Ireland, the President and members of the regional council provided input into the BluePrint Programme workstreams that will see management of laboratory services move into a single regional pathology management structure. They attended a stakeholder meeting with other professional bodies, such as the Institute of Biomedical Science and Association for Clinical Biochemistry and Laboratory Medicine, to discuss possible options for this restructuring programme. They raised numerous queries including how different levels of staffing across trusts would be managed and the regional council continues to engage at every opportunity. In Scotland, a new diagnostic strategic network was launched to oversee the transformation of diagnostic services. It is vital that pathology services are considered for any changes to be realised and to ensure a sustainable service. The Scotland Regional Council has campaigned for pathology and College input into the framework. The Wales Regional Council contributed to reports on cancer services in Wales, highlighting the importance of integration of diagnostic services. NHS Wales launched its 3-year cancer improvement plan, which recognised the need for support for pathology services to deliver advances in genomic testing. RCPath 13 AR Final ## **Inspiring the next generation** We need to ensure that the pipeline for pathology recruitment is strong. With exposure to pathology limited in the undergraduate curriculum, our events with undergraduates and sixth-form students are vital opportunities to educate students and promote pathology careers. We hosted events in both the UK and internationally to offer medical students the chance to discover more about pathology, learn about the diverse range of pathology specialties and develop a greater understanding about the knowledge and skills required to pursue a career in pathology. The International Pathology School event in May drew undergraduates from across the Sub-Saharan Africa region and the Pathology Summer School welcomed 70 medical students for a 2-day event. We collaborate with the Social Mobility Foundation (SMF) on their national scheme that supports aspiring medics from under-represented groups. This year we worked with the SMF team and our members to deliver online workshops for sixth-form students on medical ethics and patient journeys. These events attracted over 150 students from around the UK. We are also supporting the SMF’s ‘Transitions Through Medical School’ programme. Our members are involved in mentoring and providing information about pathology careers. ## **Launching the All-Party Parliamentary Group for Diagnostics – championing our workforce** There has never been a more important time to establish an All-Party Parliamentary Group (APPG) to discuss and provide solutions to optimising diagnostic services, given the size of the diagnostic backlog. At the end of February 2023 there were 1.6 million patients waiting for a diagnostic test. Pathology results are vital to patients’ diagnostic pathways, ensuring that the patient receives the correct healthcare services at the correct time and in the correct place. RCPath 14 AR Final We run the APPG secretariat alongside the Royal College of Radiologists. Maggie Throup MP was recruited as chair and is joined by APPG officers from different political parties. The APPG will raise awareness of the diagnostic workforce and the challenges and barriers faced by them and patients through debates and discussions in parliament. It will influence policy by recommending and advocating for evidence-led solutions to improve diagnostic services. Members of the APPG heard from Professor Peter Johnson, NHS England’s National Clinical Director for Cancer. He answered questions from attendees, which included parliamentarians, charity and industry representatives. They raised issues around workforce capacity, genetic testing, quality assurance within screening programmes and NHS leadership. “…never has there been a more important time for diagnostics within the NHS. With the advent of the community diagnostic centres and the need to have an effective recovery plan for the NHS post-pandemic, this aspect of healthcare is high on everyone’s agenda. I am delighted that we have a range of MPs and Lords from across Parliament within the group. I am excited to work with them and I look forward to seeing what we can achieve together.” Maggie Throup, Chair of the APPG The APPG’s work programme has focused on the roll-out of community diagnostic centres (CDCs) and the planned expansion of this programme. We held 2 roundtables in parliament to gather evidence on the successes and challenges faced by CDCs. These sessions were attended by MPs, peers and senior policymakers. We discussed how the CDC programme is progressing in terms of the number, location and the services provided, as well plans for further roll-out. It is vital that patient’s voices are heard in debates around diagnostic services. The second roundtable focused on patient experience and regional case studies. We heard from colleagues with experience of setting up and running CDCs and discussed the most effective delivery of diagnostic services to patients and how CDCs fitted into that picture. Patients need services that are easy to reach and close to their homes. To deliver this, RCPath 15 AR Final there needs to be adequate staffing and resources. This was at the centre of the discussion. The APPG will continue its review of CDCs to provide a plan for how these centres should operate in the future, to improve outcomes for patients. Recommendations from the roundtables will be presented to the Secretary of State for Health, and the Health and Social Care Select Committee. ## **Our work to address shortages in paediatric pathology – fighting for pathology services** The acute shortage of perinatal and paediatric pathologists across the UK has become a crisis after decades of under-funding and under-staffing. Over the last year, we have worked with NHS England, healthcare organisations, parliamentary groups and the media to raise awareness of the impact of shortages and to provide solutions. These pathologists provide vital services to young people and bereaved families. They diagnose and treat illnesses including genetic disorders, congenital diseases and cancers in children up to 18, and investigate and diagnose illnesses that affect unborn babies, newborns and infants. They investigate causes of pregnancy loss, miscarriage, stillbirth and neonatal disease. Their findings can aid decision-making and treatment in subsequent pregnancies and lead to improvements in care. However, around 30% of perinatal and paediatric pathology vacancies remain unfilled. There are regional disparities in the workforce, leaving Northern Ireland and Wales with either no one or a single person in post. Our workforce data was included in the joint report on safe maternity staffing levels published by the Baby Loss and Maternity All-Party Parliamentary Groups in October 2022. We highlighted that the current number of trainees is insufficient to fill vacant consultant posts. These need to be filled for safe staffing levels. There is also a postcode lottery in terms of how long bereaved families are waiting for post-mortem results compounded by uneven distribution of perinatal pathologists across the UK. RCPath 16 AR Final Dr Srinivas Annavarapu, Chair of our Perinatal, Prenatal and Paediatric Pathology Specialty Advisory Committee, was interviewed by BBC Radio 4’s File on Four as part of their programme ‘How did my child die? The crisis in paediatric pathology’. Dr Annavarapu highlighted the effect shortages have on bereaved families, particularly in the coronial system, and why recruitment is difficult. “Only 55 of the 80 full-time equivalents perinatal and paediatric pathology posts in the UK are filled, leaving 25 vacancies...” We are working with NHS England on the issues facing the workforce and have joined their Perinatal Pathology National Group as a key partner. This group will oversee all work and action areas linked to perinatal pathology services. We are asking for retention salary premiums to retain the current workforce, funding for additional training posts to address the disparity between current vacancies and the number of trainees coming through, and online delivery of the paediatric and perinatal pathology curriculum to address the postcode lottery in training places. There is an opportunity to look at new approaches, such as 1-year bridging courses for general pathologists and upskilling of biomedical scientists to undertake a 2-year diploma course in placenta reporting. We will continue to advocate to increase the number of perinatal and paediatric pathologists across the UK to improve the service offered to patients and bereaved families. RCPath 17 AR Final ## **Section 3: Better care** We work with members and the public to showcase service excellence and improve health outcomes worldwide. ## **Raising pathology standards** We published 12 NICE-accredited clinical guidelines over the past year and work started on a further 19. 4 webinars to support pathologists with the implementation of new and revised clinical guidelines were delivered. Over 130 people attended the webinars and the recordings have had over 950 views. “Clinical guidelines are one of the most important outputs of the College and frequently represent the most visited pages on the website. They are expert-led guidelines that incorporate valuable feedback from the wider College and pathology community and are very influential in improving pathology quality nationally and internationally. The guidelines are frequently cited by other healthcare quality organisations as providing the benchmark for pathology practice. I feel very privileged to have played a small part in guideline production and to have worked with the numerous expert pathologists we have as members.” Dr Brian Rous has worked on College guidelines since 2012 Our clinical guidelines continue to improve both patient care and patient outcomes. A number of our guidelines covering placental examination, perinatal post mortems, and staffing and workload for paediatric and perinatal pathology departments were cited in the interim policy statement from NHS England, and the Scottish and Welsh governments that set out criteria for perinatal post-mortem investigation of fetal and neonatal deaths in England, Scotland and Wales. The new guidance was published to support greater standardisation in access to services and to make the most of the limited capacity and resources of perinatal pathology departments. None of this work would be possible without members and volunteers who give their time to author and provide expert input into the guidelines. RCPath 18 AR Final “The work that goes into the production of clinical guidelines is significant. It is an opportunity to update oneself, and review literature and guidelines of other societies, thus constituting a vital aspect of assuring standards and providing a quality framework. It is an opportunity for senior authors to include relatively junior consultants in the writing of the guidelines. Being part of the College’s guideline programme and its role in supporting and guiding quality assurance is important and worthwhile.” Raji Ganesan has been authoring guidelines for 10 years We jointly published the ISO 15189:2022 position paper that sets standards for quality and competence in laboratories with the Institute of Biomedical Science and Association for Clinical Biochemistry and Laboratory Medicine and in collaboration with the United Kingdom Accreditation Service. The paper provides an overview of the key changes to the standard, which is patient focused and promotes continuous improvement in laboratories, to help healthcare professionals implement new requirements and recommendations for laboratories to perform gap analysis. ## **Delivering high-quality training resources and opportunities** Our International team works alongside international members to improve health outcomes of people and communities around the world. In May, we launched phase 1 of our second series of Ghana College of Physicians and Surgeons (GCPS) virtual resources. This is a continued collaboration with the GCPS and the Tropical Health and Education Trust made possible by funding secured from the UK Department of Health and Social Care. So far, 14 video lectures have been released and there were over 600 views in the first week of launch. The lectures are part of a programme by GCPS to ensure the training of their residents meets international standards. They highlight new knowledge and insights, enabling better practice, patient management and care and improve outcomes, helping to tackle some of the shared challenges facing pathology services in Ghana and the UK. RCPath 19 AR Final ## **Educating people about their care** This year’s National Pathology Week was centred on the theme ‘Pathologists and Patients’, inspiring a vast range of public events around the UK. National Pathology Week provides a focal point for educating the public on the vital role of pathology teams in their care and contributes to our mission to further public education in the field of pathology. The College held several online events aimed at medical and veterinary undergraduates, Foundation doctors and families. Through our continued partnership with the Social Mobility Foundation, our members delivered events for sixth-form students interested in pursuing medical careers. We also collaborated with Lab Tests Online UK to promote patient information pages that help people understand the different clinical laboratory tests used to prevent, diagnose and treat disease. Our Public Engagement team also supported members to run events. In Cardiff, Dr Jonathan Kell was joined by colleagues to raise awareness about inherited blood disorders, offering free screening. During the day, they screened 83 people for disorders such as sickle cell. Biomedical and clinical scientists in Belfast City Hospital held a lab open day for their nursing colleagues, highlighting the multidisciplinary effort to deliver pathology services. An interactive stand at Great Ormond Street Hospital gave patients and visitors the chance to examine slides from different parts of the body under a microscope and to speak to the scientists and laboratory staff who are involved in their care. The Lord Mayor of Northampton, Councillor Stephen Hibbert, attended Care Fertility's event, which involved Scientist Training Programme students talking with patients about fertility screening tests. ## **Recognising and celebrating service excellence** For International Pathology Day 2022 we hosted a hybrid conference exploring how laboratory medicine has adapted to global health developments and challenges. International Pathology Day continues to grow. It is an opportunity to recognise and celebrate the achievements of pathology services in addressing global health challenges and find solutions to improving patient outcomes. RCPath 20 AR Final We were delighted to welcome our keynote speaker Dr Michael Ryan, Executive Director of the WHO Health Emergencies Programme, who spoke of the vital role and innovation of pathologists in supporting the WHO’s response to disease outbreaks. Other speakers discussed issues affecting patients in their countries and the solutions that are in place, important partnership programmes and their outcomes, and improvements to laboratory services in low- and middle-income countries over the last 20 years. The roundtable discussion reflected on how the College’s international activities have evolved since it was founded. All panellists had contributed to and shaped the international work of the College and they shared their highlights. The international reach and membership of the College has grown thanks to the work of the panellists, our International team and committee, international and regional advisors, and many more. At this year’s RCPath Achievement Awards, we celebrated excellence in pathology services through teamwork and 5 teams received awards. The 5 teams represented a range of specialties, including medical microbiology and virology, reproductive science and haematology, and provide services across the UK and in Sri Lanka. The services recognised have made a difference to the care patients receive. This includes reducing the number of times cancer patients have to attend hospital for treatment, improving the accuracy of embryo selection during IVF, and introducing molecular testing in state hospitals across Sri Lanka ensuring equal access. ## **Cervical screening – Each sample represents a person** “ _I’d assisted in many speculum exams and smear tests … Despite this, I found myself worrying and apologising for the same things when on the other side”_ , says Dr Lydia Billington, a volunteer for Jo’s Cervical Cancer Trust, who attended her first smear test in 2020. In February 2023, we endorsed a report by Jo’s Cervical Cancer Trust that set out recommendations on how to eliminate cervical cancer in the UK and included contributions from pathology specialty experts. Read more about Lydia’s experience and how the RCPath 21 AR Final cervical screening programme has changed over the years from Dr Paul Cross, a consultant cellular pathologist. _“I went for my first smear test as soon as I was invited in January 2020. There is anxiety surrounding a stranger seeing very private parts of yourself. It’s exposing and embarrassment comes naturally. I was also worried it would be painful. I’d worked on a ward and assisted in many speculum exams and smear tests. You naturally provide reassurance, helping to ease people’s concerns when they apologise for their body hair or for how they may look or smell. Despite this, I found myself worrying and apologising for the same things when on the other side._ _My smear went very smoothly. Quick and painless. It was my first smear and I was young, so I thought that it had to be normal. My results letter came through – I had HPV and cell changes, along with a pre-booked appointment for colposcopy. It was a massive shock and I broke down. I wanted to know everything. What type did I have? Who did I get it from? How long have I had it? Will I put my partner at risk? What does it mean for me and the future?_ _You do feel like it’s your fault. I felt very emotional and, even though I know the science and the facts, you can’t help but blame yourself. The stigma surrounding HPV and its links to promiscuity play into this. It was scary to know that without my smear test, I would not have known I had HPV. Waiting for my colposcopy was horrible. I was anxious that during this time it might have got worse and I couldn’t stop worrying that I could be a 25-year-old with cervical cancer.”_ The cervical screening programme (often referred to as a smear test) involves multiple healthcare professionals and pathology plays a key role. The cervical screening programme has undergone changes that have altered the laboratory landscape, moving to a human papillomavirus (HPV) primary screening test. Certain types of HPV are associated with nearly all cervical cancer and up to 99.8% of cervical cancer cases are preventable. HPV primary screening tests for so-called high-risk HPV types. If a high-risk HPV type is identified, a cytology test is prepared from the same sample for examination under a RCPath 22 AR Final microscope. Cytology staff look at these prepared samples for cell changes, which may indicate pre-cancerous or cancerous cervical change. HPV awareness is still low and being told you have HPV can be a shock.* For the 15% or so of women and other people with a cervix** who are positive for high-risk HPV, about 1 in 3 will show cellular abnormalities that require referral for colposcopy. A colposcopy is a test that takes a closer look at your cervix and can reveal features suggestive of precancerous changes, and rarely cervical cancer itself. _“I attended my colposcopy and the staff were very kind and put me at ease. We had an initial conversation about what we knew so far. They explained the screening process; they test for HPV first and look for cell changes only if you are HPV positive. They showed me pictures of the different levels of changes and what each would mean in terms of needing a biopsy or treatment, depending on what they saw that day. It was very informative and I felt like I was in knowledgeable and safe hands. They used a speculum, applied some liquids to my cervix to highlight any changes and then looked closer with a microscope. They are sat within a few inches of you. Feelings of embarrassment started to creep in. I could see what they were seeing on a screen. There was an adrenaline rush as it came into focus and waiting to hear what they’d seen and what might be next. The nurse said my cervix looked healthy and normal and didn't require treatment, but that I was to attend a further smear test in a year.”_ 5.1 million women were invited for cervical screening in England between 2021 and 2022, with around 3.5 million attending for testing. This resulted in 235,223 women being referred for colposcopy. These are staggering numbers, and each sample, each screening test, represents a real woman. This must never be forgotten by laboratory staff, where it can be so easy to do so under the weight of such a large volume of tests. _“I was glad to not need a biopsy or treatment and I also felt reassured that I didn’t have to wait 3 years for my next test. I had my repeat smear test, this time during the pandemic, at the beginning of 2021 and the results were fine. I was HPV negative. Despite this, I will never forget that I once had HPV. I know that it’s something I might get again. It’s_ RCPath 23 AR Final _something I’m learning not to be ashamed of and I’m almost there. I wish it wasn't seen as such a dirty word.”_ Despite the UK cervical screening programmes being among the largest in the world, about 3,200 cases of cervical cancer are still identified each year across the UK, with around 850 women dying. Women must be encouraged to attend when invited. Efforts are underway to do this. This includes trials of at home self-testing and publicity campaigns. All of those working in laboratories are working hard to improve and deliver the screening programme and help reduce, and hopefully one day, eliminate cervical cancer. ## **Further information** *The work of Jo’s Cervical Cancer Trust is key in providing support to women with cervical cancer, as well as undertaking research and providing information for healthcare professionals on patient experience. Detailed information is given in the leaflets provided to all women at screening and organisations such as Jo’s Cervical Cancer Trust run helplines to answer any questions women may have. **In this story, the term women is used to cover women born with a cervix, a trans man and/or other non-binary person who was assigned female at birth, or a man who has a difference in sex development or is intersex. ## **The fight against antibiotic resistance** What happens when bacteria and viruses stop responding to medicines? Antimicrobial resistance is one of the most pressing health threats facing the world. It is estimated that by 2050, 10 million a year could die from antibiotic-resistant bacterial infections. Action is needed now to reduce inappropriate use of antimicrobials in humans and animals and develop new antimicrobials and alternative treatments. We responded to calls for evidence on the government’s new 5-year antimicrobial resistance national action plan. We asked for greater investment in diagnostic testing capacity and strategies to better support antimicrobial prescribing. RCPath 24 AR Final Our Vice President for Learning, Professor Angharad Davies, attended the ‘Race against resistance’ roundtable hosted by Malaria No More UK and the APPG for Malaria & Neglected Tropical Diseases, giving our perspective on the crisis. Effective diagnostic tools are vital to understanding resistance patterns and our international work in this area was highlighted as an example of good practice. ## **Stewarding antibiotic use in Nigeria** ## **By Dr Kenneth C Iregbu and Professor Samuel S Taiwo** Antimicrobial stewardship (AMS) is a major strategy to combat the challenge of antimicrobial resistance. However, awareness levels of AMS in Nigeria are low, especially among physicians, and AMS implementation is even lower. Only 10% of healthcare institutions surveyed in 2021 had some form of AMS activity. A major reason for this is poor education and lack of understanding of AMS strategies among key stakeholders. The National Postgraduate Medical College of Nigeria (NPMCN) and the Royal College of Pathologists collaborated to provide AMS training to Nigerian healthcare professionals. The online lecture series included speakers from both Nigeria and the UK, offering different perspectives from varied backgrounds. ## **Impact of the series** Feedback from the series highlighted the importance of these collaborations, with many attendees detailing how they would implement the strategies discussed. _“As a result of this training, I will introduce infection prevention and control in the Ministries of Health, Agriculture and Environment.”_ _“I will implement AMS interventions such as antibiotic guidelines, starting with start and then focus, antibiotic ordering and review.”_ _“Date, audit, prescribing apps and games are some of the AMS intervention strategies that I hope to introduce into my facility.”_ RCPath 25 AR Final _“Having speakers from the UK and Nigeria was a great idea because participants were able to have access to the experiences of the speakers from different countries, thereby giving them a broader perspective to AMS.”_ _“Alternating the presenters made a valuable mix, allowing for the interface of experiences from different backgrounds.”_ Building from this training, the Clinical Microbiology and Infectious Diseases Society of Nigeria (CLIMIDSON) is developing national guidance documents for implementing sustainable AMS across all levels of healthcare facilities in Nigeria. Following the lecture series, attendees have reported: - improved AMS knowledge among healthcare workers – evident by the high number of healthcare facilities in Nigeria participating in the 2022 World Antibiotic Awareness Week - a more cautious approach to antimicrobial prescribing by doctors, and dispensing by pharmacists - increased efforts to engage stakeholders from primary and secondary healthcare settings, and animal, veterinary and environment sectors - increased partnership support by internal bodies, resulting in the launch of AMS committees to implement new AMS activities and quality improvement projects. AMS advocacy work must continue. We encourage facilities to implement evidence-based AMS interventions and monitor the performance of their AMS programmes with quality indicators. This is a global fight and we must all do our part. RCPath 26 AR Final ## **Section 4: Our governance** ## **Our new strategy and path to value for our members** As I reach the end of my term as Chair of Trustee Board I can reflect on how it has matured in ensuring effective governance of the College. While medical and professional matters are overseen by Council, it is the trustees who ensure the integrity and viability of the College. Over the past year, we have reviewed the College strategy and we now have a clear path that will enable the new Trustee Board to continue to build on the success of the College. Throughout this review we kept in mind that the College is its members, you, and the Board regularly challenges itself to ensure we are providing value for members and able to support you. With a new membership manager and specific strategic intent, member engagement will have greater focus. During 2023, the College started its ambitious digital transformation project that will provide new and improved services to our members. We also began developing our Net Zero strategy and carbon reduction roadmap. Climate change is inextricably linked to the development and spread of diseases across communities. It is important that we take steps to reduce our carbon impact to be consistent with our aims, values and purpose. It has been an honour to be part of the College and to see the strength, governance and focus of the Board grow, providing continued strong foundations for the development of the College. Robert Smith, Chair of Trustee Board RCPath 27 AR Final ## **Trustee Board and College Council (as at 30 June 2023)** ## **Trustee Board** Mr Robert Smith, Chair and Lay Trustee Professor Michael Osborn, President Professor Sarah Coupland, Vice President for Communications Professor Angharad Davies, Vice President for Learning Professor Peter Johnston, Vice President for Professionalism Dr John Ashcroft, Treasurer and Chair, Intercollegiate Committee on Haematology Dr Lance Sandle, Registrar Dr Stephen Morley, Assistant Registrar Dr Gareth McKeeman, Chair, Northern Ireland Regional Council Dr Bernard Croal, President Elect and Chair, Scotland Regional Council Dr Anu Gunavardhan, Chair, Wales Regional Council Dr Anita Hill, Co-opted Trustee Dr Elijah Matovu, Co-opted Trustee Mr Vincent Voon, Incoming Chair and Lay Trustee ## **Council Members** Professor Michael Osborn, President (Chair) Professor Sarah Coupland, Vice President for Communications Professor Angharad Davies, Vice President for Learning Professor Peter Johnston, Vice President for Professionalism Dr John Ashcroft, Treasurer and Chair, Intercollegiate Committee on Haematology RCPath 28 AR Final Dr Lance Sandle, Registrar Dr Stephen Morley, Assistant Registrar Dr Gareth McKeeman, Chair, Northern Ireland Regional Council Dr Bernard Croal, President Elect and Chair, Scotland Regional Council Dr Anu Gunavardhan, Chair, Wales Regional Council Mr Robert Smith, Chair, Trustee Board Professor Ismail Matalka, Chair, International Committee ## **Nationally Elected Council Members** Professor Simon Cross, Elected Professor Roger Feakins, Elected Dr Giovanni Satta, Elected Dr Ravinder Sodi, Elected ## **Regionally Elected Council Members** Dr Laszlo Igali, Elected Member (England, Midlands and East) Dr Rachael Liebmann, Elected Member (England, London) Dr Negar Maghsoodi, Elected Member (England, South) Dr Alison Robb, Elected Member (England, North) ## **Co-opted Council Members** Dr Lisa Ayers, Chair, Healthcare Science Committee Professor Neil Anderson, Chair, Clinical Biochemistry SAC Dr Sian Morgan, Chair, Genomics and Reproductive Science SAC Dr Darren Treanor, Chair, Digital Pathology Committee RCPath 29 AR Final ## **Observers to Council By Invitation** Dr Shubha Allard, Clinical Director of Publishing and Engagement Dr Srinivas Annavarapu, Chair, Prenatal, Perinatal and Paediatric Pathology SAC Dr Adrian Bateman, Chair, Cellular Pathology SAC Ms Joanne Brinklow, Director of Learning Dr Sophie Roberts, Chair, Trainees Advisory Committee Professor Nicki Cohen, Clinical Director of Examinations Dr Nigel Cooper, Chair, Forensic Pathology SAC Dr Paul Craig, Chair, Dermatopathology Sub-Committee Professor Paul Cross, Chair, Cytopathology Sub-Committee Ms Diane Gaston, Director of Communications Dr Anita Hill, Co-opted Trustee Lt Col Dr Emma Hutley, Military Observer Dr Jan Kalpwijk, Chair, Toxicology SAC Professor Mary Keogan, Dean, Faculty of Pathology, Royal College of Physicians of Ireland Professor Roberto La Ragione, Chair, Veterinary Pathology SAC Dr Suzy Lishman, Chair, Medical Examiners Committee Dr Mike Eden, Clinical Director for Safety & Quality, and Chair, Quality Assurance in Pathology Committee Dr Sanjiv Manek, Clinical Director of Examinations Professor Jo Martin, National Specialty Advisor for Pathology, NHS England/Improvement Dr Elijah Matovu, Co-opted Trustee RCPath 30 AR Final Professor Ronan McMullan, Clinical Director of Training & Assessment Dr Shruthi Narayan, Chair, Transfusion Medicine SAC Ms Joanna Andrew, Institute of Biomedical Science Representative Mr Nigel Pollard, Director of Corporate Services Dr Natasha Ratnaraja, Chair, Joint Medical Microbiology and Medical Virology SAC Professor David Roberts, Chair, Research Committee Mr Daniel Ross, Chief Executive Professor Sebastian Brandner, Chair, Neuropathology SAC Ms Katherine Timms, Director of Professional Practice Dr David Turner, Chair, Histocompatibility and Immunogenetics SAC Mr Vincent Voon, Incoming Board Chair and Lay Trustee Dr Patrick Yong, Chair, Immunology SAC Dr Esther Youd, Chair, Death Investigations Committee RCPath 31 AR Final