Company Number: 01213983 Charity Number: 268396 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **ANNUAL REPORT AND UNAUDITED FINANCIAL STATEMENTS** 

**31 MAY 2021** 

RSM UK Tax and Accounting Limited Third Floor, One London Square, Cross Lanes, Guildford, Surrey GU1 1UN 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT for the year ended 31 May 2021** 

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The trustees present their report and the financial statements of The British Society for Surgery of the Hand (also known as “BSSH” or “the Society”) for the year ended 31 May 2021. 

The financial statements have been prepared in accordance with the accounting policies set out in the notes to the financial statements and comply with the Charities Act 2011, the Companies Act 2006, the Memorandum and Articles of Association of the charitable company, and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019). 

## **OBJECTIVES AND ACTIVITIES** 

## **Charitable objectives** 

The charitable objective for which the charity is established is as follows: 

To promote and direct the development of hand surgery, to foster and co‐ordinate education, study and research in hand surgery, by disseminating knowledge among members of the medical and allied health professions. 

## **Charitable activities** 

In pursuance of its charitable objectives, the Society’s principal activity is the dissemination of information as it relates to the specialty. 

Each year, this activity is undertaken in a number of ways by BSSH: 

- Leading and guiding professional practice and being responsive to the needs of constituent members of the Society; 

- Forming a governing body to formulate and implement policy and manage the affairs of the Society; 

- Undertaking specific hand surgery related projects through its committees; 

- Defining professional competency in terms of knowledge and skills; 

- Promoting under‐graduate and post‐graduate education and continuing professional development; 

- Advancing the science of hand surgery by stimulating and supporting research and disseminating knowledge at scientific meetings and through the Journal of Hand Surgery (European Volume); and 

- Being responsive to the needs and aspirations of patients and their representatives. 

The membership of the Society is composed mainly of consultant and trainee Orthopaedic and Plastic surgeons who have an interest in hand surgery. As part of their subscription to the Society, members receive the Journal of Hand Surgery, as well as details of current events such as hand surgery conferences and information on recent and relevant hand surgery issues. BSSH subscribes to the International Federation of Societies for Surgery of the Hand and the Federation of European Societies for Surgery of the Hand, thereby affiliating BSSH members to both these organisations. 

The Society normally organises two scientific meetings each year, to disseminate new medical information to members and others. The meetings consist of original papers, lectures, symposia and poster presentations. They play an important part in the training of hand surgeons and the continuing medical education of consultants. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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The Society also organises Instructional Courses in Hand Surgery comprising eight two‐day courses, held over a four‐year period. The series of courses covers the entire spectrum of surgery of the hand and wrist, making it the most comprehensive teaching in this field in Europe. 

The Journal of Hand Surgery (European Volume) is owned by the Society and published by SAGE. The Editor of the Journal’s role is to review and edit the papers submitted for publication with support and assistance provided by the Editorial Assistant and Editorial Board. The Committee of Management of the Journal provides supervision of the commercial production and marketing aspects of the Journal. 

The Education and Training in Hand Surgery Committee works to further the education and training agenda of the Society. Its remit includes the inception, development, promotion, and maintenance of activities relating to continuing professional development both of trainee and established surgeons. Educational, Travel and Student Elective bursaries and video prizes are awarded on the recommendation of this committee. The Committee also receives applications for the Stack Fellowship in memory of surgeon Graham Stack. The Fellowship is awarded to enable visits to hand surgery centres of excellence and interest both in the UK and internationally. 

The Research Committee advances and facilitates hand surgery research amongst the membership of the BSSH. The Committee reviews applications from members for an annual research fellowship as well as grants intended principally to pump prime early studies and systematic reviews that may lead to applications for larger funding from other organisations. 

The Communications Committee increases public, organisational and medical awareness of hand surgery and hand surgeons. It aims to optimise communication within the BSSH to increase connectivity, engagement and understanding amongst patients, surgeons, allied medical professionals and the general public. 

The Trauma Committee advances hand trauma care in the UK through producing standards of care for hand injuries, developing a hand injury prevention strategy, maintaining the hand injury triage app and developing clinical networks for hand trauma. 

The Audit and Hand Registry Committee advances and facilitates audit for the membership of the BSSH, and provides audit capability by maintaining, updating and upgrading the BSSH UK Hand Registry and website. The Committee oversees the annual UK Hand Registry award which supports proposals for research projects that can utilise existing and future data collected through the UK Hand Registry. 

The Overseas and Overseas Trainee Committees develop and coordinate sustainable educational and surgical projects across the developing world and aim to deliver maximum possible benefit for patients in need of hand surgery in the developing world. The Trainee Committee, created in May 2020, specifically seeks to involve trainee surgeons in the overseas work of the BSSH. The Committee manages the BSSH Overseas Fellowship which facilitates trainee involvement in global hand surgery. 

The Society has, in partnership with the University of Manchester, developed the Postgraduate Diploma in Hand Surgery. This is a validated programme of study, and on successful completion the Diploma in Hand Surgery is awarded. The programme is a distributed learning system with 8 taught modules that include locally administered coursework assessments and a final examination. 

The Society has established an MSc in Hand Surgery. This one‐year course is available to those candidates who have successfully completed the diploma course and who then choose to progress to a higher postgraduate qualification in Hand Surgery with the BSSH and in conjunction with the University of Manchester. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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The Society’s website is maintained professionally and updated by the Secretariat and Webmaster. The site provides information on all aspects of hand surgery for the members, medical professionals and the general public. 

The Society is represented by Delegates to the International Federation of Societies for Surgery of the Hand (IFSSH) and the Federation of European Societies for Surgery of the Hand (FESSH). A Council member and two further BSSH members also serve as representatives on the FESSH Hand Trauma Committee. BSSH also has representatives on the examination board of the FESSH Diploma. 

## **Indicators, milestones and benchmarks** 

The trustees monitor a range of measures by which to try to determine the success of the charity in meeting its objectives. These measures include: 

- Level of membership as a percentage of total eligible consultants, and the trend over time (increasing or decreasing); 

- Levels of interest in trustee and committee roles; 

- Attendance at the bi‐annual scientific meetings; 

- Feedback from delegates attending the scientific meetings, the uptake on new initiatives to encourage attendance, and feedback on individual sessions, papers, and lectures at the scientific meetings; 

- Numbers of papers submitted for the scientific meetings; 

- Circulation, readership and impact factor of the Journal of Hand Surgery; 

- Number of papers submitted for publication in the Journal; 

- Requests for publications including abstracts and papers; 

- Throughput of delegates taking the Instructional Courses in Hand Surgery; 

- Number of applicants for the Diploma in Hand surgery; 

- Levels of interest expressed in the range of grants offered by the Society; and 

- Number of visits to the Society’s website and feedback from visitors. 

## **Public benefit** 

The trustees have taken The Charity Commission’s general guidance on public benefit (contained within the recent publication “Charities and Public Benefit”) into consideration in preparing their statements on public benefit contained within this trustees’ annual report. 

## _Benefits and beneficiaries_ 

In accordance with its charitable objectives, the Society strives to improve patient care and to improve the quality of medical and surgical care for the benefit of patients within the specialty of hand surgery. The charity’s ultimate beneficiaries are therefore patients, and benefits to patients are provided through continuing dissemination of information in relation to the specialty by the Society. 

## _Trustees’ assessment of public benefit_ 

In relation to the assessment of public benefit, the trustees believe that the contribution of BSSH to the education and training of hand surgeons in the UK directly improves patient care. The trustees aim to confirm this by direct interaction with the public. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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During the period in question, the trustees gathered the following evidence that demonstrates to their satisfaction that BSSH continues to benefit the public through its activities targeted to achieve its charitable objectives: 

- Continuing engagement with the membership; 

- Diversifying its educational offer during the global pandemic to continue to provide high quality educational events online; 

- Monitoring attendances at and interaction in the scientific meetings; 

- Numbers of individuals attending the Instructional Courses and the Diploma in Hand Surgery; 

- Surveying delegates who attend Scientific Meetings and Instructional Courses to comment on how their attendance at such meetings and courses will ultimately be of benefit to their patients; 

- Co‐opting a lay person for a three‐year period to attend Council meetings and thereby help to inform the Trustees directly on public benefit. This is being furthered by an initiative appointing lay persons to all Committees. The Society is also considering options to further this initiative with the appointment of a new Public and Patient Initiative Lead; 

- The Society, through the work of its Education and Training Committee, has undertaken to improve the patient information leaflets available on its website; 

- Creating a scheme to offer training opportunities to allied health professionals in aspects of hand surgery, improving care for patients treated at primary care level; 

- Creating a working group to engage with NHS England, The National Institute for Health Care Excellence (NICE) and the national Getting It Right First Time (GIRFT) programme to drive up hand surgery standards across the UK, which will ultimately improve outcomes for patients; and 

- Creating a series of press releases and/or campaigns to improve public awareness of common hand injuries. 

## **Grant making policy** 

The range of grants offered by the Society is developed and awarded on the recommendation of the relevant subcommittees. Where appropriate, application forms are provided, and the subcommittee assesses applications and applicants prior to making awards. Awards in excess of the current framework are given should the applications be deemed worthy in excess of the prescribed amounts. 

The following grants are advertised annually and are available by application and peer review allocation: 

- Education and Travel Bursary. These individual grants of £5,000, with total funding of £20,000 per annum, are for members who wish to travel to centres of hand surgery, nationally and internationally and can be used to cover travel and accommodation. 

- BSSH Educational Grants. An annual amount of £10,000 is available per year for any activity supporting education and training relating to the management of patients with hand pathology. 

- UK Hand Registry Award. An annual award of £2,000 to support proposals for research projects that can utilise existing and future data collected through the UK Hand Registry. 

- Medical Student Elective Bursary. The BSSH offers four annual bursaries of £1,000 to support medical student elective programmes in Hand Surgery. 

- Pulvertaft Essay Prize. The Society offers a prize of £1,500 for an essay on a topic decided by the President of that year. 

   - Carpal Tunnel Syndrome Patient Information Package. The BSSH, in collaboration with the British Association of Hand Therapists (BAHT), has commissioned 4 unique awards totalling £1,000 to support the development of an information package for patients undergoing surgery for Carpal Tunnel Syndrome. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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- Educational Video Presentation Prize. Two prizes to the value of £750 each are intended to encourage the production of videos on hand surgery to enlarge the BSSH audio‐visual library. 

- The Stack Fellowship offers an honorarium of £12,000 to enable visits to centres of excellence and interest in the UK and elsewhere. 

- BSSH/Healing Foundation Medical Electives Awards. The Healing Foundation in conjunction with BSSH offers Medical Student Electives Awards of £1,200 for the personal support of students during their 6‐ 8 week elective period. The BSSH contributes £1,800 towards three awards annually. 

- Research Grant/Fellowship. Maximum funds of £50,000 per year are available to fund clinical or basic science research of relevance to hand surgery. 

- Pump Priming Grant. Two grants of £10,000 each are available annually for projects intending to stimulate interest in further research with the potential to benefit patients. 

- The Society offers an annual budget of £32,000 to the Overseas Committee to facilitate fellowships and deliver a programme of visits. 

- A Poster Prize of £250 is awarded for the best poster at both the Autumn and Spring Meetings. 

- Two Hand Therapists are invited to attend each Instructional Course free of charge. 

- Two Royal College of Surgeons Surgical Specialty Lead roles are funded, one fully at £15,000 and the other split with the British Association of Plastic, Aesthetic and Reconstructive Surgeons (BAPRAS) for £7,500. 

- The Society nominates a Hand Training Interface Group Fellow for the American Society for Surgery of the Hand ‘s (ASSH) International Travelling Fellowship and awards a grant of £5,000. 

- The BSSH matches the study leave funding of up to £1000 for each hand TIG fellow to attend BSSH, FESSH or IFSSH organised meetings. 

- General Funding Applications. The BSSH General grant is available to members for any work that is in line with the charitable aims of BSSH, but does not meet the criteria of the above grants. 

## **Relationships with connected entities** 

BSSH has historically shared its secretariat and office with The British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Foundation for Reconstructive International Surgery and Training (BFIRST). However, in Autumn 2019, BAPRAS/BFIRST made a decision to split away from this shared office and secretariat model. Therefore, BSSH formed an Office Review Working Group, supported with professional HR input, to negotiate and enact the required separation of the combined model. As of April 2021, the BSSH has its own secretariat staff and office space. A good professional relationship has also been maintained with BAPRAS with each organisation having a representative on the others Council. 

## **Representation on other bodies** 

The Society is one of the founding members of the Scar Free Foundation and is represented on its Research Board. 

The Society liaises with other sub‐specialties through the Royal College of Surgeons of England Interface Committee in Hand Surgery. This committee is Intercollegiate under the remit of the Joint Committees on Higher Surgical Training (JCST). The BSSH also has representation on the Hand Training Interface Group (TIG) Committee. 

In addition, and in pursuing its charitable objectives, the Society has representation on various other relevant external bodies, such as the Board of Specialist Societies of the British Orthopaedic Association and BAPRAS Council. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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The Society has a Representative Delegate on the Federation of European Societies for Surgery of the Hand (FESSH) and the International Federation of Societies for Surgery of the Hand (IFSSH). The post holder represents the BSSH at the delegate meetings of these societies. 

## **ACHIEVEMENTS AND PERFORMANCE** 

**Activities and events 1[st] June 2020 – 31 May 2021** 

## **Events** 

Due to the impact of the COVID‐19 pandemic, all of the face to face events were cancelled during this period. The events were either rearranged for dates in 2022 or held online. 

Two online events were held to allow authors of accepted papers from the planned scientific meetings to present, ensuring continued education during this time. 

The first online event was held 14‐15 October 2020. The event was free to attend and had 238 attendees, 115 were full members, 48 were associate members, 3 were honorary members, 63 were non‐members and 9 were therapists. 35 papers were presented and 18 posters were printed as virtual infographics in the ‘NXT book’, a supplement to the Journal of Hand Surgery (European volume). There were two educational partners for this event. 

The second online event was held on 14 January 2021, the event was free to attend. There were 113 participants, 36 were full members, 27 were associate members, 37 were non‐members and 13 therapists. There were 19 papers presented and 15 posters were printed as infographics in the NXT book. There were three educational partners for this event. 

The eighth series of Instructional Courses in Hand Surgery, held at the Manchester Conference Centre and Hilton DoubleTree Hotel, Manchester Piccadilly commenced in 2020. During the COVID‐19 pandemic, the Instructional Course that was meant to be held on June 2020 was cancelled as face to face events were not permitted by the UK government at this time. 

Course two in series eight was held online on 5‐6 February 2021. This event had four online trade exhibitors. There were 152 participants to the event, 142 were doctors and 10 were therapists. 

The 2020 Autumn Scientific meeting which was due to be held in Winchester on 14‐16 October 2020 was again cancelled due to the COVID‐19 pandemic. This has been rearranged to take place in October 2022. 

The 2021 Spring Scientific meeting was held online 14‐15 April 2021. At this meeting, 23 papers were presented and 18 poster infographics were printed in the NXT book. The Harold Bolton lecture was delivered by Mr S Hodgson. The meeting included guest lectures Ms C Leclercq, Dr R Farrell, Professor D Green, Dr C H Lin, Professor L Lin and Dr A Lluch. The BSSH Mentoring Scheme was launched at this event, requesting interest from consultants to sign up to become mentors to younger BSSH members. There were 291 participants, 226 were full members, 16 were associate members, 11 were honorary members and 38 were non‐members. There were seven sponsors for this event. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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## **Journal** 

The Society continues to publish the Journal of Hand Surgery (European Volume) and provides this journal to its members.  Full members also receive the Journal of Hand Surgery (American volume). The circulation of the journal is stable. Subscribers have access to the full archive of the journal going back to 1969, via SAGE online journals. For the period in question, 88 full length articles and 70 short reports and letters were published from 799 submissions. The journal twitter account continues to promote important issues instantly. 

## **Hand Diploma and Masters Committee** 

The Postgraduate Diploma in Hand Surgery programme began in September 2006 and since then 265 candidates have enrolled on the programme. 15 candidates are due to take the exam in October 2021. 57 candidates have withdrawn from the programme or were removed as they exceeded the maximum allowable period of study. The programme has been taken up enthusiastically by many but not all of the Interface Hand Fellows nationally. The Hand Diploma and Masters Committee meets regularly. There is a well refined bank of written questions and skill stations for the examinations. Much interest has been generated in other specialties who would like to benchmark the programme and there is further interest internationally. 

The Diploma workload has increased this year due to the impact of the pandemic. The March 2020 exam was postponed due to the country wide lockdown in place at the time. There was a need to communicate with candidates on a more frequent basis to help them continue their education. Requests for ‘interruption to study’ were higher than usual and contingency planning was required to ensure the postponed exam could take place. Virtual examination options were also considered, reviewed and contracted. A virtual research and design course was produced for one candidate and a virtual preparation day was provided for new candidates. 

## **The Education and Training in Hand Surgery Committee** 

The Education and Training committee have granted two Education and Travel Bursaries, three Medical Student Elective Bursaries, one Educational Grant and the Pulvertaft Prize in this period. 

Over the year, the Committee developed a BSSH Mentoring Scheme providing free professional mentoring training for consultant hand surgeons. Links will subsequently be set up between the trained mentors and newly appointed BSSH surgeons who have requested a mentor. The preliminary work was also completed on launching the inaugural BSSH International Travelling Fellowship. The aim of the fellowship is to foster international links and friendships across the speciality and facilitate the sharing of education, research and best practice in Hand Surgery. Four fellows will be selected from their national hand societies to complete the visit due in September 2021. The Committee continued to review and update the patient information leaflets available on the website increasing their accessibility. The Committee have also been continuing their research into developing a course for allied health professionals on aspects of hand surgery, although progress was stalled due to the COVID‐19 pandemic. 

## **Research Committee** 

The Research Committee has awarded three research grants in 2020/2021. Promoting research in ‘Understanding and Preventing Surgical Site Infection following Surgery for Hand and Wrist Trauma’, ‘Establishing inhibition of MMP‐14 as a viable Therapeutic in Dupuytren’s Disease’ and ‘Double tendon turndown repair: A biomechanical study and proposed classification.’ The Committee has also actively been involved in research pertaining to acute ligament injuries, non‐surgical treatments of Dupuytren’s Disease. PIP fracture dislocations and surgery for patients with Tetraplegia. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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## **Trauma Committee** 

The Hand Trauma App, launched in April 2019, is maintained and developed by the Committee and was adapted in May 2020 to provide guidelines for treating cases during the COVID‐19 outbreak. The Committee held a virtual trauma symposium in May 2021 attracting over 70 delegates and launching the National Hand Trauma network which has over 300 members signed up to it. The overall aim of the network is to improve the care patients receive by providing a platform for collaboration and best practice sharing for all professionals involved in hand trauma care. The Committee also published four further BSSH Standards of Care in Hand Trauma in the following areas: Metacarpal Neck Fracture Management, Bite Management, Flexor Sheath Infection and Mallet Injuries. 

## **Audit and Hand Registry Committee** 

The BSSH Hand Registry website was launched in 2012. The audit database has been upgraded and extended to include allied health professional working with the hand, including Hand Therapists in 2021. The Audit Committee continue to work towards including further improvements to the UK Hand Registry. The Audit database launched the first UK Hand Registry Award this year that supports research projects that will use the registry or its data. This year the award went to Flexor Tendon research. 

## **Patient and Public Initiative (PPI)** 

The Society’s PPI is fundamental to the development of the society and all its activities. As a charity that represents hand surgery care in the UK, patient care and public awareness of the care of the hand are integral to the society’s many activities. A new surgeon lead for the initiative was advertised for during this period, with the post commencing in September 2021. The post holder will continue to develop and enhance the roles of PPIs within the Society, involving PPI representatives in short term projects, such as patient information updates, multicentre trials and patient surveys. 

## **Overseas Committee** 

The Overseas Committee has remained active throughout the pandemic, despite being unable to organise physical visits to its various projects. In order to maintain a connection with overseas contacts and to continue providing educational resources to those in lower and middle income countries, the committee teamed up with BFIRST (a UK registered charity which trains surgeons working in the poorest countries in the world to enable them to undertake reconstructive Plastic Surgery) in early 2020 and has since delivered 10 online webinars which have attracted a total of 1,470 attendees from 92 countries, plus two more with the West African College of Surgeons (WACS). 

During 2020/2021, the BSSH Overseas Committee has: 

- Sponsored 10 LMIC delegates to attend the online Ganga virtual hand surgery course; 

- Set up fellowships to enable LMIC delegates to attend the 2022 IFSSH conference and visit UK hand surgery centres; 

- Set up and maintained an Overseas Trainee Committee to encourage more overseas engagement from surgeons at trainee level; and 

- Arranged initial talks with colleagues in Malawi regarding the creation of a BSSH‐supported hand surgery unit. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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## **The Communications Committee** 

The Communications Committee has worked on the following projects during the period 1st June 2020 – 31st May 2021: 

- Production of ‘Who are the BSSH?’ video; 

- Minor redesign of the BSSH website; 

- Establishment of media guide for members; 

- Production of branding guidelines and templates; 

- Begun work on style guidelines to establish the Society’s grammar, voice and tone style; 

- Designed new headed paper; 

- Ran a lapel badge design competition and arranged production of lapel and pin badges for members 

- Led a carpal tunnel patient information prize; 

- Arranged production of patient information videos to complement the patient section of the website; and 

- Expanded our presence on YouTube. 

The Society has active profiles across all main social media platforms including Twitter, LinkedIn, Facebook, YouTube and Instagram where users are kept up to date with regular content from the society and our specialty in general. The @BSSHand Twitter account now has over 4,000 followers, with fantastic engagement from the membership and our Instagram account has 2,000 followers. Our LinkedIn page meanwhile has 358 followers, and our Facebook page has 181 likes and 201 followers, while our YouTube page has gained a total of 755 subscribers. 

The Society continues to produce bi‐monthly member e‐bulletins with positive engagement from the membership. 

## **Standalone projects** 

## **Cranfield Trust** 

The Society has engaged with the Cranfield Trust, an organisation that provides pro bono business support for the voluntary sector to conduct a review into its Governance procedures. A small steering group was created to review highlighted areas of governance. The project report was received in September 2021 and it is hoped work streams will develop from this. 

## **Appointed and Elected roles review** 

The Society has created a list for members of all the BSSH elected and appointed roles that can be applied for and reviewed the election procedures for these. The terms, application dates and appointment procedures can now all be found in one place making the process more transparent. 

## **Raising hand surgery standards project** 

A group of interested surgeons have investigated potential ways of raising hand surgery standards in the UK. Relationships and lines of communications have been opened with NHS England and the Getting It Right First Time initiative. A Systematic Review on hand surgery outside of main operating theatres is underway and a NICE guideline will be developed from this, defining venues where operations should take place. 

## **Diversity review statement and objectives** 

The Society trustees have formalised their long held commitment to Equality, Diversity and Inclusion with an investigation of diversity within the BSSH and the creation of a Diversity Statement and diversity objectives. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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## **Hands Re:Worked project** 

This project to ‘crowdfund’ a coffee table style book was established in early 2021 and has since gathered involvement from an ever‐increasing number of surgeons and patients from around the UK to be included in the project. It is envisaged that the book will show an exclusive collection of photographs and inspirational stories from hand surgery patients and showcasing the work of BSSH surgeons. A working group has been created and set to work contacting and initiating regional co‐ordinators, arranging filming and photography of patients, as well as the production of the Hands Re:Worked promotional video and creation of the crowd funder for which several rewards were sought from members. The group have also now begun to make contact with publishers and seek sponsorship from interested parties. 

## **Impact of activities and events** 

The trustees believe that 2020/2021 was a successful year for BSSH, despite the impact of the global pandemic: 

- Membership levels continued to increase overall: There were 942 Members (2019/2020: 933) of which 432 were Full Members (2019/2020: 424). The number of members remains stable. 


- Attendance at Scientific Meetings has remained stable. The 2020 Autumn Meeting was cancelled due to the COVID‐19 pandemic and has been rearranged for October 2022. The 2020 Spring Meeting was also cancelled. Instead, the Society offered two online free paper events. One held in October 2020 and the second held in January 2021. The 2021 Spring Scientific Meeting, held virtually, attracted 291 delegates. 

- Number of papers presented at meetings: 35 papers and 18 Posters were presented at the October 2020 free paper event. 19 papers and 15 posters were presented at the January 2021 free paper event. 29 papers and 29 posters were presented at the last meeting held prior to the COVID‐19 pandemic in Autumn 2019. 

- There were 152 attendees at the Instructional Course in Hand Surgery held during 2020/2021. Previously figures prior to the pandemic were 215. The trustees note that attendance at the Instructional Courses can vary considerably depending on the main topic. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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- It can be seen that delegate numbers and submitted papers did not decline significantly during the COVID‐ 19 pandemic. This is likely due to diversifying the educational offer to include virtual meetings which still attracted keynote and overseas speakers. 

- The impact factor for the journal during this period increased to 2.688 making it the highest rated hand surgery journal in the world. 

- Despite the impact of the COVID‐19 pandemic, the hand diploma has 24 candidates enrolled and due to take the exam in October 2021. The master programme has 8 students enrolled. 

- Despite initial concern over the economic situation created by the global pandemic, the BSSH continued to offer all bursaries and awards. Special cases affected by the pandemic were assessed on an individual basis. It is noted that the pandemic meant there were fewer than normal applications for travel bursaries however, the Society did double the funds available for its Pulvertaft Essay prize and created a new awards for the development Carpal Tunnel Syndrome Patient Information and UK Hand Registry. 

- Although the Overseas Committee in person visits have been unable to take place, the webinar series has attracted over 1,470 delegates from approximately 92 countries. 

- The BSSH/BAHT Hand Trauma Network currently has over 300 members, comprising of both BSSH members, non‐members, surgical colleagues and allied health professionals. The Network has provided a platform for networking and the sharing of ideas and best practice for all professionals involved in hand trauma care. 

- Currently, 1 in 5 of BSSH consultants use the UK hand registry to audit their surgical outcomes and the database currently holds patients’ scores for 11,564 procedures, expanding at a rate of 2% a month, which has been greatly affected due to COVID‐19. The uptake has decreased by 61% from last year, again due to the impact of COVID‐19 on surgical procedures being performed. 

- The work of the Communications Committee has led to an increase in the number of visits to the Society's website: From June 2020 – September 2021, there were 287,614 visitors to the site (2019/2020: 179,400) . This is an increase of 108,214. The majority of this audience are deemed to be members of the public, given that most traffic received is organic (i.e., searching on Google, not looking for us directly) and most are first‐time visitors landing on patient information pages. This shows the importance of the ongoing update of patient information resources being undertaken by the education and training committee. 

- The production of a bi‐monthly e‐bulletin, which is distributed to all members and stakeholders ensures Council business and Society news is spread to a wide audience. 

- The list of all BSSH appointed and elected roles, their terms and application dates has been made available to all members. Alongside a review of election procedures, it is anticipated that this increased transparency will lead to more applications for trustee and committee roles from the membership at large. 

- The raising standards in hand surgery project has gained some traction with high level meetings arranged with key stakeholders. Systematic Reviews on hand surgery outside of main operating theatres are underway and a NICE guideline will be developed from this, defining venues where operations should take place. 

- The review into diversity and inclusion within the BSSH has led to the creation of a Council Diversity Lead role to provide guidance and ensure diversity issues are considered. A BSSH Diversity Statement and strategy has been released as well as a list of objectives including a toolkit to promote inclusion for Committee and meeting Chairs. 



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## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

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## **FINANCIAL REVIEW** 

## **Financial results of activities and events** 

During the year, the Society generated £904,249 (2019/2020: £989,524) of income and incurred expenditure of £864,877 (2019/2020: £1,025,361) principally disseminating information as it relates to any and all of the fields that pertain to the Society’s charitable objectives. In terms of the Society’s ongoing activities, subscription income increased from the prior year to £184,403 (2019/2020: £181,966). Journal income increased by £51,985 (2019/2020: increased by £4,778). Income from meetings, courses and events decreased to £52,692 (2019/2020: £199,448). 

After grant giving, an overall surplus of £39,372 (2019/2020: an overall deficit of £35,837) resulted for the year, before taking gains and losses on investment assets into consideration. The performance of the Society’s investments in 2020/2021 was acceptable in the current COVID‐19 impacted economic environment and resulted in an overall increase in value of £253,573 (2019/2020: increase in value £53,039). At the balance sheet date, the charitable company had net current assets of £128,809 (31 May 2020: £29,047), and overall net assets of £2,480,766 (31 May 2020: £2,187,821). 

## **Grant making** 

Grants, awards and prizes totalling £125,797 (2019/2020: £71,518) were recognised as resources expended following consideration of awards by the recommendation of the Research and Education and Training, subcommittees and Council. Grants for 2020/2021 comprised the following: 

||£|
|---|---|
|Stack Travelling Fellowship*|(8,000)|
|Research Support Grants|77,267|
|Joint RCS and BAPRAS Surgical Champion|23,125|
|Clinical Leaders Programme (BOA)|5,600|
|Educational grants|4,980|
|Medical Student Elective Bursaries|2,534|
|Donation to other charities|200|
|BSSH Education and Travel Bursary|15,461|
|Pulvertaft Prize|1,500|
|Educational Presentation Prize|750|
|Other grants, prizes and awards|2,380|
||_______|
||125,797|
||=======|



* A refund was received during the year for a grant provided in November 2019 in relation to the Stack Travelling Fellowship. 



**Page 13** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## **Reserves policy** 

At 31 May 2021, the charity’s ‘free reserves’ amounted to £2,480,766 (31 May 2020: £2,187,821). 

The trustees have completed a detailed review of forecast levels of income, taking into account the reliability of each source of income and the prospects for developing new income sources. The trustees have also completed a review of current spending plans. The trustees have concluded that there will be scope for funding additional grants, awards and prizes to take advantage of future needs and opportunities. Among other things, the trustees' reserves policy is designed to enable those additional activities to be undertaken with confidence by ensuring that the Society's reserves are sufficient to absorb any shortfall in income, with minimal or no impact on beneficiaries. 

## **Investments policy** 

The trustees have wide ranging powers to invest the funds of the Society as they see fit, and in practice, they receive advice from the Society’s investment managers on appropriate investments. In addition, any short‐term surplus cash funds are held in interest bearing deposit accounts. 

In line with the requirements of the Society’s reserves policy, the trustees’ investment strategy is to seek income growth whilst maintaining capital in real terms at a target value of £2.5 million. The performance of the Society’s investments against this policy is reviewed by the trustees throughout the year. The trustees will not invest in anything that they consider to be socially, environmentally or ethically unsound in any way. 

At 31 May 2021, the charity’s investment portfolio had a market value of £2,333,098 (31 May 2020: £2,139,480), and during 2020/2021, generated investment income of £113,612 (2019/2020: £101,494). For the year ended 31 May 2021, the charity’s investments portfolio grew in value by 11.9% (2019/2020: increased in value by 2.2%), and achieved an average gross income return of 4.87% (2019/2020: 4.6%) and an average net income return (after investment management costs) of 4.2% (2019/2020: 3.6%). 

The charity’s cash deposits achieved an average income return of 0.1% (2019/2020: 0.2%). 

## **PLANS FOR FUTURE PERIODS** 

## **Update on 2017 strategy plans** 

The trustees have determined medium to long term strategic imperatives, which are designed to focus developmental strategy and communicate the Society’s priorities. A strategy day, open to all members was held in June 2017 and a detailed report was subsequently produced to further the Society’s aims and directions for the future. Many work streams identified through this strategy have now been completed including: 

- The introduction of a code of conduct 

- Undertaking a review of officer election procedures 

- Forming closer links with BAHT 

- Badging of external courses by the Society 

- The introduction of a BSSH mentoring scheme 

- The creation of a visiting fellowship scheme 

- Undertaking a review of trade exhibitors at scientific meeting. 

- Reviewing and updating the Terms of Reference for all committees 

It is hoped a full review of the current strategy will take place in 2022. 



**Page 14** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## **Future activities and events** 

The society held a scientific meeting in September (Oxford) and plans to hold another in December 2021 (Exeter).The eighth Series of Instructional Courses continue with 8.4 taking place in February 2022 in Manchester and 8.5 later that year. The IFSSH Congress will be held in London on 6[th] – 10[th] June 2022 and is being organised by a Committee of BSSH members. The Congress will educate those with an interest in hand surgery across the world. 

The Diploma in Hand Surgery examination continues to be held in Birmingham. The seventeenth examination of the Diploma in Hand Surgery took place in March 2020 and the eighteenth examination was intended to take place in March 2021. Unfortunately, this was postponed to October 2021. The oral exam portion was held face to face, with a virtual option for the written component. 

The Society intends to continue to work on or start the following projects over the next financial year: 

- Raising the profile of Hand Surgery and the BSSH through its bi‐monthly e‐bulletins, “Who are we” promotional video and Hands RE:worked book projects as well as improving patient information. 

- Improving Hand Surgery standards reducing national variation, bringing low resourced UK units up to the same level as the best ones, by developing a working group to investigate potential improvements using looking at data and coding. 

- Optimise the financial potential of the Society by exploring fundraising opportunities. 

- Continue to work with the Cranfield Trust to conduct an independent review of its business planning and financial practices. 

- Complete a review of the Constitution reviewing areas for diversity and inclusivity. 

- Introduce a medical student and junior trainee membership category. 

- Increasing our ‘green’ practice and sustainability, dedicating a session to this at the December Scientific meeting. 

- Launch the inaugural BSSH Travelling Fellowship. 

- Launch the BSSH mentoring scheme. 

- Resume the programme of overseas visits in January 2022. 

- Complete a scoping exercise to establish a BSSH‐supported hand surgery unit in a lower or middle income country. 

## **Impact of future activities and events** 

The trustees will continue to principally assess the success of the above activities and events by evaluating the: 

- Membership levels 

- Interest in Trustee and Committee roles 

- Number of papers submitted to and delegates meetings and courses. 

It is the trustees’ aim that membership levels should not fall significantly below the current levels of 942. This compares to 2019/2020 when there were 933 members. It is hoped the planned review of membership categories to include Associate Specialist doctors, medical students and junior trainees will further increase these figures. 

In addition, the number of delegates attending the Autumn and Spring Meetings should not fall significantly below the most recent levels of 250. The number of delegates attending meetings continues to increase since the format has changed to include online attendance in certain cases, also due to the COVID‐19 pandemic and the cancellation of face‐to‐face meetings has created a desire within delegates to attend meetings. 



**Page 15** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

It is hoped that the IFSSH Congress will attract over 4,000 delegates although the impact of the pandemic may affect this number. Approximately 1,500 registrations are needed for the meeting to break even. The trustees have carefully considered the potential financial impact of the meeting if it should be cancelled. Where possible, plans have been put in place to mitigate potential losses, including the contract negotiations and the introduction of a virtual or hybrid option if required. 

The number of papers presented at the scientific meetings should not fall below the most recent levels. 35 papers were presented at the 2020 free paper meeting, 19 papers were presented at the second free paper meeting and 23 papers were presented at the 2021 Spring Meeting online meeting. 

The trustees are aware that the number of delegates attending the Instructional Courses will fluctuate depending on the specific topic being covered. The trustees’ target is that in financial terms each series should at least break even. The Society will underwrite the courses up to £10,000 each should they not make a surplus. The courses run during this period made a profit of £6,299. 

## **Public benefit** 

In the future, the trustees intend to ensure that BSSH continues to benefit the public by continuing to ensure the charity’s activities promote education, training and research in the specialty. The BSSH will create a working group to improve the BSSH Patient Information, improving its accessibility and obtain the Patient Forum Association (PFA) gold standard accreditation. 

## **REFERENCE AND ADMINISTRATIVE DETAILS** 

## **The Council of the Society** 

The trustees of the charity, who are also the directors of the company, are the elected officers and members of the Council of the Society, who have served on the Council since 1 June 2020, as follows: 

S M Fullilove **President** (from 1 January 2021), **Vice President** (until 31 December 2020) D J Warwick **Immediate Past President** (from 1 January 2021), **President** (until 31 December 2020) J L Hobby **Vice President** (from 1 January 2021), D P Newington **Immediate Past President** (until 31 December 2020) I S H McNab **Honorary Secretary & Company Secretary 2020‐2022** (from 1 January 2020) D E Boyce **Honorary Treasurer 2020‐2022** (appointed 1 January 2020) 

W L Lam **2018‐2020 (demitted December 2020)** Z H Naqui **2018‐2020 (demitted December 2020)** C Y Ng **2018‐2020 (demitted December 2020)** M Birks **2019‐2021** G Bourke **2019‐2021** C Little **2019‐2021** D Brown **2020‐2022** M Horwitz **2020‐2022** G Smith **2020‐2022** D Clark **2021‐2023 (appointed January 2021)** A Mishra **2021‐2023 (appointed January 2021)** L Muir **2021‐2023 (appointed January 2021)** 



**Page 16** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

The principal address of the charity and the registered office of the company is the secretariat offices of the Society at The Royal College of Surgeons of England, 38 ‐ 43 Lincoln’s Inn Fields, London WC2A 3PE. 

The charity is registered under the charity number 268396, and the company is incorporated with the company registration number 01213983. 

The Society has made the following professional appointments: 

|Solicitor:|Radcliffes Le Brasseur, 5 Great College Street, Westminster, London SW1P 3SJ|
|---|---|
|Accountant:|RSM UK Tax and Accounting Limited, Third Floor, One London Square,|
||Cross Lanes, Guildford, Surrey GU1 1UN|
|Independent examiner:|Kerry Gallagher, FCA DChA of RSM UK Tax and Accounting Limited,|
||Davidson House, Forbury Square, Reading, Berkshire RG1 3EU|
|Investment Managers:|Sarasin & Partners LLP, Juxon House, 100 St Paul’s Churchyard,|
||London EC4M 8BU|
||Cazenove Capital the trading name of Schroder & Co. Limited,|
||1 London Wall Place, London EC2Y 5AU|
|Bankers:|National Westminster Bank plc, PO Box 2021, 10 Marylebone High Street,|
||London W1U 4BT|
||Lloyds TSB Bank plc, Southampton Row Branch, Victoria House,|
||Southampton Row, London WC2B 5HR|
||CCLA Investment Management Limited, 85 Queen Victoria Street,|
||London EC4V 4ET|
||National Westminster Bank plc, Nottingham University Branch,|
||Portland Building, Level C University Park, Nottingham NG7 2AG|
||Scottish Widows Bank Plc, P O Box 12757, 67 Morrison Street,|
||Edinburgh EH3 8YJ|





**Page 17** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

The trustees of the charity are assisted and advised by the following individuals, who are co‐opted to the Council, and in that capacity, are neither trustees of the charity nor directors of the company: 

|R H Milner|Honorary Archivist (demitted December 2020)|
|---|---|
|S Hodgson|Honorary Archivist 2021 ‐ 2025 (Commenced January 2021)|
|D J Shewring|Chair of the Committee of Management for the Journal of Hand surgery|
||(European Volume)|
|J B Tang|Editor in Chief|
|J Arrowsmith|Chair of the Education and Training Committee (2019‐2021)|
|D Furniss|Chair of the Research Committee and Scar Free Foundation (2019‐2022)|
|J Rodrigues|Chair of the Audit Committee (2020 ‐ 2023)|
|J Jones|Chair of the Overseas Committee (2020 ‐ 2022)|
|S Tucker|Chair Trauma Committee (2019‐2021)|
|G Smith|Chair Interface Committee in Hand Surgery (demitted December 2020)|
|C Y Ng|Chair Interface Committee in Hand Surgery (2021‐2023)|
|J L Hobby|Representative for FESSH and IFSSH(2019‐2021)|
|D Furniss|Representative for the Research Board of the Scar Free Foundation|
|M David|Webmaster|



The following key senior members of staff are responsible for the day‐to‐day management of the Society: 

|Mrs Helen Roberts|Head of Secretariat (retired Summer 2020)|
|---|---|
|Mrs Bola Olusina|Head of Finance (until April 2021)|
|Mrs Charlotte Smith|Governance, Membership and Committee Manager (from August 2020)|
|Miss Kavita Prashar|Events Manager (from November 2020)|
|Miss Emma Brighton|Communication and Charitable Development Manager (from November 2020)|
|Ms Ruth Neave|Diploma and Committee Coordinator|
|Ms Sharon Ross|Audit Database and Membership Coordinator|
|Ms Wendy Patterson|Journal Manager|
|Ms Abigail Bradley|Journal Assistant|
|Ms Judy Richards|Finance Coordinator|



## **STRUCTURE, GOVERNANCE AND MANAGEMENT** 

## **Status and history** 

BSSH is a registered charity, and a company limited by guarantee, not having share capital. Every member undertakes to contribute an amount not exceeding £1 to the assets of the Society in the event of the Society being wound‐up during the period of membership, or within one year thereafter. 

The Society was founded in 1968 with the aim of relieving sickness and protecting and preserving public health by the promotion and development of hand surgery. 



**Page 18** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

The Society was incorporated on 28 May 1975 and became a registered charity on 22 August 1975. BSSH is governed by its rules and regulations, as set down in the company’s Memorandum and Articles of Association (Constitution), which were originally adopted on 28 May 1975 were last updated on 3 November 2005 and are currently undergoing review. 

## **Organisational Structure** 

The overall strategic direction of the charity is determined by the trustees, who are assisted and advised by co‐ opted members of the Council, and by the non‐trustee members of the various BSSH subcommittees. The subcommittees of the Society are used to focus discussion on issues pertaining to their particular roles and titles, and these subcommittees then report and submit recommendations to the Council. 

The Council comprises the President, the Vice‐President, the Immediate Past President, the Honorary Secretary, the Honorary Treasurer and currently nine elected full members serving for a four‐year period. 

The Council currently meets three times a year, and the Chairpersons of the Society’s subcommittees are all co‐ opted members of the Council. 

The day‐to‐day management of the Society has been delegated by the trustees to a team of staff reporting to the Governance, Membership and Committees Manager. 

## **Policy for remunerating senior staff and key management personnel** 

The pay of the staff, including key management personnel, is set by the trustees following a review by and upon the advice of an external human resources company (Persona People Management Ltd) which derives its recommendations from external benchmarks. The benchmarks used check pay levels of similar staff in similar posts with those of similar sized entities and, in particular, similar charities. 



**Page 19** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## **Subcommittees** 

The Society operates the following subcommittees, and the following individuals have served on the subcommittees during the year under review: 

|**Trauma Committee**<br>S Tucker<br>S Hettiaratchy<br>W Mason<br>I McNab<br>K Owers<br>A De Leo<br>M Potts<br>S Mee<br>E Bamford<br>R Baker<br>R Tahmassebi<br>G Goodwill|**Diploma and Masters Committee**<br>A J Logan<br>H Hedley<br>J Auyeung<br>M Akhavani<br>J Webb<br>S Ankarath<br>C Baldwin<br>I Chakrabarti<br>P Russell<br>M Brewster<br>A Pandya|
|---|---|
|**Research Committee**<br>D Furniss<br>J Rodrigues<br>A Sierakowski<br>B Dean<br>J Nanchahal<br>N Johnson<br>J Lane<br>R Dolan<br>M Gardiner<br>E Reay<br>A Karantana<br>D Kennedy<br>R Horton|**Education and Training Committee**<br>J Arrowsmith<br>M E Birks<br>I Chakrabati<br>H Dafydd<br>A Kocheta<br>V Bhalaik<br>S Majumder (resigned December 2020)<br>J Molyneux<br>N Riley<br>R Shirley<br>E Davidson<br>R Murphy<br>CY Ng|





**Page 20** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

**Communications Committee Audit Committee** Z Naqui Mr J Rodrigues M Horwitz Mr C Little M David Mr R Eckersley N Fine Ms E Reay W Khor Ms A Bremner‐Smith R Trickett Mr M Gardiner Mr P Stirling Mr R Wade Ms S Ross **Instructional Course Organising Committee Committee of Management for the Journal** D Clark D Shewring, P P Grieve D Boyce R J I Colville J H Coert S Gidwani G Giddins M Calcagni (FESSH representative) D Herren M Lamyman I McNab J McEachan J Hobby E Davidson (BOTA representative) W Lam R Murphy (PLASTA representative) G Leblebicioglu Z Naqui **Cadaveric Subcommittee** J B Tang Mr Z Naqui D Warwick Miss G Bourke Mr M Akhavani **Editorial Board for the Journal Overseas Committee** S Ankarath J Jones T B Hansen M Waldram J Bland S Deshmukh (on sabbatical) M Calcagni N Lloyd K Chung C Mariathas N Downing R Taha S Fullilove M Glover C Heras‐Palou W Lam N Hollevoet D Bell J Hopkinson‐Woolley F Iwuagwu S Hovius M Ricks C Jerosch‐Herold D Warwick G Leblebicioglu R Murphy I Leslie A Logan **Overseas Trainee Committee** S Luria R Nicholas J McEachan R Taha C Pailthorpe R Murphy J Rodrigues A Gough A Ross G Higgins R Sanchez‐Rosales A Smith M Solomons R Trickett P Werker 



**Page 21** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## **Method of Recruitment, Appointment, Election, Induction & Training of Trustees** 

The trustees of the charity are the officers and elected members of the Council of the Society. 

The Members of the Society are notified of forthcoming vacancies for elected Council members and invited to stand for election. Each nomination is proposed and seconded by Members, and each nominee provides written consent and a synopsis of why he/she wishes to become a Council member. New Council members are then elected by the Members through an on‐line voting system. The list of candidates will then be put to Members for election with a single transferable vote methodology used until a candidate achieves a majority. Votes will be counted for each sub‐speciality applicant individually, and then having excluded the highest ranked applicant from each sub‐speciality, as a group as a whole. Successful candidates are announced at the Autumn AGM. 

Recommendations for President are sought from the members in January each year and those recommended are then invited to apply. The President is elected by the Council at the spring meeting by a closed vote. If no applicant achieves a majority, after each round of votes the lowest scoring applicant(s) are removed and the vote repeated until one candidate achieves a majority. The successful applicant is then recommended to the members at the AGM for ratification. 

Applications for Honorary Treasurer are sought from Full Members of the Society by means of an application form during January of the incumbent Treasurer’s 3rd year of office. The Treasurer is elected by the council at the spring meeting of the incumbent Treasurer’s 3rd year of office, by a closed vote. If no applicant achieves a majority, after each round of votes the lowest scoring applicant(s) are removed and the vote repeated until one candidate achieves a majority. The successful applicant is then recommended to the members of the society at the AGM for ratification. 

Applications for Honorary Secretary are sought from Full Members of the society in January of the incumbent Secretary’s third year of office by means of an application form. Applications are short‐listed by the officers and elected members of council using criteria including commitment to hand surgery, education and research; previous involvement with the society and any other information in the application form. The short‐list of candidates will then be put to the Full Members of the society, with a single transferable vote methodology used. The successful candidate is announced to the Society at the Spring Meeting EGM. 

The President serves for one year, preceded by one year as Vice‐President and one year as Vice‐President Elect. The President remains on Council for one further year as the Immediate Past President. The Honorary Secretary serves for three years and the Honorary Treasurer serves for four years. 

In line with the recommendations of the Charity Commission, an induction manual for trustees of the Society is produced. This comprehensive manual details the activities of the Society and informs trustees of their terms of reference and continuing responsibilities. All new trustees are provided with a copy of the induction manual containing Trustees’ Code of Conduct, Officers’ Job Descriptions, subcommittee Terms of Reference, the Society Policies, the Constitution, Risk Assessment, calendar of activities and relevant Charity Commission guidance. The Society also runs annual trustee training and refresher sessions. 

## **Professional Indemnity Insurance** 

The charity has taken out an insurance policy that provides professional indemnity cover for the trustees. This policy provides trustee and Charity, clubs and associations legal liability cover of up to £5 million in respect of any one claim. The cost of this insurance for the year was £3,229 (2019/2020: £2,858). 



**Page 22** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## **Risk & Corporate Governance Matters** 

The Society does not need to expose itself to a high level of risk in order to achieve its present objectives. Therefore, an overall medium level of risk is accepted as a matter of policy. It may prove necessary to change this policy at a later date depending on initiatives recommended by the membership and implemented by the trustees. 

The Honorary Secretary and Secretariat undertake an annual Risk Review and the results are then scrutinised by the Trustees. The Risk Review is a standing item on the agenda at the Autumn meeting of Council. Any significant changes in the Society’s risk profile are presented to the membership at the Annual General Meeting. During this period, a review took place in September 2020. 

This review at this time identified the below high risk areas and agreed the following mitigation actions: 

- Meeting failure relating to the COVID‐19 pandemic: 

   - Contracts to be revisited and renegotiated where possible; 

   - Provide virtual events/online options; 

   - Where deposits have already been paid, renegotiation on meeting dates; and 

   - COVID clauses to be carefully considered before contracting any new suppliers. 

- The loss of key staff following the secretariat split: 

   - Ensure cross training of staff and hand over periods. 

- Exposure to volatility in the markets in relation to the Society’s substantial investment portfolio, particularly owing to the global pandemic: 

   - Monitoring investment risk on a continuous basis by regular reviews with the Society’s investment managers. 

All other remaining risks listed on the register being medium to low. These remaining risks whilst being kept under review are not sufficient cause for concern to be in need of active day‐to‐day management. 

On review, the previously noted high risk: Failure to secure suitable premises within the Royal College of Surgeons following completion of the major refurbishment programme, has now been assessed as low. This is due to the completion of contracts securing an appropriate number of desk licences within the building. 

## **Trustees’ Responsibilities in the Preparation of Financial Statements** 

The trustees (who are also the directors of The British Society for Surgery of the Hand) for the purposes of company law) are responsible for preparing the trustees’ annual report and the financial statements in accordance applicable law and regulations. 

Company law requires the trustees to prepare financial statements for each financial year. Under that law, the trustees have prepared the financial statements in accordance with United Kingdom Generally Accepted Accounting Practice (United Kingdom Accounting Standards and applicable law). 

Under company law, the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company as at the balance sheet date, and of its income and expenditure for that period. 



**Page 23** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **TRUSTEES’ ANNUAL REPORT** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

In preparing those financial statements, the trustees are required to: 

- select suitable accounting policies and then apply them consistently; 

- observe the methods and principles in the Charities SORP; 

- make judgements and accounting estimates that are reasonable and prudent; 

- state whether applicable UK Accounting Standards have been followed subject to any material departures disclosed and explained in the financial statements; and 

- prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in business. 

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charitable company’s transactions and disclose with reasonable accuracy at any time the financial position of the charitable company and enable them to ensure that the financial statements comply with Companies Acts 2006. They are also responsible for safeguarding the assets of the charitable company and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. 

The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charitable company’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from the legislation in other jurisdictions. 

## **Independent Examiner** 

Kerry Gallagher FCA DChA of RSM UK Tax and Accounting Limited has indicated her willingness to continue in office. 

## **FUNDS HELD AS CUSTODIAN** 

Although the Society maintains restricted funds to deal with incoming resources that are earmarked for a particular purpose by donors, sponsors, and other funders, BSSH does not currently hold, and the trustees do not anticipate that it will in the future hold, any funds as custodian for any third party. 

This report was approved by the trustees on 6 January 2022, and was signed for and on behalf of the board by: 


## ………………………………….. **Honorary Secretary & Company Secretary** 

I S H McNab 

20/01/22 

Date: ………………………………….. 



**Page 24** 

## **INDEPENDENT EXAMINER’S REPORT TO THE TRUSTEES OF THE BRISTISH SOCEITY FOR SURGERY OF THE HAND** 

I report to the trustees on my examination of the financial statements of the British Society for Surgery of the Hand (the charitable company) for the year ended 31 May 2021, which are set out on pages 25 to 34. 

## **Responsibilities and basis of report** 

As the trustees of the charitable company (and also its directors for the purposes of company law) you are responsible for the preparation of the financial statements in accordance with the requirements of the Companies Act 2006 (‘the 2006 Act’). 

Having satisfied myself that the financial statements of the charitable company are not required to be audited under Part 16 of the 2006 Act and are eligible for independent examination, I report in respect of my examination of your charitable company’s financial statements as carried out under section 145 of the Charities Act 2011 (‘the 2011 Act’). In carrying out my examination, I have followed the Directions given by the Charity Commission under section 145 (5)(b) of the 2011 Act. 

An independent examination does not involve gathering all the evidence that would be required in an audit and consequently does not cover all the matters that an auditor considers in giving their opinion on the financial statements. The planning and conduct of an audit goes beyond the limited assurance that an independent examination can provide. Consequently, I express no opinion as to whether the financial statements present a ‘true and fair view’ and my report is limited to those specific matters set out in the independent examiner’s statement. 

## **Independent examiner’s statement** 

Since the company's gross income exceeded £250,000 your examiner must be a member of a body listed in section 145 of the 2011 Act. I confirm that I am qualified to undertake the examination because I am a member of The Institute of Chartered Accountants in England and Wales, which is one of the listed bodies. 

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

1. accounting records were not kept in respect of the charitable company as required by section 386 of the 2006 Act; or 

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

3. the financial statements do not comply with the accounting requirements of section 396 of the 2006 Act other than any requirement that the financial statements give a ‘true and fair view’ which is not a matter considered as part of an independent examination; or 

4. the financial statements have not been prepared in accordance with the methods and principles of the Statement of Recommended Practice: Accounting and Reporting by Charities applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Ireland (FRS 102). 

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

## Kerry Gallagher 

Signed: ………………………………………… 

Name: Kerry Gallagher FCA DChA Name of applicable listed body: The Institute of Chartered Accountants in England and Wales Relevant professional qualification or membership of professional body: Chartered Accountant 

ON BEHALF OF RSM UK TAX AND ACCOUNTING LIMITED Chartered Accountants 27/01/22 Davidson House, Forbury Square, Reading, Berkshire RG1 3EU Date: ……………………………. 



**Page 25** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **STATEMENT OF FINANCIAL ACTIVITIES (including Income and Expenditure Account) for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

|||**Unrestricted Funds**|**Unrestricted Funds**|
|---|---|---|---|
|||**Total**|**Total**|
|||**2021**|**2020**|
||**Notes**|£|£|
|**INCOME FROM:**||||
|**Charitable activities**||||
|Disseminating information on the specialty|2|790,601|884,542|
|**Investments**|3|113,648|104,982|
|||________|________|
|**TOTAL**||904,249|989,524|
|**EXPENDITURE ON:**||||
|**Raising funds**||||
|Investment management fees||(16,901)|(21,407)|
|**Charitable activities**||||
|Disseminating information on the specialty|4|(847,976)|(1,003,954)|
|||________|________|
|**TOTAL**||(864,877)|(1,025,361)|
|Net gains on investments|7|253,573|53,039|
|||________|_______|
|**NET INCOME AND NET MOVEMENT IN FUNDS**||292,945|17,202|
|**RECONCILIATION OF FUNDS**||||
|Total funds brought forward at 1 June 2020||2,187,821|2,170,619|
|||________|________|
|**TOTAL FUNDS CARRIED FORWARD AT 31 MAY 2021**|11|2,480,766|2,187,821|
|||========|========|





**Page 26** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

|**THE BRITISH SOCIETY FOR SURGERY OF THE HAND**|||**Page 26**|
|---|---|---|---|
|**BALANCE SHEET**||||
|**as at 31 May 2021**||Company Number:|01213983|
|___________________________________________________________________________________________||||
|||**2021**|**2020**|
||**Notes**|£|£|
|**FIXED ASSETS**||||
|Investments|7|2,351,957|2,158,774|
|**CURRENT ASSETS**||||
|Debtors|8|152,127|77,775|
|Cash at bank and in hand||314,014|352,113|
|||_______|_______|
|||466,141|429,888|
|**LIABILITIES**||||
|Creditors: Amounts falling due within one year|9|(337,332)|(400,841)|
|||_______|_______|
|**NET CURRENT ASSETS**||128,809|29,047|
|||________|________|
|**TOTAL ASSETS LESS CURRENT LIABILITIES & NET ASSETS**||2,480,766|2,187,821|
|||========|========|
|**THE FUNDS OF THE CHARITY**||||
|**Unrestricted income funds**||||
|General fund|11|2,480,766|2,187,821|
|||________|________|
|**TOTAL CHARITY FUNDS**||2,480,766|2,187,821|
|||========|========|



For the year ended 31 May 2021, the charitable company was entitled to exemption from audit under section 477 of the Companies Acts 2006 (the Act) relating to small companies and the members have not required the charitable company to obtain an audit of its financial statements for the year in question in accordance with section 476 of the Act. 

The trustees acknowledge their responsibility to keep accounting records in accordance with section 386 of the Act and for preparing financial statements which give a true and fair view of the state of affairs of the charitable company as at 31 May 2021 and of its result for the year then ended in accordance with sections 394 and 395 of the Act and which otherwise comply with the requirements of the Act, so far as applicable to this charitable company. 

These financial statements have been prepared in accordance with the provisions applicable to companies subject to the small companies’ regime. 

The financial statements on pages 25 to 34 were approved by the trustees and authorised for issue on 6 January 2022, and are signed on their behalf by 

|sue fullilove||
|---|---|
|………………………………….**President**|………………………………….**Honorary Treasurer**|
|S M Fullilove|D E Boyce|
|26/01/22|27/01/22|
|Date: ………………………………….|Date: ………………………………….|





**Page 27** 

**THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## 1. **ACCOUNTING POLICIES** 

## **Company information** 

The British Society for Surgery of the Hand (the charitable company) is a private company limited by guarantee incorporated in England and Wales. The registered office and principal place of business is at The Royal College of Surgeons of England, 38/43 Lincoln’s Inn Fields, London WC2A 3PE. The charitable company’s principal activities are disclosed in the trustees’ annual report. 

## **Basis of accounting** 

These financial statements have been prepared in accordance with FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” and under the historical cost convention, except as modified for the annual revaluation of fixed asset investments. 

Within the definitions of FRS 102, the charity is a public benefit entity. 

The financial statements have been prepared in accordance with the accounting policies set out in more detail below and comply with the Charities Act 2011, the Companies Act 2006, the Memorandum and Articles of Association of the charitable company, and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019). 

## **Going concern** 

Whilst there remains significant uncertainty regarding the global economic impact of the COVID‐19 virus pandemic and the ability of charitable company to withstand its negative effects, nevertheless having sought appropriate assurances in the form of forecasts and action plans, the trustees have a reasonable expectation that the charitable company will continue in operational existence for the foreseeable future and be able to meet all of its financial obligations as they fall due for a period of at least twelve months from the date of approval of these financial statements. 

Based on these forecasts and action plans, the trustees consider it is appropriate for the financial statements to be prepared on the going concern basis. The financial statements do not include any adjustments that would result should the going concern basis of preparation not be appropriate. In the event that this basis is not appropriate provisions may be required and assets may need to be written down to their recoverable amount. 

## **Income** 

General donations and other similar types of voluntary income are brought into account when receivable. Donated income is included gross of any attributable tax recoverable, where relevant. Donations given for specific purposes are treated as restricted income. 

Investment income is also accounted for on a receivable basis once the dividend has been declared or interest has been earned. Credit is taken in the accounts for the proportion of subscriptions, which are receivable in the financial period. All other similar types of income are accounted for on an accruals’ basis. 



**Page 28** 

**THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## 1. **ACCOUNTING POLICIES** (Continued) 

## **Expenditure** 

Expenditure is allocated to the charitable company’s principal activity where the costs can be identified as being directly related to that activity. All costs that cannot be identified as relating directly to the charitable company’s principal activity are categorised as either support costs or governance costs. Any costs that cannot be specifically categorised are allocated in proportions based upon a suitable ratio applicable to the nature of the cost involved. 

Grants payable are recognised in the period in which the approved offer is conveyed to the recipient except in those cases where the offer is conditional, such grants being recognised only when the conditions attaching to the award are fulfilled. Grants offered subject to conditions, which have not been met at the balance sheet date, are noted as a potential commitment, but are not treated as a liability. 

## **Taxation** 

The charitable company is a registered charity and as such its income and gains falling due under section 471 to 489 of the Corporation Tax Act 2010 or section 256 of the Taxation of Chargeable Gains Act 1992 are exempt from corporate tax to the extent that they are applied to its charitable objectives. 

## **Investments** 

The charitable company’s investments are included in the balance sheet at fair value (their market value). The gains or losses arising upon their annual revaluation are included in the statement of financial activities. 

## **Liabilities** 

A contingent liability is disclosed for those grants, which do not represent liabilities, where the possible obligation, which arises from past events, will only be confirmed by the occurrence of one or more uncertain future events not wholly within the trustees’ control. Provisions are recognised for those grants where there is uncertainty as to the timing or amount, and any uncertainty regarding the amount is more than one of the determining factors for reasonable estimation of the liability arising from that constructive obligation. 

## **Financial instruments** 

A financial instrument is a contract that gives rise to a financial asset of one entity and a financial liability or equity instrument of another entity. Financial instruments are therefore classified and accounted for according to the substance of the contractual arrangement as financial assets, financial liabilities or equity instruments. An equity instrument is any contract that evidences a residual interest in the assets of the entity after deducting all of its liabilities. 

## **Financial assets and liabilities** 

The charitable company’s debtors and creditors that meet the definition of either a financial asset or a financial liability are initially recognised at the transaction value and thereafter are stated at amortised cost using the effective interest method. 



**Page 29** 

**THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## 1. **ACCOUNTING POLICIES** (Continued) 

## **Pension contributions** 

The charitable company participates in a multi‐employer defined benefit pension scheme known as the Superannuation Arrangements of the University of London (“SAUL”). The scheme is contracted out of the State Earnings‐Related Pension Scheme and is a centralised scheme for certain employees with the assets held in separate trustee‐administered funds. 

The charitable company is unable to identify its share of the underlying assets and liabilities of the scheme. Accordingly, the amount charged to the statement of financial activities in respect of pension costs is the total contributions payable for the year. 

## **Fund accounting** 

The general fund comprises the accumulated surpluses of unrestricted income over expenditure, which are available for use in furtherance of the general objective of the charitable company. 

Designated funds are a particular form of unrestricted fund consisting of amounts which have been allocated or designated for specific purposes by the trustees. The use of designated funds remains at the discretion of the trustees. 

Restricted funds are comprised of amounts subject to specific conditions imposed by donors or other types of funder. The purpose and use of restricted funds are set out in the notes to the financial statements. Amounts unspent at the year end are carried forward in the balance sheet. 

## 2. 

## 3. 

|**INCOME FROM DISSEMINATING**|**2021**|**2020**|
|---|---|---|
|**INFORMATION ON THE SPECIALTY**|**£**|**£**|
|Subscription income from members|184,403|181,966|
|Journal income|522,030|470,045|
|Income from meetings, courses and events|52,692|199,448|
|Hand Diploma income|26,775|32,870|
|Grant income|4,500|‐|
|Other income|201|213|
||_______|_______|
||790,601|884,542|
||=======|=======|
|**INVESTMENTS**|**2021**|**2020**|
||**£**|**£**|
|Bank interest receivable on short term cash deposits|36|488|
|Income from investments listed on a recognised stock|||
|exchange in the UK|113,612|104,494|
||_______|_______|
||113,648|104,982|
||=======|=======|





**Page 30** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

|4.|**COSTS OF DISSEMINATING**|||**2021**|**2020**|
|---|---|---|---|---|---|
||**INFORMATION ON THE SPECIALTY**|||**£**|**£**|
||Direct costs:|||||
||Membership costs|||37,967|8,172|
||Journal expenditure|||107,655|103,679|
||Meetings, courses and events expenditure|||69,277|282,093|
||Hand Diploma costs|||8,000|10,800|
||Grants, bursaries and prizes awarded to fifteen|||||
||(2019/2020: seven) individuals|||125,797|71,518|
||Website and public relations costs|||11,165|53,167|
||Other direct costs|||760|2,704|
|||||_______|_______|
|||||360,621|532,133|
||Support and governance costs (see note 5)|||487,355|471,821|
|||||________|________|
|||||847,976|1,003,954|
|||||========|========|
|5.|**SUPPORT & GOVERNANCE COSTS**|**Support**|**Governance**|**Total**|**Total**|
|||**costs**|**costs**|**2021**|**2020**|
|||£|£|£|£|
||Staff costs (see note 6)_(95:5)_|309,808|16,306|326,114|341,234|
||Premises ‐ operating lease costs_(95:5)_|4,104|216|4,320|5,761|
||Office overheads_(95:5)_|34,946|1,839|36,785|53,023|
||Legal and professional fees_(95:5)_|26,007|1,369|27,376|14,620|
||Annual report costs, including independent|||||
||examination fees_(0:100)_|‐|15,675|15,675|8,000|
||Accountancy and advisory fees_(90:10)_|58,351|6,484|64,835|2,285|
||Irrecoverable VAT_(95:5)_|11,637|613|12,250|46,893|
||Foreign exchange loss (_95:5_)|‐|‐|‐|5|
|||_______________________________|||_______|
|||444,853|42,502|487,355|471,821|
|||===============================|||=======|



The above costs are allocated between support costs and governance costs using the ratios shown in italic in each case. Where not otherwise calculated, the ratio used follows the allocation of staff costs, for which 5% is considered to be the amount of staff time relating to governance matters. 

Bookkeeping costs, which were previously included within staff costs, have now been outsourced in the current year. 

During the year, no trustees were reimbursed for travel and meeting expenses (2019/2020: nine trustees totalling expenses of £17,174). 



**Page 31** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

|6.|**STAFF COSTS**|**2021**|**2020**|
|---|---|---|---|
|||No.|No.|
||The average monthly number of persons employed by the Society|||
||(excluding Council members) during the year was, as follows:|||
||Secretariat office|8|8|
|||==|==|
|||£|£|
||Staff costs for the above persons:|||
||Wages and salaries|258,961|244,538|
||Social security costs|25,422|25,784|
||Other pension costs|37,818|34,501|
||Health insurance costs|3,068|5,352|
||Other staff costs|845|31,059|
|||_______|_______|
|||326,114|341,234|
|||=======|=======|



The costs of employees were shared with The British Association of Plastic, Reconstructive and Aesthetic Surgeons until 31 March 2021 and the two charitable companies also used to share the secretariat and its related office space. 

With effect from 1 April 2021, the Society now operates its own separate and independent secretariat. 

No employee received total emoluments in excess of £60,000 during the current or previous year. The total amount of employee benefits received by key management personnel for their services to the charitable company amounted to £108,356 (2019/2020: £93,472) and the charitable company incurred employer’s national insurance contribution costs of a further £10,315 (2019/2020: £9,114) in relation to the employment of these same members of staff. 

No Council member received any remuneration for services as a Council member provided to the Society during the current or previous year. 

The charitable company has taken out an insurance policy that provides professional indemnity cover for the trustees. This policy provides cover of up to £5 million in respect of any one claim, and the cost of this insurance for the year was £3,229 (2019/2020: £2,858). 

## **Contribution of volunteers** 

In addition to the trustees, the charitable company is also reliant upon the contributions made by other members who contribute significant amounts of their time in the delivery of charitable activities. The trustees are unable to estimate the contribution of volunteers in any meaningful or consistent manner, but they are grateful for the support that members continue to provide. 



**Page 32** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

|7.|**INVESTMENTS**|**2021**|**2020**|
|---|---|---|---|
|||£|£|
||Investment listed on a recognised stock exchange, held primarily|||
||to provide an investment return, at market value:|||
||1 June 2020|2,139,480|2,426,516|
||Purchase cost|56|200,000|
||Proceeds from disposals|(60,010)|(540,075)|
||Realised gains|12,976|7,831|
||Unrealised gains|240,596|45,208|
|||________|________|
|||2,333,098|2,139,480|
||Cash held by the investment managers|18,859|19,294|
|||________|________|
||31 May 2021|2,351,957|2,158,774|
|||========|========|
||At the balance sheet date, the market value of the portfolio comprised|||
||UK investments in unit trust funds as follows:|||
||Sarasin Endowments Multi‐Asset Fund accumulation units|1,201,414|1,121,080|
||SUTL Cazenove Charity Multi‐Asset Fund accumulation units|1,131,684|1,018,400|
|||________|________|
|||2,333,098|2,139,480|
|||========|========|



At the balance sheet date, the historical cost of the investments was £1,711,091 (31 May 2020: £1,757,621). 

|8.|**DEBTORS**|**2021**|**2020**|
|---|---|---|---|
|||£|£|
||Amounts falling due within one year:|||
||Trade debtors|10,214|23,085|
||Other debtors|664|7,124|
||Prepayments and accrued income|141,249|47,566|
|||_______|_______|
|||152,127|77,775|
|||=======|=======|





**Page 33** 

## **THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

## **NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

|9.|**CREDITORS**||||**2021**|**2020**|
|---|---|---|---|---|---|---|
||||||£|£|
||Amounts falling due within one year:||||||
||Trade creditors||||22,290|13,962|
||Other taxation and social security||||18,275|111,590|
||Accruals||||77,860|14,810|
||Deferred income – Meetings, courses and events||||250|3,100|
||Deferred income – Journal income||||218,657|257,379|
||||||________|________|
||||||337,332|400,841|
||||||========|========|
||Deferred income reconciliation:||||||
||As at 1 June||||260,479|291,103|
||Released to income||||(260,479)|(291,103)|
||Received in advance during the year||||218,907|260,479|
||||||________|________|
||As at 31 May||||218,907|260,479|
||||||========|========|
|10.|**FINANCIAL INSTRUMENTS**||||**2021**|**2020**|
||||||£|£|
||Carrying amount of financial assets|measured at fair value:|||||
||Equity instruments||||2,333,098|2,139,480|
||||||=========|=========|
|11.|**THE FUNDS OF THE CHARITY**||||||
|||**1 June**|||**Gains on**|**31 May**|
|||**2020**|**Income**|**Expenditure**|**investments**|**2021**|
|||£|£|£|£|£|
||**Unrestricted income funds:**||||||
||General fund|2,187,821|904,249|(864,877)|<br>253,573|2,480,766|
|||________|________|________|_______|________|
|||2,187,821|904,249|(864,877)|<br>253,573|2,480,766|
|||========|========|========|=======|========|
|||**1 June**|||**Gains on**|**31 May**|
|||**2019**|**Income**|**Expenditure**|**investments**|**2020**|
|||£|£|£|£|£|
||**Unrestricted income funds:**||||||
||General fund|2,170,619|989,524|(1,025,361)|<br>53,039|2,187,821|
|||________|________|________|_______|________|
|||2,170,619|989,524|(1,025,361)|<br>53,039|2,187,821|
|||========|========|========|=======|========|



Included within the General Fund are net unrealised gains arising on the revaluation of investments totalling £622,007 (31 May 2020: £381,859). 



**Page 34** 

**THE BRITISH SOCIETY FOR SURGERY OF THE HAND** 

**NOTES TO THE FINANCIAL STATEMENTS** (Continued) **for the year ended 31 May 2021** 

___________________________________________________________________________________________ 

## 12. **PENSION COMMITMENTS** 

The charitable company is a participating employer in a centralised defined benefit scheme known as the Superannuation Arrangements of the University of London (“SAUL”) for all qualified employees with the assets held in separate trustee‐administered funds. It is not possible to identify the charitable company’s share of the underlying assets and liabilities of SAUL. Therefore, contributions are accounted for as if SAUL were a defined contribution scheme and pension costs are based on the amounts actually paid (cash amounts). The amount charged to the statement of financial activities in respect of pension costs (as shown in note 6) is the total contributions payable for the year. Any contributions payable at the balance sheet date are treated as creditors (as shown in note 9). 

SAUL is subject to triennial valuation by professionally qualified and independent actuaries. The last available valuation was carried out as at 31 March 2020 using the projected unit credit method in which the actuarial liability makes allowance for projected earnings. The main assumptions used to assess the technical provisions were: 

|Pre‐retirement discount rate|Full gilt yield curve less 0.3% p.a.|
|---|---|
|Post‐retirement discount rate|Full gilt yield curve|
|General salary increases|CPI plus 1%|
|Price inflation – RPI|2.70% per annum|
|Price inflation – CPI|1.70% per annum|
|Pension increases in payment|CPI max 2.5% p.a.|



The actuarial valuation applies to SAUL as a whole and does not identify surpluses or deficits applicable to individual employers. As a whole, the market value of SAUL’s assets was £3,612 million representing 94% of the liability for benefits after allowing for expected future increases in salaries. 

Based on the strength of the employer covenant and the trustee’s long‐term investment strategy, the trustees agreed to maintain member contributions at 6% of salaries. Employer contributions will remain at 16% of salaries until 31 March 2022, before increasing to 19% from 1 April 2022 to 31 December 2022, and then further increasing to 21% from 1 January 2023. 

There will also be the introduction of a defined contribution feeder scheme in 2023 for new employees. This will be for the first three years of their employment, with employer contributions of 16%, before being entitled to join the SAUL CARE scheme above. 

The above rates will be reviewed when the results of the next formal valuation (as at 31 March 2023) are known.