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← The British Society For Surgery Of The Hand

2025-05-31-accounts

Charity registration number 268396

Company registration number 01213983 (England and Wales)

BRITISH SOCIETY FOR SURGERY OF THE HAND

ANNUAL REPORT AND FINANCIAL STATEMENTS

FOR THE YEAR ENDED 31 MAY 2025

BRITISH SOCIETY FOR SURGERY OF THE HAND

LEGAL AND ADMINISTRATIVE INFORMATION

Trustees C Heras Palou (President)
G Bourke (Immediate Past President)
W Lam (Vice President)
S Talwalkar (Vice President Elect) (Appointed 1 January 2025)
I S H McNab (Honorary Secretary & Company Secretary)
Z Naqui (Honorary Treasurer)
J McEachan
R Shirley
J Jones
H Dafydd
F Iwuagwu
EP Jesudason
ID Russel
S Tucker
I McGraw (Appointed 1 January 2025)
A Barnard (Appointed 1 January 2025)
S Sajid (Appointed 1 January 2025)
R Horton (Patient Representative to Council)
Senior management C Smith Head of Secretariat
S Ellerton Financial Controller
Charity number 268396
Company number 01213983
Registered Office Royal College of Surgeons of England
38 - 43 Lincoln's Inn Fields
London,
WC2A 3PE.
Auditor Gravita Audit Oxford LLP
First Floor, Park Central
40-41 Park End Street
Oxford
OX1 1JD
Bankers National Westminster Bank plc
PO Box 2021
10 Marylebone High Street
London
W1U 4BT
Solicitors Radcliffes Le Brasseur
5 Great College Street
Westminster
London
SW1P 3SJ

BRITISH SOCIETY FOR SURGERY OF THE HAND

LEGAL AND ADMINISTRATIVE INFORMATION

Investment advisors 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

BRITISH SOCIETY FOR SURGERY OF THE HAND CONTENTS

Page
Trustees‘ report 1 - 8
Statement of trustees' responsibilities 9
Independent auditor's report 10-12
Statement of financial activities 13-14
Balance sheet 15
Statement of cash flows 16
Notes to the financial statements 17 - 26

BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) FOR THE YEAR ENDED 31 MAY 2025

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 2025.

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).

Charitable objectives

The objects for which the Society is established are for the public benefit, to promote and direct development of hand surgery and to foster and co-ordinate education, study and research in hand surgery, including:

Charitable activities

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

The Society accomplishes its charitable objectives by undertaking a number of core activities:

Indicators, milestones and benchmarks

The Trustees use a range of measures to determine the success of the charity in meeting its objectives. This includes monitoring:

Public benefit

The BSSH exists for public benefit ultimately striving to improve the quality of medical and surgical care for patients. The Trustees believe the continuing distribution of information relating to the specialty, alongside the contribution of the BSSH to the education and training of surgeons and allied professionals directly improves patient care and outcomes.

The BSSH has developed a Patient and Public Involvement and Engagement Network offering members the opportunity to influence the future care of patients with hand conditions. The Network involves patients in working groups that seek to determine best practice in the delivery of hand care, research priorities and create accessible patient information.

The Trustees also ensured that patients are involved at the very heart of BSSH decision making by creating a patient Trustee role.

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

Grant making policy

The budget available for bursaries and grants is agreed by the Trustees annually and awards are made in accordance with the charity’s charitable purposes and based on the funding available.

All applications are considered, peer reviewed, scored/ranked and awarded by the BSSH Council or relevant committees and grants are allocated on their recommendation.

available bursaries, grants and awards are advertised on the Society’s website and through direct marketing to members.

Relationships with connected entities

BSSH works closely with its parent surgical specialties; the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) and the British Orthopaedic Association (BOA). Close links are also maintained with the British Foundation for International Reconstructive Surgery and Training (BFIRST) for its overseas projects.

The BSSH has a strong relationship with the British Association of Hand Therapists (BAHT) offering representative positions to BAHT members on each of its Committees and Council.

BSSH subscribes to the International Federation of Societies for Surgery of the Hand (IFSSH) and the Federation of European Societies for Surgery of the Hand (FESSH), thereby affiliating BSSH members to both these organisations.

Representation on other bodies

In pursuing its charitable objectives, the Society has representation on the following relevant external bodies:

Representation on external bodies varies from time-to-time dependant on relevant or emerging issues.

Achievements and performance Membership Levels

Membership levels increased from the previous year. The Society recorded a total of 1127 Members for this period, increasing from 1037 in 2023/2024. 428 of these are Fellow Members (2023/2024: 416). It is the trustees’ aim that membership levels should not fall significantly below the current levels.

Strategy Development

The Society consulted with its members on their priorities in 2023 and used the feedback to create a 5-year strategic plan. Five strong themes emerged from the process: Communication, Financial Health, Academic and Clinical Excellence, Innovation and Modernisation and Influence, Outreach and Partnership. The plan was published in September 2024. Progress is monitored by Trustees biannually. You can find the plan on the BSSH website.

Events

The Society held two scientific meetings during 1[st] June 2024 – 31 May 2025, educating 1,117 surgeons and allied health professionals. Expected face to face delegate numbers increased during the year by 417 individuals across the two meetings, mainly due to the Spring 25 meeting being joint meeting with the Spanish Society. 35 Exhibitors attended across the two meetings. Keynote speakers included Marybeth Ezaki, Max Hearle, Joe Dias and Alex Lluch. 151 free papers were presented affording the opportunity to

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

share and disseminate knowledge and learning. The German and Spanish Societies for Surgery of the hand attended as invited guests building international networks and relationships.

Two Instructional Courses in Hand Surgery took place in June 2024 and February 2025 focussing on Soft Tissue Reconstruction, Burns and Infection and Fractures and Joint Injuries respectively. 193 delegates attended across the two courses consisting of 38 consultants, 123 trainee surgeons, 24 hand therapists, and 8 students. A further 56 individuals signed up to receive post event recordings of the course. These course recordings are also made available free of charge to residents of lower and middle income countries and were downloaded by 41 individuals.

A Cadaveric Masterclass on Arthroplasty of the Hand and Wrist was held in June 2024 selling out the 18 delegate spaces within days of advertising. The course offered a teaching ratio of 2:1 and had an international faculty.

Journal of Hand Surgery (European Volume)

The Society continues to own and publish the Journal of Hand Surgery (European Volume) and provides this journal to all its members. Circulation and sales of the journal remain stable for this period. 70 full length articles, 27 review articles and 75 short reports and letters were published from 649 submissions. The impact factor for the journal for the period 1 June 2024 – 31 May 2025 2.0 (5 year Impact Factor: 2.4)

Hand Diploma and Masters

356 candidates have enrolled on the Postgraduate Diploma in Hand Surgery programme since its inception in 2006. 166 students have graduated from the programme in this time. 11 candidates sat the exam in November 2024 with all passing. The programme continues to be taken up enthusiastically with new 22 candidates enrolling in 2024/2025. The diploma remains popular with a total of 104 candidates registered on the programme at 31 May 2025.

The masters programme has 1 student enrolled. 0 new dissertations were submitted in 2024. 0 MSc was awarded in 2024. 1 dissertation was for resubmitted in 2025. 13 People were withdrawn from the programme as they were unable to complete due to conflicting responsibilities.

Grants and Bursaries

7 Education and Travel Bursaries, 3 Medical Student Elective Bursaries, and 2 Educational Presentation (multimedia) prizes were awarded in this period.

Raising Standards and Outcomes

The BSSH also contributed to the raising of standards in hand surgery by:

Global Partnership Activity

The emphasis for this period has been collaboration, highlighted by the following activities:

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

Other Activity

Mentoring Scheme continues to provide free professional training for consultant hand surgeons. 4 matches were set up between the trained mentors and newly appointed BSSH surgeons.

The BSSH International Travelling Fellowship which fosters international links across the speciality and facilitates the sharing of education, research and best practice took place in November 2024. 2 surgeons from Germany and Nigeria completed an observership at UK hand surgery centres of excellence at the Pulvertaft Hand Centre in Derby and Ulster Hospital, Belfast.

Financial review

During the year, the Society generated £1,254,103 (2023/2024: £1,359,120) of income and incurred expenditure of £1,185,191 (2023/2024: £1,530,987) 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 £229,078 (2023/2024: £211,940). Journal income generated was £539,248 (2023/2024: £528,215). Income from meetings, courses and events was £325,075 (2023/2024: £411,403).

After grant giving, an overall surplus of £68,912 (2023/2024: an overall deficit of £171,867) resulted for the year, before taking gains and losses on investment assets into consideration. The performance of the Society’s investments in 2024/2025 was acceptable in the current economic environment. No cash was drawn down in the year to maintain cashflow (2023/24: £250,000). The overall the value of investments increased by £51,706 (2023/2024: increase in value £118,894). At the balance sheet date, the charitable company had net current assets of £303,752 (31 May 2024: £226,581), and net assets of £2,162,862 (31 May 2024: £2,042,245).

Grant making

Grants, awards and prizes totalling £41,774 (2023/2024: £222,793) were recognised as resources expended following consideration of awards by the recommendation of the relevant committees and Council.

Reserves and Investments

At 31 May 2025, the charity’s ‘free reserves’ amounted to £2,162,862 (31 May 2024: £2,042,245).

The Society’s Reserves policy was last reviewed by the Trustees in March 2025. It was agreed that the minimum level of free reserves should equivalent to the sum of:

Maintaining this level of free reserves aims to ensure that BSSH will continue to be able to discharge its liabilities as they fall due. At 31 May 2025 the minimum level of free reserves amounted to £361,722.

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 shortterm surplus cash funds are held in interest bearing deposit accounts.

The BSSH wish to ensure that the investments in its portfolio do not conflict with its aims or the views of a majority of members. This precludes direct or indirect investment in companies which generate more than 10% of its revenues from tobacco or gambling.

The Society’s investment policy was reviewed in March 2025.

At 31 May 2025, the charity’s investment portfolio had a market value of £1,859,110 (31 May 2024: £1,815,664). Further details are set out in note 14 to the accounts.

During the year in question, the Trustees completed a detailed assessment of forecast levels of income, considering the reliability of each source and the prospects for developing new income sources. The Trustees reviewed spending plans and concluded that a reduction in expenditure is required to align income and expenditure for the 2024/2025 financial year. This reduction in spending is reflected in the 2024/2025 budget.

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

Alongside the reduction in spending, the Trustees have also taken the following action to address the Charity’s deficit:

Plans for future periods

The Society’s strategic plan provides full details of future activities but includes:

Strategic plan objectives:

Events

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. 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 its Memorandum and Articles of Association (Constitution), which were originally adopted on 28 May 1975.

5

BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

The trustees, who are also the directors for the purpose of company law, and who served during the year and up to the date of signature of the financial statements were:

C Heras Palou (President) G Bourke (Immediate Past President) W Lam (Vice President) S Talwalkar (Vice President Elect) (Appointed 1 January 2025) D Boyce (Resigned 31 December 2024) ISH McNab (Honorary Secretary & Company Secretary) Z Naqui (Honorary Treasurer J McEachan (Resigned 31 December 2024) R Shirley (Resigned 31 December 2024) J Jones H Dafydd F Iwuagwu EP Jesudason ID Russel S Tucker I McGraw (Appointed 1 January 2025) A Barnard (Appointed 1 January 2025) S Sajid (Appointed 1 January 2025)

R Horton (Patient Representative to Council)

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:

S Hodgson Honorary Archivist (2021 - 2025) G E B Giddins Chair of the Committee of Management for the Journal of Hand Surgery (E) (2022 - 2026) W Lam Editor in Chief of the Journal of Hand Surgery (2022-2025) M Birks Chair of the Education and Training Committee (2022-2024) R Poulter Chair of the Education and Training Committee (2025–2027) A Karantana Chair of the Research Committee and Scar Free Foundation (2022-2025) A Lupu Chair of the Clinical Data and Registries Committee (2022 - 2025) Mariathas Chair of the Global Partnership Committee (2022 - 2024) J Bedford Chair of Trauma Committee (2022 - 2024) R Trickett Chair of the Communications Committee (2022 - 2024) M Jones Council Trainee Representative (2022-2024) R Taha Council Trainee Representative (2025-2027) A Middleton Chair of Interface Committee in Hand Surgery (2024-2026) G Smith International and European representative (2022-2024) D Boyce International and European Representative (2025–2027) J Paniker Equity, Diversity and Inclusion Lead (2023-2025) M David Webmaster

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

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 roles. They are delegated responsibilities and activities and report and submit recommendations to the Council.

The day-to-day management of the Society has been delegated by the Trustees to a team of staff reporting to the Head of Secretariat.

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 the Head of Secretariat deriving recommendations from external benchmarks and obtaining advice from an independent HR consultant if required. The benchmarks used check pay levels of similar staff in similar posts with those of similar sized entities and, in particular, similar charities.

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.

Eligible 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 peers, and each nominee provides written consent and a synopsis of why he/she wishes to become a Council member. New Council members are elected by the members through an on-line voting system using a single transferable vote methodology. Votes are 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 online vote using a single transferrable vote methodology. The successful applicant is then recommended to the members at the AGM for election. The President serves for two years prior to their presidential year and one year post.

Applications for Honorary Treasurer are sought from eligible members of the Society by means of an application form. The Treasurer is elected by the Council at the spring meeting of the incumbent Treasurer’s 3rd year of office, by a closed online vote using a single transferrable vote methodology. The successful applicant is then recommended to the members of the society at the AGM for election.

Applications for Honorary Secretary are sought from eligible 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. The short-list of candidates is then put to the voting members of the Society, for election on an electronic voting system using a single transferable voting methodology. The successful candidate is announced to the Society at the Spring Meeting EGM.

On election, Trustees are sent an induction pack containing an explanation of their responsibilities, the Society’s Code of Conduct, Job Description, relevant Terms of Reference, the Constitution, risk register, calendar of activities and relevant Charity Commission guidance. The Society also runs Trustee training and refresher sessions as required.

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 £4,617 (2023/2024: £4,617).

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BRITISH SOCIETY FOR SURGERY OF THE HAND TRUSTEES' REPORT (INCLUDING DIRECTORS' REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

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 Trustees review the risk register annually as a minimum. In the financial year in question, the risk register was reviewed in September 2024 and March 2025. Any significant changes in the Society’s risk profile are presented to the membership at the Annual General Meeting.

There were no risks recorded as high at the most recent review in March 2025, due to the mitigation measures put in place. All medium level risks, whilst being kept under review, were not sufficient cause for concern to be in need of active day-to-day management.

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.

Auditor

In accordance with the company's articles, a resolution proposing that Gravita Audit Oxford LLP be reappointed as auditor of the company was approved at the Annual General Meeting held in November 2024.

Disclosure of information to auditor

Each of the trustees has confirmed that there is no information of which they are aware which is relevant to the audit, but of which the auditor is unaware. They have further confirmed that they have taken appropriate steps to identify such relevant information and to establish that the auditor is aware of such information.

The trustees' report was approved by the Board of Trustees.

Zan .............................. Merb I S H McNab (Honorary Secretary & Company Secretary) Trustee

26/11/2025

Date: .............................................

8

BRITISH SOCIETY FOR SURGERY OF THE HAND STATEMENT OF TRUSTEES' RESPONSIBILITIES FOR THE YEAR ENDED 31 MAY 2025

The trustees, who are also the directors of British Society for Surgery of the Hand for the purpose of company law, are responsible for preparing the Trustees' Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

Company Law requires the trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the society and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that year.

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

The trustees are responsible for keeping adequate accounting records that disclose with reasonable accuracy at any time the financial position of the society and enable them to ensure that the financial statements comply with the Companies Act 2006. They are also responsible for safeguarding the assets of society and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

9

BRITISH SOCIETY FOR SURGERY OF THE HAND INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF BRITISH SOCIETY FOR SURGERY OF THE HAND

Opinion

We have audited the financial statements of British Society for Surgery of the Hand (the ‘society’) for the year ended 31 May 2025 which comprise the statement of financial activities, the balance sheet, the statement of cash flows and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice).

In our opinion, the financial statements:

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We are independent of the society in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the trustees' use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the society’s ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

Other information

The other information comprises the information included in the annual report other than the financial statements and our auditor's report thereon. The trustees are responsible for the other information contained within the annual report. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

In our opinion, based on the work undertaken in the course of our audit:

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BRITISH SOCIETY FOR SURGERY OF THE HAND INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF BRITISH SOCIETY FOR SURGERY OF THE HAND

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the society and its environment obtained in the course of the audit, we have not identified material misstatements in the directors' report included within the trustees' report.

We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 requires us to report to you if, in our opinion:

Responsibilities of trustees

As explained more fully in the statement of trustees' responsibilities, the trustees, who are also the directors of the society for the purpose of company law, are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the trustees are responsible for assessing the society’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor's responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

The extent to which our procedures are capable of detecting irregularities, including fraud, is detailed below.

Our approach to identifying and assessing the risks of material misstatement in respect of irregularities, including fraud and non-compliance with laws and regulations, was as follows:

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BRITISH SOCIETY FOR SURGERY OF THE HAND INDEPENDENT AUDITOR'S REPORT TO THE MEMBERS OF BRITISH SOCIETY FOR SURGERY OF THE HAND

We assessed the susceptibility of the company’s financial statements to material misstatement, including obtaining an understanding of how fraud might occur, by:

To address the risk of fraud through management bias and override of controls, we:

In response to the risk of irregularities and non-compliance with laws and regulations, we designed procedures which included, but were not limited to:

There are inherent limitations in our audit procedures described above. Material misstatements that arise due to fraud can be harder to detect than those that arise from error as they may involve deliberate concealment or collusion.

A further description of our responsibilities is available on the Financial Reporting Council’s website at: https:// www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor's report.

Use of our report

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006. Our audit work has been undertaken so that we might state to the charitable company's members those matters we are required to state to them in an auditor's report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

OM hees Katherine Wilkes (Senior Statutory Auditor) for and on behalf of Gravita Audit Oxford LLP

.........................23/12/25

Chartered Accountants Statutory Auditor

Gravita Audit Oxford LLP First Floor, Park central 40-41 Park End Street, Oxford OX1 1JD

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BRITISH SOCIETY FOR SURGERY OF THE HAND STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 MAY 2025

Notes
Income from:
Donations and legacies
3
Charitable activities
4
Investments
5
Total Income
Expenditure on:
Raising funds
6
Charitable activities
7
Total expenditure
Net gains on investments
12
Net expenditure
Transfers between funds
Net movement in funds
10
Reconciliation of funds
Fund balances at 1 June 2024
Fund balances at 31 May 2025		 Unrestricted
Funds
2025
£
50
1,118,247
72,432
1,190,729
7,666
1,020,471
1,028,137
51,705
214,297
(93,680)
120,617
2,042,245
2,162,862		 Restricted
funds
2025
£
63,374
-
-
63,374
-
157,054
157,054
-
(93,680)
93,680
-
-
-		 Total
2025
£
63,424
1,118,247
72,432
1,254,103
7,666
1,177,525
1,185,191
51,705
120,617
120,617
2,042,245
2,162,862

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

13

BRITISH SOCIETY FOR SURGERY OF THE HAND STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 31 MAY 2024

Notes
Income from:
Donations and legacies
3
Charitable activities
4
Investments
5
Total Income
Expenditure on:
Raising funds
6
Charitable activities
7
Total expenditure
Net gains on investments
12
Net expenditure
Transfers between funds
Net movement in funds
10
Reconciliation of funds
Fund balances at 1 June 2023
Fund balances at 31 May 2024		 Unrestricted
Funds
2024
566
1,177,598
75,983
1,254,147
11,446
1,394,091
1,405,537
118,894
(32,496)
(20,477)
(52,973)
2,095,218
2,042,245		 Restricted
funds
2024
104,973
-
-
104,973
-
125,450
125,450
-
(20,477)
20,477
-
-
-		 Total
2024
105,539
1,177,598
75,983
1,359,120
11,446
1,519,541
1,530,987
118,894
(52,973)
(52,973)
2,095,218
2,042,245

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

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BRITISH SOCIETY FOR SURGERY OF THE HAND BALANCE SHEET FOR THE YEAR ENDED 31 MAY 2025

2025 2025 2024 2024
£ £ £ £ £
Fixed assets
Investments 14 1,859,110 1,815,664
Current Assets
Stock 15 18,900 70,000 70,000
Debtors 16 175,127 240,108 240,108
Cash at Bank and in hand 480,871 461,054 461,054
674,898 771,162 771,162
Creditors: Amounts falling due
within one year 17 (371,146) (544,581) (544,581)
Net current assets 303,752 226,581
Total assets less current liabilities 2,162,862 2,042,245
Net assets 2,162,862 2,042,245
The funds of the society
Unrestricted funds 2,162,862 2,042,245

26/11/2025

The financial statements were approved by the trustees on .........................

.............................. ..............................

C Heras-Palou (President) Z Naqui (Honorary Treasurer)

Company registration number 01213983 (England and Wales)

15

BRITISH SOCIETY FOR SURGERY OF THE HAND STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 MAY 2025

Cash flows from operating activities
Cash absorbed by operations
23
Investing activities
Proceeds from disposals of investments
Investment income received
Net cash generated from investing activities
Net cash used in financing activities
Net increase in cash and cash equivalents
Cash and cash equivalents at beginning of year
Cash and cash equivalents at end of year
Relating to:
Cash at bank and in hand		 2025
£
£
(55,494)
3,000
72,432
75,432
-
19,938
480,012
499,950
499,950		 2024
£
£
(214,495)
252,634
92,841
345,475
-
130,980
349,032
480,012
480,012		 2024
£
£
(214,495)
252,634
92,841
345,475
-
130,980
349,032
480,012
480,012
130,980
349,032
480,012
480,012

16

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

1 Accounting policies

Charity information

British Society for Surgery of the Hand is a private company limited by guarantee incorporated in England and Wales. The registered office is Royal College of Surgeons of England, 38 - 43 Lincoln's Inn Fields, London, WC2A 3PE.

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).

The financial statements are prepared in sterling, which is the functional currency of the Charity. Monetary amounts in these financial statements are rounded to the nearest £.

1.2 Going concern

Despite the loss for the year, 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.

1.3 Charitable funds

Unrestricted funds are available for use at the discretion of the trustees in furtherance of their charitable objectives.

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 funders. 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.

1.4 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.

17

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

1 Accounting policies (continued)

1.5 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.

1.6 Fixed asset 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.

1.7 Cash and cash equivalents

Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of three months or less, and bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities.

1.8 Financial instruments

The society has elected to apply the provisions of Section 11 ‘Basic Financial Instruments’ and Section 12 ‘Other Financial Instruments Issues’ of FRS 102 to all of its financial instruments.

Financial instruments are recognised in the society's balance sheet when the society becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the assets and settle the liability simultaneously.

Basic financial assets

Basic financial assets, which include debtors and cash and bank balances, are initially measured at transaction price including transaction costs and are subsequently carried at amortised cost using the effective interest method unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market rate of interest. Financial assets classified as receivable within one year are not amortised.

Debt instruments are subsequently carried at amortised cost, using the effective interest rate method.

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of operations from suppliers. Amounts payable are classified as current liabilities if payment is due within one year or less. If not, they are presented as non-current liabilities. Trade creditors are recognised initially at transaction price and subsequently measured at amortised cost using the effective interest method.

Derecognition of financial liabilities

Financial liabilities are derecognised when the society’s contractual obligations expire or are discharged or cancelled.

18

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

2 Critical accounting estimates and judgements

In the application of the society’s accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

Critical judgements

Deferred Income

Deferred Income has been estimated based upon sales invoices paid during the financial year that partly or entirely relate to the following financial year. Deferred Income totalled £268,117 during the financial year (2024: £289,670).

3 Income from donations and legacies

Donations
Donations
of
equipment		 Unrestricted
Funds
2025
£
50
-
50		 Restricted
funds
2025
£
63,374
-
63,374		 Total
2025
£
63,424
-
63,424		 Unrestricted
Funds
2024
566
-
566		 Restricted
funds
2024
70,973
34,000
104,973		 Total
2024
71,539
34,000
105,539

4 Income from charitable activities

Disseminating information on the speciality
Subscription income from members
Journal income
Income from meetings, courses and events
Hand diploma income
Other income		 Unrestricted
Funds
2025
£
229,078
539,248
325,075
24,300
546
1,118,247		 Unrestricted
Funds
2024
£
211,940
528,215
411,403
24,150
1,890
1,177,598

19

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

5 Income from investments

Income from listed investments
Bank interest receivable on short term cash deposits
6
Expenditure on raising funds
Investment management
7
Expenditure on charitable activities
Direct costs
Membership costs
Journal expenditure
Meetings, courses and events expenditure
Hand diploma costs
Website and PR costs
Other direct costs
Global partnership costs
Faculty costs
Grants, bursaries and awards
Share of support and governance costs (see note 8)
Support
Governance
Analysis by fund
Unrestricted funds
Restricted funds		 Unrestricted
Funds
2025
£
65,717
6,715
72,432
Unrestricted
Funds
2025
£
7,666
Disseminating
information on
the speciality
2025
£
56,111
112,000
207,478
20,092
2,538
4,163
162,123
38,983
603,488
41,774
494,990
37,273
1,177,525
1,020,471
157,054
1,177,525		 Unrestricted
Funds
2024
£
70,558
5,425
75,983
Unrestricted
Funds
2024
£
11,446
Disseminating
information on
the speciality
2024
£
46,852
108,068
284,714
57,488
1,752
14,804
141,954
66,883
722,515
222,793
534,010
40,223
1,519,541
1,394,091
125,450
1,519,541

20

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

8 Support costs allocated to activities

Staff costs (95:5)
Premises (95:5)
Office overheads (95:5)
Legal and professional fees (95:5)
Accountancy costs
Irrecoverable VAT (95:5)
Health insurance & other staff costs (95:5)
Governance
Analysed between:
Disseminating information on the speciality		 2025
£
408,408
6,304
38,140
679
2,838
33,855
4,766
37,273
532,263
532,263		 2024
£
414,408
12,683
27,755
979
10,879
46,703
20,603
40,223
574,233
574,233

The above costs are allocated between support costs and governance costs using the ratios shown in brackets 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.

9 Net movement in funds

The net movement in funds is stated after
charging/(crediting):
Fees payable to the charity's auditor:
- for the audit of the charity's financial statements
- for other financial services		 2025
£
11,370
-		 2024
£
10,530
3,000

10 Trustees

During the current year, seven trustees were reimbursed for travel and subsistence expenses totalling £15,879 (2023/2024: eleven trustees were reimbursed for travel and subsistence expenses totalling £9,175).

11 Employees

2025 2024
The average monthly number of employees during the year
was: 9 9

21

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

11 Employees (continued)

Employment costs

Wages and salaries
Social security costs
Other pension costs
There were no employees whose annual remuneration was more than
£60,000.
Remuneration of key management personnel
The remuneration of key management personnel was as follows:
Aggregate compensation		 2025
£
336,352
26,865
66,686
429,903
2025
£
107,095		 2024
£
339,745
29,708
67,850
437,303
2024
£
102,626

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 £4,682 (2023/2024: £4,682).

12 Gains and losses on investments

Gains arising on:
Revaluation of investments		 Unrestricted
funds
2025
£
51,705		 Unrestricted
funds
2024
£
118,894

13 Taxation

The charity is exempt from taxation on its activities because all its income is applied for charitable purposes.

22

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

14 Fixed asset investments

1 June 2024
Valuation changes
Changes in cash
Investment charges
Disposals
31 May 2025
Carrying amount
At 1 May 2025
31 May 2024
15
Stocks
Medical equipment held for use in the Lion project
16
Debtors
Amounts falling due within one year:
Trade debtors
Prepayments and accrued income
17
Creditors: amounts falling due within one year
Amounts falling due within one year:
Other taxation and social security
Deferred Income
Trade creditors
Other creditors
Accruals		 listed
Investments
1,796,706
51,706
(5,381)
(3,000)
1,840,031
1,840,031
1,796,706		 cash in
portfolio
£
18,958
2,406
(2,285)
19,079
19,079
18,958
2025
£
18,900
2025
£
88,668
86,459
175,127
2025
£
48,707
268,117
9,030
6,908
38,384
371,146		 Total
£
1,815,664
51,706
2,406
(7,666)
(3,000)
1,859,110
1,859,110
1,815,664
2024
£
70,000
2024
£
135,445
104,663
240,108
2024
£
49,636
289,670
17,597
7,830
179,848
544,581

23

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

18 Deferred income

Other deferred income
Deferred income is included in the financial statements as
follows:
Current liabilities
Movements in the year:
Deferred income at 1 June 2024
Released from previous periods
Resources deferred in the year
Deferred income at 31 May 2025		 2025
£
268,117
268,117
289,670
(289,670)
268,117
268,117		 2024
£
289,670
289,670
257,710
(257,710)
289,670
289,670

19 Restricted funds

The restricted funds of the charity comprise the unexpended balances of donations and grants held on trust subject to specific conditions by donors as to how they may be used.

Lion project
Belfast subvention
Lion project		 At 1 June
2024
£
-
-
-
At 1 June
2023
£
-		 Incoming
resources
£
48,374
15,000
63,374
Incoming
resources
£
104,973		 Resources
expended
£
(142,054)
(15,000)
-157,054
Resources
expended
£
(125,450)		 Transfers
£
93,680
-
93,680
transfers
£
20,477		 At 31 May
2025
£
-
-
-
At 31 May
2024
£
-

The aim of the Lion (Lilongwe Institute of Orthopaedics and Neurosurgery) project is to empower local surgeons and therapists in Malawi to specialise in hands, through education and training. A Hand Service, with regular hand surgery and hand therapy clinics, dedicated theatre lists and protected teaching time, has now been established in the newly opened and bespoke LION facility, thanks to the continuous presence of a rotating team of BSSH/BAHT volunteers. We expect that we will be able to gradually withdraw our presence on the ground over time and that this new Hand Unit will become a sustainable service and continue to help heal the hands of Malawi in the future.

During the year the society held a scientific meeting in Belfast. A donation of £15,000 was received from Visit Belfast, the marketing organization for Belfast City. The funds received from Visit Belfast were restricted for use on venue hire, audio visual equipment and travel & accommodation costs for guest speakers.

24

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

20 Operating lease commitments

At the reporting end date the society had outstanding commitments for future minimum lease payments under non-cancellable operating leases, which fall due as follows:

Within one year
Between two and five years		 2025
£
20,159
-
20,159		 2024
£
21,032
16,487
37,519

21 Related party transactions

One trustee was paid editor fee's totalling £16,000 (2024: one trustee was paid editor fees totalling £16,000).

22 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, included within unrestricted funds, in respect of pension costs (as shown in note 7) is the total contributions payable for the year. Any contributions payable at the balance sheet date are treated as creditors (as shown in note 10). At the year end, unpaid contributions totalled £6,908 (31 May 2024: £7,826).

SAUL is subject to triennial valuation by professionally qualified and independent actuaries. The last available valuation was carried out as at 31 March 2023 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 3.37% per annum
Price inflation – CPI 2.37% 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 £3,096 million representing 105% 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 increased from 19% to 21% of salaries from 1 January 2023.

25

BRITISH SOCIETY FOR SURGERY OF THE HAND NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 MAY 2025

22 Pension commitments (continued)

A defined contribution feeder scheme was introduced in 2023 for new employees. This is 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 2026) are known.

23 Cash generated from operations

Surplus / (Deficit) for the year
Adjustments for:
Investment income recognised in statement of financial
activities
Investment charges recognised in statement of financial
activities
Fair value of gains on investments
Movements in working capital
Decrease in stocks
Decrease / (increase) in debtors
(Decrease) / increase in creditors
(Decrease) / Increase in deferred income
Cash absorbed by operations		 2025
£
120,617
(72,432)
5,381
(51,705)
51,100
64,981
(151,882)
(21,553)
(55,494)		 2024
£
(52,973)
(75,983)
15,785
(118,894)
8,000
(134,544)
133,944
31,960
(192,705)

24 Analysis of changes in net funds

The society had no material debt during the year.

26