2020-12-31-accounts - The British Kidney Patient Association

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BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Registered number: 1228114 Charity number: 270288 Charity number (Scotland): SC048198

BRITISH KIDNEY PATIENT ASSOCIATION, operating as Kidney Care UK

(A Company Limited by Guarantee)

TRUSTEES REPORT AND FINANCIAL STATEMENTS

for the year ended 31 December 2020

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

The Trustees (who are also directors of the Charity for the purposes of the Companies Act) submit their annual report, which incorporates the Directors' report, and the financial statements of The British Kidney Patient Association (BKPA), operating as Kidney Care UK, for the year ended 31[st] December 2020. The financial statements comply with the Charities Act 2011, the Companies Act 2006, the Memorandum and Articles of Association, and Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their financial statements in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) (effective 1 January 2019).

Foreword

When we started 2020, we began the year knowing that 2019 had seen us reach and support more patients and families than ever before. There was talk of a respiratory virus coming from China, but we had no idea what was to come or the scale of a global pandemic with its unprecedented medical, psychological, economic and social consequences for the kidney community.

Covid-19 dominated the year and impacted every aspect of the charity’s work and operations. We quickly had to move staff to home working arrangements and learn new digital ways of operating and delivering our patient support services. Many activities had to be cancelled or paused due to Government rules around social distancing, with the cancellation of holidays and respite breaks along with major events like the Transplant Games and Kidney Care UK activity breaks, all at a time of great uncertainty around the Charity’s income and fundraising activities.

However, with kidney patients classified as clinically extremely vulnerable and told to stay at home and self-isolate, it was clear that our priority was to ensure we were there to support patients and their families through worrying and anxious times, and able to meet the surge in demand for help from those facing the brunt of the pandemic; To provide a vital lifeline to up-to-date, clear information and guidance in a constantly changing world, to urgently respond to the increased demand for practical support and to help patients and families cope with the impacts of prolonged social isolation and hardship, and to ensure that we took the voice and concerns of the patient community to the heart of decision making in both Government and the NHS.

A year of shielding and isolation for patients followed, with the impact that has on patients’ mental and physical wellbeing, not to mention the stress about feeling forced to work in potentially unsafe environments or not being able to work at all. Restrictions may have kept everyone apart, but our wonderful staff and supporters rose to the challenge and ensured that our information, and practical, emotional, and financial support helped support and keep the kidney community connected.

With most of our staff forced to work from home we ensured a rapid response including ordering additional equipment and adjusting our working practices to ensure staff could move from working at our office to working from home within a matter of days.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Regular meetings with the professional associations and Government departments allowed us to ensure patients’ concerns were at the forefront of decision makers’ thinking - whether around employment concerns, food delivery and shielding support, or patient safety for those who still had to travel to hospital for dialysis.
We translated the constantly changing rules and regulations into patient friendly advice and guidance and established the Charity as the first port of call for information support, seeing a 30% increase in calls to the charity in March and April, and a fourfold increase to nearly a million visits to our website in the year.
Our campaigning on behalf of patients, often in partnership with other national health charities achieved our biggest impact in the media with almost 1,600 pieces of media coverage.
We responded to the increased demand for our in-depth personal support, by increasing our resources and capacity across advocacy and counselling and delivered over 4,000 sessions for patients and their loved ones.
We responded to patients’ financial concerns with a doubling of our hardship grants, to nearly £100,000 in urgent support, and our welfare and benefits service, supporting over 500 patients, securing over £900,000 of financial benefit for families needing a little extra support to get by.

Although the need to respond to the immediate impact of the pandemic has affected the scale and pace of planned development activity for the Charity, we are pleased to report that the Charity continued to maintain a strong development focus, with both improvements at an operational level as well as the completion of our new 5-year strategy, which will see us continue to grow and support even more patients and make a bigger difference to peoples’ lives.

Tragically, 2020 has seen this cruel virus take too many of our colleagues, friends and peers before their time, and as a Charity we were saddened to lose two key individuals, without whom the charity would not be where it is today. In July, our founder Elizabeth Ward OBE sadly passed away. Mrs Ward founded the charity in 1975, when her son Timbo started dialysis. Elizabeth pioneered the very first organ donor card, as well as setting up the first holiday facilities in the UK and Europe for dialysis patients. She dedicated her life to improving the quality of life for kidney patients and made a huge difference to thousands of people with kidney disease over three decades. We at Kidney Care UK carry her mantle forward today and will continue to build on her legacy.

Unfortunately, we were also deeply saddened by the untimely passing of our Chair of Trustees, and a giant figure in renal care for over 30 years, Professor Donal O’Donoghue OBE, who lost his short battle with Covid19 at the start of January 2021. The thoughts of everyone at the Charity remain with his wife Marie and their family. Donal spent more than 30 years working to improve the care of people with kidney disease; He was the first Kidney Czar, a past President of the Renal Association and a founding member of the British Renal Society. He had been our Chair since 2016 and everyone at the charity misses him terribly.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Donal was an inspiration to so many in our community; tireless in his support for people with kidney disease, never hesitating to listen to all, to highlight inequalities and promote the best possible care for kidney patients. His passion remains at the heart of the ethos and values that Kidney Care UK carries forward into the future.

Whilst 2020 is a year none of us would like to repeat, we know Elizabeth and Donal would have been incredibly proud of the role the charity played in supporting kidney patients over the last 12 months, and like us, enormously grateful to all the staff, supporters and volunteers who made it possible.

Sir Jonathan Michael MB, BS, FRCP, FKC Paul Bristow Chair of Trustees Chief Executive

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

About Us

Kidney Care UK is the UK’s leading kidney patient support charity working to improve the quality of life for everyone affected by kidney disease. We provide practical, financial and emotional support to kidney patients, their families and carers, work in partnership with health professionals and statutory bodies to improve access and quality of health and care services, represent the patient voice in campaigning for change in policy and practice, and raise awareness of kidney disease amongst the wider public.

A diagnosis of kidney disease can be devastating, taking a considerable toll on patients and their loved ones; affecting their physical health, emotional wellbeing, financial situation, relationships as well as employment and lifestyle. We are the foremost kidney patient charity in the UK, working every day to change lives for patients, whatever their age, wherever they are in the UK and at whatever stage of the disease they might be. With our help no one should face kidney disease alone.

Our Vision: A better life for kidney patients, where patients can live their life to the full

Our Mission: To improve the quality of life of everyone affected by kidney disease:

Financial Support

We are there in times of hardship with our patient grants and advice on welfare and benefit entitlements when families need a little help to make ends meet, have a much-needed holiday or respite break or just a little help to get back on the road to employment.

Emotional Support

The impact of kidney disease affects all aspects of a patient’s life, not just their physical health. We understand that care and support needs to be holistic and are there when patients just need to talk to someone or help to take back control of their lives.

Practical Support

Whether it is having access to the right information, talking to our Advocacy Team or finding peer-topeer support through our online community; whatever the situation or stage of kidney disease, we are always there to help support and advise.

Working to Improve Health and Care Services

For more than 40 years Kidney Care UK has been supporting improvements and innovation in care, investing in better facilities, funding new roles or service improvement projects and working with key decision makers to drive sustainable improvements in patient care.

Campaigning for Change

Our policy team work tirelessly, influencing Government and key decision makers to raise important issues in policy and practice, campaigning for improvements and ensuring that patients’ views are represented at all levels.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Our Impact in 2020 – Goals and Achievements

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

How we spent our funds in 2020

2020; Our priorities and achievements

Last year’s annual report set out our priority strategic aims for 2020, committing us to:

Continue to raise the profile of the Charity, and kidney disease in the wider population, and ensure even more patients are aware of and have access to the information and support we provide.
Continue to develop our information support by expanding our content and use of multimedia and digital channels to ensure more patients can access the information they need.
Continue to develop and expand our direct support services to provide more in-depth personal support to patients and their loved ones.
Continue to co fund the Kidney Quality Improvement Partnership with the RA and BRS to ensure that service improvement is fully embedded in kidney care and seek to drive the wider adoption of best practice that reduces unwarranted variations in care across the UK.
Seek to strengthen our existing partnerships and develop alliances with key health professionals and other organisations and work collaboratively to drive faster and greater change in kidney health and care services.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Continue to respond quickly to issues and ensure a strong patient voice at the heart of policy and practice, with services that are adequately resourced, appropriately commissioned, equitable to all and working to defined quality standards.
Continue to transform our frontline and back office systems, processes and ways of working and ensure our technology is fit for purpose in supporting effective security governance and efficiency of our operations.
Work to ensure that the new organ donation law in England is effectively implemented and supported through sufficient public awareness and education, and NHS capacity planning, and work with key decision makers in Scotland and Northern Ireland to influence and support similar law changes in the devolved governments.
We will review and strengthen our impact reporting so that more people are aware of the work we do and the difference it makes every day to patients’ lives.

– Supporting patients and their wellbeing Our direct support services

A diagnosis of kidney disease can devastating for individuals and families, scary and confusing. Sometimes upon hearing those words, whether expected or out of the blue, patients can block out everything else and do not think to ask their doctor questions; or even know where to start with what they need to know about living with a chronic illness. That is why we believe it is so important that people have the best possible access to the support and information they need to live well with kidney disease.

However you want to receive that support and information, we are here to help; whether through speaking to experienced advocacy officers working on patients’ behalf’s; financial and welfare support to help with money worries; a confidential telephone counselling service; or expert patient information via our website, digital channels or printed leaflets. We are here to ensure no one faces kidney disease alone.

As awareness of the Charity continues to grow so does the demand for our services:

Our Advocacy and Patient Support Officers dealt with a total of 2,876 referrals in 2020, a 5% increase on the previous year.
Our Welfare & Benefits Service, delivered by our patient advocacy team and in partnership with Auriga, secured nearly £1 million in benefits in 2020, providing more than 500 kidney patients and their families with access to funds and support they were entitled to receive but had thus far been out of their reach.
We provided counselling support to more patients and their families than ever before; 223 individual clients received specialist, personal help in 2020, and we delivered over 1,000 counselling sessions to help patients cope and regain control of their lives, a 61% increase on 2019.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

The number of individual title orders of our patient information, delivered in partnership with the Renal Association, was up 18% from 1,616 in 2019 to 1,911 in 2020 and the number of units ordering has now increased to more than 150, over half of the units in the UK.
The reach of our digital and social media channels, a lifeline to many during the prolonged isolation caused by Covid-19, grew significantly with Twitter followers up 35%, Facebook followers increasing by 52%, Instagram by 87% and nearly a million visits to our website.
2020 was the year we achieved our biggest impact in the media with almost 1,600 pieces of media coverage (1,592), more than double the total achieved in 2019, supporting our efforts to ensure patients concerns were heard and raising greater awareness of kidney disease.
Our hardship grants for patients in urgent need increased from £54,897 in 2019 to £99,272 in 2020, with the number of individual grants increasing by more than 40% compared to 2019.

All this resulted in the Charity spending over £1.5m on direct personal support for kidney patients.

Practical support – Our vital patient support and advocacy team

The National Advocacy Service is pivotal to our patient support. The team of 14 Advocacy Officers provide non-medical advice and guidance. They empower patients on their treatment journeys and

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

help patients to navigate health and social care systems, whist also acting as the vital link to our other patient support services and those of external organisations.

This year has been the most challenging year for the Advocacy Service, many of them patients themselves and having to self-isolate for their own safety. We supported more people than ever before, with a total of 2,876 referrals compared to 2,742 in 2019, a 5% increase. The service saw peak calls in March - a response to the early weeks of the pandemic when our patient community felt at its’ most vulnerable. April, June, July, September, and November saw referrals top 250 each month, typically responding to different phases of lockdown.

Despite so much of our focus being on the pandemic we still dealt with a huge number of calls from patients struggling to navigate the benefits and welfare system, just to secure the financial support they were entitled to. Our Welfare & Benefits Service, delivered in partnership with Auriga, supported over 500 patients and their families and secured nearly £1 million in financial support, helping ease just a little the increased financial concerns as a result of the pandemic. Whilst the Advocacy Service also secured over £130,000 of benefits through successful PIP & ESA applications and appeals.

With demand for our support increasing annually and in accordance with our ambition to ensure every patient has access to our help and support, we expanded the service with the addition of two Advocacy Officers, both with career backgrounds spanning many years as NHS Renal Social Workers, in the North East and South Central; bringing the team up to fourteen officers, covering all regions and countries of the UK.

Working from home has been challenging and an essence of our work had been lost – face to face contact with patients. To combat this, we trialed a virtual online support group in three areas, to help Advocacy Officers reach isolated patients via Teams or Zoom and help others feel connected. This service we will grow and develop in 2021 as we find new and innovative ways to increase our support.

“Leigh-Anne has phoned saying that the ESA appeal was successful! We are so thankful for all your help; it's been very much appreciated from both of us.”

Leigh-Anne has Autism Spectrum Disorder along with stage 5 CKD. She was yet to start dialysis as she had three failed attempts at creating an arteriovenous fistula. Leigh-Anne was placed in the workrelated activity group for ESA, despite the fact her social anxiety makes it impossible for her to speak to anyone outside of her family circle and she cannot leave her home unaccompanied. Speaking to Leigh-Anne through her mum Diane, we appealed the original ESA decision and liaised with LeighAnne’s unit to get support letters. The appeal was successful, and Leigh-Anne is now in the support group of ESA, £39 better off each week and received a backdated payment of nearly £2,000.

Patient information – A trusted source of information so desperately needed

At any time in a patient’s life, being able to access clear and accurate information, available whenever and wherever its needed, is vital and can make all the difference to an individual’s care experience.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

However, during a global pandemic this has become more important than ever before.

This year much of the patient information activity shifted towards a priority focus on providing up to date, timely information for kidney patients around coronavirus guidance, constantly changing throughout the year as Government advice and clinical guidelines evolved in response to the pandemic, with digital and social media channels being key in ensuring that often daily updates could be provided to patients.

“Congratulations for working so hard to support kidney patients. You have been creative in adapting to new ways of reaching out to patients during these difficult, ever changing and scary times.”

Our social channels have grown significantly with Twitter followers up 35%, Facebook followers having increased by 52% and Instagram increased by 87%. Our online Facebook support group continues to thrive, providing a virtual kidney community and safe space for patients and carers to share posts and experiences. By the end of 2020, the group had increased its membership to nearly 10,000 members (9,505, up from 8,310 members at the start of 2020, representing a growth of 14% over the year).

This trend for digital support was reflected in the fact that nearly one million website user sessions recorded. This leap (increase of 173% on 2019) is unquestionably a result of our digital and media activity focussed on Covid19 patient information and campaigning, and successfully establishing our website as the ‘go to’ site for patients and healthcare professionals. However, Covid19 advice only accounts for 39% of total traffic to the website so our core offering of patient information particularly diet, CKD specific information, services and winter wellness advice have all contributed.

“The Kidney Care UK website has been our go-to source as the government advice around shielding changed. The website is always up-to-date, and we know it will be completely relevant… giving us the information we need. We check it every day and can’t thank you enough for such a vital resource.”

Our partnership with the Renal Association to co-produce the highest quality, trusted source of patient information continued to grow, with another 12 leaflets developed in 2020 and the continued growth of kidney units ordering regularly. The number of individual title orders was up 18% to 1,911 in 2020, with over 50% of the units in the UK using the material.

2020 also saw the continued development of the Kidney Kitchen website and by the end of December there were 62 recipes online, including a package of recipes for the first time for Christmas, with a range of festive feasts which proved extremely popular. In total there were nearly 80,000 page views in 2020.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“I would like to thank you for your wonderful recipes. I have been diagnosed with stage 3 CKD and my potassium was a bit high, so I searched online for some recipes and am really grateful for finding your site.

“I have never been much of a cook. However, since the beginning of the first lockdown I have stocked my cupboards with many new spices and have learned to cook food I actually like. I have found your recipes really tasty and have enjoyed watching the demonstrations too even if mine doesn't always look exactly the same!”

Kidney patient feedback

_______________

Another popular initiative introduced in response to growing anxiety from patients as lockdown was easing was the ‘Distance Aware’ shielding badges, with approximately 8,000 distributed to hospital units by our Grants team in 2020. The campaign aimed to act as a polite reminder to maintain respectful distancing around others when possible, and we produced button badges that feature this symbol for our supporters. We also worked directly with Twitter to create a Distance Aware emoji that would appear every time the hashtag was used in 2020.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

We continued to work with Public Health England on our joint winter wellness campaign, and to promote uptake of the flu jab. We were able to produce tailored materials for kidney patients including social media content and a leaflet that can be downloaded from our website.

One of our proudest moments of 2020 was receiving the following feedback on our ‘Put a lid on it’ keyrings. Introduced at the end of 2019, over 7,500 of these have been distributed in 2020 and as Sarah told us, Graham ended up using his sooner than he had expected…

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“On behalf of our patients I would like to say a big thank you for the Kidney Care UK ‘put a lid on it’ campaign. Teaching patients how to look after their fistula is an important part of our work and every patient is given an education pack with an information leaflet, gauze, tape and a Kidney Care UK ‘put a lid on it’ keyring, with instructions on how to use it, in case the fistula starts to bleed at home.

As part of his annual fistula care update, we gave Graham Riley a Kidney Care UK ‘put a lid on it’ keyring. That same day, Graham went home after his dialysis session using hospital transport. As he got to his front door his fistula suddenly started to bleed profusely. Graham asked the transport driver to put the bottle top-shaped key fob over the bleeding site and maintain even pressure on it. The driver quickly did as he was asked, trapping air inside the bottle top, and after about five minutes the bleeding stopped. This incident just goes to prove that the Kidney Care UK ‘put a lid on it’ keyrings quite literally have the potential to save a life!”

Sarah Simpson, Senior Sister (renal services), Seacroft Hospital, Leeds

Emotional support – counselling to help patients regain control during an uncertain year

The impact of the Covid19 pandemic had a huge impact on the levels of worry and anxiety in the kidney community, with kidney patients at a significantly higher risk of mortality from the virus. Our series of patient surveys throughout 2020 showed that around 40% of patients reporting that their mental health had been affected and 60% reporting disruption to their life saving care.

Our counselling service is a lifeline for many during “normal” times, particularly with the continued lack of universal access to high quality psychosocial provision for kidney patients. Throughout 2020 it was needed more than ever, and we ensured an uninterrupted, five-day-a-week, phone-based counselling service for kidney patients and their families.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

We expanded from two to three counsellors, enabling us to offer up to 40 session hours per week, and delivered over 1,000 counselling sessions to more than 200 patients to help them regain control of their lives and cope with the pandemic, a 61% increase on 2019.

“I want to say a big thank you for all your support and counselling over the past few months. As a partner of someone living with CKD5 and transitioning onto dialysis, I truly don’t think we would still be together as a couple without the Kidney Care UK counselling support. It was a very dark time, juggling all the medical appointments, Covid, children, jobs, and general life, whilst having to stay super strong for my partner and without having any idea of what was about to happen or how life would change for us.

Just having someone to talk to about how I felt and how to keep sane really pulled me through. After a very rocky time, we are now set up on dialysis and I feel like a different person to the one who first phoned the Kidney Care UK team for help a few months ago.”

Feedback from counselling client

Financial support – our assistance grants were a safety net for so many

Kidney Care UK has always been here to provide a safety net of financial support for patients through our individual grants programme and welfare services. We are there to ensure that those who are struggling to make ends meet because of their kidney disease can get that little bit of extra support to help get back on their feet.

However, a global pandemic and a population of kidney patients told to shield led to a shift in how we supported people in 2020. With holidays cancelled for everyone, and the increased worry over employment prospects for many, the focus of our support centered on financial assistance through our hardship grants. Working with the national network of renal social workers, we ensured a quick response to patient needing financial help to cope, with many patients continuing to receive financial support within a week of their application being received.

We have assisted patients and their families with cookers, fridges, washing machines, furniture, carpets, beds, all the items a person needs but which many of us can take for granted, as well as support with rent and mortgage payments so families can keep a roof over their heads. We provided grants to 1,194 patients in 2020, totaling £567,471, and in particular saw our support providing hardship grants for patients in urgent need increased by 80% from £54,897 in 2019 to £99,272 in 2020, providing urgent help to over 300 patients.

Our Benefits and Welfare Health Check Service continued to provide a financial lifeline to many just trying to secure the support they are entitled to and struggling to navigate the complex world of benefits. We helped over 500 patients secure nearly £1m (£900,193) in welfare support across the wide range of benefit systems, from Personal Independence Payments to Employment Support Allowance.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Patient grants awarded by category

Education and Training	£ 16,309.57	28
Rent & Housing Costs	£ 46,636.15	67
Domestic, Heating & Utility Bills	£ 30,445.04	79
Household Goods, Furniture and Sheds	£ 211,449.26	449
Travel & Motor Costs	£ 43,937.26	113
Holidays & Respite Breaks	£ 51,998.49	81
Funeral Costs	£ 60,245.98	43
Clothing and Hardship	£ 99,272.00	308
General	£ 7,177.86	26
	£ 567,471.61

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“My new fridge freezer arrived last week. This has made an enormous difference to the way I can plan and shop for meals because I am now able to freeze food which cuts down on trips to the shops, which are places that I am trying to avoid because of covid19. This grant has been had such a positive impact on my life and taken some of the stress out of daily living. Thank you so much to Kidney Care UK for all you have done to help and support me.”

Patient grant recipient

Improving access and quality in health and care services

As well as providing a direct lifeline to patients, we also work with hospitals, health professionals and other leading organisations to drive significant, sustainable improvements to health and care services provided to kidney patients. We know that there is considerable variation in patient support and outcomes across the UK, and every hospital will have its own challenges and specific local needs, many of which will have been exacerbated by the coronavirus pandemic. Our hospital improvement grants are designed to help meet local improvement needs, drive new and innovative ways of improving patient care and outcomes, supporting new staff posts, as well as quality improvement projects right across the UK.

Hospital Improvement Grants – supporting local innovation and service improvements

In 2020, our grant funded initiatives indirectly supported over 3,000 kidney patients and we spent nearly £500,000 (£473,742) in grants and partnerships, supporting 65 individual projects to improve patient care. At the end of 2020, our ongoing commitments and liabilities, as we fund projects over a number of years, totalled over £1¼ million (£1,311,067).

As the uncertainties of 2020 unfolded, we took the decision to continue our hospital grants programme, to ensure the Charity continued to be there and provide vital ongoing support to care improvements at this challenging time. The Grants Committee awarded 4 new grants in 2020, totalling £246,195, funding a Renal Psychologist at Sunderland (which had no dedicated mental health support for patients), an innovative web-based application to support patient self-monitoring and virtual care at Portsmouth and two posts at Newcastle to support the pilot of an innovative enhanced recovery programme (ERAS) for transplant patients.

We continued our support to seed fund psychosocial support staff, including counsellors, psychologist and youth workers, so often not seen as priority for NHS funding. We provided funding for 16 staff in 2020 investing over £250,000 (£251,436) to provide immediate patient support whilst working to ensure these posts become permanently funded by the NHS. Posts funded included a specialist renal mental health nurse in London, a Shared Care Assistant in Middlesbrough, as well as a Renal Supportive Care Nurse in University Hospital Crosshouse, to develop a palliative care service for patients and their families.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“As a family it was a difficult time, not just knowing that there was only one eventual outcome but emotionally and logistically there was a lot to cope with too. In you there was a constant and informed voice to help make sense of everything that was happening.

Throughout her last few months, she also greatly appreciated and valued your visits and attention. Yours was the guidance I needed and would have been lost without it’ medical expertise and professionalism aside, you have the empathy and compassion that characterises the NHS as its best.

I am and always will remain grateful to you and to Kidney Care UK for the support, guidance and care you gave me and my family.”

Feedback given to the Renal Supportive Care Nurse; a role funded by Kidney Care UK at University Hospital Crosshouse, and winner of the Renal Nurse of the Year Award 2021.

Although our young adult activity weekend couldn’t go ahead in 2020, we continued to support young adult kidney patients through our partnership with the national peer support network (Young Adult Kidney Group), and together we agreed to move the weekend to a virtual, event – and so the Virtual Young Adult Weekend 2020 was born!

The weekend was designed to emulate the typical events that would have usually taken place but in this new digital setting and activities included a Friday Night Quiz, an art project, Saturday Night Social, photography competition and even a gaming stream on Twitch. There was also a Diversity and CKD Seminar and a Live Q&A. Teaming up with our Kidney Kitchen, there was a live cook-along on Zoom with Chef Paul Ripley and the weekend finished with an online showing of Childs Play. The weekend was well attended and enjoyed by all, and much needed at a time when keeping connected to friends and colleagues was more vital than ever before.

Thank you for bringing the weekend trip to us virtually this year. People were starting to open up and see this as not just a place to talk about your problems or just advice but, like myself, looked at it like a family. We may not have met up as normal but this weekend brought joy and laughter to so many of us. I hope this is something that could be done again as I believe it helps us more than people would realise.

Feedback from young adult kidney patient

Strong partnerships - delivering sustainable, systemic change to health and care services

It takes a strong joined up kidney community to provide that vital network of support to deliver sustainable change and we continue to build strong partnerships with the leading health associations to embed improvements across the whole UK permanently, and to work with local kidney patient organisations and national charities to deliver better support for patients than we could deliver alone.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

We continue to seek stronger regional relationships, working with local Kidney Patient Associations (KPA) and supporting key ‘Educational and Information Days’ for adults, young adults and children. We spent over £13,000 in this area in 2020, including supporting the photography exhibition ‘Survivors Life Unfiltered’ and funding a new website for the North Staffordshire KPA. Our work in the devolved countries was expanded, working in partnership with the leading welsh charities, The Paul Popham Fund and Kidney Wales, to introduce a regular Covid-19 newsletter and with the Scottish Kidney Federation to deliver a national patient conference.

The Renal Arts Group is another team who have been able to make use of technology to ensure they stay in touch as well as allow for greater participation outside of the immediate Belfast area. The group, initially funded by Kidney Care UK, launched their website in the summer of 2020. Recognising the power that creative arts have, the site brings together different arts strands including music, poetry, and visual art.

As part of the Kidney Charities Together team (the leading national kidney charities), we saw the most successful World Kidney Day campaign to date, as we again worked together to raise awareness of kidney disease to a wider audience. With a new brand and strapline, we sent out 265 supporter packs, saw 80% more website visitors than previous years, and an influencer social reach of over 1.1 million.

We continued to partner with the Renal Association on the national Kidney Quality Improvement Partnership, although the programme managers funded by the two organisations were increasingly diverted to support regional efforts to support patients and hospitals through the pandemic. Our national programmes on Vascular Access, Transplant First and DayLIFE (home therapies), were effectively paused as all resources were needed to cope with the impacts of Covid-19. We hope to see a major relaunch in 2021.

Involving patients and putting their voice at the heart of service improvement

The Kidney Patient Reported Experience Measure (PREM)

To reduce the burden on kidney centres and in accordance with infection control measures to protect patient safety, the Kidney PREM survey was hosted online only in 2020. Whilst the number of completions was down on previous years, we still achieved nearly 10,000 responses from all 70 main adult renal centres, ensuring that patients’ views and feedback continued to be at the heart of service improvement across the UK. Encouragingly, despite all the challenges of experiencing care during a pandemic, most patients continue to rate their overall experience of kidney care highly, with an average score of 6.2 out of 7.

Huge efforts were made in Wales to increase patient responses in 2020, meaning that this region saw an increase in returns from 365 in 2019 to 968 in 2020, making up over 10% of the total Kidney PREM and representing over a quarter of patients on renal replacement therapy in Wales.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

This year, a group of kidney patients worked with the Kidney PREM Working Group to design four additional Covid19 specific questions which are being analysed separately to better understand and learn how the pandemic impacted the experience of kidney care and what learning and experience can be shared between patients, centres and the national kidney community.

Launch of the Kidney Patient Involvement Network (KPIN)

2020 saw the formal launch of the Kidney Patient Involvement Network, funded and supported by Kidney Care UK to significantly increase the level and quality of patient involvement in the UK. KPIN is designed to embed the patient and carer’s voice into the planning and delivery of health and care services, research and quality improvement. It provides a network of patients and health professionals to share good practice and resources, and build an infrastructure that connects and coordinates patient involvement and promotes user and carer interests.

“This really puts patients as the drivers of innovation and improvement…Looking forward to seeing all the service improvement programmes in Wales when the analysis is published.”

Welsh Renal Clinical Network Manager

Campaigning for change and a better future for kidney patients

At Kidney Care UK we work tirelessly to campaign for better care and support people with kidney disease. This has been more important than ever during the Covid19 pandemic and evidence from patients has been a vital part of our work. At the same time kidney disease doesn’t wait and we needed to support continuing programmes and campaigns for and with patients, such as the organ donation opt-out law and maintaining the funding for dialysis treatment after the country exited the EU.

Covid19 support – the voice for thousands of kidney patients when they needed to be heard

At Kidney Care UK we committed to providing up to date and relevant information for patients at an early stage; our patient information partnership with the Renal Association meant we were well placed to do so. This commitment has remained throughout the pandemic, from the beginnings of shielding advice to the vaccine rollout and life beyond. Our online guidance is the cornerstone of information provision, and we ran regular webinars together with leading health professionals to provide in depth advice and support on issues of concern to the community. By the end of 2020 our main coronavirus advice page had received 634,271 page views with an average reading time of over 5 minutes and was listed as a top resource on the NHS website on the page for Chronic Kidney Disease.

Our webinar programme was delivered in partnership with leading health professionals and regional and community charities, to ensure we could reach and engage with as many patients as possible and tailor our information to specific devolved countries and marginalised communities, covering the topics that patient wanted to talk about and providing a platform for them to ask questions.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

This included a webinar specifically for the BAME communities covering vaccine hesitancy, when we were delighted to be joined by ITV’s Charlene White who shared her own experiences with us before she had to leave to present the evening news bulletin. More than 1,000 patients joined our webinars, with many more benefiting from the video soundbites we were able to record and publish.

By listening to patients and being their voice on Covid19, we were able to identify the issues that were of most concern to them and raise them with policy makers. In 2020 we surveyed over 2,000 kidney patients which resulted in our ‘Worried Sick’ and ‘Out of Sight, Out of Mind’ reports in May and October. These reports highlighted the impact the pandemic was having on patients’ mental wellbeing as well as their physical care and were used by commissioners in local networks to plan how they prioritised returning to more regular services.

We also ran a series of online meetings on the shielding experience with patients, NHS England and the Ministry of Communities, Housing and Local Government (MCHLG), with feedback from these going up to the government’s Scientific Advisory Group for Emergencies (SAGE) committee. We successfully campaigned to secure inclusion in the shielding group, and the associated additional support, for all kidney patients, including those with CKD stage 5 and other kidney diseases treated with immunosuppressants, and this was confirmed by the Government with inclusion in the clinically extremely vulnerable group. This is particularly important because of the 23% mortality amongst patients with Covid-19, with shielding status helping employers to understand whether patients should be furloughed and helped with access to priority supermarket slots.

“Thank you … such an important webinar especially for the BAME community, it was highly informative, I reconsidered my decision and had my vaccine on Monday."

“I just wanted to say thank you so very very much for the fantastic conference last night. It exceeded my expectations and was pitched at the right level to be both very interesting and informative. It answered all the questions I had, and I look forward to any further events run online like this. I am hugely grateful.”

Patient feedback

Reducing inequalities and ensuring our support is there for everyone affected by kidney disease – BAME engagement

We were very pleased that Amjid Ali joined us as a partner on BAME inclusion and engagement in 2020. His role will help to support Kidney Care UK with its aspiration to form a genuine partnership with BAME communities, encouraging the active involvement of patients, carers, and community partners. Despite the challenges we faced in 2020 due to Covid19 Amjid began his work by setting up listening events with healthcare professionals and also with community groups in order to identify gaps in care and awareness and how we can work together to address these.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“For me personally, success depends on our ability to engage in a way that continually demonstrates a respect and understanding of the cultural differences and the importance of having regular community conversations that gather insight, seek guidance and invite constructive challenge.”

Amjid Ali, BAME inclusion lead at Kidney Care UK

Changing the law - Improving rates of organ donation to save more lives

For many years Kidney Care UK has worked to promote an increase in organ donation and transplantation and on we were delighted that on May 20[th ] 2020, the opt-out law in England was passed and accompanied by a short video from the Secretary of State specifically citing the Charity’s work and welcoming the benefit for kidney patients. We continue to work in the devolved countries of Scotland and Northern Ireland and hope to see them follow Wales and England in shortly.

Brexit – standing up for patients’ concerns

Following our four-year campaign, we were delighted to be able to let patients know that reciprocal healthcare arrangements were to continue after the EU exit, meaning that patients can continue to receive dialysis at no or very limited charge when they travel in the EU, with the former EHIC system has now been replaced by the Global Health Insurance Card (GHIC). At the end a difficult year, news that kidney patients would not be disadvantaged by BREXIT was a welcome relief.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

“I fully appreciate the importance of EHIC for kidney dialysis patients, and I am grateful for the continued role Kidney Care UK has played in ensuring the implications for this group of people are well understood.”

Edward Argar, Minister of State for Health at the Department of Health and Social Care

Fundraising – a year in which our supporters really stepped up

We are incredibly grateful for the generosity of all our supporters, who are essential to helping us improve lives for kidney patients in the UK. It is only through them that we can do even more to meet the needs of the growing population of people living with kidney disease.

2020 was the final year of the first fundraising strategy as Kidney Care UK. It was meant to be the cherry on the top of a strategy that established solid foundations and consistent growth in both supporter numbers and the amount raised. The year started that way with a record 797 supporters (50% up on 2019) raising a record £68k in the first two months of the year. But then everything changed. For us all.

Like every aspect of life, fundraising and the third sector had to adapt and change to a world with Coronavirus; individual priorities changed; mass participation events were cancelled; community fundraising could only occur at a safe distance, and interaction became virtual. But these challenges brought innovation of new activity and new opportunities to reach and engage in a Covid safe way; mass challenge events were carried out in your own garden; virtual get togethers became the norm; and those individuals and organisations who could, showed their support more than ever.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

More than 4,000 new supporters engaged in our growing range of fundraising products and activities. 500 new supporters gave a donation, which along with existing supporters, generated £114k (£25k more than in 2019). 1,900 individuals ordered an item via our shop, which supported a record £42k being raised via our trade revenue (up £10k on 2019). We also secured more support from trusts and partnerships (to £75k to £120k). And, even in those areas most affected by the pandemic, we saw opportunities. 80 supporters signed up to one of our virtual challenges with many more supporting us via the reimagined London Marathon and Great North Run. In total, 245 individuals took on a challenge event in 2020 (up from 200 in 2019).

In total, 2020 saw a further 6% growth in non-legacy fundraised income (up to £469k) and 10% growth in the number of people and organisations supporting the charity with a gift or donation. Perhaps most importantly, 2020 saw a record net income that was more than 3 times that achieved at the start of the strategy in 2017.

The last word must go to the dedication and generosity of our fabulous supporters who run, walk, cycle, drink coffee, bake cakes as well as find a wide range of often downright weird and wacky ways to help other kidney patients.

“I really wanted to get involved with Kidney Care UK as my son-in-law is a kidney transplant recipient. I’d never thought of myself as a fundraiser before. I wasn’t a marathon runner or an organiser of big events. However, I decided to give it a go setting up a Just Giving page and sharing the line was so simple and donation from friends and family quickly followed. I’m so glad I asked for support.

The more we raise together, the more people Kidney Care UK can help, and the more lives will be improved.”

Eileen, fundraiser

Looking ahead to 2021 – Our aims and Goals

Despite the challenges of Covid-19, we were pleased to launch our new five-year strategy at the end of 2020. Building on the transformational plan developed in 2015, our new strategy is about evolution rather than revolution, and continues our work to develop and expand our support and reach and engage with even more patients, so that no one has to face kidney disease alone. The strategy was developed after a major consultation programme with all our key stakeholders and the wider kidney community, including kidney patients, KPA Chairs and health professionals

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

We will reach and engage with more people and their families living with kidney disease, making them aware that they can turn to us for support.
We will improve the way kidney patients are cared for across the UK with access to the highest quality holistic care
Manage our Charity as effectively and efficiently as possible
Ensure that patients’ views are effectively represented at the highest level and campaign for better patient outcomes and care
Inspire more people to support our work and grow our fundraised income so we can do more

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS For the year ended 31 December 2020

Trustees

Prof. Donal O'Donoghue OBE BSc MBChB MRCP FRCP (Chair - deceased 3 January 2021) Sir Jonathan Michael MB BS FRC, FKC (Chair - appointed 12 March 2021) Ms. Sarah Hillary, Treasurer Mrs. Marcelle de Sousa MBE FRCN MA RGN RSCN Miss Alison Burnapp RN MA Mrs. Ingrid Gubbay Mr. Andrew Chapman Ms. Patricia Gooden Ms. Angela Griffiths Ms. Ofrah Muflahi RN BSc MSc Mr. Amar Radia (appointed 1 April 2020) Mr. William Richard Caldwell (appointed 1 April 2020) Ms. Grainne Walsh (appointed 1 July 2020) Mr. Robert Lant (appointed 1 July 2020)

Company Registered Number 1228114 (England and Wales) Charity Registered Number 270288 (England and Wales) SC048198 (Scotland) Registered Office and 3 The Windmills, St Mary's Close, Turk Street, Alton, Hampshire, GU34 1EF Operating Office Chief Executive Mr Paul Bristow Senior Management Team Mr Paul Bristow Mrs Fiona Loud Miss Emma Cutler (contract ended 26 February 2021) Dr Jan Gough (appointed 15 February 2021) Company Secretary Southern Secretarial Services Ltd, Wey Court West, Union Road, Farnham, Surrey, GU9 7PT Auditors Kreston Reeves, Springfield House, Springfield Road, Horsham, West Sussex RH12 2RG Bankers Lloyds TSB PLC, 75 Castle Street, Farnham, Surrey, GU9 7LT Investment Managers Cazenove Capital Management, 12 Moorgate, London EC2R 6DA Smith & Williamson Investment Management LLP, 25 Moorgate, London, EC2R 6AY

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Structure, Governance and Management

Our Structure

The Company is a Charitable Company Limited by Guarantee and is governed by its Memorandum and Articles of Association. The Company was incorporated on 29th September 1975, with company registration number 1228114 (England and Wales). The Company is also a registered charity with charity registration number 270288 (England and Wales) and SC048198 (Scotland).

Our Trustees

The Board of Trustees is legally responsible for directing our affairs. They are directors of the company and serve for renewable terms of three years, up to a maximum of nine years. Our Articles mandate that the Board should be between 8 and 16 members and the Charity considers that 12 is the optimum number of Board members to service the Committees of the Board. The recruitment of four new Trustees in 2020 saw The Board made up of 14 trustees as at 31[st] December 2020, holding a wide range of skills, knowledge and experience including clinical and professional. We monitor the mix of skills and length of service to ensure that we maintain a good balance and recruit new trustees in a timely fashion.

The Board appoints all new Trustees on the advice of a Nominations Committee, and we recruit Trustees through a process of advertisement, application and interviews, and on a selection criterion that ensures a broad range of relevant skills, experience and diversity is maintained. We offer a tailored induction programme and provide further updates and training as needed.

The Board of Kidney Care UK are committed to good governance and recognise the importance of continued development. Following a full external governance review in 2019, the Charity conducts an annual Board self-evaluation survey, which along with any changes to the Governance Code, results in an annual Board Governance Development Plan, ensuring a culture of ongoing review and improvement. Changes to the Governance Code, published in December 2020, will be reviewed by the Strategy and Governance Committee in 2021 and actions reflected in the annual plan to ensure continued compliance both in letter and spirit.

Organisational Structure and Decision Making

The Board meets at least 4 times a year to regularly review Kidney Care UK’s general policies, strategy, budget and performance. The Board delegates the day-to-day management of the charity to the Chief Executive and Senior Management Team, which includes making recommendations to the Board of Trustees about strategy, budget and planning. Specific responsibilities are delegated to four Board Committees, under terms of reference agreed by the Board and which report back to the Board on a regular basis. All Committees are advisory and decision-making authority is retained by the full Board. A number of extraordinary meetings were held in 2020 to ensure the Board’s full involvement in the development of a new five-year strategy for the Charity, as well as to receive financial updates and briefings from the Finance, Investment and Audit Committee on the impacts of Covid and mitigating actions taken to effectively manage the Charity’s financial wellbeing during the challenging year.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT

for the year ended 31 December 2020

Governance, Strategy & Risk Committee (GS&R). This Committee is responsible for ensuring the Board fulfils its legal, ethical, and functional responsibilities through effective governance, ensuring strategy is properly developed and reviewed at regular intervals and that the Board is fully apprised of risk and processes put in place to manage such risks. The Committee meets three times a year. A busy year for the Committee in 2020, with a full strategic review and the development and launch of the Charity’s new five-year strategy (2021 – 2025), which was approved by the Board in September 2021.
Finance, Investment & Audit Committee (FI&A). The Committee is charged with monitoring and reporting on financial matters including financial, accounting, investment and risk policies, and developing appropriate strategies for the good financial management of the affairs of the charity. The Committee liaises regularly with the two investment fund managers and the investment advisors, and annually with the auditors. It works closely with the GS&R Committee over the latter’s overall responsibility for risk. It meets four times a year, including a formal investment review with the discretionary fund managers and investment advisers. A busy year for the Committee in 2020, given the considerable uncertainty and market turbulence throughout 2020, and the need for the Charity to remain agile and able to respond quickly to the challenges posed by COVID-19. To ensure the appropriate level of financial oversight, the Committee introduced monthly update sessions with the CEO and ensured the Board was kept fully briefed throughout 2020.
Grants Committee . The Grants Committee meets twice a year and receives and considers all applications for grants of more than £10,000 from NHS Trusts and other organisations, such as local kidney patient associations and the UK Renal Registry. It advises the Board on which grants should be approved. The Committee also regularly reviews Kidney Care UK’s grant making policies. It is currently the only committee, which includes non-Board members. During 2020 the Committee maintained its meeting schedule to ensure that health care professionals and patients continued to be supported by the Charity at a time of considerable challenge and increased patient need.
Staffing and Remuneration Committee. The Committee is responsible for supporting the Board in determining the remuneration and terms and conditions of the Chief Executive, other SMT members and employees of the charity, and for overseeing the development and implementation of suitable human resources policies and procedures. During 2020 several additional briefings and discussions took place between the Committee and CEO to ensure an appropriate level of support was in place to safeguard staff wellbeing. These included the rapid move to working from home when the national lockdown was announced in March, ensuring covid safe working arrangements in the office for those staff members who remained office based, introducing new digital ways of supporting and protecting the emotional health and mental wellbeing of staff and consideration for the use of furlough arrangements where required.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Volunteers

The Board and Senior Management Team are supported and advised on issues affecting patients by our Patient Advisory Group (PAG), made up of kidney patients and carers, many of whom are officers of local kidney patient associations. PAG members, like Trustees are volunteers and receive no remuneration, only expenses.

Risk Management

The Board of Trustees has overall responsibility for risk management at Kidney Care UK. This includes setting the risk appetite for the Charity (formal risk appetites are codified in the Charity’s risk register), ensuring that there are reasonable procedures in place for the prevention and detection of major risks and ensuring that risk procedures are reviewed when issues arise. The Board formally review the Risk Policy and Register twice a year. The Board considers risks to be anything that can adversely affect our ability to achieve our objectives for people affected by kidney disease, sustain our operations, maintain our reputation or meet legal and regulatory requirements. The Charity maintains a suite of core organisation policies, covering all aspects of its work and management, which are subject to a formal, regular review cycle and supported by our Committee structure.

The Board are supported by the GS&R Committee and FI&A Committee which play key roles in overseeing management of our principal risks and provide assurance to the Board that we have adequate risk management systems and mitigating actions in place. The GS&R Committee undertakes twice yearly risk reviews and Senior Management Team Meetings, chaired by the Chief Executive oversee a comprehensive annual planning and budgeting process, performance monitoring through key performance indicators and a regular review and monitor of key strategic and operational risks. The Board consider this an effective approach to evaluate significant risks to the Charity, establish effective controls and determine necessary and prompt action.

Principle Risks Identified and Controls

2020 was a challenging year, when rumours of a new virus in China became reality in the UK with a complete national lockdown in March. As COVID-19 dominated the year, and impacted every aspect of the Charity’s operation, our response to the risks posed is highlighted in a separate section below.

Investment Performance . Kidney Care UK’s investments are managed on a total return basis. The Trustees consider variability of returns on the Charity’s investment portfolio and a significant drop in the value of the portfolio to constitute the Charity’s principal financial risk. A 10% drop in the value of the portfolio triggers the discretionary investment managers and the finance advisors to enter into immediate discussions with the Finance, Investment & Audit Committee. Investment managers produce regular reports (quarterly) to the F, I&A Committee, which in turn reports quarterly to the Board of Trustees and advises it on investment performance and trends. The investment advisers report formally to the F,I&A Committee every six months. The investment portfolio is divided between two investment managers (one active and one passive) to reduce the Charity’s investment risk profile, and the Board have agreed a medium risk appetite.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Service Quality in Patient Care. Kidney Care UK’s key risk is that patients suffer harm or ineffective care. As a Charity that works with vulnerable individuals, we give the highest priority to matters of safeguarding. The Charity has a robust safeguarding policy, with ownership firmly established on the Senior Management Team. This includes a Designated Safeguarding Lead, a Designated Safeguarding Administrator and five Designated Safeguarding Persons in the patient support teams. All staff who have contact with patients and carers receive an enhanced DBS Check, which are updated every three years. The Advocacy Team meets quarterly and receives regular highquality training on areas such as safeguarding, and the Charity has a published complaints policy and log which is regularly reviewed along with patient and carer feedback and incident reporting. Our counselling service is staffed by fully qualified and accredited counsellors and adhere to the BACP guidelines and regulatory framework. 2021 will see a full review of our safeguarding policy and operating practices in 2021 and an independent external audit is planned for 2022, following changes to the Charity Governance Code published in December 2020.

Data and Information Security. We have a dedicated Data and IT Manager who ensures that policies and procedures are in place to protect staff, supporter and beneficiaries’ personal data, oversee regular staff training and ensure we comply with the highest standards stipulated in guidelines and regulations. The Charity regularly reviews its data protection and privacy policies and conducts security audits with independent third-party organisations to ensure its cyber security is robust. In 2020, following a major review of our IT support systems and supplier arrangements, the Charity appointed a new IT support company and service framework. This included a new server, the migration to cloud based technology through Microsoft 365, the introduction of two-factor authentication, enhanced back-up recovery plans and a revised cyber security policy.

Brexit. Kidney Care UK receives no funding from the European Union and the majority of risks are likely to be those with an indirect impact on the Charity, in particular any decline in the economy, which along with the impact of COVID-19, may impact our income and investments. There is also the potential for foreign holidays / travel to become more challenging for patients, although the introduction of the GHIC card, has gone a considerable way to mitigate this. It remains difficult to predict specific impacts as this will ultimately depend on UK Government policy, however the Charity will continue to monitor the situation and seek to ensure that people with kidney disease are not negatively impacted.

Our response to COVID-19

2020 was an exceptional year, dominated by the considerable uncertainty and significant challenges posed by COVID-19 and the worldwide pandemic. Like all charities this was unknown territory and affected every aspect of the Charity’s work and operations, with risks to our income, financial security, the services we deliver, staff safety and wellbeing, and the move to homeworking, all whilst ensuring that we continued to be there for vulnerable patients at a time of increased need.

By the end of March, the impact on the market saw our investments drop by c 18%, triggering a major review with our Investment Managers and Advisors. We received assurances that our portfolio remained well structured, with sufficient liquidity to meet the Charity’s cash needs until the end of 2020. A financial oversight and management framework was quickly established, involving monthly meetings between the Finance Committee and CEO, and the Board kept fully updated with regular

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

briefings. A prudent cash management strategy was developed, based on financial modelling, to ensure we were agile and adaptable, able to respond quickly in a changing environment to a range of impact scenarios, whilst ensuring we protected delivery of our charitable activity at a time when the Charity’s support was needed more than ever.

Cash management was supported by the cancellation of a number of face-to-face patient support activities as a result of the inclusion of people affected by kidney disease in the extremely clinically vulnerable group and subsequent need to comply with Government shielding protocols. We are pleased to report that at this time of increased community anxiety and patient need, the Charity were able to respond by increasing our support activity. No support activity was cancelled or reduced as a result of a decision by Kidney Care UK and any cancelled activity was the result of external factors due to the impact of the pandemic on Government or regulatory policy.

The impact on fundraising was considerable right across the charity sector, with the greatest impact being felt in events and community fundraising due to the impact of lockdown and social distancing restrictions. The fundraising team effectively had to rewrite its fundraising plans for the new reality, with reduced expenditure and a move to new digital fundraising products and ways of engaging with supporters. Although annual income was considerably down on our budget expectations, our rapid response did result in a small increase in non-legacy fundraised income compared to 2019. Further details are provided in the financial update later in the report.

From the early stages of the pandemic, we focused on adapting our services and ways of working to support the patient community, which was experiencing considerable anxiety and concern regarding safety and emotional wellbeing as a result of enforced isolation under Government shielding arrangements. We established the Charity as the main source of patient information during the pandemic, translating Government policies and NHS guidance into accessible patient information on our website. This involved weekly calls with the Renal Association, and at times daily updates to our website, which saw a fourfold increase in visitors during 2020. Although holidays were cancelled for all patients, our grants programme was quickly adapted to respond to the significant increase in support and hardship grants needed and our advice, guidance and advocacy support adapted for digital delivery. With the high levels of anxiety in the patient community, especially with so many having to travel to hospital for dialysis three times a week despite being told to shield, demand for our counselling service increased and the Charity responded by increasing our capacity through the recruitment of additional counsellors.

From the early stages of the pandemic, we focused on adapting our services and ways of working to address risks from the virus. Urgent action was taken to move staff to homeworking arrangements at the end of March, a transition undoubtedly supported by our earlier progress and investment in improved IT operations. This involved a considerable amount of work to ensure that IT resources were purchased and configured, department operating procedures reviewed, and new ways of internal communication introduced to support staff wellbeing and sense of inclusion. Virtually all staff members were moved to homeworking except for a skeleton team, on a rota basis, managing our office and patient grant functions. As a result of the increase in demand for the Charity’s services, only one member of staff was placed on furlough, due to childcare arrangements because of school closures.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Going Concern

COVID-19 and the resulting UK lockdown and its economic consequences have had a significant impact on Kidney Care UK. The market remains volatile and future performance remains uncertain, although we have seen a partial market recovery since April 2020. Our approach remains to take a long-term view of our investments and we remain confident that the steps and processes we have put in place will allow us to ride out the continued volatility. As a result, our Trustees have reviewed our financial position and plans along with our risk management in light of the new environment and have a reasonable expectation that the company has adequate resources to continue in operational existence for the foreseeable future. For this reason, they continue to adopt the going concern basis in preparing the financial statements. Further details regarding the adoption of the going concern basis can be found in the Accounting Policies.

Our Approach to Fundraising

It is only the generosity of our supporters that allows us to continue our vital work to improve life for kidney patients and their families. They are at the heart of everything we do and giving to us should be a positive and rewarding experience. We have built our fundraising approach around this very ideal.

Kidney Care UK, by registering with the Fundraising Regulator, has made a public promise to ensure all our fundraising activity is legal, open, honest and respectful. We are active members of the Chartered Institute of Fundraising and are engaged with the Fundraising Preference Service.

In 2020, we increased the range of fundraising products and activities we promote to ensure every supporter, individual, group or organisation could engage and support the Charity in a way that suits them. We developed the tools and resources that support these activities and share these with our supporters through the channels they request, and with their permission, we keep them informed about how their support is making a difference.

We have built relationships with a small number of organisations and consultants to help us grow and deliver our products and activity. These relationships help us provide the positive and rewarding experience we want to deliver. We do not participate in any third party or commercial fundraising techniques and have never approached or contacted individuals to whom we are not already known.

It is our promise that we will communicate appropriately and sensitively when engaging with supporters and the general public. We promise to make it easy for supporters to tell us how they would like us to contact them and, if they’d rather we didn’t get in touch in a particular way, or contact them at all, we won’t. We promise to keep their personal details safe, secure and confidential and we will never sell or swap any details with any third party.

To ensure we manage our fundraising approach and keep it under review, we record any complaints and any failures to comply with the standards we have set and follow. We are pleased to say that in 2020 we did not have to respond to any complaints made by our supporters or the general public and

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

continue to grow in confidence in delivering our fundraising as we have set out to do. Our full fundraising promise and further details of our fundraising products and activity is online at www.kidneycareuk.org.

Grant Making

Kidney Care UK makes grants to both hospitals to fund innovation and quality improvements in kidney patient care and to help patients struggling to make ends meet financially. Both schemes are managed in a formal and consistent process, according to a clear and comprehensive set of guidelines. Hospital grants applications are formally peer reviewed by the Grants Committee, containing experts in their field, and scored against clearly defined and published guidelines. The Committee makes a recommendation for funding to the Board for their review and approval. In all instances where there is a conflict of interest the committee member is excluded from any discussion and decision.

Public Benefit

The Trustees have taken account of the Charity Commission’s general guidance on public benefit when reviewing the Charity’s aims objectives and planning. The Trustees ensure that the activities undertaken are in line with the aims of Kidney care UK.

Financial Review

Reserves policy

The Trustees have reviewed the Charity’s needs for reserves in line with the guidance issued by the Charity Commission. For the foreseeable future, the Trustees anticipate that there will be a continuing significant growth in the need for support of renal patients by reason of changing demographics and the increasing incidence of renal failure as a proportion of the population in the UK along with reduced government spending for the NHS.

The Charity expects for the foreseeable future, within the parameters of its current policies, to be able to meet the needs for financial support of patients and their families, professional clinical and social carers, the development of services and facilities and the provision of equipment for the better treatment of kidney patients and their families, and research into the effectiveness of those services and provisions.

Kidney Care UK does not have ‘free’ reserves in the sense that the Charity readily re-deploys elements of its investments to fund posts, projects or research or for cash flow purposes. The Charity relies on investment income and capital appreciation to fund programmed day-to-day expenditure in support of its primary charitable objects i.e. improving the quality of life of kidney patients. The Charity could not deliver the help needed to support its beneficiaries without its investment income and Kidney Care UK is therefore not at liberty to deploy invested funds elsewhere without potentially incurring a penalty to the future delivery of its primary objective. The Charity’s investments will remain an essential source of income if programmed and ongoing expenditure profiles are to be met, at least in the foreseeable future. It therefore remains the case that Kidney Care UK does not have reserves to

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

dispose of freely as defined in either SORP or Charity Commission guidance documents.

The Charity has set aside a core designated invested reserve fund, the income and capital appreciation of which, together with voluntary donations and income arising from other activities will for the foreseeable future provide for the administration of the Charity, the needs of our “Objects”, and the depreciation of the purchasing power of resources by inflation. In addition, the Charity will seek to retain sufficient surplus resources to mitigate against the inherent volatility of holding investments. The reserves policy and level of the core investment funding is reviewed annually by the Board. Resources in excess of the Designated Reserve are retained as a General Reserve, which the Trustees will seek to apply appropriately over the short term.

Investment policy and performance

During the year under review Cazenove Capital Management and Smith & Williamson Investment Management LLP managed the charity’s dual investment portfolio split approximately 47% : 53% respectively. The whole of the small Endowment Fund is also managed by Smith & Williamson. The funds are split with Smith and Williamson operating an active fund managed approach and Cazenove a passive fund solution to diversify the Charity’s investment risk profile. The Investment Managers have full discretionary powers within certain restrictions and limitations, as delegated by the Trustees, and they report to the Finance, Investment & Audit Committee on a regular basis. The Finance, Investment & Audit Committee and the Trustees continue to be supported by the advice of Enhance Group (UK) Limited, based in Jersey.

Stock market conditions proved challenging in the year due to coronavirus, particularly in equity markets resulting in a realised and unrealised surplus of circa 1% of funds under management amounting to £206,023 surplus (2019 surplus £3,719,441).

The investment objective is to achieve a long-term total return as a result of growth in capital and income derived from a diversified portfolio of investment assets with a moderate degree of risk. As at 31st December 2020 the charity’s investments were 22% in UK equities, 49% in overseas equities, 13% in fixed interest, 8% in property, 4% in alternatives and 4% in cash.

Kidney Care UK’s investment policy stipulates there should be no direct exposure to tobacco stocks.

Review of Year

2020 was a challenging year for the whole sector with difficult and volatile market conditions and a general reduction in fundraised income due to coronavirus.

Our total income for the year was down 29% at £1,345,584 (2019: £1,832,398). This was due to a drop in legacy and dividend income at £248,782 and £616,924 respectively , compared to £520,177 and £870,486 in 2019. Non-legacy fundraised income increased by 6% to £469,200 (2019: £441,735), reflecting our continued investment in fundraising in order to support more patients and broaden our income streams.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Our commitment to reach out and support more kidney patients and meet the increased demand for our services due to the impact on coronavirus, was reflected in an increase in spending across many of our direct support services including counselling, advocacy, policy work and patient information. Although our patient grants spending was reduced by around 29% to £567,471 (£794,504 in 2019), this was due to external factors with the cancellation of holiday dialysis due to COVID-19. In responding to patient need at this difficult time, our hardship grants increased by over 80% to £99,272, and overall, excluding holiday grants, our grants programme was maintained at 2019 levels.

Overall, our charitable activity expenditure was down in 2020 at £2,796,720 compared to £3,431,572 in 2019, a reduction caused by external factors because of COVID-19. The increased pressure on the health service resulted in the pausing of many research and quality improvement initiatives which was reflected in spending on our service improvement grants, holidays and dialysis away from base was cancelled, and major events such as the UK Transplant Games and our national young adult weekend had to be cancelled. By contrast investment in our own direct patient support services (excluding holidays) increased by 9% from £1,377,585 in 2019 to £1,498,310 as we responded to the immediate practical, financial and emotional needs of the community during this difficult year.

Although fundraising costs grew slightly, reflecting the continued investment in our fundraising capability, other costs remained relatively static as we seek to develop the charity with a keen eye on efficiencies and tight control over overheads. Total overhead costs were reduced by 9% in 2020 at £1,350,200 compared with £1,482,766 in 2019.

Our expenditure exceeded our income again for the year ending 31[st] December 2020, reflecting our continued commitment to invest in the transformation of the Charity and provide greater support to more patients. Our final operating result for 2020 was a deficit of £1,955,154 (2019: deficit £2,117,707). This reflects the ongoing commitment from the Charity to continue to invest in its growth and patient support activities under the new five-year strategy and despite the challenges of Coronavirus. Investments were up slightly in the year (as previously reported) with a final result of a net deficit of £1,749,131. (2019: £1,601,734 surplus).

As at 31 December 2020 unrestricted funds totalled £31,978,460 (2019: £33,727,791) and restricted funds totalled £43,506 (2019: £42,882) and endowment funds £79,216 (2019: £79,604). Of the unrestricted amount £30,000,000 is set aside as a designated fund to deliver our grant giving programmes in perpetuity; the remaining balance is free reserves which were £1,978,460 (2019: £3,727,791).

The reserves are currently sufficient to meet the reserves policy.

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

Key Management and Staff Remuneration

The Senior Management Team is responsible for the day-to-day running of the Charity and comprises the Chief Executive, and the Directors of Policy, Marketing and Communications, and a new post of Director of Patient Support who joined the Charity on the 15[th] February 2021. In 2021 a further restructure will see the post of Director of Marketing and Communications replaced with a Director of Fundraising, Marketing and Communications to strengthen our fundraising activity, enhance working practices across the two departments and further strengthen the SMT.

The Staff and Remuneration Committee meets at least annually and advises on the remuneration policy of the Charity. This includes reviewing the annual recommendation from the Chief Executive for general salary changes, based on external independent data, and regularly reviewing the pay and benefits of staff benchmarked against current trends and rates across the voluntary sector.

The pay of the Charity’s Chief Executive is reviewed annually by the Board, based on market rates and benchmarks, personal performance and scope and complexity of the role.

Small Company Provisions

This report has been prepared in accordance with the special provisions relating to companies subject to the small companies regime within Part 15 of the Companies Act 2006.

Trustees' Responsibilities Statement

The Trustees (who are also directors of The British Kidney Patient Association for the purposes 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. 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 and of the incoming resources and application of resources, including the income and expenditure, of the charitable company for that period. In preparing these financial statements, the Trustees are required to:

Select suitable accounting policies and then apply them consistently;
Make judgments and accounting estimates that are reasonable and prudent;
Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charitable company will continue in operation.
Observe the methods and principles in the Charities SORP;
State whether applicable UK accounting standards have been followed, subject to any material departures disclosed and explained in the financial statements;

BRITISH KIDNEY PATIENT ASSOCIATION

(A Company Limited by Guarantee)

TRUSTEES' REPORT for the year ended 31 December 2020

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 the Companies Act 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 legislation in other jurisdictions.

Disclosure of Information to Auditor

Each of the persons who is a Trustees at the time when this Trustees' report is approved has confirmed that:

So far as that Trustee is aware, there is no relevant audit information of which the charitable company's auditors are unaware, and
That Trustee has taken all the steps that ought to have been taken as a Trustee in order to be aware of any information needed by the charitable company's auditors in connection with preparing their report and to establish that the charitable company's auditors are aware of that information.

This report was approved by the Trustees on 18[th] June 2021 and signed on their behalf by:

………………………………………………………………………

Sir Jonathan Michael MB, BS, FRCP, FKC Chair of Trustees

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

Opinion

We have audited the financial statements of British Kidney Patient Association t/a Kidney Care UK (the 'charitable company') for the year ended 31 December 2020 which comprise the Statement of financial activities, the Balance sheet, the Statement of cash flows and the related notes, including a summary of 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:

give a true and fair view of the state of the charitable company's affairs as at 31 December 2020 and of its incoming resources and application of resources, including its income and expenditure for the year then ended;
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
have been prepared in accordance with the requirements of the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006.

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 Auditors' responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the United Kingdom, including the Financial Reporting Council'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 charitable company'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.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Other information

The Trustees are responsible for the other information. The other information comprises the information included in the Annual report, other than the financial statements and our Auditors' report thereon. Our opinion on the financial statements does not cover the other information and we do not express any form of assurance conclusion thereon.

In connection with our audit of the financial statements, 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 audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. 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.

Matters on which we are required to report by exception

We have nothing to report in respect of the following matters where the Charities (Accounts and Reports) Regulations 2008 and the Charities Accounts (Scotland) Regulations 2006 (as amended) requires us to report to you if, in our opinion:

the information given in the Trustees' report is inconsistent in any material respect with the financial statements; or
sufficient and proper accounting records have not been kept; or
the financial statements are not in agreement with the accounting records and returns; or
we have not received all the information and explanations we require for our audit.

Responsibilities of trustees

As explained more fully in the Trustees' responsibilities statement, the Trustees (who are also the directors of the charitable company for the purposes 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 charitable company'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.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Auditors' responsibilities for the audit of the financial statements

We have been appointed as auditor under section 144 of the Charities Act 2011 and section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and report in accordance with the Act and relevant regulations made or having effect thereunder.

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 Auditors' 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.

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud is detailed below:

Capability of the audit in detecting irregularities, including fraud

The objectives of our audit are to identify and assess the risks of material misstatement of the financial statements due to fraud or error; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud or error; and to respond appropriately to those risks.

Based on our understanding of the charity and industry, and through discussion with the directors and other management (as required by auditing standards), we identified that the principal risks of non-compliance with laws and regulations related to health and safety, anti-bribery and employment law. We considered the extent to which non-compliance might have a material effect on the financial statements. We also considered those laws and regulations that have a direct impact on the preparation of the financial statements such as the Companies Act 2006, 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. We communicated identified laws and regulations throughout our team and remained alert to any indications of non-compliance throughout the audit. We evaluated management’s incentives and opportunities for fraudulent manipulation of the financial statements (including the risk of override of controls), and determined that the principal risks were related to: posting inappropriate journal entries to increase income or reduce expenditure, management bias in accounting estimates and judgemental areas of the financial statements such as accounting treatment of grants awarded not yet claimed and accounting for legacies receivable. Audit procedures performed by the engagement team included:

Discussions with management and assessment of known or suspected instances of non-compliance with laws and regulations (including health and safety) and fraud; and
Assessment of identified fraud risk factors; and
Challenging assumptions and judgments made by management in its significant accounting estimates; and
Performing analytical procedures to identify and unusual or unexpected relationships, including related party transactions, that may indicate risks of material misstatement due to fraud; and
Confirmation of related parties with management, and review of transactions throughout the period to identify any previously undisclosed transactions with related parties outside the normal course of business; and
Reading minutes of meetings of those charged with governance; and
Review of significant and unusual transactions and evaluation of the underlying financial rational supporting the transactions; and
Identifying and testing journal entries, in particular any manual entries made at the year end for financial statement preparation; and
Performing substantive procedures on grant approvals at board level, progress of conditions being met and identification of grants not recognised that may indicate risks of material misstatement due to fraud; and - Confirmation of legacy estimations susceptible to fraud or irregularity from solicitors.

Page 40

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

There are inherent limitations in the audit procedures described above and the further removed non-compliance with laws and regulations is from the events and transactions reflected in the financial statements, the less likely we would become aware of it. Also, the risk of not detecting a material misstatement due to fraud is higher than the risk of not detecting one resulting from error, as fraud may involve deliberate concealment by, for example, forgery or intentional misrepresentations, or through collusion.

As part of an audit in accordance with ISAs (UK), we exercise professional judgment and maintain professional scepticism throughout the audit. We also:

Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.
Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion of the effectiveness of the charitable company's internal control.
Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Trustees.
Conclude on the appropriateness of the Trustees' use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the charitable company's ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our Auditors' report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our Auditors' report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.
Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.

We communicate with those charged with governance regarding, among other matters, the planned scope and timing of the audit and significant audit findings, including any significant deficiencies in internal control that we identify during our audit.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Use of our report

This report is made solely to the charitable company's trustees, as a body, in accordance with Part 4 of the Charities (Accounts and Reports) Regulations 2008 and regulation 10 of the Charities Accounts (Scotland) Regulations 2006. Our audit work has been undertaken so that we might state to the charitable company's trustees those matters we are required to state to them in an Auditors' 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 its members, as a body, for our audit work, for this report, or for the opinions we have formed.

Kreston Reeves LLP

Chartered Accountants Statutory Auditor Horsham 6 July 2021

Kreston Reeves LLP are eligible to act as auditors in terms of section 1212 of the Companies Act 2006.

Page 42

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2020

Note Income and endowments from: Donations and legacies 4 Other trading activities 5 Investments 6 Total income and endowments Expenditure on: Raising funds 7,8 Charitable activities 10 Total expenditure Net income / (expenditure) before net (losses) / gains on investments Net (losses) / gains on investments Net movement in funds Reconciliation of funds: Total funds brought forward Net movement in funds Total funds carried forward	Endowment funds 2020 £ - - 2,153 2,153 - 2,153 2,153 - (424) (424) 79,640 (424) 79,216	Restricted funds 2020 £ 75,113 - - 75,113 - 74,489 74,489 624 - 624 42,882 624 43,506	Unrestricted funds 2020 £ 610,677 42,870 614,771 1,268,318 504,018 2,720,078 3,224,096 (1,955,778) 206,447 (1,749,331) 33,727,791 (1,749,331) 31,978,460	Total funds 2020 £ 685,790 42,870 616,924 1,345,584 504,018 2,796,720 3,300,738 (1,955,154) 206,023 (1,749,131) 33,850,313 (1,749,131) 32,101,182	Total funds 2019 £ 929,391 32,521 870,486 1,832,398 518,533 3,431,572 3,950,105 (2,117,707) 3,719,441 1,601,734 32,248,579 1,601,734 33,850,313

The Statement of financial activities includes all gains and losses recognised in the year.

The notes on pages 47 to 68 form part of these financial statements.

Page 43

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee) REGISTERED NUMBER: 1228114

BALANCE SHEET AS AT 31 DECEMBER 2020

Note Fixed assets Tangible assets 16 Investments 17 Current assets Debtors 18 Cash at bank and in hand Creditors: amounts falling due within one year 19 Net current liabilities Total assets less current liabilities Creditors: amounts falling due after more than one year 20 Net assets excluding pension asset Total net assets	143,049 358,913 501,962 (828,645)	2020 £ 394,475 32,348,655 32,743,130 (326,683) 32,416,447 (315,265) 32,101,182 32,101,182	370,822 367,693 738,515 (1,024,965)	2019 £ 384,019 34,018,758 34,402,777 (286,450) 34,116,327 (266,014) 33,850,313 33,850,313

Page 44

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee) REGISTERED NUMBER: 1228114

BALANCE SHEET (CONTINUED) AS AT 31 DECEMBER 2020

Note Charity funds Endowment funds 21 Restricted funds 21 Unrestricted funds 21 Total funds	2020 £ 79,216 43,506 31,978,460 32,101,182	2019 £ 79,640 42,882 33,727,791

		33,850,313

The entity was entitled to exemption from audit under section 477 of the Companies Act 2006.

The members have not required the entity to obtain an audit for the year in question in accordance with section 476 of the Companies Act 2006.

However, an audit is required in accordance with section 144 of the Charities Act 2011 and section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005.

The Trustees acknowledge their responsibilities for complying with the requirements of the Act with respect to accounting records and preparation of financial statements.

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

The financial statements were approved and authorised for issue by the Trustees and signed on their behalf by:

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

Ms. Sarah Hillary Treasurer Date: 18 June 2021

The notes on pages 47 to 68 form part of these financial statements.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2020

Cash flows from operating activities Net cash used in operating activities Cash flows from investing activities Dividends, interests and rents from investments Purchase of tangible fixed assets Proceeds from sale of investments Purchase of investments Decrease in cash deposits (investments) Net cash provided by investing activities Change in cash and cash equivalents in the year Cash and cash equivalents at the beginning of the year Cash and cash equivalents at the end of the year The notes on pages 47 to 68 form part of these financial statements	2020 £ (2,470,770) 616,924 (31,060) 8,861,455 (7,351,979) 366,650 2,461,990 (8,780) 367,693 358,913	2019 £ (2,642,628) 870,486 (26,566) 7,991,053 (8,682,842) 1,956,580 2,108,711 (533,917) 901,610 367,693

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

1. General information

The company is a charitable company limited by guarantee, incorporated in England and Wales. The trustees on page 2 are also members of the company. In the event of the company being wound up, the liability in respect of the guarantee is limited to £1 per member.

The registered office is 3 The Windmills, St Mary's Close, Turk Street, Alton, GU34 1EF.

2. Accounting policies

2.1 Basis of preparation of financial statements

The financial statements have been prepared in accordance with the Charities SORP (FRS 102) - 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 Reporting Standard applicable in the UK and Republic of Ireland (FRS 102) and the Companies Act 2006.

British Kidney Patient Association t/a Kidney Care UK meets the definition of a public benefit entity under FRS 102. Assets and liabilities are initially recognised at historical cost or transaction value unless otherwise stated in the relevant accounting policy.

2.2 Going concern

The Trustees have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus they continue to adopt the going concern basis in preparing the annual financial statements. The continuing impact of COVID-19 has been included in the charity's forecasting and in the planning of the future and the going concern assumption takes this into consideration

2.3 Income

All income is recognised once the Charity has entitlement to the income, it is probable that the income will be received and the amount of income receivable can be measured reliably.

The recognition of income from legacies is dependent on establishing entitlement, the probability of receipt and the ability to estimate with sufficient accuracy the amount receivable. Evidence of entitlement to a legacy exists when the Charity has sufficient evidence that a gift has been left to them (through knowledge of the existence of a valid will and the death of the benefactor) and the executor is satisfied that the property in question will not be required to satisfy claims in the estate. Receipt of a legacy must be recognised when it is probable that it will be received and the fair value of the amount receivable, which will generally be the expected cash amount to be distributed to the Charity, can be reliably measured.

Grants are included in the Statement of financial activities on a receivable basis. The balance of income received for specific purposes but not expended during the period is shown in the relevant funds on the Balance sheet. Where income is received in advance of entitlement of receipt, its recognition is deferred and included in creditors as deferred income. Where entitlement occurs before income is received, the income is accrued.

Income tax recoverable in relation to investment income is recognised at the time the investment income is receivable.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

2. Accounting policies (continued)

2.4 Expenditure

Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement and the amount of the obligation can be measured reliably. Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges allocated on the portion of the asset’s use.

Expenditure on raising funds includes all expenditure incurred by the Charity to raise funds for its charitable purposes and includes costs of all fundraising activities events and non-charitable trading.

Expenditure on charitable activities is incurred on directly undertaking the activities which further the Charity's objectives, as well as any associated support costs.

Grants payable are charged in the year when the offer is made except in those cases where the offer is conditional, such grants being recognised as expenditure when the conditions attaching are fulfilled. Grants offered subject to conditions which have not been met at the year end are noted as a commitment, but not accrued as expenditure.

All expenditure is inclusive of irrecoverable VAT.

2.5 Government grants

Income from government grants is recognised when the Charity has met the conditions or incurred the expenditure attaching to the grant and it is probable that the grant will be received.

2.6 Interest receivable

Interest on funds held on deposit is included when receivable and the amount can be measured reliably by the Charity; this is normally upon notification of the interest paid or payable by the institution with whom the funds are deposited.

2.7 Tangible fixed assets and depreciation

Tangible fixed assets costing £1000 or more are capitalised and recognised when future economic benefits are probable and the cost or value of the asset can be measured reliably.

Tangible fixed assets are initially recognised at cost. After recognition, under the cost model, tangible fixed assets are measured at cost less accumulated depreciation and any accumulated impairment losses. All costs incurred to bring a tangible fixed asset into its intended working condition should be included in the measurement of cost.

Depreciation is charged so as to allocate the cost of tangible fixed assets less their residual value over their estimated useful lives, using the straight-line method.

Depreciation is provided on the following bases:

Freehold property	- 50 years straight line
Fixtures and fittings	- 10 years straight line
Office equipment	- 3 years straight line

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

2. Accounting policies (continued)

2.8 Investments

Fixed asset investments are a form of financial instrument and are initially recognised at their transaction cost and subsequently measured at fair value at the Balance sheet date, unless the value cannot be measured reliably in which case it is measured at cost less impairment. Investment gains and losses, whether realised or unrealised, are combined and presented as ‘Gains/(Losses) on investments’ in the Statement of financial activities.

2.9 Debtors

Trade and other debtors are recognised at the settlement amount after any trade discount offered. Prepayments are valued at the amount prepaid net of any trade discounts due.

2.10 Cash at bank and in hand

Cash at bank and in hand includes cash and short-term highly liquid investments with a short maturity of three months or less from the date of acquisition or opening of the deposit or similar account.

2.11 Liabilities and provisions

Liabilities are recognised when there is an obligation at the Balance sheet date as a result of a past event, it is probable that a transfer of economic benefit will be required in settlement, and the amount of the settlement can be estimated reliably.

Liabilities are recognised at the amount that the Charity anticipates it will pay to settle the debt or the amount it has received as advanced payments for the goods or services it must provide.

A contingent liability is identified and disclosed for those grants resulting from:

• a possible obligation which will only be confirmed by the occurrence of one or more uncertain future events not wholly within the trustees’ control; or

• a present obligation following a grant offer where settlement is either not considered probable; or

• the amount has not been communicated in the grant offer and that amount cannot be estimated reliably

2.12 Financial instruments

The Charity only has financial assets and financial liabilities of a kind that qualify as basic financial instruments. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value with the exception of bank loans which are subsequently measured at amortised cost using the effective interest method.

2.13 Pensions

The Charity operates a defined contribution pension scheme and the pension charge represents the amounts payable by the Charity to the fund in respect of the year.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

2. Accounting policies (continued)

2.14 Fund accounting

General funds are unrestricted funds which are available for use at the discretion of the Trustees in furtherance of the general objectives of the Charity and which have not been designated for other purposes.

Designated funds comprise unrestricted funds that have been set aside by the Trustees for particular purposes. The aim and use of each designated fund is set out in the notes to the financial statements.

Restricted funds are funds which are to be used in accordance with specific restrictions imposed by donors or which have been raised by the Charity for particular purposes. The costs of raising and administering such funds are charged against the specific fund. The aim and use of each restricted fund is set out in the notes to the financial statements.

Endowment funds are funds, the income from which, are to be used in accordance with specific restrictions imposed by donors. The cost of raising and administering such funds are charged against the specific fund. The aim and use of the endowment fund is set out in the notes to the financial statements.

Investment income, gains and losses are allocated to the appropriate fund.

3. Critical accounting estimates and areas of judgment

Estimates and judgments are continually evaluated and are based on historical experience and other factors, including expectations of future events that are believed to be reasonable under the circumstances.

Critical accounting estimates and assumptions:

The Charity makes estimates and assumptions concerning the future. The resulting accounting estimates and assumptions will, by definition, seldom equal the related actual results. The estimates and assumptions that have a significant risk of causing a material adjustment to the carrying amounts of assets and liabilities within the next financial year are discussed below.

Critical areas of judgment:

Legacies receivable

The Charity only recognises legacy income when it is certain to be received and can be measured or estimated with sufficient reliability. Estimations of legacy income may be based on a solicitors valuation of an estate and therefore adjustments may need to be made following actual receipts. Therefore some amounts included in the financial statements are estimations.

Grants committed

The Charity recognises grants committed as a contingent liability once the grant has been approved by the Grants Committee. When the conditions of the grant are achieved by all parties, the grant is recognised as a creditor in the financial statements. A judgement is made to determine that all conditions have been satisfied.

Page 50

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

4. Income from donations and legacies

Donations Legacies Grants	Restricted funds 2020 Unrestricted funds 2020 £ £ 75,113 351,218 - 248,782 - 10,677 75,113 610,677	Total funds 2020 £ 426,331 248,782 10,677
		685,790

During the year the charity received government grants in the form of payments under the CJRS for employees furloughed during COVID-19 restrictions.

Donations Legacies	Restricted funds 2019 £ 5,702 - 5,702	Unrestricted funds 2019 £ 403,512 520,177 923,689	Total funds 2019 £ 409,214 520,177
			929,391

5. Income from other trading activities

Income from non charitable trading activities

Unrestricted funds 2020 £ Trading income 42,870 Unrestricted funds 2019 £ Trading income 32,521	Total funds 2020 £ 42,870
	Total funds 2019 £ 32,521

Page 51

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

6. Investment income

Income from listed investments Investment income - cash Income from listed investments Investment income - cash	Endowment funds 2020 Unrestricted funds 2020 £ £ 2,153 614,613 - 158 2,153 614,771 Endowment funds 2019 Unrestricted funds 2019 £ £ 2,153 867,615 - 718 2,153 868,333	Total funds 2020 £ 616,766 158
		616,924
		Total funds 2019 £ 869,768 718
		870,486

7. Expenditure on raising funds

Fundraising trading expenses

Unrestricted funds 2020 £ Fundraising and publicity 43,639 Wages and salaries 268,989 Social security costs 16,375 Pension costs 12,062 341,065	Total funds 2020 £ 43,639 268,989 16,375 12,062
	341,065

Page 52

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

7. Expenditure on raising funds (continued)

Fundraising and publicity Wages and salaries Social security costs Pension costs	Unrestricted funds 2019 £ 111,882 187,206 14,588 9,936 323,612	Total funds 2019 £ 111,882 187,206 14,588 9,936
		323,612

8. Investment management costs

Unrestricted funds 2020 £ Investment management fees 162,953 Unrestricted funds 2019 £ Investment management fees 194,921	Total funds 2020 £ 162,953
	Total funds 2019 £ 194,921

Page 53

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

9. Analysis of grants

Grants, patient support Grants, Direct patient support Grants by type Post funding, projects and equipment Dialysis freedom Small grants Grants to patients Research/Development Board approved grant Mount Cook	Grants to Institutions 2020 £ 487,952 Grants to Institutions 2019 £ 973,090	Grants to Individuals 2020 £ 567,471 Grants to Individuals 2019 £ 794,504 2020 £ 257,527 35,315 47,465 567,471 143,238 - 4,407 1,055,423	Total funds 2020 £ 1,055,423
			Total funds 2019 £ 1,767,594
			2019 £ 488,128 42,640 113,240 794,504 196,524 106,788 25,770
			1,767,594

Page 54

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

Grants by institution

Association of Nephrology Nurses UK (ANN UK) Altnagelvin Hospital James Cook University Hospital King's College Hospital NHS Foundation Trust Kings College Hospital (London South Bank University leading) Plymouth Derriford Northern General - Sheffield Queen's University Hospital Belfast BASW BASW - Renal Special Interest Group Small grants Paedriatric holidays Transplant games kQuiP project Christmas gifts - Paedriatric units 2019 Childrens hopsitals Other grants Barts Health NHS Trust University Hospital Crosshouse University of Salford & Hope KPA Hammersmith Hospital European Dialysis Transplant Nurses Association Renal psychological services group	2020 £ - 19,340 29,311 - - - 32,354 7,459 - - 36,340 3,921 7,500 103,618 - 46,018 151,949 800 32,519 4,324 6,999 1,500 4,000 487,952	2019 £ 22,000 118,197 89,307 44,942 45,912 407 64,708 14,942 2,000 16,000 39,264 9,697 42,900 106,788 200 101,158 254,668 - - - - - -
		973,090

10. Analysis of expenditure on charitable activities Summary by fund type

	Endowment	Restricted	Unrestricted	Total
	funds	funds	funds	funds
	2020	2020	2020	2020
	£	£	£	£
Direct patient support	2,153	74,489	2,720,078	2,796,720

Page 55

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

10. Analysis of expenditure on charitable activities (continued)

Summary by fund type (continued)

	Endowment	Restricted	Unrestricted	Total
	funds	funds	funds	funds
	2019	2019	2019	2019
	£	£	£	£
Direct patient support	2,153	5,702	3,423,717	3,431,572

11. Analysis of expenditure by activities

Direct patient support Direct patient support	Activities undertaken directly 2020 £ 895,115 Activities undertaken directly 2019 £ 699,745	Grant funding of activities 2020 £ 1,055,423 Grant funding of activities 2019 £ 1,767,594	Support costs 2020 £ 846,182 Support costs 2019 £ 964,233	Total funds 2020 £ 2,796,720
				Total funds 2019 £ 3,431,572

Page 56

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

11. Analysis of expenditure by activities (continued)

Analysis of direct costs

Direct patient support 2020 £ Staff costs 618,047 Counselling 3,470 Advocacy 26,695 Policy service 55,288 Patient information 191,615 895,115 Direct patient support 2019 £ Staff costs 393,307 Counselling 1,776 Advocacy 77,221 Policy service 51,513 Patient information 175,928 699,745	Total funds 2020 £ 618,047 3,470 26,695 55,288 191,615
	895,115
	Total funds 2019 £ 393,307 1,776 77,221 51,513 175,928
	699,745

Page 57

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

11. Analysis of expenditure by activities (continued)

Analysis of support costs

Staff costs Depreciation Communication costs Repairs and maintenance IT costs Motor and travel Insurance Rates, heat, light and telephone General expenses Hire of equipment Recruitment and redundancy costs Legal & professional fees Printing, postage & stationery Staff training Advisory board Bank charges Trustee expenses Governance costs	Direct patient support 2020 £ 402,539 20,604 95,557 17,883 74,705 1,340 7,795 33,647 6,114 2,287 15,843 54,787 3,245 2,825 1,445 202 347 105,017 846,182	Total funds 2020 £ 402,539 20,604 95,557 17,883 74,705 1,340 7,795 33,647 6,114 2,287 15,843 54,787 3,245 2,825 1,445 202 347 105,017
		846,182

Page 58

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

11. Analysis of expenditure by activities (continued)

Analysis of support costs (continued)

Direct patient support 2019 £ Staff costs 490,887 Depreciation 21,328 Communication costs 138,772 Repairs and maintenance 23,320 IT costs 51,035 Motor and travel 7,547 Insurance 6,931 Rates, heat, light and telephone 33,170 General expenses 10,794 Hire of equipment 1,699 Recruitment and redundancy costs 15,396 Legal & professional fees 39,425 Printing, postage & stationery 1,974 Staff training 1,025 Advisory board 5,619 Bank charges 586 Trustee expenses 2,779 Governance costs 111,946 964,233	Total funds 2019 £ 490,887 21,328 138,772 23,320 51,035 7,547 6,931 33,170 10,794 1,699 15,396 39,425 1,974 1,025 5,619 586 2,779 111,946
	964,233

Direct patient
support
2019
£
Staff costs
490,887
Depreciation
21,328
Communication costs
138,772
Repairs and maintenance
23,320
IT costs
51,035
Motor and travel
7,547
Insurance
6,931
Rates, heat, light and telephone
33,170
General expenses
10,794
Hire of equipment
1,699
Recruitment and redundancy costs
15,396
Legal & professional fees
39,425
Printing, postage & stationery
1,974
Staff training
1,025
Advisory board
5,619
Bank charges
586
Trustee expenses
2,779
Governance costs
111,946
964,233

Total
funds
2019
£
490,887
21,328
138,772
23,320
51,035
7,547
6,931
33,170
10,794
1,699
15,396
39,425
1,974
1,025
5,619
586
2,779
111,946

964,233

Governance costs General expenses Recruitment costs Auditors remuneration Accountancy costs Wages and salaries	2020 £ - - 14,430 1,698 88,889 105,017	2019 £ 313 6,080 12,960 2,838 89,755
		111,946

Page 59

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

12. Auditors' remuneration

	2020	2019
	£	£
Fees payable to the Charity's auditor for the audit of the Charity's annual
accounts	14,430	12,960

13. Staff costs

Wages and salaries Social security costs Contribution to defined contribution pension schemes	2020 £ 1,242,340 97,477 67,084 1,406,901	2019 £ 1,040,572 83,615 61,492

		1,185,679

The average number of persons employed by the Charity during the year was as follows:

Grants and patient aid Fundraising Advocacy service Counselling service Policy service Management and administration	2020 No. 5 6 10 2 2 12 37	2019 No. 5 5 10 1 2 11

		34

The number of employees whose employee benefits (excluding employer pension costs) exceeded £60,000 was:

		2020	2019
		No.	No.
In the band £60,001	- £70,000	-	1
In the band £70,001	- £80,000	1	1
In the band £80,001	- £90,000	-	1
In the band £90,001	- £100,000	1	-

The key management personnel of the charity comprise the trustees, the Chief Executive Officer, Policy Director and the Director of Market and Communications. The total employee benefits of the key management personnel of the charity were £226,073 (2019 £220,369) and employer pension contributions £16,624 (2019 £13,958).

Page 60

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

14. Trustees' remuneration and expenses

During the year, no Trustees received any remuneration or other benefits (2019 - £NIL).

During the year ended 31 December 2020, expenses totalling £95 were reimbursed or paid directly to 3 Trustees (2019 - £3,789 to 12 Trustees).

There was also a total of £1,704 (2019: £1,600) paid by the charity in relation to trustee indemnity insurance on behalf of trustees.

15. Taxation

The charity's income and gains arising each year are applied to charitable activities and so fall within the exemptions from taxation available for charities. The trading income in the year does not breach the trading exemption limits therefore no taxation charge arose during the current or preceding year.

16. Tangible fixed assets

Cost or valuation At 1 January 2020 Additions At 31 December 2020 Depreciation At 1 January 2020 Charge for the year At 31 December 2020 Net book value At 31 December 2020 At 31 December 2019	Freehold property £ 395,595 - 395,595 56,051 4,791 60,842 334,753 339,544	Fixtures and fittings £ 65,599 20,014 85,613 38,382 6,365 44,747 40,866 27,217	Office equipment £ 75,281 11,046 86,327 58,023 9,448 67,471 18,856 17,258	Total £ 536,475 31,060
				567,535
				152,456 20,604
				173,060
				394,475
				384,019

Page 61

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

17. Fixed asset investments

Cost or valuation At 1 January 2020 Additions Disposals Revaluations Net movement in cash At 31 December 2020 Net book value At 31 December 2020 At 31 December 2019	Listed investments £ 34,018,758 7,351,979 (8,861,455) 206,023 (366,650)
	32,348,655
	32,348,655
	34,018,758

Investments at market value comprise:

Listed investments Cash held by investment managers	UK 2020 £ 16,657,967 1,174,434 17,832,401	Overseas 2020 £ 14,516,254 - 14,516,254	Total funds 2020 £ 31,174,221 1,174,434 32,348,655

There were no investments at the year-end that were individually greater than 5% of the total portfolio. In 2020, cash held as investments represented 4% (2019: 3%) of the total.

The historical cost of the investments total £27,002,233 (2019: £26,719,381).

Page 62

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

Fixed interest Equities Property Alternatives Cash held by investment managers 18. Debtors Due within one year Other debtors Prepayments and accrued income 19. Creditors: Amounts falling due within one year Trade creditors Grants payable Accruals and deferred income 20. Creditors: Amounts falling due after more than one year Grants payable	2020 £ 4,178,409 23,032,058 2,587,991 1,375,763 1,174,434 32,348,655 2020 £ 129,614 13,435 143,049 2020 £ 166,087 589,880 72,678 828,645 2020 £ 315,265	2019 £ 3,769,529 22,883,621 2,276,467 3,960,103 1,129,038
		34,018,758
		2019 £ 358,761 12,061

		370,822
		2019 £ 133,707 827,866 63,392

		1,024,965
		2019 £ 266,014

Page 63

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

21. Statement of funds

Statement of funds - current year

Unrestricted funds Designated funds Designated Fund General Fund Total Unrestricted funds Endowment funds Endowment Fund Restricted funds Kidney Machine Children and Young activity breaks Childrens fund AO Kidney Kitchen Energy grants Total of funds	Balance at 1 January 2020 £ 30,000,000 3,727,791 33,727,791 79,640 42,882 - - - - - 42,882 33,850,313	Income £ - 1,268,318 1,268,318 2,153 - 220 150 42,143 32,055 545 75,113 1,345,584	Expenditure £ - (3,224,096) (3,224,096) (2,153) - (220) (150) (42,143) (31,431) (545) (74,489) (3,300,738)	Gains/ (Losses) £ - 206,447 206,447 (424) - - - - - - - 206,023	Balance at 31 December 2020 £ 30,000,000
					1,978,460
					31,978,460
					79,216
					42,882 - - - 624 -
					43,506
					32,101,182

Page 64

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

21. Statement of funds (continued)

Statement of funds - prior year

Unrestricted funds Designated funds Designated Fund General funds General Fund Total Unrestricted funds Endowment funds Endowment Fund Restricted funds Kidney Machine Children and Young activity breaks Advocacy officer Total of funds	Balance at 1 January 2019 £ 30,000,000 2,136,794 32,136,794 68,903 42,882 - - 42,882 32,248,579	Income £ - 1,824,543 1,824,543 2,153 - 5,547 155 5,702 1,832,398	Expenditure £ - (3,942,250) (3,942,250) (2,153) - (5,547) (155) (5,702) (3,950,105)	Gains/ (Losses) £ - 3,708,704 3,708,704 10,737 - - - - 3,719,441	Balance at 31 December 2019 £ 30,000,000
					3,727,791
					33,727,791
					79,640
					42,882 - -
					42,882
					33,850,313

Page 65

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

21. Statement of funds (continued)

Designated funds are sums that the Trustees have set aside to be used for the payment of future regularly occurring grants and running costs. These sums are not fully committed at the balance sheet date and are held as investments to generate income to facilitate future grant payments.

Following a review of the current commitments of the Charity, and taking into account the advice of our investment fund managers, it was agreed that the Designated Reserves Fund should remain at £30,000,000; this being the minimum level required to generate sufficient income to cover the regularly occurring grants and running costs, leaving the balance on the Operating Fund to be expended over the short term.

The General Funds are resources in excess of the Designated Reserves that have been separately identified. The trustees have committed themselves to substantially reducing this excess in the short term.

The Kidney Machine Fund is from a specific legacy bequeathed for the provision of dialysis machines. The Children and Young Activity Breaks fund relates to specific donations received from time to time by the Charity, to support holiday and respite breaks for Children and Young Adults.

The Children’s fund relates to specific donations received from time to time by the Charity, to fund support for children.

The Kidney Kitchen fund relates to income received specifically to fund the work and development of patient information related to the Kidney Kitchen.

The Advocacy Officer fund relates to specific donations received from time to time by the Charity to fund the Charity’s Patient Support and Advocacy Service.

The Energy grants fund relates to grant income specifically designed to fund energy voucher scheme for patients on pre-paid meters.

The Endowment Fund is an endowment received from the Chris Perrott Critical Illness Trust. The income from this Endowment Fund is also used to provide holidays for children with kidney problems.

22. Analysis of net assets between funds

Analysis of net assets between funds - current period

Tangible fixed assets Fixed asset investments Current assets Creditors due within one year Creditors due in more than one year Total	Endowment funds 2020 £ - 79,216 - - - 79,216	Restricted funds 2020 Unrestricted funds 2020 £ £ - 394,475 - 32,269,439 43,506 458,456 - (828,645) - (315,265) 43,506 31,978,460	Total funds 2020 £ 394,475 32,348,655 501,962 (828,645) (315,265) 32,101,182

Page 66

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

22. Analysis of net assets between funds (continued)

Analysis of net assets between funds - prior period

Tangible fixed assets Fixed asset investments Current assets Creditors due within one year Creditors due in more than one year Total	Endowment funds 2019 £ - 79,640 - - - 79,640	Restricted funds 2019 £ - - 42,882 - - 42,882	Unrestricted funds 2019 £ 384,019 33,939,118 695,633 (1,024,965) (266,014) 33,727,791	Total funds 2019 £ 384,019 34,018,758 738,515 (1,024,965) (266,014) 33,850,313

23. Reconciliation of net movement in funds to net cash flow from operating activities

Net income/expenditure for the period (as per Statement of Financial Activities) Adjustments for: Depreciation charges Gains on investments Dividends, interests and rents from investments Decrease in debtors Increase/(decrease) in creditors Net cash used in operating activities Analysis of cash and cash equivalents Cash in hand Total cash and cash equivalents	2020 £ (1,749,131) 20,604 (206,023) (616,924) 227,773 (147,069) (2,470,770) 2020 £ 358,913 358,913	2019 £ 1,601,734 21,328 (3,719,441) (870,486) 50,408 273,829 (2,642,628) 2019 £ 367,693 367,693

24. Analysis of cash and cash equivalents

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2020

25. Analysis of changes in net debt

Cash at bank and in hand	At 1 January 2020 £ 367,693 367,693	Cash flows £ (8,780) (8,780)	At 31 December 2020 £ 358,913
			358,913

26. Contingent liabilities

The charity has contingent liabilities in reference to grant applications that have been received by Trustees for approval but remain contingent upon the applicant's completion. The total amount not recognised in the financial statements totals £405,960 (2019: £448,398).

27. Pension commitments

The group operates a defined contribution pension scheme. The assets of the scheme are held separately from those of the group in an independently administered fund. The pension cost charge represents contributions payable by the group to the fund and amounted to £69,205 (2019 - £61,492).

28. Operating lease commitments

At 31 December 2020 the Charity had commitments to make future minimum lease payments under noncancellable operating leases as follows:

Not later than 1 year Later than 1 year and not later than 5 years Later than 5 years	2020 £ 23,067 92,268 11,354 126,689	2019 £ 23,067 92,268 34,601

		149,936

29. Related party transactions

In the year, donations received from trustees totalled £5,480 (2019: £5,320). There have been no other related party transactions in the reporting period that require disclosure.

Page 68

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

Opinion

In our opinion the financial statements:

give a true and fair view of the state of the charitable company's affairs as at 31 December 2020 and of its incoming resources and application of resources, including its income and expenditure for the year then ended;
have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and
have been prepared in accordance with the requirements of the Charities Act 2011, the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006.

Basis for 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.

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

Page 38

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Other information

We have nothing to report in this regard.

Matters on which we are required to report by exception

the information given in the Trustees' report is inconsistent in any material respect with the financial statements; or
sufficient and proper accounting records have not been kept; or
the financial statements are not in agreement with the accounting records and returns; or
we have not received all the information and explanations we require for our audit.

Responsibilities of trustees

Page 39

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Auditors' responsibilities for the audit of the financial statements

Capability of the audit in detecting irregularities, including fraud

Discussions with management and assessment of known or suspected instances of non-compliance with laws and regulations (including health and safety) and fraud; and
Assessment of identified fraud risk factors; and
Challenging assumptions and judgments made by management in its significant accounting estimates; and
Performing analytical procedures to identify and unusual or unexpected relationships, including related party transactions, that may indicate risks of material misstatement due to fraud; and
Confirmation of related parties with management, and review of transactions throughout the period to identify any previously undisclosed transactions with related parties outside the normal course of business; and
Reading minutes of meetings of those charged with governance; and
Review of significant and unusual transactions and evaluation of the underlying financial rational supporting the transactions; and
Identifying and testing journal entries, in particular any manual entries made at the year end for financial statement preparation; and
Performing substantive procedures on grant approvals at board level, progress of conditions being met and identification of grants not recognised that may indicate risks of material misstatement due to fraud; and - Confirmation of legacy estimations susceptible to fraud or irregularity from solicitors.

Page 40

BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

As part of an audit in accordance with ISAs (UK), we exercise professional judgment and maintain professional scepticism throughout the audit. We also:

Identify and assess the risks of material misstatement of the financial statements, whether due to fraud or error, design and perform audit procedures responsive to those risks, and obtain audit evidence that is sufficient and appropriate to provide a basis for our opinion. The risk of not detecting a material misstatement resulting from fraud is higher than for one resulting from error, as fraud may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal control.
Obtain an understanding of internal control relevant to the audit in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion of the effectiveness of the charitable company's internal control.
Evaluate the appropriateness of accounting policies used and the reasonableness of accounting estimates and related disclosures made by the Trustees.
Conclude on the appropriateness of the Trustees' use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the charitable company's ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our Auditors' report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our Auditors' report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.
Evaluate the overall presentation, structure and content of the financial statements, including the disclosures, and whether the financial statements represent the underlying transactions and events in a manner that achieves fair presentation.

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BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (CONTINUED)

Use of our report

Kreston Reeves LLP

Chartered Accountants Statutory Auditor Horsham 6 July 2021

Kreston Reeves LLP are eligible to act as auditors in terms of section 1212 of the Companies Act 2006.

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