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2021-12-31-accounts

THE BRITISH KIDNEY PATIENT ASSOCIATION operating as Kidney Care UK (A Company Limited by Guarantee)

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

Kidney Care UK Trustees report and financial statements For the year ended 31 December 2021

Contents

Page
Foreword by Chairman and Chief Executive Officer 1
Our aims 3
Trustees’ report
About us 3
Our impact in 2021 - Goals and achievements 4
Our approach to fundraising 32
Looking ahead to 2022 – Our aims and goals 32
Our finances 33
Our structure, governance and management 36
Trustees’ responsibilities statement 40
Reference and administrative details of the charity, its trustees and advisers 42
Independent auditors’ report 44
Statement of financial activities, incorporating income and 49
expenditure account
Balance sheet 50
Cash flow statement 52
Notes to the financial statements 53

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Foreword

2021 continued to be a year dominated by the Covid pandemic, affecting the people we support, the environment we operate in, and our organisation. With schools reopening on Monday January 4[th] , we had hoped that 2021 would be a year when we could finally emerge from the restrictions and health challenges that Covid presented to our community. Sadly, it was not to be. Within a day, schools had closed again, setting the scene for another year of isolation, worry and anxiety for many patients and their loved ones.

Our priority remained firmly on ensuring we were able to be there for every single individual and family that needed our support. We continued to strengthen and adapt the organisation to ensure we could respond quickly and meet the increased demand for support; we expanded our reach and engagement with patient communities to make them aware of the help available and reduce the feelings of isolation, we continued to adapt our ways of working both in fundraising and operations to ensure we could function effectively in a covid environment, and we redoubled our efforts to represent patients’ views and campaign to ensure their voices were heard and not forgotten or ignored.

Despite the continued challenges and constraints on the organisation, we were there with the financial, practical and emotional support so vital for living well with kidney disease:

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

now and, in the future, developing a road map of new priority services so we could emerge from Covid quickly as a stronger organisation.

Another Covid year meant another year of loss for many in our community, and once again we were not immune. Having lost both our Founder and Chair in 2020, it was with deep sadness we had to say farewell to Amjid Ali, a champion of kidney patients from ethnic minority communities and Kidney Care UK’s Inclusion and Diversity Lead. Our thoughts remain with his family and friends and everyone who lost family members, colleagues and friends over the last two years.

None of our work would be possible without all the wonderful supporters and donors who make us what we are. We are truly grateful to every individual and organisation who helped ensure we were there for everyone who needed our support. Finally, our thanks to all Kidney Care UK staff and volunteers for the amazing job you do and have continued to do in challenging times. It is because of your hard work, dedication compassion and tenacity that we have been able to help more people than ever before.

As we emerge from the immediate pandemic period and society moves on, we know that for many kidney patients things are not so simple. Many individuals remain unsure what if any level of vaccine protection they have, and the new cost of living crisis is leaving many patients anxious about heating and eating choices. We enter 2022 a stronger, larger, and better run Charity with a clear plan for the future, with a focus on expanding our reach and engagement, a programme of new support service development, a stronger profile and greater fundraised income. We know we must continue to do better to support individuals from marginalised communities as well as ensuring we are ready to respond quickly with help and support to everyone affected by the most difficult financial challenges facing our community for a generation. People are still being diagnosed every day with kidney disease and we will continue to do all that we can to support them to live their lives as fully as they can so that no one has to face kidney disease alone.

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

Paul Bristow Chief Executive

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

TRUSTEES’ REPORT

Our Aim

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.

About Us

The trustees (who are also directors of the Charity for the purposes of the Companies Act) present 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 2021. 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 (SORP 2019) 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).

The legal status and governance structure is explained in the “Structure, governance and management” section of this report on pages 36 to 40.

The Trustees have taken account of the Charity Commission’s general guidance on public benefit and the activities we carry out to further our charitable objects are for the public benefit.

Our charitable objects as set out in our articles of association are:

  1. to educate and inform the public regarding all forms of kidney and associated disorders;

  2. to promote the welfare of persons suffering from kidney and renal diseases or

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

associated disorders (“Kidney Patients”) including providing them with financial assistance;

  1. to make grants to hospitals for new buildings and other construction works for kidney units, for facilities for kidney transplantation, dialysis and their renal treatment and to meet cost of employing personnel to provide renal services; and

  2. to fund research for benefit of Kidney Patients.

Our five-year strategy was developed to deliver these objects.

Our Impact in 2021 – Goals and Achievements

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Our five-year strategy

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. It 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.

Our Priorities and Achievements

In our 2020 annual report, we set out our priority strategic aims for 2021, committing us to:

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Reaching and engaging with more people and their families living with kidney disease

As the UK’s leading kidney patient support charity, we believe Kidney Care UK should be the go-to charity for kidney patients; the organisation that people with kidney disease, and their families, turn to when they need non-medical support.

Our Patient Support Services and our Marketing and Communications functions are key to ensuring that support is there for those who need us, and that people with kidney disease, and their families, are aware of the charity. When someone has just been diagnosed unexpectedly, or their kidney function has suddenly rapidly declined – these are the times when we are often needed the most. Whether through speaking to experienced advocacy officers with lived experience, who really do just ‘get it’; 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.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

How our Patient Support Services have engaged with more patients

As we faced the second year of the pandemic, the ways we have adapted to working remotely has allowed our Patient Support Services to continue and expand its support to people affected by kidney disease and their families. As a result of an increase in demand for our support we have grown our Advocacy and Counselling teams, which provide national coverage, five days a week. We are also developing standard operating procedures to ensure the high-quality services we provide continue to grow and develop.

We also began a strategic review of our patient support services in 2021, consulting and engaging with a broad range of stakeholders to agree the service priorities for the next three-years. As part of our consultation and engagement work in 2021, we identified the high-quality patient experience from people who use our current services. However, we know that the patient audience we currently support can be broadened even further by introducing digital access to the charity’s services.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

National Advocacy Service

Throughout 2021, Kidney Care UK continued to offer comprehensive, independent and person-centred support though its UK-wide Advocacy Service that complements the frontline care and services of the NHS and Social Care. The impact of Covid-19 meant that there was a strong demand for our Advocacy Service, with more than 2,500 clients being referred to the service. In total, together with our Welfare and Benefits Health check service, we were able to secure over £1m in benefits for patients and their families. Of this, our Advocacy team alone secured £336,043, a significant increase from the £149,912 in benefits we were able to generate for our community in 2020.

Across the UK, our expanded team of 16 Patient Support and Advocacy Officers provide tailored support to patients and their support networks at times of need and great change in their lives. The team played a key role in signposting individuals to reliable, trusted, and high-quality information, and supported individuals to access and build supportive networks with professionals and other agencies, ensuring holistic support was available when required. The Advocacy Service also supported and empowered individuals’ voices to be heard across a variety of settings, ensuring patients were central to decision making and shape the care and support they received.

The team supported a total of 2,645 patients in 2021. Welfare benefits advice, access to grants, and information relating to treatment were the areas of greatest need where the team offered support. Building relationships that are founded in trust and confidence remains the cornerstone of the team's work and the support we offer.

Our Welfare and Benefits Service, delivered in partnership with Auriga, continued to offer much needed advice and guidance to patients. On behalf of Kidney Care UK, Auriga deliver a service that assesses a patient’s current financial circumstances, offers guidance on income maximisation, and assists individuals to apply for welfare benefit entitlement. Throughout 2021, 492 individuals were supported with welfare and benefits advice and guidance. In conjunction with the direct support offered by our Patient Support and Advocacy Officers, over £1.25 million of financial support was realised for those accessing the Advocacy service. This aspect of the team’s work, and our partnership with Auriga, will remain a key component to the support we offer in 2022 to support patients with increasing fuel bills and as the cost of living continues to rise.

Despite the continued challenges of Covid-19 and restricted opportunities to deliver an inperson service, the team has continued to adapt to new ways of working through virtual online engagement and telephone support.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

" As a kidney patient during the coronavirus pandemic, you rely on health services being coordinated to receive ongoing treatment, advice, and vaccines. Sometimes these services don’t join up very well and you’re left feeling alone and unsure of who to turn to.

“When I couldn’t get information or an appointment for my third primary covid-19 vaccine, Linzi from Kidney Care UK helped me. She contacted various services on my behalf, and she made me feel like I wasn’t on my own .”

Feedback from a patient who was supported by our Welsh Advocacy Officer, Linzi Isaac

Providing emotional support through our Counselling Service

In 2021 our Counselling Service continued to deliver specialist support to patients and their families. Growing numbers of patients were contacting the charity, needing psychological and emotional support where there was either nothing timely or suitable available through their local NHS services. Shielding was still very much in place for many renal patients, bringing isolation, loneliness, and feelings of being left behind and forgotten. Clients were often struggling with anxiety, depression, anger, and frustration. There was also a marked increase in feelings of vulnerability and death anxiety became a more predominant concern than in previous times. Our service provides a lifeline to those kidney patients who have nowhere else to turn.

The significant increase in demand for our Counselling Service saw an expansion of the service to four qualified counsellors by October 2021. Despite the recruitment and resulting induction and training involved, we delivered over 1,100 counselling sessions in 2021, an increase of 11% compared to 2020. As a result of operational and technological advances, we were able to offer choices of telephone or online one to one counselling and in addition to this developed a couples counselling service with the use of online platforms and a member of our team who is specifically trained in relationship work.

In total, 245 individual clients were supported from January to December 2021 and 1,148 sessions were delivered throughout the year. Time and time again clients expressed their relief at being able to work with specialist renal counsellors where they could feel that the grueling aspects of kidney disease were fully appreciated, understood, and professionally supported.

“Today, I am sat on the bench where in September I felt like my world was just about at an end. I feel a sense of peace and well-being that I have not felt in a long time. I can without question thank you for guiding me on this journey and say how words cannot express my gratitude for your help and sincerity.” Patient who received support from our Counselling team

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

How our financial support is changing lives

The financial support Kidney Care UK offers to patients is a lifeline to those individuals and families who are struggling to make ends meet because of their kidney disease and who need that little bit of extra support to help get back on their feet. Together with our welfare and benefits support service, and working in partnership with renal social workers, our patient grants provide vital financial assistance to patients who may be struggling with their energy and water bills, or who need help to pay the rent or put a hot meal on the table for their family.

In 2021, the Charity awarded nearly 1,200 grants totaling £550,000, often with the money being sent to patients in a just a few days. Although holiday grants remained unviable, with travel prohibited for most of the year, our emergency hardship grants remained at double the 2019 levels at £100,000, and made a huge difference in easing patients financial worries.

"Kidney Care UK have been genuinely instrumental in supporting the patients I work with as a renal youth worker over the last 6 years. They have without doubt positively changed the lives of so many patients here in Wales and across the UK.

“The charity has safeguarded patients through crucial emergency grant support and without these grants I do not know where we could have turned. They have also been able to provide grants to help improve people's quality of life; grants which help give people back independence, which help people cope with the difficulties of living with kidney disease. It is always a pleasure working with Kidney Care UK and I hope we can continue supporting patients together for many years to come".

Shaun Thomas, Senior Renal Youth Worker, Cardiff and Vale UHB & Swansea Bay UHB

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

“Thank you so very much for the generous gift of £300 towards my heating costs and for arranging delivery of a washing machine to help with my constant need to wash bedding because of allergies and asthma. Now has been a dreadful time for my old washing machine to break beyond repair. Having undergone an emergency operation to prepare me for dialysis early January this year, I now face another operation next week to address the constant pain I experience, your contribution has helped greatly to relieve my financial worries due to being signed off on sick leave and not yet had income. It is imperative I keep the heating on, and you have helped me address that issue. Thank you!”

Patient grant recipient

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

How we have reached and engaged with more kidney patients through our Marketing and Communications

As the leading kidney patient support Charity in the UK, our Marketing and Communications play a vital role in raising awareness of kidney disease and raising the profile of the Charity amongst everyone affected, so they are aware of and able to access the support that we provide.

Website performance

Our Covid-19 guidance remained one of our most visited pages - throughout 2021 it remained in the top three most visited pages on the site, with patients often being signposted to the website via their health and care teams. Overall, in 2021 the website received 673,160 unique visits to the site - almost identical to the numbers in 2020 (671,218) – but representing an increase of 144% against pre-pandemic 2019 numbers. Coronavirus still attracts users to our website who then visit other pages and consequently return time and time again, proving that our website content is accessible, credible and engaging.

Email

In 2021 we sent out over 50 emails on a wide variety of topics, as part of our strategy to keep the kidney community connected and up to date on what was happening. Topics included our monthly eNewsletters, Coronavirus news, fundraising, our Kidney Matters magazine, webinar promotion and updates on Policy & Campaigns. Our main mailing group continues to grow, and we now have over 10,700 subscribers. This is more than double the number we started with in 2020 and every email achieved above average open rates and click through rates, reassuring us that our information was engaging and providing information that people wanted to read and act on after doing so.

PR & media

2021 was our most successful year to date, with over 1,700 pieces of media coverage, including regular features in national and local papers, on the BBC and on ITV. Our media work is vital in raising awareness of kidney disease amongst the public and spearheading our campaigning work to ensure that the voices of kidney patients were heard, particularly when it came to the pandemic and the fact that so many of our kidney community felt that they were being ignored.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Social media

Social media plays a critical information and support role in today’s communications, helping keep the kidney community connected and engaged, up to date with the latest information and providing peer support through sharing other patients’ stories and views. We grew all our social media audiences in 2021 either in line with or ahead of our targets (44% growth on Instagram, 28% growth on Facebook and 22% growth on Twitter, see below). Real patient stories continued to strike a chord and resulted in excellent engagement rates across the year and our Facebook peer support community exceeded 10,000 members this year.

----- Start of picture text -----
Social media growth in 2021
10,000
8,000
6,000
4,000
2,000
0
Instagram Facebook Twitter
Jan-21 Dec-21
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It was Covid-19-related content that performed best across all our channels, highlighting the continued need for us to respond to the news agenda and ensure we provide the relevant information and advice that kidney patients have come to rely on us for.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Webinars

We continued to develop new digital ways of engaging patients and delivering our key information support. In 2021 we delivered five more of our Covid-19 Question Time Webinars and an additional four in Scotland, in partnership with Living Donation Scotland. Subjects included ‘updates on vaccines and treatments’, ‘living donation’, and ‘support on emotional wellbeing and dealing with anxiety’. All were well-received, with webinars becoming a valued way for people living with CKD to hear and discuss the many queries people with kidney disease continue to have.

Over the nine webinars, we had over 1,500 people register to attend and receive a copy of the webinar report. Of those that registered, nearly 80% were kidney patients, carers or family members. Over 85% rated the webinar experience as “very” or “extremely satisfied” and found the sessions relevant and informative.

“Thank you to so much to you and the whole team for a very informative, helpful and supporting webinar. I’m sure it took many hours of preparation. Great work, well done.” Richard, webinar attendee.

Diary of a Kidney Warrior Podcast

Keen to expand our digital channels even further, in July we partnered with Dee Moore to launch a new patient information product with the Diary of a Kidney Warrior Podcast. These podcasts coordinate a mix of kidney patient stories from the patient community and listener-led conversations and Q&As with health care professionals to closely align with our own objectives to reach and engage more people affected by kidney disease and represent the voice of patients. In 2021, we produced 17 episodes which have been downloaded over 5,000 times in 46 countries and is currently the top-ranking kidney podcast in the world!

“As someone with stage 4 CKD it has helped me with what to expect and how to manage! Thank you”

“Your joy and energy really power through the microphone, so keep up the good work. I’ve learnt more from you than going to hospital appointments for 20 years!”

Podcast Listener

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

“I am truly honoured to be in Partnership with Kidney Care UK for Diary of a Kidney Warrior Podcast. Kidney Care UK ‘s investment in the podcast has enabled me to produce high quality podcasts, with excellent quality artwork to benefit kidney patients across the UK. The charity’s support to promote the podcast has been invaluable and has increased my ability to reach kidney patients exponentially.”

Dee Moore

Kidney Matters

Our quarterly Kidney Matters magazine continued to grow in popularity, helping patients feel connected to the wider kidney community, when at times their whole world feels like the four walls of a dialysis centre. By the end of 2021, we had increased our postal subscribers by 5% and email subscribers by 20% and sent over 20,000 copies to units and hospitals four times per year.

In each issue, professional contributors shone a light on available medical, surgical and psychological treatments for kidney disease, and these interviews were further brought to life with supporting patient ‘lived experiences’ of these treatments.

Kidney Matters also carried various patient contributions on lifestyle matters and how to live well with kidney disease, including hints and tips on how to take holidays whilst on dialysis, coping with work, managing medication and associated side-effects, dialysis at home, and living a life as near normal as is possible with kidney disease. These have proved to be hugely popular with our readership, most of whom will experience periods where their medical condition feels overwhelming.

‘I still wanted to be able to travel, and I found out how I could do that in Kidney Matters. Before that, I had no idea you could travel whilst you were on dialysis.’

Kidney Matters also shared a regular Kidney Kitchen recipe each quarter. These recipes are developed by professional chefs and have been approved by the British Dietetic Association Renal Nutrition Group (BDA, RNG) as being safe for kidney patients to eat, but delicious enough for the whole family to want to share.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Kidney Kitchen

Living with a restrictive kidney diet can be challenging for many patients who must work closely with renal dietitians to come up with a diet that is tailored to their needs. The Kidney Kitchen continues our work to develop “Go to” hubs for key lifestyle information to help patients live well.

We continued to grow and develop the Kidney Kitchen and welcomed a new recipe developer to the team in 2021.

We now have 138 recipes, with 71 of these on the website and the remaining being uploaded in 2022. We also broadened our range of different cuisines by inviting Sumaya Masood (Kidney Matters deputy editor) and her brother Nassar to join us in the Kitchen.

They cooked a wonderful range of kidney-friendly recipes, suitable for people with CKD who celebrate Ramadan as they break their fast. In December, we also welcomed Michelin-starred chef, Nathan Outlaw, back into the kitchen to cook one of his own (adapted to suit the dietary needs of people with CKD) fish recipes. Nathan is a great advocate of the Kidney Kitchen and the work we do to make food fun and tasty again for people with CKD.

During 2021, the Kidney Kitchen website traffic increased substantially, and we were delighted to report our most successful year on engagement and awareness, with 132,752 unique page views to the site, compared to 56,632 in 2020. Almost 8,000 (7,847) recipes were downloaded and our ‘meet the dietitians’ video was the second most popular video on our YouTube channel – watched by 2,644 people. As the reach and engagement with the Kidney Kitchen expands, we will be looking to develop a broader range of affordable recipes to reflect the challenging economic conditions as well as investing in a more diverse range of videos to appeal to different demographics.

Healthcare Professional Engagement

One of the key ways we can reach and engage with more people in need of our support is through working with healthcare professionals. In 2021, we continued to develop this work by creating a resource kit for renal dietitians using our Kidney Kitchen materials. To date, we have built a network of 96 renal dietitians who are using and sharing 3,480 Kidney Kitchen recipe books with patients.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

“They are such a fantastic resource we tell all our patients about them!” Emma Carder, Renal Dietitian Liverpool Hospitals NHS Foundation Trust

Patient Information you can trust

Patient Information that is trusted and available when, and in the format patients want is a core service for Kidney Care UK. In 2021, much of our patient information activity shifted towards providing reactive, up-to-date information for kidney patients around Covid-19 guidance. Despite this, 15 new patient information leaflets were produced, and we now have a total of 75 leaflets printed and available to order regularly, 57 as a result of our partnership with the UK Kidney Association.

Our focus in 2021 was on making more of our patient information accessible beyond leaflets, with a major effort to transfer all the content from downloadable PDFs and into web pages where translation and accessibility needs can be better met. This approach has been hugely effective in growing our overall reach and engagement online, representing more than a 200% increase in 2021 from 152,629 to 487,156 unique visits engaging with our patient information resources. This work was supported with the growth of the team and the recruitment of an additional Communications Officer, who joined the team in October.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

While the overall quantity of leaflets we distributed in 2021 remained consistent, we fulfilled more requests for orders than ever before! At 2,338 in total, that’s an average of 45 orders per week and is over 400 (22%) more orders than in 2020, and encouragingly we are seeing more repeat orders, which now average just over two repeat orders per year.

Improving the way kidney patients are cared for across the UK with access to the highest quality holistic care

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. These service improvement projects help to improve the way kidney patients are cared for across the UK with access to the highest quality holistic care.

Improvement Grants – supporting local innovation and service improvements

In 2021, our grant-funded hospital initiatives supported over 12,000 kidney patients and we spent over £650,000 in grants to improve patient care. As we fund projects over a number of years, 2021 saw our ongoing commitments total over £1 Million including those in contingent liabilities.

Our hospital improvement grants are designed to help meet local improvement needs, drive new and innovative ways of supporting patients, support new staff posts, as well as invest in the development of quality improvement projects across the UK. Many staff posts are seed funded and are a ‘first in post’ for that renal unit. This allows the Trust to gather qualitative and quantitative data to prove that there is value in the NHS permanently funding these key renal posts in future. We know this approach works. Data shows that over the last 10 years 75% of the roles we initially seed funded were then taken on permanently by the Trusts.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Case study: ERAS project

The ERAS project (Enhanced Recovery After Surgery) is making huge improvements to the transplant recovery pathway in Newcastle-upon-Tyne Hospitals NHS Trust. The preliminary results of this pilot have shown that the length of stay in hospital post-transplant has now been reduced from 12 days down to 5 days and feedback from patients has been hugely positive:

Feedback from patients:

“ERAS pretty much removed all my anxiety. I felt in control.”

“The mobility wall chart motivated me to get up and beat my targets.”

Feedback from Carrie Scuffell, Lead Nurse at the Freeman Hospital:

“It has been a privilege to witness the positive difference ERAS has made to both the experience and recovery of our transplant patients. We have also seen a culture shift on the transplant unit, positively affecting the care of other non-renal transplant patients. This would not have been possible without the generous funding and support from KCUK, and we are now sharing our results with other units, hoping to use what we have learnt to ultimately improve the recovery and experience of other transplant patients across the UK and beyond.”

In 2021 we awarded 6 new grants totalling nearly £300,000 (£286,888) including a Paediatric Psychologist and Paediatric Renal Social Worker in Cardiff; the funding of a compassionate mindful resilience pilot programme in Belfast; and investment in a Renal App to be trialled in Walsall, designed to raise awareness of healthy lifestyle choice for ethnic minority communities.

The 2021 grants round funded posts and projects

Hospital Post/Project Funding
The Children’s Kidney
Centre, Cardiff		 Paediatric Principal Practitioner Psychologist £40,009
The Children’s Kidney
Centre, Cardiff		 Paediatric Renal Social Worker £27,543
Queen’s University,
Belfast, with
Mindfulness UK		 Compassionate Mindful Resilience Pilot
Programme		 £65,796
Walsall Manor Hospital Renal App
(Raising awareness on healthy lifestyle
choices,BAME)		 £11,000

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Omagh (Western
Health and Social Care
Trust)		 Combined support of Renal Clinical
Psychologist and Renal
Wellbeing Practitioner		 £99,868
Royal Hull Hospital Research Assistant:
To assess the use of smartphone/tablet-
based gaming apps for the delivery of
patient-led cognitive gamified training during
haemodialysis sessions to improve cognitive
function.		 £42,672
Total Awarded £286,888

– Strong partnerships To deliver patient involvement and sustainable, systemic change to health and care services

We continue to build strong partnerships with the leading health associations to embed improvements across the whole UK permanently, and work with local kidney patient organisations and national charities to deliver more and better support for patients than we could deliver alone. Our ongoing partnership grants continued to fund the renal social worker, counsellor and psychologist and nurse associations, helping them to operate as effective, professional groups and ensuring the importance of psychosocial support in helping patients live well remained a priority in kidney care.

2021 also saw a continued focus on strengthening our work to support greater patient involvement and ensure patients have a voice and a choice. This included projects to support patients to have more control over their own care decisions and become a partner in their own health care, as well as ensuring that patient involvement in all aspects of kidney care was taken seriously, from research to governance, service improvement and policy.

Patient Reported Experience Measure (PREM)

Our partnership with the UK Kidney Association (UKKA) continued to deliver the national patient experience survey, providing patients with the opportunity to feedback on their care experiences and for hospitals to learn and improve their care services. In 2021 the PREM survey was undertaken as a hybrid online (79%) and physical paper (21%) model. We received 12,416 valid responses from across all 68 adult units in the UK. Most significantly, 3,880 provided written comments and 90% gave permission to share their responses as part of a new thematic qualitative report. A further 1,475 answered the Covid-19 question to provide insight into the ongoing impact on patient experience. In addition to producing the main report, we coordinated marketing materials and an interactive session with the UKKA based on the insights from the 2020 comments report. The ‘Little Gems’ approach ‘that small things make a difference to patient experience’ was a key theme identified in the 2020 report.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Kidney Patient Involvement Network (KPIN)

We continued to fund and partner with KPIN, a network of kidney organisations, charities and individual patients committed to quality patient, public involvement and engagement (PPIE), who are willing to work collaboratively on initiatives to improve standards and develop patient leaders of the future. Our aim remains to create and support a stronger, better networked and cohesive kidney community, and we are already seeing greater and higher quality patient involvement across research, quality improvement projects, advisory groups and committees.

Shared Care Training

The NHS Long Term Plan highlights the growing body of evidence that shows better outcomes and experiences, as well as reduced health inequalities, are possible when people have the opportunity to actively shape their care and support. With this in mind we continue to support the national shared care training programme for health care professionals, accredited by the Royal College of Nursing. Over 2021 we delivered seven more courses and one managers workshop reaching 40 kidney teams and 90 attendees.

Quotes from virtual course staff this year:

“We discovered that many patients were scared that SHC was about needling and didn’t know they could participate in any task following the questionnaire”

“I have used different conversations and one of my patients has now decided to needle herself”

“2 patients have reduced their BP meds because they understand fluid balance better”

“Listening to other units & hearing their successes & how they had similar issues that they were able to overcome has motivated me to continue to rejuvenate our shared care programme”

“The patients’ perspective is phenomenal. It really gives us the push to do this”

Managing our Charity as effectively and efficiently as possible

As the Charity grows, it is essential that we develop a strong platform on which to achieve our growth aspirations to reach and support even more patients. We owe it to every single supporter and donor that we spend their money wisely by being as efficient as possible. 2021 saw significant effort invested in increasing our staff numbers to meet patient demand and in strengthening our infrastructure, processes and leadership right across the organisation.

IT, hybrid working and cyber security

During another challenging year, with most staff continuing to work primarily from home, we continued to ensure stability of our IT platforms and further reinforced our systems.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

This included switching to FTTP (Fibre to the Premises) to our Head Office, which increased our connection speeds four-fold and users experienced a much more stable connection, with no downtime due to connection loss since installation in June 2021.

To maintain the security of our systems, and protect patient information, external penetration and dark web testing were completed by Cyber Armed Security. Tests will be completed every two years unless testing shows that our vulnerability risk has risen. Overall, we were delighted with the results of the testing as the security systems and protocols that we have in place on the server were working as expected and the remedial actions required were only minor adjustments that needed to be made. As with most organisations, our main vulnerability could be phishing attacks. To further protect against phishing attacks, Barracuda Total Email Protection was introduced successfully in November 2021 to provide comprehensive protection against all email threat types, from spam and malware to business email compromise and account takeover.

To further support hybrid working as our staff started to return to Head Office, the further utilisation of the softphone capabilities of the telephone system have been more widely introduced to enable easy connectivity for all users. This has streamlined the patient experience as they can now be transferred to the service that they need to access reducing the delays caused by call back requests.

Strengthening leadership across the Charity

As a charity we know we are only as good as the people who work for us and support the delivery of care to patients. As we grow it is essential that we have leaders right across the organisation ensuring that our values are embedded in all our support and that we continue to put patients first.

2021 saw us strengthen the Senior Management Team with the recruitment of our first ever Director of Patient Support Services, as well as the first Director of Marketing, Communications and Fundraising. Early 2021 will see us further expand with a Finance Director and HR Manager. In addition, despite the increased workload, we took the bold decision to create the space and time for all our managers to engage in the organisations first Leadership Development Programme, which launched in September 2021, and is designed to equip managers and leaders working for the charity with best practice tools and techniques to increase the effectiveness of themselves, their teams and the charity.

Ensuring that patients’ views are effectively represented at the highest level and campaign for better patient outcomes and care

Our commitment to campaign relentlessly on behalf of people with kidney disease continued in 2021. Whilst the pandemic still dominated our focus, we also made significant progress in areas including organ donation, patient transport and Brexit.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Our continued response to the pandemic in 2021

Through our Covid-19 patient experience reports, we received 2,400 separate responses about how the Covid-19 pandemic affected people with CKD and their families. This was a unique resource that we used to demonstrate to policymakers and parliamentarians the depth and breadth of the direct impact that Covid-19 continued to have on people in our community. This highlighted the continuing need for support for people with kidney disease to move back into society, to restart surgery and transplants, and to support their mental health.

As our understanding of Covid-19 grew, and the roll out of the vaccination programme began, it became even clearer that those most at risk needed advice, guidance and support. Unfortunately, there were three groups at particular risk and who may not be protected in the way that everyone else is by vaccines – they are people on dialysis, people with organ transplants (on immunosuppressants) and people with blood cancer.

While we worked hard to promote and support the roll out of Covid-19 vaccinations, we also had to push back when it became difficult for kidney patients to receive their third primary doses due to a lack of understanding in vaccination teams and the inability of NHS IT systems to register them. We engaged with and challenged NHS England on making it easier for people to be able to get their third primary dose of the Covid vaccine, which was not the same as a booster jab and had been poorly communicated. This work and our patient surveys highlighting these difficulties, hit the national headlines twice in two months, with 500 patients giving us their direct experience of these difficulties overnight. We found that 79% had faced difficulties accessing their third dose of Covid-19 vaccination.

Eventually NHS IT systems were updated, but the consequence was that some immunosuppressed people did not receive their third primary doses in good time for the Omicron variant.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Through regular meetings with other charities, with the vaccines Minister, Nadim Zahawi, and subsequently with Minster Maggie Throup, with the Lords Health Minister, Lord Kamall, and many others, we used every occasion to speak up for the needs of people with kidney disease and to create an awareness overall about kidney disease.

Charity coalition meeting with Vaccines Minister on 1 December 2021

Covid-19 – the Safe at Work campaign

As restrictions started to lift in 2021, Kidney Care UK led a group of 25 charities representing clinically extremely vulnerable (CEV) people, calling on the government to do more to support those who are CEV as they returned to the workplace. We commissioned a survey, which found that 68% of people (including employers) were not aware that people with suppressed immune systems were not adequately protected by their vaccines. Half a million people in the UK are immunosuppressed and may have low/not have any protection, even after two doses of the vaccine. Many vulnerable people felt forced to choose between protecting their livelihoods and protecting their lives.

We created a letter that individuals could download from our website and share with their employers as restrictions eased. Throughout 2021, our advocacy officers used this frequently to support patients in discussions with their employers, and it has been widely disseminated to policy makers, employer groups and the Health and Safety Executive.

Organ Donation

Despite most of the year being dominated by work on the pandemic, it was far from the only area of work for the charity. The anniversary of the Organ Donation opt-out law was on 20[th] May and the charity was pleased to continue to work with NHS Blood and Transplant (NHSBT) and others to support the publicity around the anniversary. Despite the fact that

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

transplants were well down compared to 2019, one third of proceeding transplants were under the new laws, resulting in 741 organs being transplanted. We secured an Early Day Motion at Westminster, referring to the need to work on the backlog of transplants and through other parliamentary contacts, raised several written parliamentary questions on organ donation to help maintain awareness of the issue within Westminster.

Opt-out law in Northern Ireland

Following many years of work by our Northern Ireland ambassador and former MLA Jo-Anne Dobson, plus more recent work in the last four years by Kidney Care UK, the final stage of the organ donation opt-out bill in Northern Ireland was passed. Once the bill becomes law, all UK countries will be working on the basis of an organ donation opt-out rule.

“I once again place on record my sincere thanks to Jo-Anne Dobson, who started the journey and who personally convinced me that our organ donation laws needed to change. I also thank the many individuals, families, teachers, patient support groups and charities across Northern Ireland who have worked tirelessly over many years to promote organ donation.”

Health Minister Robin Swann, on the day of the final debate at Stormont.

Organ Utilisation Group

Kidney Care UK co-leads the stakeholder forum for the Organ Utilisation group, to follow on from the introduction of the opt-out law. Set up by the Secretary of State for Health and Social Care and reporting to all Ministers of Health in the UK, the Group aims to deliver recommendations on how to maximise the potential for organ transplantation and provide a premier healthcare system, that delivers equity, excellence, and innovation to meet the needs of those on the transplant waiting list. It will also address how the barriers to organ transplantation can be overcome, so that the UK continues as a world-leader in innovation in the field of transplantation and no opportunity for a successful transplant operation is missed.

A universal commitment to free transport for all journeys to and from dialysis

As members of the NHS England expert advisory group, we brought the voices of dialysis patients forward and shared their often-difficult transport experiences. We were very pleased to be able to share the news in August 2021 that NHS England have recommended that dialysis transport will be free to all dialysis patients, and that those who wish to travel under their own steam will be fully, fairly and rapidly reimbursed.

As a member of its transport Expert Advisory Group, Kidney Care UK has engaged extensively with NHS England on this report to make the case for improved quality and access to dialysis transport. We did this using patient experiences, including what people said through our annual PREM survey. This is the first time that the NHS has reviewed transport for many years, so it is much needed and critical to quality of life.

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This commitment means free transport and is either:

This commitment is not means-tested and also says that the appropriate type of transport should be a shared decision, reflecting people’s needs and preferences as well as the appropriate use of NHS resources. Patients should be empowered and supported to retain their independence and a personalised approach should be promoted. This system will be brought in over the next year and means that no-one will have to pay for transport to and from dialysis, and that the quality of transport will be properly monitored. It has however already taken over two years since the transport review was commissioned to publish the recommendations, so we continue to press NHS England to prioritise this.

Brexit – a win for kidney patients

As the country’s leading kidney patient support charity, Kidney Care UK was uniquely placed to understand and amplify the voice of kidney patients in response to complex, everchanging and multi-faceted Brexit challenges.

Patients faced multiple challenges, especially were there to be a no deal. Almost 30,000 people would potentially lose the right to freely travel to the EU and receive life-maintaining dialysis through reciprocal healthcare agreements. In addition, threats of supply disruption could affect almost 67,000 people with kidney problems, on dialysis or with kidney transplants, who rely on the timely and safe supply of life-maintaining and enhancing medications and consumables.

Utilising multiple communication tools, Kidney Care UK’s patient-led Brexit Campaign saw us motivate and lead an entire patient community. We engaged with Brexit negotiators and challenged those responsible at all levels across the regions of the United Kingdom as well as the European Commission, both during the Brexit negotiations and in the transition period.

As a direct result, the Government protected the rights of kidney dialysis patients to receive dialysis care within the EU as part of the Global Health Insurance Card (GHIC). This powerful campaign has protected and enhanced the rights of kidney patients today and for future generations. The charity was very pleased to receive a Communique award for Charitable Campaign of the Year, but the real win is for kidney patients.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Chronic Kidney Disease developments

Kidney Care UK represented the charity in the development of new guidelines on CKD by NICE (the National Institute for Health and Care Excellence). There was concern from our medical colleagues that the adjustment for ethnicity did not reflect the wide diversity within individuals of black ethnicity, with the adjustment based on outdated biological assumptions for differences between ethnic groups at the expense of better understanding of social and ancestral determinants. For some black patients, ethnicity adjustment could lead to inaccuracy in their estimated kidney function, and potential inequality in delivery of care.

In the 2021 NICE CKD guidelines, the recommendation for an ethnicity adjustment was removed. On review of the evidence, NICE agreed that adding an adjustment to eGFR for different ethnicities may not be valid or accurate. We were pleased to see that these new guidelines included much more emphasis on shared care decisions.

New drug developments

Following our recent work with NICE on their latest CKD guidelines, we took part in another Appraisal Consultation on a new drug, which stands to delay the progression of kidney disease in people with and without diabetes. It is one of a new class, called SGLT2, which encourages excretion of glucose and NICE have now recommended its adoption in the NHS. Our comments were featured in the plans, and we have ensured patient feedback throughout this exercise.

Loss of a dear friend and colleague

We were absolutely devastated that we lost our friend and colleague Amjid Ali who passed away in September 2021. Amjid was a wonderful, compassionate man who did so much to promote organ donation and inclusion through his work with the Charity, NHSBT, as well as commissioners from a number of regions across the UK.

He was a courageous, strong and kind man, hugely respected by everyone who knew him. Although softly spoken, when Amjid spoke – you listened. He had a talent for bringing people together and produced extraordinary results through determination and patience, and he never hesitated to ask or challenge when it came to ensuring the experiences and

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needs of people from South Asian and Black communities were represented and included in all the work that he did.

He played an instrumental role in bringing together influential Scholars & Imams, umbrella groups, community organisations and clinical leads to look at the challenges that need to be addressed to move the organ donation debate forward. His perseverance and hard work over the course of five years led to the development of an updated religious edict (Fatwa) on Transplantation and Organ Donation in Islam, issued June 2019.

His compassion was clear for all to see and whilst it will take us all some time to come to terms with the huge loss to our community, we take comfort in knowing that Amjid made a huge impact on everyone he met. He used his time in the world to change organ donation and kidney care, and his work has - and will continue - to save many lives.

Inspiring more people to support our work and grow our fundraising income so we can do more

We are incredibly grateful for the generosity of all our supporters who make possible our charitable mission. It is only through their support that we can continue to offer our free patient support services that provide the much need practical, emotional and financial support that the growing population of people affected by kidney disease need. Over the year the team welcomed three new members to the team which brought the team back up to full strength and ready to kick on into a busy 2022.

By the end of 2025, we set ourselves the ambitious target of growing our voluntary income to £3.5 million and our supporter numbers to 10,000. 2021 was the first year of this strategy, and we were able to raise a record £1.3million via 11,315 donations from 3,472 donors. This is £587,000 more than 2020, representing a huge achievement in the face of the challenges presented by the pandemic.

Legacy income totaled £689,000, representing an increase on the previous two years. A record £584,000 was raised via non-legacy activity. This is £147,000 more than 2020 and £165,000 more than the pre-pandemic levels of 2019.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Along with the continued growth and development of our more established activities, we also benefited from the introduction of new products over the year. Our partnership with clothes recycling company, iCollect Clothes, generated £19,000 and we also increased the reach and engagement of our Kidney Care UK-led community and challenge activity, including virtual events and new and increased Christmas activity.

2021 also saw the revamp of the legacy proposition (‘A Promise to Care’), the introduction of a free will writing partner, and the beginning of a new suite of engagement and support materials. We were pleased with the early results of this work, and we will see greater impact following further marketing and promotional activity in 2022.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Individual giving

We secured a record £124,000 via 6,293 donations from 1,288 individual donors in 2021 (up from 1,135 donors in 2020). This is an encouraging development in the face of extremely challenging fundraising conditions, which meant that many charities were sadly forced to shut down. As the team continues to develop its skills and experience, we are confident of growing our individual giving income over the coming years, building on the compelling and credible campaigns we have created to support more patients and those affected by chronic kidney disease across the UK.

In Memoriam

We were delighted to be chosen by 228 individuals and families, raising a record £104,000 via in memoriam donations in 2021. This represents an increase of £65,000 of income compared to 2020, fueled by a rise in collections (as opposed to one-off donations). This type of support is often a collective effort, especially where physical attendance at funeral services isn’t always possible.

Trade

Trade income generated a record £62,000, which is £19,000 more than 2020. It was particularly pleasing that 1,200 people made a purchase via our online shop, generating £34,000. This included another record year for the Christmas Collection with £24,000 of sales (compared to £21,000 in 2020, £16,000 in 2019 and £14,000 in 2018). We also sold a record number of Kidney Kitchen calendars (1,228).

Trusts

We raised £53,000 of income from trusts or grant giving foundations in 2021. We submitted a record 200 applications, worth a collective £1,000,000 in 2021 with some £700,000 still pending a decision, which will now support 2022 income. Work identifying several larger scalable projects that will also support the desired growth in 2022 was also completed.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Corporate

A total of £41,000 was received via company support. This is just the start of these corporate relationships, with bigger and better relationships being developed for 2022 and beyond.

Challenge Events

254 supporters took on a challenge event in 2021, raising a record £169,000. This is £77,000 more than 2020 and £18,000 more than 2019. We were also delighted to welcome back mass participation events and supported our biggest ever teams at the London Marathon (raising a record £65,000) and Great North Run (raising £13,500). We had our first team run the London Landmarks Half Marathon and grew the number of events we promote to 35 (and counting). Those ‘doing their own thing’ also increased with a record £24,000 being raised this way.

Community Fundraising

2021 saw income via community fundraising increase by £22,000 to £83,000. In a year deeply affected by Covid-19 and the challenges this brings to social engagement, it was pleasing to see this income back to its pre-pandemic levels (£85,000 in 2019).

The year saw continued robust income via In Celebrations with more than 150 supporters raising £30,000. A further 38 supporters raised more than £10,000 via other collections and we supported 60 groups, clubs or individuals ‘doing their own thing’, raising nearly £30,000. The remaining income came via Kidney Care UK-led activities such as our World Kidney Day activity, the Big Street Car Wash, and the Big Christmas Collection.

It was great to see our reach and engagement increase across all parts of the UK. Highlights included the £11,000 raised at the Charity Classic Moto-X in Northern Ireland in August, and £6,500 raised via a Gala Dinner in York in early December.

“After losing my sister to kidney disease in March 2021 at age 33, our family felt compelled to begin fundraising in her memory to help support others living through this battle in any way we could.

“My sister had two charities she followed closely and one of them was Kidney Care UK, so it made sense this was one of the charities we would like to fundraise for. Since engaging with the fundraising team we felt really supported in our efforts regardless of the scale of what we were trying to achieve.

The sensitivity in which Laura Toop (Community Fundraising Manager) asked about our story, why we were fundraising and finding out how she could help us achieve our goals has been really appreciated. We felt championed by our efforts and not pressured, and it has been a great experience and we hope to continue to raise further funds for Kidney Care UK in the future.”

Stacie Jackson-Ross, Kidney Care UK Supporter

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

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 principle.

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 2021, we increased the range of fundraising products and activities 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 shared these with our supporters through the channels they request. With their permission, we keep them informed about how their support is making a difference.

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 2021 we did not have to respond to any complaints made by our supporters or the general public. We 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.

Looking ahead to 2022 – Our aims and goals

We enter 2022 a stronger, larger and better run Charity, with a clear plan for the year and a focus on expanding our reach and engagement, with new service development, a stronger brand and profile, and greater fundraised income.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Our priority strategic aims for 2022 are:

Our Finances

Financial review of the year

Despite the pandemic continuing into 2021, our total income for the year increased by 50% to £2,014,261 (2020: £1,335,584). This was due to legacy income increasing by £439,949 to £688,731 (2020: £248,782) and investment income by £62,132 to £679,056 (2020: £616,924). Non-legacy fundraised income increased by 34% to a record £584,256 (2020: £437,008),

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

reflecting our strategic objective to support more patients and broaden our income streams. We also increased our trading income from £42,870 in 2020 to £62,218, a 45% increase.

Overall, our charitable activity expenditure increased by 18% in 2021, to £3,296,179 compared to £2,796,720 in 2020. We saw an increase in the need for information for kidney patients and their families, which is understandable during a pandemic when many were isolating and this was reflected in our increase in expenditure on patient information. This year, we spent £390,166 on patient information compared to £191,615 in 2020, a 104% increase. Another area that has seen growth this year is our grants funding of renal posts, projects and equipment, our new commitments in the year increased from £257,527 in 2020 to £576,708 in 2021. This is in line with our strategy to “improve the way kidney patients are cared for across the UK with access to the highest quality holistic care”.

Our fundraising costs have also increased this year as we strengthened the fundraising team in order to sustain and advance our fundraised income in the future. Again, this is in line with our strategic aim “inspire more people to support our work and grow our fundraised income so we can do more”. We have seen positive results from this investment as our fundraised income has increased to record levels.

As of 31 December 2021, unrestricted funds totalled £32,802,743 (2020: £31,978,460). Restricted funds totalled £34,882 (2020: £43,506) and endowment funds £91,848 (2020: £79,216). Of the unrestricted amount, £30,000,000 is set aside as a designated fund to deliver our grant giving programmes in perpetuity; the balance is free reserves which were £2,802,743 (2020: £1,978,460).

The reserves are currently sufficient to meet the reserves policy.

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 and Investment Committee on a regular basis. The Finance and Investment Committee and the Trustees continue to be supported by the advice of Enhance Group (UK) Limited, based in Jersey.

Stock market conditions improved during the year, particularly in equity markets resulting in a realised and unrealised surplus of circa 9% of funds under management amounting to £2,869,412 surplus (2020 surplus £206,023). However, we expect markets to remain volatile in the immediate future.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

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 of 31st December 2021, the charity’s investments were 22% in UK equities, 50% in overseas equities, 11% in fixed interest, 8% in property, 6% in alternatives and 3% in cash.

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

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 significant growth in the need for support of renal patients. This is driven by changing demographics and the increasing incidence of renal failure as a proportion of the population in the UK, along with government spending challenges for the NHS.

For the foreseeable future, within the parameters of its current policies, the charity expects to be able to meet the needs for financial support of patients and their families. The charity expects to be able to sustain its support for, 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 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 to deliver programmed and ongoing expenditure profiles. It therefore remains the case that Kidney Care UK does not have reserves to 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.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

Going Concern

The war in Ukraine broke out in February 2022 and the effect on the global markets of this and other uncertainties such as further Covid-19 restriction in China has seen a reduction post year end in the value of our investments. 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 charity 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.

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. 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.

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.

Our Structure, Governance and Management

Structure

Kidney Care UK is a charitable company limited by guarantee, incorporated on 29[th] September 1975. The company was established under a Memorandum of Association which establishes it objects and powers and is governed under its Articles of Association. The company is registered as a company in England and Wales, registration number 1228114. Kidney Care UK is registered as a charity with the Charity Commission for England and Wales, charity number 270288 and in Scotland with the Office of the Scottish Regulator, registration number SC048198. In the event of the company being wound up members are required to contribute £10.

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

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

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 three new Trustees in 2021 saw the Board membership grow to 14 trustees as of 31[st] December 2021. The Board have 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 trustees who served during the year are detailed on page 42.

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 Charity Commission Governance Code, published in December 2020, were reviewed by the Governance, Strategy & Risk Committee in 2021 and actions as a result were reflected in the annual plan to ensure continued compliance both in letter and spirit.

Decision making

The Board of Trustees meets four times per 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. The Board decided during the year to amend the committee structure with affect from 1 January 2022. While retaining four committees the Governance, Strategy & Risk Committee will be replaced by the Audit and Risk Committee and the Finance, Investment & Audit Committee will be replaced by the Finance and Investment Committee.

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

portfolio. It makes recommendations to the Board on plans and budgets and monitors performance against these, reviews the Annual Report and Accounts. It recommends investment policy and oversees its effective implementation, ensuring compliance with regulatory requirements and Kidney Care UK’s governing document. The committee meets four times per year.

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, Fundraising Marketing and Communications, Finance, and Patient Support.

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

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.

Our 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 per 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

38

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

meet legal and regulatory requirements. The Charity maintains a suite of core organisational 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 Audit and Risk Committee (A&R) which plays a key role 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 Committee undertakes twice yearly risk reviews and the Senior Management Team monthly 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

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 2021 we conducted penetration testing to ensure that our security systems and protocols were sufficient. This highlighted the need for greater protection to phishing attach as a result of this we have introduced email protection against all types of email attacks.

Service Quality in Patient Care

Kidney Care UK’s key risk is that patients suffer harm or ineffective care. The Charity has a robust safeguarding policy, including a Designated Safeguarding Officer and Deputy Safeguarding Officer, the Advocacy Team meets quarterly and receives regular high-quality training on areas such as safeguarding and Equality and Diversity, 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 who adhere to the BACP guidelines and regulatory framework. In 2021 we carried out an internal review of our safeguarding policies and operating procedures updating these where necessary. An external audit of safeguarding is planned for 2022.

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 immediate discussions with the Finance and Investment Committee. Investment managers

39

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

produce regular reports (quarterly) to the Finance and Investment 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 Finance and Investment 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.

Fundraised Income

Kidney Care UK’s strategic growth is based on achieving challenging fundraising targets. The organisation has developed a fundraising strategy that looks to target a diverse range of funding opportunities. We have strengthened the knowledge and skills in the fundraising team to enable delivery of our strategy. Monitoring of actual to budget and latest forecast is achieved by a monthly review of reports by senior management and oversight by the Finance and Investment Committee. Kidney Care UK regularly reviews its fundraising procedures to ensure compliance with the Fundraising code of practice.

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:

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.

40

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

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:

This report was approved by the Trustees on 16[th] June 2022 and signed on their behalf by:

………………………………………………………………………

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

41

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

REFERENCE AND ADMINISTRATIVE DETAILS OF THE CHARITY, ITS TRUSTEES AND ADVISERS For the year ended 31 December 2021

Trustees

Prof. Donal O'Donoghue OBE BSc MBChB MRCP FRCP (Chair - deceased 3 January 2021) Sir Jonathan Michael MB BS FRCP, FKC (Chair - appointed 12 March 2021) Ms. Sarah Hillary (Chair of Audit and Risk Committee) Mrs. Marcelle de Sousa MBE FRCN MA RGN RSCN (resigned 31 July 2021) Miss Alison Burnapp RN MA Mrs. Ingrid Gubbay (resigned 1 June 2021) Mr. Andrew Chapman (resigned 2 March 2022) Ms. Patricia Gooden Ms. Angela Griffiths Ms. Ofrah Muflahi RN BSc MSc (resigned 16 March 2022) Mr. Amar Radia Mr. William Richard Caldwell Ms. Grainne Walsh Mr. Robert Lant (Chair of Finance and Investment Committee) Dr Graham Lipkin (appointed 1 August 2021) Dr Sally Hulton (appointed 1 August 2021) Mr Michael Zelouf (appointed 1 November 2021)

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, Operating Office Hampshire, GU34 1EF

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) Mr Laurie Cuthbert (appointed 1 November 2021) Mrs Vanessa Clarke (appointed 5 January 2022)

Company Secretary

Southern Secretarial Services Ltd, Wey Court West, Union Road, Farnham, Surrey, GU9 7PT

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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK (A company limited by guarantee)

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
Investment Advisers Enhance Group Limited, 3rdFloor, 29/31 Esplanade, St Helier,
Jersey JE2 3QA

43

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

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

Opinion

We have audited the financial statements of The British Kidney Patient Association t/a Kidney Care UK (the 'charitable company') for the year ended 31 December 2021 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:

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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THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF THE 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:

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.

45

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF THE 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:

46

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF THE 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:

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.

47

THE BRITISH KIDNEY PATIENT ASSOCIATION T/A KIDNEY CARE UK

(A company limited by guarantee)

INDEPENDENT AUDITORS' REPORT TO THE MEMBERS OF THE 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

Date 24 June 202223 June 2022

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

48

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

STATEMENT OF FINANCIAL ACTIVITIES (INCORPORATING INCOME AND EXPENDITURE ACCOUNT) FOR THE YEAR ENDED 31 DECEMBER 2021

Income and endowments
from:
Donations and legacies
4
Other trading activities
5
Investments
6
Total income and
endowments
Expenditure on:
Raising funds
7
Charitable activities
8
Net gains on investments
12
Net movement in funds
Reconciliation of funds:
Total funds brought forward
Net movement in funds
Note
Total expenditure
Net income/(expenditure)
before net gains
on investment
Total funds carried forward		 2021
£
-
-
1,892
Endowment
Funds		 2021
£
39,187
-
-
Restricted
Funds		 2021
£
1,233,800
62,218
677,164
Unrestricted
Funds		 Total
Funds
2021
£
1,272,987
62,218
679,056		 Total
Funds
2020
£
685,790
42,870
616,924
1,892 39,187 1,973,182 2,014,261 1,345,584
-
1,892		 -
47,811		 759,203
3,246,476		 759,203
3,296,179		 504,018
2,796,720
1,892 47,811 4,005,679 4,055,382 3,300,738
-
12,632		 (8,624)
-		 (2,032,497)
2,856,780		 (2,041,121)
2,869,412		 (1,955,154)
206,023
12,632 (8,624) 824,283 828,291 (1,749,131)
79,216
12,632		 43,506
(8,624)		 31,978,460
824,283		 32,101,182
828,291		 33,850,313
(1,749,131)
91,848 34,882 32,802,743 32,929,473 32,101,182

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

The notes on pages 53 to 73 form part of these financial statements

49

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee) REGISTERED NUMBER: 1228114

BALANCE SHEET AS AT 31 DECEMBER 2021

Note
FIXED ASSETS
Tangible assets
17
Investments
18
19
CURRENT ASSETS
Debtors
CREDITORS:amounts falling due within one
year
20
Cash at bank and in hand
CREDITORS:amounts falling due after more
than one year
TOTAL ASSETS LESS CURRENT LIABILITIES
TOTAL NET ASSETS
21
NET CURRENT LIABILITIES		 £
£
£
£
394,486
394,475
32,875,893
32,348,655
33,270,379
32,743,130
1,014,912
501,962
32,929,473
32,101,182
2020
2021
503,110
511,802
(828,645)
(147,502)
(315,265)
(326,683)
(1,208,316)
33,076,975
(193,404)
358,913
32,416,447
143,049		 £
£
£
£
394,486
394,475
32,875,893
32,348,655
33,270,379
32,743,130
1,014,912
501,962
32,929,473
32,101,182
2020
2021
503,110
511,802
(828,645)
(147,502)
(315,265)
(326,683)
(1,208,316)
33,076,975
(193,404)
358,913
32,416,447
143,049
(315,265)
32,416,447
32,101,182

50

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee) REGISTERED NUMBER: 1228114

BALANCE SHEET AS AT 31 DECEMBER 2021

Note
22
22
22
Restricted funds
Endowment funds
Unrestricted funds
CHARITY FUNDS		 £
91,848
34,882
32,802,743
32,929,473
2021		 £
79,216
43,506
31,978,460
2020
32,101,182

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:

…....................................

Mr. Robert Lant

Chair of Finance and Investment Committee Date: 16 June 2022

The notes on pages 53 to 73 form part of these financial statements

51

THE BRITISH KIDNEY PATIENT ASSOCIATION

(A company limited by guarantee)

STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEMBER 2021

Note
Cash flows from operating activities
Net cash used in operating activities
24
Cash flows from investing activities:
Proceeds from sale of investments
Purchase of 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
25
Dividends and interest from investments
Purchase of tangible fixed assets		 2021
£
(2,856,632)
679,056
(22,785)
6,267,047
(4,056,782)
2,866,536
9,904
1,533,347
1,543,251		 Restated
2020
£
(2,419,198)
616,924
(31,060)
10,590,751
(8,720,544)
2,456,071
36,873
1,496,474
1,533,347

The notes on pages 53 to 73 form part of these financial statements.

52

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

1. General Information

The company is a charitable company limited by guarantee, incorporated in England and Wales. The trustees on page 42 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 £10 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.

The 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.

53

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

2. Accounting policies (continued)

2.3 Income (continued)

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.

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.

54

THE BRITISH KIDNEY PATIENT ASSOCIATION

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

2. Accounting policies (continued)

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 £1,000 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

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.

55

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

2. Accounting policies (continued)

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.

56

THE BRITISH KIDNEY PATIENT ASSOCIATION

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

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 judgement

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.

57

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

3. Critical accounting estimates and areas of judgement (continued)

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 judgement:

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.

4. Income from donations and legacies

Donations
Legacies
Grants		 Total
Funds
2021
£
573,912
688,731
10,344		 Total
Funds
2020
£
426,331
248,782
10,677
1,272,987 685,790

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

5. Income from other trading activities

Non-charitable trading - Merchandise sales Total
Funds
2021
£
62,218		 Total
Funds
2020
£
42,870

58

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

6. Investment income

Income from listed investments
Investment Income - Cash		 Total
Funds
2021
£
679,032
24		 Total
Funds
2020
£
616,766
158
679,056 616,924

7. Expenditure on raising funds

Cost of raising voluntary income
Investment management fees		 Total
Funds
2021
£
584,142
175,061		 Total
Funds
2020
£
341,065
162,953
759,203 504,018

59

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

8. Expenditure on charitable activities

Note
Direct Patient Support
9,10,11
Direct Patient Support
9,10,11
Analysis of direct costs
Staff costs
Counselling
Advocacy
Policy service
Patient Information
Analysis of grant funding activities
Grants, patient support
Grants, patient support		 Activities
undertaken
directly
£
1,259,916		 Grant
funding of
activities
£
1,358,012		 Support
Costs
£
678,251		 Total 2021
£
3,296,179
Activities
undertaken
directly
£
895,115		 Grant funding
of activities
£
1,055,423		 Support
Costs
£
846,182		 Total 2020
£
2,796,720
Note
8
Note
8
8		 Grants to
Institutions
2021
£
808,463		 2021
£
771,384
4,512
24,235
69,619
390,166		 2020
£
618,047
3,470
26,695
55,288
191,615
1,259,916 895,115
Grants to
Individuals
2021
£
549,549		 Total
2021
£
1,358,012
Grants to
Institutions
2020
£
487,952		 Grants to
Individuals
2020
£
567,471		 Total
2020
£
1,055,423

9. Analysis of direct costs

10.

60

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

10. Analysis of grant funding activities (continued)

Note
Grants by type
Post funding, projects and equipment
Small grants
Dialysis Freedom
Mount Cook
Grants to patients
Research/Development
8
Grants by Institution
Small grants
Transplant games
kQuiP project
Childrens hospitals
Other grants
Kidney Patient Involvement Network KPIN
Royal Preston Hospital
York Teaching Hospital
Wrexham Maelor Hospital
European Dialysis Transplant Nurses Association
Renal Psychological Services Group
Southmead Hospital & University of Bristol
Sunderland Royal Hospital
Hull Royal Infirmary
Newcastle Freeman Hospital
Queen's University Hospital Belfast
Queen Alexandra Hospital - Wessex Kidney Centre
British Renal Society
Walsall Manor Hospital
King's College Hospital
Mount Cook
Dialysis Freedom		 2021
£
576,708
36,997
35,627
1,487
549,549
157,644		 2020
£
257,527
47,465
35,315
4,407
567,471
143,238
1,358,012 1,055,423
2021
£
36,997
-
-
2,000
157,825
-
-
-
-
-
8,000
101,767
48,885
42,673
103,740
65,796
28,968
113,970
11,000
49,728
1,487
35,627		 Restated
2020
£
43,044
7,500
106,788
63,644
104,291
48,200
10,010
45,835
12,918
6,000
-
-
-
-
-
-
-
-
-
-
4,407
35,315
808,463 487,952

61

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

11. Analysis of support costs

Note
Governance
Finance
Information Technology
Human Resourses
Premisies and facilities
Communications
8
12.
Net gains on investments
Realised (losses)/gains on investments
Unrealised gains on investments
18		 2021
£
122,446
80,916
141,983
85,997
104,275
142,634		 2020
£
147,546
81,812
147,527
66,224
107,878
295,195
678,251 846,182
2021
£
(11,076)
2,880,488		 2020
£
51,572
154,451
2,869,412 206,023

13. Taxation

The Association is a charity and is entitled to exemption from taxation on its charitable income and profits by virtue of Section 505 of the Income and Corporation Taxes Act 1988.

14. Auditors' remuneration

Auditors' remuneration 2021
£
16,470		 2020
£
14,430

62

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

15. Staff costs

Staff costs were as follows:

Wages and salaries
Social security costs
Pension costs		 2021
£
1,319,226
123,559
80,213		 2020
£
1,242,340
97,477
67,084
1,522,998 1,406,901

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

Grants and patient aid (including support costs)
Fundraising
Advocacy Service
Counselling service
Policy service
Management and administration		 2021
No.
6
8
16
3
2
10		 2020
No.
5
6
10
2
2
12
45 37

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

2021 2020
No.
 No.
60-70k 2
 -
70-80k -
 1
80-90k -
 -
90-100K 1
 1

The key management personnel of the charity comprise the trustees, the Chief Executive Officer, Policy Director, Director of Marketing and Communications, and Director of Patient Support Services. The total employee benefits of the key management personnel of the charity were £275,460 (2020: £226,073) and employer pension contributions £12,285 (2020: £13,958).

63

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

16. Trustees' remuneration and expenses

During the year, no trustee received any remuneration or other benefits (2020: £nil).

During the year ended 31 December 2021, expenses totalling £86 were reimbursed or paid directly to 1 Trustee (2020: £95 to 3 trustees).

There is a total of £1,591 (2020: £1,704) paid by the charity in relation to trustee indemnity insurance on behalf of trustees.

17. Tangible fixed assets

Cost or valuation
At 1 January 2021
Additions
At 31 December 2021
Depreciation
At 1 January 2021
Charge for the year
At 31 December 2021
Net book value
At 31 December 2021
At 31 December 2020		 Land and
buildings
£
395,595
-		 Fixtures and
fittings
£
85,613
-		 Office
Equipment
£
86,327
22,785		 Total
£
567,535
22,785
395,595 85,613 109,112 590,320
60,842
4,695		 44,747
5,632		 67,471
12,447		 173,060
22,774
65,537 50,379 79,918 195,834
330,058 35,234 29,194 394,486
334,753 40,866 18,856 394,475

The Charity’s premises were acquired in 2011. The land value was £100,000.

64

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

18. Fixed asset investments

Fixed asset investments
Cost or valuation
At 1 January
Additions
Disposals
Net gain on revaluation
Market value at 31 December
Cash balances
Total market value at 31 December
Investments at market value comprise:
Listed investments
Cash held by investment managers		 UK
2021
£
15,073,712
1,031,449		 2021
£
31,174,221
4,056,782
(6,267,047)
2,880,488		 Restated
2020
£
32,889,977
8,720,544
(10,590,751)
154,451
31,844,444
1,031,449		 31,174,221
1,174,434
32,875,893 32,348,655
Overseas
2021
£
16,770,732
-		 Total
2021
£
31,844,444
1,031,449
16,105,161 16,770,732 32,875,893

The historical cost of the investments total £25,697,291 (2020: £27,002,233).

Fixed interest
Equities
Property
Alternatives
Cash held by investment managers
Total		 2021
£
3,679,968
23,753,976
1,795,406
2,615,094
1,031,449		 2020
£
4,178,409
23,032,058
2,587,991
1,375,763
1,174,434
32,875,893 32,348,655

65

THE BRITISH KIDNEY PATIENT ASSOCIATION

(A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

19.
Debtors
Due within one year
Other debtors
Prepayments and accrued income
20.
Creditors: Amounts falling due within one year
Trade Creditors
Accruals and deferred income
Grants payable
21.
Creditors: Amounts falling due after more than one year
Grants payable		 2021
£
402,612
100,498		 2020
£
129,614
13,435
503,110 143,049
2021
£
381,738
71,888
754,690		 2020
£
166,087
72,678
589,880
1,208,316 828,645
2021
£
147,502		 2020
£
315,265

66

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

22. Summary of funds

Statement of funds - current year

Unrestricted Funds
Designated Funds
General Fund
Total Unrestricted Fund
Endowment Funds
Endowment Fund
Restricted Funds
Kidney Machine
The Advocacy officer Fund
Kidney Kitchen
Other
Total Restricted Funds
Total of Funds		 Balance at
1 January
2021
£
30,000,000
1,978,460		 Income
£
-
1,973,182		 Expenditure
£
-
(4,005,679)		 Gains/
(Losses)
£
-
2,856,780		 Balance at
31 December
2021
£
30,000,000
2,802,743
31,978,460 1,973,182 (4,005,679) 2,856,780 32,802,743
79,216 1,892 (1,892) 12,632 91,848
42,882
-
624
-		 -
34,567
3,500
1,120		 (8,000)
(34,567)
(4,124)
(1,120)		 -
-
-
-		 34,882
-
-
-
43,506 39,187 (47,811) - 34,882
32,101,182 2,014,261 (4,055,382) 2,869,412 32,929,473

67

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

22. Summary of funds - continued

Statement of funds - prior year

Unrestricted Funds
Designated Funds
General Fund
Total Unrestricted Fund
Endowment Funds
Endowment Fund
Restricted Funds
Kidney Machine
The Advocacy officer Fund
Kidney Kitchen
Other
Total Restricted Funds
Total of Funds		 Balance at
1 January
2020
£
30,000,000
3,727,791		 Income
£
-
1,268,318		 Expenditure
£
-
(3,224,096)		 Gains/
(Losses)
£
-
206,447		 Balance at 31
December
2020
£
30,000,000
1,978,460
33,727,791 1,268,318 (3,224,096) 206,447 31,978,460
79,640 2,153 (2,153) (424) 79,216
42,882
-
-
-		 -
42,143
32,055
915		 -
(42,143)
(31,431)
(915)		 -
-
-
-		 42,882
-
624
-
42,882 75,113 (74,489) - 43,506
33,850,313 1,345,584 (3,300,738) 206,023 32,101,182

68

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

22. Summary 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 Operating Funds 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 Endowment Fund is an endowment received from Chris Perrot Critical Illness Trust. The income from the Endowment Fund is also used to provide holidays for children with kidney problems.

The Kidney Machine Fund is from a specific legacy bequeathed for the provision of dialysis machines.

The Advocacy Officer Fund relates to specific donations received by the charity to fund the Charity's Patient Support and Advocacy Service.

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

69

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

23. 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
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		 Restricted
Funds
2021
£
-
91,848
34,882
-
-		 Unrestricted
Funds
2021
£
394,486
32,784,045
980,030
(1,208,316)
(147,502)		 Total Funds
2021
£
394,486
32,875,893
1,014,912
(1,208,316)
(147,502)
126,730 32,802,743 32,929,473
Restricted
Funds
2020
£
-
79,216
43,506
-
-		 Unrestricted
Funds
2020
£
394,475
32,269,439
458,456
(828,645)
(315,265)		 Total Funds
2020
£
394,475
32,348,655
501,962
(828,645)
(315,265)
122,722 31,978,460 32,101,182

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

Adjustments for:
Depreciation charges
Unrealised gains on investments
Dividends, interest and rents from investments
(Increase)/decrease in debtors
Increase/(decrease) in creditors
Net cash provided by/(used in) operating activities
Net income/(expenditure) for the reporting period (as per the Statement of
Financial Activities)		 2021
£
828,291
22,774
(2,880,488)
(679,056)
(360,061)
211,908		 2020
£
(1,749,131)
20,604
(154,451)
(616,924)
227,773
(147,069)
(2,856,632) (2,419,198)

70

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

25. Analysis of cash and cash equivalents

Cash in hand
Cash held as part of investments
Total cash and cash equivalents
Analysis of change in debt
Cash at bank and in hand
Cash held as part of investments		 Note
26
At
1 January
2021
358,913
1,174,434		 2021
£
511,802
1,031,449		 2020
£
358,913
1,174,434
1,543,251 1,533,347
Cash flows
152,889
(142,985)		 At 31
December
2021
511,802
1,031,449
1,533,347 9,904 1,543,251

26. Analysis of change in debt

27. Contingent liability

The charity has contingent liabilities in reference to grants 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 amount to £167,410 (2020: £405,960).

28. Pension commitments

The charity operates a defined contribution pension scheme. The assets of the scheme are held separately from those of the charity in an independently administered fund. The pension cost charge represents contributions payable by the charity to the fund and amounted to £80,213 (2020: £67,084) and the amount owing at the year end was £12,855 (2020: £nil).

71

THE BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

29. Operating lease commitments

‑ At 31 December 2021 the company had annual commitments under non cancellable operating leases as follows:

Within one year
Between 2 and 5 years
Over 5 years
Land and Buildings
Within one year
Between 2 and 5 years
Over 5 years
Other		 2021
£
2,285
5,891
330		 2020
£
2,288
7,516
990
8,506 10,794
23,067
83,248
-		 23,067
92,268
14,047
106,315 129,382

30. Related party transactions

In the year, donations received from trustees totalled £6,605 (2020: £5,480). There have been no other related party transactions in the reporting period that require disclosure.

31. Post balance sheet events

After the balance sheet date, the investment portfolios held with Cazenove and Smith & Williamson reduced in value following world events such as the war in Ukraine. At the end of May the investment portfolios had fallen by 10% representing £3,285,383. As stated in the Trustees report the Charity continues to take a long term view of its investments and seeks to avoid short term measures that would limit its longer term impact solely because of the market movements. As a result the Charity is taking the necessary steps to ensure that its finances are effectively managed.

72

BRITISH KIDNEY PATIENT ASSOCIATION (A company limited by guarantee)

NOTES TO THE FINANCIAL STATEMENTS for the year ended 31 December 2021

32. Prior year statement of financial activities

Note
Income and endowments
from:
Donations and legacies
4
Other trading activities
5
Investments
6
Total income and
endowment
Expenditure on:
Raising funds
7
Charitable activities
8,10
Total expenditure
Net gains on investments
12
Net movement in funds
Reconciliation of funds:
Total funds brought forward
Net movement in funds
22
Net income/(expenditure)
before net (losses)/gains on
investment
Total funds carried forward		 Endowment
Funds
2020
£
-
-
2,153		 Restricted
Funds
2020
£
75,113
-
-		 Unrestricted
Funds
2020
£
610,677
42,870
614,771		 Total
2020
£
685,790
42,870
616,924
2,153 75,113 1,268,318 1,345,584
-
2,153		 -
74,489		 504,018
2,720,078		 504,018
2,796,720
2,153 74,489 3,224,096 3,300,738
-
(424)		 624
-		 (1,955,778)
206,447		 (1,955,154)
206,023
(424) 624 (1,749,331) (1,749,131)
79,640
(424)		 42,882
624		 33,727,791
(1,749,331)		 33,850,313
(1,749,131)
79,216 43,506 31,978,460 32,101,182

73