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2024-03-31-accounts

The National Brain Appeal Funding advances in neurology and neurosurgery 3b84 1. s Ics- . &1, CONSU SERVI Report& Accounts Tr4 2023-24

Financial Statements for the year ended 31 March 2024

Trustees’ Report

Trustees’ Report’ Report Report
Trustees’ Report’ Report Report 3
Trustees’ Report’ Report Report
Who we are and what we do 5
Welcome letter 6
Our year at a glance 8
How we raised our money 11
Our strategic performance 12
#1 Inspiring funding programmes 13
#2 Sector-leading insight and impact measurement 26
#3 Ambitious fundraising 32
#4 Awareness raising 37
What’s planned for next year, by strategic area 40
Donors 42
Legal and administrative details 43
About this report 44
Trustees 46
Independent Auditor’s Report 48

Financial Statements

Financial Statements
Financial Statements 53
Statement of Financial Activities 54
Balance Sheet 56
Statement of Cash Flows 58
Notes to the Financial Statements 59

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The National Brain Appeal Report & Accounts 2023-24

Trustees’ Report

The National Brain Appeal Report & Accounts 2023-24

Professor John Duncan at the construction site of the New Centre for Neuroscience at 256 Grays Inn Road Photograph © Jane Ferguson

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Senior nurse Glenda Baillie is director of nursing for UCLH’s specialist hospitals clinical board and became a National Brain Appeal trustee in spring 2024 Photograph © Jane Ferguson

The National Brain Appeal Report & Accounts 2023-24

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Who we are and what we do

The National Brain Appeal exists to transform the lives of millions of people affected by neurological conditions.

We do this by funding state-of-the-art facilities, pioneering research, providing access to the best technology for expert diagnosis and treatment, and training tomorrow’s leading clinicians.

Our mission is to drive world-class neurological innovation, treatment and advancement through bold and ambitious fundraising and investment; and so, we raise funds for The National Hospital for Neurology and Neurosurgery and the UCL Queen Square Institute of Neurology (together known as Queen Square), because it is an international centre of neurological excellence with a huge impact.

The innovative projects that we support are selected because they will have the greatest possible benefit for people affected by a wide range of neurological conditions. They include the funding of facilities and research that will have a transformative effect on the treatment of these conditions and the future of people living with them.

Since The National Brain Appeal was created 40 years ago, it has provided more than £51m of funding for capital infrastructure, service redevelopment, ‘bench to bedside’ research initiatives and projects led by frontline hospital staff.

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Welcome letter

It’s been an extraordinary year for The National Brain Appeal.

We have funded over 30 vital projects supporting research, improving treatments and providing cutting-edge equipment and facilities, to improve the care and outcomes for patients with often devastating neurological conditions.

Alongside this, we have also raised more funds for our work than ever before, through new partnerships, more and bigger events and innovative fundraising initiatives.

Simply put, our goal is to increase the impact of The National Hospital for Neurology and Neurosurgery and UCL Institute of Neurology.

We do this by funding carefully considered programmes that have the potential to harness the knowledge of our world-leading clinicians and scientists to make life-changing breakthroughs for people with neurological conditions, who are the heart of our focus and decision making.

There have been some significant changes at the charity this year as we have said farewell to some old friends. Some of our long-serving Trustees have retired having made significant contributions to our work, and

Theresa Dauncey, our former CEO, has moved on to pastures new after 18 wonderful years at the helm. We express our grateful thanks to them all for their unwavering commitment.

This means that we’ve also welcomed some new faces to the charity. Throughout the year four new Trustees from a variety of walks of life have joined us, who, together with our new Chief Executive, Claire Wood Hill, will help drive the continued delivery of our strategy and benefit more patients than ever before.

In this, the second year of our current strategy, we have made great strides towards achieving our goals.

A significant landmark has been the success of our campaign to fund the creation of the Rare Dementia Support Centre, for which we are within £1m of our target. The centre will provide a physical home for Rare Dementia Support, a service we have funded since 1994, and will be the culmination of many years’ hard work. It will offer a welcoming space for those with a rare dementia and their families to come together, meet with specialists, learn about their condition and share experiences.

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The National Brain Appeal Report & Accounts 2023-24

We look forward to seeing this project come to fruition in the year ahead, thanks to the support of some major funders as well as a wider range of fundraising from our supporters. You can read more about this in the report that follows, along with a variety of other projects that we have supported; some are similarly large in scale while others are smaller, but have the potential to act as catalysts for revolutionary new approaches with a far greater impact.

The projects covered in the following pages also include many newly funded programmes, and details of impact that has been achieved in the past year by some of our earlier funded initiatives. These include the funding of work by three PhD researchers on Frontotemporal Dementia (FTD) – the Frontotemporal Dementia Doctoral Training Programme in memory of David Blechner. Their work included the development of an app to help track the progression of the disease, and research into depression, anxiety and psychosocial risk to aid development of psychological intervention tools for people with FTD.

There are many exciting challenges ahead for the coming year. We are committed to raising funds to support A New Home for Neuroscience on Grays Inn Road, which will include a first-of-its-kind, patient research hub, best-in-class MRI imaging equipment and a state-of-the-art stem cell laboratory. You can read more about this once in a generation project on p14.

We will continue to develop our funding programmes and ensure that impact is recorded and knowledge shared for maximum benefit. We will maintain our focus on raising awareness of neurological conditions and communicating the importance of the work we fund; this, in turn, supports our ambition to raise increasing sums each year to enable us to make brain breakthroughs happen faster.

This financial year saw total income increase to £6.96m from £4.03m with increased income from across a range of fundraising initiatives, in particular major gifts from partnerships supporting our two capital projects.

None of this would be possible without the generosity of our supporters, and this year we have been delighted to raise more funds than ever before.

Jackie Ashley Chair of Trustees

The Trustees would like to thank everyone who has supported The National Brain Appeal over this year. We have continued to fund new initiatives, which not only directly move the field forward in terms of new treatments, support and research, but also provide incredible motivation to the researchers and clinicians working on them.

Claire Wood Hill Chief Executive

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The National Brain Appeal Report & Accounts 2023-24

Our year at a glance

increase 72% in income... £6.96m total income generated in 2023-24, up from £4.03m in 2022-23

11%

increase in the number of supporters and trusts who have helped fund our work

£6.53m

spent on projects that will transform the future of neurological care – this includes funds committed to the development of the world-first Rare Dementia Support Centre

spent on improving patient care for young people through dedicated support roles

£97k

£4.9m

spent on research, treatments and support...

for people with devastating neurodegenerative and neuromuscular conditions

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30 projects supported...

spanning a huge range of areas from the purchasing of advanced neuroradiology equipment to the funding of new roles in brain tumour research and young adult care

£700k

spent on improving diagnosis and treatment of stroke and aneurysm

21% increase in income raised by challenge events...

with our supporters raising an impressive £380k

64%

growth in income from special events, which also raised national awareness of brain conditions

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The National Brain Appeal Report & Accounts 2023-24

Also this year…

specialist 4 roles funded...

working across research and patient care at Queen Square to improve future outcomes for people with brain conditions

We improved the lives of people affected by 100+ different neurological conditions

£65k awarded to 19 small-scale projects...

led by frontline staff and that can be quickly implemented to improve patient care and experiences

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The National Brain Appeal Report & Accounts 2023-24

How we raised How we spent

our money our money

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£6.96m £6.53m
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£1.71m
Cost of Raising Funds
Direct costs: £0.89m
Support costs: £0.82m
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Income Charitable Activities Spend

General donations: £2.59m

Donations from charitable trusts: £2.48m Legacies: £0.80m Rental and other income: £0.42m Sporting and challenge events: £0.38m Special events and activities: £0.29m

Neurodegeneration (NDG): £4.91m Neurology (NRL): £0.70m

Governance and support costs (notes 7, 7a & 8): £0.61m Queen Square (QSQ): £0.16m Technology and Innovation (T&I): £0.11m Neurosurgery (NSG): £0.04m

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Our strategic performance

Our 2022-27 strategy sets out how we plan to grow our impact, through the delivery of inspiring and impactful grant funding into pioneering research, innovative treatments and world-class facilities.

It includes objectives for the coming years and how they will help us achieve our ambition to improve outcomes for many more people living with brain conditions. We measure our progress against these objectives.

Our 2023-2024 period was the second year of this strategy. The following pages include reporting on how we have made progress across the four headline areas of the strategy during that period, detailing many of the past year’s projects, initiatives and achievements.

Our strategy goals

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1 Inspiring funding programmes
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2 Insight and impact
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#3 Growing our income #4 Awareness raising

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Artist’s impression of UCL’s in central London.

Strategy goal #1 Inspiring funding programmes

In line with the aims of our strategy, we deliver charitable projects that are well-known, informed and understood by world-leading players in the neurological community.

Over the past year, we have focused on three specific areas of funding, in order to make funding as accessible as possible to a diverse range of projects from small to large and encompassing all types of neurological conditions.

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Patient research hub

A New Home for Neuroscience

The National Brain Appeal has committed to raising £7m towards the creation of UCL’s new, state-of-theart £281m neuroscience centre on Grays Inn Road.

Bringing together research scientists, clinicians and patients, the centre will provide additional space and facilities for three organisations – the UCL Queen Square Institute of Neurology (IoN), the Dementia Research Institute Hub and the National Hospital for Neurology and Neurosurgery (NHNN). One of the most ambitious capital projects UCL has ever embarked on, this will bridge the gaps between existing research, academia and healthcare.

The first-of-its-kind centre will bring together clinical work with patients and laboratorybased research, with an on-site outpatient facility seeing 190,000 patients a year, allowing clinicians and researchers to work closely with people with neurological disorders, alongside their families, doctors and researchers.

The facility will house up to 1,000 scientists and clinicians to enable advances to translate from bench to bedside and back again.

Our commitment of funding will go towards the following three key facilities and services:

1) Patient research hub 2) Stem-cell facility 3) MRI scanners suite

On average, it takes 15 years for a research finding to get put into clinical practice. Our aim is to see this reduced to 15 months. Having the same people in the same building will help us to short circuit the process − so therapies and diagnostic tests can be made available much, much more quickly.”

Professor John Duncan, consultant neurologist, UCLH clinical lead for the facility, and National Brain Appeal Trustee

Currently only around 3% of National Hospital patients take part in research. The goal is to increase that number tenfold so that 25,000 patients and their families are engaged with vital research programmes every year, by 2030.

A dedicated hub will promote patient-oriented research from their first clinic appointment onwards. This crucial facility will accelerate research, with the ultimate goal of discovering breakthroughs for a variety of neurological and neuromuscular conditions.

The Patient Research Hub will be revolutionary. When patients attend appointments, it will maximise the potential of each visit. This means more samples and faster progress towards breakthroughs. There will be banners and video screens promoting research and ambassadors will be on hand to help signpost people to relevant studies and hand out leaflets on recent projects, results and upcoming studies.

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The National Brain Appeal Report & Accounts 2023-24

Stem-cell facility

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Artist’s impression. All rights reserved by UCL.
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MRI scanners suite

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Artist’s impression. All rights reserved by UCL.
ae aa
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We will fund two Cima.X 3T research-enabled MRI scanners, part of a suite of scanners located in the basement.

The new labs will enable researchers to study diseases in a petri dish using stem cells taken from skin biopsies.

The cells can then be used to test treatments more rapidly and develop new therapies for patients.

This will create one the largest research-focused neuroradiology scanning facilities in the world. This means shorter appointment lengths, faster diagnosis and more in-depth research data collection. Plus capacity for scanning is increased, meaning that 10% more patients will be able to be seen.

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The National Brain Appeal Report & Accounts 2023-24

ie Nee aNd ae ~~Sv~~ Rare Dementia Support e

The National Brain Appeal has supported Rare Dementia Support (RDS) since 1994. RDS offers specialist social, emotional and practical support services for individuals living with, or affected by, a rare dementia diagnosis.

Rare, inherited or young onset dementias affect between 5% and 15% of people living with dementia – they bring a set of unique and complex challenges, which can include difficulties with vision, language, movement and behaviour.

As a natural extension to the growth of RDS, The National Brain Appeal has committed to raise up to £7m to create the world’s first centre of excellence for rare dementias near Queen Square, at the heart of the neurological research and healthcare community.

This UCL Institute of Neurology-led, collaborative Rare Dementia Support Centre (RDSC) will be a leader in how best to support those living with a rare dementia.

The new centre has three key aims:

The past financial year has seen great success in securing funding for RDSC; we are now within £1m our funding target and look forward to seeing the centre opening in the coming year (see strategy goal #3 ‘Ambitious fundraising’, p36 for more details).

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Two interconnected buildings in London’s
Woburn Square have been purchased for the centre
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During this time, a beautiful property in London’s Woburn Square was secured for the centre. This location, just minutes away from Queen Square, will help to maximise the impact of the centre, making it much easier for people grappling with a new rare dementia diagnosis to go directly to the RDSC to receive unparalleled support.

Renovation of the buildings will be spearheaded by specialist architects Hawkins\Brown, with dementia needs at the forefront. The uniquely designed layout of the two main floors will be a welcoming, informal environment with substantial kitchen at the heart of the centre, lounge areas for larger group discussions and smaller rooms for conversations between individuals. Activities in the centre will include support group sessions, arts and cultural activities, research into successful support models and education of professionals working with people living with dementia

Creating a bespoke space where we can provide specialist help and guidance for people living with rare dementias has been our dream and our vision for many years. On behalf of the many thousands of people affected by rare dementias and those who care for and about them I am extremely grateful to the many donors and fundraisers for their support and to The National Brain Appeal without which none of this would have been possible.”

Professor Nick Fox, consultant neurologist and director of the Dementia Research Centre at the UCL Institute of Neurology

Computer generated impressions of the new centre

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Innovation Fund ~~ee~~

Using Extended Reality (XR) to aid neurorehabilitation for stroke patients

The National Brain Appeal’s Innovation Fund provides vital seed-funding for cutting-edge projects led by world-leading researchers and clinicians at Queen Square.

We know it is essential to invest in the latest technology and innovation to achieve change for those people living with a neurological condition. There is a huge demand for the Innovation Fund: for every project funded we receive around 20 applications.

This financial year saw good progress in the following two Innovation Fund projects, as well as long-term impact made by two further projects detailed in strategy goal #2, p26.

In January 2024, part of the Innovation Fund grant was used to employ Dr Merlin Williams to focus on the diagnosis aspect of developing the XR software.

Over the past six months, Dr Williams has been using machine learning to determine the exact movements that individual patients need to make to maximise their rehabilitation progress.

He is working as part of a team of three, each of whom are focusing on a different aspect of the project. Sarah Imdad, an engineering PhD student, is overseeing ‘acquisition’ i.e. the way that the programme tracks the motion of the person using it, while Anna Strøe, a virtual reality/neuroscience PhD student, is working on the implementation of the virtual reality environment, the sort of games or activities that the patient will be doing.

“We have a game where a bunch of orbs are coming towards you and you have to hit the orbs with your hands,” says Dr Williams.

“The idea is to integrate the outputs of the body tracking into the virtual reality environment so that as the patient hits things with their hand, elbow or shoulder, they are generating the movements that we want to see”.

He and the team are very excited about the potential the programme offers to increase the dose of rehab that patients currently receive, “Broadening access to an optimal amount of rehab will make a huge difference in terms of the everyday lives of people with upper limb impairments who are struggling to go about daily life.”

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The effect of climate change on the brain

The funding and support we’ve received from The National Brain Appeal has been crucial in our efforts to address the impacts of climate change for people with neurological diseases. This generous Innovation Fund grant has enabled us to appoint a clinical research fellow who will drive these efforts forward – probably the first such research post in the world!”

The Innovation Fund awarded £55k to Professor Sanjay Sisodiya’s project to investigate and mitigate the harmful effects of global heating on people affected by neurological conditions.

In September 2023, Dr Sara Leddy joined him, becoming the world’s first climate neurology research fellow. She is preparing to run an experimental project exploring the direct impact of different temperatures on the symptoms of people with these conditions.

Professor Sisodiya published a Personal View article in Lancet Neurology. Following a review of 332 papers published across the world between 1968 and 2023, Professor Sisodiya and colleagues considered 19 different nervous system conditions, including stroke, migraine, Alzheimer’s, meningitis, epilepsy and multiple sclerosis. The team also analysed the impact of climate change on several serious but common psychiatric disorders, including anxiety, depression and schizophrenia.

“We need to raise awareness about climate change and the adverse effects it will have on health and healthcare provision, to take action now, and to undertake research so that we can understand how these changes will affect people with neurological diseases, and how best to mitigate those effects,” says Professor Sisodiya.

The team have emphasised the urgent need to understand the impact of climate change on people with neurological conditions in order to preserve their health and prevent worsening inequalities. They expect the scale of the potential effects of climate change on neurological diseases to be substantial.

The research was funded jointly by The National Brain Appeal’s Innovation Fund and the Epilepsy Society.

See p26 to read about the wider impact of two further Innovation Fund projects.

Professor Sanjay Sisodiya, honorary consultant neurologist

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Designing a reusable helmet for mobile brain scanning

Small Acorns Fund ~~oo~~

The Small Acorns Fund enables frontline staff at The National Hospital and The Institute of Neurology to apply for funding for small-scale projects that will have a positive impact on patients’ care and lives, and can be implemented quickly.

They are a fast, effective way to improve the experience and outcomes of people being treated at Queen Square.

In the 11 years since the fund was launched, we’ve funded 170 projects in this way, each costing less than £5,000. Championed by a wide range of clinicians across many different departments, projects have varied from purchasing practical equipment and producing information materials for patients, to setting up conditionspecific support groups and developing new technology for rehabilitation. 19 projects totalling £65k have been awarded during this year.

Three of our recent projects included:

Dr Nicholas Alexander, postdoctoral research fellow at the UCL Queen Square Institute of Neurology was awarded £2,041 to design a reusable helmet for mobile brain scanning.

A new brain imaging technique called optically pumped magnetometer-based magnetoencephalography (OPMMEG) has made it possible to scan brains without the need for a traditional scanner, by placing the OPM sensors into wearable helmets. But, the helmet is currently manufactured bespoke for each person at a cost of around £2,500.

Dr Alexander used the grant to create a flexible neoprene cap system, using computer-aided design and 3D printing to produce a series of working prototypes that were tested on several participants to record brain activity as they moved. The project successfully demonstrated that a costeffective and precise OPM-MEG cap system is achievable.

This could revolutionise scanning of people with neurological conditions, enabling scanning in weightbearing situations including walking, providing new insights into conditions such as Parkinson’s disease. Virtually anyone could be scanned with far more ease, even young children or those who find it challenging to stay still in traditional scanners, such as those with tremor.

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Using biofeedback technology to improve balance

Dr Diego Kaski, consultant neurologist at The National Hospital was awarded a grant of £5,000. He explored how the use of sensory prompts that encourage patients to make changes to their body and movement could treat poor balance in people with neurological conditions.

The grant was used to purchase equipment that records balance and provides accurate and instant information to the clinician and patient about the patient’s balance so that they can take action to modify it.

The team worked with 18 patients gathering personal and clinical histories, conducting neurological assessments, and making recordings of balance tasks. The data gathered enabled them to better understand how visual and tactile feedback can help patients when balance is challenged and to begin patient education and rehabilitation.

In addition to benefiting the participants, this project could have a much greater impact by informing the wider use of biofeedback to treat people with neurological gait disorders at the hospital and beyond.

“We feel incredibly lucky to have received support to run this clinical study.” says Dr Kaski. “The project represents an international collaboration with colleagues in Brazil and Switzerland and has produced important findings. We have identified patterns of sway across patients with loss of sensation arising from the inner ear (vestibular) compared to damage to nerves in the hands and feet (peripheral neuropathy). Our hope is that these findings will improve patient care by helping clinicians better assess balance disorders.”

By tailoring tests to identify specific types of sensory loss, we can provide more accurate diagnoses and develop more effective treatment plans for patients with balance issues.”

Diego Kaski MBBS PhD, consultant neurologist

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Detecting spinal small vessel disease

Dr Richard Ibitoye, UCL Honorary Research Associate, was awarded a grant of £4,900 to progress research into small vessel disease (SVD), the most common form of acquired brain disease.

SVD occurs with ageing and contributes to the balance decline and falls that affect two in five people over 65 years. These falls often have a huge impact on patients themselves, and a much wider socio-economic impact in terms of health and social care. Post-mortem MRIs suggest that the spinal cord may play a part in SVD symptoms, but few spinal MRIs are carried out on living patients.

The grant funded scans of the spinal cords of six older patients in a high-resolution MRI scanner. The team hopes to use data from these scans to support a larger research application for a study of spinal SVD pathology in living patients and its impact on balance.

This work could advance understanding of SVD, pave the way for new treatments and transform care for millions of people affected by this condition worldwide.

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Other projects

We have been delighted to have funded focused research programmes for three rare dementia conditions. This was made possible by three generous individual donors.

Understanding fFTD (familial frontotemporal dementia)

One of the three individual donors funded a three-year PhD studentship into familial frontotemporal dementia.

Sophie Goldsmith will undertake her three-year studentship, supervised by Professors Selina Wray and Jon Rohrer. Her research involves growing cultured brain cells called ‘mini brains’ from skin cells donated by patients with mutations in a gene called progranulin.

People who have these mutations have less progranulin protein, and this causes other proteins to build up in the brain. The reasons for this, and how it leads to fFTD, are not known. It is hoped that the ‘mini brains’ will illustrate what’s happening in the brains of people with the condition and provide insight into the underlying mechanisms of the disease.

Soon, this work will move to The New Home for Neuroscience, in its state-of-the-art stem cell labs.

edding light on ntotemporal dementia (FTD)

O funded five-year programme, the Frontotemporal Dementia Doctoral Training Programme in memory of David Blechner, supported three PhD studentships into FTD at the UCL Dementia Research Centre.

Each of the three students has their own specific areas of research. Jess Jiang measured hearing problems and how to improve communication function for people living with FTD, PPA and Alzheimer’s disease, while Rhian Convery developed digital biomarkers in FTD, including the development of an app designed for early detection of dementia. Both Jess and Rhian have stayed on at the Dementia Research Centre to study at a post-doctoral level.

The third student, Caroline Greaves, conducted research looking at depression, anxiety and psychosocial risk with a view to developing a tailored psychological intervention. She went on to join the Clinical Psychology training scheme at Liverpool University and hopes to become a neuropsychologist working with people with dementia.

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New ‘brainsight’ test developed

The third project we supported was from Dr Keir Yong, who is the Etherington PCA Senior Research Fellow for the Etherington PCA Programme.

This is a form of dementia that mainly affects the parts of the brain that process visual and spatial information.

His work featured in The Lancet Neurology and international news and involved sharing data on PCA symptoms and causes from over 1,000 participants worldwide. He explored how visual perception, spatial orientation and coordinated movements may be altered by neurodegenerative disease, and what this means for diagnosis and management.

Dr Yong was able to incorporate his research findings into continuing professional development resources for UK optometrist and occupational therapist professional bodies to promote assessment and understanding of dementia-related visual loss. He has also developed a cortical visual test to better detect and distinguish cortical visual (‘brainsight’) from eyesight loss. This has been implemented in the UK Biobank repeat imaging sub-study.

Using bioinformatics to improve outcomes for glioblastoma patients

including biology, computer science, programming and statistics, to understand and work with large, complex data sets. He also has a detailed understanding of glioblastoma genetics. He designs computational pipelines that will process and analyse patient samples and research experiments. This multidisciplinary approach is informing and shaping the group’s groundbreaking research to enable it to advance further and faster.

We awarded a grant to the UCL Glioblastoma Research Group, led by Dr Paul Mulholland, to fund the work of senior computational biologist, Dr Ben Kinnersley. This has brought a new dimension to the team’s work into developing as a treatment for glioblastoma, for which the current average survival time is just nine months from diagnosis.

“Our aim is to rapidly bring about improved outcomes for patients with glioblastoma,” says Dr Mulholland. “We are bringing together the best science, with a multidisciplinary team of clinicians, experimental scientists and bioinformaticians of which Dr Ben Kinnersley, with his unique skill set, plays an essential role.”

We are very grateful to The National Brain Appeal for funding Dr Kinnersley’s important post.”

Dr Kinnersley has experience in bioinformatics, which brings together multiple disciplines,

Dr Paul Mulholland, consultant medical oncologist and leader of the UCL Glioblastoma Research Group

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Chapel Organ Appeal

The National Brain Appeal teamed up with the Friends of University College Hospitals to revive a vital part of The National Hospital’s heritage that brings joy to staff, patients and their families – the chapel organ.

The project was conceived as a way of thanking staff at The National for their tireless work during the pandemic by enhancing a space that is a haven of calm for many. It is hoped that restoring the organ will revive the hospital’s music-making tradition, encouraging music therapy for patients, and relaxation for staff.

The instrument, built by Robert Spurden Rutt in 1938, was awarded a Historic Organ Certificate Grade II in 2014 but had been silent since 2019 due to electrical safety concerns.

The £114k organ restoration project was carried out alongside repairs to the chapel roof – paid for by Queen Square Estates – and the organ was reinstalled in March 2024.

To mark the successful restoration of The National Hospital’s chapel organ, staff were treated to a recital by one of the country’s leading organists, Richard Hills, and the Royal College of Organists paid a visit to hear it in action and record for their podcast (right).

‘UT. 4 tl i ei , } ~ = { } N 7 ~ . | Podcaster Mark O’Brien with Dr Christopher Batchelor, well-known organist and distinguished organ expert, : who oversaw the restoration project.

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Strategy goal #2

- Sector leading insight and impact measurement

As well as funding the very best research, facilities and treatments, we are committed to making sure the impact of this work can be measured and the insights from it shared widely in order to benefit as many people as possible.

We work towards this objective on a year by year basis, finding better ways to amplify the results of the groundbreaking work that we fund by collaborating with medical professionals, researchers, patients and supporters to build awareness and understanding of neurological conditions.

But, the most important measures of our impact are the outcomes of the work that we fund. In this section, we have pulled out some examples of projects that have resulted in tangible, lasting progress in our mission to improve the lives of people with brain conditions.

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26 The National Brain Appeal Report & Accounts 2023-24

The National Brain Appeal | Report and Accounts 2023-24

Faster, more accurate diagnosis of hereditary neurodegenerative diseases

In 2021, we awarded a grant to Dr Enrico Bugiardini, clinical research associate at UCL and locum consultant neurologist at The National Hospital to explore a promising new technology called Optical Genome Mapping (OGM).

He used the grant to assess the efficacy of OGM in diagnosing some of the most common hereditary neurological conditions including frontaltemporal dementia, muscular dystrophies including ALS and some neuropathies which cannot be diagnosed by the current technology, Next Generation Sequencing.

The Innovation Fund grant enabled Dr Bugiardini to rent the machine needed to validate the technology, which, in turn, enabled him to secure funding to purchase the machine and have it installed permanently in Queen Square in 2021.

Over the past year, the OGM machine has been used to get faster, more accurate diagnoses for more than 100 patients, with a range of hereditary neuro-conditions.

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Dr Enrico Bugiardini © Jane Ferguson
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It is thought to be the first such machine to be used across the NHS.

Dr Bugiardini and his team are currently working to expand the use of this technology by collaborating with colleagues from paediatric neurology for unsolved cases of muscular dystrophy.

Ultimately, they hope that OGM will be adopted more widely by the NHS so that more patients can access it and benefit from this latest advance in diagnosis.

Having the technology available has also enabled Dr Bugiardini to secure a further £80k to take part in an international research project.

Alongside this, our Small Acorns Fund has also awarded a grant of £5,000 to researcher Stephanie Efthymiou to assess the efficacy of OGM technology in diagnosing familial Alzheimer’s disease (FAD). The funding will cover the cost of the chemical reagents needed to test the DNA of 12 patients using OGM. These patients have already been diagnosed with FAD using NGS technology but if OGM proves effective in detecting the disease, it has the potential to reduce the diagnosis time from several weeks to just three days.

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First in-human trials planned for new keyhole brain surgery tool

We have been following the progress and success of one of our Innovation Fund’s earlier projects, which involved building an innovative robotic instrument that would make keyhole brain surgery safer and available to more patients.

Our Innovation Fund grant, awarded in 2019, allowed the team to provide proof-of-concept for their tool and has now enabled them to raise more than £2m in private investments and non-dilutive government grants. This means they can move to the next phase of this exciting project, which will involve in-human trials of the surgical tool at Queen Square. Project leaders Mr Hani Marcus and Emmanouil Dimitrakakis expect this to happen in early 2025.

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Mr Hani Marcus
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Even the most modest estimations suggest that this technology will improve how much of the tumour we can remove and how safely we can do the surgery.

We would roll out the technology as part of research at Queen Square so that, long before it is commercially available, patients in our hospital will start benefiting from that technology. As we do the most pituitary operations in the UK – about 200 each year – that will have a big impact on patients.

This has all been made possible by the initial seed funding from The National Brain Appeal’s Innovation Fund, which gave us a proof of concept.”

Mr Hani Marcus, consultant neurosurgeon and project co-lead

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Queen Square Intensive Comprehensiv Aphasia Programme (ICAP)

The two-year Queen Square ICAP programme completed during this reporting period saw all patients who took part make significant progress.

Ninety people with aphasia – speech and language difficulties following stroke, traumatic brain injury or brain tumours – benefited from a high dose of 100 hours of therapy, compared to the average 12 hours patients currently receive.

The programme involved four participants at a time receiving personalised speech and language therapy five days a week for four weeks. They then continued with independent goal-directed work at home to keep up their progress, which the team monitored at three months, six months and one year later.

They all made significant gains in speaking, listening, reading and writing – with speaking improving the most.

They also made large gains in their language function, as judged by their loved ones, at three months and beyond, meaning that they were able to incorporate their improved language into everyday communication. In addition, the participants’ own rating of their language skills showed an increase, and they reported significantly improved mood, with some being able to return to work.

ICAP co-founders, UCL professors Alex Leff and Jenny Crinion and the clinical psychology and speech and language therapy team analysed what had been learned and are producing a model ICAP template for the NHS in the hope that services will be commissioned. ICAPs have also been included in the new National Clinical Guidelines for Stroke, published in April 2023.

The results were published in a special issue of Aphasiology . The project also featured in The Times newspaper and in BBC Radio 4’s All in the Mind for which the co-founders were interviewed and one of the patient sessions recorded.

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Professors Jenny Crinion and Alex Leff
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© Marie Mangan
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We are so grateful to The National Brain Appeal for helping us implement new research approaches to transform the quality of treatment and chance of recovery for people with aphasia. Their funding has helped us to prove what a huge impact a high dose of speech and language therapy can have. Being once again able to do things many of us take for granted, such as being able to read a bedtime story to their kids, having a chat on the phone or ordering a coffee in a cafe has made a big impact on the lives of the people with aphasia that took part.”

Jenny Crinion, UCL professor of cognitive neuroscience and UCLH consultant speech and language therapist

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Awareness and marketing surveys

Faster, safer stroke and aneurysm treatment

October 2023 saw the installation of a biplane scanner – a device with two- and three-dimensional scanning capabilities that provides imaging of the brain, arteries and spine with one single injection of X-ray dye, meaning that imaging is both faster and safer.

Funded with a grant of £700k, the biplane scanner is now in full use, aiding faster diagnosis and treatment of neurological disorders including stroke and aneurysms.

The scanner enables earlier intervention for stroke patients, possibly preventing permanent damage and minimising the longterm effects typically associated with the condition. Since installation, it has already been used for approximately 920 stroke cases, aiding a wide range of procedures including 68 thrombectomies as well as angioplasty, carotid stent, caudal epidural, gamma knife angio, lumbar puncture and spinal embolisation tumour procedures.

Volunteer programme extends Rare Dementia Support

Our £350k a year commitment to Rare Dementia Support continues; this money helps deliver the service that more than 6,500 people a year have now come to depend upon.

In this financial year, we have helped to grow the support offering by match–funding support from a generous grant making trust for the RDS Champions Volunteering Scheme including the Cascaders programme. Cascader volunteers are RDS members who host talks for community groups, care/nursing homes, local health trusts and charity organisations in their local area about their lived experience or caring for someone living with a rarer dementia.

A pilot scheme was highly successful and has been welcomed by the thousands of people living with rarer dementias. This has now been rolled out across the UK; 62 events have been held with a total of 1,432 attendees.

The charity has continued to build awareness of its work within Queen Square via a number of different routes.

One of the most successful has been the introduction of a dedicated National Hospital/Institute of Neurology-wide monthly e-letter, which details the funding that has been recently awarded and events for staff to attend.

A Queen Square staff survey conducted to gauge awareness of the charity’s work produced impressive results – 95% of staff knew about The National Brain Appeal.

The charity also ran a marketing survey with almost 800 supporters to discover which messages resonate most with our audience and which would motivate them to give, specifically to our New Home for Neuroscience appeal. The results gave the Charity a good steer on strong campaign wording and imagery to use going forward.

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30 The National Brain Appeal Report & Accounts 2023-24

Improved care for hundreds of young patients

We funded a project designed to improve the transition of young people from paediatric healthcare providers into adult care at The National Hospital.

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Franchesca James (left) and Louisa Griffiths (right)
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Last year, under 25s attended more than 16,000 clinic appointments at The National, and 100 patients under the age of 18 were admitted as inpatients over the same period.

The year-long Children and Young Person Project was awarded £100k to cover the cost of employing a specialist nurse to evaluate existing provision, and a dedicated youth worker. Together, they worked with more than 400 young patients during the project, and provided training to more than 100 staff on how to improve treatment for this patient group.

“If we don’t receive these patients appropriately from the paediatric setting it has a long-term impact on how they engage with healthcare. It can affect everything if you’re not managing your condition well; including education and employment,” said Louisa Griffiths, Lead Nurse

on the project. “Teenagers are not the same as adults; they don’t make decisions in the same way, so we need to support them within an outpatient and inpatient setting.”

Both Louisa and Frenchesca have now secured funding for their work to continue beyond the end of the pilot we funded.

It’s amazing that The National Brain Appeal has been able to provide the funding for this because it’s so, so needed. We’re already making a big impact, which is really exciting.”

Frenchesca James, youth and young adult support coordinator

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Strategy goal #3 Ambitious Fundraising

This year, we raised significantly more money and did so in a greater variety of ways, which means we are in a better position to improve the lives of many more people with brain conditions going forwards. We did this by implementing a diverse and sustainable fundraising strategy that will set up the charity to deliver on its ambitious target of £15m per year by 2027.

Overall, our total voluntary income increased to an amazing £6.53m in this financial year, up from £3.66m in 2023. With the exception of legacies, there was increased income from all activities, but especially from

grant-making trusts and corporates supporting the two capital projects. The cost of raising these funds was £1.71m compared to £878k in 2023 due to the additional staff we employed to make the growth happen.

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The National Brain Appeal | Report and Accounts 2023-24

Corporate support grew

Our supporters have made this a fantastic year for The National Brain Appeal. We want to say a huge thank you to all of the grant makers, companies and individual donors who trust us to make the best possible use of their donations. The support we have been given for all of our work and particularly this year for the Rare Dementia Support Centre appeal has been amazing, and we look forward to showing our supporters the impact that their generosity is making.”

Charlie Keep, Director of Fundraising, The National Brain Appeal

We secured our first major ie ; Richard Walker Fl supermarket corporate partner, in the form of Iceland Foods. In connection with its own charity, -i y > + Iceland Foods Charitable Foundation (IFCF) our partnership raised an incredible £1.11m towards the Rare Dementia Support Centre. at < Kd \

Iceland Foods’ Executive Chairman Richard Walker spearheaded the campaign to raise funds by summiting Mount Everest on behalf of the IFCF in May 2023. Colleagues from Iceland Foods and the Food Warehouse across their 1,002 stores across the country then took part in a range of fundraising activities in store to support people living with rare dementias. Fundraising activities included hiking their own version of Everest up mountains in the UK, running, cycling, bake sales, dressing up and singing all in aid of The National Brain Appeal.

We also had a fantastic array of other corporate support from organisations including Asian Media Group, which generated donations from its Pharmacy Business Awards for us; Bestway, which chose us as the benefitting charity of its Ascot Race Day Gala Lunch; specialist Intellectual Property firm Mewburn Ellis, which selected us as its nominated charity for the year; clothing company Nila Rubia, which supported our RHS Chelsea Flower Show garden and A Letter in Mind; and private equity firm NorthEdge, which supported our Rare Dementia Support Fund and the Rare Dementia Support Centre appeal with sporting fundraisers.

This partnership was a big win for the charity in terms of strategic goals for our corporate stream.

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More supporters took on challenge events

We are very grateful for the dedication of our fabulous supporters who, this year, raised more than £380k through taking on challenge events, a 21% increase from the previous year.

As well as greater numbers of people raising money for us, we saw a wider selection of challenges being undertaken. Notable examples include Avril and Michael Stanton’s ambitious 780km trek along the Camino Francés pilgrimage route (see p35) and Grant Berry’s golf day fundraiser, which alongside the marathon he ran for us, raised a remarkable £100k.

Our biggest event of the year, the TCS London Marathon, was once again a record breaker with 42 supporters running for The National Brain Appeal and bringing in more than £130k.

Among this year’s participants in the London Royal Parks Half Marathon were journalist and broadcaster Rosie Millard OBE and Anthony Hamilton, a wheelchair participant, who has taken part in multiple events to support us since undergoing life-saving surgery at Queen Square in 2020.

In 2020, Anthony Hamilton, then 60, had three surgeries at Queen Square after a brain haemorrhage left him unconscious in the bath, where he was discovered after four days. Today, he is a champion fundraiser for The National Brain Appeal.

“I remember waking up from the induced coma and the last thing I remembered was being in the bath and thinking that was ‘curtains’ for me. I was thrilled to be alive, entirely thanks to the team at The National Hospital.”

Anthony has made a remarkable recovery; initially unable to eat or speak, he relearned to do both over time.

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Anthony Hamilton
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I received the best possible care anywhere in the world at Queen Square. There’s no doubt that The National Hospital saved my life against the odds. I’m always going to be very grateful.”

Anthony Hamilton, former patient at The National Hospital

In October 2023, Anthony took part in the London Royal Parks Half Marathon as an assisted wheelchair participant, along with runners Elisa Grosso and Francesca Bowen, raising more than £12,000 for The National Brain Appeal.

“I’m very happy to be helping raise funds for The National Brain Appeal. We have made huge steps forward in understanding neurology in the past 20 years, and without organisations like The National Brain Appeal that would not be possible.”

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34 The National Brain Appeal Report & Accounts 2023-24

Ancient pilgrimage, 21st century cause

Avril and husband Michael Staunton (left) completed the ancient 780km Camino Francés pilgrimage in June 2023, having set out from their home in Bridgwater, Somerset, 6 weeks earlier. Avril was diagnosed with posterior cortical atrophy (PCA), a rare form of dementia that initially affects vision and spatial awareness, in 2015 when she was 60. They raised £7,000 for the Rare Dementia Support Centre.

Avril and Michael are both Rare Dementia Support members. Michael said: “We are grateful to Professor Nick Fox for recognising Avril’s symptoms and diagnosing PCA. It is a devastating condition, but at least once we knew what it was, and with the help of the wonderful team at Rare Dementia Support, we could start to work out how to adjust and get on with our lives.”

Reflecting on the Camino, Avril said: “It was a hard work, but it was it was enjoyable – I enjoyed everything that I that I encountered.”

Michael added: “We were able to see two magnificent Gothic cathedrals crammed full of the most beautiful art. So, there were lots of high points and wonderful memories being evoked.”

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Rare Dementia Support Centre appeal close to target

We have also continued to maintain a strong focus on grant-making trusts and philanthropy, the impact of which has been tremendous.

A very generous lead gift of £2.7m in grant funding was awarded from The Hilary and Galen Weston Foundation for the RDSC project via UCL. This sum entirely funded the purchase, in March 2024, of two interconnected buildings in London’s Woburn Square where the centre will be based, and will also contribute to the refurbishment work.

We were delighted to further secure £2.25m of direct grant funding from the Garfield Weston Foundation for the project. This second major grant award, together with the support from the partnership with the Iceland Food Charitable Foundation, creates considerable momentum which we continue to harness to ensure further growth.

High-profile events and opportunities

Our income from special events and activities grew by almost 64% in the past financial year, up to almost £291k.

Further support for The Rare Dementia

Support Centre was garnered at an event at House of Lords, held by invitation of Lord Boateng. This was a hugely successful event, enabling us to thank our existing supporters as well as get to know new potential supporters of the appeal.

In October 2023, we celebrated the 10-year anniversary of our art event of A Letter In Mind (ALIM). The event was our biggest ALIM yet, where we sold over 550 individual pieces of art raising £56k. Celebrity contributors included Oscar-winning director Sir Christopher Nolan, celebrated illustrator Axel Scheffler and Sir Grayson Perry to mention just three. This event also proved very important in awareness raising (see page 21).

Different approaches

We have continued developing a variety of other income streams to keep our revenue sources as broad and sustainable as possible.

In the second year of our lottery initiative, we were able to increase participant numbers by promoting it around the hospital, in our communications and through a Facebook campaign. We also built on the successes of last year’s Facebook Challenge, running a second one in February 2024. In addition, we grew our Individual Giving income stream through sending out seven direct cash appeals. Together these revenue streams brought in almost £150k.

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Joanna David and Joanna Lumley

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Strategy goal #4

Awareness raising

Over the past year we have made excellent progress towards our goal of ‘raising awareness of The National Brain Appeal so that even those who haven’t been personally affected by neurological conditions understand the importance of our work and the need for funding in this area’.

A range of high-profile coverage has enabled us to engage with new audiences and build our profile in news, healthcare, science, and philanthropy-focused outlets. Often this has been supported by our network of high-profile supporters including celebrities, influencers and public figures who enthusiastically

and voluntarily amplify our messages and increase our reach. Consequently, the quality and volume of our social media content has increased exponentially in the past year.

The following events not only raised large sums of money, but helped us to make significant progress in this area.

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Rare Space Garden

The National Brain Appeal’s Rare Space Garden sponsored by Project Giving Back provided a huge range of opportunities for drawing national attention to neurological conditions.

The garden was designed by awardwinning landscape designer Charlie Hawkes to be enjoyed by people living with rare forms of dementia, particularly visual and spatial forms of the condition.

Its launch, at The 2023 RHS Chelsea Flower Show, was our biggest event yet. It was the only garden at the show to win three awards, a coveted RHS Gold medal plus awards for Best Sanctuary Garden and Best Construction Award (Sanctuary Garden).

During the show, we had wideranging celebrity support and highprofile visitors. Actor Stephen Graham, who played a character with youngonset dementia in C4 drama Help , acted as The National Brain Appeal’s celebrity ambassador on Press Day at the show.

High-profile visitors to the garden included Dame Joanna Lumley, Sir Derek Jacobi, Imelda Staunton CBE, Jim Carter OBE, Jim Broadbent, Joanna David, Richard Clifford, David and Samantha Cameron, Jerry Hall, Ellie Harrison, Nick Grimshaw, Mary Berry and Abi Morgan.

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During the show, the charity and garden featured in either the BBC One or BBC Two RHS Chelsea Flower Show programmes every day of the week. Average audience figures for BBC One programmes alone reach just under 3m viewers. It was also widely covered in national, regional, local, consumer and trade media.

This attention has been absolutely crucial in helping us raise awareness of rare dementias.

The garden has now been temporarily relocated to Exbury Gardens in Hampshire. This enabled us to raise awareness about neurological conditions with an entirely new audience. More national, regional and consumer press included live broadcasts from the garden by ITV Good Morning Britain weather presenter, Laura Tobin, who highlighted the garden’s dementia-friendly design, and the Rare Dementia Support Centre appeal. Average viewing figures for the programme are 1m.

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Monty Don with designer Charlie Hawkes © Marie Mangan
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A Letter in Mind

This event enables us to engage with another new, different audience and, alongside raising a record sum for the charity, our 10th anniversary exhibition attracted some great media coverage.

This included a full-page feature in Metro newspaper (2.3m readership) and a BBC London TV News interview with longstanding National Hospital patient and artist, Christopher Samuel talking about the hospital, and the staff who played a role in his becoming an artist. Major appeals manager Eva Tait was also interviewed on behalf of the charity.

Also in the news

Other mainstream media coverage of the work we fund continued with particular success when sharing stories about our funding of Dr Paul Mulholland’s trailblazing work on glioblastoma, an aggressive form of brain cancer with a poor prognosis.

The Times health section carried a print and online story about Dr Mulholland’s brain cancer research, including interviews with Siobhain McDonagh MP, whose sister Margaret had glioblastoma, and Dr Mulholland.

This led to further impactful coverage in the The Times about patient Ben (right, with wife Emily), diagnosed with glioblastoma, whose scans showed no active tumour 18 months on from immunotherapy treatment as part of a clinical trial led by Dr Paul Mulholland. As well as online, the story was published in the Saturday Times . The story generated an avalanche of media, across TV, radio and print press. This resulted in over 1,000 people visiting our website from search, referral and direct visits.

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What’s planned for next year, by strategic area Over the coming year, we will continue to build Developing our ight on the success of our funding programme d impact work over the past 12 We will maintain our focus on delivering our Al ur new grants strategy, we will months and to pursue major capital appeal project, A New Home develop a new impact framework next year our strategic aims: for Neuroscience, through a combination of to ensure that we are collecting the most developing support from philanthropy and meaningful feedback from the grants we award, partnerships, and a new public-facing campaign. to ensure that we’re able to maximise learning and insight that can be disseminated throughout We will develop a new grants strategy to ensure the field of neurology. we focus our impact on key areas where we can make the greatest difference. Working with our We will continue to collate qualitative and clinical and scientific colleagues at Queen Square, quantitative reporting and feedback on our we will determine how our investments can be existing funding programmes, as well as maintaining best deployed in key areas for maximum effect. a focus on developing our library of case studies to enable us to bring to life the impact of our work We will continue to grow and develop our to a range of non-clinical and academic audiences. key funding programmes, Small Acorns and the Innovation Fund, ensuring that we attract high-calibre funding applications from across Queen Square. |) 40 The National Brain Appeal Report & Accounts 2023-24 CONTENTS • TRUSTEES’ REPORT • INDEPENDENT AUDITOR’S REPORT • FINANCIAL STATEMENTS ~~a~~

Growing our income

We will work towards the completion of our two major appeals, raising the capital funds needed to deliver A New Home for Neuroscience and The Rare Dementia Support Centre, alongside which we will continue to provide revenue funding for Rare Dementia Support.

We will invest in the growth of our sustainable, unrestricted income across a range of areas in order to provide a secure base for the funding of the charity’s operations over the coming years.

Building on the success of the Innovation Fund, we will develop our fundraising product portfolio to proactively match the innovative work taking place across Queen Square with donors of all kinds.

We will invest in our fundraising infrastructure with the aim of improving the return we get on every penny we spend on fundraising. This will mean developing our data and insight capacity, improving the efficiency of our administration, and better targeting our fundraising at those most interested in and impacted by our work.

Awareness raising

In order to support our awareness-raising focus, we will undertake a refresh of The National Brain Appeal brand, to ensure that how we look and communicate remains fresh, engaging and meaningful to our key stakeholders.

We will work with our NHS colleagues to build awareness of our work across The National Hospital, creatively using the space that is available to ensure that significant stakeholders, i.e. patients, their families and staff, have high levels of awareness of our work and the opportunities with which they can engage.

We will continue to refine our use of data-driven decision making in reaching our key audiences, to ensure that we’re harnessing both digital and analogue channels that can most cost-effectively enable us to communicate our messages and calls to action to greatest effect. We will also continue to develop the quality and quantity of relationships with a range of priority stakeholders.

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Donors

Without the support of so many donors, alongside a number of companies and grant-making trusts and foundations, The National Brain Appeal would be unable to fund such a wide range of projects.

Our grateful thanks to all who have supported this year. These include:

General Fund

Frazer Trust

Gillham Charitable Trust Goldman Sachs Grand Order of Water Rats Henry Family Investments Ice and a Slice Jurist Lodge Marex

Marks & Spencer PLC Mewburn Ellis Oldhurst Trust

The Bryan Guinness Charitable Trust The Lodge of True Friendship The Peter Courtauld Charitable Trust Timothy Franey Charitable Foundation

Innovation Fund

Ambrose & Ann Appelbe Trust C A Pilgrim 3 Ltd Consuelo and Anthony Brooke Charitable Trust Rosetrees Trust The RDJ Foundation

Rare Dementia Support and Rare Dementia Support Centre

Asian Media Group Daiwa Corporate Garfield Weston Foundation Girdlers’ Company Iceland Foods Charitable Foundation Jan and Belinda Pethick

Charitable Trust

Mercers’ Company Nila Rubia NorthEdge Paragon Trust Rosetrees Trust RSM UK Foundation Semaphore Charitable Trust The Charity of Sir Richard Whittington The Galen and Hilary Weston Foundation

GIR/A New Home for Neuroscience

Highfields Trust James Clifford Campling Trust Otto Krahn Group PF Charitable Trust

Small Acorns

A.B. David Charity The Michael Cornish Charitable Trust

Neurosurgery Fund

Bestway Foundation Cure Myotonic Dystrophy UK Charity (CDM) Lupin Healthcare NRT University College London

Dementia Research Q Charitable Trust

Gifts in kind

Project Giving Back META Iceland Foods Charitable Foundation Exbury Gardens Nila Rubia FOLK

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The National Brain Appeal Report & Accounts 2023-24

Gary Newman climbed Mount Snowdon with friends and family to raise money for The National Brain Appeal

Legal and administrative details

The National Hospital for Neurology and Neurosurgery Development Foundation (also known as The National Brain Appeal)

A company limited by guarantee

Chair Jackie Ashley

Treasurer

Chief Executive/ Company Secretary Claire Wood Hill (appointed 16 October 2023)

Charity Registration Number 290173

Company Number 01844281

Principal Address

and Registered Office The National Hospital, Queen Square, London WC1N 3BG

Statutory Auditor

Moore Kingston Smith LLP, 6th Floor, 9 Appold Street, London EC2A 2AP

Solicitors

Charles Russell Speechlys LLP, 5 Fleet Place, London EC4M 7RD

Bankers

Royal Bank of Scotland, 127-128 High Holborn, London WC1V 6PQ

Investment Managers

Cazenove Capital, 1 London Wall Place, London EC2Y 5AU

Richard Blakey

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About this report

The Trustees, who are the directors

of the charitable company, present their report and the audited accounts for The National Hospital Development Foundation (the Foundation) for the year ended 31 March 2024.

The Charity’s working name is The National Brain Appeal. The financial statements comply with current statutory requirements, the memorandum and articles of association and the Statement of Recommended Practice (SORP) “Accounting and Reporting by Charities”.

Status and Objects

The Foundation was incorporated on 29 August 1984 and is a company limited by guarantee with charitable status. It is registered as a charity in England and Wales, number 290173.

The Foundation has been established to promote the relief and prevention of diseases of the nervous system. Funds raised by the Foundation are to be used for the erection and maintenance of buildings, the purchase and maintenance of medical equipment, for education and for clinical research.

Public Benefit

We have referred to the

guidance contained in the Charity Commission’s general guidance on public benefit when reviewing our aims and objectives and in planning our future activities. The Charity supports a range of activities to advance treatment of and research into neurological conditions which is clearly of public benefit.

Governance

The Trustees determine the direction and policy of the Foundation in response to requests from The National Hospital for Neurology and Neurosurgery (NHNN) and the Queen Square Institute of Neurology. The members are elected by Council (which comprises the directors of the company) to serve a period of three years and are unremunerated. There are currently 14 Trustees and they are recruited by recommendation, advertisement and interview. Ad hoc committees, which include the Trustees, are formed to run periodic special events. The Trustees who met five times in the year ended 31 March 2024 have delegated the day-to-day administration of the Charity to the Chief Executive. The Chief Executive has regular meetings with the Chair and Treasurer. The Chair determines the salary of the Chief Executive.

Investment powers

Under the memorandum and articles of association, the Charity has the power to make any investment the Trustees see fit.

A Sub-Committee of the Trustees monitors the Charity’s investments and reports annually to the Board.

The policy for invested funds focuses on maximising income. The performance for the year was considered satisfactory.

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Reserves policy

Total reserves held at the year end by the Charity amounted to £9,041,846 (2023: £9,809,129), of which £4,974,730 were held as restricted funds (2023: £5,557,405) and a further £2,510,000 were designated for specific purposes (2023: £3,210,000). The Trustees have established a policy whereby the unrestricted funds not committed or invested in tangible fixed assets (“the free reserves”) held by the Charity should be sufficient to meet between 9 and 15 months’ staff and office costs. Total free reserves as at 31 March 2024 were £1,557,116, which complies with our reserves policy. The Trustees consider that they would be able to continue the current activities of the Charity in the event of a drop in funding as a sufficient proportion of the designated funds will not be required in the next 12 months.

Risk exposure

The Trustees have addressed the major risks to which the Charity is exposed, in particular those relating to its operations and finances, and are satisfied that the systems in place are sufficient to manage the exposures identified. As the Charity does not directly provide charitable services, the main risks are being unable to deliver promised funding on time. However, Trustees are careful not to overcommit and pledges are considered in relation to assets held and predicted cash flow. A risk register has evolved to detail risks and the controls and mitigations in place to manage this risk. The risk register is reviewed each year. In addition, the Trustees approved a risk appetite statement during the financial year that helped to underpin strategic decision making.

Fundraising

We have referred to the charity finance regulations (SORP) and can confirm:

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Trustees

The Trustees of the Charity who served during the year were:

Jackie Ashley (Chair)

Glenda Bailey (appointed 13 March 2024)

Richard Blakey (Treasurer)

Caroline Church

(resigned 13 March 2024, now President)

Joanna David (resigned 28 September 2023)

Professor John Duncan

Jules Foster (resigned 13 March 2024)

Joan Grieve

(resigned 13 March 2024)

Professor Mike Hanna

James Knight (resigned 20 March 2024)

Hani Marcus

(appointed 28 September 2023)

Suzanne Miller

Diarmid Ogilvy

Dame Elizabeth Slade

Michael Smith

(resigned 31 March 2024)

Professor Alan Thompson (resigned 28 September 2023)

Dr Chris Turner

Dee Rudran

(appointed 27 June 2024)

Hadi Manji (appointed 8 April 2024)

The President of the Charity is Edward Datnow FRCS (resigned 14 December 2023)

Caroline Church (appointed 14 December 2023)

The Honorary President is Edward Datnow FRCS (appointed 14 December 2023)

Statement of Trustees’ Responsibilities

The Trustees (who are also directors of The National Hospital for Neurology and Neurosurgery Development Foundation for the purposes of company law) are responsible for preparing the Trustees’ Report (incorporating the Directors’ Report) and the financial statements in accordance with applicable law and regulations.

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

Under company law the Trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of the income and expenditure of the charitable company for that period.

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46 The National Brain Appeal Report & Accounts 2023-24

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.

In so far as the Trustees are aware:

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

Auditor

A resolution to re-appoint the auditor, Moore Kingston Smith LLP will be proposed at the annual general meeting.

Small company provisions

The report has been prepared in accordance with the special provisions for small companies under Part 15 of the Companies Act 2006.

By order of the Trustees

Jackie Ashley Chair

Date: 26 September 2024

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Independent Auditor’s Report ~~_-~~ he

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Opinion

We have audited the financial statements of (the National Hospital for Neurology and Neurosurgery Development Foundation (‘the company’) for the year ended 31 March 2024 which comprise the Statement of Financial Activities, the Balance Sheet, the Cash Flow Statement and notes to the financial statements, including significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including FRS 102 ‘The Financial Reporting Standard Applicable in the UK and Republic of Ireland’ (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

Basis for opinion

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

Conclusions relating to going concern

In auditing the financial statements,

we have concluded that the trustees’ use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have

performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the 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.

Other information

The other information comprises the information included in the annual report, other than the financial statements and our auditor’s report thereon. The trustees are responsible for the other information contained within the annual report.

Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the course of the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether there is a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

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Opinions on other matters prescribed by the Companies Act 2006

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

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the company and its environment obtained in the course of the audit, we have not identified material misstatements in the trustees’ annual report.

We have nothing to report in respect of the following matters where the Companies Act 2006 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.

Auditor’s responsibilities for the audit of the financial statements

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

As part of an audit in accordance with ISAs (UK) we exercise professional judgement and maintain professional scepticism throughout the audit.

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We also:

— Conclude on the appropriateness of the trustees’ use of the going concern basis of accounting and, based on the audit evidence obtained, whether a material uncertainty exists related to events or conditions that may cast significant doubt on the charitable company’s ability to continue as a going concern. If we conclude that a material uncertainty exists, we are required to draw attention in our auditor’s report to the related disclosures in the financial statements or, if such disclosures are inadequate, to modify our opinion. Our conclusions are based on the audit evidence obtained up to the date of our auditor’s report. However, future events or conditions may cause the charitable company to cease to continue as a going concern.

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.

Explanation as to what extent the audit was considered capable of detecting irregularities, including fraud

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.

The objectives of our audit in respect of fraud, are; to identify and assess the risks of material misstatement of the financial statements due to fraud; to obtain sufficient appropriate audit evidence regarding the assessed risks of material misstatement due to fraud, through designing and implementing appropriate responses to those assessed risks; and to respond appropriately to instances of fraud or suspected fraud identified during the audit. However, the primary responsibility for the prevention and detection of fraud rests with both management and those charged with governance of the charitable company.

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Our approach was as follows:

There are inherent limitations in the audit procedures described above. We are less likely to become aware of instances of non-compliance with laws and regulations that are not closely related to events and transactions reflected in the financial statements. 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.

Use of our report

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

Adam Fullerton (Senior Statutory Auditor)

for and on behalf of Moore Kingston Smith LLP, Statutory Auditor: 6th Floor, 9 Appold Street, London EC2A 2AP Date: 30 September 2024

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52 The National Brain Appeal Report & Accounts 2023-24

Bestway hosted its Royal Ascot Charity Race Day to raise vital funds for The National Brain Appeal

Financial Statements

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Statement of Financial Activities

Unrestricted Restricted Total funds Total funds
funds funds 2024 2023
Notes £ £ £ £
Income
Donations and legacies 4 1,537,041 4,997,228 6,534,269 3,656,228
Investment income 5 405,068 - 405,068 357,462
Rental income 16,897 - 16,897 11,806
Total income 1,959,006 4,997,228 6,956,234 4,025,496
Expenditure
Costs of raising funds 6 1,595,961 113,070 1,709,031 878,178
Expenditure on charitable activities 7 608,807 5,922,450 6,531,257 1,548,677
Total expenditure 2,204,768 6,035,520 8,240,288 2,426,855
Net income/(expenditure) before transfers (245,762) (1,038,292) (1,284,054) 1,598,641
Transfers between funds (455,617) 455,617 - -
Net income before gains and losses (701,379) (582,675) (1,284,054) 1,598,641
Net gains(losses) on revaluation of investments 12 516,771 - 516,771 (705,380)
Net income/(expenditure) and net movement in funds 11 (184,608) (582,675) (767,283) 893,261

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Unrestricted Restricted Total funds Total funds
funds funds 2024 2023
Notes £ £ £ £
Reconciliation of funds
Total funds brought forward at 1 April 2023 4,251,724 5,557,405 9,809,129 8,915,868
Total funds carried forward at 31 March 2024 4,067,116 4,974,730 9,041,846 9,809,129

All above amounts are derived from continuing operations. All gains and losses for the year are shown above. The notes on pages 59 to 74 form part of these financial statements.

The National Hospital for Neurology and Neurosurgery Development Foundation

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Balance Sheet

2024 2023
Notes £ £ £ £
FIXED ASSETS
Investments 12 11,801,670 8,400,796
11,801,670 8,400,796
CURRENT ASSETS
Debtors 13 510,705 1,481,223
Bank balances and cash in hand 847,474 499,178
1,358,179 1,980,401
CREDITORS
Amounts falling due within one year 14 (4,118,003) (572,068)
NET CURRENT (LIABILITIES)/ASSETS (2,759,824) 1,408,333
TOTAL ASSETS LESS CURRENT LIABILITIES 9,041,846 9,809,129

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ACCUMULATED FUNDS

Unrestricted funds
General fund 16 1,557,116 1,041,724
Designated funds 16 2,510,000 3,210,000
Total Unrestricted Funds 4,067,116 4,251,724
Restricted Funds 17 4,974,730 5,557,405
TOTAL FUNDS 19 9,041,846 9,809,129

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

The financial statements were authorised for issue on 26/09/2024 and were signed on their behalf by

Richard Blakey Treasurer

Jackie Ashley Chair

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Statement of Cash Flows

A. RECONCILIATION OF NET INCOMING RESOURCES
TO NET CASH INFLOW FROM OPERATING ACTIVITIES Notes 2024 2023
£ £
Net movement in funds (767,283) 893,261
(Gain)/Loss on disposal of fixed assets/investments (unrealised) (516,771) 705,380
Decrease/(increase) in debtors 970,518 (1,317,811)
Increase/(decrease) in creditors 3,545,935 145,461
Investment (income) shown in investing activities (405,068) (357,462)
Net cash inflow from operating activities 2,827,331 68,829
STATEMENT OF CASH FLOWS 2024 2023
£ £
Net cash inflow from operating activities A 2,827,331 68,829
Cash flows from investing activities
Financial investment (purchase) (500,000) -
Proceeds from disposal of investments (at opening market value) 25,448 -
Investment income received 405,068 357,462
(Increase)/decrease in investment cash (2,409,551) -
Cash (used in)/provided by investing activities (2,479,035) 357,462
(Decrease)/increase in cash and cash equivalents in the year 348,296 354,377
Cash and cash equivalents at the beginning of the year 499,178 144,801
Cash and cash equivalents at the end of the year 847,474 499,178

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Notes to the fnancial statements

1 Company information

The National Hospital for Neurology and Neurosurgery Development Foundation is a charitable company limited by guarantee incorporated in England & Wales and domiciled in England.

The Registered Office is The National Hospital, Queen Square, London WC1N 3BG.

The principal activity of the Charity is to promote the relief and prevention of diseases of the nervous system.

The Company’s registered number is 01844281. The registered Charity number is 290173.

The functional and presentation currency of these financial statements is GBP and the financial statements are rounded to the nearest £1.

2 Accounting policies

(a) Accounting basis

The financial statements cover the period 1 April 2023 to 31 March 2024.

The financial statements have been prepared in accordance with 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 2015) - (Charities SORP (FRS 102)), the Financial Reporting standards applicable in the UK and Republic of Ireland (FRS 102), the Companies Act 2006 and the Charities Act 2011.

The National Brain Appeal 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 policy note(s). They are prepared under the historical cost convention with the exception of fixed asset investments, which are recorded at market value.

(b) Going concern

The financial statements are prepared on a going concern basis which assumes the charitable company will continue in operational existence for the foreseeable future.

The Trustees have considered the going concern status of the Charity for a period of twelve months from the date of approval of these financial statements.

The Trustees do not believe there are any indicators why the going concern status of the Charity would not be supported and this is supported by the open market investments of £8,990,521 (2023: £7,999,198) and total funds of £9,041,846 (2023: £9,809,129). Outflows from the Charity are dependent on the income levels received by the Charity on an on-going basis.

Accordingly, the Trustees continue to adopt the going concern basis in the preparation of the financial statements.

(c) Incoming resources

All incoming resources are included in the Statement of Financial Activities when the Charity is legally entitled to the income and the amount can be quantified with reasonable certainty.

(d) Legacies

Legacies are included when the Charity is advised by the personal representative of an estate that payments will be made, is probable of its receipt, and the amount involved can be quantified.

(e) Incoming resources from activities to generate funds

Income from activities to generate funds. Income from activities to generate funds comprises amounts receivable from fundraising events for which tickets have been sold.

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(f) Resources expended

All expenditure is accounted for on an accruals basis, inclusive of irrecoverable VAT, and is allocated to the appropriate heading in the accounts.

Costs of raising funds include the costs incurred in generating voluntary income and the costs of direct publicity intended to raise the profile of the Charity.

Charitable expenditure comprises services supplied and activities undertaken which are identifiable as wholly or mainly in support of the Charity’s objectives.

Governance costs included in charitable activities are those costs associated with the governance arrangements of the Charity, and these include audit, legal advice for Trustees, costs associated with Trustee meetings and the cost of the preparation of the statutory accounts.

Support costs are those costs which enable raising funds and charitable activities to be undertaken. Where activities relate to more than one cost category. Costs are apportioned on the most appropriate basis predominantly with reference to staff time and on a reasonable and consistent basis.

(g) Investments

Investments are accounted for at market value, giving rise to unrealised gains/ losses included in the Statement of Financial Activities. Realised gains/losses arising on the disposal of investments during the year are also included in the Statement of Financial Activities.

(h) Funds

The General fund is available to use at the discretion of Trustees in furtherance of the Charity’s objectives. Designated funds comprise funds which have been set aside by the Trustees for specific purposes. Restricted funds are funds received which are subject to specific restrictions as imposed by the donor or the nature of the appeal.

(i) Cash and cash equivalents

Cash is represented by cash in hand and deposits with financial institutions repayable without penalty on notice of not more than 24 hours. Cash equivalents are highly liquid investments that mature in no more that three months from the date of acquisition and that are readily convertible to known amounts of cash with insignificant risk of changes in fair value.

(j) Operating leases

Operating lease charges are recognised in the Statement of Financial Activities when due.

3 Judgements

In preparing the Financial Statements, management is required to make estimates and assumptions which affect reported income, expenses, assets, liabilities, and disclosure of contingent assets and liabilities. Use of available information and application of judgement are inherent in the formation of estimates, together with expectations of future events believed to be reasonable under the circumstances. Actual results in the future could differ from such estimates.

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4 Donations and legacies

Donations and legacies
Unrestricted Restricted 2024 2023
£ £ £ £
General donations (including major donors) 764,429 1,823,504 2,587,933 1,168,072
Donations from charitable trusts 40,100 2,436,240 2,476,340 1,382,072
Legacies 454,261 344,895 799,156 615,253
Sporting and challenge events 148,032 232,201 380,233 313,552
Special events and activities 130,219 160,388 290,607 177,279
1,537,041 4,997,228 6,534,269 3,656,228

5 Income from investments

5 Income from investments Income from investments
2024 2023
£ £
Interest receivable from bank deposit accounts - 8
Income from investment portfolio 405,068 357,454
405,068 357,462

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6 Costs of raising funds

Costs of raising funds
Unrestricted Restricted 2024 2023
£ £ £ £
Direct costs 865,844 22,216 888,060 396,079
Support costs(note 8)
Staff costs 600,425 90,854 691,279 360,820
Rent and rates 49,509 - 49,509 42,039
Other costs 80,183 - 80,183 79,240
1,595,961 113,070 1,709,031 878,178

7 Charitable activities

7 Charitable activities Charitable activities
Unrestricted Restricted 2024 2023
£ £ £ £
Direct costs 25,118 5,895,883 5,921,001 964,769
Governance costs (note 7a) 196,631 19,200 215,831 142,873
Support costs (note 8) Staff
costs 305,543 7,367 312,910 314,455
Rent and rates 29,260 - 29,260 26,187
Other costs 52,255 - 52,255 100,393
608,807 5,922,450 6,531,257 1,548,677

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2024 2023
Grants by activity £ £
Neurodegeneration 4,908,634 632,869
Neurology 703,584 72,422
Neurosurgery 39,159 52,876
Education and Staff Development - 1,839
Queen Square 159,232 61,775
Technology and Innovation 110,392 142,921
Other - 67
5,921,001 964,769
Grants by organisation 2024 2023
£ £
UCLH NHS Foundation Trust 4,311,390 558,258
University College London 945,012 346,578
Other 664,599 59,933
5,921,001 964,769

No grants were made to individuals in the current or prior year.

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7a Governance costs

7a Governance costs Governance costs
Notes 2024 2023
£ £
Audit fee 20,453 17,083
Insurance 1,133 1,200
Other costs 50,440 61,756
Support costs
Staff costs 8 133,311 46,768
Rent and rates 8 3,351 2,910
Other costs 8 7,143 13,156
215,831 142,873

8 Support costs

8 Support costs Support costs
2024 2023
£ £
Rent and rates 82,120 71,136
Staff costs 1,137,500 722,043
Other costs 139,581 192,789
1,359,201 985,968

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9 Staff

Staff
Staff costs 2024 2023
£ £
Wages and salaries 134,965 -
Ex-gratia 30,000 -
Social security costs 16,324 -
Pension costs 3,757 -
UCLH recharged staff costs 738,459 722,044
Temporary staff 218,994 95,149
1,137,500 817,193

The Charity is eligible for a £5,000 employment allowance. The above social security costs bill of £11,323 is net of this allowance.

Historically, the Charity’s workforce was employed by University College London Hospitals NHS Trust (UCLH). During the year, the charity began employing staff directly for the first time. Accordingly, the Charity’s staff costs comprise a combination of both directly employed staff and staff whose costs are recharged from UCLH.

During the year, there were four employees (on average) employed directly by the Charity (2023: none). There were 11 staff (2023: 13) on average

employed by University College London Hospitals NHS Trust, contracted to work for the Charity. Staff costs are charged on the basis of time spent. The recharge paid by the Charity to University College London Hospitals NHS Trust contributes to the cost of the individual by providing a managerial service.

The Charity’s key management personnel during the year comprised the CEO, director of finance and resources, head of digital transformation and, director of fundraising.

There were 4 (2023: 0) members of key management personnel directly employed by the Charity during the year, with 3 at year end.

There were 3 (2023: 3) members of 2024 2023 2024 2023
key management personnel directly
employed by University College London £60,001 - £70,000 - -
1
Hospitals NHS Trust during the year £70,001 - £80,000 2 2
(1 person at year end). £80,001 - £90,000 2 -
£110,001 - £120,000 1 -
Aggregate remuneration for the year £120,001 - £130,000 - -
1

Aggregate remuneration for the year for key management personnel was £438,298 (2023: £265,892).

The Trustees received no remuneration (2023: £nil) and reimbursement of expenses £85 (2023: £nil).

Ex-gratia payments of £30,000 were made during the year.

There were no other contracts or transactions with Trustees or connected parties except that the Foundation is grateful for a number of charitable donations totalling £11,024 (2023: £4,375) from 10 trustees.

The number of employees and UCLH staff whose remuneration exceeded £60,000 are as follows:

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10 Related Party Transactions

There was a transaction with a related party of the chief executive during the year of £178 (2023: £240) and an amount outstanding at the year end from the chief executive of £30.

11 Net incoming resources

2024 2023 £ £ This is stated after charging: Operating lease rental - premises 45,720 47,192 Auditors’ remuneration - Audit fees 20,453 17,083 _

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12 Fixed asset investments

Fixed asset investments
2024 2023
£ £
Market value of equities and bonds at 1st April 7,999,198 8,704,578
Additions at cost 500,000 -
Disposals at opening market value (25,448) -
Net unrealised gains/(losses) on revaluation at 31st March 516,771 (705,380)
Market value of equities and bonds at 31st March 8,990,521 7,999,198
Cash deposits 2,811,149 401,598
Market value at 31st March
11,801,670		 11,801,670 8,400,796
Historic cost at 31st March 8,296,559 7,944,612
Portfolio at 31st March 2024 2023
£ £
Multi-asset fund 8,990,520 7,999,198
Cash - Sterling 2,811,150 401,598
Market value at 31st March
 11,801,670 8,400,796

The above represents holdings greater than 5% of the total market value of the portfolio at year end.

The Charity’s Multi-asset fund is invested with Cazenove in its SUTL Charity NURS Fund.

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13 Debtors

13 Debtors Debtors
2024 2023
£ £
Prepayments 80,722 83,479
Accrued Income; donations and legacies 422,758 1,046,847
Other Debtors 7,225 350,897
510,705 1,481,223

14 Creditors

14 Creditors Creditors
2024 2023
£ £
Due within one year
University College London, for Rare Dementia Support Centre 3,612,660 -
University College London, Institute of Neurology 96,771 354,607
Other creditors and accruals 408,572 217,461
4,118,003 572,068

15 Contingent liabilities

At the year end TNBA had a contingent liability with UCL in relation to the Rare Dementia Support Centre (RDSC) project to the value of £130,000 (only payable once the building is complete and open). UCL may issue a payment request from TNBA in respect of the operational costs of the centre for each 12 month period throughout the five year operational period.

This covers initial building running costs and is an annual payment over the first 5 years of building opening.

Under the terms of the agreement, the charity may have to pay an additional grant to UCL. The maximum amount that could be payable is £100k but is contingent on future events.

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16 Unrestricted funds: movements in year

Balance Income Expenditure Investment Transfers Balance
1.4.23 gains/(losses) gains/(losses) 31.3.24
£ £ £ £ £ £
Designated funds
National Hospital - small project funding 10,000 - - -
-		 - 10,000
Stroke Project 700,000 - - - (700,000) -
New Home for Neuroscience: Grays Inn Road 2,500,000 - - - - 2,500,000
Total designated funds 3,210,000 - - -
-		 (700,000) 2,510,000 (700,000) 2,510,000
General fund 1,041,724 1,959,007 (2,204,769) (2,204,769)
516,771		 244,383 1,557,116 244,383 1,557,116
4,251,724 1,959,007 (2,204,769) 1,959,007 (2,204,769) 516,771 (455,617) 4,067,116

Unrestricted Funds have been specifically designated by The National Hospital for Neurology and Neurosurgery Development Foundation for the following purposes:

Stroke Project

Funds used and remainder released back to general funds.

New Home for Neuroscience: Grays Inn Road

National Hospital: small projects funding

Two rounds of applications per annum in spring and autumn. Funds have been released as the designated reserve requirement going forward is not expected to be more than £10k.

£2.5m was designated, forming the initial part of the Charity’s intended contribution of £7m to a new, state-of-the-art neuroscience centre on Grays Inn Road.

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17 Restricted Funds: movements in year

Balance Income Expenditure Investment Transfers Balance
1.4.23 gains/(losses) gains/(losses) 31.3.24
£ £ £ £ £ £
Neurodegeneration
Neurodegeneration - 7,533 (3,207) - - 4,326
NDGMDT Myotonic Dystrophy Research - 4,413 - -
-		 - 4,413
Centre for Neuromuscular Diseases 210,643 32,400 (40,666) (40,666)
-		 - 202,377
CJD - Prion Fund - - - -
-		 - -
Dementia Research 486,210 74,582 (43,425) (43,425)
-		 - 517,367
Posterior Cortical Atrophy 399,733 212,151 (76,009) (76,009)
-		 - 535,875
FTD - Pick’s Disease Research Fund 197,102 345,077 (11,122) (11,122)
-		 - 531,057
Rare Dementia Centre 1,050,184 3,083,597 1,050,184 3,083,597 (3,975,243) (3,975,243)
-		 - 158,538
Rare Dementia Support Group 844,925 278,066 (835,732) (835,732)
-		 - 287,259
Dystonia Research 3,000 - - - - 3,000
Myotonic Dystrophy Research 3,490 - - - - 3,490
NDGNDM Non-Dystrophic Myotonia - 88,532 - -
-		 - 88,532
Parkinson’s Disease 823 303 - - - 1,126
Neurosurgery
Neurosurgery 105,322 25,648 (39,159) - - 91,811
Acute Brain Injury 21,693 - - - - 21,693
Brain Tumour Unit 196,130 10 - - - 196,140
Molly’s Fund 89,722 - - - - 89,722
Medical Intensive Therapy Unit 9,008 - - - - 9,008
Neurocritical Care 1,965 - - - - 1,965
Neurosurgical Education 2,396 - - - - 2,396
Sub Arachnoid Haemorrhage 18,983 - - - - 18,983
Surgical Intensive Therapy Unit 250,000 - - - - 250,000
Neurology
Neurology 764 285,039 - - - 285,803
Mitochondrial Diseases (J Land) - - - - - -
MS Fund 129,816 1,000 (3,584) (3,584)
-		 - 127,232
MS Primary Progressive 20,125 - - -
-		 - 20,125

70 The National Brain Appeal Report & Accounts 2023-24 CONTENTS • TRUSTEES’ REPORT • INDEPENDENT AUDITOR’S REPORT • FINANCIAL STATEMENTS ~~a~~

Balance Income Expenditure Investment Transfers Balance
1.4.23 gains/(losses) gains/(losses) 31.3.24
£ £ £ £ £ £
Neuro-ophthalmology 9,980 - - -
-		 - 9,980
Neuro-otology 21,251 - - -
-		 - 21,251
Neuro-rehabilitation - 20 - -
-		 - 20
Encephalitis and Long Covid Research - 100,000 - - - 100,000
NHDEPI Epilepsy Fund 10,022 2,222 - -
-		 - 12,244
Neurorehab - high dose Aphasia - 2,523 - - - 2,523
Research Fund 7,445 - - -
-		 - 7,445
Stroke Project 235,193 9,190 (700,000) - 455,617 -
Stroke Research 176,202 - - -
-		 - 176,202
Education and Staff Development
Education and Staff Development		 - 675 - -
-		 - 675
Gorlov Prize 2,750 - - - - 2,750
Queen Square
Queen Square 102,146 14,563 (76,200) - (16,745) 23,764
Queen Square History Book 774 774
Small Acorns Programme 40,774 23,713 (81,232) - 16,745 -
Wards/Nursing 16,549 - - - - 16,549
Grays Inn Road 315,040 148,989 (39,550) - - 424,479
Technology and Innovation
Technology and Innovation 3,804 1,540 - 5,344
Innovation Fund 242,639 97,950 (36,376) 304,213
Neuropsychology 56 - - - - 56
Neuroimmunology 130,589 - - -
-		 - 130,589
T&INER Neuroresponse (87,725) - (74,015) (74,015)
-		 - (161,740)
Neuro-immunotherapy (NEAT) - 58 - -
-		 - 58
Brain Cancer Research Fund 288,656 156,660 - -
-		 - 445,316
TOTAL RESTRICTED FUNDS 5,557,405 4,997,231 (6,035,520) 5,557,405 4,997,231 (6,035,520) 5,557,405 4,997,231 (6,035,520) - 455,617 4,974,730 455,617 4,974,730

Transfers to restricted funds occur when expenditure exceeds income, and the balance is made up from unrestricted funds.

The Emergency Fund is now part of the general fund for Queen Square.

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18 Restricted Funds: movements 2022-23

Balance Income Expenditure Investment Transfers Balance
1.4.22 gains/(losses) gains/(losses) 31.3.23
£ £ £ £ £ £
Neurodegeneration
Neurodegeneration - 7,373 (20,290) - 12,917 -
Centre for Neuromuscular Diseases 315,461 - (104,818) (104,818)
-		 - 210,643
CJD - Prion Fund 1,917 - (2,000) (2,000)
-		 83 -
Dementia Research 423,985 92,306 (30,081) (30,081)
-		 - 486,210
Posterior Cortical Atrophy 293,832 186,561 (80,660) (80,660)
-		 - 399,733
FTD - Pick’s Disease Support Group 31,304 - - - (31,304) -
FTD - Pick’s Disease Research Fund 218,723 94,847 (116,468) (116,468)
-		 - 197,102
Myrtle Ellis 90 - - - (90) -
Rare Dementia Centre 389,565 678,810 (18,191) (18,191)
-		 - 1,050,184 - 1,050,184
Rare Dementia Support Group 429,650 607,913 (224,032) (224,032)
-		 31,394 844,925
Dystonia Research 3,000 - - - - 3,000
Myotonic Dystrophy Research 3,490 - - - - 3,490
Parkinson’s Disease 583 240 - - - 823
Neurosurgery
Neurosurgery 104,865 23,086 (22,629) (22,629)
-		 - 105,322
Acute Brain Injury 21,668 25 - - - 21,693
Brain Tumour Unit 196,115 15 - - - 196,130
Molly’s Fund 81,866 7,856 - - - 89,722
Medical Intensive Therapy Unit 9,008 - - - - 9,008
Neurocritical Care 1,965 - - - - 1,965
Neurosurgical Education 2,396 - - - - 2,396
Pituitary Surgery 29,427 - (29,472) (29,472)
-		 45 -
Sub Arachnoid Haemorrhage 19,758 - (775) (775)
-		 - 18,983
Surgical Intensive Therapy Unit 167,595 - - - 82,405 250,000
Neurology
Neurology - 16,575 (39,955) (39,955)
-		 24,144 764
Mitochondrial Diseases (J Land) - - (36,237) (36,237)
-		 36,237 -
MS Fund 148,363 2,889 (21,436) (21,436)
-		 - 129,816

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72 The National Brain Appeal Report & Accounts 2023-24

Balance Income Expenditure Investment Transfers Balance
1.4.22 gains/(losses) gains/(losses) 31.3.23
£ £ £ £ £ £
MS Primary Progressive 20,000 125 - -
-		 - -
20,125
Neuro-ophthalmology 9,980 - - -
-		 - -
9,980
Neuro-otology 21,251 - - -
-		 - -
21,251
Neuro-rehabilitation 60,356 25 - -
-		 (60,381) -
Epilepsy Project - TMS - - (26,672) (26,672)
-		 26,672 26,672
-
NHDEPI Epilepsy Fund - 10,022 - -
-		 - -
10,022
Neurorehab - high-dose Aphasia - 2,995 20,638 - (23,633) -
Research Fund 37,600 - (3,355) (3,355)
-		 (26,800) 7,445
Stroke Project 234,957 5,236 (5,000) (5,000)
-		 - -
235,193
Stroke Research 27,970 148,232 - -
-		 - -
176,202
Education and Staff Development
Education and Staff Development		 - 1,042 (1,340) (1,340)
-		 298 298
-
Gorlov Prize 3,250 - (500) - - 2,750
Queen Square
Queen Square 79,608 24,988 (2,450) (2,450)
-		 - -
102,146
Small Acorns Programme 17,753 81,993 (58,972) (58,972)
-		 - -
40,774
Wards/Nursing 16,549 - - - - 16,549
Grays Inn Road 29,785 285,255 - - - 315,040
Technology and Innovation
Technology and Innovation - 3,804 - -
-		 - -
3,804
Innovation Fund 152,474 120,229 (30,066) (30,066)
-		 - -
242,639
Neuropsychology 56 - - - - -
56
Neuroimmunology 146,754 9,000 (25,165) (25,165)
-		 - -
130,589
T&INER Neuroresponse - - (87,725) (87,725)
-		 - -
(87,725)
Brain Cancer Research Fund 51,907 236,749 - -
-		 - -
288,656
TOTAL RESTRICTED FUNDS 3,804,876 2,648,191 3,804,876 2,648,191 (967,651) - 71,987 5,557,405 71,987 5,557,405

Transfers to restricted funds occur when expenditure exceeds income, and the balance is made up from unrestricted funds.

The Emergency Fund is now part of the general fund for Queen Square.

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73 The National Brain Appeal Report & Accounts 2023-24

19 Analysis of net assets between funds

Fixed Net current Total Total
investments liabilities 2024 2023
£ £ £ £
General fund 498,094 1,059,022 1,557,1161,041,724 1,041,724
Designated funds 2,510,000 - 2,510,0003,210,000 3,210,000
Total unrestricted funds 3,008,094 1,059,022 4,067,1164,251,724 4,251,724
Restricted funds 8,793,576 (3,818,846) 8,793,576 (3,818,846) 4,974,7305,557,405 5,557,405
11,801,670 (2,759,824) 9,041,8469,809,129 9,809,129

20 Operating lease commitments

At 31st March 2024 the foundation had total commitments under non-cancellable operating leases of land and buildings as set out below:

Payable as follows: 2024 2023
£ £
Up to one year 34,290 34,290
45,720
Two – five years 102,870 137,160 102,870 137,160
More than five years - -

Lease payments expensed in the year are disclosed in note 11.

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----- Start of picture text -----
Dr Paul Mulholland with Siobhain McDonagh MP,
whose sister Margaret had glioblastoma
Photograph © Jack Hill, The Times
----- End of picture text -----

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75 The National Brain Appeal Report & Accounts 2023-24

Contact us

To find out more, please visit nationalbrainappeal.org

[@BrainAppeal]

[TheNationalBrainAppeal]

[brain_appeal]

[The National Brain Appeal]

The National Brain Appeal 3rd Floor, Ormond House 26-27 Boswell Street London WC1N 3BG

T 020 3448 4724

Registered charity no. 290173

Right: The National Hospital patient and artist, Christopher Samuel at the A Letter in Mind exhibition Photograph © Marie Mangan

CONTENTS • TRUSTEES’ REPORT • INDEPENDENT AUDITOR’S REPORT • FINANCIAL STATEMENTS

76 The National Brain Appeal Report & Accounts 2023-24