2024-03-31-accounts

Annual report and accounts for the year ended 31 March 2024

Contents

Trustees’ report	3
Chair’s welcome	3
About the British Liver Trust	4
Meet the Children’s Liver Disease
Foundation	5
Support for everyone	6
Our nurse helpline changes lives	8
Raising awareness, tackling stigma	10
Our virtual support groups connect people, wherever they are	12
Improving early diagnosis	14
Our Love Your Liver roadshow has
its busiest year ever	16
Driving change in healthcare and policy	18
Partnering on research and involving
patients	20
Our fundraising approach	22
Financial review	24
Statement of trustees’ responsibilities	28
Independent auditor’s report	29
Financial statements	32
Notes to the fnancial statements	35

Reference and administrative details

Chairman

Alastair King DL

Chief Executive Officer Pamela J Healy OBE

Trustees

Alastair King DL Sally Benatar QPM Diana Gornall Abigail Jesson Toby McMaster David Meek (resigned 9 October 2023) Professor Steve Ryder Victoria Sheriff Professor Douglas Thorburn Graham Warner (Treasurer – appointed 26 June 2023) Wim (William) Bushell Professor Richard Thompson (1 April 2024) Georgina Catt (1 April 2024) Dr Ahmed Elsharkawy (appointed 10 July 2024)

Principal Office

1st Floor Offices, Venta Court 20 Jewry Street, Winchester SO23 8FE

Company Registration Number 2227706

Charity Registration Number 298858 (E&W), SC042140 (Scotland)

Bankers

CAF Bank, PO Box 289 West Maling, Kent ME19 4TA

NatWest, 2 Tavern Street, Ipswich, Suffolk IP1 3BD

Auditor

Hopper Williams & Bell Ltd Chartered Accountants & Statutory Auditors Highland House, Mayflower Close, Chandlers Ford, Eastleigh, Hampshire, SO53 4AR

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Trustees’ report

Chair’s welcome

Welcome to the British Liver Trust’s annual report and accounts for the year ended 31 March 2024.

We ended an actionpacked year by taking a big step for the future – agreeing a merger with the Children’s Liver Disease Foundation, which took place on 1 April 2024. Turn to page 5 to meet the team. By bringing together our combined passion, resources, and expertise, we aim to reach and support even more people and become a more powerful voice to improve the quality of care for children and adults with a liver condition.

Staff, senior management and Trustees of both charities are already working together on a vision for the integrated charity. In the meantime, all the services and activities provided by both charities will continue.

Collaboration underpins a great deal of the Trust’s success. Whether that’s between our teams or working with outside organisations, our impact is much more than the sum of its parts.

A perfect example is our Love Your Liver roadshow. Our new unit was on the road across the UK this year, supported by colleagues from across the Trust as well as volunteers and local NHS teams. I was delighted to welcome the roadshow to the Old Bailey in London in July and see the team in action, raising awareness of liver health and providing free scans for the 76 visitors.

Our roadshow team plays an important role in our political influencing. As well as supporting high profile events at Holyrood and Westminster, Love Your Liver helps us engage policy-makers at a local level. MPs often visit the roadshow when it’s in their area.

Getting a scan brings alive the importance of early diagnosis – and seeing the engagement from their constituents underlines how important this issue is for so many people.

This year we have seen that engagement bear fruit, with successful campaigns to expand viral hepatitis testing in England, uprate Minimum Unit Pricing and reinstate a pathway for faster diagnosis of liver cancer in Scotland.

Our policy and influencing work builds on a rising tide of increased public awareness of liver health and liver disease. Our communications team secured high profile broadcasts on both ITV and the BBC this year, and hit the headlines online and in print 780 times.

Sadly, it isn’t only awareness of liver disease that’s increased over the last few years. Liver disease deaths skyrocketed during the pandemic, and they show no sign of falling.

This means there is more need than ever for our information and support services, especially in the context of people not being able to see their doctor. Our committed team of nurses have been helping people with increasingly complicated enquiries. While the information and support section of our website was viewed over 2.9 million times.

I am proud to tell people I’m the Chair of such a dynamic and impactful organisation. My thanks to everyone who makes this happen, our dedicated staff, fantastic volunteers, and amazing fundraisers and donors.

Alastair King, September 2024

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Trustees’ report

About the British Liver Trust

The British Liver Trust is the leading charity for adults with liver disease or liver cancer in the UK. Our mission is to transform liver health by improving awareness, prevention, care and support.

As well as our own activities, we also play a key role in bringing together the wider community. The UK Liver Alliance (UKLA) is a coalition of over 30 organisations dedicated to improving liver health. Our CEO, Pamela Healy OBE, is proud to chair the Alliance. “By working together, we are more than the sum of our parts and can speak that much more loudly to government, ensuring liver disease is not forgotten.”

Alcohol-related liver disease deaths

rose by a shocking 46%

between 2012 and 2022.

Most of that rise was between 2019 and 2022, with a 31% increase over those 3 years

1,143 people

were newly diagnosed with hepatitis B in the first 12 months of a pilot that tested people in A&Es.

This suggests rates of hepatitis B in the UK are much higher than previously thought

50 people died from liver disease or liver cancer every day in 2022

Total deaths for each nation

UK 18,246 England 14,682 Northern Ireland 581 Scotland 1,926 Wales 1,057

Around 1 in 8 people

in the UK are affected by the more serious form of fatty liver disease, metabolic dysfunction-associated steatohepatitis (MASH)

Last year the waiting list for liver transplants was the biggest it has ever been, with 818 on the list

Our extended strategy 2021 to 2025

• Support everyone affected by liver disease and liver cancer.

• Improve early detection so more people are diagnosed at a stage when the damage can be reversed.

• Drive up standards of care and improve outcomes for people affected by liver disease and liver cancer.

• Increase awareness and improve people’s understanding of liver disease and liver cancer and reduce stigma.

• Campaign for policy changes that make it easy for everyone to be healthier.

• Work in partnership to support research and ensure patients are part of the conversation.

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Trustees’ report

The British Liver Trust and the Children’s Liver Disease Foundation become one big family

The liver disease community deserve a strong champion. An organisation with deep understanding of their needs who can speak loudly on their behalf and make change happen. So in summer 2023, the British Liver Trust and the Children’s Liver Disease Foundation opened discussions that would lead to our merger in April 2024.

The more our organisations talked, the more sense it made to combine our forces into one organisation. By coming together, we can more effectively support people though their whole liver disease journey. We also reduce duplication of effort, for example with representation on government boards and committees, and with administrative, fundraising, compliance and regulatory activities.

Key operations and communications colleagues in both organisations worked intensively to support the legal, financial and logistical aspects of our merger in the run up to April. Our staff were all brought on board in January 2024, with joint meetings taking place to announce the merger and introduce the organisations to one another.

The process of getting to know each other continues. Both organisations will continue to deliver their activities and services. While in the background we together tackle the task of aligning around a shared vision, mission, strategy and identity. The British Liver Trust are extending our 2021 – 2024 strategy for a year, while this important groundwork takes place.

We are looking forward to working with all our stakeholders to maximise the benefits and opportunities of the merger.

The Children’s Liver Disease Foundation’s services team at the British Transplant Games.

The Children’s Liver Disease Foundation will continue to support young people and their families in 3 key areas.

• A comprehensive and trusted information hub for young people, families and medical professionals.

• Specialist support for young people and their families, including one-on-one calls, confidential social media groups and online get-togethers.

• A campaigning voice for everyone affected, including the flagship Yellow Alert campaign for early identification of liver disease in newborns.

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Trustees’ report

Support for everyone

The British Liver Trust is here for everyone with liver disease or liver cancer and their loved ones. Our online and printed information helps people understand their diagnosis. Our support groups and online forum connect people, sharing experiences and forming bonds. And our unique nurse helpline is on hand whether people have complex questions or just need someone to listen.

In 2023/24 our information and support provided a lifeline for thousands of people

Over Our online forum We ran Our helpline nurses received grew by 108 support 70,000 24% group sessions copies to a total of with a total of of our resources 4,821 were ordered or 36,272 1,244 enquiries downloaded members attendees

Living well with liver disease

We know that liver disease doesn’t just affect your liver. It impacts people’s whole lives - from food to family to finances. So, we created a comprehensive new web resource that covers all these topics and more, to help people live the best life possible with

liver disease. It also includes information specifically for family members and carers.

To make sure the information is accurate, engaging and useful we

worked with patients, family members, and a range of healthcare professionals including hepatologists, dietitians and physiotherapists, as well as social workers and other experts.

We launched the new Living with a liver condition section on 1[st] February 2024, and in the first 3 months there were 126,000 views. When asked to rate the information, the vast majority of visitors agreed it was easy to understand (93%) and that they could find what they needed (83%).

“When I was initially diagnosed I had no idea about my disease. I googled a lot and found the British Liver Trust. Wow the website was amazing and answered so many questions for me and any ‘myths’ I had googled. Since then I have been more informed and asked more questions of my consultant.

I’ve attended regular online support groups set up by the Trust which greatly help bring people together to share their many experiences.

The British Liver Trust are amazing and without such an informative and easy to use website, plus calls to their wonderful helpline nurses, I think many people would find it difficult to deal with the many questions and feelings that you go through with liver disease.”

Jen lives with autoimmune hepatitis

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Trustees’ report

Our mission to host in person support groups at all 7 UK liver transplant centres

Finding out you need a transplant is a scary time for patients and their loved ones. There is a lot to take in – especially for people who are very poorly. And the psychological and emotional side of waiting for the call takes a toll.

In 2023/24 we launched a 5 year project to offer in-person support for everyone going through a liver transplant. We aim to have an in-person Support Group meeting every 3 months at each of the 7 UK centres for liver transplant. We are working in partnership with medical staff at the centres, so as well as meeting people in a similar situation, patients will have an opportunity to ask questions and get information about their care from a medical professional.

This year we held the first meeting of our new support group at the Freeman Hospital in Newcastle. And we held 4 meetings of our group based at the Royal Infirmary of Edinburgh.

Art project helps people come to terms with liver cancer

In February participants in our liver cancer support group were invited to a unique event that aimed to aid understanding of liver health, liver disease, and liver cancer, through art.

The event was hosted by researchers from the University of Birmingham and the National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre (BRC). Artist Dr Felicity Inkpen, artist in residence at the BRC, led an immersive art session. Dr Inkpen, a former scientist, loved

how integral the patient experiences have been for the researchers in the project. She says that “through the motor action of making marks and doing drawings, you can free up new ways of thinking and new paths of conversation”.

Patients were encouraged to use painting as a medium to express their journey and hopes. Their creations during the project will be exhibited at the Centrala Gallery in Birmingham in June 2024.

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Trustees’ report

Our nurse helpline changes lives

Kay’s story

“I am confident the helpline nurses have helped me change the course of my liver disease for the better and it feels like a bit of a miracle.

I have a very demanding job and I really didn’t have the energy to be cooking so started eating more and more takeaways. I know now this was a form of self-neglect – when you’re that busy you put yourself down the bottom of the list.

In 2022 I had a scan for something else which spotted the fatty liver. I had another test and was again told I had a fatty liver. My doctors seemed quite relaxed about my diagnosis. Surely if it was something serious, they would have said.

Then I started getting stabby pains in my stomach and my blood test results showed my ALT level, a marker for liver damage, kept climbing. I was referred to a gastroenterologist who asked for a FibroScan. Then literally on Christmas Eve I got a letter from the hospital saying I was at the advanced stage of liver damage and there wasn’t any way to repair it.

I was in shock reading the letter and more panicked the more I read about liver disease. I had so many questions but couldn’t get through to the consultant because it was so close to Christmas.

I started doing more research and read so many horror stories. But then I came across the British Liver Trust and called the nurse helpline. The nurse went through the letter with me, explained what the liver does and what fatty liver disease is in terms I understood. She didn’t sugarcoat the diagnosis but was also reassuring, saying: “Yes, this can become serious, but this is what you can do.”

I went for more tests and finally saw my consultant again in February. I was sad to hear that the liver damage was too advanced to ever be repaired or improved. I asked if there was any way I could get back to stage 1 of liver damage. He said no.

I called the British Liver Trust nurses afterwards and they said they had come across cases where people do improve. This gave me hope and I was determined to be one of those cases.

So I now had my motivation, but knowing that food is likely what got me into this situation did cause some anxiety around knowing what to eat. The nurses really helped with that too. I lost weight very quickly and was really enjoying the food. It was very Mediterranean based and felt like holiday food.

I lost nearly four stone and have successfully reversed my liver disease. Blood tests showed my ALT levels had gone from 275 down to 22 and my FibroScan results were 3.2Kpa in August 2023 down from 11.4kpa in November 2022!

I am one of the really lucky ones and it could have been very different. The British Liver Trust is an absolute asset and its nurses are the most helpful, insightful, empathetic and supportive professionals. I would have been lost without their input.

Every nurse I spoke to was not only knowledgeable, but also genuinely interested which made me feel heard and supported. They are one of the first people I contacted when I found out it had been reversed – they were as excited as I was which was lovely.”

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Trustees’ report

What makes our nurse helpline so special?

For patients and their family and friends our nurses provide a lifeline, especially when GP and hospital appointments are hard to get and clinicians don’t always have time to explain things. As well as sharing information and helping people understand their diagnosis, our nurses are there to support people with the emotional fallout.

Every member of our helpline team is a senior specialist nurse, making our service the only one of its kind in the UK. We can support callers with any type of adult liver disease including liver cancer, autoimmune hepatitis, transplant, gastroenterology and viral hepatitis. Excitingly this year we established an innovative new role in our team for a Macmillan Liver Cancer Nurse working within the British Liver Trust. Our new nurse will start later in 2024.

Nurse Manager Rebecca reflects on the increased complexity of enquiries over the last year.

“With people struggling to get in to see their doctor, I’m so glad we can be there for them. Often they’re calling about one thing, but that turns into a whole cascade of issues. Because we can support someone across multiple calls and emails, we can really help them get to grips with what’s happening and make the most of their doctor’s time.”

On average, calls last over 15 minutes, but an enquiry can take up to an hour and a half

The top 3 reasons On average, for contacting our nurses were calls last over 15 minutes, fatty liver disease, but an enquiry can take up to getting a diagnosis, and cirrhosis an hour and a half Enquiries grew by In total our nurse team spent around 16% over the year to a 2,000 hours total of 4,821 handling enquiries

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Trustees’ report

Raising awareness, tackling stigma

Liver disease and liver cancer are a big problem too few people have heard of. This lack of awareness contributes to late diagnosis, a lack of prevention, and patients facing stigma on a daily basis. The British Liver Trust continue to shout about liver disease. We’ve had an incredible year for media coverage and we even went viral, racking up half a million views of our fatty liver stages video on our new TikTok channel.

The British Liver Trust Our Liver Cancer UK website website was viewed nearly had more than 2.2 million times 160,000 views

22,669 people receive our monthly InTouch email newsletter

Across our social media channels we have more than 30,000 followers including 12,823 on Facebook and 3,652 on TikTok

Our media work generated 780 stories which could have been seen over 600 million times

Good Morning Britain

Following over six months of discussions and planning, we are delighted that Good Morning Britain broadcast a significant piece about liver disease featuring the British Liver Trust on 17th October.

In the lead up to this broadcast, we invited Dr Hilary Jones along to our Love Your Liver roadshow to find out about our work and in particular how we use FibroScan to detect early signs of liver damage. Dr Hilary’s scan and conversation with British Liver Trust nurse Kirsty featured in the programme.

Additionally, we worked with Professor Steven Ryder and Nottingham University Hospital Trust to have the ITV crew broadcasting from the hospital on the morning of the interview.

The main piece included an interview with a British Liver Trust spokesperson and was supported with a shorter news piece each hour – at 6am, 7am and 8am.

With viewing figures in the millions, this coverage was an excellent opportunity to focus attention on the liver and help viewers understand how to look after theirs – and what to do if anything might be wrong. We were also able to highlight our Make Early Diagnosis Routine campaign which calls for an assessment of fibrosis to be available throughout the UK.

Good Morning Britain presenter, Dr Hilary Jones, with our Chief Clinical Advisor Professor Steven Ryder

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Trustees’ report

Challenging stigma and sharing information on World Hepatitis Day

On 28[th] July we marked World Hepatitis Day with a big splash. The day aims to raise awareness of hepatitis B and C and improve life for people living with the conditions.

Our social media campaign aimed to bust myths about hepatitis B and combat stigma. This included patient Amanda who shared her story of ‘walking in darkness’ after being diagnosed in 2019. Amanda now proudly talks

about her condition to shine a light and tackle stigma.

We also launched comprehensive new patient information on hepatitis B, which has since had 25,000 page views. And promoted a new NHS portal for people in England to get tested for hepatitis C.

Bringing liver health awareness to your community

Our outreach team deliver liver health awareness events across the country. Held in community venues from libraries to village halls, we’re out and about helping people know more about their liver and how to look after it.

We’re proud to be a founder member of the Bite Size Health Events organised by Betsi Cadwaladr University Health Board in North Wales. With lots of different organisations in attendance, they’re a one-stop-health-shop for locals. People can get their flu jab and come and chat to us and complete our liver health screener questionnaire at the same time.

In 2023/24 we attended over 35 community talks and events – online and in person.

Our campaign pledges to Stamp Out Stigma

We know that people with liver disease face stigma on a daily basis. Our anti-stigma work is a collective voice to challenge stigmatising behaviour and show the realities of living with liver disease.

In our second campaign, we shared people’s stories of the issues they have faced and in some cases of how they fought back. We took a joined-up approach, using other campaigns and opportunities to highlight specific areas of stigma, for example in both our World Hepatitis Day and our Alcohol

Awareness Week activity. Over the 4 month campaign, 2,546 people pledged to Stamp Out Stigma.

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Trustees’ report

Our virtual support groups connect people, wherever they are

Born out of necessity during lockdowns, our Virtual Support Groups are now a core part of our services. Being online, we can bring people together right across the UK – and welcome people who are too poorly to leave home. We’ve even had people logging in from hospital.

Our skilled team facilitate group conversations to share experiences, learn from, and support one another. Groups include alcohol-related liver disease, cirrhosis, genetic and autoimmune liver disease, and a group for family and carers.

“I wish I had known about the Support Groups when I was diagnosed. The experience of my transplant journey enabled me to help others on a similar road. One of the best things about these meetings is friendship and hearing the great news someone else has received a liver transplant.”

James

John’s story – I went from reluctantly attending my first Support Group to volunteering for the Trust

“From life being very enjoyable to being told you have a chronic liver disease - it was such a sudden shock.

I thought it was my fault. There was this guilt attached to it more than anything. When the doctor actually explained that haemochromatosis was a hereditary thing, something I wasn’t in control of, I was still wondering ‘well, how have I done it then?’.

I was a very private person so I wondered whether going along to a support group was really for me. Anyway, I went along and I’ve never looked back. They are a fantastic group of people. It’s like this bridge between the medical and emotional needs.

I gain so much from going to the Support Group, from helping other people as well as being helped myself. It just made me think what else I could do and since then I’ve just got more involved with the Trust. I know Julie in the Outreach Team pretty well now, and she’s always there to support me.

I’ve made a video about the Support Groups, helped with patient information and I volunteer to help at health awareness events or when the roadshow comes to town. It feels great to be helping so many other people and that’s what the Trust does – they help you when you need it. And because of that, now I’m in a position to help others which is the most wonderful feeling.”

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Trustees’ report

“Without this group I may have chosen to come off the transplant list. I am so thankful they were there to help me through it. The groups are a lifeline particularly for people living in a rural location with limited resources.”

Susan

“This group was a life saver for me. I joined as I was listed for transplant and it was amazing. I no longer felt alone. Now nearly 3 years on I’m able to help and support others.”

Chris

“The British Liver Trust’s Support Groups are full of laughter and everyone is so caring and open. I don’t think I would have been as positive without them. Sometimes you don’t know whether things are normal, but if you speak to someone who gets it, you feel less alone.”

Shona

“I always feel welcome in the group. When I was newly diagnosed it was a great place to tap into a wealth of experience, from people who really understood what I was going through. Now I’m helping others who are newly diagnosed.”

Chrissie

“The group made me realise that I was not alone. It gave me purpose and brought light back into my dark world.”

Amanda

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Trustees’ report

Improving early diagnosis

The liver has a fantastic ability to repair itself, which means that if caught early enough, liver disease can be reversed. But far too many people are only diagnosed when their liver disease has gone past the point of no return. Liver disease often has no symptoms in the early stages – to find it, we need to look for it.

Make Early Diagnosis Routine campaign is shifting the picture

----- Start of picture text -----
2020 2023
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36% of health bodies now have an early diagnosis pathway in place up from 26% in 2020

Wales and Scotland are making good progress with all 8 bodies in Wales and 9 of 14 in Scotland now green showing a full pathway in place

680 supporters wrote to their MP urging them to meet with the local health body

We met with 5 health bodies to discuss improvements in their local area

Finding liver disease early needs coordinated action across the NHS. That means a clear pathway including GPs and community health services as well as hospitals. Our campaign first mapped the places with a full, partial or no pathway in 2020.

Since then we have campaigned relentlessly for change. And thanks to hundreds of our supporters writing to their MP and urging them to raise the issue with their local health body, that change is starting to happen.

In 2023 we resurveyed health bodies and the proportion with a full pathway (green on the map) has risen from 26% to 36%. This is life-

changing, life-saving news. In these areas liver disease is much more likely to be diagnosed while there’s still time to change the outcome.

This work continues, most areas of the UK still do not have a full pathway. And England in particular shows a very mixed picture. Worryingly, areas with the highest levels of liver disease deaths, such as Manchester, still have no pathway at all.

We will publish our latest findings in 2024. Armed with clear evidence that change is both needed and possible, we will continue to push hard to make sure there’s a pathway in place for everyone.

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Trustees’ report

Raising awareness of vital liver cancer checks

In October our Liver Cancer Awareness Month campaign centred on surveillance – liver cancer checks for people with cirrhosis. Doctors recommend people with liver disease that puts them at higher risk of liver cancer have these checks every 6 months. They help find liver cancer at an early stage when it can often be cured.

We mailed awareness packs including posters and postcards to over 2,000 gastroenterologists and hepatologists to help them raise awareness of the checks with their patients. The resources were also available to download, along with an explainer animation co-produced with NHS England. We highlighted the key message that catching liver cancer early often means it can be treated and encouraged people not to miss out on their regular checks.

----- Start of picture text -----
Don’t miss out on your
regular liver scans
People with long-term liver disease have a higher chance of getting liver
cancer. When liver cancer’s found early, it can often be cured. If you live When liver cancer is
with a serious liver condition, you may be invited for an ultrasound scan
every 6 months. found early it can often
The scans are quick, they don’t hurt, and they can spot early signs of liver be cured.
cancer. It helps your healthcare team
keep an eye on your liver health too. A quick and painless surveillance scan every 6 months
liver helps find liver cancer. If you have serious liver disease,
don’t miss out. It’s important to go every time, even if you
feel well and your liver disease isn’t causing problems.
www.livercanceruk.org/find-it-early
----- End of picture text -----

----- Start of picture text -----
Liver Cancer UK is part of the British Liver Trust. Registered Charity in England and Wales 298858, in Scotland SC042140.
----- End of picture text -----

Successful lobbying reinstates faster liver cancer detection in Scotland

In 2023 we were pleased to see results showing a liver cancer detection pilot in Scotland was achieving its aims. It significantly sped up patient care, reducing the time for GPs to receive information about their patient’s imaging findings from nearly a month to just 1 day. And the average time for patients to be referred to an appropriate service halved from 44.5 days to 21.5 days.

So we were deeply concerned to learn that funding for the pilot had been stopped.

Working in partnership with clinicians including Ms Anya Adair, consultant and surgeon at Royal Infirmary Edinburgh, we urgently raised the issue with the Scottish Government and NHS Scotland.

We are delighted to report that our lobbying efforts were successful. Funding is back in place for the pilot to continue throughout 2024 and we will push to see this approach rolled out across Scotland afterwards.

“The British Liver Trust has played a crucial role throughout the development of this service. It has been so encouraging to hear from patients and healthcare professionals about the benefit it’s provided during their cancer journey.”

Ms Anya Adair, consultant and surgeon at Royal Infirmary Edinburgh

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Trustees’ report

Our Love Your Liver roadshow has its busiest year ever!

In 2023/24 our roadshow

Covered 4545 miles

Visited 18 different regions across the UK

Opened on 57 days

Demand is soaring for our Love Your Liver roadshow. Our Roadshow Manager, Emma, puts this down to a mix of good news and bad news. On the one hand increased awareness and interest in liver health among the public, and on the other, people struggling to get GP appointments.

After launching in March 2023, our new roadshow unit took to the road visiting all 4 UK nations – including a ferry trip to Belfast and Derry.

Visitors to the roadshow complete a health screener, to help them understand their risk of liver disease. They then have a free liver scan that checks for liver scarring, a tell-tale sign of liver damage. If the scan suggests there could be some damage, they are given a letter to take to their GP, asking them to follow up with more tests.

Our CEO Pamela Healy with Caral Ni Chuilin MLA, Sinn Fein

Of 4,309 visitors who had a free liver scan 1 in 10 (483) people’s results suggested liver damage

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We remember Alison Brind and thank her for her dedicated support

As a consultant hepatologist at University Hospitals North Midlands, Dr Alison Brind was all too familiar with the devastating impact of liver disease – especially when diagnosed at a late stage. She cared deeply that liver patients could get the treatment they needed.

Alison was a huge advocate for community screening and scanning, so we were delighted to have her team support us on the new roadshow unit she helped to fund when we visited Stoke-on-Trent in June 2023. Our 3-day tour of the area included a record-breaking day in Stafford, scanning 167 people thanks to phenomenal support from Alison and her team in the scanning rooms.

Determined that her legacy would improve people’s liver health in her local area, Alison donated funds for Stoke Love Your Liver events for the next 5 years.

Sadly Alison passed away in April 2024. We will miss her greatly, all our condolences to her family and liver unit team.

Partnering with NHS Lanarkshire to find liver disease earlier

In summer 2023 we partnered with NHS Lanarkshire to deliver 10 community liver health and scanning events using our new Love Your Liver roadshow unit. Visitors completed our liver health screener and were offered a free liver scan. Hepatitis C testing was also available for those found to be at risk.

In total 847 people visited one of these events, and 431 had a liver scan. Of these, 12% (52 people) had a result that showed they could have liver damage – including 16 with potentially more serious damage. Attendees were advised to see their GP or in some cases referred to the gastroenterology and liver service at University Hospital Hairmyres.

Visitors could also get information on a range of liver health issues, including alcohol, weight, diet and viral hepatitis. People could also find out about local financial and welfare support services. Or get referred to local alcohol and drug services if needed.

“By working together NHS Lanarkshire and the British Liver Trust aim to make a tangible difference to the lives of those affected by this silent yet potentially devastating disease.”

Jonathan Worsfold, Director of Service Delivery

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Driving change in healthcare and policy

Influencing policy makers relies on 3 things – engaging their attention, making a strong case, and keeping the pressure up. Our Policy and Public Affairs team have seen real success over 2023/24, with high profile events and activities from Westminster to the devolved national parliaments. And we couldn’t do it without our dedicated supporters and volunteers, from writing to MPs to speaking at events, it all makes a difference.

We tabled Our written evidence to the We held Health Committee’s future 80 cancer inquiry, April 2023, 3 parliamentary was spotlighted in Parliamentary events questions The Observer, the Guardian attended by a total of 101 across all Parliaments and Daily Mail parliamentarians

We held the We attended the first ever debate Conservative and on liver disease Labour Party and obesity conferences at Westminster Hall in June 2023

60 elected politicians backed our motions

Westminster liver health awareness event urges MPs to support early diagnosis

In January over 80 MPs and Peers attended our Love Your Liver Month event in Westminster. Attendees included the then Health Minister, Andrew Stephenson MP, and the opposition Health Minister at the time, Preet Kaur Gill MP.

Dawn Butler MP attending our Westminster event

Our scanning team were on hand, offering liver scans to MPs and demonstrating our work to directly support early diagnosis of liver disease. Our team engaged with parliamentarians on the need for early diagnosis, sharing the shocking statistic that 1 in 10 people scanned at our roadshow in 2023 showed signs of liver damage.

Statistics are a core part of our message, but nothing brings it to life like hearing from patients. We are immensely grateful to Monica, Emma and Gordon for sharing their stories on the day. Gordon, who was diagnosed with fibrosis during the pandemic, told MPs: “It was identified in time, which then gave me a chance to give up alcohol, which I did two years ago. If you get it [a diagnosis] early enough it can be reversible. It did take the shock of a diagnosis to make me change my lifestyle.”

Meeting MPs at events like this helps us make the case and shore up their support for when we need it. That could be sponsoring a debate, speaking up for liver disease patients in the House, or voting on legislation.

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“I want to shout about liver disease to everyone. That’s why I attended the British Liver Trust’s Westminster event as a patient advocate. I shared the trauma of my real-life story with people in power because hearing a patient talk about what they went through brings the facts and statistics surrounding liver disease to life.”

Emma spoke with MPs at our Westminster event in January

Campaigning to uprate Minimum Unit Pricing in Scotland

Following sustained advocacy and campaigning from the British Liver Trust and other charities the Scottish Parliament voted to increase minimum unit price (MUP) to 65 pence.

The policy had already demonstrated its effectiveness in tackling alcohol-related harm in Scotland, saving hundreds of lives. But to

remain effective, it needed to keep pace with inflation.

In the face of a surge in alcohol-related deaths, we advocated strongly for increasing MUP by 30%, as proposed by the Scottish Government. We submitted consultation responses and met with ministers, so we were delighted with the outcome of this work.

NHS viral hepatitis testing programme gets £20M for essential expansion

The NHS programme testing A&E patients for 3 blood-borne viruses – HIV, hepatitis B and hepatis C – diagnosed 2,000 people in its first year. However, the testing was only available in London, Manchester, Brighton and Blackpool.

The British Liver Trust joined forces with other key charities including the Terence Higgins Trust, Elton John Aids Foundation and the Hepatitis C Trust, to urge NHS England to expand the programme.

After months of sustained action, in November the UK Government announced an investment package of £20 million to cover a total of 46 A&Es in 33 areas including Birmingham, Portsmouth, Derby

and Peterborough. The programme aims to identify over a quarter of a million people estimated to be living with undiagnosed viral hepatitis in the UK.

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Trustees’ report

Partnering on research and involving patients

People with liver disease and liver cancer are at the heart of everything we do. From patient information to policy calls, we involve people with lived experience in all of our work.

Whether you are designing a trial or making government decisions, to find out what someone wants, you must ask them – to build what they need, you must involve them. This is our message to researchers and policy-makers, and we’re helping more and more such projects meaningfully include patients.

ICANEQUAL partnership unpicks inequality in liver cancer

Led by Mohamed Bekheit (NHS Grampian) and Sara Maclennan (University of Aberdeen), the ICANEQUAL project partners also include Egality and the British Liver Trust.

Funded by a National Institute of Health Research (NIHR) grant, it aims to uncover the barriers that stop underserved populations getting the same access to liver cancer diagnosis and care as their mainstream counterparts.

Across 3 workshops in 2023/24 the research team investigated different models of care, looked for the gaps, and identified priorities for the next stage of research. The British Liver Trust supported 3 patients to get involved.

The partnership team, including the British Liver Trust, will now submit a funding proposal to test ideas for community-based interventions to diagnose liver cancer earlier through screening and rapid diagnosis clinics.

A visual summary of ICANEQUAL’s work

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Trustees’ report

Participate B: Improving diagnosis and care for people living with hepatitis B

This innovative partnership, which includes the British Liver Trust, brings together clinicians with a range of expertise. It was important to the partnership that people with lived experience of hepatitis B were involved from the start.

The team worked with hepatitis B patients to understand the difficulties they face and test ideas for how things could be improved. There is no typical hepatitis B patient, this is an incredibly diverse group of people with wide-ranging circumstances and needs.

The British Liver Trust advised on patient involvement and delivered 2 focus groups – one online and one in person. To help recruit as wide a group as possible, we worked with

clinicians and peer supporters, as well as encouraging people attending our hepatitis B support group to get involved.

The partnership gathered feedback on their 2 main ideas to help people navigate their care – an app or a peer support worker. Patient involvement was critical in steering them towards the latter. Participate B will now apply for funding to support a research trial of peer support in hepatitis B.

As well as helping the Trust cement our ties with the hepatitis B clinical and research community, being involved in this research has helped inform our own thinking in developing our hepatitis B programme.

“This research absolutely relies on listening to people with hepatitis B. Involving as many patients as possible has been crucial in steering our decisions – and will continue to be in the next stages.”

Ahmed Elsharkawy, Consultant Hepatologist and Lead Investigator

‘Liver talks’ resource helps clinicians talk to their patients about liver disease risk

Launched in January, this new training toolkit was developed by the Vocal Liver Network in collaboration with the British Liver Trust. The resource was created as part of the Integrated Diagnostics for Early Detection of Liver Disease (ID LIVER) project led by the University of Manchester and Manchester University NHS Foundation Trust.

The toolkit has everything healthcare professionals (HCPs) need to self-deliver the session, including a timed session plan, presentation and an animation based on real people’s stories. The toolkit aims to bring to life both people’s desire to understand

and own their health, as well as the best tactics for HCPs to do so sensitively and appropriately for someone’s situation and cultural background.

A clip from the animation, based on real people’s stories

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Trustees’ report

Our fundraising approach

Thank you to every single donor and funder who supports our work. Our strategy is to create sustainable income for the charity by raising funds from a wide range of sources – charitable trusts and foundations, companies, community activity and individual donors.

Every fundraiser, gift and grant allows us to empower and support patients and loved ones, to provide trusted information and guidance to all liver disease patients, and to campaign for long term change.

This year we have again had incredible support from individuals running, cycling, baking and wing walking. Along with donations and grants from companies and charitable trusts, this ensures we can deliver our work, and plan for the future.

It feels like there was a big focus on physical challenges this year, with runners of all distances, cyclists and walkers, including a wonderful team trekking the Three Peaks.

The London Marathon is always a highlight, and 2023 was no exception. Places are always in high demand and our incredible team raised over £18,500.

Our Leg it for Liver campaign in the spring allows supporters to choose their own distance to walk, run or cycle. And for those who prefer a more sedate form of fundraising we had several coffee mornings and bake sales – always a popular way to raise funds.

Gifts range from small, regular monthly donations, such as our £1-a-week Lottery, through to very kind supporters who remember us in their Will. Legacy income has grown in recent years thanks to supporters appreciating the impact such a gift can make, to a cause they care about.

Last but by no means least, we are grateful to have so many funders who know and understand the value of our work. From the National Lottery to our Trust funders and corporate donors, we develop lasting relationships based on demonstrable impact.

We were delighted to achieve our income targets again this year.

Thank you to all of our donors and funders.

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Trustees’ report

Due to limitations on space, we have only included by name those funders who have given grants of over £2,500 this year, but we are grateful for each and every grant. Thank you.

Advanz Pharma

AstraZeneca UK

Banham Foundation Limited

Bank of Scotland Foundation

Boston Scientific

British Association for the Study of the Liver British Society of Gastroenterology

Pilkington Charities Fund Robert Luff Foundation Limited

Roche Pharma

Roger Raymond Charitable Trust Schroder Charity Trust

Siemens plc

Sir James Knott Trust

Chiesi

Echosens (UK)

Eisai

Eveson Charitable Trust Garfield Weston Foundation

Gilead

Grifols UK Ltd

Harry Cureton Charitable Trust

Incyte Biosciences

Ipsen Solutions Ltd

Mark Benevolent Fund

Maureen Boal Charitable Trust

National Lottery Community Fund England

National Lottery Community Fund Northern Ireland

National Lottery Community Fund Scotland

Norgine

P F Charitable Trust Pfizer UK

Sir Jules Thorn Charitable Trust

Sylvia Aitken Charitable Trust

Takeda UK Ltd

The 29th May 1961 Charity

The Adint Charitable Trust The Annandale Charitable Trust The Childwick Trust

The February Foundation

The Foundation for Liver Research The Henry Lumley Charitable Trust The Hugh Fraser Foundation The Murdoch Forrest Charitable Trust The Reed Foundation

The Shears Foundation

The Simon Gibson Charitable Trust The Souter Charitable Trust

The Waterloo Foundation Walter Lees Foundation

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Trustees’ report

Financial review

In 2021 we set out a financial strategy for growth, using previously accumulated reserves to develop both charitable activities and fundraising capability. The deficit for the year to 31 March 2024 of £80,773 is a much improved result than the previous year and enables the British Liver Trust to take greater reserves than anticipated forward into 2024/25. This is extremely useful given our merger with Childrens’ Liver Disease Foundation on 1 April has inevitably incurred some additional costs before we achieve the consequent savings of combining two organisations.

The chart below shows the Trust’s growth over the past 8 years and our utilisation of previous years’ surplus. Our budget for 2024/25 reflects our intention to continue this growth as well as the contribution brought by the merger.

Income and Expenditure Trends

----- Start of picture text -----
2,000,000
1,600,000
1,200,000
800,000
400,000
Income
0 Expenditure
Actual Actual Actual Actual Actual Actual Actual Actual
2016/17 2017/18 2018/19 2019/20 2020/21 2021/22 2022/23 2023/24
----- End of picture text -----

Income

The next chart shows income from different sources and the growth of each of those strands. Grants from the statutory sector ceased in 2023/24, whilst corporate income includes the hire of our Love your Liver unit, including to NHS bodies, hence the increase in this income stream. A significant percentage of the increase in income from individuals, though not all, relates to one person in particular, as has been highlighted previously in this report. The recruitment of a very able Trust Fundraising Manager, now supplemented by an assistant, has ensured that income from charitable trusts continues to grow. Our income from legacies has been strong this year. Trustees will review our reserves policy at the AGM to determine whether we still need to treat this area of income as any higher risk than others, and therefore whether we still require a legacy equalisation fund. Other income includes patient liaison work on behalf of research, and this area has grown over the year.

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Trustees’ report

----- Start of picture text -----
600,000
550,000
500,000
450,000
400,000
350,000
300,000
250,000
200,000 2018/19
2019/20
150,000
2020/21
100,000
2021/22
50,000 2022/23
0 2023/24
Publications Trusts Corporate Community In Mem Individuals Legacies Statutory Other
Grants
----- End of picture text -----

Expenditure

Approximately 81% of our expenditure was for our charitable purposes, whilst 19% was spent raising funds to provide more services.

Fundraising

The charity employs a small team of fundraisers to secure charitable grants and donations across the income streams shown in the graph above. The fundraising strategy is developed by the Director of Fundraising and agreed by the Chief Executive and Trustees. Professional fundraisers are used on a time-limited project basis, under the management and monitoring oversight of our Director of Fundraising.

We are registered with the Fundraising Regulator and are members of the Chartered Institute of Fundraising and comply with all voluntary regulation of these bodies. We have received no fundraising complaints during the year or previous year. We comply fully with data protection legislation and our Director of Fundraising and Data & Digital Manager plan and monitor all activity to ensure that there is no activity which puts vulnerable people and other members of the public at risk of intrusion of privacy. Our activity is measured and does not place undue pressure on supporters to give money or other assets.

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Trustees’ report

Reserves

At 31 March 2024 the charity held £912,025 in reserves, (2023 £992,798) of which £238,402 (2023 £127,563) represents funds restricted in their use by the donor. In accordance with the reserves policy, the Board of Trustees have designated £127,014 (2023 £367,859) of the unrestricted reserves for future use as follows:

Growth Investment Fund

In previous years we have designated a fund to cover budgeted deficits, in accordance with our operating strategy. We have a deficit budget for 2024/25, but the trustees have agreed that we will then aim for balanced budgets and therefore there is no set aside of reserves to meet this or future deficits (2023 £314,065)

Legacy Equalisation Fund

The charity includes legacy income in its budget, but recognises this as a point of risk, due to the unpredictability of this income stream. Trustees have therefore set aside earlier positive budget variances for legacies to cover future negative variances. Legacy income was £73,220 above budget for 2023/24 and this amount has therefore been added to the legacy equalisation fund, leaving it at £127,014 at 31 March 2024 (2023 £53,794).

The Trustees’ policy is to hold non-designated unrestricted reserves of 3 to 6 months budgeted expenditure, having adjusted that expenditure for restricted funds held that will contribute towards it. At 31 March 2024 the non-designated unrestricted reserves held by the charity were £546,609 (2023 £497,376) which amounts to 3.5 months such expenditure (pre-merger).

Going Concern

As outlined, the Trust has both the reserves and the strategic planning to be able to assure its status as a going concern. The current 3 year rolling budget predicts that unrestricted reserves will remain at more than 3 months expenditure throughout that 3 year period and cashflow forecasts show that liquidity will not be an issue.

Investment Policy

The Trust holds its funds in a range of low risk current and deposit accounts with varying notice periods and interest rates, with the aim of maximising interest whilst ensuring liquidity. Deposits of over 90 days are shown as current asset investments on the balance sheet and amount to £209,590 (2023 £488,454). Deposits over 12 months are shown as fixed assets investments on the balance sheet and amount to £108,933 (2023: £nil).

Structure, Governance and Management

The charity is a company limited by guarantee and a charity registered with the Charities Commission in England and Wales and the Scottish Charity Regulator. Its governing document, updated during 2021/22, is the Memorandum and Articles of Association registered with Companies House. The charity is governed by the Board of Trustees, although operational matters are delegated to the Chief Executive, Pamela Healy OBE, who has been in post throughout the year, along with Directors of Finance and Operations, Alison Orman, Communications and Policy, Vanessa Hebditch, Fundraising, Audrey Cornelius and Service Delivery, Jonathan Worsfold.

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Trustees’ report

A full Board meeting is held four times a year, attended by the Executive Team, with reports received from other managers and staff members. The Audit and Risk Committee meets before every Board meeting and at other times as matters relating to financial and risk governance arise. A remuneration committee also meets once a year to agree general pay scales and cost of living rises and to discuss executive pay.

Prospective trustees are selected following a full recruitment process including an application and an interview with the Nominations Committee. New trustees receive a full induction pack with information pertaining to both the charity and the role of a trustee. They also have an induction meeting with the CEO and each of the senior management team. A new treasurer has been appointed during the year and the trustees are satisfied that the financial expertise on the Board is now sound.

Risk

The Trust has a risk register which is a living document, updated regularly by the Director of Finance and Operations as new risks are recognised and mitigations required. The register is reviewed by the Audit and Risk Committee at each meeting following an update, and by the Board of Trustees at least annually. In these reviews the trustees are keen to ensure that residual risk has been reduced to a level they are content with and support the Executive Team in ensuring that this happens. A separate risk register was developed in connection with the merger that has taken place since the year end and a combined risk register is being developed.

Public Benefit

The trustees confirm that they have had regard to the Charity Commission’s guidance on public benefit when reviewing the Trust’s aims and objectives and in planning future activities and setting the policies for the year.

Events since the End of the Year

On the 1 April 2024 Children’s Liver Disease Foundation (CLDF) and British Liver Trust merged to combine resources. The legal nature of the merger was that British Liver Trust has taken over the assets, liabilities and responsibilities of CLDF, which joined British Liver Trust with restricted funds of £58,707, designated funds of £60,000 and unrestricted funds of £369,390. For the present, CLDF and British Liver Trust will maintain their external identities, whilst the trustees and senior management team develop a strategy and branding identity for the combined organisation.

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Trustees’ report

Statement of trustees’ responsibilities

The trustees (who are also the directors of British Liver Trust for the purposes of company law) are responsible for preparing the trustees’ report and the financial statements in accordance with the United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) and applicable law and regulations.

Company law requires the trustees to prepare financial statements for each financial year. Under company law the trustees must not approve the financial statements unless they are satisfied that they give a true and fair view of the state of affairs of the charitable company and of its incoming resources and application of resources, including its income and expenditure, for that period. In preparing these financial statements, the trustees are required to:

• select suitable accounting policies and apply them consistently;

• observe the methods and principles in the Charities SORP;

• make judgements and estimates that are reasonable and prudent;

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

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

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

The annual report was approved by the trustees of the charity on 16th September 2024 and signed on its behalf by:

Alastair King DL Chair of Trustees

28

Independent Auditor’s Report

Independent Auditor’s Report to the Members of British Liver Trust

Opinion

We have audited the financial statements of British Liver Trust (the ‘charitable 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 a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

• give a true and fair view of the state of the charitable company’s affairs as at 31 March 2024 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended;

• have been properly prepared in accordance with United Kingdom Generally Accepted Accounting Practice; and

• have been prepared in accordance with the requirements of the Companies Act 2006.

Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditors’ responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the ethical requirements that are relevant to our audit of the financial statements in the 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 trustees are responsible for the other information. The other information comprises the information included in the Annual Report, other than the financial statements and our Report of the Independent Auditors thereon.

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.

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Independent Auditor’s Report

In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006

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

• the information given in the Report of the Trustees for the financial year for which the financial statements are prepared is consistent with the financial statements; and

• the Report of the Trustees has been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception

In the light of the knowledge and understanding of the charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Report of the Trustees.

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:

• adequate accounting records have not been kept or returns adequate for our audit have not been received from branches not visited by us; or

• the financial statements are not in agreement with the accounting records and returns; or

• certain disclosures of trustees’ remuneration specified by law are not made; or

• we have not received all the information and explanations we require for our audit.

Responsibilities of trustees

As explained more fully in the Statement of Trustees’ Responsibilities, 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.

Our 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 a Report of the Independent Auditors 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

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Independent Auditor’s Report

and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

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

• We obtained an understanding of the legal and regulatory frameworks that are applicable to the company, and the industry in which it operates. These include but are not limited to compliance with the Companies Act 2006, UK Generally Accepted Accounting Principles and the relevant tax compliance regulations for the company.

• We obtained an understanding of how the company is complying with these frameworks through discussions with management.

• We enquired with management whether there were any instances of non-compliance with laws and regulations or whether they had knowledge of actual or suspected fraud. These enquiries are corroborated through follow-up audit procedures including but not limited to a review of legal and professional costs, correspondence and a review of board minutes.

• We assessed the susceptibility of the company’s financial statements to material misstatement, including the risk of fraud and management override of controls. We designed our audit procedures to respond to this assessment, including the identification and testing of any related party transactions and the testing of journal transactions that arise from management estimates, that are determined to be of significant value or unusual in their nature.

• We assessed the appropriateness of the collective competence and capabilities of the engagement team, including consideration of the engagement team’s knowledge and understanding of the industry in which the company operates in, and their practical experience through training and participation with audit engagements of a similar nature.

A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at www.frc.org.uk/auditorsresponsibilities. This description forms part of our Report of the Independent Auditors.

Use of our report

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

Michaela Johns FCCA

(Senior Statutory Auditor)

For and on behalf of Hopper Williams & Bell Limited, Statutory Auditor Highland House, Mayflower Close, Chandler’s Ford, Eastleigh, Hampshire, SO53 4AR

Date: 16th September 2024

31

Financial statements

Statement of Financial Activities for the Year Ended 31 March 2024

(Including Income and Expenditure Account)

		Unrestricted	Restricted	Total	Total
		funds	funds	2024	2023
	Note	£	£	£	£
Income and Endowments from:
Donations and legacies	2	1,104,186	625,105	1,729,291	1,529,403
Charitable activities	3	42,307	-	42,307	31,717
Investment income	4	21,427	-	21,427	10,742
Total Income		1,167,920	625,105	1,793,025	1,571,862
Expenditure on:
Raising funds		(360,370)	-	(360,370)	(356,559)
Charitable activities	5	(1,001,186)	(512,242)	(1,513,428)	(1,401,021)
Total Expenditure		(1,361,556)	(512,242)	(1,873,798)	(1,757,580)
Net income / (expenditure)		(193,636)	112,863	(80,773)	(185,718)
Transfers between funds		2,024	(2,024)	-	-
Net movement in funds		(191,612)	110,839	(80,773)	(185,718)
Reconciliation of funds
Total funds brought forward		865,235	127,563	992,798	1,178,516
Total funds carried forward	20	673,623	238,402	912,025	992,798

All of the charity’s activities derive from continuing operations during the above two periods. The funds breakdown for 2024 is shown in note 20.

32

Financial statements

Balance Sheet as at 31 March 2024

Company registration number: 02227706

	Note	2024	2023
Fixed assets		£	£
Tangible fxed assets	11	56,671	78,541
Fixed asset investments	12	108,933	-
		165,604	78,541
Current assets
Stocks	13	6,086	7,995
Debtors falling due within one year	14	275,532	183,433
Debtors falling due after more than one year	14	8,829	8,829
Current asset Investments	15	209,590	488,454
Cash at bank and in hand		422,352	395,075
		922,389	1,083,786
Creditors: Amounts falling due within one year	16	(175,968)	(169,529)
Net current assets		746,421	914,257
Net assets		912,025	992,798
Funds of the Charity:
Restricted funds		238,402	127,563
Unrestricted income funds
Board designated funds		127,014	367,859
Unrestricted funds		546,609	497,376
Total funds	20	912,025	992,798

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

The financial statements on pages 32 to 51 were approved by the trustees, and authorised for issue on 16th September 2024 and signed on their behalf by:

Graham Warner Trustee

33

Financial statements

Statement of Cash Flows for the Year Ended 31 March 2024

		2024	2023
	Note	£	£
Cash fows from operating activities
Net cash (expenditure)/income		(80,773)	(185,718)
Adjustments to cash fows from non-cash items
Depreciation & loss on disposal of assets	7	23,726	23,705
Investment income	4	(21,427)	(10,742)
		(78,474)	(172,755)
Working capital adjustments
(Increase)/Decrease in stocks	13	1,909	(504)
(Increase)/Decrease in debtors	14	(92,099)	12,574
Increase/(Decrease) in creditors and deferred income	16	6,439	18,731
Net cash fows from operating activities		(162,225)	(141,954)
Cash fows from investing activities
Interest receivable and similar income	4	21,427	10,742
Purchase of tangible fxed assets	11	(1,856)	(74,998)
Net cash fows from investing activities		19,571	(64,256)
Net decrease in cash and cash equivalents		(142,654)	(206,210)
Cash and cash equivalents at 1 April		883,529	1,089,739
Cash and cash equivalents at 31 March	22	740,875	883,529

All of the cash flows are derived from continuing operations during the above two periods.

34

Notes to the financial statements

Notes to the Financial Statements for the Year Ended 31 March 2024

1 Accounting policies

Summary of significant accounting policies and key accounting estimates

The principal accounting policies applied in the preparation of these financial statements are set out below. These policies have been consistently applied to all the years presented, unless otherwise stated.

Statement of compliance

British Liver Trust is a registered charity, registration number 298858 (E&W), SC042140 (Scotland), company number 2227706, registered in the United Kingdom. The address of the charity is given in the reference and administrative details on page 2 of these financial statements. The nature of the charity’s operations and principal activities are described in the Trustees’ annual report.

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 Financia es Accounts (Scotland) Regulations 2006 (as amended) the Charities Act 2011 and UK Generally Accepted Practice as it applies from 1 January 2015.

Basis of preparation

The charity constitutes a public benefit entity as defined by FRS 102.

The financial statements are prepared on a going concern basis under the historical cost convention, modified to include certain items at fair value. The financial statements are prepared in sterling which is the functional currency of the charity and rounded to the nearest £.

Going concern

The financial statements have been prepared on a going concern basis. The trustees have considered the level of funds held and the expected level of income and expenditure for 12 months from authorising these financial statements and it is clear that the charity is able to continue as a going concern.

35

Notes to the financial statements

Income and endowments

Voluntary income including donations, gifts, legacies and grants that provide core funding, or are of a general nature, is recognised when the Charity has entitlement to the income, it is probable that the income will be received and the amount can be measured with sufficient reliability.

Grants

Grants relating to revenue are recognised in income over the period in which the related costs are recognised.

Donations and legacies

Donations are recognised on a receivable basis when receipt is probable, and the amount can be reliably measured. For legacies, entitlement is taken as the earlier of the date on which either: the charity is aware that probate has been granted, the estate has been finalised and notification has been made by the executor to the charity that a distribution will be made, or when a distribution is received from the estate. Receipt of a legacy, in whole or in part, is only considered probable when the amount can be measured reliably. Where legacies have been notified to the charity, or the charity is aware of the granting of probate, and the criteria for income recognition have not been met, then the legacy is a treated as a contingent asset and disclosed if material.

Investment income

Investment income is recognised on a receivable basis.

Charitable activities

Income from charitable activities includes income recognised as earned (as the related goods or services are provided) under contract.

Expenditure

All expenditure is recognised once there is a legal or constructive obligation to that expenditure, it is probable settlement is required and the amount can be measured reliably. All costs are allocated to the applicable expenditure heading that aggregate similar costs to that category. Where costs cannot be directly attributed to particular headings they have been allocated on a basis consistent with the use of resources.

Raising funds

These are costs incurred in attracting voluntary income.

Charitable activities

Charitable expenditure comprises those costs incurred by the charity in the delivery of its activities and services for its beneficiaries. It includes both costs that can be allocated directly to such activities and those costs of an indirect nature necessary to support them.

36

Notes to the financial statements

Governance costs

These include the costs attributable to the Charity’s compliance with constitutional and statutory requirements, including audit, strategic management and Trustees’ meetings and reimbursed expenses.

VAT

Irrecoverable VAT is charged against the category of resources expended for which it was incurred.

Expenditure is posted net of VAT and any irrecoverable VAT is posted to the expenditure on which it was incurred on a quarterly basis.

Taxation

The charity is considered to pass the tests set out in Paragraph 1 Schedule 6 of the Finance Act 2010 and therefore it meets the definition of a charitable company for UK corporation tax purposes. Accordingly, the charity is potentially exempt from taxation in respect of income or capital gains received within categories covered by Chapter 3 Part 11 of the Corporation Tax Act 2010 or Section 256 of the Taxation of Chargeable Gains Act 1992, to the extent that such income or gains are applied exclusively to charitable purposes.

Tangible fixed assets

Individual fixed assets costing £250 or more are initially recorded at cost, less any subsequent accumulated depreciation and subsequent accumulated impairment losses.

Depreciation and amortisation

Depreciation is provided on tangible fixed assets for the entire year, regardless of when an asset is purchased, so as to write off the cost or valuation, less any estimated residual value, over their expected useful economic life as follows:

Asset class	Depreciation method and rate
Furniture and Equipment	20% straight line basis
Software	33% straight line basis

Stock

Stock is valued at the lower of cost and estimated selling price less costs to complete and sell, after due regard for obsolete and slow moving stocks. Cost is determined using the firstin, first-out (FIFO). Items donated for resale or distribution are not included in the financial statements until they are sold or distributed.

37

Notes to the financial statements

Trade debtors

Trade debtors are amounts due from customers for merchandise sold or services performed in the ordinary course of business.

Trade debtors are recognised initially at the transaction price. They are subsequently measured at amortised cost using the effective interest method, less provision for impairment. A provision for the impairment of trade debtors is established when there is objective evidence that the charity will not be able to collect all amounts due according to the original terms of the receivables.

Cash and cash equivalents

Cash and cash equivalents comprise cash on hand and call deposits, and other short-term highly liquid investments that are readily convertible to a known amount of cash and are subject to an insignificant risk of change in value.

Investments

Investments comprise cash deposits held for investment purposes in deposit accounts with access greater than 90 days. There is a planned programme to draw on these deposits to fund our growth.

Trade creditors

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of business from suppliers. Accounts payable are classified as current liabilities if the Charity does not have an unconditional right, at the end of the reporting period, to defer settlement of the creditor for at least twelve months after the reporting date. If there is an unconditional right to defer settlement for at least twelve months after the reporting date, they are presented as non-current liabilities.

Fund structure

Unrestricted income funds are general funds that are available for use at the trustees’ discretion in furtherance of the objectives of the Charity.

In accordance with their reserves policy, trustees take a risk based approach to reserves management and designate funds from the unrestricted funds to meet defined strategic objectives.

Restricted income funds are those donated for use in a particular area or for specific purposes, the use of which is restricted to that area or purpose.

Leases

Leases in which substantially all the risks and rewards of ownership are retained by the lessor are classified as operating leases. Rentals payable under operating leases are charged in the Statement of Financial Activities on a straight line basis over the lease term.

38

Notes to the financial statements

Pensions and other post retirement obligations

The charity operates a defined contribution pension scheme. Contributions are charged in the statement of financial activities as they become payable in accordance with the rules of the scheme.

Accounting estimates

Estimates and judgements are continually evaluated and are based on historical experience and other factors, that are believed to be reasonable under the circumstances and there is sufficient information provided to prepare a reasonable estimate. The critical accounting estimate and area of judgement made within these accounts relates to legacies.

Legacy income is accrued when the conditions of entitlement, certainty and measurement are all present. Entitlement is achieved when confirmation is received from the Executor that probate has been granted and that the British Liver Trust has been named as the beneficiary. Certainty is met when the executor confirms that probate is sufficient to cover the bequest and that there are no challenges to the will or any other circumstances where the resultant bequest could be significantly diminished. Measurement is achieved through either having a clear statement from the Executor of the value of the bequest or being able to reasonably estimate this from the will and probate.

39

Notes to the financial statements

2. Income from donations and legacies

Donations and legacies: Legacies Other grants & donations	Unrestricted funds £ Restricted funds £ Total 2024 £ Total 2023 £ 173,220 - 173,220 85,463 930,966 625,105 1,556,071 1,443,940 1,104,186 625,105 1,729,291 1,529,403

£643,367 of the income in the prior year was attributable to restricted funds and £886,036 was attributable to unrestricted funds.

3. Income from charitable activities

Sale of publications Health events, PPI etc	Unrestricted funds £ Restricted funds £ Total 2024 £ Total 2023 £ 9,203 - 9,203 17,717 33,104 - 33,104 14,000 42,307 - 42,307 31,717

All of the income in the prior year was attributable to unrestricted funds.

4. Investment income

	Unrestricted	Restricted	Total	Total
	funds	funds	2024	2023
	£	£	£	£
Interest receivable on bank deposits	21,427	-	21,427	10,742

All the income in the prior year was attributable to unrestricted funds.

40

Notes to the financial statements

5. Expenditure on charitable activities

Employment costs Other direct costs Premises and offce expenses IT costs Printing, posting and stationery Training, subscriptions and conferences Cleaning Travel and subsistence Legal and professional costs Communications and awareness Bank charges Depreciation & loss on disposal of tangible fxed assets Governance costs	Total 2024 £ Total 2023 £ 1,063,831 959,928 192,693 146,476 71,095 56,389 49,982 50,163 10,987 11,282 6,060 10,417 574 717 16,700 30,688 - 5,465 40,036 87,318 573 598 23,726 23,705 37,171 17,875 1,513,428 1,401,021

£1,001,186 (2023 - £719,895) of the above expenditure was attributable to unrestricted funds and £512,242 (2023 - £681,126) to restricted funds.

Within the expenditure analysed above, there are governance costs of £37,171 (2023 - £17,875) which relate directly to charitable activities. See note 6 for further details.

41

Notes to the financial statements

6. Analysis of governance costs

Audit of the fnancial statements Auditor fees in respect of other services Companies House Annual Report production Treasurer Recruitment Expenses Legal and professional Other	Unrestricted funds £ Restricted funds £ Total 2024 £ Total 2023 £ 13,700 - 13,700 15,360 5,603 - 5,603 530 - - - 13 1,186 - 1,186 1,650 - - - 322 16,642 - 16,642 - 40 - 40 - 37,171 - 37,171 17,875

The legal and professional fees were incurred as a result of the merger with the Children’s Liver Disease Foundation.

7. Net incoming resources

Net incoming/outgoing resources for the year include:

	2024	2023
	£	£
Audit fees	13,700	15,360
Other non-audit services	5,603	530
Depreciation	23,726	23,442
Loss on disposal of fxed assets	-	263

8. Trustees’ remuneration and expenses

No trustees, nor any persons connected with them, have received any remuneration from the charity during the year.

The amount of expenses received by the trustees during the year totalled £Nil (2023 - £Nil).

42

Notes to the financial statements

9. Staff costs

The aggregate payroll costs were as follows:

Staff costs during the year were: Wages and salaries Social security costs Pension costs	2024 £ 2023 £ 1,151,128 1,052,181 105,676 94,428 96,692 85,264 1,353,496 1,231,873

The monthly average number of persons (including senior management team) employed by the charity during the year was as follows:

	2024	2023
	No	No
Charitable activities	37	37

Two employees received emoluments of more than £60,000 during the year.

The number of employees whose emoluments fell within the following bands was:

		2024	2023
		No	No
£60,001	- £70,000	1	-
£80,001	- £90,000	1	1

The total employee benefits of the key management personnel of the charity were £337,689 (2023 - £292,154). The number of the executive increased by one during the year.

The chief executive officer, as the highest paid member of staff, received employee benefits, including pension, totalling £98,175 (2023 - £97,350).

During the year, the charity made an ex-gratia payment which was in relation to a settlement agreement. The total payment made for the settlement was £5,400 (2023: £Nil).

43

Notes to the financial statements

10. Taxation

The charity is a registered charity and is therefore exempt from taxation.

11. Tangible fixed assets

Cost At 1 April 2023 Additions Disposals At 31 March 2024 Depreciation At 1 April 2023 Charge for the year Eliminated on disposals At 31 March 2024 Net book value At 31 March 2024 At 31 March 2023	Furniture and equipment £ Software £ Total £ 124,510 1,122 125,632 1,856 - 1,856 (5,557) - (5,557) 120,809 1,222 121,931 45,969 1,122 47,091 23,726 - 23,726 (5,557) - (5,557) 64,138 1,222 65,260 56,671 - 56,671 78,541 - 78,541

12. Fixed asset investments

Deposit accounts 13. Stock Stocks	2024 £ 2023 £ 108,933 - 2024 £ 2023 £ 6,086 7,995

44

Notes to the financial statements

14. Debtors

Amounts due within one year Amounts due after more than one year Trade debtors Prepayments Accrued income VAT Other debtors Other debtors 15. Current asset investments Deposit accounts 16. Creditors: amounts falling due within one year	2024 £ 2023 £ 58,403 47,716 66,696 38,025 131,825 85,856 10,810 - 7,798 11,836 275,532 183,433 2024 £ 2023 £ 8,829 8,829 8,829 8,829 2024 £ 2023 £ 209,590 488,454

Trade creditors Taxation and social security Other creditors Pension scheme creditor Accruals Deferred income	2024 £ 2023 £ 92,745 61,808 26,328 24,529 1,702 2,803 14,134 12,044 41,059 35,345 - 33,000 175,968 169,529

45

Notes to the financial statements

17. Pension and other schemes

Defined contribution pension scheme

The Charity operates a defined contribution pension scheme. The pension cost charge for the year represents contributions payable by the Charity to the scheme and amounted to £96,692 (2023 - £85,264).

Contributions totalling £14,134 (2023: £12,044) were payable to the scheme at the end of the year and are included in creditors.

18. Charity status

The charity is limited by guarantee, incorporated in England & Wales, and consequently does not have share capital. Each of the trustees is liable to contribute an amount not exceeding £1 towards the assets of the charity in the event of liquidation.

19. Commitments

Operating Lease Commitments

The total amount recognised as an expense for operating leases during the year was £43,201 (2023: £39,411). The total amount contracted for but not provided in the financial statements was £64,963 (2023 - £122,348).

46

Notes to the financial statements

20. Funds

Unrestricted funds General Unrestricted income fund Designated Growth investment fund Legacy equalisation fund Total unrestricted funds Restricted funds General research PSC / Cholangiocarcinoma research Love your Liver roadshows Love your Liver Stoke Helpline National Lottery England Liver transplant support groups Patient Information International NASH day Wales cross-party working gp Scotland projects Wales projects Policy role Foundation for Liver Research UKLA Patient survey LCUK LYL Unit Total restricted funds Total funds

Balance at April 2023 £ Incoming resources £ Resources expended £ Transfers £ Balance at 31 March 2024 £ 497,376 1,167,920 (1,361,556) 242,869 546,609 314,065 - - (314,065) - 53,794 - - 73,220 127,014 865,235 1,167,920 (1,361,556) 2,024 673,623 286 - (286) - - 21,564 - - - 21,564 9,897 203,994 (102,264) - 111,627 - 50,000 - 50,000 - 83,750 (83,750) - - - 39,277 (39,277) - - - 5,000 (2,801) - 2,199 1,582 36,200 (37,782) - - - 9,800 (9,800) - - 4,341 - (2,059) - 2,282 71,505 29,500 (87,505) - 13,500 10,055 10,000 (15,409) - 4,646 - 27,000 (27,000) - - - 35,000 (35,000) - - 8,333 23,000 (20,000) - 11,333 - 11,343 (3,879) - 7,464 - 45,430 (45,430) - - - 15,811 - (2,024) 13,787 127,563 625,105 (512,242) (2,024) 238,402 992,798 1,793,025 (1,873,798) - 912,025

47

Notes to the financial statements

20. Funds (continued)

Unrestricted funds General Unrestricted income fund Designated Growth investment fund Legacy equalisation fund Total unrestricted funds Restricted funds General research PSC / Cholangiocarcinoma research Love your liver roadshows Helpline Patient Information Wales cross-party working group Scotland projects Wales projects Policy role Foundation for Liver Research UKLA GP training tool ICS International NASH Day LCUK LYL Unit Total restricted funds Total funds

Balance at April 2022 £ Incoming resources £ Resources expended £ Transfers £ Balance at 31 March 2023 £ 637,371 928,495 (1,035,576) (32,914) 497,376 246,614 - - 67,451 314,065 88,331 - - (34,537) 53,794 972,316 928,495 (1,035,576) - 865,235 14,963 - (14,677) - 286 21,564 - - - 21,564 14,515 109,176 (113,794) - 9,897 35,249 25,250 (73,725) 13,226 - 10,973 9,725 (30,616) 11,500 1,582 4,877 - (536) - 4,341 59,056 126,164 (113,715) - 71,505 16,057 138,080 (144,082) - 10,055 7,435 - (7,435) - - - 48,000 (48,000) - 8,333 20,000 (20,000) - 8,333 10,440 - (10,440) - - 2,738 - (2,738) - - - 6,800 (6,800) - - - 127,672 (102,946) (24,726) - - 32,500 (32,500) - - 206,200 643,367 (722,004) - 127,563 1,178,516 1,571,862 (1,757,580) - 992,798

48

Notes to the financial statements

Designated funds:

Growth Investment Fund – The charity had a 3 year strategy for growth, as required to deliver its mission statement and meet growing need. A strategy for investment in fundraising was developed, to grow income to a sustainable level beyond the 3 year strategy, but this investment, and the use of reserves to grow service delivery in the meantime produced a deficit budget. The Trustees agreed that reserves that were planned to be utilised through deficit would be set aside funds for this purpose. In the year to March 2024 this amounts to £Nil (2023 £314,065). The trustees have agreed that there will be an intention to have balanced budgets from 2025/26 onwards.

Legacy Equalisation Fund – The charity is now including legacy income in its budget, but recognises this as a point of risk, due to the unpredictability of this income stream. Trustees therefore established a legacy equalisation fund to absorb variations from budget on this income stream. Legacy income exceeded budget by £73,200 during the year to 31 March 2024 and therefore the fund has been increased by this amount. This brings the total fund, which will be increased or reduced as legacies exceed or fall short of expectation, to £127,014 (2023: £53,794).

Restricted funds:

The specific purposes for which the funds are to be applied are as follows:

General research – Money held from former donations for general research projects. The Trust is utilising these funds towards its patient involvement in research and development projects with pharmaceutical and other organisations.

PSC / Cholangiocarcinoma research – This represents donations for research into a Quality of Life tool for people living with PSC in partnership with University College London. The use of the remaining funds is in discussion.

Love Your Liver Roadshows – Funds are raised both nationally and regionally, normally from charitable trusts. Regionally raised funds are generally for specific roadshows and allocated towards the roadshows in that area. The roadshows raise awareness of liver disease and its prevention, as well as promoting early detection and community diagnosis. The funds held at 31 March are therefore for specific upcoming roadshows. The expenditure on roadshows for the year exceeds that raised, the balance being met from unrestricted funds.

Love your Liver Stoke – These funds were donated by Dr Alison Brind to pay for the Love Your Liver Roadshow to visit the Stoke area, where she practised, during the years 2024 to 2028.

Helpline – Donations have been provided for the provision of information and support, through a nurse-led telephone and email helpline, to anyone affected by liver disease including patients, carers and health care professionals. Expenditure on this project exceeds restricted funding and the balance is funded from unrestricted funds.

National Lottery England – This funding was the initial tranche of a grant to part fund our outreach and peer support work in England over a 3 year period.

Liver transplant support groups – This funding is a grant from Payce-Chiesi Copadi Ltd for peer support groups for those going through liver transplant.

Patient Information – This represents funding for the production and dissemination of information on liver health and liver conditions.

International NASH day – This was funding received from Advanz Pharma UK & Ireland Ltd to raise awareness of the causes of NASH on International NASH day. The funds were fully used in this campaign.

49

Notes to the financial statements

Wales Cross-party Working Group – This funding has been provided to facilitate the functioning of a cross-party working group in Wales. The funding was received before the year end to 31 March 2021, but the formation of the group was delayed by COVID-19. The group was formed in the year to 31 March 2022 and early meetings have taken place, but the use of remote technology has reduced the costs. It is planned to have face to face meetings during coming years.

Scotland Projects – Donations have been received, largely from charitable trusts, for the promotion and development of support groups for liver patients and relatives/carers in Scotland, together with raising awareness of liver health and promoting early detection.

Wales Projects – Funding has previously been provided by the Welsh government for the promotion and development of support groups for liver patients and relatives/carers in Wales, together with raising awareness of liver health and promoting early detection. Further funding has been received from charitable trusts and will be utilised towards the same aims.

Policy role and Foundation for Liver Research – Funding has been received to support the salary of a Policy Manager, working through Westminster and across the devolved nations. £35,000 (2023 £48,000) of this funding was from the Foundation for Liver Research with whom we have a close working relationship.

UK Liver Alliance – We received funding from British Association for the Study of the Liver and British Society for Gastroenterology to chair and act as the secretariat for the UK Liver Alliance, bringing together all the voices of the liver community.

GP Training Tool – This funding is towards the production of a training tool to help raise GP awareness of liver disease and increase early detection rates. This work has been completed and the funds expended.

Integrated Care Systems (ICSs) – This funding was transferred for use in our project to improve the early detection of liver disease, working with the ICSs across the country, when not used for a roadshow during the pandemic. Permission was granted by the charitable trust concerned. The funds have now been used for this purpose.

Patient Survey – This funding was provided to undertake a survey of patients living with liver disease and was in progress before and after the year end.

Liver Cancer UK – This funding is donated from a number of sources to fund only our work with liver cancer, be it patient support or information.

Love your Liver Unit – In 2022 we were donated funds and purchased a unit for our Love Your Liver Roadshows. In 2023 a donation was received to purchase new technology devices for this unit. Fitting works took place on the unit during this period, but the devices were purchased and set up after the year end.

21. Analysis of net assets between funds

Tangible fxed assets Current assets Debtors over 1 year Current liabilities Total net assets	Unrestricted funds £ Restricted funds £ Total funds at 31 March 2024 £ 56,671 - 56,671 784,091 238,402 1,022,493 8,829 - 8,829 (175,968) - (175,968) 673,623 238,402 912,025

50

Notes to the financial statements

22. Analysis of net funds

Fixed asset investments Current asset investments Cash at bank and in hand Total	At 1 April 2023 £ Cash fow £ At 31 March 2024 £ - 108,933 108,933 488,454 (278,864) 209,590 395,075 27,277 422,352 883,529 (142,654) 740,875

23. Related party transactions

During the year the Charity made the following related party transactions:

Wim Bushell

Wim Bushell is a Trustee and a Deputy Chair of Arthur J Gallagher, who act as insurance brokers for the Trust. Transactions of £11,386 (2023: £10,090) during the year with Arthur J Gallagher were in the normal course of business. The balance outstanding due to Arthur J Gallagher, for invoices in relation to the following period, which have also been prepaid, amount to £13,297 (2023: £Nil).

Alison Orman

(Alison Orman is the Director of Finance and Operations of British Liver Trust) Expenses of £791 were reimbursed to Alison Orman during the year (2023: £974). At the balance sheet date the amount due to/from Alison Orman was £Nil (2023 - £Nil).

Pamela Healy

(Pamela Healy is the CEO for British Liver Trust)

Expenses of £1,034 were reimbursed to Pamela Healy during the year (2023: £649). At the balance sheet date the amount due to/from Pamela Healy was £18 (2023 - £Nil).

Vanessa Hebditch

(Vanessa Hebditch is the Director of Communications and Policy for British Liver Trust) Expenses of £598 were reimbursed to Vanessa Hebditch during the year (2023: £129). At the balance sheet date the amount due to/from Vanessa Hebditch was £189 (2023 - £129).

Audrey Cornelius

(Audrey Cornelius is the Director of Fundraising for British Liver Trust during the year) Expenses of £1,858 (2023 - £2,580) were reimbursed to Audrey during the year. At the balance sheet date the amount due to/from Audrey Cornelius was £149 (2023 - £nil).

24. Non-adjusting Post Balance Sheet Event

On the 1 April 2024 Children’s Liver Disease Foundation (CLDF) and British Liver Trust merged to combine resources. The funds of CLDF at the date of merger were restricted funds of £58,707, designated funds of £60,000 and unrestricted funds of £369,390.

51

“The consultant told me it was cirrhosis, and there was no treatment. I wasn’t expecting that.

I had to lose weight, do a bit more exercise, drink coffee and not touch alcohol. It sounded really simple but it’s not.

I felt very bewildered by it all, but I knew I had to take it seriously because I didn’t want to die. That’s when I found the British Liver Trust.

I pored over the patient stories and videos. And joined the Trust’s Support Group for people with fatty liver disease. It’s been a real source of inspiration and motivation as well as helping me feel less alone. Talking with people going through the same thing is cathartic and there’s no sense of judgement.

I’ve been quite open about my diagnosis my with friends, because there shouldn’t be stigma. Everyone assumes liver disease is self-inflicted, but you’re coping with a serious condition and don’t need people’s judgement.”

Liz was diagnosed with cirrhosis in 2023

The British Liver Trust is the largest UK liver charity for adults and leads the fight against liver disease and liver cancer.

Our work is only possible thanks to voluntary grants and donations. Thank you to all those who support our work and enable us to deliver our services.