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Investing for the next generation

Annual Report and Financial Statements 2022-2023

All staf f are so welcoming and friendly, giving respect and care 100%.

PATIENT COMMENT

Company no. 02033936 | Registered charity no. 298867 (England and Wales)

4 Chair’s Report

10 Trustees’ Annual Report: Including Directors’ Report and Strategic Report 82 Independent Auditor's Report 87 Statement of Financial Activities

88 Balance Sheet 90 Cash Flow Statement 91 Notes to Cash Flow Statement 92 Notes to Financial Statements

A transcript of this document is available in large print. Please ring 01923 886310.

C H A I R ' S R E P O R T

Chair's report

I wanted to start this report with a series of thank yous. Firstly, to all those who have continued to support Paul Strickland Scanner Centre and who have contributed so generously to allow us to deliver an increasing number of high-quality clinical scans. And I want to thank our staff, who have worked so hard to be able to provide these scans and who engaged with a wide range of new projects this year to improve care for our patients.

I also want to thank our previous Chair Mrs Cathy Williams, who retired from the Board in September. Cathy has had a very long association with the centre and we benefited enormously from her knowledge, skills and commitment. She is a very hard act to follow and I know the Board and all the staff wish her well and every happiness for the future. As well as Cathy, we also said goodbye to Dilip Manek, another very long serving expert Trustee, who has played an integral part in shaping our strategy and the work of the centre. Last but not least, we said goodbye to Dr Roberto Alonzi, another great colleague who has been so helpful and thoughtful in his clinical work and strategic insight in supporting and developing the centre. We will miss the knowledge and enthusiasm of our colleagues very much. However, we have recruited two new Trustees: Mr Andre Nunes who has previously worked at Paul Strickland Scanner Centre and has a background in radiology, strategy and clinical excellence, and Mrs Jean Liao, who brings a wealth of expertise in global health and technology. We continue to review the skills and expertise of our Trustees and will continue recruitment to fill in any gaps and ensure we can deliver the full range of objectives for the centre and achieve our charitable purpose.

Looking back on the year, we can see the impact of Covid-19. It’s not been as overwhelmingly intrusive as in the past few years but it still impacts on how we work, on staff health and

C H A I R ’ SX RX XE PX OX RXTX X

I want to thank everyone for their continued support and I hope you agree that your donations have been put to a very good use.

MS JOANNE LANGFIELD

C H A I R ’ S R E P O R T

wellbeing and has continued to have a cost in terms of additional requirements. However, we know we have to live with Covid, and as such you will see that we have managed to deliver a large number of scans and have seen many patients as part of their cancer journey.

As a centre, we continue to work very closely with our excellent clinical colleagues from Mount Vernon Cancer Centre. We have reviewed for example the timeliness of our reporting, so we can make sure when patients are seen at Mount Vernon Cancer Centre (and other trusts') clinics the reviewing clinical multidisciplinary team has the most up to date scan to support treatment decisions. Without the hard work of all our staff, we could not manage to make sure we have timely reporting on treatment progress. We continue to work closely with NHS East Of England, both to deliver their specialist scans but also as committed partners in trying to find a sustainable solution for the future of the Mount Vernon Cancer Centre, as we see ourselves as integral in providing excellent clinical scans to support patient care. We hope that in the next year a longterm solution will be found, but in the meantime we remain fully committed as a Board to working with both NHS East of England and East and North Herts NHS Trust, who manage the services at Mount Vernon Cancer Centre, in order to provide the best care we can for local people.

Having said that, we do recognise the limitations of being on the Mount Vernon site in terms of the quality of our accommodation and the space we occupy. We are therefore very proud of the work our staff have undertaken, within our existing facilities, to review their work patterns and find additional capacity to offer our patients a wider range of appointment times. This in turn has enabled us to explore new roles within the clinical teams., and we have been successful in recruiting new staff to work at PSSC.

As well as staff productivity, thanks to our generous supporters we have been able to invest in new technology to support our clinical work. For example, our new MRI scanners and improved software have allowed us to reduce the time it takes to scan patients whilst simultaneously improving the quality of the scans. Improving patient comfort and clinical benefit are two of the ambitions of both our staff and Board, so we were delighted to be able to achieve both of these goals with our new technology. The work on improving the centre’s financial sustainability, known as Project Luna, reflects decisions taken at our December 2022 strategy session where the Board reviewed the future of the centre and set some ambitious but achievable targets to increase the number of scans we perform, recruit additional staff and focus on how we can help meet the challenge of an increasing number of people with cancer, contributing to a more accurate diagnosis and more effective treatment for patients.

C H A I R ’ S R E P O R T

As a result, we have managed to do 1,580 more scans this year, undertook recruitment and amongst other things eliminated our waiting list for PSMA PET-CT scans. It’s been a lot of work and staff have been very flexible in how they work to deliver more scans, without any compromise to the quality of the scan or the reporting time. The success of our work has been measured externally by the Quality Standard for Imaging (QSI), who endorsed us for the quality of our clinical delivery. Preparing and submitting information for an external validation is very time consuming, but it does provide the board and our team with an independent view on the quality of our service and how well we perform.

Anyone visiting the centre will see the work in progress to install our new PET-CT scanner, which should be operational in the spring of 2024. It’s been a huge undertaking, as we have had to remodel the existing space and we are very grateful to the London Borough of Hillingdon planning team for their help in our redesign being approved. If you visit, you will see our new patient reception and we would like to thank in particular Annie Harrington, the patient representative on our Patient Experience Group, for her input. Her suggestions have been incorporated into new areas and have resulted in a big improvement for our patients. We look forward to celebrating the results of the hard work of our staff and the generosity of our donors at an opening event during 2024.

Other highlights of the year include the continuing success of our PET-CT scanner at the Lister Hospital in Stevenage via a subcontractor, which has increased accessand reduced travel and waiting times for those patients who prefer to have their scan in North Hertfordshire.. We have also completely revamped our website, making it easier to find out about our work, our staff, our scans and more. As part of the revamp, we created a purpose-built reporting suite for our consultants, improving amongst other things opportunities for learning for the radiologists of tomorrow. Thanks to the work of this team, we also featured in the New Scientist magazine this year, with an interesting article about the work of the centre and our role locally.So looking forward, one of our ambitions for 2023/4 is to ensure the successful opening of our new PET-CT scanner and ensuring that patients and staff derive the maximum benefit from the machines’ new capabilities. We are currently not expecting to buy any new scanners in the immediate future beyond the

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new PET-CT scanner that will be bought in 2023/24, but we do want to look at the opportunities the increasing use of AI will bring in delivering excellent clinical care. We also want to continue focusing on our staff, so they can develop and provide excellent care and, while continuing to be the employer of choice for existing and new staff, push forward on how we can make best use of our scanners and deliver more clinical activity.

Given the difficult financial circumstances that many people face, I wanted to end by thanking everyone for their continued support and I hope you agree that your donations have been put to a very good use. We will continue to do this so that we will have another successful year delivering high-quality scans for our patients.

Ms Joanne Langfield

Chair of the Board of Trustees, April 2024

Some of the patient facing members of our team at Paul Strickland Scanner Centre

The staf f who carried out the scan were all so friendly and made me relaxed for my time in the scanner. Overall, I couldn’t find anything other than excellence whilst at Paul Strickland Scanner Centre. I’m very grateful to everyone there. PATIENT COMMENT

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Trustees’ report

We will lead the way in imaging for the diagnosis, treatment and monitoring of cancer and other clinical conditions.

For our patients and referrers:

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P R I D E
Providing roviding Responding Improving Demonstrating Enabling clinical
world class promptly to patient clinical and technology
diagnostic patient and outcomes excellence advancements
imaging referrer needs
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Providing roviding world class diagnostic imaging

For the year ended 30 September 2023

Medical staf f are all so patient and lovely. Nothing is too much trouble. No question is too Super friendly. stupid. Well done! Thank you! PATIENT COMMENT

PATIENT COMMENT

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About us

At Paul Strickland Scanner Centre, we specialise in medical imaging for patients dealing with cancer and other serious conditions.

As a registered charity, our focus is on providing the best possible care to improve the lives of our patients. We offer MRI, CT, and PET-CT scans to both NHS and private patients from North West London, Middlesex, Hertfordshire, Buckinghamshire and Bedfordshire. These scans are essential for diagnosing and monitoring cancer and other serious conditions, such as dementia. We also support life-changing medical research. As an independent charity with no government funding, we rely on the generosity of our supporters to keep our doors open and help us make a difference in the lives of our patients.

Public benefit

Our board of trustees is focussed on making sure the charity’s work meets the Charity Commission’s guidance on public benefit.

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Cancer imaging pioneer

Paul Strickland OBE

Dr Strickland qualified in 1943 and came to Mount Vernon Hospital in 1946, becoming consultant radiotherapist in 1955.

For many years he was Chairman of the Mount Vernon Medical Committee and, in 1970, became head of the Radiotherapy Department. In 1988, 12 years after his official retirement, he was awarded the OBE.

Scanning for opportunities

In the 1970s, two British Nobel Laureates developed the CT and the MRI scanner. Dr Strickland quickly realised the importance of medical imaging in the accurate diagnosis and subsequent treatment of patients with cancer and other serious conditions.

In 1982, in the midst of a recession, he became Vice Chairman of the appeal to obtain a CT scanner for Mount Vernon. A friend remarked: “He was an absolute dynamo. He really drove everybody.” The Appeal was launched in February 1983, aiming to reach £1,250,000 in three years. In just two years, by March 1985, £1,700,000 was raised, enough to fund a CT and an MRI scanner and the building to house them, which became Paul Strickland Scanner Centre. The result is a world class centre which attracts the highest calibre radiologists and radiographers.

Dr Paul Strickland pictured with our patron, HRH The Duchess of Kent

Carry on what you are doing. Brilliant care. PATIENT COMMENT

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The first diagnostic imaging unit for NHS and private patients in the UK

When Dr Paul Strickland launched his fundraising drive to buy the first scanner for Mount Vernon Hospital, nobody expected that a world-leading, independent cancer imaging centre bearing his name would be thriving on the same spot three-and-a-half decades later. The first diagnostic imaging unit for NHS and private patients in the UK, it opened in 1985 with one CT and one MRI scanner.

The first CT and MRI patients were scanned the same year, and both original scanners underwent the first of many upgrades and replacements in the early 1990s, thanks to the generosity of our supporters.

There have been enormous advances in technology over the years. Image quality has improved dramatically, allowing a much more accurate diagnosis, and scans are much quicker, meaning we can scan many more patients. Whole-body MRI scanning, which is the centre’s speciality and particularly important for patients with metastatic cancers, would not have been possible back then.

Medical imaging is now an essential part of modern cancer care and changes thousands of lives for the better every year.

Very relaxed, can’t wait to come back.

PATIENT COMMENT

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Our CEO and team

Our staff team is led by Claire Strickland, who has been our Chief Executive since 2014. She reports to our Board of Trustees, which is chaired by Joanne Langfield, a long-standing member of our Board.

We are hugely grateful to a number of very dedicated volunteers who support our charity. Claire is the daughter of our founder and believes that the patient must always come first when delivering high-standard care. Most of our staff are either radiographers (clinical staff who produce CT, MRI and PET-CT images using our specialised equipment) or radiologists (doctors who specialise in diagnosing and reporting on illnesses and injuries through the use of medical images). Other staff support patients by booking appointments and making sure the centre is efficiently run.

Fundraising and research

We have a small fundraising and communications team who work to raise awareness and money to fund new scanners and research. Our clinical staff actively support medical research delivered at the centre.

A world-class centre which attracts the highest calibre radiologists and radiographers.

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Claire Strickland, our Chief Executive

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Objectives and activities

To provide state-of-the-art, cross sectional medical diagnostic imaging systems, and to operate them principally to benefit patients attending the Mount Vernon Cancer Centre, but also for patients referred from anywhere in the UK or abroad. To carry out late translational imaging research.

Our objectives

[ To continuously improve the quality of services in order to provide the ] best care and optimise health outcomes for each and every individual.
[ To excel at customer service, achieving outstanding levels of communication ] including patient, carer and referrer satisfaction.
[To consolidate services and enhance local access to specialist services in order ] to deliver high quality, safe, seamless, innovative and integrated services which are sustainable.
[ To support the continued development of Paul Strickland Scanner Centre in ] conjunction with Mount Vernon Cancer Centre, and provision of leading local and tertiary cancer services including the development of innovative clinical research.
[ To improve staff engagement and organisational culture, ensuring patient ] safety as a top priority.

O B J E C T I V E 1

To continuously improve the quality of services in order to provide the best care and optimise health outcomes for each and every individual.

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Quality Standard for Imaging

We are very proud to continue to have achieved our Quality Standard of Imaging (QSI) accreditation for the 7th year in a row.

The QSI sets the national quality criteria for imaging services, and is a collaboration between The Royal College of Radiologists (RCR) and the College of Radiographers (CoR), and is managed by United Kingdom Accreditation Service (UKAS). Last year saw the launch by the colleges of the new 2021 standard to which the centre successfully transitioned to in July 2023. In meeting this standard, accredited by UKAS, we know that our quality management system exceeds the baseline requirements of regulators such as the Care Quality Commission and the culture of quality is embedded across our organisation.

By assessing our performance against this standard and continually making improvements, we are assuring our patients receive consistently high-quality services, delivered by skilled staff, within a safe environment.

Paula Merry, Quality and Governance Lead at Paul Strickland Scanner Centre, said: “Successful transition to the new QSI standard is due to the passion of our staff for excellent patient care and continued professionalism.”

Paula Merry, Quality and Governance Lead

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Audit team

Striving for the best care and health outcomes for our patients

Our Audit Team actively promotes audit for all Paul Strickland Scanner Centre staff, overseeing development and coordination as well as monitoring implementation of the Centre’s Clinical Audit Programme. The team reports on compliance against existing guidance or internal standards and receives audit proposals as well as audits summary sheets for the Centre. In addition, Audit Team members:

[Receive audit proposals and audit summary sheets for the Centre.]
[Receive reports and findings from completed audit summaries and approve action plans]
arising from those audit findings.
[Develop and maintain a robust system to monitor the progress of all Action Plans] through to completion.
[Present findings and learning points to centre staff.]
[Support staff undertaking audit.]
[Actively promote and search for new audit/research ideas.]

Advanced Radiographer Manpreet Kaur Punia, our Clinical Audit Lead, joined us from a wellknown private hospital in 2021. She said: “There’s a real focus on audit at Paul Strickland Scanner Centre compared to where I worked previously and I was very keen to join the centre’s audit team soon after I started.

“Being a member of the audit team has been great. I’ve been involved in a number of audits and seeing changes in the way we do things as a result of the audit team’s work has been really encouraging.

“There is also a big focus on communicating audit results externally in order to drive improvements to patient care in the wider healthcare systems.”

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Advanced Radiographer Manpreet Kaur Punia, our Clinical Audit Lead

A U D I T C A S E S T U D Y

MRI Deep Learning Reconstruction: Revolutionising liver imaging

In the fast-evolving world of medical imaging, advancements often hold the promise of more efficient and accurate diagnoses. One such leap forward lies in the deep learning reconstruction (DLR) technique applied to magnetic resonance imaging (MRI). Recently, an audit at Paul Strickland Scanner Centre shed light on the potential of this technology, particularly in liver imaging.

MRI Advanced Radiographer Rupi Jillard

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A team led by MRI Advanced Radiographer Rupi Jillard evaluated conventional diffusion imaging in the liver with a new diffusion sequence provided by the company Siemens. The aim was to assess the impact on both image quality and scan time.

At the heart of this evaluation lies Siemens’ “Deep Resolve Boost,” a sophisticated application harnessing neural networks to improve image quality and reduce scan times. These new sequences are available across the centre’s 1.5 T Siemens Sola MRI scanners.

Rupi examined 15 patient cases between August and September 2023, analysing acquisition times, signal-to-noise ratios, and qualitative image assessments. The new scan demonstrated an average acquisition time of just 5 minutes compared to the conventional 8 minutes and 30 seconds. The signal-to-noise ratio increased with the new sequence, enhancing image clarity. The qualitative analysis further revealed substantial improvements in motion artifacts and noise reduction.

But what does this mean for patients? The new diffusion sequence translates into expedited scans, potentially reducing patient anxiety and time spent in the scanner, reducing appointment times from 45 minutes to 30 minutes. This boosts efficiency but also increases accessibility.

This innovative approach, integrating cutting-edge technology into routine clinical practice, promises a brighter future for MRI imaging. By maintaining established image quality standards while drastically reducing acquisition times, Deep Resolve showcases the potentially transformative power of deep learning in healthcare.

As Rupi and her team continue to integrate the Deep Resolve into other MRI protocols, the promise of improved patient outcomes looms on the horizon. This marks not just a technological advancement but a pivotal shift in efficiency and access to our MRI service for patients. As demand for MRI services increases, these advancements may well prove to be a game-changer, ushering in an era of more effective, streamlined, and patient-friendly medical imaging.

All of the staff were wonderful! Friendly and reassuring.

PATIENT COMMENT

O B J E C T I V E 2

To excel at customer service, achieving outstanding levels of communication including patient, carer and referrer satisfaction.

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Supporter inspired by our care for his mum and dad

Rick Wilmott raised several thousand pounds for us by running the Big Half marathon as well as the Vitality 10k. He said: “Paul Strickland Scanner Centre is a charity close to my heart as they looked after my dad prior to his passing last year and are now also looking after my mum. Nothing like keeping it in the family!”

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What our patients say about us

100%

of our patients say they were “satisfied” or “very satisfied” with their care

When asked to rate their overall experience at Paul Strickland Scanner Centre

100%

of our patients would recommend us to family and friends for a scan

Based on an anonymous survey during December 2022 of 261 Paul Strickland Scanner Centre patients

Project Luna: Enhancing patient care and financial stability at Paul Strickland Scanner Centre

In a bid to bolster the financial resilience of Paul Strickland Scanner Centre, underpinned by our commitment to safety and service quality, we launched Project Luna in early 2023.

A project team, along with a working party made up of key staff members, was formed to increase scanning capacity. Additional scanning slots were strategically utilised to accommodate more patients, thereby enhancing service access for both NHS and private patients, with waiting time reduction benefitting both NHS and private patients.

This strategic move led to an increase in MRI referrals from private GPs, a growth facilitated by the creation of new marketing literature tailored to their needs. In addition, we established a new supply chain for PSMA PET-CT, which helped clear our waiting list for PSMA PET-CT imaging. To further improve our service, we revamped the Paul Strickland Scanner Centre website with a focus on patient needs, particularly those of our private patients, thereby making it more userfriendly and patient-centric.

Cherith Desmeules, Strategy Lead and Service Manager for Paul Strickland Scanner Centre, said: “Project Luna is a really important initiative for the centre and will help put us on a sustainable footing for the future. It’s been a real privilege leading the project team.”

Cherith Desmeules, Strategy Lead and Service Manager

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Patient Experience Group

Paul Strickland Scanner Centre has a dedicated multidisciplinary Patient Experience Team, which meets regularly throughout the year and drives the patient experience agenda.

Patient Experience Group chair Rachel Jacobs

The team is comprised of staff members who represent different disciplines within the Centre including radiographers, bookings, administration and communications. In addition to key staff members, a patient volunteer is part of the team, ensuring the patient perspective is heard and represented at all times.

Amongst other projects, multiple methods are used to acquire patient feedback, including via comments cards handed to patients during the course of their appointment as well as by means of an annual patient satisfaction survey. This data enables us to create and develop a yearly action plan. All members of staff are involved in the patient experience agenda by means of an interactive Quality Improvement afternoon.

The team closely tracks the experience of patients at the centre and the centre makes changes to the service as a result. A good example of this is how a project to digitise the centre’s patient information offering was launched as a result of patients feeding back that they would prefer an alternative to paper copies of our patient information booklets.

Rachel Jacobs, Chair of the Group, said: “The Patient Experience Group assesses and enhances the experience of our patients, their families and carers. In particular, we monitor and ensure that the centre complies with Quality Standard for Imaging statements relating to patient information, privacy and dignity, patient-focussed service delivery and patient feedback.”

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Fundraising and Communications

We reviewed and refocussed our fundraising and communications strategy during the reporting period in order to adjust to the post-pandemic world and the much tougher fundraising climate brought about by difficult conditions, as well as the need of the centre to increase private referrals.

This work included a major revamp of the Paul Strickland Scanner Centre website, making it more up to date and attractive to patients and donors alike.

With a member of the team on maternity leave, we engaged a specialist trust and grants fundraiser to make targeted approaches to charitable trusts and similar grant making bodies, which has resulted in funding from a variety of sources.

The Fundraising and Communications Team recruited a new Philanthropy Manager as part of our drive to grow income from not only trusts and foundations but also from companies and in particular major donors.

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Donations in memory of Julia conclude power injector appeal

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Julia Bell
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Our appeal for an MRI power injector has successfully concluded thanks to in memory donations.

Julia Bell began her support of Paul Strickland Scanner Centre when as a patient; she wanted to do something to help. She set up a birthday fundraiser on Facebook and asked her friends to donate to this cause that was so close to her heart. Following on from that, Julia and her husband Stephen had collection boxes at home and their place of work to continue to raise money.

Sadly, Julia passed away during 2023 but her friends and family donated so generously in her memory, as was her wish, raising £10,000 which has enabled us to close our appeal for an MRI power injector. This piece of equipment will help us scan even more patients and increase the number of clinical trials we are able to support.

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Fundraisers pictured during the annual London Winter Walk.

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Local businesswoman Louise Rayner ran the London Marathon in April 2023 to raise money for Paul Strickland Scanner Centre.

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Supporters flocked to our annual Stepping Up For Cancer fundraising walk in May 2023.

O B J E C T I V E 3

To consolidate services and enhance local access to specialist services in order to deliver high quality, safe, seamless, innovative and integrated services which are sustainable.

An ambitious upgrade to Paul Strickland Scanner Centre is currently underway, involving significant building work.

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Second scanner concludes MRI upgrade

With the installation of our second new scanner, we completed the upgrade of our MRI service started earlier in 2022.

The two new Siemens Magnetom Sola 1.5 scanners produce higher resolution images — which can mean referrers receive more detailed information about a patient’s cancer. Additionally, they have a wider bore, which benefits patients who are claustrophobic. Faster image acquisition times could allow us to scan more patients than previously, improving access to our high-quality, award-winning service. They will also allow us to scan more people who have had implants, such as metal hips, than currently.

The new scanners are an excellent choice for wholebody MRI scans, an area where Paul Strickland Scanner Centre is the global leader, having performed more scans of this type than any other comparable centre.

In addition to the impressive hardware improvements, the new scanners feature very advanced new software, bringing the artificial intelligence revolution that is currently sweeping modern medicine, to Mount Vernon.

Mr Will McGuire, Deputy Superintendent for MRI at Paul Strickland Scanner Centre, said: “When you put together the better hardware and new software, you are looking at insane levels of scan time reduction, with better image quality.”

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One remarkable feature of the new scanners is that they are able to run a prostate MRI scan completely by themselves for the first time. “The benefit for the patient is that you eliminate variability between scans caused by the operator, as every scan will be done in exactly the same way. If your objective is the improvement of healthcare, then it’s got to be this way, in particular given the long-standing shortage of radiographers.”

Ms Claire Strickland, Paul Strickland Scanner Centre CEO, expressed her gratitude to those who have supported the charity over the years and continue to do so. She said: “It’s thanks to donations and money raised by supporters that we have been able to make this level of investment.”

Centre upgrade continues

Building works required for a new PET-CT scanner, improved patient areas and a new reporting suite for our radiologists saw excellent progress during 2023. The works form part of what is probably the biggest upgrade in the centre’s history and follows installation of two MRI scanners.

“It’s a very exciting project—you don’t often see such significant upgrades,” according to Bruno Ferreira, our Superintendent for PET-CT.

As in the case of our MRI upgrade, the work will improve patient comfort and allow us to scan more patients than before, even though the new Siemens Biograph Vision 600 PET-CT scanner is replacing our two existing scanners. Just like the new MRI scanners, the new PET-CT scanner will be faster, produce higher definition images and feature very advanced artificial intelligence software. This will aid cancer Superintendent for diagnosis and monitoring. Having just one PET-CT scanner instead of PET-CT, Bruno Ferreira two will free up a significant amount of space, which will be used to construct new cannulation and uptake bays—clinical areas where patients are injected with radiopharmaceutical agent before their scan and wait for it to be dispersed through their body.

Superintendent for PET-CT, Bruno Ferreira

It is expected the new uptake bays will improve patient comfort, privacy and radiation shielding. Mr Ferreira said: “This is a huge project but will be rewarding when it has been completed.” The new PET-CT scanner is scheduled to arrive during 2024.

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One of our new Siemens Sola 1.5T MRI scanners.

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Successful early diagnosis pilot leads to NHS adoption

A pilot study involving Paul Strickland Scanner Centre and the NHS which seeks to diagnose or rule out cancer in patients who visit their GP with vague symptoms, has proven so successful that it is now being rolled out across Hertfordshire.

The Vague Symptoms Pathway (VSP) programme aims to find the quickest, most efficient way to reach a diagnosis in patients who visit their GP with “non-specific” symptoms, including anything from unexplained weight loss, tiredness, constantly feeling sick, bloated, or even just feeling generally unwell for a period of weeks.

Although the risk is very low, these non-specific symptoms may sometimes be caused by a serious illness, such as cancer. By making a referral under the VSP, a GP can give their patients rapid access to diagnostic tests, including a CT scan, that could help catch cancer earlier.

Cherith Desmeules, Service Manager and Strategy Lead at Paul Strickland Scanner Centre, is leading and overseeing the programme at the centre.

She said: “Living with vague, undiagnosed symptoms can be traumatic and devastating to someone’s quality of life, affecting everything from mental health to personal finances.

“Getting clarity on whether or not someone has cancer early on can not only improve survival chances but can also avoid a lot of unnecessary anxiety for patients and their loved ones.”

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Very friendly staff who put you at ease.

PATIENT COMMENT

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She said: “We carried out the pilot with Herts Valley Clinical Commissioning Group in order to determine whether there might be a need for this service on the NHS.

“We started in March 2021 and scanned 308 patients during 18 months. Of those patients, 49 (16%) had an unexpected finding on their scans. Not all of those findings were cancer but they were referred on for further investigation, which will have led to their conditions been treated if required and their lives improved as a result. Some of the non-cancer conditions picked up include pulmonary embolisms (a blocked blood vessel in your lungs which can be life-threatening), kidney or liver problems, or other infections.

“We’ve now evaluated the pilot and it has been so successful that it is being commissioned as a service by West Herts Hospitals NHS Trust, the NHS organisation that looks after Watford General Hospital, Hemel Hempstead Hospital and St Albans City Hospital, and is being rolled out across Hertfordshire.”

Lower radiation than elsewhere

“The patients referred to us during the pilot study were mostly over 40— very often in their 60s and 70s - who are more likely to develop cancer than those in younger age groups.”

GPs do have guidelines to support them in making a decision when it comes to whether someone should be referred through the pathway. The CT scan isn’t the only test that is done – patients will usually have had blood, urine and other tests to rule out other conditions.

Paul Strickland Scanner Centre’s dual energy CT scanner allows for lower doses of radiation than similar scans at many other centres and hospitals.

“We initially only agreed to support the pilot, but have now committed to being part of the programme long-term, with one of our lead radiologists attending the West Hertfordshire Hospitals multi-disciplinary team meetings in order to provide specialist cancer imaging advice.

“The commissioners have specifically commented on the exceptional care our team provide to patients on the pathway and the fantastic service referrers received. We’re very pleased that the pilot has been so successful that it is now being rolled out on the NHS.”

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“It will be interesting to see what happens on a bigger scale. Until now we’ve run a small pilot which has proven to be very successful, with more patients coming through. Ultimately, if rolled out nationally, we hope to diagnose cancer much earlier through the Vague Symptoms Pathway than would otherwise have been the case. It’s taking a more preventative approach to cancer, as well as other diseases. This can not only improve quality of life and clinical outcomes but also prevent the condition from becoming an emergency and resulting in a diagnosis following a visit to accident and emergency.”

CHERITH DESMEULES, STRATEGY LEAD AND SERVICE MANAGER

O B J E C T I V E 4

To support the continued development of Paul Strickland Scanner Centre in conjunction with Mount Vernon Cancer Centre, and provision of leading local and tertiary cancer services including the development of innovative clinical research.

17 Peer reviewed accepted journal publications by our clinical team. Source: PubMed.gov Data refer to period between 1 October 2022 and 30 September 2023

770 scans completed for 56 separate clinical trials

41 trials involved CT scans 13 trials involved MRI scans 2 trials involved PET-CT scans

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EMPIRIC study now well underway

Clinical research at Mount Vernon Cancer Centre that could drastically improve the survival chances of women with cervical cancer in the future, saw excellent progress during the reporting period.

The EMPIRIC study, which featured in our last annual report and is supported by Paul Strickland Scanner Centre, aims to use our advanced MRI techniques in combination with other tests to predict a patient’s response to treatment and whether they might be at greater risk of seeing their cancer return.

Senior Clinical Research Fellow Dr Mohammed Abdul-Latif said: “We have successfully recruited our first patients of the 40 we need for the study and are on track to complete within the next 2-3 years. The quality of the MRI scans produced by Paul Strickland Scanner Centre are excellent. We are honoured by the willingness of patients who have so far consented to the EMPIRIC study. Their enthusiasm to join the study reflects how important research is to our patients. Thanks to their contribution, we are collecting data vital to demonstrating the value of MRI in improving the treatment of cervical cancer. We have also shown that incorporating multiple, complicated MRI scans into cervical cancer radiotherapy is feasible— and this opens the door to wider use of MRI in this context.”

J¢, Dr MohammedAbdul-Latif 53

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Dr David Lilburn
BSc (Hons) MB ChB (Hons)
MSc PhD FRCR,
Consultant Radiologist
(Molecular and Cancer
Imaging)
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Dr Nemi Gandy MBChB FRCR, Consultant Radionuclide Radiologist

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Dr Muhammad Dharas,
MBBS BSC
Consultant Radiologist
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Dr Andrew Gogbashian MB BS MRCS FRCR, Consultant Oncological Radiologist Lead Consultant, CT

Dr Wai Lup Wong BA (Hons) FRCP FRCR, Consultant Radiologist Lead Consultant, PET-CT

Professor Anwar Padhani MB BS FRCP FRCR, Consultant Radiologist Lead Consultant, MRI

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Dr Heminder Sokhi
MBChB MRCS FRCR,
Consultant Radiologist
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Dr Anthony Chambers MB BS MRCP FRCR, Consultant Oncological and Radionuclide Radiologist

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Dr Subhadip Ghosh-Ray
BSc MBBS FRCR,
Consultant Head and
Neck Radiologist
Lead Consultant for
Information Technology
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Dr James Diss
BSc (Hons) MBBS
PhD FRCR,
Consultant
Radiologist
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Dr Amish Lakhani
MBBS MA (Cantab) FRCR,
Consultant Radiologist
Lead Consultant, Training
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Dr Kathryn Wallitt MBBS, BSc, FRCR, Consultant Radiologist, Nuclear Medicine

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R E S E A R C H C A S E S T U D Y

Research could lead to better outcomes for ovarian cancer patients

The results of a groundbreaking pilot cohort study involving Paul Strickland Scanner Centre and Mount Vernon Cancer centre suggest that a new dual-energy CT imaging model could revolutionise the way response to treatment in patients with high-grade serous ovarian cancer is assessed.

This innovative approach, centred around measuring CT iodine contrast concentration within cancer tissue, shows promising potential in accurately monitoring treatment response and predicting patient outcomes. The study was led by widely recognised ovarian cancer expert Prof Marcia Hall, Consultant Oncologist at Mount Vernon Cancer Centre.

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Great care from staf f. Made me feel at ease.

PATIENT COMMENT

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The results were recently published in the journal Cancer Imaging, in an article titled 'Development of a dual energy CT based model to assess response to treatment in patients with high grade serous ovarian cancer: a pilot cohort study', authored by Prof Hall, Dr Zena Alizzi, Dr Emmanouil Karteris and Dr Andrew Gogbashian, lead consultant for CT at Paul Strickland Scanner Centre.

Around 7,300 cases of ovarian cancer are diagnosed in the UK every year, with women in their mid-seventies at greatest risk.

Despite its name, ovarian cancer most frequently originates in the fallopian tubes rather than the ovaries. The cells in the fallopian tubes, responsible for catching eggs, divide very frequently.

The frequency of cell division puts them at an increased risk of errors during cell division, leading to an increased risk of cancer. The challenge lies in detecting malignant cells, as they tend to drop off into the abdominal cavity, where they are impossible to visualise using conventional imaging techniques, until they grow to a mass of cells approximately 0.5cm, or 1/5 inch (the equivalent of 10 million cells).

Typically, doctors rely on the Response Evaluation Criteria in Solid Tumours (RECIST) to assess treatment response, which involves measuring changes in the size of tumour lumps.

However, this method is not ideal for ovarian cancer, which often presents as tiny spots or sheets of disease, making it challenging for radiologists to measure accurately.

Prof Hall and her team explored an alternative approach based on iodine concentration measurements from dual-energy CT scans. They found that iodine concentration changes correlated more accurately with patient outcomes compared to RECIST measurements.

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Warm, clean and friendly. Welcome, efficient and caring. Thank you.

PATIENT COMMENT

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CA125, a blood-based protein marker, is routinely used in the clinic to assess response to treatment for patients with ovarian cancer, although this can sometimes produce false results, it is the best test we have to confirm or refute response to treatment in these patients.

However, the regulatory authorities do not accept CA125 response as proof that new treatments are effective. Changes in iodine concentration mirror CA125 responses to treatment much better than RECIST measurements and if validated may prove to be more acceptable as proof of efficacy for novel drugs.

Prof Hall said: “The results from this study suggest a more objective and reliable way to assess treatment responses, especially in patients without measurable lumps.

By analysing iodine concentration changes, doctors may be able to make better-informed decisions about the effectiveness of treatments, ultimately leading to improved patient care.” Despite the encouraging findings, further research and validation are necessary to establish this technique as the new standard for treatment assessment. Prof Hall hopes that evidence produced with additional funding and larger trials involving multiple centres could result in the technique being more widely adopted and lead to the development of more effective treatments.

She said: “The study has the potential to expand the pool of patients eligible for clinical trials, ensuring that even those with non-measurable tumours can benefit from innovative treatments. The research also highlights the need for objective imaging measures, which will contribute to the development of more targeted and effective therapies for high-grade serous ovarian cancer.” Prof Hall hopes to explore such opportunities to advance this pioneering technique and bring it closer to clinical implementation.

She said: “While our research is still in its early stages, the potential benefits for ovarian cancer patients are immense. The hope is that this breakthrough could transform the way doctors assess and treat high-grade serous ovarian cancer, providing a brighter outlook for patients.”

It was thanks to a gift left by a supporter in her Will that Paul Strickland Scanner Centre was able to jointly fund a research fellow post for Dr Zena Alizzi, which made this study possible, together with Mount Vernon Cancer Centre, the John Bush Academic Fund and the Cancer Treatment Research Trust.

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Measuring the carbon footprint of molecular imaging

Mr Mark Cracknell, Radiographer Paul Strickland Scanner Centre; Gerry Lowe, Medical Physicist the Mount Vernon Cancer Centre and Robert Chuter, Principal Clinical Scientist from The Christie Hospital, Manchester, have embarked on a sustainability project to measure the carbon footprint of SPECT and PET-CT scans for a single patient.

The aim of the project is to provide a benchmark, identify hotspots, and target reduction efforts and it is part funded by Institute of Physics and Engineering in Medicine (IPEM) (www.ipem.ac.uk).

The NHS contributes to 5% of UK carbon emissions, according to NHS England. The health service has set ambitious targets to reach net zero by 2040, with an 80% reduction by 2028 to 2032 for emissions directly controlled by the NHS. For emissions that the NHS can influence, the aim is to reach net zero by 2045, with an 80% reduction by 2036 to 2039.

The team will use a “bottom-up” approach, which involves identifying and quantifying all materials and processes involved for a single patient (activity data). Once the activity data has been collected, Emission factors will be used to convert the activity data into carbon dioxide equivalent (CO2e). Data are being acquired from Paul Strickland Scanner Centre activity, and the team are also inviting other centres throughout the UK to contribute their data in order to make the final dataset more generalisable.

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The power consumption of different devices around the Paul Strickland Scanner Centre PET-CT department was calculated using a readily available power monitor.

The consumables used for a typical cannulation were weighed, and then a conversion factor applied. Consumables associated with the automatic injector (used to inject the PET radiopharmaceuticals) were also weighed, to be converted into CO2e.

Data from Energy Meters connected to each scanner were collected and compared with the number of patients scanned to calculate energy use in kWh per patient.

Over a two-week period, the amount of waste produced in PET-CT was weighed and recorded according to each type (General waste, Clinical Waste, Recycling). The number of patients for the previous day was also noted, to calculate waste per patient. Conversion factors according to the method of disposal will then be applied to calculate the CO2e for waste produced per patient. Patient travel data will be collected via a questionnaire, with the intention to survey 200 patients over a two-to-three-month period. Patients will be asked from where they are travelling for their appointment and what mode of transport they used. A similar survey will be sent to PET-CT staff. The CO2e will then be calculated using the Green House Gases emissions factor for the mode of transport, available from the BEIS/DEFRA database.

Future work includes collecting energy consumption data for A/C units and including the carbon footprint for the production and delivery of radioactive tracer. The team hopes to produce the results by the end of 2024. This project represents a significant step towards understanding and reducing the environmental impact of medical imaging.

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Quick and efficient. PATIENT COMMENT

O B J E C T I V E 5

To improve staff engagement and organisational culture, ensuring patient safety as a top priority.

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Wellbeing and staf f engagement

The charity’s Wellbeing, Intranet and Staff Engagement (WISE) Team carried out a number of activities as part of its ongoing programme to support and engage staff. Staff wellbeing has become even more important than before as a result of the understandable anxiety experienced by many healthcare workers due to the pandemic.

Some of the team’s key activities during the reporting period included:

Staff Wellbeing Champions

A team of three wellbeing champions support staff who are struggling emotionally, signposting them to the extensive support services provided by the Trust if necessary.

Anonymous feedback

In order to generate more ideas from staff, we implemented an anonymous feedback system, which allowed individual staff members to make suggestions as to how the centre can be improved. Staff welcomed the idea and a number of suggestions were received.

One suggestion that was implemented for example was to upload the centre's annual leave chart to the cloud so that staff could check it when away from the workplace, making it easier for them to plan their life outside of work.

Values-based workshop

As part of our Quality Improvement programme for staff, the WISE team organised and hosted an afternoon session during September which focusses on improving staff wellbeing and team building.

During the session, staff listened to a talk by the East and North Hertfordshire NHS Trust Freedom to Speak Up Guardian Sylvia Gomes about the process to raise concerns. In addition, Dementia Nurse Specialist gave an insightful talk into the experience of patients with dementia and how staff can best support them.

Staff summer event

We once again held our annual barbecue for staff and trustees at Batchworth Golf Club, which recently replaced our annual Christmas dinner together in order to reduce the risk of Covid transmission amongst staff.

QI afternoons

The centre’s hosts regular Quality Improvement (QI) afternoons for all staff. At these important all-staff education and engagement events, our people receive safety and other training relevant to their work at Paul Strickland Scanner Centre. During the pandemic, these meetings were held online.

A number of topics were covered during the reporting period, including staff wellbeing and engagement, clinical audit, patient experience and safety.

Today, as always, staff are very skilled and ef ficient. They keep patients informed about any delays and are compassionate and patient-centred.

PATIENT COMMENT

What it’s like to work for us

Marie Fennessy, who recently joined us as MRI superintendent, shares her experience of working at Paul Strickland Scanner Centre.

“All the staff are so friendly and enthusiastic and it’s an amazing place for patients. They are given time and the opportunity to ask questions and examinations are tailored to the individual patient needs. Patient satisfaction is a priority. I joined Paul Strickland Scanner Centre from a large district general hospital, which had been a huge challenge and privilege – although it was a large hospital serving a substantial portion of west London, we were under-resourced both with staffing and equipment, having just one MRI scanner, when compared with three MRI scanners at Paul Strickland Scanner Centre.

“The waiting list was enormous. Particularly after the pandemic, it felt like an impossible situation to turn around.

“There’s so much more emphasis placed on training, learning and developing at Paul Strickland Scanner Centre and the centre invests heavily in both equipment and staff. Sadly, quite often in the NHS there just isn’t the scope to expand services as we do here.

“Prior to joining, I knew Paul Strickland Scanner Centre was a charity set up to transform patients’ lives through medical imaging and that voluntary donations play a vital role in funding equipment. In many other hospitals, acquiring funding for new equipment can be an extremely difficult and a bureaucratic process; you come up against multiple obstacles. At Paul Strickland Scanner Centre, things seem to be a lot more straightforward. From my experience, if you submit a sound and clinically justified business case for equipment, you are likely to get it funded. It really is a breath of fresh air.”

It really is a breath of fresh air. MARIE FENNESSY, MRI SUPERINTENDENT

I attended with my father who has mild dementia. Everyone was so kind and patient. Thank you to the reception staff for being so patient.

PATIENT COMMENT

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How we manage principal risks and uncertainties

At bi-monthly board meetings the Trustees continue to focus on major risks for the charity which would have a severe impact on operational performance as well as reputation, should they occur.

The Audit and Risk Committee, which is a sub-committee of the Board of Trustees, met three times during the reporting period. The work of the sub-committee is reported to the Board of Trustees. The committee jointly reviews the centre’s risk register, and during the reporting period reviewed all risks on the register, including compliance, clinical risk, income, contracts, business continuity, costs, investments, succession planning, fundraising, growth, capacity and expansion as well as business approach and governance. The Audit and Risk Committee updates the risk register after each meeting, which the board then reviews annually. The latest review by the Board took place on 15 September 2023.

We carry out surveys amongst patients and referrers to see how satisfied they are with our service. Our staff analyse the results, develop, and implement action plans to make improvements which will improve the experience for both patients and the doctors who referred them. Clinical audit and peer review of reports form an important part of the overall quality review process and serve not only as a safeguard for patients, but also facilitate individual and collective learning. Reviewing and learning from internal audits, past scan reports and correct identifications of disease or otherwise provides a forum for learning and forms a body of evidence of reflective practice to support annual appraisals and revalidation.

Learning Meetings are held regularly to give radiologists an opportunity to discuss specific cases with learning points. The outcomes of the meeting are communicated to all our reporters by the radiology governance lead. Depending on the urgency of the feedback, prior or subsequent communications between staff and referrers take place through which any potential patient harm is minimised and the lesson learnt is appropriately shared. Through appraisals, reporters also personally reflect on points learned and actions taken. The centre has a reciprocal peer review arrangement with University College London Hospitals (UCLH) for PET-CT scan reports.

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FINANCIAL REVIEW

This financial review outlines our charity's financial performance over the year, as detailed in the accompanying financial statements.

Income for the year closely aligned with our forecasts, with total income reaching £8.896m for the period ending 30 September 2023 (2022: £8.013m), marking an 11% increase. This growth is primarily due to the strategic expansion of our charitable activities, highlighted by our investment in new MRI scanners in the preceding year.

Total income from charitable activities was £8.102m (2022: £7.107m), an increase of £995k (14%).

The number of scans carried out is the principal activity driver for the charity; the total number of scans performed during the year was 18,823, compared to 17,243 in the whole of 2021/22, an increase of 1,580 scans (9%). This 9% increase can be significantly attributed to the strategic acquisition and deployment of new MRI scanners in the previous year. The mix of scans conducted has a bearing on total revenue achieved because of the pricing structure. Total scan numbers in recent years are as follows:

2019	16,955	2022	17,243
2020	15,116	2023	18,823
2021	16,176

Total expenditure increased by £451k from £9,310k to £9,761k (0.5%). An overall increase in expenses was driven by rises in staff costs (£101k), depreciation (£256k), and support expenses (£210k). Despite these pressures, the charity has proactively implemented several measures to manage and offset these increases effectively. These strategies include leveraging technology to reduce manual processes, and renegotiating contracts and procurement processes to secure more favourable terms.

The charity generated a deficit of £865k (2022: 1,297k deficit). The result is a moderately positive outcome for the charity due to impacts of the economic downturn and inflation.

The charity needs to generate a surplus, year on year, to enable it to continue to invest in new scanners, associated equipment and other advanced technology as well as provide the services which are in such demand. To help rebuild the charity finances, the charity is planning to invest in new scanners and equipment. Depreciation charged on fixed assets was £725k.

The financial position of the charity has deteriorated due to annual financial deficit of £865k. In the year under review, the charity made a significant investment of £1.446 million in preparatory costs for a new PET CT scanner. This strategic investment is expected to enhance our service capacity, enabling us to conduct a higher volume of scans and reduce waiting times for our beneficiaries. Total net assets are £11.775m (2022: £12.640m). The balance sheet of the charity is very liquid, with cash balances, including investments of £8.593m.

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Structure, Governance and Management

TRUSTEES AND THEIR INTERESTS

Paul Strickland Scanner Centre is a charitable company, limited by guarantee. It is a registered charity governed by its Articles of Association and it does not have share capital, therefore, there are no Trustees’ interests.

STATEMENT OF TRUSTEES’ RESPONSIBILITIES

Our Trustees (who are also directors of Paul Strickland Scanner Centre for the purposes of company law) are responsible for preparing the Trustees’ Annual Report and Financial Statements in accordance with applicable laws and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company law requires the Trustees to prepare financial statements for each financial year, which give a true and fair view of the state of affairs of the charitable company and of the incoming resources and application of resources, including the income and expenditure of the charitable company for that period. In preparing these financial statements, our Trustees are required to:

Observe the methods and principles in the Charities SORP 2019 (FRS 102);
Select suitable accounting policies and then apply them consistently;
Make judgements and accounting 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;
Prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue its activities;

44 66 Excel é t staff. PATIENT C NT

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Our Trustees are responsible for keeping adequate accounting records that 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.

HOW WE WORK

The governing document of Paul Strickland Scanner Centre is its Articles of Association, and policy decisions are made by our Board of Trustees. As set out in the Articles of Association, new Trustees may be appointed by the existing Trustees by resolution but must retire from office at the next general meeting and shall be eligible for election at that meeting. At each annual general meeting one third of the Trustees must retire from office. The Trustees to retire by rotation shall be those who have been longest in office since their last appointment. A Trustee shall not hold office for more than nine consecutive years and shall not be eligible for appointment or reelection upon the expiry of such period until a period of twelve months has elapsed since they retired as a Trustee. There shall be a minimum of three and a maximum of twelve Trustees. Our Trustees come from a variety of backgrounds and have been carefully chosen because of their qualifications, experience, or connection to our cause and patient community.

Our chief executive officer is Claire Strickland. She isn’t on the board and the Trustees have delegated the daily running of the charity to her and she is supported by the staff team. Claire and her strategy team are accountable to the Board of Trustees, who meet six times per year.

NEW TRUSTEES

When we need a new Trustee to join our board, we invite candidates to the centre, show them around and tell them about our work. Candidates are selected by interview involving at least two Trustees. They also meet the other Trustees and get the opportunity to ask them about the charity and the work of the board. We circulate their CV to the existing Trustees and provide the candidate with an information pack about the different types of scans at the centre, our financial situation and the latest financial statements. Once their appointment has been agreed by the board, we provide new Trustees with copies of our governing documents. This includes the board terms of reference, statement of Trustee liability, frequency and timings of board meetings, a list of current Trustees, organisational structure, our current strategic plan and summary of all insurance policies. Each Trustee takes part in a carefully

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designed induction programme to help them understand how we help patients and their families as well as what their responsibilities are.

INVESTMENT POWERS

Under the Articles of Association, our Trustees have the power to decide which investments are best for the charity. We follow a cautious investment strategy and have taken careful steps to make sure that our reserves are not put at undue risk. During the period and at the Balance Sheet date, most of our cash reserves have been put in short term fixed deposit accounts spread across a range of institutions. This is a prudent approach and deposits are held in short term account of usually no longer than 6 months maturity so that we remain flexible.

RESERVES POLICY STATEMENT

The Charity diligently establishes, and regularly evaluates, its reserves policy to safeguard the maintenance of sufficient funds that cover essential operational expenses, including staff salaries and associated costs, for a 6 to 9 months period. This is to ensure that not only will ongoing commitments be fulfilled, but also to sustain services in alignment with the Charity’s objectives. Currently, our total unrestricted funds amount to £11,672,818 and our total free reserves are £4,997,579. Our reserves policy has been developed taking account of guidance published by the Charity Commission.

This strategic approach is designed to facilitate responsiveness during emergencies, safeguard the well-being of our patients, and provide the flexibility to redirect resources for intricate and enduring specialist clinical care pathways, should the unlikely event of winding up the Charity arise. The Trustees are aware of the finite operational lifespan of the scanning equipment currently in use. Consequently, provisions are set aside from the accumulated fund to acknowledge the Charity’s future commitment to funding the vital replacement of older equipment. By adhering to these financial practices, we aim to assure potential funding partners that our commitment to financial prudence is aligned with sustaining our mission and responsibilities as a provider of state-of-the-art imaging scans.

STAFF PAY AND CONDITIONS

Pay and conditions of staff are determined nationally, as set out in the NHS Terms and Conditions of Service Handbook and subject to a national job evaluation scheme.

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CRITERIA OR MEASURES USED TO ASSESS SUCCESS IN THE REPORTING PERIOD

A set of key performance indicators is in place and these are measured throughout the reporting period, so that Trustees can assess the charity’s performance and results against its objectives to ensure the charity is working towards meeting them. It is reviewed and discussed at board meetings. The measures include activity, quality, patient experience and contract compliance and these are discussed in the relevant earlier sections of the report.

FUNDRAISING COMPLIANCE

The fundraising team at Paul Strickland Scanner Centre organises events and other fundraising activities in the local community. Due to the end of the pandemic, we have been able to restart many of our popular events, such as our annual Charity Golf Day. During the reporting period, Paul Strickland Scanner Centre involved an external fundraising professional on a contract basis to carry out fundraising from trusts and grant makers as a result of a vacancy that had arisen due to maternity leave. Paul Strickland Scanner Centre has signed up to the Fundraising Regulator’s Code of Fundraising Practice. The team keeps up to date with the latest developments and best practice by attending conferences and webinars throughout the year. Volunteer fundraisers are given a briefing by the Information Governance lead before they raise funds for Paul Strickland Scanner Centre. All direct marketing is undertaken by the fundraising team to ensure that it is not unreasonably intrusive or persistent. Contact is made through direct marketing five times a year with our supporter magazine, as well as through relevant emails to those who have consented to receiving email. We closely follow UK-GDPR guidelines. All marketing material contains clear instructions on how a person can be removed from mailing lists. No complaints for conduct that contravenes the Fundraising Regulator’s Code of Practice were received by the department in this period.

BOARD OF TRUSTEES

The Trustees serving during the year and since year end were as follows: Dr Roberto Alonzi (resigned April 2023)

Mrs Nimisha Jadeja Ms Joanne Langfield (Chair since April 2023) Mr André Nunes (Appointed April 2023) Mr Dilip Manek (resigned April 2023) Ms Amy Page (appointed December 2022) Mr Daniel Ross (Treasurer) Mr George Wharton Mrs Cathy Williams (Chair to April 2023) Mrs Jean Liao (Appointed November 2023)

**• 66 Polite, heLpfuL staff. PATIENT COMMENT 79

Other administrative details

Company Number: 02033936 Charity registration number: 298867 Registered office: Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, HA6 2RN

Principal Bankers: Barclays Bank plc. Solicitors: Veale Wasbrough Vizards LLP

Auditors

Our auditors, Nunn Hayward LLP, are deemed to be reappointed under section 487(2) of the Companies Act 2006. Their address is: Nunn Hayward LLP, Chartered Accountants and Statutory Auditor, 2-4 Packhorse Road, Gerrards Cross, Buckinghamshire, SL9 7QE.

RELATED PARTIES

Details of transactions with Trustees and other related parties are given in [Note 17] to the financial statements.

STATEMENT OF DISCLOSURE TO THE AUDITORS

So far as the Trustees are aware, there is no relevant audit information (as defined by Section 418 of the Companies Act 2006) of which the charity’s auditors are unaware, and each Trustee has taken all the steps that they ought to have taken as Trustees in order to make themselves aware of any relevant audit information and to establish that the charity’s auditors are aware of that information. In approving the Trustees’ Annual Report, we also approve the strategic report included therein, in our capacity as company directors.

Ms Joanne Langfield,

Chair of the board of Trustees, dated 26 April 2024 On behalf of the Board of Trustees

Ir 81

I N D E P E N D E N T A U D I T O R ' S R E P O R T

Independent auditor's report

TO THE MEMBERS OF PAUL STRICKLAND SCANNER CENTRE

OPINION

We have audited the financial statements of Paul Strickland Scanner Centre (the 'charitable company') for the year ended 30 September 2023 which comprise the statement of financial activities, the balance sheet, cash flow statement and the related notes, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 'The Financial Reporting Standard applicable in the UK and Republic of Ireland' (United Kingdom Generally Accepted Accounting Practice).

In our opinion the financial statements:

[give a true and fair view of the state of the charitable company's affairs as at] 30 September 2023 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 auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the charitable company in accordance with the

I N D E P E N D E N T A U D I T O R ' S R E P O R T

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 trustees' annual report, other than the financial statements and our auditor’s report 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. 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.

I N D E P E N D E N T A U D I T O R ' S R E P O R T

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 trustees' report, which includes the strategic report and] the directors’ report prepared for the purposes of company law, for the financial year for which the financial statements are prepared is consistent with the financial statements; and
[the strategic report and the directors’ report included within the trustees' report have] 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 strategic report and the directors' report included within the trustees' report.

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

[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' and directors' 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 set out on page 74, 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.

I N D E P E N D E N T A U D I T O R ' S R E P O R T

In preparing the financial statements, the trustees are responsible for assessing the charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

AUDITOR'S RESPONSIBILITIES FOR THE AUDIT OF THE FINANCIAL STATEMENTS

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We identified and assessed the risks of material misstatement of the financial statements from irregularities, whether due to fraud or error, then designed and performed audit procedures that addressed these risks in order to obtain sufficient and appropriate audit evidence to provide a basis for our opinion. These procedures and the extent to which they are capable of detecting irregularities, including fraud, are detailed below.

[Enquiry of management, those charged with governance and the charitable company’s] solicitors around actual and potential litigation and claims.
[Enquiry of the charitable company’s staff in accounting, tax and compliance functions to] identify any instances of non-compliance with laws and regulations having a direct effect on the financial statements including the Companies Act 2006, the Charities Act 2011 and the Charities SORP (FRS 102).
[Reviewing financial statement disclosures and testing to supporting documentation to] assess compliance with the above mentioned laws and regulations,
[Enquiry of the charitable company’s staff in accounting, tax and compliance functions to] identify any instances of non-compliance with other laws and regulations which do not have a direct effect on the financial statements but compliance with which could be fundamental to the charity's ability to operate or to avoid a material penalty, including CQC regulations.

I N D E P E N D E N T A U D I T O R ' S R E P O R T

[Reviewing minutes of meetings of those charged with governance including their own] assessment of significant risks as carried out and reported by the Audit and Risk Committee
[Auditing the risk of management override of controls, including through testing journal entries] and other adjustments for appropriateness, and evaluating the business rationale of significant transactions outside the normal course of business.

Because of the inherent limitations of an audit, there is a risk that we will not detect all irregularities, including those leading to a material misstatement in the financial statements or non-compliance with regulation. This risk increases the more that compliance with a law or regulation is removed from the events and transactions reflected in the financial statements, as we will be less likely to become aware of instances of non-compliance. The risk is also greater regarding irregularities occurring due to fraud rather than error, as fraud involves intentional concealment, forgery, collusion, omission or misrepresentation.

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 auditor’s report.

This report is made solely to the charitable company's members (who are also the trustees for the purposes of charity law and the company's members and directors for the purposes of company law), as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006, and to the charity’s trustees, as a body, in accordance with regulations made under section 154 of the Charities Act 2011. 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.

Tom Lacey (Senior Statutory Auditor)

for and on behalf of Nunn Hayward LLP, Statutory Auditor

Nunn Hayward LLP is eligible to act as an auditor in terms of Section 1212 of the Companies Act 2006 2-4 Packhorse Road, Gerrards Cross, Buckinghamshire SL9 7QE

Date: 26 April 2024

F I N A N C I A L S T A T E M E N T S

Statement of financial activities (including income and expenditure account)

FOR THE YEAR ENDED 30TH SEPTEMBER 2023

		General	Designated	Restricted	Total	Total
		Fund	Fund	Fund	2023	2022
	Notes	£	£	£	£	£
INCOME
Donations and legacies	3	474,587	-	43,251	517,838	439,624
Income from charitable activities:
Clinical services	3	8,101,628	-	-	8,101,628	7,106,542
Investment income	3	276,355	-	-	276,355	321,643
Other income - proft on sale of tangible fxed assets		-	-	-	-	145,000
TOTAL INCOME	16	8,852,570	-	43,251	8,895,821	8,012,809
EXPENDITURE
Costs of raising funds	5	179,560	-	-	179,560	171,890
Expenditure on charitable activities	6	9,581,007	-	-	9,581,007	9,138,246
TOTAL EXPENDITURE	16	9,760,567	-	-	9,760,567	9,310,136
NET (EXPENDITURE)/INCOME		(907,997)	-	43,251	(864,746)	(1,297,327)
TRANSFERS BETWEEN FUNDS	16	325,495	(325,495)	-	-	-
NET MOVEMENT IN FUNDS		(582,502)	(325,495)	43,251	(864,746)	(1,297,327)
FOR THE YEAR
RECONCILIATION OF FUNDS
FUNDS BROUGHT FORWARD	15,16	5,580,081	7,000,734	58,721	12,639,536	13,936,863
FUNDS CARRIED FORWARD	15,16	4,997,579	6,675,239	101,972	11,774,790	12,639,536

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

The notes on pages 91 to 107 form part of these financial statements.

F I N A N C I A L S T A T E M E N T S

Balance sheet

Balance sheet F I N A N C I A L S T A T E M E N T S
AS AT 30TH SEPTEMBER 2023		£ 4,121,239 2,554,000	2022 £ 1,897,149 6,012,547	£ 3,315,734 3,685,000
Notes FIXED ASSETS Tangible assets 8 Investments 9 CURRENT ASSETS Debtors 10 Cash at bank and in hand 9 CREDITORS - AMOUNTS FALLING DUE WITHIN ONE YEAR Creditors and accruals 11 NET CURRENT ASSETS TOTAL ASSETS LESS CURRENT LIABILITIES CREDITORS - AMOUNTS FALLING DUE AFTER MORE THAN ONE YEAR 12 TOTAL NET ASSETS FUNDS: Unrestricted funds: - General funds 16 - Designated funds 16 Total unrestricted funds Restricted funds 16 TOTAL CHARITY FUNDS	2023 £ 2,282,762 6,038,765
		6,675,239 5,136,120		7,000,734 5,695,219
	8,321,527 3,185,407		7,909,696 2,214,477

		11,811,359 36,569		12,695,953 56,417
		11,774,790		12,639,536
		4,997,579 6,675,239		5,580,081 7,000,734
		11,672,818 101,972		12,580,815 58,721
		11,774,790		12,639,536

F I N A N C I A L S T A T E M E N T S

Balance sheet (continued)

AS AT 30TH SEPTEMBER 2023

These financial statements were approved at a meeting of the Trustees held on 26 April 2024.

TRUSTEES

Daniel Ross

Ms Joanne Langfield

Company number: 02033936 Registered Charity number: 298867

The notes on pages 91 to 107 form part of these financial statements.

F I N A N C I A L S T A T E M E N T S

Cash flow statement

FOR THE YEAR ENDED 30TH SEPTEMBER	2023
		2023	2022
	Notes	£	£
CASHFLOWS FROM OPERATING ACTIVITIES
Net cash provided by/(used in) operating activities	1	378,020	(1,014,483)
CASH FLOWS FROM INVESTING ACTIVITIES
Interest received on deposits held		71,359	3,765
Purchase of tangible fxed assets		(1,530,811)	(2,374,391)
Disposals of tangible fxed assets		-	145,000
Net cash used in investing activities		(1,459,452)	(2,225,626)
CASH FLOWS FROM FINANCING ACTIVITIES
Interest paid		(3,502)	(4,865)
Repayment of obligations under fnance leases		(19,848)	(24,322)
Net cash used in fnancing activities		(23,350)	(29,187)
DECREASE IN CASH AND CASH EQUIVALENTS		(1,104,782)	(3,269,296)
CASH AND CASH EQUIVALENTS
AT THE BEGINNING OF THE YEAR		9,697,547	12,966,843
CASH AND CASH EQUIVALENTS
AT THE END OF THE YEAR	2	8,592,765	9,697,547

F I N A N C I A L S T A T E M E N T S

Notes to the cash flow statement

FOR THE YEAR ENDED 30TH SEPTEMBER 2023

1. RECONCILIATION OF NET MOVEMENT IN FUNDS TO NET CASH FLOW FROM OPERATING ACTIVITIES

Net expenditure and net movement in funds for the year (as per the Statement of Financial Activities) Adjustments for: Depreciation charges Proft on sale of fxed assets Interest received Interest paid (Increase)/decrease in debtors Increase/(decrease) in creditors Net cash provided by operating activities 2. ANALYSIS OF CASH AND CASH EQUIVALENTS Fixed asset investments - term deposits Cash at bank and in hand	2023 £ (864,746) 725,306 - (71,359) 3,502 (385,613) 970,930	2022 £ (1,297,327) 469,052 (145,000) (3,765) 4,865 2,439,850 (2,482,158)
	378,020	(1,014,483)
	2023 £ 2,554,000 6,038,765	2022 £ 3,685,000 6,012,547
	8,592,765	9,697,547

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

Notes to the financial statements

FOR THE YEAR ENDED 30TH SEPTEMBER 2023

1. STATUTORY INFORMATION

Paul Strickland Scanner Centre is a company limited by guarantee registered in England and Wales (company number 02033936). The liability of the members (who are also the trustees) is limited to £1 each in the event of winding up. The charity's registered and principal office is Mount Vernon Hospital, Northwood, Middlesex, HA6 2RN.

The accounts are presented in £ Sterling and rounded to the nearest £1.

2. STATEMENT OF ACCOUNTING POLICIES

The accounting policies adopted, judgements and key sources of estimation uncertainty in the preparation of the financial statements are as follows:

2.1 Basis of preparation

The financial statements have been prepared in accordance with Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland issued in October 2019, the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102), the Charities Act 2011, the Companies Act 2006 and UK Generally Accepted Accounting Practice.

Paul Strickland Scanner Centre meets the definition of a public benefit entity under FRS 102. The financial statements are prepared on a going concern basis and under the historic cost convention unless otherwise stated in the relevant accounting policy note(s).

These financial statements are prepared in accordance with applicable charity and company law.

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

2.2 Income

Income is credited to the statement of the financial activities in the period to which it relates. With the exception of voluntary income arising from legacies, donations and gifts, all income is credited to the statement of financial activities on a receivable basis.

Income from donations and gifts is recognised on a cash received basis. Income from pecuniary legacies are recognised as receivable once probate has been granted and notification has been received. Residuary legacies are recognised as receivable once probate has been granted, provided that sufficient information has been received to enable valuation of the charity's entitlement.

Income tax recoverable in respect of gift aid donations received to 30 September 2023 has been accrued for in these financial statements.

Fees receivable for scans are brought into the financial statements on the date on which the services are provided by the scanner centre.

Investment income is recognised on a receivable basis

Grants received, which relate to a specific period of time, are dealt with on an accruals basis.

2.3 Donated services

The charity is not in receipt of any donated goods or services, other than general volunteers. In accordance with the Charities SORP (FRS 102), the economic contribution of general volunteers is not recognised in the accounts.

2.4 Expenditure

Expenditure is recognised on an accruals basis as a liability is incurred. Expenditure includes any VAT which cannot be fully recovered, and is reported as part of the expenditure to which it relates.

Costs of raising funds comprises the costs associated with attracting and managing donated income.

Expenditure on charitable activities comprises services identifiable as wholly or mainly in support of the company's charitable and operational work. These costs are regarded as an integral part of carrying out the direct charitable objectives of the charity and include

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

an appropriate proportion of overhead costs. Research and development expenditure is written off in the statement of financial activities in the year in which it is incurred.

Governance costs comprise expenditure incurred for constitutional and statutory requirements and are included within expenditure on charitable activities.

Support costs are costs indirectly incurred by the charity in supporting its charitable activities. They include the central functions and have been allocated to categories on a basis consistent with the use of resources.

2.5 Tangible fixed assets

Tangible fixed assets are stated at cost less accumulated depreciation and any impairment losses. Depreciation is provided at rates calculated to write off the cost less estimated residual value of each asset over its expected useful life, as follows:

Land and buildings leasehold - over the length of the lease Property improvements - over the length of the lease Scanners - between 5 - 7 years straight line Scanner upgrades - between 4 - 6 years straight line Equipment - 25% straight line

Where significant building costs are incurred in order to install the new scanners, these costs are capitalised and depreciated in line with the respective scanner. General property improvements are depreciated over the remaining length of the lease.

At the year end fixed assets are reviewed to determine whether there is any indication that those assets have suffered impairment loss. If there is an indication of possible impairment, the recoverable amount of any affected assets is estimated and compared to its carrying amount. If the estimated recoverable amount is lower, the carrying amount is reduced to its estimated recoverable amount, and an impairment loss is recognised in the statement of financial activities.

If an impairment loss subsequently reverses, the carrying amount of the asset is increased to the revised estimate of its recoverable amount, but not in excess of the amount that would have been determined had no impairment loss been recognised for

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

the assets in prior years. A reversal of an impairment loss is recognised immediately in the statement of financial activities.

2.6 Investments

Investments are deposits held at bank which have been set aside for future capital expenditure and equals the amount of designated funds.

2.7 Debtors

Fees receivable and other debtors are recognised at the settlement amount due. Prepayments are valued at the amount prepaid based on the cost value of the expenditure suffered.

2.8 Cash at bank

Cash at bank includes cash held in current, deposit and treasury deposit accounts and excludes amounts recognised under investments.

2.9 Creditors and provisions

Creditors and provisions are recognised where the charity has a present obligation resulting from a past event that will probably result in the transfer of funds to a third party and the amount due to settle the obligation can be measured or reliably estimated. Creditors and provisions are normally recognised at their settlement amount.

2.10 Finance and operating leases

Leases are classified as finance leases whenever the terms of the lease transfer substantially all the risks and rewards of ownership of the leased asset to the charity. All other leases are classified as operating leases.

Assets held under finance leases are recognised initially at fair value of the leased asset at the inception of the lease. The corresponding liability to the lessor is included in the balance sheet as a finance lease obligation. Lease payments are apportioned between finance charges and a reduction of the lease obligation using the effective interest method so as to achieve a constant rate of interest on the remaining balance of the liability. Finance charges are recognised in the statement of financial activities. Assets held under finance leases are included in tangible fixed assets and depreciated and assessed for impairment in the same way as owned assets.

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

Rentals payable under operating leases are charged on a straight-line basis over the term of the lease. The aggregate benefit of lease incentives are recognised as a reduction to the expense recognised over the lease term on a straight line basis.

2.11 Taxation

The company is a registered charity and, therefore, is not liable for income tax or corporation tax on income derived from its charitable activities, as it falls within the various exemptions available to registered charities if applied for charitable purposes.

2.12 Funds

Unrestricted funds (general funds and designated funds) are those funds expendable at the discretion of the trustees in accordance with the charitable objects.

Restricted funds are monies raised for, and their use restricted to, a specific purpose, or donations subject to donor imposed conditions.

2.13 Financial instruments

The charity only has financial assets and liabilities of a kind that qualify as basic financial instruments: cash at bank, debtors and creditors. Basic financial instruments are initially recognised at transaction value and subsequently measured at their settlement value.

2.14 Judgements and estimation

Preparation of the financial statements requires management to make significant judgements and estimates. The items in the financial statements where judgements and estimates have been made include:

Useful economic life of tangible assets

The annual depreciation charges for tangible assets are sensitive to changes in the estimated useful economic lives and residual values of the assets. The useful economic lives and residual values are amended when necessary to reflect current estimates, based on technological advancement, future investments, economic utilisation and physical condition of the assets.

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

3. INCOME Donations and legacies Donations, gifts and funds raised Trusts and Grants Legacies Gift Aid recoverable on donations Income from charitable activities Fees from patients and health authorities Investment income Royalties receivable Cyclotron rental income Bank interest and bank treasury deposit interest receivable	2023 £ 172,821 18,416 324,636 1,965	2022 £ 194,997 12,752 199,598 32,277
	517,838	439,624
	2023 £	2022 £
	8,101,628	7,106,542
	2023 £ 60,000 144,996 71,359	2022 £ 172,872 145,006 3,765
	276,355	321,643

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

4. NET INCOME

4. NET INCOME
Net income is stated after charging: Operating lease rentals Finance lease interest Auditors’ remuneration - audit Auditors’ remuneration - accountancy services Depreciation 5. COSTS OF RAISING FUNDS Fundraisers’ salaries and assistance Event costs Printing and mailing General expenses	2023 2022 £ £ 1,247,065 1,506,545 3,502 4,865 15,000 13,000 3,000 8,000 725,306 469,052
	2023 2022 £ £ 139,866 133,876 12,156 7,508 17,995 19,712 9,543 10,794
	179,560 171,890

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

6. ANALYSIS OF TOTAL RESOURCES EXPENDED

Direct Costs £ 179,560	Support Costs £ -	Governance Costs £ -	Total £ 179,560
8,181,865	1,379,142	20,000	9,581,007
8,181,865	1,379,142	20,000	9,581,007
8,361,425	1,379,142	20,000	9,760,567
171,890	-	-	171,890
8,075,505	1,039,741	23,000	9,138,246
8,075,505	1,039,741	23,000	9,138,246
8,247,395	1,039,741	23,000	9,310,136
	Staffng Costs £ 500,101	Other Costs £ 879,041	Total £ 1,379,142
	370,870	668,871	1,039,741

Support costs represent the staffing costs which are not directly attributable to the clinical services of the charity and other costs including insurances, building costs and general office expenditure which are again, not directly attributable to clinical services. No allocation of support costs has been made to either the research or fundraising functions of the charity as these are deemed to be negligible.

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

7. ANALYSIS OF TOTAL STAFFING COSTS

The East and North Hertfordshire NHS Trust employs staff under joint contracts with the charity. The Trust administers the payroll and the charity is recharged for its share of the associated costs. These recharges are detailed below:

	2023	2022
	£	£
Wages and salaries	2,796,561	2,711,404
Social security	576,092	558,549
Pension	296,764	297,957
	3,669,417	3,567,910
During the year, emoluments of recharged staff earning in excess of £60,000 was as follows:-
	2023	2022
	No.	No.
£60,000 to £70,000	3	2
£70,000 to £80,000	1	1
£80,000 to £90,000	2	3
£90,000 to £100,000	1	0
£100,000 to £110,000	1	1
£120,000 to £130,000	1	1

The number of recharged staff earning above £60,000 to whom retirement benefits are accruing under defined benefit schemes was 9 (2022: 8).

The average number of staff analysed by function was as follows:-

Medical and radiographic Clerical and administration	2023 2022 No. No. 61 61 10 11
	71 72

Key management comprise the trustees and the leadership team. Remuneration of key management in the year was £1,584,612 (2022: £1,553,049). The cost of trustees' indemnity insurance borne by the charity was £2,331 (2022: £2,104). The trustees did not receive any remuneration or fees for their services to the charity during the year under review.

100

N O T E S T O T H E F I N A N C I A L S T A T E M E N T S

8. TANGIBLE FIXED ASSETS

8. TANGIBLE FIXED ASSETS
Leasehold Land & Buildings £ Cost At 1 October 2022 2,091,883 Additions - Disposals - At 30 September 2023 2,091,883 Depreciation At 1 October 2022 2,091,883 Charge for the year - Disposals - At 30 September 2023 2,091,883 Net book value At 30 September 2023 - At 30 September 2022 - Net book values At 30 September 2023 At 30 September 2022 Depreciation charge for the year At 30 September 2023 At 30 September 2022 Included above are assets held under fnance leases	Leasehold Land & Buildings £ 2,091,883 - -	Property Improvements £ 1,437,513 1,445,930 -	Scanners £ 7,000,102 - -	Equipment £ 2,575,458 84,881 -		Total £ 13,104,956 1,530,811 -
	2,091,883	2,883,443	7,000,102		2,660,339	14,635,767
	2,091,883 - -	843,532 77,497 -	4,777,886 440,523 -		2,075,921 207,286 -	9,789,222 725,306 -
	2,091,883	921,029	5,218,409		2,283,207	10,514,528
	-	1,962,414	1,781,693		377,132	4,121,239
	-	593,981	2,222,216		499,537	3,315,734
		as follows:				Equipment £ 49,876

						75,898
						26,022


						28,191

The expenditure on land buildings as shown above does not include the cost of the main building housing the Scanner Centre. Had these costs been capitalised then they would have been fully depreciated by 30 September 2005.

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9. CASH AND CASH EQUIVALENTS

9. CASH AND CASH EQUIVALENTS
	2023	2022
	£	£
Investments - cash at bank and on deposit	2,554,000	3,685,000
Cash at bank and in hand	6,038,765	6,012,547
Cash and cash equivalents	8,592,765	9,697,547

Amounts included in investments represent cash at bank and other cash investments set aside by the charity as planned capital expenditure over the next three financial years. As such, capital preservation of these funds is deemed to be of paramount importance and in order to minimise risk, the charity has decided that these funds should be held in cash deposits which are geared to mature in line with the planned capital expenditure schedule.

10. DEBTORS

Fees receivable Prepaid scanner maintenance costs Other debtors Prepayments Legacies receivable	2023 2022 £ £ 1,504,863 1,239,308 228,589 228,124 248,518 172,874 154,180 133,318 146,612 123,525
	2,282,762 1,897,149

Included in fees receivable is £335,263 (2022: £136,986) due from East and North Hertfordshire NHS Trust.

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11. CREDITORS - AMOUNTS FALLING DUE WITHIN ONE YEAR

Trade creditors Accruals and deferred income Other creditors - East and North Hertfordshire NHS Trust Other creditors Value added Tax Net obligations under fnance leases 12. CREDITORS - AMOUNTS FALLING DUE AFTER MORE THAN ONE YEAR Net obligations under fnance leases Amounts payable: Over one year but less than fve	2023 2022 £ £ 1,253,115 1,178,150 692,383 649,348 679,968 356,379 520,320 - 16,271 7,250 23,350 23,350
	3,185,407 2,214,477
	2023 2022 £ £ 36,569 56,417
	36,569 56,417

Net obligations under finance leases are secured on the assets concerned.

13. FINANCIAL COMMITMENTS

At 30 September 2023 the charity was committed to making the following payments under non-cancellable contracts over the life of the lease:

Operating and service contracts which expire: Less than one year Over one year but less than fve Over fve years	2023 2022 £ £ 349,223 160,627 825,700 487,889 191,418 293,536
	1,366,341 942,052

Financial commitments on scanner maintenance agreements will lapse when the related scanner is replaced. The financial commitments on such agreements are recognised over the estimated remaining life of the scanners.

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14. CAPITAL COMMITMENTS

The Trustees regularly review the need to upgrade or replace scanners in order to maintain operational efficiency and offer up to date medical imaging to patients. To achieve these objectives, as at the year end, the charity had placed an order for a new PET CT scanner for £1.9m. The Trustees have already spent £1.446m towards the installation and associated building costs and expect a further £0.654m to be spent on installation and associated costs for this scanner over the next year. .

15. ANALYSIS OF NET ASSETS BETWEEN FUNDS

Fixed assets Current assets Creditors due within one year Creditors due after one year Net assets	General funds Designated funds Restricted funds 2023 Total funds 2022 Total funds £ £ £ £ £ - 6,675,239 - 6,675,239 7,000,734 8,219,555 - 101,972 8,321,527 7,909,696 (3,185,407) - - (3,185,407) (2,214,477) (36,569) (36,569) (56,417)
	4,997,579 6,675,239 101,972 11,774,790 12,639,536

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16. MOVEMENT IN FUNDS

16. MOVEMENT IN FUNDS
	Balance at	Incoming	Resources	Transfers	Balance at 30
	1 October 2022	resources	expended	between funds	September 2023
	£	£	£	£	£
General funds	5,580,081	8,852,570	(9,760,567)	325,495	4,997,579
Total general funds	5,580,081	8,852,570	(9,760,567)	325,495	4,997,579
Restricted funds
Brachytherapy study	1,400	-	-	-	1,400
Lung Cancer Study	-	2,000	-	-	2,000
Research Funds	42,105	2,560	-	-	44,665
Power injector Fund	-	16,394	-	-	16,394
Scanner fund	-	11,450	-	-	11,450
AI software	-	500	-	-	500
Patient welfare	15,216	10,347	-	-	25,563
Total Restricted funds	58,721	43,251	-	-	101,972
Designated funds
Scanner Replacement Fund	3,500,000	-	-	(946,000)	2,554,000
Designated property &	3,315,734	-	-	805,505	4,121,239
equipment fund
IT and Communications & other	185,000	-	-	(185,000)	-
Total Designated funds	7,000,734	-	-	(325,495)	6,675,239
Total	12,639,536	8,895,821	(9,760,567)	-	11,774,790

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16. MOVEMENT IN FUNDS (continued)

Designated funds

A designated fund is a ‘ring fencing’ by the trustees of existing unrestricted funds for a particular project or use by the charity.

Designated property & equipment fund

The property & equipment fund represents the net book value of the charity’s fixed assets, including the lease and improvements to the premises on site at Mount Vernon Hospital, together with the scanners and other equipment used by the charity in the course of its day to day operations. The transfer from General Funds represents the increase in value in tangible fixed assets.

Scanner replacement fund

The trustees of Paul Strickland Scanner Centre recognise that the operational life of the scanner equipment currently in use is limited. Therefore, amounts are set aside from the accumulated fund to acknowledge the future commitment of the charity to fund the replacement of the existing equipment. During the year, the charity started the project to purchase and install a replacement PET CT scanner, which will complete in 2023/24. The level of the scanner replacement designated fund has therefore been set at the remaining estimated costs for this replacement project which comprise £1,900,000 for the PET CT scanner and £654,000 further associated build-in costs.

The trustees therefore believe that the amounts set aside as designated funds as shown above are appropriate.

Restricted funds

Brachytherapy

To fund a Brachytherapy pilot study which will enable the PhD study to give an extra scan time point.

Lung cancer study

Grant funding for a lung cancer study

General Research

To fund various projects relating to the diagnosis and treatment of cancer and other life limiting conditions.

Power injector fund

Funds raised for the purchase of a power injector. This equipment was purchased after the year end.

Scanner fund

Funds raised towards the purchase of a replacement CT scanner.

AI software

Funds raised for the purchase of AI software.

Patient welfare

To fund equipment to improve patient welfare. In 2022/23 £10,347 was received into this fund which was not spent in the year, however an order was placed post year end for reception furniture for patient use totalling £14,086.

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17. RELATED PARTY TRANSACTIONS

The only transactions with related parties, other than those disclosed in note 7, were for payments totalling £1,425 to a business operated by a trustee, Amy Page. These payments were for the provision of Continuing Professional Development services provided to employees of the charity and not for services provided in the performance of duties as a trustee.

18. COMPARATIVE STATEMENT OF FINANCIAL ACTIVITIES FOR THE YEAR ENDED 30TH SEPTEMBER 2022

Notes INCOME Donations and legacies 3 Income from charitable activities: Clinical services 3 Investment income 3 Other income - proft on sale of tangible fxed assets - TOTAL INCOME EXPENDITURE Costs of raising funds: Costs of generating voluntary income 5 Charitable activities 6 TOTAL EXPENDITURE NET (EXPENDITURE)/INCOME TRANSFERS BETWEEN FUNDS NET MOVEMENT IN FUNDS FOR THE YEAR RECONCILIATION OF FUNDS FUNDS BROUGHT FORWARD FUNDS CARRIED FORWARD 15	General Fund Designated Fund Restricted Fund Total 2022 £ £ £ £ 397,992 - 41,632 439,624 7,106,542 - - 7,106,542 321,643 - - 321,643 145,000 - - 145,000
	7,971,177 - 41,632 8,012,809
	171,890 - - 171,890 9,138,246 - - 9,138,246
	9,310,136 - - 9,310,136
	(1,388,959) - 41,632 (1,297,327) 386,543 (312,509) (74,034) -
	(952,416) (312,509) (32,402) (1,297,327) 6,532,497 7,313,243 91,123 13,936,863
	5,580,081 7,000,734 58,721 12,639,536

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19. ANALYSIS OF INCOME AND EXPENDITURE

APPEALS FUND Notes Income Donations, gifts and funds raised Legacies received Income tax recoverable Bank interest and bank treasury Trusts and Grants Less: expenditure Fundraisers’ salaries and assistance Event costs Printing and mailing costs General expenses Surplus - appeals fund Add: Defcit – Scanner Centre 20 Defcit in the year	2023 £ 139,866 12,156 17,995 9,543	£ 172,821 324,636 1,965 71,359 18,416	2022 £ 133,876 7,508 19,712 10,794	£ 194,997 199,598 32,277 3,765 12,752
		589,197 179,560		443,389 171,890

		409,637 (1,274,383)		271,499 (1,568,826)

		(864,746)		(1,297,327)

The above analysis is included to provide additional information to assist in the understanding of the financial activities of the charity.

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20. ANALYSIS OF INCOME AND EXPENDITURE

SCANNER CENTRE	2023		2022
	£	£	£	£
Income
Fees from patients and health authorities		8,101,628		7,106,542
Proft on sale of assets		-		145,000
Royalties receivable		60,000		172,872
Cyclotron rental income		144,996		145,006
		8,306,624		7,569,420
Less: expenditure
Staff salaries and radiologists' fees	4,394,745		4,103,166
Other staffng costs	52,295		7,830
Maintenance contracts and scanner repairs	500,607		657,443
Repairs and renewals of equipment and building	404,104		387,696
Lease charges on equipment	1,077,061		1,336,541
Medical and surgical supplies, cryogens and
other consumables	1,600,261		1,340,160
Coronavirus costs	-		49,764
Rent and rates	170,004		174,504
Heat, light and facilities	264,000		264,000
Printing, postage, stationery and telephone	139,345		109,085
Auditors’ remuneration	15,000		13,000
Medical conferences and travel	10,330		4,717
Miscellaneous expenses	17,606		11,862
Bank charges	3,456		2,149
Legal, professional and consultancy fees	76,240		95,229
Insurance	126,515		107,183
Interest on fnance leases	3,502		4,865
Depreciation	725,306		469,052
		9,581,007		9,138,246
Defcit - scanner centre		(1,274,383)		(1,568,826)

The above analysis is included to provide additional information to assist in the understanding of the financial activities of the Charity.

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2023-09-30-accounts

Investing for the next generation

Contents

Chair's report

C H A I R ’ S R E P O R T

Ms Joanne Langfield

Trustees’ report

For our patients and referrers:

About us

Public benefit

Cancer imaging pioneer

Paul Strickland OBE

Scanning for opportunities

The first diagnostic imaging unit for NHS and private patients in the UK

Very relaxed, can’t wait to come back.

Our CEO and team

Fundraising and research

Objectives and activities

Our objectives

O B J E C T I V E 1

Quality Standard for Imaging

Audit team

Striving for the best care and health outcomes for our patients

MRI Deep Learning Reconstruction: Revolutionising liver imaging

O B J E C T I V E 2

Supporter inspired by our care for his mum and dad

What our patients say about us

100%

100%

Project Luna: Enhancing patient care and financial stability at Paul Strickland Scanner Centre

Patient Experience Group

Fundraising and Communications

Donations in memory of Julia conclude power injector appeal

O B J E C T I V E 3

Second scanner concludes MRI upgrade

Centre upgrade continues

Successful early diagnosis pilot leads to NHS adoption

Lower radiation than elsewhere

O B J E C T I V E 4

EMPIRIC study now well underway

R E S E A R C H C A S E S T U D Y

T R U S T E E S ’ A N N U A L R E P O R T : I N C L U D I N G D I R E C T O R S ’ R E P O R T A N D S T R A T E G I C R E P O R T

T R U S T E E S ’ A N N U A L R E P O R T : I N C L U D I N G D I R E C T O R S ’ R E P O R T A N D S T R A T E G I C R E P O R T

Measuring the carbon footprint of molecular imaging

O B J E C T I V E 5

Wellbeing and staf f engagement

Staff Wellbeing Champions

Anonymous feedback

Values-based workshop

Staff summer event

QI afternoons

What it’s like to work for us

How we manage principal risks and uncertainties

FINANCIAL REVIEW

Structure, Governance and Management

TRUSTEES AND THEIR INTERESTS

STATEMENT OF TRUSTEES’ RESPONSIBILITIES

HOW WE WORK

NEW TRUSTEES

INVESTMENT POWERS

RESERVES POLICY STATEMENT

STAFF PAY AND CONDITIONS

CRITERIA OR MEASURES USED TO ASSESS SUCCESS IN THE REPORTING PERIOD

FUNDRAISING COMPLIANCE

BOARD OF TRUSTEES

Other administrative details

Auditors

RELATED PARTIES

STATEMENT OF DISCLOSURE TO THE AUDITORS

Ms Joanne Langfield,

Independent auditor's report

TO THE MEMBERS OF PAUL STRICKLAND SCANNER CENTRE

OPINION

BASIS FOR OPINION

CONCLUSIONS RELATING TO GOING CONCERN

OTHER INFORMATION

OPINIONS ON OTHER MATTERS PRESCRIBED BY THE COMPANIES ACT 2006

MATTERS ON WHICH WE ARE REQUIRED TO REPORT BY EXCEPTION

RESPONSIBILITIES OF TRUSTEES

AUDITOR'S RESPONSIBILITIES FOR THE AUDIT OF THE FINANCIAL STATEMENTS