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2023-03-31-annual-report

Cancer Lifeline

(a company limited by Guarantee)

Trustees Report

For the year ended 31 March 2023

Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

______________

A warm welcome to our Annual Report for 2022 / 2023.

2022/23 has been a challenging year for the organization. The sharp rise in the cost of living coupled with reduced funding opportunities has meant Cancer Lifeline, like many other community organisations, has faced financial pressures, exacerbated by the rapid growth in demand for support services.

All face-to-face services were fully operational as Cancer Lifeline made a return to pre-pandemic service delivery. Funding through the Department of Health’s (DoH) Cancer Charities Support Fund has been key to enabling Cancer Lifeline to develop key areas of support service delivery to include: -

The COVID-19 pandemic had a devastating impact on cancer patients. Some experienced extreme anxieties, stress, worry and isolation. Many are still facing difficulties because of its impact. Tailored support services delivered throughout 2022-2023 have been critical in helping some of the most vulnerable individuals and families address their physical and mental, health and wellbeing being concerns.

Carers NI’s annual State of Caring Survey most recent report paints a bleak picture of issues facing carers, showing the extent to which, many are sacrificing their own health, wellbeing, and life chances in order to care. Thanks to crucial support from The National Lottery Community Fund through the People and Communities programme, Cancer Lifeline continues to develop our range of support services to carers as well as people living with cancer, recognising the very important role of the carer in the cancer journey of individuals. Cancer is a ‘family illness’ as it affects the whole family. We look forward to sharing our evaluation findings of our Cancer Carer support services in May 2022

On a more positive note, In October 2022 the local community, schools and a range of allied health professionals came together to celebrate Cancer Lifeline’s newly extended premises. The Right Honourable Lord Mayor Counsellor Christina Black was guest of honour on the fantastic day of

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Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

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community celebration and pride. The refurbishment work was funded through the Belfast Investment Fund (via Belfast City Council) and the Department for Communities.

Demand for support services has more than doubled throughout the year. Access to face-to-face support again has been a lifeline to many. We hope this report gives you an overview of the work delivered throughout the year, supporting cancer patients and their families throughout North Belfast.

Our sincere thanks to all the volunteers, staff, funders, allied health professionals, community organisations who without their support we would not have been able to deliver our services to individuals and families in North affected by cancer. Many of whom have faced some of the most difficult times in their lives. Their strength, dignity, and resilience, humble us each day. We look forward to working with you in the year ahead to ensure this vulnerable target group continue to be supported as we continue to put our best foot forward.

Board of Directors and Staff

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Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

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Reference and administrative details

Registered Charity name

Cancer Lifeline

Charity registration number

NIC1000002

Company registration number

NI055010

Principal office & registered address

44 Alliance Avenue Belfast BT14 7PJ

The Trustees:

Bernadette Montgomery Breige Petticrew Gloria Mathews Rosemary McGuigan

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Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

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Structure, governance and management

Governing Document :

The organization is a charitable company limited by guarantee, incorporated on 14th April 2005. The company was established under a Memorandum of Association, which established the objects and powers of the charitable company and is governed under its Articles of Association. In the event of the company being wound up members are required to contribute an amount not exceeding £1.

Appointment of Trustees :

The Trustees of the company are also charity trustees for the purposes of charity law and under the company's Articles are known as members of the Management Committee. Under the requirements of the Memorandum and Articles of Association the members of the Management Committee are elected to serve for a period from one Annual General meeting to the next.

Trustee Induction and Training:

New trustees are invited to an induction meeting to familiarise themselves with the charity and the context within which it operates. These are facilitated by Development Staff and Management Committee, they cover:

Potential Trustees are encouraged to attend a series of business committee meetings as a trail period to familiarise themselves with the work before committing themselves to the role, if this is agreed as appropriate. Trustees are encouraged to attend appropriate training events in-house and external, where these will facilitate the undertaking of their role.

Organisational Structure:

Cancer Lifeline has a Board of Trustees not less than 3, who meet fortnightly and are responsible for the strategic direction and running of the charity. In delivering the objectives of the charity a Coordinator is appointed by the Trustees along with the Development Manager to manage the day-to-day operations of the charity and they are supported by other members of staff.

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Cancer Lifeline Company Limited by Guarantee Trustees Report and Financial Statements For the year ended 31 March 2023

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Objectives and activities

The Trustees have regard to the Northern Ireland Charity Commission's Public benefit requirements. The statutory guidance state the objects and principal activities of the charity are to:

The main activities undertaken to further these aims are detailed in the "Achievements and performance" section of this report.

Trustees' responsibilities statement

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

Company law requires the charity trustees to prepare financial statements for each year which give a true and fair view of the state of affairs of the charitable company and the incoming resources and application of resources, including the income and expenditure, for that period.

In preparing these financial statements, the trustees are required to:

The trustees are responsible for keeping adequate accounting records that are sufficient to show and explain the charity's transactions and disclose with reasonable accuracy at any time the financial position of the charity 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 charity and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

In so far as the trustees are aware:

•There is no relevant audit information of which the charitable company's auditors are unaware; and

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•The trustees have taken all steps that they ought to have taken to make themselves aware of any relevant audit information and to establish that the auditors are aware of that information.

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

Financial Review

The total income for the year 31st March 2023 was £450,411 of this, £359,997 was restricted and the total expenditure for the year was £447,728. of this, £327,904 was restricted

Due to the difficult times, we are facing we have to highlight the importance of maintaining our fundraising activities, and the continuance of voluntary donations, to enable our charity to do its work.

It is also very important that you continue to support our charity shop with any clothes or furniture you may have. We would also like to thank Colm, staff and our volunteers for the great work they do down there as this is a critical source of funds due to the shortfall.

Many thanks for all your support and we look forward to your support in the future.

Reserves Policy

The management committee has examined the charity's requirements for reserves considering the main risks to the organisation. It has established a policy whereby the unrestricted funds, not committed or restricted by the provider (restricted funds) should be separated between general funds and designated funds, the latter ideally representing 6 months of the expenditure. The reserves are needed to meet the working capital requirements of the charity and the Management Committee are confident that at this level they would be able to continue the current activities of the charity in the event of a significant drop in funding until alternative funding resources are found. The present level of designated reserves therefore falls short of the target level. The strategy is to continue to build reserves through operating surpluses.

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Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

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Achievements

PROVIDING VITAL SUPPORT SERVICES IN CHALLENGING TIMES.

Cancer Lifeline is based on Alliance Avenue in North Belfast, in the Ardoyne ward and targets North Belfast an area of significant deprivation, with extensive health inequalities aligned to deprivation. The area has significant need and high levels of cancer within the population, as demonstrated by the following key statistics.

The numbers of people on the cancer register from North Belfast has been growing annually and between 2013 and 2022 there has been an increase of 54% in the numbers of people living with a cancer diagnosis.

A report by the Cancer Registry in November 2020 estimates that the number of cancer cases diagnosed is projected to double by 2040 (45% for males and 58% for females).

The need and demand for Cancer Lifeline’s services in North Belfast is evident from the growing numbers of service users registering annually. Cancer Lifeline is a membership-based organisation. Membership is free but upon making contact, individuals are asked to register and engage in a one-toone meeting with a member of staff to discuss how best Cancer Lifeline can meet their needs. There has been a 70% growth in registered service users since the Covid pandemic.

During 2022-2023 a total of 8,121 ONE TO ONE SUPPORT INTERVENTIONS were facilitated. This included: -

2359 sessions of counselling have been delivered to 276 beneficiaries.

164 pre-assessment counselling sessions were delivered to 164 individuals.

2199 sessions of Complementary Therapies have been delivered (1104 were delivered inhouse to 279 beneficiaries and 1095 were delivered via outreach to 525 individuals.)

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Trustees Report and Financial Statements For the year ended 31 March 2023

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2205 advocacy /support calls have been made to 557 individuals.

292 assessments were carried out with 292 individuals.

646 peer support sessions were delivered to 217 individuals.

79 Welfare Benefits advice sessions have been facilitated on behalf of 63 individuals.

177 Foodbank referrals.

GROUP SUPPORT SERVICE PROVISION DURING 2022-2023

1731 attendances by 191 individuals in a range of health and wellbeing workshops and courses. This included: -

708 attendances in Yoga classes.

407 attendances in Walking Group sessions

92 attendances in Vital Nutrition workshops

46 attendances in Relaxation workshops

94 attendances in Stress Management workshops

121 attendances in Craft workshops

31 attendances in Fatigue Management workshops

75 attendances in Pop Chats (informal opportunities to meet and connect with others)

33 attendances in Bereavement Support group sessions

71 attendances in Female Support group sessions

43 attendances in Male Support group sessions

10 attendances in a Money Talks workshop

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Trustees Report and Financial Statements For the year ended 31 March 2023

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145 referrals to other sources of support were also facilitated for 93 individuals. This included referrals to a wide range of allied health professionals, community organisations, other cancer charities etc.

SERVICE IMPACT WHAT OUR MEMBERS HAVE TOLD US?

(An independent interim evaluation completed in December 2022 of support services delivered as part of the DOH Cancer Charity Fund highlights the positive health outcome of the work)

As a user led model, Cancer Lifeline Committee members and volunteers are themselves living with cancer and this is a critical strength. Provision of peer support and understanding is a unique aspect to the support services of Cancer Lifeline.

It is important to highlight the effectiveness of Cancer Lifeline’s model of delivery. Service users consistently referenced the excellent support and proactive approach of staff and volunteers. Specifically:

Provision of Psychological Support / Counselling

As a result of counselling support, the numbers of service users reporting their sense of stress, anxiety and fear as being very poor / poor was reduced from 88% to 17%. 91% of Support Group participants surveyed report their attendance has helped reduce their stress, anxiety and fear. Focus group discussion has highlighted that counselling support and peer support has been critical for both those living with cancer and family and friends supporting cancer patients. Counselling beneficiaries report the benefits of counselling with respect to:

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Trustees Report and Financial Statements For the year ended 31 March 2023

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Evaluation sheets asked beneficiaries to self-assess their perception of a variety of health outcome indicators which counseling is seeking to address. These indicators were assessed as part of the initial counselling meetings and again at the end of the period of counselling. Impact indicators assessed included:

Analysis of findings shows.

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The graph below shows Counselling Service User Self-Assessment of Stress, Anxiety, Fear

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70%
60%
60%
50%
36%
40%
28%
30% 26%
20% 16% 17%
7%
10% 4% 5%
1% 1% 1%
0%
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Extremely Poor Poor Satisfactory Good Very Good Excellent
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The graph below shows Counselling Service User Self-Assessment Rating - Very Good / Excellent

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Self-care 12% 43%
Isolation / loneliness 9% 32%
Connections with others 20% 49%
Family relationships 40% 62%
Quality of life 7% 30%
Self confidence 4% 26%
Knowledge about cancer support services 10% 66%
Emotional resilience / coping skills 4% 32%
Stress / anxiety / fear 2% 22%
Mental health and wellbeing 4% 30%
0% 10% 20% 30% 40% 50% 60% 70%
End Start
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Support Group participants reported the positive impact of engaging with others on a cancer journey and the positive impact this has on reducing their sense of isolation and loneliness.

Services to Support Physical and Mental Health and Wellbeing

Complementary Therapy is contributing to physical wellbeing with participants reporting pain levels before complementary therapy as very poor / poor falling from 72% at the outset of accessing the service, to 14% after five sessions. The expertise of the therapists employed and their experience in adapted techniques, supplemented by the availability of aromatherapy oils and Bach Flower remedies, have all contributed to enhanced physical wellbeing. In-house complementary therapy sessions were reported to be excellent in terms of helping relaxation, aiding sleep and providing pain relief while the oils and remedies help with stress, anxiety, nausea, sleep and skin conditions.

The graph below shows Complementary Therapy User Self-Assessment Rating –Very Good / Excellent

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25%
22%
20%
17%
15%
10%
6%
5% 5%
5% 4% 3% 4% 4%
1% 1%
0% 0% 0%
0%
Stress / Emotional Isolation / Self-care Sleep Breathing Pain levels
anxiety / resilience / loneliness patterns
fear coping skills
Start End
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Cancer Lifeline Company Limited by Guarantee

Trustees Report and Financial Statements For the year ended 31 March 2023

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Focus group and 1:1 consultation highlighted the benefits of complementary therapy and participants reported that treatments help them to relax, aid better sleep and for those with neuropathy, as a result of their treatment, provides pain relief. Comments included:

“After my session I feel like I am walking on air”

“It calms my mind”

“I had terrible pain in my feet and joints and the reflexology helped ease the pain.”

The cancer experience of therapists and the adaptive techniques used was referenced and their ‘gentle’ approach was welcome for those who availed themselves of therapy while going through treatment. Bach Flower Remedies and aromatherapy blends were reported to help with anxiety, nausea, sleep, scarring and skin conditions because of treatment.

Participants spoke positively about access to complementary therapy. Initial discussions upon joining Cancer Lifeline make members aware of the services on offer and the availability of both in-house massage and reflexology as well as BFR and aromatherapy blends, mixed to suit their needs, is a valued service.

Enhanced provision of and access to practical support for people with cancer

The workshops and short courses delivered have provided service users with practical tips and strategies for managing their health and wellbeing during their cancer journey. Nutrition workshops have provided practical advice and guidance on foods that should be included in diets and those that should be avoided. The fatigue workshop has been helpful in reinforcing the need for cancer patients to recognise their fatigue and the need to listen to their body and its limitations. Service users report they have made changes because of the workshops and feedback demonstrates the very positive impact this has had on overall health and wellbeing, individual self-confidence in managing their illness and their emotional resilience.

Improved Access to Information and Support Services

The availability of a local cancer support service in North Belfast was consistently referenced during the focus groups as a much needed and valued resource. Service users welcomed the ‘drop in’ ethos of Cancer Lifeline and the relaxed and homely style of the centre encourages service user participation in activities. Staff were also praised in terms of their communication with members, their interaction with all those visiting Alliance Avenue, their empathy with service user needs and the quality of the services provided. All of this encourages access to cancer support services in North Belfast, demonstrated by the growing number of people registering with Cancer Lifeline.

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Monitoring data also confirms the role of Cancer Lifeline in raising awareness of support services and thus health literacy of service users.

The newsletter is an important source of information on services available at Cancer Lifeline as well as other important supports such as the local hospitals, Cancer Centre, Public Health Agency, Breast Care Team, Chemo Helpline, Bridgewater Suite, and Covid Helpline.

STRATEGIC CONTEXT

There are many health-related strategies and initiatives which the work of Cancer Lifeline has aligned to during the year, in terms of contributing to the attainment of the vision and aspirations in respect to health and wellbeing, addressing health inequalities and tackling deprivation at a local level. Specifically, the following strategies, plans and initiatives are important.

NI Programme for Government Draft Outcomes Framework

In 2021 the NI Executive consulted on a proposed strategic framework of nine outcomes for a new Programme for Government (PFG), presenting a picture of NI having “ an inclusive society in which people of all ages and backgrounds are respected and supported. A society which has no barriers to people living prosperous and fulfilling lives”. The consultation document references an Outcomesbased PFG in which government, partnering with civic society will respond to the needs of people and

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communities everywhere to ensure an inclusive society where outcomes of individual and collective wellbeing are the drivers for the government agenda.

Two of the nine outcomes are particularly relevant to the work of Cancer Lifeline

Cancer Lifeline is an important service provider in North Belfast for people living with cancer. North Belfast is an area with some of the most deprived areas in Northern Ireland and an area experiencing significant health inequalities. Cancer Lifeline has been responding to the health inequalities in the area through a community-based response and the work of the organisation is clearly aligned to the priorities and intended outcomes of the NI Programme for Government.

Health and Wellbeing 2026: Delivering Together

The Department of Health’s Delivering Together report presents the out workings of an expert panel led by the internationally recognised expert, Professor Rafael Bengoa on tackling the challenges in Northern Ireland’s Health and Social Care system. The report outlines challenges and the opportunities facing the sector and puts people at the forefront, with a focus on enabling people to stay well for longer and where care or support is needed, it will be wherever possible, provided in the community setting.

Of particular relevance to Cancer Lifeline and its work in the community is the identified opportunity to “ promote a new way of working with the community and voluntary sectors through the innovative use

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of social procurement clauses, and commissioning services based on social value rather than simply on the basis of lowest cost ”. The report outlines an ambition for a future in which:

The report refers to a new model of person-centered care focused on prevention, early intervention, supporting independence and wellbeing and towards a model underpinned by a more holistic approach to health and social care.

One of the explicit changes outlined in the report is the need to build capacity in communities. The report states “We will work with communities to support them to develop their strengths and use their assets to tackle the determinants of health and social wellbeing. We will support the development of thriving and inclusive communities. In particular, the HSC will become better at tapping into the innovative ideas and energies in communities themselves, and in the community and voluntary sectors.

Cancer Lifeline is an important community resource, which puts people living with cancer and their families at the forefront of their service delivery. The availability of easily accessible services in North Belfast, an area of health inequality, is extremely important to ensuring that the high level of need and demand is met. There is evidence that the services provided enable beneficiaries to keep well, providing them with information, education, and support to make informed choices and take control of their own health and wellbeing and their model of working collaboratively with others is an excellent example of ‘delivering together’.

Cancer Strategy for Northern Ireland 2021 – 2031

The publication of a 10-year Cancer Strategy was identified as an immediate priority of the Northern Ireland Executive in New Decade, New Approach and in August 2021 the Department of Health (DoH) published the draft strategy for public consultation. The aims of the strategy are threefold;

Cancer Lifeline has a role to play with respect to the aim of improving the experience of people diagnosed with cancer and their carers.

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Support for carers is unique to Cancer Lifeline and the strategy references “ Support and care provided by families and informal carers is vital to the wellbeing of patients given their assistance in managing medications, treatment regimes, symptom management, personal care, social and psychological support. However, providing informal care is challenging for many and can have a negative impact on both physical and mental health. Evidence has shown that there is a need to deliver improved services for informal carers of patients with cancer in Northern Ireland .”

The strategy also references the importance of access to bereavement support, an important service offering at Cancer Lifeline – “ Most bereavement services in Northern Ireland are provided by the community and voluntary sector. Capacity is an issue, with long waiting lists in many areas. Capacity issues are also preventing Trust social work teams from offering greater levels of bereavement support, including follow-up services with carers and loved ones.

Access to pre-bereavement and bereavement support is crucial to meeting the holistic needs of carers and loved ones. It is vital that we adopt a wider approach and ensure that those important to the person living with cancer, including children, are not forgotten. This type of early intervention and support can be helpful in preventing mental health issues connected to early/traumatic loss and complex grief reactions .”

Overall, the services of Cancer Lifeline have an important role to play in supporting the mental health of people living with cancer and their carers. The Cancer Strategy recognised that mental ill health cross cuts the entire cancer pathway and identifies that some services are offered by the voluntary sector but outside of this provision, formalised pathways do not exist for cancer patients. This reinforces the importance of Cancer Lifeline services. The strategy states “ preventing mental health conditions from developing amongst those living with cancer, as well as ensuring adequate management of conditions should they occur are important in the provision of holistic cancer care. The numbers of people needing help with their mental health is likely to grow as more people are living longer following a cancer diagnosis. There are significant gains to be realized, both in patient quality of life and savings in health care costs. ”

Lastly the Cancer Strategy references the need to improve health literacy with respect to addressing health inequality. “ Low levels of health literacy are associated with poorer access to health services, poorer communication with health-care professionals, lower adherence to treatment and poorer selfmanagement of health conditions. Better health literacy could therefore contribute to reducing health inequalities, strengthen health and improve health-care efficiency .” Cancer Lifeline services are strongly focused upon increasing the health literacy of users, ensuring they are connecting to other support services and have improved self-management skills with respect to their cancer diagnosis.

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Cancer Lifeline Company Limited by Guarantee Trustees Report and Financial Statements For the year ended 31 March 2023 Cancer Recovery Plan, Building Back; Rebuilding Better A Cancer Recovery Plan, Building Back; Rebuilding Better has been developed to address the immediate Issues in adult cancer services with the aim of getting to a place where services are stronger than before, providing a solid foundation for the world class service envisaged in the strategy. In June 2021 the Minister for Health published a three-year blueprint for rebuilding cancer care in Northern Ireland The Cancer Recovery Plan. Objectives detailed in the Cancer Recovery Plan which Cancer Lifeline are contributing to include: Ensuring all patients living with cancer feel supported across their pathway and have access to a Clinical N urse Specialist, appropriate psychological su pport, information, and signposting to other services. Creating smoother and more efficient patient pathways from initial referral, through diagnosis and treatment encompassing the appropriate care and support during and after treatment with the aim of improving cancer waiting time and patient outcomes and patient experience. From the above it is evident that Cancer Lifeli ne is successfully del ivering against the strategic priorities of the Department of Health. The trustees, annual report was approved on 4, September 2023 and signed on behalf of the board of trustees by: Bernadette Mont omery ria Mathews Trustee Report.. Page 18

Cancer Lifeline Company Limited by Guarantee

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Acknowledgements

Cancer Lifeline would like to acknowledge all the Funders, Committee, Staff, Therapists, Counsellors, Steering Group members, Statutory, Community and Voluntary agencies, Friends of Cancer Lifeline, Shop staff, Volunteers, Individuals and Families, the Business Community and Political Representatives for their support during 2022 / 2023.

Our heartfelt and genuine thanks to everyone who has helped us throughout this challenging year to make a real difference to the lives of those coping with cancer. We look forward to your continued support.

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Via
The Comic Relief Empower
Change Core Programme
Department of Health
Cancer Charity Fund
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