TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS, REPORT) FOR THE YEAR ENDED 31 MARCH 2024 The Trustees present their annual report and financial statements for the year ended 31 March 2024. The financial statements have been prepared in accordance with the a¢¢ounting policies set out in note 1 to the financial statements and comply with the charity's governing document, the Companies Act 2006 and "Accounting and Reporting by Charities.. Ststement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland {FRS 102)" (effective 1 January 2019). TheAnnual Report serves the purposes of both a Trustees, report and a directors, report under company law. Objectlves and activities Policies and objectives The principle activity of the charity is to Gontinually improve the provision of holistic care for all those with musculoskeletal injury or disease in Northern Ireland. b. Activities undertaken to achieve objectives The trustees are pleased to report that the charity continues with their aims of providing holistic care for all those with musculoskeletal injury or disease in Northern Ireland, through their 3 strategic aims.- Research Education and Support. c. Main activities undertaken to further the company's purposes for the public benefit The Charity has a number of different projects running, the results of the major ones are listed below in the main achievements and review of activities of the company. Achievements and perforniance Charity Staff The charity has worked well with two staff members. A lull time Band 6 Office Fundraising ManagerlFundraising Co- ordinator and a part time Band 4 Office Administrator. This has allowed more time for the charity to focu5 on Jndraising which includes,. bespoke fundraising events and campaigns, application of project grants, working on brand development and growing the donor database. The charity also funds four Belfast Trust Research Staff {1 Research Manager, 1 Research Coordinator, 1 Dats Analysis, 1 Clinical Research Nurse). Fundraising The last 12 months has been a huge improvement for TORC with the launch of new fundraising eventslcampaigns and a focus on raising brand awareness. The return of the annual walk on the 9th June 2023 was a big success and accounted for 57 % of the overall fundraising income. Using new digital plalforms such as Eventbrite, Enthuse, Just Giving, Linkedln, Mail Chimp and Facebook Events has helped increase the charity's visibility and promotion of each event and this has also increased our followers to the charity's social media platfomis. Also, working with corporate partnerships such as Saintfield United Football Club, Victoria Square, Oceanic Events and Kingsbridge has helped raise the charity's profile and for the first time TORC was chosen as the beneficiary charity for award ceremonies. The Europa Hotel Abseil and the Belfast Castle Abseil were two successful events for TORC which enabled stsff and past patients to get involved and fundraise. TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS, REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 1st April 2023 to 1st April 2024 Fundraising & Donation Figures (only) Fundraising Events TORC Walk 2023 (including GiftAid) Community Fundraising Gift in Will General Donations Corporate Fundraising Total £41,775.00 £13,869.43 £10,000.00 £4,843.71 £2,527.82 £73,015.96 Patient Llalson Group The Patient Liaison Group had its first meeting since COVID on Monday 26th February in TORC'S Simulation Room. The group is aiming to meet quarterly and is actively looking for new members. The next PLG meeting is scheduled for May 2024. Research The following clinical trials have been on going.. Name pi Sponsor SCIENCE - Surgery or Cast for Injuries of the Epicondyle in Children's Elbows Mr Richard Napier University of Oxford The Humeral Shaft fracture trial - HUSH Mr Owen Diamond University of Oxford Bracing Adolescent Idiopathic Scoliosis night-time vs full-time bracing adolescent idiopathic scoliosis (BASIS) Mr Sam Sloan Sheffield Children's NHS Foundation Trust Study of retrieved orthopaedic implants, associated tissues & data Mr Richard Napier University of Leeds TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS. REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 The following clinical trials have started in the last 12 months.. Name pi Sponsor The Meniscal Transplant surgery or Optimised Rehabilitation full randomised trial (METEOR-2} Ms Clara Stevenson University of Warwick World Hip Trauma Evaluation.. Lidocaine Intravenous Trial (WHITE LIT) Dr Clara O'Donnell University of Oxford World Hip Trauma Evaluation- Dual mobility vs standard articulation THR in the treatment o older adults with hip fracture (WHITE DUALITY) Mr Owen Diamond University of Oxford Reverse or Anatomical replacement for Painful Shoulder Osteoarthritis, Differences be￿een Interventions (RAPSODI) Mr Brendan Gallagher University of York PERI-operative biologic DMARD management: Stoppage or Continuation during orthoPaEdic operations (PERISCOPE) Mr Ravi Pagoti University of Leeds & Leeds Teaching Hospital NHS Trust Deprivation levels of patients waiting for TH and TKA in Nl Prof David Beverland Belfast Trust The research team where involved in the following publications.. 1. Early surgery improves survival after femoral fractures in the elderly- A retrospective review of 502 fragility fractures. Catherine Gilmore Alistair Mayne, Christopher Goodland, Roslyn Cassidy, Lisa MacDonnell Paul Mogey , Lynn Murphy , Owen Diamond. Injury. 2024 Feb',55{2).'111275. 2. Reoperation risk of periprosthetic fracture after primary total hip arthroplasty using a collared cementless or a taper-slip cemented stem. Matthew Lynch Wong, Mark Robinson, Leeann Bry￿, Roslyn Cassidy. Jonathan N. Lamb. Owen Diamond, David Beverland. 2024 February 1. Bone Joint J 2024,'10&B(2}'.144- 150. 3. Technical note the use of an inclinometer to a¢¢urately guide intra-operative femoral de-rotational osteotomies. Alistair IW Mayne, Owen J Diamond. 2023 July 31. J Hip Pres Surg, 2023 Jul 31',10 (3-41=253-255. 4. The painful truth of waiting for hip and knee arthroplasty in Northern Ireland. Karayiannis PN. Warnock M, Cassidy R, Jones K, Scott CEH, Beverland D. Bone Joint J. 2023 Jul 1-105-B(7).'783-794. 5. Are Patients With Morbid Obesity at Increased Risk of Pulmonary Embolism or Proximal Deep Vein Thrombosis After Lower Limb Arthroplasty? A Large-database Study. Thompson R, Cassidy R, Hill J. Bryce L, Napier R, Beverland D. 2023 July 20 -482(1)-115-24. 6. Survivorship of 500 Cementless Total Knee Arthroplasties in Patients Under 55 Years of Age. Sheridan GA, Cassidy RS, McKee C, Hughes I, Hill JC, Beverland DE. J Arthroplasty. 2023 May;38(5).'820-823. 7. 15 Cementless Total Knee Arthroplasty Safe in Women Over 75 Y of Age? Gibbons JP, Cassidy RS, Bryce L, Napier RJ, Bloch BV, Beverland DE. J Arthroplasty. 2023 Apr;38<4)'.691-699. TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS. REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 Education Staff, orthopaedic trainees and students have attended the following conferences to present both oral and poster presentations of TORC research.. Northem Ireland Britlsh Geriatrlc Society April Meeting 20th April, Antrim Audit of Delirium Screening and Documentation in Older Patients on Trauma Wards. C Sheridan, L Shery, R Cassidy, O Diamond, E Cunningham, J Lynch. POSTER Irish Orthopaedic Association Annual Meeting• 16th- 17th June Limerick Long term follow up of Ceramic on Metal Total Hip Arthroplasty. D Milligan, G Baker, J Hill, F O'Neill, N Gallagher, J Mcchesney, M Stevenson, D Beverland. PODIUM Alzheimer's Association International Conference Julyj 16th - 20th July, Amsterdam Delirium following elective arthroplasty predicts mild cognitive impairment {MCI) and dementia eight years later however this is not independent of pre-operative neurodegenerative biomarkers and cognition. A Sweeney, AP Passmore, D Beverland, B McGuinness, DF McAuley, S O'Brien, A Heslegrave, JM Schott, H Zetterberg, E Veleva, R Laban, EL Cunningham. POSTER Eight Year Follow-up of an Observational Cohort of Postoperative Delirium in An Older Elective Arthroplasty Population. Aoife Sweeney. PODIUM Presentation at Perioperative Cognition and Delirium Professional Interest Area Preconference Session European Federation of National Associations of Orthopaedics and Traumatology (EFORT) Annual Congress, 24th - 26th May• Vienna Early Surgical Intervention Leads To A Reduction In Mortality For Patients With Fragility Femoral Shaft Fractures. C Gilmore, A Mayne, C Goodland, R Cassidy, P Mogey, L McDonnell, L Murphy, O Diamond. PODIUM Instability And Periprosthetic Fracture Rates In A Continuous Series Of 11,683 Exeter And Corail Stems Carried Out In Musgrave Park Hospital Over A 10 Year Period. M Robinson, M Lynch-wong, J Lamb, L Bryce R Cassidy, J Hill. D Beverland. PODIUM Belfast Trust Trauma & Orthopaedics physiotherapy Conference 20th September, Llsburn Surgical Update on Soft Tissue Re¢onstru¢tion of the Knee. R Napier PODIUM Surgical management of hip dysplasia and hip impingernent, O Diamond PODIUM European Delirium Association (EDA) Annual Meeting. 6th- 8th September Birmingham Clinical Postoperative Delirium Resilience: Associations and Subsequent Eight Year Cognitive Outcomes in An Observational Cohort Study. Aoife Sweeney. PODIUM. British Orthopaedic Association {BOAI Annual Congress, 19th- 22rd September, Liverpool Charnley Lecture- Failure is a Gift. D Beverland International Society for Technology in Arthroplasty, 27th- 30th September, Newyork Statistical Shape Model Enabled Pre-operative Templating Can Improve Femoral Offset and Neck Shaft Angle Measurement from Standard Radiographs. O Denton, N Dunne, J Hill, D Beverland, A Lennon. PODIUM Impact of Radiographic Projection on Assessment of Internal Femoral Geometry. O Denton, N Dunne, J Hill, D Beverland, A Lennon. PODIUM TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT {INCLUDING DIRECTORS, REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 British Hip Society Annual S¢ientifi¢ Meeting 2024 at th8 ICC Belfast, 28th February- 1st March 2024 Does an intraoperative femoral fracture impact one year PROMS when using a cementless Corail stem? M Robinson, M Lynch Wong, R Cassidy, L Bryce, J Lamb, O Diamond, D Beverland. PODIUM Six should be the new four. D Beverland. PODIUM The painful truth of waiting for hip arthroplasty in Northern Ireland- A cohort study of the worst NHS waiting lists for elective hip arthroplasty. POSTER. Reducing Variability in Apparent Operative Inclination {AOI) during Total Hip Arthroplasty- Comparing the Ball in Cage Reality Based Navigation Instrumentation to a Digital Inclinometer. C Goodland, M Robinson, R. Cassidy, D Beverland. POSTER Mortality after femoral fractures in the elderly, a retrospective review of 502 fragility fractu￿$. C Gilmore, A Mayne, C Goodland, R Cassidy, L Murphy, O Diamond. POSTER TORC continues to provide patient booklets to major trauma patients. Support The following projects have been supported by TORC in the last 12 months: Branded Ortholove leg elevators for patient use. these arrived at the end of January 2024 and have been delivered to 5 hospitals across the province. These branded leg elevators are used by patients recovering from lower limb fractures. The Royal Victoria Hospital, Craigavon Area Hospital, Altnagelvin Hospital, Ulster Hospital and Musgrave Park Hospital all received these. Funders for this project also included: Danske Bank Employees Charity Group. Enkalon Foundation and W.G Edwards Charitable Foundation. Patient and staff feedback on these has been very positive. Funding to create a realistic model of a paediatric elbow for training purposes to teach registrars. Organisation and funding of the Major Trauma Centre Conference at Belfast City Hospital Postgraduate Centre. Future Plans In the next 12 months, the ￿Search team will be continuing with the on-going research studies and aiming to get approval for planned research. Clinical Trials Starting 2024= G-FORCE.. Gait in Fixed Or Rotating Cementless Total Knee Arthroplasties (G-For¢e TKA) IMPACTS.. Acceptability and Feasibility ofAcceptance and Commitment Therapy in Total Knee Arthroplasty Patients Can the use of Virtual Reality Improve Outcomes Following Total Knee Arthroplasty with Spinal Anaesthesia?_A Pilot Study SarcoSIGHT- A Randomised-control Trial of Fluorescence Guided Sar¢oma Surgery Versus the Standard of Care (multicentre NIHR study) Education and Support.. The refurbishment of the BART Room in Musgrave Park Hospital into the TORC Training and Education Hub will be completed. This will be a multifunctioning room to facilitate meetings, training, seminars and teaching courses, in addition it will provide a focal point in the hospital to meet, in particular to grow TORC'S research capacity. Part funding for a Sarcoma clinical nurse specialist in Musgrave Park Hospital (Sophie's Nurse}. Working alongside BOOM Foundation & Mathewson Family to support this. Yearly maintenances costs of the Resus¢itative Thoracotomy Manikin for Major Trauma Team in Royal Victoria Hospital. Design of patient education videos for patients waiting for hip and knee surgery. TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS, REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 TORC'S Fundraising Strategy will primarily focus on: Developing into new areas of business: legacies, donation in lieu of flowers, and grow gift in will donations Competition fundraising l incentives Recruit new charity ambassadors who will activity promote and empower our work Develop and add to products and campaigns with new ideas Grow income streams with donor development segmentation Continue to recruit for new corporate partners Invest in a CRM system and Sum-up card reader machine Financial review After reviewing the charity's forecasts and projections, the trustees are confident that the charity has adequate financial resources to continue in operational existence for the foreseeable future. The charity therefore continues to adopt the growing concerns basis in preparing its financial statements. Staff salary costs continue to rise and are approximately £250k per year. The TORC Training and Education Hub project is another high cost that the charity will have to absorb. The project has been discussed several times by the trustees at TORC'S interim meetings and AGMS and was given approval at the November 2023 AGM. The quotation from the Belfast Trust's Estates Department was £150.160.53. TORC have secured a total of £30,000 from funders and requested a further £80,000 from other funding bodies. The Charity plans to add any shortfall from their financial reserves to cover the remainder of the costs. This has been discussed with the trustees and it was felt that the benefits of the new Hub would outweigh the risks of using our reserves. The Hub will bring in more funding, and enable research and training to take place so it's considered to be essential for the future of the charity. The trustees will receive regular updates on the progress of the Hub including the budget. The Net Current Assets at 31 st March 2024 were £802,268 (2023 - £829,014) with restricted funds at £180.146 (2023 - £113,486), designated funds amounting to £338,379 (2023 - £338,379) reflecting an underlying unrestricted funds reserve of £283,743 {2023 - £377,149). The designated funds are expected to be utilised over the next 12 to 24 months. structu￿, governance and management a. Constitution Trauma & Orthopaedics Research Charity is registered as a charitable company limited by guarantee and was set up by a Trust Deed. b. Methods of appointment or election of trustees The management of the company is the responsibility of the Trustees who are elected and co-opted under the temis of the Trust Deed. c. Organisational structure and decision making polici8S The board is responsible for setting the mission, vision, values and strategic objective of the charity and for overseeing the implementation of those objectives. David Beverland has been delegated day to day management. d. Pay policy for key management personnel Trustees are not remunerated and are appointed based on merit against objectives criteria. Although trustee appointments are not public appointments, the charity aim to comply with the principles of Commissioners for Public Appointments in Northern Ireland (rnerit, diversity, equality. openness, transparency, independence, integrity, proportionality and respect) TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS. REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 Financial Risk management The trustees has assessed the major risks to which the company is exposed, in particular those rekted to the operations and finances of the company, and are satisfied that systems and procedures are in place to mitigate exposure to the major risks. The Trustees, who are also the directors for the purpose of company law, and who served during the year and up to the date of signature of the financial statements were.. Mrs K Carolan Mr S Curry Mr O Diamond Mr D Gibson Dr R Hogg Mrs G Keenan Mr P Magill Dr J Mccaffrey Mr E McGinley Mr D Molloy Mr R Napier None of the Trustees has any beneficial interest in the company. All of the Trustees are members of the company and guarantee to contribute £1 in the event of a winding up. Statement of Trustees, responsibilities The Trustees, who are also the directors of Trauma & Orthopaedics Research Charity for the purpose of company law. are responsible for preparing the Trustees, Report and the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice). Company Law requires the Trustees to prepare financial statements for each financial year which give a true and fair view of the state of affairs of the charity and of the incoming resources and application of resources, including the income and expenditure. of the charitsble company for that year. In preparing these financial statements, the Trustees are required to.. select suitable accounting policies and then apply them consistently- observe the methods and principles in the Charities SORP., make judgements and estimates that are reasonable and prudent- state whether applicable UK Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements., and p￿pare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation. The Trustees are responsible for keeping adequate a¢¢ounting records that disclose with reasonable accuracy at any time the financial position of the charity and enable them to ensure that the financial statemen ts 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. Auditor In accordance with the company's articles, a resolution proposing that Miscampbell & Co be reappointed as auditor of the company will be put at a General Meeting. TRAUMA & ORTHOPAEDICS RESEARCH CHARITY TRUSTEES. REPORT (INCLUDING DIRECTORS. REPORT) (CONTINUED) FOR THE YEAR ENDED 31 MARCH 2024 The Trustees, report was approved by the Board of Trustees. Napier Trustee Date..