EMMS NAZARETH
(KNOWN AS THE NAZARETH TRUST)
ANNUAL REPORT 2025
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TRUSTEES
Geoffrey Spence, Chair Jason Leitch, Vice-Chair Murray McNicol, Trustee Financial Officer Azar Ajaj Dave Pye Elias Haddad Judith Hill (departed November 2025) Kate Gerrish Linda de Caestecker (appointed June 2025) Mary Macleod Naomi Beer Stephen Nash (departed June 2025)
SENIOR EXECUTIVES
Waseem Dibbini, CEO Dr Fahed Hakim, Hospital Director Dr Salam Hadid, Nursing School Director Maha Sayegh, Nazareth Village Director Rev. Frank Kantor, Spiritual Director Steve Sanderson, International Director (appointed June 2025)
BANK
Bank of Scotland Ardmillan Terrace Dalry Road Edinburgh, EH11 2JN
AUDITOR
KPMG Somekh Chaikin 17 Ha’arba’a Street, PO Box 609 KPMG Millennium Tower Tel Aviv 6100601, Israel
PRINCIPAL UK & REGISTERED OFFICE
The Nazareth Trust Annan House, 10 Palmerston Place, Edinburgh, EH2 3JZ
PRINCIPAL ISRAEL OFFICE The Nazareth Trust Nazareth Hospital EMMS, PO Box 11, Nazareth, 16100
LEGAL ADVISOR (ISRAEL)
Kiyon Bilal M. Firon & Co. Solicitors Adgar 360 Tower, 2 Haslosha Street 6706054, Tel Aviv PO Box 9445, 6109302
The Nazareth Trust is the operating name of EMMS Nazareth and
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Is a company limited by guarantee, registered in Scotland (SC225661)
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Is a charity registered in Scotland (SC032510)
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Is registered as a foreign-owned company and not-for-profit institution in Israel (#560019945)
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1. Objectives and Aims
Our purpose, set out in our Memorandum and Articles of Association, is as follows:
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The relief of sickness, poverty or suffering by the establishment, maintenance etc. of Medical Mission in accordance with Christian principles and in conformity with Christ's own example and command: "Heal the sick, and say unto them, 'The Kingdom of God is come nigh unto you” in Israel and elsewhere.
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The advancement of the Christian religion throughout the world.
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The advancement of education and, in particular, the education of the general public throughout the world as to the teachings, life and times of Jesus of Nazareth.
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The advancement of education by the teaching of all aspects of medicine and medical sciences and the promotion of medical science and medical research.
To fulfil these objectives, the Nazareth Trust (TNT) manages the following:
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Nazareth Hospital EMMS.
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Nazareth Academic School of Nursing.
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SERVE Nazareth.
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Nazareth Village.
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Spiritual Care
The above broadly encompass five key categories that aim to satisfy TNT's healthcare purposes, healthcare education, biblical education, and Christian witness.
Healthcare – Nazareth Hospital EMMS
Nazareth Hospital EMMS is the leading regional healthcare provider and principal trauma centre serving Nazareth and the wider Galilee region, providing care to a catchment population of approximately 570,000 residents. During 2025, the Hospital delivered more than 236,000 patient encounters, including over 80,000 Emergency Department attendances, more than 156,000 outpatient visits, and approximately 33,000 inpatient days, reflecting its central role in delivering acute, specialized, and community-based healthcare services across Northern Israel.
The Hospital offers a comprehensive range of medical services, including Emergency and Trauma Care, Internal Medicine, General Surgery, Orthopedics, Urology, Obstetrics and Gynecology, Maternity and Neonatal Intensive Care, Psychiatry, Intensive Care, Cardiology and Cardiac Catheterization, Renal Dialysis, Gastroenterology, Pulmonology, Oral and Maxillofacial Surgery, IVF, and a growing portfolio of advanced diagnostic and subspecialty services.
Affiliated with the Azrieli Faculty of Medicine at Bar-Ilan University, Nazareth Hospital EMMS serves as a regional academic medical center actively engaged in medical education, residency training, clinical research, innovation, and workforce development. Guided by its Christian
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ethos and longstanding mission of service since 1861, the Hospital strives to deliver the highest standards of clinical excellence, compassion, accessibility, and patient centered care while advancing health equity and improving the wellbeing of all communities across Northern Israel.
Healthcare Education – Nazareth Academic School of Nursing
Established in 1924 to address a national shortage of nurses, the Nazareth Academic School of Nursing offers vocational work opportunities to the local, underserved, and predominantly Israeli Arab population.
Each academic year, up to 300 students are enrolled at the School. The programme available range from Nursing conversion programme to BA Nursing degrees in collaboration with Ono Academic College, Israel. Since its establishment, the Nazareth Academic School of Nursing has continued as the only Arab nursing school in Israel. The School runs a special programme accredited by the Higher Council of Education to empower and equip underprivileged youngsters to join the Academy.
SERVE Nazareth
SERVE Nazareth provides volunteer opportunities in the Galilee region, which, in recent years, has grown to be the most extensive programme of its kind in Northern Israel.
Out of the many opportunities available, volunteers can serve in the hospital chaplaincy or Pastoral Care team, volunteer in the hospital, guide at Nazareth Village, or provide other vital support within the Nazareth Trust or local Christian ministries.
Biblical Education – Nazareth Village
The Nazareth Village allows visitors to experience Nazareth as it was in the first century, during Jesus's time. Tour guides share Biblical stories, bringing them to life using a working farm, traditional buildings, including a synagogue, and authentic first-century meals.
The Nazareth Village is well established as a major Christian ministry and tourist operation in Northern Israel. There have been over 1 million visitors to the Nazareth Village since its founding in 2001.
Christian Witness – Spiritual Care
The Spiritual Care Team are key in providing and integrating Spiritual Care in all of the Trust's activities as well as offering pastoral support to patients, staff and the community.
Their vision is to extend healing, hope, and hospitality in Jesus’ name to every staff member, volunteer, and service user in Nazareth in times of need.
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2. Achievements, Performance and Future Plans
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In 2025, the security situation in Israel escalated, leading to nationwide emergency measures and major disruptions to healthcare services. The hospital shifted to emergency operations, reducing activity to essential services only, operating approximately 50 protected beds on campus, and relocating the dialysis unit to a fortified unit.
During October 2025 a ceasefire came into effect bringing hope to the millions affected, and in turn positively impacting some of the Trust's operations.
Activities at the Nazareth Village and the SERVE Nazareth volunteer programme were almost ceased.
The Maana Psychological Centre, affiliated with The Nazareth Hospital continues to provide extensive mental health support to staff, patients, and the community in general affected by the conflict. Throughout 2025, the Nazareth Trust remained steadfast in its mission to provide healthcare, education, and spiritual support, adapting to challenges and continuing to serve the community in Nazareth and beyond.
2.1.1 Healthcare – Nazareth Hospital EMMS
The Nazareth Hospital is located in the heart of the city of Nazareth and is the main acute care hospital of the region. Despite being a small hospital, it provides a range of emergency lifesaving services and operates the only Arab Psychiatric department in the country, providing culturally sensitive treatment to the Arab population.
During 2025, the Hospital achieved several important milestones, and continued growth of its academic, residency and fellowship programmes. The Hospital also strengthened its emergency preparedness capabilities while maintaining uninterrupted services during periods of regional conflict and heightened security challenges.
National recognition during 2025 included leading performance in Internal Medicine, Neonatal Care, Emergency Department quality indicators, and patient satisfaction, further reinforcing Nazareth Hospital's EMMS position as one of Israel's leading regional healthcare institutions and a trusted centre of excellence for clinical care, education, research, and community service.
Furthermore, the hospital achieved notable successes in various areas: -
Capital Developments
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Opening of a new protected Emergency Department complex.
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Launch of a fully operational state-of-the-art MRI service. The MRI machine is one of the most advanced in Israel. Equipped with AI features, it enhances MRI efficiency, benefiting emergency and trauma services.
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Expansion of Emergency Medicine, Gastroenterology and Pulmonology services
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Nazareth Village Discovery Centre (NVDC) - following the receipt of the long-awaited building permit, excavation works commenced with a contractor appointed. Planning also commenced for the associated Roman theatre project.
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Construction of additional facilities for the Maana Centre was approved to support its growing role in strengthening community resilience. Over the year, the Centre expanded its staff and significantly increased non-income-generating community activities.
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Completion of the fortified storage area designed to accommodate 36 emergency admission beds.
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New water tanks were completed during the year and are now fully operational, improving the resilience and reliability of essential water supplies.
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- The construction of the Academic School of Nursing two additional floors was completed, increasing its capacity and improving facilities, including the addition of smart classrooms, advanced simulation rooms and a new multimedia system. A celebration marking these achievements and the Centenary of the Academic School of Nursing was held on 13 November. The event was attended by numerous government and community officials, partners, and representatives of the media. It was a hugely successful occasion.
Other Developments & Achievements
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Oral & Maxillofacial Surgery services were established on a minimal level, covering emergency, outpatient, elective, and surgical care and Dr. Waseem Abboud was appointed as Consultant Oral & Maxillofacial Surgeon.
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The hospital was ranked 1[st] nationally for Internal Medicine services in the Ministry of Health's national quality survey.
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The hospital was ranked 1st nationally for the fifth consecutive year for Neonatal Care by the Ministry of Health.
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The hospital was ranked among Israel’s top hospitals for lowest hospital-acquired infection rates.
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The hospital ranked 2nd nationally in the Patient Satisfaction Survey - an outstanding achievement.
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A hospital operating licence was secured until February 2027, the longest extension in many years.
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Steve Sanderson was welcomed as International Director of EMMS Nazareth.
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New senior management appointments included a Development & HR Director and Administrative Director.
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The first collective agreement in the history of EMMS Nazareth and the Arab community in Israel was established.
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Prof Fahed visited Canada and the US in May 2025 to strengthen partnerships, explore funding opportunities, and raise the institution’s international profile. The visit coincided with Prof. Fahed’s participation in the American Thoracic Society Conference.
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Employee morale was boosted with special programme for nurses, doctors, paramedics, and administrative staff, as well as spiritual activities and workshops.
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Within the Village, the Easter Programme saw locals enjoy the reenactment of the Passion Week of Christ.
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For the first time in a few years, the Christmas tree lighting ceremony could resume, bringing renewed hope and jo y to the community.
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International Nurses Week 2025 was celebrated with a hospital-wide recognition programme.
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A staff retreat was attended by 220 employees.
2.1.2 Academia & Research
The hospital continues to prioritise teaching, residency programmes, and academic research:-
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Dr. Salam and Dr. Amir, graduates of the prestigious Inbar Programme, participated in the MILE (Maoz Intensive Leadership Experience) in Boston.
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Dr. Shadi Bada'an, Head of Urology and Dr. Mokbel Shalah, Head of Orthopaedics were accepted to the prestigious Marom Leadership Programme. Senior Nurse Hanan Marjieh received the national "Humanity in Nursing Award" in recognition of her compassion and dedication.
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Dr. Najeeb Nasrallah was appointed Director of the newly expanded Emergency Medicine Division.
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12 physicians successfully passed Stages 1 and 2 of their residency examinations.
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Several Nazareth Hospital physicians were recognised by the Faculty of Medicine at Bar-Ilan University Faculty of Medicine for outstanding clinical teaching. Honourees included Dr. Salim Khoury, Dr. Amir Farah, Dr. Ahmad Lubani, and Dr. Rimon Moussa. Recognition was based on student evaluations and teaching excellence.
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Prof. Amir Mari led the first European initiative to develop clinical guidelines for the diagnosis and treatment of pharyngeal and oesophageal swallowing disorders. This achievement represents significant international recognition in gastroenterology.
Research continued to a high level and included the following:
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The Nursing Research Club continued its structured activities throughout the year. Current work focuses on research design, literature reviews, and evidence-based practice.
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Dr. Amer Saffouri and Dr. Saleh Ghrifat presented research on the clinical and laboratory characteristics of patients diagnosed with brucellosis.
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A study examined the impact of GLP-1 agonists on small intestinal bacterial overgrowth (SIBO) breath test results.
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Dr. Fadia Younis presented research on demographic factors, disease perception, treatment response, and health outcomes among Arab patients with inflammatory bowel disease in Israel.
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Dr. Najeeb Nasrallah and Dr. Yara Amara presented a study on seasonal and gender-related patterns in severe carbon monoxide exposure cases in Northern Israel between 2020 and 2025.
2.1.3 HOSPITAL EMPLOYEES BY JOB FUNCTION
| Sector | Full-Time Equivalent No. of Employees |
|---|---|
| Nursing | 211 240 |
| Aid Nurses and Orderlies | 42 46 |
| Administrative | 156 198 |
| Paramedical | 70 106 |
| Physicians | 153 208 |
| Total | 631 798 |
2.1.4 PHYSICIANS BY ROLE
| Physicians | Total |
|---|---|
| Specialist | 66 |
| Senior Specialist (Specialists with additional sub-speciality) | 23 |
| Director | 1 |
| Resident Physicians | 74 |
| Interns/Medical Trainees | 25 |
| House Physician | 19 |
| Total | 208 |
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2.1.5 MATERNITY DEPARTMENTS
| Maternity Statistics | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Births | 2,008 | 1,863 | 1,760 | 1,855 |
| Neonatal Intensive Care Numbers | 38 |
40 | 39 | 37 |
2.1.6 Hospital Departments:
| Anaesthesia | Hydrotherapy | Paediatric Surgery |
|---|---|---|
| Autonomic Neurology Unit In Vitro Fertilisation | Pharmacy | |
| Bariatric Unit | Infectious Diseases | Physiotherapy |
| Biomedical Engineering | Intensive Care | Prenatal |
| Bone Density | Internal Medicine | Psychiatry |
| Cardiology |
Laboratory | Psychology Centre |
| Catheterisation (incl. | Neonatal Intensive Care | Pulmonology Clinic |
| cardiovascular) | ||
| Chest Surgery Clinic | Neurology | Radiology (inc. X-ray, CT, US) |
| Delivery Room |
Obstetrics & Gynaecology | Social Services |
| Dialysis | Operating Theatres | Stroke Unit |
| Dieticians |
Oral and Maxillofacial Surgery TB Clinic | |
| Emergency Medicine | Orthopaedic Surgery | Urology |
| Gastroenterology | Outpatient Clinic | Vascular Surgery |
| General Surgery |
2.1.7 Teaching Departments – in partnership with Faculty of Medicine - Bar Ilan University:
Anaesthesia General Surgery Dialysis Internal Medicine Gastroenterology Neurology
An average of 15 rotations per year, 8-10 students per rotation.
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2.1.8 PATIENT NUMBERS
| Hospital Admissions | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|
| Admitted patients | 14,632 | 14,861 | 15,743 | 14,304 |
| Admission days | 45,382 | 42,434 | 42,017 | 39,026 |
| ER (incl. Night Centre) | 72,050 | 74,550 | 80,164 | 84,364 |
| Outpatients | 119,428 | 153,881 | 156,931 | 185,595 |
| Admissions by dept. | 2022 | 2023 | 2024 | 2025 |
| Orthopaedics | 1432 | 1447 | 1717 | 1611 |
| ICU | 975 | 1425 | 1565 | 1600 |
| General Surgery | 3809 | 3438 | 3435 | 3162 |
| Obs. & Gyn. | 837 | 880 | 1114 | 1101 |
| NICU | 159 | 112 | 122 | 131 |
| Internal Medicine | 4181 | 4009 | 4058 | 4255 |
| Dialysis patients | 172 | 185 | 240 | 164 |
| Weekly Dialysis Sessions | 366 | 390 | 456 | 468 |
| Psychiatric | 230 | 253 | 225 | 160 |
| Catheterisation Interventions | 1164 | 1360 | 1183 | 1609 |
| Covid-19 (ICU) | 228 | - | - | - |
| Total | 13,553 | 13,499 | 14,115 | 14,261 |
2.1.9 RESIDENCY PROGRAMME
| Department | Approved (months) | Out of (months) |
|---|---|---|
| Urology | 30 | 54 |
| ER | FULL | |
| Anaesthesia | 33 | 39 |
| Internal Medicine | FULL | |
| Orthopaedics | Full + a 6-month rotation in the sub-units of arthroscopyand spine surgeryfull |
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| General Surgery | 36 | 54 |
| Obs. & Gyn. | 51 | 54 |
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| IVF | 6-month rotation | |
|---|---|---|
| US | 6-month rotation | |
| Psychiatry | 24 | 54 |
| Radiology | 24 | 45 |
| Neonatology | 12 | 36 |
| Paediatrics | 6-month rotation | 54 |
| Cardiology | Full |
2.2.1 Updates
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The school continued to maintain its good academic record and excellent reputation. Since the SON opened in 1924, 3,300 students have graduated.
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The BA programme: The Council for Higher Education has approved the Nazareth Academic School of Nursing as an extension of the Department of Nursing in Ono Academic College. This will allow the SON to open a BA programme in Nursing and offer a transition programme to prepare students who do not have the admission requirements to study nursing.
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In 2025, two groups of the "Afik Maavar" preparation programme were opened, in May (19 students) and August (19 students).
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The first group of the BA programme was launched in November 2024 with 52 students.
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The second group of BA programme was launched in November 2025 with 35 students.
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The second group of transition to the BA Nursing programme was launched in February 2025 (35 students) and the third group of transition to the BA Nursing programme was launched in October 2025 (50 students).
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Almost 40 SON students volunteered in the hospital and the community during the year.
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Two research studies were conducted in 2025 with Maana and the Department of Mental Health on the impact of war on health behaviours, stress, and PTSD, and on virtual reality in simulationroom practice. A joint study with the Ono College team will also examine VR as a skills-training tool in simulation rooms.
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The expansion of the existing School of Nursing (SON) building was completed, adding two new floors featuring smart classrooms, one of the most advanced simulation rooms in the country, breakout corners, and an additional student cafeteria. The project to install multimedia systems in classrooms and simulation rooms has begun. We have completed the purchases of furniture and equipment for the simulation rooms.
2.2.2 SCHOOL OF NURSING EXAMS
| 2022 | 2023 | 2024 | 2025 | |
|---|---|---|---|---|
| Students taking the Government | 78 | 112 | 104 | 86 |
| nursing exams | ||||
| Pass rate | 97% | 98% | 97% | 80% |
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2.2.3 ENROLLED STUDENTS
| Student Numbers 2025 | Total |
|---|---|
| BA Students | 83 |
| Career Retraining (Transition programme) | 102 |
2.3 Biblical Education – Nazareth Village
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The total number of visitors for 2025 was 17,012 .
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This year in October the Nazareth Village celebrated its 25[th] anniversary since opening its doors. Plans for a special celebration event were postponed indefinitely due to the 12 day war with Iran in June. Despite this, we marked this major milestone with special banners highlighting it on site.
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The Nazareth Village for the first time held a special Olive Festival over two days in October that saw around 650 locals attending. The special tours allowed visitors to take part in picking olives from our trees, learn how soaps and perfumes were made, and witness the olive crushing and pressing process. At the end of the tour, they spent time enjoying our first century market with food, crafts, olive products and hand pickling olives.
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In December, the Nazareth Village was once again able to host our special Christmas tours for the local community as well. Approximately 1500 visitors experienced key moments from the Christmas story during this special tour.
2.3.1. VILLAGE VISITORS
| Visitor Numbers | |||
|---|---|---|---|
| 2022 | 2023 | 2024 | 2025 |
| 57,811 | 80,445 | 5, 676 | 17,012 |
2.4 Christian Witness – SERVE Nazareth
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During 2025, SERVE had 2 seasons where it was safe for volunteers to come and stay in Nazareth.
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Majdoleen, SERVE Coordinator succeeded in maintaining the relationship with interested people and got them to come when ceasefires occurred.
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Communication was maintained with previous volunteers and potential volunteers.
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When the situation wasn't safe to have volunteers, The SERVE Coordinator worked in several departments, including surgical department and collections office.
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New initiatives have been explored, including offering a funded volunteering programme, adding Serve to volunteering programme search engine, and exploring a summer camp for foreigners.
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Maintaining relationship with current partners while exploring new partners.
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2.4.1 SERVE VOLUNTEERS
| 2022 | 2023 | 2024 | 2025 | |
|---|---|---|---|---|
| (until 6th Oct) | ||||
| Volunteers | 12 | 61 | 2 | 41 |
| F/T staff equivalent | 2.9 | 5.2 | 2 | 2.126 |
| KPI comparison to 2023 | 2024 | 2025 | |
|---|---|---|---|
| Total number of Volunteers | 2 | 41 | |
| No. volunteer months from individuals | 3 | 18.4 | |
| No. of volunteer days from groups | 0 | 0 | |
| Total Volunteer Days |
90 | 552 |
2.5 Christian Witness - Spiritual Services **
The ministry of the Pastoral Care Team (PCT) during 2025 continued to be shaped by the painful and traumatic war in Gaza and Lebanon until the ceasefire agreement which came into effect on 10 October 2025. We chose the theme of hope for the year and built our messaging and spiritual care activities around this theme. We gave expression to this theme by bearing faithful, hopeful and loving witness to our staff, patients, and volunteers through regular visits and spiritual care activities during the year. These included the following:
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Arranging special services during Lent, Pentecost, and Advent to which Church leaders from different Church traditions were invited to lead and participate.
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Taking staff on pilgrim walks in the footsteps of Jesus on his final journey to Jerusalem over successive weekends during Lent which culminated with us joining thousands of fellow pilgrims for the Palm Day procession from Bethphage down the Mount of Olives to the Old City of Jerusalem.
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Planning, organising, and helping to run the Farah Summer Camp for the children of our staff in August, which was held in the Bernath Auditorium in the Hospital for the first time. This venue provided a good space for the varied activities and oversight and control of the children for this camp which was greatly appreciated by children and their parents.
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Spiritual care week activities in partnership with the Maana Centre, which provided writing and art therapy workshops with our staff to help them de-stress and relax.
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The creation of a Well-Being Forum comprising representatives from the PCT, the Maana Centre, and the HR Department to look at ways to enhance the well-being and flouring of all our staff and students.
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Advent and Christmas celebrations which were carried out with sensitivity to the on-going suffering of people in the region, which served to focus our hearts and minds on the true reason for the season - the birth of Jesus in Bethlehem!
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Routine daily visits to patients in our care and their families to offer a ministry of prayer and presence at their point of need.
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2.6 Future Plans
2.6.1 Nazareth Hospital
We continue to enhance the quality of health care at Nazareth Hospital for our patients and their families. In recent years, we have substantially modernised our facilities and expanded our capacity. To strengthen our position as the leading trauma and acute care hospital in Nazareth, we will complete the infrastructure for expanding our Emergency Room (ER) department by June 2025 and begin recruiting additional ER medical staff.
Our new MRI infrastructure is already in place and was opened in September 2025. This state-of-theart technology will significantly improve diagnostic capabilities.
We are also committed to developing our mental health services. This includes recruiting additional specialists and relocating the facility back to the hospital premises. By 2026, 25% of our hospital beds will be allocated to the new Psychiatry Department. Our mental health expansion includes the completion and operation of the Maana Resilience Psychology Centre.
Additionally, we are expanding our Maternity Department to provide private rooms for every mother, ensuring greater comfort and privacy.
2.6.2 Academic School of Nursing
We strategically invest in student recruitment by engaging in face-to-face meetings with graduates and high school students, hosting open days to showcase our facilities, and leveraging social media advertising to reach a broader audience. At the same time, we are finalising the acquisition of state-ofthe-art equipment and multimedia resources, and setting up advanced simulation rooms to enhance practical learning experiences. We are also prioritising staff training to ensure proficiency in innovative teaching methods. Furthermore, through a collaborative partnership with Ono Academic College, we continue to develop our BA and Transition programme and the "Afik Maavar" preparatory programme. As part of our focused initiative, we are expanding the School of Nursing (SON) facility to accommodate a larger student body and to support the launch of Advanced Nursing Programme in response to the growing demand for healthcare education.
2.6.3 Nazareth Village
The first phase of digging for the retaining wall for the foundations of the new Discovery Center is complete. Several contractors have been approached with the working plans so that they can submit bids for the next phase, the shell. In the meantime, plans for the interior design and multi- media presentation content is in progress.
2.6.4 SERVE Nazareth
We aim to stay in touch with potential volunteers and current partners so that we are ready to get back to full capacity when they are ready. Especially universities and student who risk management evaluation was hindering them from coming.
We also plan to apply for approval to be granted volunteer visas from the Ministry of Interior since there were some changes in policies and logistics.
We are exploring 10-day trip that would include a taste of SERVE as well as to get to know and see the country and our organisation.
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2.6.5 Christian Witness – Spiritual Services
2025 has been a significant period of transition for PCT, with the imminent retirement of the Spiritual Director and the restructuring of the Spiritual Care Department to better meet the evolving needs of our staff and service users. While the search for a new Spiritual Director has been challenging, we remain confident that the right person will soon be appointed and that the Spiritual Care Department and Pastoral Care ministry of the Nazareth Trust will continue to offer healing, hope, and hospitality in Jesus’ name.
We thank God and all our supporters for your prayers and encouragement throughout this transition. Your support has strengthened and sustained us amid the challenges of the past year.
3. Governance, Structure & Management
3.1 Board of Trustees
The Board of Trustees meets typically four or five times annually – twice in Nazareth, once in Edinburgh or Glasgow, and once/twice in London. As an internationally based Board, additional video conferences are scheduled as needed.
As detailed in the Memorandum and Articles of Association and supplemented by the Board's Standing Orders, the Board appoints all new Trustees. New Trustees go through an induction
period, which includes an orientation visit to Nazareth, where possible, training on Trustee responsibilities, and TNT’s governance process.
Trustee responsibilities focus on stewardship, governance, risk, public accountability, and
strategic development. To support the Board in specific matters, three Committees also meet regularly. These are:
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Governance Committee (re-established March 2023)
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Finance & Audit Committee
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Remuneration and Nominations Committee
All Committees meet at least three times annually except for the Remuneration Committee, which meets at least once annually.
There are two additional committees planned for 2026. These are:
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Clinical Quality and Safety Committee: This Committee will exist to oversee, guide, and ensure the highest standards of quality and safety across the organisation’s operations. The Committee will provide strategic direction and oversight to ensure that services are developed and delivered safely, efficiently, and in compliance with relevant regulatory and accreditation standards.
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Christian Witness Committee:
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This Committee will exist to provide oversight, guidance, and advice to ensure that the Nazareth Trust remains faithful to its Christian identity, ethos, and mission. The Committee will support the Board in safeguarding and promoting the Trust’s spiritual objectives across all its activities.
Though day-to-day management is delegated to the Chief Executive Officer, Trustees are required to direct TNT by the following principles:
- Direction: providing strategic visions, utilising a life-long perspective on good governance
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and development.
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Expertise in evaluating organisational effectiveness, efficiency, and resource use, ensuring that the needs of those we serve are met.
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Impartiality: ensuring legal, operational, and HR frameworks are enforced without bias.
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Discipleship: protecting and promoting the Christian heritage, mission, vision, and identity of the Nazareth Trust.
3.2 Senior Management
In keeping with the Articles and Memorandum of Association, the Board of Trustees act independently of the Trust’s senior management, delegating day-to-day operational duties to the Chief Executive Officer.
The structure of the Executive Team is as follows:
----- Start of picture text -----
CEO
International Chief Financial Director of School Spiritual Director of SERVE Nazareth
Director Hospital Director Officer of Nursing Director Nazareth Village Coordinator
HR & Economic
Hospital Director of Nursing Deputy Hospital Director Development Director Administrative Director
----- End of picture text -----
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Mr Waseem Dibbini, Chief Executive Officer
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Prof Fahed Hakim, Hospital Director
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Mr Steve Sanderson, International Director (appointed 2025)
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Dr Salam Hadid, School of Nursing Director
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Mr Frank Kantor, Spiritual Director
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Mrs Maha Sayegh, Nazareth Village Director
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Ms Majdoleen Nawatha, SERVE Coordinator
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Marta Bahous, Hospital Director of Nursing
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Dr Ameer Eleimy, Deputy Hospital Director (appointed 2025)
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Ibrahim Habib, HR & Economic Development Director (appointed 2025)
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Khalil Natcho, Administrative Director (appointed 2025)
Following the appointment of Mr Waseem Dibbini as CEO, the role of Acting CFO will be appointed in 2026.
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3.3 Risk Management
3.3.1 Operational Risk
Formal risk assessments are carried out regularly and conducted with the assistance of internal auditors. These assessments cover all TNT's operations and involve identifying the types of operational risk faced and the potential impact on TNT should the risk occur.
As a healthcare provider, all significant medical incidents and sentinel events are reported to the Clinical Services Committee and then to the full Board on a timely basis.
Beginning in 2016, as directed by the Finance and Audit Committee, a focus was given to conducting audits on issues with higher risk factors. In 2017, the Finance & Audit Committee and the Board of Trustees agreed upon an internal audit plan that included areas not previously reviewed. In 2020, the Board initiated a review of all risk across all areas of the organisation.
The Quality & Safety directorate is separated into two distinct categories of 'Quality' and 'Patient Safety'- a split intended to facilitate a focused approach to both issues and implement higher clinical care standards. These directorates are responsible for preparing & reviewing clinical protocols, holding inspections to assure protocol compliance, staff education, data collection & analysis, setting KPIs, reporting to management and investigating cases when applicable.
TNT acknowledges its duty of care to safeguard its staff, volunteers, and users and is committed to ensuring that safeguarding practice reflects statutory responsibilities and government guidance and complies with best practices. Policies are in place in both the UK and Israel—the latter set out and governed by Israeli employment law. The former is reviewed on a three-year basis according to TNT’s policy review practice.
The Hospital must comply with Information Security Management Systems standards. As national legislation requires, significant efforts and resources are invested in compromised systems and back-ups to enable a full data recovery in the unlikely event of harm. ISO accreditation is in place.
In keeping with GDPR legislation introduced in 2018, TNT updated its governance measures organisation-wide regarding data usage and storage and will review these as required.
The Hospital also cooperates with the Israeli government to be prepared for local or national emergencies such as war, natural disasters, or any other mass casualty events.
TNT also employs a Safety Officer who manages the facilities' safety and works according to an annual plan approved and supervised by management.
3.3.2 Financial Risk
TNT reviews its financial position on an ongoing basis. Management accounts are produced internally and submitted by the Chief Financial Officer to the Chief Executive Officer and Trustee Finance Officer. The Finance and Audit Committee meets a minimum of three times annually to review performance against the planned budget, to optimise both income and expenditure whilst ensuring continuing quality of services. An Annual Plan is generated covering planned capital developments and the associated required funds.
From 2022, all public hospitals in Israel, including the Nazareth hospital, are supported by the MOH with an operational budget which enables the hospitals to cover costs. Due to that, The Nazareth hospital was able to sign a collective agreements with the workers' committee and trade union to
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equalise the hourly rate paid to its employees with the rates accepted in governmental hospitals. The main financial risks that the Nazareth hospital are as follows:
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Most of TNT’s income is negotiated through contracts with Israel's government-mandated healthcare insurers [‘Sick Funds’]. The most prominent of these is the Clalit Sick Fund, which insures around 70% of Nazareth's area population. Clalit also owns a hospital just outside of Nazareth, which puts them in a position of strength when negotiating contract terms. As such, the Nazareth Hospital must offer highly discounted rates to maintain operations.
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In recent years, Israel has faced instability due to the COVID-19 pandemic and the ongoing war. This instability has led to shortages in supplies and rising costs, which are not always matched by increases in income. It may also affect the Trust’s income streams due to constraints on medical activities. In addition, reduced tourism has further contributed to financial pressures.
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As hospital activity and the range of services increase, malpractice insurance costs and deductibles also rise. This creates a need to maintain reserves to manage potential large compensation claims. The hospital must therefore ensure sufficient financial buffers are in place.
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Rapid technological change and growing demand for improved facilities place significant pressure on the organisation. This requires continuous investment in new equipment and infrastructure upgrades. To remain competitive, the Trust must invest in capital development. Fundraising is essential due to limited budget resources.
3.4 Annual Budget & Monitoring Accounts
An annual budget is prepared each year, taking into consideration: -
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TNT’s future plans.
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The previous year's budgetary performance.
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Changes in economic and legal environment which have a potential financial impact.
The Chief Financial Officer prepares the budget and presents it to the Finance and audit Committee for consideration. After approval or amendment, the budget is brought to the Board and ratified.
TNT aims to maintain an operationally balanced budget, at least. Over time, it aims to begin generating funds internally to contribute to improving the Trust’s infrastructure and managing the replacement of essential equipment. Cost-saving strategies during the year included identifying additional income streams, delaying recruitment if possible, and enhancing additional efficiencies in operational expenditure.
3.5 Remuneration 2025
Total staff no: - 900+
Management: Total cost: £989,176
| Data | Total Gross Salaries |
Employers NI Contribution |
Employers defined Pension Scheme Contribution |
Operating costs of Employers defined Pension Scheme (exc. pension finance costs);& other employee benefits |
|---|---|---|---|---|
| Execs | £ 782,171 | £ 33,003 | £83,914 (pension & Provident funds) |
£ 27,724(advanced study fund) £ 62,364(employer salarytax) |
Trustee cost: £50,942
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Trustees are engaged on a voluntary basis only. The costs above reflect reimbursement of reasonable expenses incurred while conducting business on behalf of the Nazareth Trust and are primarily costs arising from travel and accommodation required for the meetings in Nazareth, Israel, twice each year and the same for meetings held in Edinburgh and London, respectively.
The Remuneration and Nomination Committee meets at least annually to review and assess the pay levels of senior staff.
Only four staff are UK employees, the rest being employed in Israel under Israeli employment law, and in accordance with the national pay scales of Israeli hospitals. For salaries for healthcare public employees in Israel, the Israeli Government dictates annual wage agreements known as collective agreements. Nazareth Hospital EMMS, whilst complying with legislation, pays reduced salaries compared to other public health care providers in Israel to deliver a balanced budget.
It is also important to note, as a small trauma and acute care general hospital, with numerous but small departments, our on-call allowances are divided among a small population of key consultants. For example, our Neonatal Unit has only 2 Senior Doctors who provide all the on-call required. Currently the on-call payments (c.2600 NIS per on-call according to Israel collective agreements) make up more than 40% of the salaries alone. In addition, the fluctuation of the exchange rate of GBP against Israel NIS is reflected in the remuneration table below, as the data
Staff Salaries > £60K (Gross including benefits)
| Between £400,000 & £410,000 | 1 |
|---|---|
| Between £320,000 & £400,000 | 0 |
| Between £310,000 & £320,000 | 2 |
| Between £300,000 & £310,000 | 1 |
| Between £270,000 & £300,000 | 0 |
| Between £260,000 & £270,000 | 1 |
| Between £250,000 & £260,000 | 1 |
| Between £240,000 & £250,000 | 0 |
| Between £230,000 & £240,000 | 4 |
| Between £220,000 & £230,000 | 1 |
| Between £210,000 & £220,000 | 1 |
| Between £200,000 & £210,000 | 1 |
| Between £190,000 & £200,000 | 2 |
| Between £180,000 & £190,000 | 4 |
| Between £170,000 & £180,000 | 3 |
| Between £160,000 & £170,000 | 1 |
| Between £150,000 & £160,000 | 4 |
| Between £140,000 & £150,000 | 7 |
| Between £130,000 & £140,000 | 4 |
| Between £120,000 & £130,000 | 2 |
| Between £110,000 & £120,000 | 8 |
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| Between £100,000 & £110,000 | 17 |
|---|---|
| Between £90,000 & £100,000 | 29 |
| Between £80,000 & £90,000 | 65 |
| Between £70,000 & £80,000 | 58 |
| Between £60,000 & £70,000 | 74 |
Total Salary Data
| Data | Total Gross Salaries |
Employers NI Contribution |
Employers defined Pension Scheme Contribution |
Operating costs of Employers defined Pension Scheme (exc. pension finance costs); & other employee benefits |
|---|---|---|---|---|
| All staff |
£ 35,266K | £ 2,082K | £ 3,429K (pension & provident funds) |
£1,518K (advanced study fund) £2,664K(employer salarytax) |
The Nazareth Trust’s table of remuneration disclosure reflects salary levels that may appear higher than is typical within the UK charity sector. These figures arise from a collective agreement designed to align doctors’ pay at the Nazareth Hospital, with comparable roles across the Israeli healthcare system. These salaries are typically not covered by donor income but instead by medical insurance payments. As a healthcare provider serving a predominantly Arab/Palestinian Israeli population, the Nazareth Trust is committed to delivering the highest quality medical care to an otherwise under-served local population. Achieving this requires attracting and retaining highly skilled clinicians, which in turn necessitates offering competitive salaries consistent with national remuneration expectations .
4. Financial Review
4.1 General
Although the war in the past two years has negatively affected the Nazareth Village and the SERVE programme, the Hospital and the School of Nursing experienced a short-term decrease in activities, which quickly returned to full volume. The actual performances in 2024 and 2025 shows that the Trust was able to contain the effects of the war and continue to meet its financial plan.
In 2024, the Nazareth Trust achieved a financial surplus and embarked on strategic expansions despite ongoing challenges due to the war. Furthermore, the surplus was achieved in spite of the fact that the Trust has signed a collective agreement with the trade union significantly increasing its payroll expenses and equalling the hourly rate it pays to its employees to those paid in governmental hospitals. The Trust's financial performance exceeded the projected budget, as reflected in the audited accounts. Overall, the Trust strengthened its financial position and maintained stability.
The improvement in financial performance primarily consists of the following elements achieved:
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Improved Sick Fund performance.
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Increased Ministry of Health (MOH) support due to excellent performance in national initiatives plans, such as internal medicine, NNICU, ER and IVF.
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Improvement of maternity income after introducing the own suite initiative
4.2 Funding Sources
Typically, the majority of TNT's income derives from the activities of Nazareth Hospital EMMS, which operates within the framework of the Israeli healthcare system. Within this, income is primarily generated through contracts with governmental health insurance schemes (Sick Funds), in which all Israeli citizens are enrolled.
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4.3 Reserves
The cash reserves held by TNT relate to restricted and designated funds according to the law and regulations under which the charity must operate. These are principally for capital development projects, for which targets are typically high. TNT's policy is to hold cash reserves in a separate bank account equal to at least the amount of the restricted funds.
A reserves policy was introduced in November 2025. The policy ensures responsible stewardship of funds, supports financial sustainability, and aligns with guidance from OSCR and SCVO and Israeli regulators.
The Trust's aim over the medium term is to generate sufficient surpluses from unrestricted operations to provide cash reserves equal to 90 days of operational expenditure.
The laws under which TNT operate stipulate that reserves may be held in bank deposits or governmental bonds. Given the low returns on governmental bonds when considering related expenses, TNT invests its cash reserves in bank deposits only. Terms and length of deposits are examined periodically and resolved according to cash requirements, current investments, and projected investments for the near future.
4.4 Reserves Status
At the close of 2025, TNT's reserves totalled £70,640k, and the restricted fund balance totalled £3,381k. Restricted funds are primarily for imminent capital developments, mainly the development of the Maana Centre.
4.5 Auditor
KPMG are the appointed auditors after a tender process conducted in 2013.
4.6 Trustees’ Responsibility in Relation to Financial Statements
Company law requires Trustees to prepare financial statements that give an accurate and fair view of the state of affairs of EMMS Nazareth (The Nazareth Trust) for the financial year and of its surplus or deficit for that financial year. In doing so, Trustees are required to:
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Select suitable accounting policies and then apply them consistently.
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Make sound judgments and estimates that are reasonable and prudent.
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Prepare the financial statements on a going concern basis unless it is inappropriate to assume that EMMS Nazareth (The Nazareth Trust) will continue to operate.
Trustees are responsible for maintaining proper accounting records which disclose, with reasonable accuracy, at any time, the financial position of EMMS Nazareth (The Nazareth Trust) and enable them to ensure that the financial statements comply with the Companies Act 1985. Trustees are also responsible for safeguarding the assets of EMMS Nazareth (The Nazareth Trust) and hence for taking reasonable steps to prevent and detect fraud and other irregularities.
This report has been prepared and issued by order of EMMS Nazareth (The Nazareth Trust) Board of Trustees.
Geoffrey Spence, Chair of the Board of Trustees
25th June 2026 Date:
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