Annual Report and Financial Statements 2018/19 by Kidney Research UK

Annual Report and Financial Statements 31 MARCH 2019

ANNUAL REPORT 2018-19 | 1

Contents 04 OUR IMPACT IN 2018/19

04 05 06 08 10 12 14 16 17

Our vision Foreword A pivotal result for people on dialysis A year of discovery Tomorrow’s breakthroughs Tackling inequalities in kidney health Our supporters – we can’t do this without you Meeting our goals in 2018/19 Looking ahead to 2019/20

18 REPORT FROM THE TRUSTEES

20 Financial review 22 Structure and governance 25 Statement of trustees’ responsibilities

26 INDEPENDENT AUDITOR’S REPORT 28 FINANCIAL STATEMENTS

28 29 30 31 35

Consolidated statement of financial activities Balance sheet Consolidated statement of cash flows Principle accounting policies Notes to the financial statements

Our vision is to FREE LIVES FROM KIDN EY DISEASE AROUND ONE IN TEN PEOPLE

have chronic kidney disease, for which there is no cure.

About 3,600 transplants are completed each year. Five people die every week while on the waiting list for a donor kidney.

It is a privilege to have a job like mine in which, every day, I can feel proud of and inspired by the work we do. Proud of the commitment, shown by our staff and volunteers, to make a difference. From helping a patient who has called for advice, or supporting a fundraiser preparing for an event, to the care taken in choosing which research projects to award our precious funds. So many little things that add up to make Kidney Research UK a charity that can make a big difference. In October 2018, the results of our PIVOTAL clinical trial were announced bringing this four year study to an end. The study revealed the best and safest way to treat anaemia during dialysis. It was the largest project that we had ever coordinated, and it will prevent the debilitating effects of anaemia for so many people. Our thanks go to the hundreds of patients and clinicians who took part. It has been inspiring to see the achievements our scientists have made over the year. Discoveries like Professor Richard Cowardâ&#x20AC;&#x2122;s work on page 9 which is giving us better scientific understanding of kidney disease and holds real promise for the future.

Today in the UK:

ALMOST 5,000 PEOPLE ARE ON THE WAITING LIST FOR A KIDNEY TRANSPLANT

Aiming even higher

Collaboration is key to much of our work, and to the way we are shaping our focus for the future. Conversations with patients and their families, staff, health professionals and researchers motivated us to think bigger. Progress in tackling kidney disease is happening, but not fast enough. In the coming years we will aim even higher; broadening our thinking and significantly accelerating the rate of advance.

WAITING LIST

NEARLY 30,000 PEOPLE NEED DIALYSIS TO SURVIVE

It takes several hours, three or more days a week, causing side effects and impacting quality of life.

These advances must include ways to tackle, reduce and eradicate the vast inequalities in kidney health across the UK. We shone a spotlight on these issues with an important report this year; a starting point for us and others to ramp up work in this area. Research into these disparities is absolutely fundamental, so one of our first steps is to galvanise the renal community to investigate the issues. Weâ&#x20AC;&#x2122;re grateful for your support as we commit to taking the next and perhaps biggest steps in our journey towards a world free from kidney disease.

SANDRA CURRIE Chief Executive

Together we can STOP KIDN EY DISEASE IN ITS TRACKS 4 | ANNUAL REPORT 2018-19

ANNUAL REPORT 2018-19 | 5

A pivotal result for people on dialysis This year our ‘PIVOTAL’ study concluded, publishing evidence around the safest way to treat anaemia in dialysis patients. We were delighted to have delivered one of the largest renal clinical trials to have taken place in the UK. Anaemia is a common problem in dialysis, for which patients take iron and erythropoietin (EPO). EPO is a hormone that’s important for red blood cell production, but is linked to heart problems and stroke. That’s why many doctors prefer to give more iron, and less EPO. However, until this year, very little evidence has supported this approach, or any other.

The results were unequivocal. High-dose iron reduced people’s risk of dying, having a heart attack or developing heart failure. The group receiving high-dose iron also needed less EPO and fewer blood transfusions.

Paul Spree was one of the 2,141 people across 50 UK centres who took part in the trial. He was in the group who were proactively given high doses of iron, while another group were given low doses, and only when their iron levels got too low.

“I saw my dose of EPO reduce down to the bare minimum, so there was a clear benefit there which I was really pleased about” said Paul. “I felt like I was contributing to medical evidence for the future, aimed at trying to help make decisions about what is best for patients going forwards. I was doing my bit really, doing my duty to help other haemodialysis patients.”

“The PIVOTAL trial nurse would come around every four to six weeks, check how I was doing, including my blood test results, and make sure everything was tickety boo”, Paul explains.

PIVOTAL was the largest project we’d ever coordinated. It’s plugged the gap in evidence about treating anaemia in dialysis, and we owe a debt to all the patient volunteers who made that possible.

Thanks to volunteers like Paul – some who were part of the trial from the beginning – a large amount of data about the effects of each dosing regime was collected.

The results have reassured doctors that high iron and low EPO is the best approach, and one that we now want to see adopted everywhere.

6 | ANNUAL REPORT 2018-19

Paul’s story Paul Spree was diagnosed with kidney failure aged 38. He still remembers that moment. “It was 23 November 2015. The first words the consultant said to me were ‘we need to talk about dialysis’. We discussed the way things might go – they thought I had three to five years left. My wife broke down. It was real a wake-up call. “My condition quickly worsened. I was off food and constantly sick. I had a disgusting taste in my mouth. My legs were so swollen I couldn’t wear regular trousers and I was freezing cold all the time. I was severely anaemic and just felt exhausted constantly – it got to the point that I was only really awake at mealtimes. “In January 2016 I was admitted to hospital and an emergency neck line was inserted to get me on to dialysis quickly. I dialysed in hospital three times a week for nearly three years. Initially the after-effects were awful, like a really bad hangover. But I was lucky that they weren’t long-lasting and my body eventually got used to the process. “In October 2018 my wife started training in home dialysis. It’s made a big difference because it’s so much more flexible – I’ve been able to go back to work full time. “Because I dialyse in the evenings, and have to watch what I eat and drink so carefully, I can’t enjoy the social life I once had. And you can’t just take a holiday whenever you fancy because there’s so much organisation involved. “Kidney failure does impact our life, but I’ve worked hard to take ownership and become an expert in my own condition. I feel like I’m in control of it, not the other way around.”

ANNUAL REPORT 2018-19 | 7

A year of discovery

This year, many research projects we funded came to fruition, with their results endorsed by experts and published in high quality journals, boosting universal understanding of kidney disease and taking us closer to lifechanging improvements for kidney patients. People young and old will benefit from these outcomes which will influence treatment in years to come. Here are three examples of projects which were published this year. A more effective treatment for children

Lifting the dialysis fog

We funded an international study led by Dr Rukshana Shroff at Great Ormond Street Hospital. Data suggests that a newer form of dialysis treatment called haemodiafiltration (HDF) is more effective, safer and better tolerated by children than conventional haemodialysis (HD).

This year a study in Glasgow sought the help of almost 100 patients to investigate the ‘dialysis fog’ that many people describe. Each completed mental tasks, and scientists measured blood flow to their brain both during dialysis, and on non-dialysis days.

Dialysis is vital for some children, but it can severely impact quality of life and they can develop other life-threatening conditions later on, such as heart and circulatory disease.

The study found that blood flow to the brain, and memory, were reduced during dialysis. In those who remained on dialysis, MRI scans also revealed detrimental changes to brain white matter over one year. In contrast, the patients who had a kidney transplant saw their memory and brain scans recover.

The results of the international team’s year-long study of 133 children – 78 on dialysis, 55 on HDF – were striking. Both artery thickness – a sign of blood vessel disease – and blood pressure increased in the children on HD, but not in children who received HDF. Only the children on HDF grew taller during the study. Most importantly, children on HDF reported that they felt better, with fewer headaches and episodes of dizziness or cramps than children on dialysis. They also recovered from each treatment more quickly, allowing them to play and attend school more. We look forward to these findings being confirmed in a clinical trial as quickly as possible.

Breakthroughs come more quickly when knowledge is shared. Last year our research was PUBLISHED IN 155 PAPERS, which in turn will help shape future research. 8 | ANNUAL REPORT 2018-19

Study leader, Dr Mark Findlay, is now planning research to explore if it’s possible to limit this potential side effect of dialysis. He’ll begin by testing simple interventions such as listening to music, brain-training games or methods to improve sleep patterns.

Kidney controller unmasked “In 2013 Kidney Research UK funded me to lead a research project involving teams from around the world, using our complementary skills to uncover insights into kidney function. Our results were published in January 2019, with really important implications. “We discovered that, to work properly, our kidneys rely on an enzyme called GSK3. The enzyme is active in podocyte cells, which are a critical part of the kidney’s blood-filtering apparatus. GSK3 comes in two forms, alpha and beta, which are similar but not identical so understanding what each of these forms do is very important. We found that when both forms of GSK3 are suppressed, it causes severe kidney failure. “As well as being fascinating for those of us researching kidney health and disease, our discovery is also important right now for patients. Some current medicines are known to suppress both forms of GSK3, including lithium, which is commonly prescribed for mood conditions including manic depression. “In light of our findings, we believe that patients taking lithium should have regular urine tests to check their kidney function. If they have increased protein in their urine they should consider reducing their lithium dose or switching medicines – it could prevent them developing kidney failure and requiring dialysis and/or a kidney transplant in the future. “There’s previously been a drive from pharmaceutical companies to develop GSK3 inhibitors for treating diabetes, cancer and Alzheimer’s. We’ve urged the industry to make sure that any medicines like this are designed to suppress only one form of the enzyme, leaving the other form to keep the kidneys ticking over. “Now in the lab, we’re delving into why and how GSK3 is so important. By working out exactly what the alpha and beta forms do, we hope to reveal clues for future ways to prevent or treat a range of kidney diseases.” Professor Richard Coward, University of Bristol

As well as shedding light on the issue of ‘dialysis fog’, this research may also hold clues to the links between kidney disease and brain diseases, such as stroke.

We invested £8.5 MILLION in research last year, supporting 75 studies that could make LIFE-CHANGING DISCOVERIES in the coming years. ANNUAL REPORT 2018-19 | 9

Billi’s story

Tomorrow’s breakthroughs

“It was in my first year of secondary school that I started always feeling cold, completely lost my appetite and felt really tired all the time. The GP did a blood test and at 2am an ambulance turned up out of the blue and rushed me straight to Bristol Children’s Hospital. I had no idea what was going on. I got a diagnosis of stage 5 kidney failure the next morning.

This year, thanks to the generosity of our supporters, we were able to award 75 new research grants. We fund studies that range from exploring kidney biology, and tests on cells in the lab, to trials of therapies in patients. Some of these studies will reveal insights that change the lives of today’s kidney patients, while others may sow a seed towards medical advances that benefit the generations to come. All of them will bring us closer to our vision of lives free from kidney disease. Here are three examples of projects we’ve funded this year. Giving donor kidneys the best chance

Managing weight after transplant

You might already be aware that we’re half way through funding a large trial of ‘warm perfusion’. It’s a procedure that could improve the success of kidney transplants, and increase the number of viable donor organs, by flushing kidneys with blood before they are transplanted.

Many people who’ve had a kidney transplant put on weight after their surgery. This happens for a variety of reasons, including transplant medicines that affect the appetite. Being overweight or obese is linked to poor health post-transplant, so we must support people to maintain a healthy weight.

This year we funded an additional project to investigate if adding an anti-rejection drug to the perfusion liquid could help to ‘prime’ the donor kidney and give it an even better start in its new body.

We’ve funded Ellen Castle, a renal physiotherapist at King’s College Hospital, to develop an interactive online weight management tool for kidney transplant recipients. Working with patients and the transplant team, she’ll design the digital resource. Then she’ll begin to test its acceptability to patients.

With our grant, Newcastle University medical student Ellen Irwin will complete a year of research as part of her medical training. She’ll study kidneys that have been declined for transplantation, perfusing them with liquid enriched with basiliximab, to see if it can better prepare donor kidneys. Basiliximab is an anti-rejection drug that’s already commonly given to kidney transplant patients.

Using stem cells to treat kidney injury In acute kidney injury, known as AKI, the kidneys suddenly stop working properly. AKI affects over 100,000 people every year in England alone. The damage caused to the kidneys means that surviving patients have a greater risk of developing chronic kidney disease in the future, and become reliant on dialysis or a transplant to stay alive. We’ve funded Dr Bettina Wilm at the University of Liverpool to investigate if stem cell therapies could be used to repair the damage caused by AKI. Her previous work showed that stem cells can boost the kidney’s own repair processes after AKI in rats. Now, with our funding, she can delve deeper into how the cells do this. The insights she gathers will help us understand how stem cell therapy might be safely and effectively used in AKI patients, to reduce the risk of chronic kidney disease.

The tool, called ‘Weigh it up’, will involve 12 monthly online sessions from six weeks post-transplant. It will combine dietary information, individually prescribed physical activity and recognised techniques to encourage behaviour change, such as goal-setting.

Uncovering clues in diabetic kidney disease 10,000 people in the UK requiring dialysis or a transplant have a diabetes-linked kidney disease, called diabetic nephropathy. It’s one of several conditions where the first layer of the filtration barrier on the inner lining of kidney blood vessels – the glycocalyx – becomes leaky and allows proteins to pass through. This can eventually lead to kidney failure.

“I managed school and dialysis for about two and half years. At that time I had a lot of other stuff going on. I was in foster care for some of the time and I was bullied at school because of my kidney failure and because I’m visually impaired. “With dialysis I felt like my life was on hold and I’d grown to hate it. During the sessions my skin felt really weird from the inside – it’s hard to explain. Almost the worst bit is that my diet was so restricted. “I was deteriorating mentally and really struggling to cope – I even refused dialysis one day. I was pretty much suicidal. “Then one Saturday night I was playing Playstation with my mate and my mum came up with the phone saying we’d had the call – I had a donor. Initially I didn’t know how to feel: scared, happy, excited. Then fear kicked in. “I don’t know why I was scared really, but it was like there was suddenly some hope in my life. I no longer wanted to die, and I was fearful that something could go wrong in the operation. “After the transplant it was like the opposite of how I was feeling before. I had life to live. I was so much more positive than before. And I could eat what I wanted! “I’ve got nothing in my way now. I started at the Royal National College for the Blind in September 2018; I’ll be doing sport and recreation and business administration courses. I’m also transitioning from childrens’ to adult kidney services. It’s gonna be hard getting to know everyone and, for me, finding my way around a new hospital, but I’ll be alright.” Billi, 17

Dr Simon Satchell works at the University of Bristol in a group at the forefront of glycocalyx research. This year we funded him to lead a study that will help us better understand how the glycocalyx becomes damaged in people with diabetes. By uncovering the details of this process, the team will spot potential ways we could design medicines to prevent this damage, and protect kidney health in diabetes.

Kidney disease is linked to several other major diseases, so people living with kidney problems are often also coping with other chronic illnesses. That’s why we’re committed to funding high quality research that tackles the complex biology linking kidney health to other systems in the body. Dr Satchell’s project is just one example of our investment in this type of work. 10 | ANNUAL REPORT 2018-19

ANNUAL REPORT 2018-19 | 11

Sabina’s story

Tackling inequalities in kidney health

“I’ve lived with kidney disease my entire life; my right kidney was removed when I was two months old, after being damaged by a blockage in my ureter. My remaining kidney lasted until I was a teenager and was removed after a live transplant from my amazing mother. “I’ve been on dialysis a lot, and have had a few lifethreatening complications over the years. I’m currently on the transplant waiting list again after the kidney from my mum had to be removed recently.

How much money do you have? It might not be something you consider when thinking about your health. Yet, whether you’re rich or poor is one of the things that significantly affects your chance of developing chronic kidney disease (CKD). Last year, we published a report revealing that a mix of biological, societal and economic factors lead to unequal risk of kidney disease in the UK population. Our genes, education, neighbourhood and culture all play a role.

Who’s at risk? People can be disadvantaged in their chances of developing kidney disease, in how severe their disease is, in the treatment they receive and in their outcomes.

we stressed that health professionals, the NHS, researchers and policy-makers must do things differently in order to tackle the disparities. For example, we must get better at including people from disadvantaged groups in research studies, to ensure that advances work for everyone. And we have to make a step change in research efforts to understand how biology, society and economics influence our risk of kidney disease, and to trial ways we can overcome it.

Our report reviewed all the evidence and exposed widespread health inequalities, including:

What we’re doing

c People living in deprivation are more likely to have CKD, be

As well as urging others to take action, we committed to playing a big part in improving kidney health for all. You can read our pledges on our website.

diagnosed at a later stage and progress faster, are less likely to have a transplant, and die earlier from their disease

c People from black, Asian and minority ethnic populations are more likely to progress faster to kidney failure, and less likely to receive a transplant

cW omen are more likely to be diagnosed with CKD, but men are more likely to start dialysis.

What needs to be done? We launched Kidney health inequalities in the UK. An agenda for change, in the House of Commons in March 2019. At the launch

We’ve begun by making inequalities a priority area of our work and have assigned resources to drive this forward. We’re asking all research funding applicants to consider how health inequalities could be built into their project, and we’re reaching out to the research community with this challenge. Our peer educators, like Sabina, are playing a big part too. For instance, they’re helping us with a community project to break down barriers to accessing healthcare, and increase organ donation, among black, Asian and minority ethnic people.

“All this means I’ve spent a lot of time in hospital, and met lots of other people with kidney failure. I’m a really positive person and always like to try and cheer people up, bring a smile to their faces, even though we’re all going through a tough time. “I guess it was this drive to help others that first got me interested in Kidney Research UK’s Peer Educator programme. Black, Asian and minority ethnic people in the UK tend to be less aware of kidney disease, less likely to be organ donors and less likely to seek help from their doctor. I want to help change that. “Thinking back to being a Muslim child with kidney disease, organ donation was never openly discussed or encouraged in my community. In fact, there has been widespread misconception that our religion doesn’t allow it. But now we’re talking about it more and more, and it’s so rewarding when I attend an event as a Peer Educator and people choose to sign up as a donor right in front of me. “I have so many ideas on ways I can spread the message, but I wouldn’t be able to do it on my own. My mentor at the charity has given me the training and confidence to educate people about the issues – whether one-to-one, or presenting to a room full of people. “Unfortunately my dialysis and health means I can’t do as much as I’d like to. But every time I do put on the purple t-shirt and get out there to talk to people, I do it with all my energy and heart.” Sabina Saeed, Peer Educator

! There are more people with kidney disease in areas of HIGHER SOCIAL DEPRIVATION 12 | ANNUAL REPORT 2018-19

People from black, Asian and minority ethnic groups are LESS LIKELY TO RECEIVE A KIDNEY TRANSPLANT

There are high rates of SEVERE MENTAL ILLNESSES amongst people with CHRONIC KIDNEY DISEASE ANNUAL REPORT 2018-19 | 13

Mandi Shipton

We can’t do this without you

“2018 was the 20th anniversary that my ‘big sis’ said her goodbyes.

We raise money in many different ways, and we’re always searching for innovative sources of income to fund future discoveries. But donations from members of the public, companies, charitable trusts and our volunteers remain our largest slice of income. We couldn’t fund life-changing advances without you.

Twenty-five years ago, Paschal donated a kidney to his brother Liam. To mark the anniversary, they brought friends and family along to take part in the 2018 Kidney Research UK London Bridges Walk.

Our income of £9.8 million was down by 10.8 per cent compared to the previous year, falling short of our target. 2017/18 was a recordbreaking year that we knew would be hard to match this year. But 2019/20 is forecast to show income going up again to £11.7 million. Timing of large pieces of income account for some of the year to year fluctuation. Overall the trustees are satisfied with the results and the financial strength of the charity. Read more about our finances on page 21.

“Twenty-five years on and we’re as fit as fiddles. Until the Bridges Walk I had never met another living donor. It’s such a great atmosphere and every year it gets better and better.”

Thousands of you – extraordinary people and loyal supporters – have already joined the fight by donating your time or money, or both. Here we give a flavour of just some of the amazing ways you supported Kidney Research UK last year.

In 2018 Sam Blackburn received his second kidney transplant. His employer, Exclusive Networks, marked it with their third annual charity football tournament in aid of Kidney Research UK and Sheffield Hospitals Charity. Over 300 people got involved, raising more than £40,000.

Consultant nephrologist Dr Ian Logan completed an almighty oneday challenge in August to raise funds, and highlight the need for organ donors. In blistering heat, Ian cycled 312km, completing a full lap of the island of Mallorca. “Every day in clinical practice I see patients that will die with kidney failure or require lifelong dialysis, because of a shortage of donor kidneys. I wanted to do something special to help raise awareness of transplantation.”

Star volunteer Barry Jacobs is a superstar. Not only is he a member of our Lay Advisory Committee – who provide us with the patient’s perspective on everything we do – he’s a volunteering allrounder. Barry has handed out medals at the London Bridges Walk, shaken a collecting bucket at Kings Cross, given talks about the charity, and completed a trek in Iceland to raise funds. Last year he even led a convoy of Land Rover Defenders in a multi-terrain fundraising tour of UK transplant centres, raising almost £40,000. Always passionate and enthusiastic, we’re so grateful to Barry for everything he does. 14 | ANNUAL REPORT 2018-19

7,881 LOYAL SUPPORTERS have committed to a REGULAR DONATION, helping us to fund longer-term research programmes

Our incredible volunteers gave their ENERGY, SKILLS AND OVER 25,000 HOURS of their time to help support our endeavours in our office and shops

Thank you to the pupils, parents and teachers at Denstone College, who were inspired to support us by pupil Izzy Belton, who was born with kidney disease. They raised over £2,000 for us through events at their school this year and challenged their teachers to raise even more by running the Liverpool Marathon.

71 LONDON MARATHON RUNNERS RAISED £218,039 for Kidney Research UK in 2018

“Kidney disease is really devastating for everyone it comes into contact with.”

“Karen was truly special. Beautiful, loving, funny, caring, sharing and courageous. Karen suffered from kidney failure for many years, she was diagnosed at 16. She had to do dialysis several times a day, had many operations, lived on meds…but where possible she didn't let her illness stop her living a full life. “She went to college and studied Art and Photography, she loved music and was a hospital DJ, she liked hanging out with friends, passed her driving test (first time), she just wanted to live a normal life. She was amazing. The bravest person I have ever known. She was 27 years old when she died. “One of Karen's wishes was to help fund research into kidney disease, to help improve the quality of lives for other kidney patients in the hope that they might not have to suffer like she did. Even then she was thinking of others. “Sometimes I take up a challenge in Karen's memory to raise money for Kidney Research UK. In September 2018 I did my biggest challenge to date. “I entered the Rat Race Coast to Coast, crossing Scotland east to west. 105 miles over two days of running, road bike, mountain bike and kayak, and camping overnight. It finished with a half marathon. “Every step was the challenge I suspected! Fourteen and a half hours of sheer determination. It was fun, painful, gruelling, wet, awesome and over £3,700 raised for Kidney Research UK. Totally worth it!”

Mark Camidge, who raised nearly £12,000 for Kidney Research UK by rafting down the dangerous Zambeze River. Mark’s wife, Rachael, received a lifechanging kidney transplant in August 2018 after 14 years of ill health.

We received £2.9 MILLION IN LEGACIES thanks to supporters’ exceptional commitment to our cause beyond their own lifetimes ANNUAL REPORT 2018-19 | 15

Looking ahead to 2019/20

Meeting our goals in 2018/19

This year we will launch our 2020-30 strategy. It will set out how we intend to make a step-change in progress to deliver life-changing advances in kidney disease.

In the previous pages we’ve shared a few examples of our work, your support, and the discoveries you’ve made possible this year. It’s also important for our supporters to see how we’ve performed across the charity, against the goals we set ourselves – where we have achieved what we set out to do, and where we’ve fallen short.

Our 2019/20 year marks the start of this new strategy. Our plans below demonstrate how we will continue the great work we are already doing whilst taking the first steps into our longer term ambitions by 2030.

c Launch and start work with a new strategy focussed on changing the outcomes for those affected by kidney disease sooner.

c Invest a total of £7.5 million into research across the causes, Fund more research into kidney disease in children.

YES. We invested £558,000 in six projects, compared to £357,000 in three projects last year.

Invest £8.6 million in 68 grants.

YES. We funded 75 grants - albeit falling just short of our investment target, spending £8.5 million

prevention and treatment of kidney disease in children and adults. This is a decrease from 2018/19, which was particularly high due to the timing of the last £750,000 Making Every Kidney Count investment and completion of the Pivotal project.

c Accelerate research in to leading causes of kidney disease such as diabetes and high blood pressure by continuing to work with other disease specific charities to deliver research collaboratively.

Forge partnerships to boost research funding in kidney disease.

YES. We’ve collaborated with researchers and funders in a number of areas, securing £2.7 million for kidney research.

Accelerate research into diabetic kidney disease.

YES. We are collaborating closely with Diabetes UK and other charities to identify research needs, and – hopefully – jointly fund research.

c Leverage the most from our relationships and influence with other

Complete the ASSIST-CKD project; a healthcare model being trialled in 20 areas to identify and monitor people at risk of kidney decline.

YES. Project completed in October 2018. Many trial sites have retained the system beyond the trial. Results are due in 2020.

c Ensure the NURTuRE biobank completes sample collection for

Complete the PIVOTAL trial into the best way to treat anaemia in dialysis patients.

YES. Trial completed and practice-changing findings published. See pages 6-7 of this report.

Invest in our staff and improve our IT systems.

YES. We provided more training and development opportunities for staff, and improved our use of technology, including cyber security.

funders and partners to boost research funding into kidney disease. chronic kidney disease and idiopathic nephrotic syndrome and opens access to researchers. Secure funding for other sample types.

c Facilitate year one of the Iron and Muscle study; a clinical trial to identify if giving iron can improve wellbeing in patients with chronic kidney disease who are not yet anaemic or on dialysis.

c Advance research areas recommended in our inequalities report, and continue our work with at risk communities.

c Grow the number of people signed up to our patient Ensure that at least 75 pence in every pound we raise is spent on our charitable objectives.

YES. We spent 80 pence in every pound raised on our work, with 20 pence being spent to help us raise the next pound.

Raise the profile with policymakers of kidney disease in the UK.

YES. We organised parliamentary events in Scotland and England.

Respond to the recommendations in the health inequalities report.

YES. We launched the report and its recommendations to the kidney community at a Westminster event. We are now asking researchers applying to us for funding to consider the challenges of health inequalities and how to address them.

Complete sample collection in the NURTuRE kidney biobank.

NOT QUITE. Collection of chronic kidney disease samples is due to complete in June 2019, with total collection complete in January 2020.

Increase our work with kidney patients, and help more to participate in research.

PARTLY. 239 people signed up to our new network, Kidney Voices, through which we promote opportunities to get involved in research. However, new GDPR rules have vastly reduced our ability to identify and reach out to people on our database with kidney disease.

Raise £11.2 million to support our work.

NO. We fell short of our fundraising target this year, raising £9.85 million.

c Raise £11.7 million to fund our work. Whilst this seems significantly

Achieved 16 | ANNUAL REPORT 2018-19

community, Kidney Voices, and help more to participate in research.

Partly/almost achieved

higher than last year, we would expect fluctuations due to the timing of larger pieces of income.

c Invest in future opportunities for raising income and awareness. c Invest in our staff and technology to maximise what we can do, including launching a new website.

c Improve how we report the impact of our work. c Ensure that at least 80 pence in every pound we raise is spent on our charitable objectives.

Not achieved ANNUAL REPORT 2018-19 | 17

Report from the trustees 18 | ANNUAL REPORT 2018-19

ANNUAL REPORT 2018-19 | 19

Financial review Where our income came from

Trading Income

This year we can report that our income was £9.8 million. This follows a very successful year in 2017/18 where our income exceeded £10 million for the first time in the charity’s history, reaching £10.9 million.

This includes charity shop income as well as income from our raffle.

£665k

Investment Income

£436k

Donations and Gifts

£3.1 million

The decrease of 10.8 per cent (£1.1 million) on 2017/18 is mainly due to fluctuations in legacy income and timing on other large pieces of income, some of which will move into 2019/20. Last year legacy income reached £3.8 million, an exceptional growth of 20 per cent on the previous year. In 2018/19 our legacy income reached £2.9 million and is forecast to increase again in 2019/20. In 2018/19 trustees approved expenditure higher than the income earned in the year, taking into account the level of available reserves (see Reserves policy on page 21) and the overall financial performance of the charity.

TOTAL INCOME

£9.8 million

This includes one-off donations as well as regular giving.

Trust and Partnerships

Charitable expenditure reached £9.6 million in the year with an increase of £322k (3.79%) in research spending.

Trading

£1.1 million

£509k

This includes the cost of running our charity shops and raffles.

Investments

Reserves policy

The charity’s investments portfolio and cash holdings rose to £18.25 million. Volatility in the equity markets saw the portfolio value move up and down over the year. However, by the end of the year it showed an increase of 5.7 per cent, which was in line with benchmark and ahead of inflation. This provided an unrealised gain of £371,000. Income from the portfolio and cash amounted to £436,000.

The charity’s policy is to maintain the following reserves:

Investment Management Costs

This includes working with patients and raising awareness of kidney disease.

£20k

At close of business on 18 September 2019, the investments had a market value of £18,005,277. This represents a rise in value of £560,109 since 31 March 2019.

Financial position

TOTAL EXPENDITURE

£12 million 20 | ANNUAL REPORT 2018-19

Generating Income

£1.9 million

80 pence

£2.9 million

This includes income to support our ongoing projects such as PIVOTAL, assist-CKD and NURTuRE, the data and kidney biobank collaboration, and Stonygate Trust income.

Awareness and Education

Pence in the pound invested in research and awareness in 2018/19:

At this stage, we are not aiming to increase this number further. We aim to sustain a high level of financial efficiency, while also maintaining and being able to invest in improving our operating standards and in securing future income sources to meet the need for research funding.

Legacies

£2.7 million

Where the money is spent This year, our total expenditure was £12 million, split between research, awareness and education and investing to raise the next pound.

We strive to work efficiently and to invest as much as possible of each pound in research and raising awareness of kidney disease. The pence in the pound invested this year decreased by three pence.

Total reserves at the end of the year totalled £8.2 million of which: Research

£8.5 million

This includes research and career development.

£622,000 are Restricted Funds; £5.4 million are Designated Funds; £2.2 million are General Funds. See the Reserves Policy to the right for details.

estricted Funds – funds that have R been donated to the charity for a specific purpose.

Designated Funds – funds identified and already committed for expenditure on research, awareness and education, and key operational commitments.

eneral Funds – funds available to G meet any unforeseen circumstances which the charity may face. The benchmark for the charity’s General Funds has been set at nine to twelve months of operating expenditure, which is intended: a) To cover a period of continuity for key operations in the event of an emergency which stops the charity from generating voluntary income; b) To cover the eventual winding up costs of the charity, should closure become necessary.

have taken into account the Charity Commission’s guidance on public benefit. The trustees ensure that the charity’s activities are in line with the aims of Kidney Research UK.

Investment policy Reserves are supported by the charity’s investment portfolio which is actively managed on behalf of the charity by Cazenove Capital. The investment objective is to maximise long-term total return while maintaining a level of diversification within an intermediate risk profile. The investment mandate stipulates no direct investment in tobacco related financial vehicles. The Finance and Risk Committee reviews the investment mandate regularly and monitors performance and position of the portfolio against agreed benchmarks. In the year the income requirement was increased from £300,000 per annum to £350,000 per annum.

General Funds at 10.9 months of operating expenditure were within the benchmark at year-end.

Public benefit When reviewing aims, objectives and planning future activities, the trustees ANNUAL REPORT 2018-19 | 21

People

Structure and Governance

Trustees

The following people have been members of our Board of Trustees during the year. TRUSTEES

SUBCOMMITTEE MEMBER

APPOINTED/RETIRED

Professor John Feehally (Previous Chair) MA DM FRCP Professor Fiona Karet PhD FHEA FRCP FMedSci Iain Pearson Federica Pizzasegola David Prosser MSt (Cantab), MA, FCA Anna-Maria Steel Andrew Tripp Dr Charles Tomson MA BM BCh FRCP DM Tom Kelly Deirdre Jennings Professor Sunil Bhandari MBChB, FRCP, PhD, M Clin Ed Julia Moross ACA Dr Jill Norman BSc, PhD Adrian Akers Professor Jeremy Hughes (Chair) MA MB BS PhD FRCPE Dr Adnan Sharif MD MRCP Professor Elizabeth Lightstone MBBS (Hons), MA, PhD, FRCP Dr David Hughes PhB, MBChB, FRCPCH Professor Caroline Savage MD, PhD, FRCP, FMedSci

RSC, F&R & RC RSC Chair F&R & RC F&R F&R

Retired (as Chair/Trustee 26/09/18) Retired 26/09/18

Retired 26/09/18 Retired 26/09/18

F&R RSC

RSC RSC F&R F&R, RSC

Appointed Chair Elect 22/03/18 Chair with effect from 27/09/18

RSC RSC

Appointed 05/12/18

RSC RSC

Appointed 05/12/18 Appointed 25/03/19

Committee key RSC Research Strategy Committee | RGC Research Grants Committee | F&R Finance and Risk Committee | RC Remuneration Committee

Kidney Research UK is a company limited by guarantee, Company Registration No. 00905963, and is registered with the Charity Commission 252892 (England and Wales) and SC039245 (Scotland). The charity is governed by its Memorandum and Articles of Association. In the event of the charity being wound up, company members must contribute £1. The wholly owned subsidiary company, Kidney Research Enterprises Limited, Company Registration No.2932606 undertakes trading and retail activities for the benefit of Kidney Research UK.

In 2018, Kidney Research UK started using the recently launched Charity Governance Code as a framework for systematic assessment and improvement of its governance. As noted by the Charity Commission, “…this Code is not a legal or regulatory requirement… Instead, the Code sets the principles and recommended practice for good governance and is deliberately aspirational: some elements of the Code will be a stretch for many charities to achieve… It is important that trustees discuss the Code’s principles and recommended practice and make well-considered decisions about how these should be applied in their charity.” In initiating this review, Kidney Research UK is demonstrating its commitment to good governance and to continuous improvement. A full assessment was completed during the

22 | ANNUAL REPORT 2018-19

year ended 31 March 2019. This will be repeated annually together with a review of progress on actions. The review has been completed in a rigorous manner, with input from management, trustees and other relevant stakeholders. Our auditors, Haysmacintyre LLP have been consulted during the process. As envisaged in the design of the code, the findings and related action plan provide a comprehensive assessment of the current position, including evidence to confirm where principles are met, and a good basis for continuous improvement where such opportunities are identified. We are pleased to report that we are fully compliant in most areas of the code. A small number of areas have been identified where we have progress to make, and an action plan is in place to address possible improvements.

The Board is made up of 15 trustees although we may occasionally have more for a short period where we want to ensure continuity of knowledge between particular outgoing and incoming trustees. We monitor the skill mix and length of service to ensure we keep a good balance on the Board and plan succession in a timely way.

Trustees initially sit on the Board for three years. They can be re-elected for another three years after which they must retire from the Board. After a clear minimum gap of three years off the Board, trustees may elect them to return for a three-year term – giving a total service to the Board of nine years. The three-year gap ensures that the Board’s membership has sufficiently changed from their previous period of service.

Trustees are encouraged to use their specific skills and experience in the charity and several are members of sub-committees of the Board. Training is provided throughout their service. All instances where a trustee may have a conflict of interest are documented and dealt with in a transparent way, in accordance with established procedures. The trustees set the strategy of the charity with the management team, and oversee its implementation.

Four sub-committees working under terms of reference agreed with the Board support the delivery of the strategy. c

The Research Strategy Committee sets the strategy for research funding.

T he Research Grants Committee, made up of both experts in kidney medicine and patients, reviews grant applications under a rigorous peer review process and recommends which research should be funded.

T he Finance and Risk Committee monitors the charity’s performance, governance and areas of risk.

T he Remuneration Committee oversees the charity’s remuneration policy and its implementation.

A Lay Advisory Committee, made up of kidney patients and other lay members, advises the charity and trustees on issues affecting kidney patients. Under terms of reference agreed by the Board, the committee gets involved in many charity activities including promoting its work to the wider community, providing patient input to public consultations, reaching out to other patient groups, acting as a sounding board for research ideas and plans and representing the charity at events. The committee has between 15 and 25 members.

Trustee Board Senior Management Team

Research Strategy Committee

Research Grants Committee

Finance and Risk Committee Remuneration Committee ANNUAL REPORT 2018-19 | 23

Management structure The Senior Management Team directs the charity on a day to day basis. During 2018/2019, this team comprised the Chief Executive; Directors of Finance, Research Operations, Communications, Research Development and Fundraising; Head of Human Resources and Head of Insight and Engagement.

Remuneration The charity’s policy on remuneration is guided by the following principles: c

F airness to employees, supporters and patients;

ecruitment, motivation and retention of R the appropriate calibre of staff without paying more than necessary;

ecognition and reward of contribution R to the charity;

ompliance with current legislation, C for example, minimum wage and living wage;

ecognition of best practice in the R charity sector including transparency to staff and other stakeholders.

The Remuneration Committee meets at least annually and advises on the remuneration policy of the charity. The committee oversees its implementation by: c

greeing the charity’s overall approach A to remuneration including relative position within the labour market and employee benefits including pension provision, also reviewing the levels of remuneration across the organisation;

eviewing from time to time, and at R least every three years, pay and benefits trends and benchmark pay rates and benefits, within the voluntary sector;

eviewing the annual recommendation R from the CEO for general salary changes;

onitoring the remuneration of the M Senior Management Team, benchmarked against independent external data;

greeing the remuneration of the CEO A in the context of market rates and benchmarks, personal performance, the scope and complexity of the role and affordability.

Staff development Continuing from the previous year, personal and professional training and development was a goal for 2018/19. During the year the team benefited from 137 individual training opportunities. These included presentation skills, training for our supporter care team and others across the charity to deal with difficult conversations, and bespoke training 24 | ANNUAL REPORT 2018-19

for individuals to develop their ability to excel in their roles. Further GDPR training was also delivered during the year across the charity. We continue to work with Birdsong Charity Consulting. Sam Attenborough continued to work with us on a generous pro-bono basis on the ‘Nuthatch’ initiative which was launched last year. This initiative aims to create a safe environment in which individuals are able to improve communication both within their teams and across the charity and to explore ways to support each other by addressing challenges in a positive way.

Grant making We have a formal and consistent approach applied to research grants in the charity. Research applications for funding are formally peer reviewed by experts in their field. They are then prioritised by quality of science and reviewed by the Research Grants Committee. This committee makes a recommendation for funding to trustees for their review and approval. In all instances where there is a conflict of interest, the committee member is excluded from any discussion and decision. For more information on our research strategy please refer to our website: www.kidneyresearchuk.org/research/ research-strategy

Our fundraising approach We are extremely appreciative of the lengths all our supporters go to support our fundraising efforts as together, we strive towards better diagnosis, prevention and improved treatment for kidney disease. The commitment people make to raise funds for us is immense. Some set their own personal challenge, and friends and family support them. Thousands of people give us a regular gift every month through their bank or salary – and often don’t want any recognition or acknowledgement. Some people send us a gift on their kidney-versary (the anniversary of their kidney transplant) or on an anniversary in lieu of presents. Every mile our supporters walk, every marathon they run, every mountain they climb, every road they cycle or metre they swim makes a real difference to our work, and every contribution is invaluable. As a charity, we are committed to the highest standards of fundraising and work hard to help our supporters to support us in their own, individual ways.

Whilst our income is generated from many different sources, we ensure all our fundraising activities adhere to the Code of Fundraising Practice and we are registered with both the Fundraising Regulator and Fundraising Preference Service. We aim to ensure everyone who gives Kidney Research UK a gift of money, time, donates items or supports us in other ways will receive the best possible experience and we exceed their expectations. Because our activity covers a wide range of fundraising practices and we engage with thousands of supporters every year, we work with carefully selected partners and ensure we have robust policies in place to ensure our fundraising ethics are adhered to and reinforced through our fundraising volunteers and staff. We acknowledge that sometimes we don’t get things right. So we encourage supporters to share with us their ideas on how we can improve and to raise concerns. We respond to all complaints within two working days and resolve them as soon as possible. We have a robust reporting process enabling us to learn from our supporters where we haven’t met their expectations and, where appropriate, improve our fundraising practices. During 2018/19, we only received 24 complaints which is a very small proportion of the number of engagements we have with our supporters.

Risk management We are committed to effective risk management as an integral part of ensuring good charity governance. The Finance and Risk Committee oversees our exposure to risk, ensures that we have adequate risk management systems in place and reports on risk to the full Board of Trustees. We limit exposure to risks by following recognised good practice in ensuring our compliance with the law and other obligations, having clear and meaningful measures to check progress against our goals and having a risk management structure which enables us to act promptly when necessary. Processes in place regarding risk management include: c

monthly review by the Management A Team of risks to the charity as a whole and to significant projects.

isks identified through this process R are recorded in risk registers under the traffic light system to indicate relative level of risk exposure, and allocated to a Management Team member responsible

for mitigating controls/actions. c

T he Finance and Risk Committee carries out a quarterly review of the risk register, including movement and mitigation plans and actions. This is considered an effective way for trustees to evaluate significant risks to the charity, to establish the degree to which they are controlled and moderated, and to determine necessary action. T he Finance and Risk Committee receives reports and recommendations from our external auditors on the effectiveness of controls and recommendations.

Examples of some of the principal risks identified and controls are: c

aintaining performance of the M charity while undergoing a period of organisational change to support new strategies c Mitigating control – Close monitoring of performance against targets and benchmarks and regular review of capacity and resource requirements. aising enough funds to achieve R our strategic aims while adhering to our fundraising promise and agreed level of risk. c Mitigating control – We continue to secure income from an increasing number of sources and we closely monitor performance against targets. Cyber security c Mitigating control – A review was carried in the year and systems and procedures have been upgraded, for example breach detection for servers and workstations. Formal and continuous training and testing has been implemented across the charity.

Statement of trustees’ responsibilities The trustees (who are also the directors of Kidney Research UK 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 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 the group and of the income and expenditure, of the group for that period. In preparing these financial statements, the trustees are required to: c

select suitable accounting policies and then apply them consistently;

bserve the methods and principles in Accounting and Reporting by Charities o Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable to the United Kingdom and Republic of Ireland (FRS102);

make judgments and estimates that are reasonable and prudent;

s tate whether applicable United Kingdom Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements; and

prepare the financial statements on the going concern basis unless it is inappropriate to presume that the charity will continue in operation.

The trustees are responsible for keeping proper accounting records that disclose with reasonable accuracy at any time the financial position of the charity and group and enable them to ensure that the financial statements comply with the Companies Act 2006, the Charities and Trustee Investment (Scotland) Act 2005 and the Charities Accounts (Scotland) Regulations 2006. They are also responsible for safeguarding the assets of the charity and group and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities.

Each of the trustees confirms that: c

s o far as the trustee is aware, there is no relevant audit information of which the charity’s auditor is unaware; and

the trustee has taken all the steps that he/she ought to have taken as a trustee in order to make himself/herself aware of any relevant audit information and to establish that the charity’s auditor is aware of that information.

This confirmation is given and should be interpreted in accordance with the provisions of s418 of the Companies Act 2006. The trustees are responsible for the maintenance and integrity of the corporate and financial information included on the charity’s website. Legislation in the United Kingdom governing the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

The Trustees’ report was approved on 23 September 2019 and signed on their behalf by: Jeremy Hughes Chairman ANNUAL REPORT 2018-19 | 25

Independent auditor’s report to the trustees and members of Kidney Research UK

Responsibilities of trustees for the financial statements As explained more fully in the trustees’ responsibilities statement set out on page 25, the trustees (who are also the directors of the charitable company for the purposes of company law) are responsible for the preparation of the financial statements and for being satisfied that they give a true and fair view, and for such internal control as the trustees determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error. In preparing the financial statements, the trustees are responsible for assessing the group’s and the parent charitable company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the {group or the parent charitable company or to cease operations, or have no realistic alternative but to do so.

Auditor’s responsibilities for the audit of the financial statements

Opinion We have audited the financial statements of Kidney Research UK for the year ended 31 March 2019 which comprise the Consolidated Statement of Financial Activities, the Balance Sheets, the Consolidated Statement of Cash Flows and notes to the financial statements, including a summary of significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Standard applicable in the UK and Republic of Ireland (United Kingdom Generally Accepted Accounting Practice). In our opinion, the financial statements: c

ive a true and fair view of the state of the group’s and of the parent g charitable company’s affairs as at 31 March 2019 and of the group’s and parent charitable company’s net movement in funds, including the income and expenditure, for the year then ended;

ave been properly prepared in accordance with United Kingdom h Generally Accepted Accounting Practice; and

ave been prepared in accordance with the requirements of the h Companies Act 2006 and the Charities and Trustee Investment (Scotland) Act 2005 and regulation 8 of the Charities Accounts (Scotland) Regulations 2006.

Basis for opinion We conducted our audit in accordance with International Standards on Auditing (UK) (ISAs (UK)) and applicable law. Our responsibilities under those standards are further described in the Auditor’s responsibilities for the audit of the financial statements section of our report. We are independent of the group in accordance with the ethical requirements that are relevant to our audit of the financial statements in the UK, including the FRC’s Ethical Standard, and we have fulfilled our other ethical responsibilities in accordance with these requirements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

26 | ANNUAL REPORT 2018-19

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (UK) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements. A further description of our responsibilities for the audit of the financial statements is located on the Financial Reporting Council’s website at: www.frc.org.uk/auditorsresponsibilities. ~This description forms part of our auditor’s report.

misstatements, we are required to determine whether there is a material misstatement in the financial statements or a material misstatement of the other information. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact. We have nothing to report in this regard.

Opinions on other matters prescribed by the Companies Act 2006 In our opinion, based on the work undertaken in the course of the audit: c

the information given in the Trustees’ Annual Report (which incorporates the strategic report and the directors’ report prepared for the purposes of company law) for the financial year for which the financial statements are prepared is consistent with the financial statements; and

t he strategic report and the directors’ report included within the Trustees’ Annual Report have been prepared in accordance with applicable legal requirements.

Matters on which we are required to report by exception In the light of the knowledge and understanding of the group and the parent charitable company and its environment obtained in the course of the audit, we have not identified material misstatements in the Trustees’ Annual Report (which incorporates the strategic report and the directors’ report). We have nothing to report in respect of the following matters in relation to which the Companies Act 2006 and the Charity Accounts (Scotland) Regulations (as amended) require us to report to you if, in our opinion: c

adequate accounting records have not been kept by the parent charitable company, or returns adequate for our audit have not been received from branches not visited by us; or

the parent charitable company financial statements are not in agreement with the accounting records and returns; or

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

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

Conclusions relating to going concern We have nothing to report in respect of the following matters in relation to which the ISAs (UK) require us to report to you where: c

t he trustees’ use of the going concern basis of accounting in the preparation of the financial statements is not appropriate; or

t he trustees have not disclosed in the financial statements any identified material uncertainties that may cast significant doubt about the group’s or the parent charitable company’s ability to continue to adopt the going concern basis of accounting for a period of at least twelve months from the date when the financial statements are authorised for issue.

Other information The trustees are responsible for the other information. The other information comprises the information included in the Trustees’ Annual Report and the Foreword. Our opinion on the financial statements does not cover the other information and, except to the extent otherwise explicitly stated in our report, we do not express any form of assurance conclusion thereon. In connection with our audit of the financial statements, our responsibility is to read the other information and, in doing so, consider whether the other information is materially inconsistent with the financial statements or our knowledge obtained in the audit or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material

Use of our audit report This report is made solely to the charitable company’s members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 2006, section 44(1)(c) of the Charities and Trustee Investment (Scotland) Act 2005 and regulation 10 of the Charities Accounts (Scotland) Regulations 2006. Our audit work has been undertaken so that we might state to the charitable company’s members those matters we are required to state to them in an Auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the charitable company and the charitable company’s members as a body, for our audit work, for this report, or for the opinions we have formed.

Kathryn Burton (Senior statutory auditor) for and on behalf of Haysmacintyre LLP, Statutory Auditor 10 Queen Street Place, London EC4R 1AG ANNUAL REPORT 2018-19 | 27

Consolidated statement of financial activities

Balance sheet As at 31 March 2019

Year to 31 March 2019

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Consolidated statement of cash flows

Principal accounting policies 31 March 2019

Year to 31 March 2019

30 | ANNUAL REPORT 2018-19

ANNUAL REPORT 2018-19 | 31

Principal accounting policies

31 March 2019

32 | ANNUAL REPORT 2018-19

ANNUAL REPORT 2018-19 | 33

Principal accounting policies