The objectives are to provide specialised knowledge and advanced training, education, research and scholarship in science and technology in cooperation with other bodies to its members to benefit their patients.

In addition, the ACPGBI aims to be a complete resource of knowledge and help to patients with colorectal disease, empowering and ensuring the best treatments are available to all who seek them.

The ACPGBI's mission is derived from these objectives. The Trustees of ACPGBI are responsible for defining its strategic aims and directing its Executive's activities to further these objectives. The Council has had due regard to the Charity Commission's guidance on reporting public benefit.

The ACPGBI, established in 1990, was registered with the Charity Commissioners. The charity was an unincorporated Association (registration number 1013924) until 30th June 2007. All the assets of the former charity were transferred to the Association of Coloproctology of Great Britain and Ireland, a company limited by guarantee (company number 05962281) and registered as a charity with the Charity Commission (charity number 1118063).

The ACPGBI business, organisational structure and working practices are governed by its constitution. This document is updated yearly, and any changes are approved at the AGM. ACPGBI is led by an Executive Committee and guided by a representative Council. Administration and marketing are carried out by its Secretariat. The Executive formulates policy and considers all matters concerning the Association. All decisions are notified to Council regularly for approval. Posts for Council, chapter representatives and major positions (President, Secretary, Treasurer etc.) are advertised on the website and ballots are held where appropriate.

Along with the ACPGBI ofice bearers (President, Honorary Secretary and Honorary Treasurer), the Executive Committee includes chairs of the Education and Training, External Afairs, Multidisciplinary Clinical and Research and Audit committees.

The executive appointments are made as either 'Assistant' (e.g., secretary and treasurer) or in waiting / elect (e.g., President). This gives appointees suficient time (2 years) to become thoroughly acquainted with the roles they are due to take up at the Annual Meeting.

The Board of Trustees comprises the Executive members (President, Honorary Secretary and Honorary Treasurer) and non-executive members who include medical (at least five medical trustees and ideally will include one nurse) and lay members. The medical trustees are members with previous experience in holding ofice in the Association, none of whom currently sit on committees of the Association. The lay members include a minimum of two patient representatives, a lawyer, a trustee from a financial background and a non- medical academic. Additional or replacement Trustees will be appointed by the Board of Trustees as they see fit, as there are no formal policies for inducting new Trustees.

ACPGBI has undergone a formal risk assessment process to help identify areas of concern and formulate suitable action plans. ACPGBI's short, medium and long-term priorities and goals are discussed in the annual strategy meetings, and appropriate action plans are finalised.

The ACPGBI aims to achieve high standards and advance the science of coloproctology by promoting and publishing the results of research and audit. The charity also provides and disseminates information to help professionals and the public on matters concerning coloproctology. Furthermore, ACPGBI seeks to promote high ethical standards and continues to endorse high standards in training and best clinical practice through its AGM and links with all geographical regions in the UK & Ireland based on regional chapter representation.

The Charity (ACPGBI) has grown in size and influence since its foundation. Total membership stands at around 1,650 persons, including consultant surgeons, surgeons in training, physicians, pathologists, radiologists, clinical scientists, medical students and clinical nurse specialists with interest in coloproctology.

ACPGBI is one of several specialist institutions within the broad spectrum of general surgery. It has assumed an increasingly important and influential role in the organisation of colorectal services within the United Kingdom and Ireland. ACPGBI is a direct stakeholder in the National Institute for Health and Care Excellence (NICE), contributes to health technology appraisals and is a key advisor to the Royal College of Surgeons in matters relating to coloproctology.

The strength of ACPGBI continues to be its representation throughout the UK & Ireland mediated via the regional chapter structure. Each chapter has meetings to disseminate scientific, best practices and political strategies agreed upon at Council meetings. Equally, in a democratic manner, concerns and clarifications raised at a regional level concerning central policy can be brought back to both the Council and Executive.

The administrative ofice is responsible for the day-to-day running of the charity and efective communication between elected oficers, chapter representatives and the general membership.

Executive meetings are held four times, and Council meetings are held three times per year in addition to an Annual General Meeting. The Trustees meet thrice a year, under the leadership of the chairperson, and oversee the activities and performance of the Association. The Annual Meeting is the flagship event of the year. It is organised by the President, and in 2024 was held in Newport and attended by nearly 1000 delegates.

The chief administrator for the Association is Mrs Adele Sutton. The day-to-day management of the Association is delegated to her. Payments to creditors need dual authorisation by Mrs Sutton and the Treasurer. Ms Nicole Taub also works in the ofice to oversee membership and marketing, which has helped with raising the organisation's profile via social media.

The administrative centre of ACPGBI is located at the Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London WC2A 3PE. Since July 2017, ACPGBI has leased an ofice directly from the Royal College of Surgeons (RCS) located in the refurbished RCS Building. In line with Association's strategy, in May 2018, ACPGBI set up an independent payroll for our employees, and ACPGBI has its employer reference at HMRC. The website was redesigned under a new company and released in July 2021. This website (www.acpgbi.org.uk) has sections aimed for the public, patients and professionals.

In 2024, the ACPGBI continues to deliver successfully on its activities and strategic objectives. The Association is pleased to have maintained a high level of performance during this demanding post-covid recovery period.

/ carers added several updates and new content including position statements and educational activities across the regions. The website has proved its worth as the front end of ACPGBI's activities.

Face to face events continued following the pandemic, with a wide range of topics covered at local Chapter meetings, educational events arranged by the Dukes' Club and other ACP-endorsed meetings. The association however made a strategic decision to maintain virtual events like the Advanced Coloproctology Course (ACC) after overwhelming feedback received requesting this format to be continued.

The executive committee and Council met in person to plan and deliver what amounted to an excellent portfolio of activities, events and meetings to the benefit of members and associates. The trustee meetings continued as virtual meetings. There was one face to face trustee meeting in Newport, Wales in July.

The Advanced Coloproctology Course (ACC) was held in March 2024 on a virtual online platform and broadcast presentations of outstanding quality to a large worldwide audience of more than 1000 registrants. This was repeated for this third consecutive year.

The Annual Meeting in July 2024 was held in Newport in a face-to-face venue attended by over 900 delegates. The meeting incorporated cutting-edge developments in management of colorectal diseases, with a strong

emphasis on patient involvement in most sessions. Unlike the previous year, the meeting made a modest loss.

The committee tasked with supporting medical students with an interest in coloproctology grew its membership and ran events aimed specifically at students. Medical students were supported if they wanted to attend the annual meeting with free registration.

Following a stringent selection process held in 2023, ACPGBI invested a further small amount of money held in the reserve accounts into the already existing Ruffer investment portfolio in August 2024, to guard against inflation.

Executive agreed the development and implementation of a formal, rolling 5-year strategy document, aimed at focussing the workstream of each of the committees, sub-committees and the organisation as a whole. This was developed at Strategy in November 2024.

The Annual Meeting was held on 1st – 3rd July 2024 in Newport in a face-to-face venue attended by 920 delegates, providing stimulating educational and networking opportunities.

For the first time in a number of years, the meeting made a loss. Despite ongoing appreciable levels of sponsorship and registration income, other factors not originally budgeted for meant that there was a loss of

£49,315.54. A large factor in this loss were additional management fees paid to Integrity Events to help with the conference organisation, a mitigation put in place to cover anticipated Secretariat absence due to sick leave.

The meeting received impressive feedback, both for the educational content and the opportunity to network. The investment in educational pursuit is in line with ACPGBI's objectives and engagement with the members and professional stakeholders.

The Education and Training Committee meets regularly with their predominant aim being to improve education and training within coloproctology. The Chair represents the views of the committee on the Executive and Council.

The ACC was held over 2 days in March 2024 and again used Sayso Medical to deliver the event via a virtual platform following feedback from previous courses. Registration fees were kept low, with free registration for medical students and those from low- and middle-income countries (LMICs). The costs of delivering the course were covered by a combination of registration fees and generous industry support. We had over 1000 worldwide registrations and the feedback from delegates was once again excellent, reinforcing that this format is valued by ACPGBI members and non-members alike. Further metrics can be provided. There is a fine balance to cover costs of delivering the course, but the ACPGBI executive have been very supportive in seeing any costs incurred as an investment by ACPGBI in coloproctology education both in Great Britain and Ireland and worldwide.

Plans for the future – similar format for 2025, appreciating that the course may need financial support from the ACPGBI to make it as accessible as possible with a review following the Advanced Coloproctology Course 2024.

We developed and rolled out the Fundamentals of Coloproctology Course in 2023, aimed at more junior resident doctors and allied health professionals, and consisting of a one-day virtual event (“The Theory”) delivered free via the Medall platform in order to allow open access to medical professionals followed by regionally delivered practical workshops (“The Practical”) supported by industry educational partners. The feedback from each component of the course was excellent. Developing this further we have incorporated parts of the Fundamentals of Coloproctology – “The Theory” course into national online core surgical teaching.

The ACPGBI received significant industry funding from Intuitive (Intuitive Surgical) in 2023 to fund robotic fellowships via the ACPGBI. Via a competitive selection process 2 units were chosen as the training centres and 4 post CCT robotic fellows were selected following a competitive application and interview processes. The units selected were Colchester and Glasgow with fellowships running October 2024-April 2025 and April-Oct 2025.

This is an educational session within the ACPGBI Annual Meeting which provides an update on core topics for members. The session was well attended at the 2024 meeting. The rolling programme will continue for the 2025 meeting.

The Trainer of the Year Award recognises excellence in training and is awarded on a yearly basis after a careful selection process involving the Education and Training committee who consider nominations.

This award is designed to identify and highlight colorectal trainees nationally who have been outstanding throughout their training and have shown excellence in the areas of research and academia, leadership and education and training. This initiative provides a platform to recognise and encourage talent amongst colorectal trainees.

The ACPGBI 2024 Trainee Coloproctologist of the Year was awarded to Kat Parmar. The ACPGBI funded the winner to enrol in the Royal College of Surgeons of Edinburgh's Future Leaders' Programme.

Whereas previously the MCC Chair had a very broad overview and responsibility for all diferent aspects of clinical coloproctology, the remit of the Chair evolved during 2024 to be a more supportive, leadership role for each of the subcommittee Chairs. The Chair sits on the ACPGBI Executive.

To undertake further webinars on topics relevant to Emergency General Surgery. In order to establish topics of relevance, establishing a link with Dukes' committee to provide training for individuals that are looking to sit the FRCS in the next few years

Continued funding for 4 ACPGBI six-month fellowships from Intuitive Surgical was obtained to be delivered at the two previously selected centres in Glasgow and Colchester. Outcomes and feedback from first cohort of fellowships has been gathered and will be presented

Development of document. Great progress has been made with this document, but it is not yet complete. Unfortunately, not every person who agreed to contribute has managed to do so. The committee has addressed this recently and has issued invitations to new contributors

Increasing the functionality of the ACPGBI website to improve institutional memory, i.e. creating a repository within the ACPGBI website to store minutes and records from both chapter and committee meetings

Setting up interview series (Colorectal Leading Lights) to highlight excellence, such as medical students winning Royal College of Surgeons Green Shoots award, and interview with Jim Khan around new robotic training centres

Fundamentals of Coloproctology- Practical. Our regional representatives have been integral to running the practical part of the Fundamentals of Coloproctology course. We have so far organised this course in the following regions: Shefield, London and Mersey

In our opinion, the financial statements:

give a true and fair view of the state of the charitable company's affairs as at 31 December 2024 and of its incoming resources and application of resources, including its income and expenditure, for the year then ended;

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

have been prepared in accordance with the requirements of the Companies Act 2006.

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 charity 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.

In auditing the financial statements, we have concluded that the trustees' use of the going concern basis of accounting in the preparation of the financial statements is appropriate.

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the charity's ability to continue as a going concern for a period of at least twelve months from when the financial statements are authorised for issue.

Our responsibilities and the responsibilities of the trustees with respect to going concern are described in the relevant sections of this report.

The other information comprises the information included in the annual report other than the financial statements and our auditor's report thereon. The trustees are responsible for the other information contained within the annual report. 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. 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 course of the audit, or otherwise appears to be materially misstated. If we identify such material inconsistencies or apparent material misstatements, we are required to determine whether this gives rise to a material misstatement in the financial statements themselves. If, based on the work we have performed, we conclude that there is a material misstatement of this other information, we are required to report that fact.

We have nothing to report in this regard.

In our opinion, based on the work undertaken in the course of our audit:

the information given in the trustees' report for the financial year for which the financial statements are prepared, which includes the directors' report prepared for the purposes of company law, is consistent with the financial statements; and

the directors' report included within the trustees' report has been prepared in accordance with applicable legal requirements.

the trustees were not entitled to prepare the financial statements in accordance with the small companies regime and take advantage of the small companies' exemptions in preparing the trustees' report and from the requirement to prepare a strategic report.

As explained more fully in the statement of trustees' responsibilities, the trustees, who are also the directors of the charity for the purpose 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 charity's ability to continue as a going concern, disclosing, as applicable, matters related to going concern and using the going concern basis of accounting unless the trustees either intend to liquidate the charitable company or to cease operations, or have no realistic alternative but to do so.

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

Irregularities, including fraud, are instances of non-compliance with laws and regulations. We design procedures in line with our responsibilities, outlined above, to detect material misstatements in respect of irregularities, including fraud. The extent to which our procedures are capable of detecting irregularities, including fraud, is detailed below.

In identifying and assessing risks of material misstatement in respect of irregularities, including fraud and non- compliance with laws and regulations, our procedures included the following:

Obtaining an understanding of the legal and regulatory framework that the charity operates in, focusing on those laws and regulations that had a direct effect on the financial statements and operations;

Obtaining an understanding of the charity's policies and procedures on fraud risks, including knowledge of any actual, suspected or alleged fraud;

Discussing among the engagement team how and where fraud might occur in the financial statements and any potential indicators of fraud through our knowledge and understanding of the company and our sector-specific experience.

As a result of these procedures, we considered the opportunities and incentives that may exist within the association for fraud. We are also required to perform specific procedures to respond to the risk of management override. As a result of performing the above, we identified the following areas as those most likely to have an impact on the financial statements: health & safety and employment law, as well as compliance with the UK Companies and Charities Acts.

In addition to the above, our procedures to respond to risks identified included the following:

Making enquiries of management about any known or suspected instances of non-compliance with laws and regulations and fraud;

Reviewing minutes of meetings of the board and senior management.

Reading correspondence with regulators

Challenging assumptions and judgements made by management in their significant accounting estimates; and

Auditing the risk of management override of controls, including through testing journal entries and other adjustments for appropriateness.

Due to the inherent limitations of an audit, there is an unavoidable risk that some material misstatements in the financial statements may not be detected, even though the audit is properly planned and performed in accordance with the ISAs (UK). For instance, the further removed non-compliance is from the events and transactions reflected in the financial statements, the less likely the auditor is to become aware of it or to recognise the non-compliance.

A further description of our responsibilities is available on the Financial Reporting Council's website at: https:// www.frc.org.uk/auditorsresponsibilities. This description forms part of our auditor's report.

This report is made solely to the charitable company's members, as a body, in accordance with Chapter 3 of Part 16 of the Companies Act 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.

The Association of Coloproctology of Great Britain and Ireland is a private company limited by guarantee incorporated in England and Wales. The registered office is The Royal College of Surgeons of England, 35-43 Lincoln's Inn Fields, London, WC2A 3PE.

The financial statements have been prepared in accordance with the charity's Memorandum and Articles of Association, the Companies Act 2006, FRS 102 “The Financial Reporting Standard applicable in the UK and Republic of Ireland” (“FRS 102”) and the Charities SORP "Accounting and Reporting by Charities: Statement of Recommended Practice applicable to charities preparing their accounts in accordance with the Financial Reporting Standard applicable in the UK and Republic of Ireland (FRS 102)" (effective 1 January 2019). The charity is a Public Benefit Entity as defined by FRS 102.

The financial statements are prepared in sterling, which is the functional currency of the charity. Monetary amounts in these financial statements are rounded to the nearest £.

The financial statements have been prepared under the historical cost convention, modified to include the revaluation of certain financial instruments at fair value. The principal accounting policies adopted are set out below.

At the time of approving the financial statements, the trustees have a reasonable expectation that the charity has adequate resources to continue in operational existence for the foreseeable future. Thus the trustees continue to adopt the going concern basis of accounting in preparing the financial statements.

Unrestricted funds are available for use at the discretion of the trustees in furtherance of their charitable objectives.

Restricted funds are subject to specific conditions by donors or grantors as to how they may be used. The purposes and uses of the restricted funds are set out in the notes to the financial statements.

Income is recognised when the charity is legally entitled to it after any performance conditions have been met, the amounts can be measured reliably, and it is probable that income will be received.

Cash donations are recognised on receipt. Other donations are recognised once the charity has been notified of the donation, unless performance conditions require deferral of the amount. Income tax recoverable in relation to donations received under Gift Aid or deeds of covenant is recognised at the time of the donation.

Legacies are recognised on receipt or otherwise if the charity has been notified of an impending distribution, the amount is known, and receipt is expected. If the amount is not known, the legacy is treated as a contingent asset.

Expenditure is recognised once there is a legal or constructive obligation to transfer economic benefit to a third party, it is probable that a transfer of economic benefits will be required in settlement, and the amount of the obligation can be measured reliably.

Expenditure is classified by activity. The costs of each activity are made up of the total of direct costs and shared costs, including support costs involved in undertaking each activity. Direct costs attributable to a single activity are allocated directly to that activity. Shared costs which contribute to more than one activity and support costs which are not attributable to a single activity are apportioned between those activities on a basis consistent with the use of resources. Central staff costs are allocated on the basis of time spent, and depreciation charges are allocated on the portion of the asset's use.

Intangible assets acquired separately from a business are recognised at cost and are subsequently measured at cost less accumulated amortisation and accumulated impairment losses.

Amortisation is recognised so as to write off the cost or valuation of assets less their residual values over their useful lives on the following bases:

Computer software and website

33% straight line

Tangible fixed assets are initially measured at cost and subsequently measured at cost or valuation, net of depreciation and any impairment losses.

Depreciation is recognised so as to write off the cost or valuation of assets less their residual values over their useful lives on the following bases:

Fixed asset investments are initially measured at transaction price excluding transaction costs, and are subsequently measured at fair value at each reporting date. Changes in fair value are recognised in net income/(expenditure) for the year. Transaction costs are expensed as incurred.

At each reporting end date, the charity reviews the carrying amounts of its tangible and intangible assets to determine whether there is any indication that those assets have suffered an impairment loss. If any such indication exists, the recoverable amount of the asset is estimated in order to determine the extent of the impairment loss (if any).

Cash and cash equivalents include cash in hand, deposits held at call with banks, other short-term liquid investments with original maturities of three months or less, and bank overdrafts. Bank overdrafts are shown within borrowings in current liabilities.

The charity has elected to apply the provisions of Section 11 ‘Basic Financial Instruments' and Section 12 ‘Other Financial Instruments Issues' of FRS 102 to all of its financial instruments.

Financial instruments are recognised in the charity's balance sheet when the charity becomes party to the contractual provisions of the instrument.

Financial assets and liabilities are offset, with the net amounts presented in the financial statements, when there is a legally enforceable right to set off the recognised amounts and there is an intention to settle on a net basis or to realise the asset and settle the liability simultaneously.

Basic financial assets, which include debtors and cash and bank balances, are initially measured at transaction price including transaction costs and are subsequently carried at amortised cost using the effective interest method unless the arrangement constitutes a financing transaction, where the transaction is measured at the present value of the future receipts discounted at a market rate of interest. Financial assets classified as receivable within one year are not amortised.

Basic financial liabilities, including creditors and bank loans are initially recognised at transaction price unless the arrangement constitutes a financing transaction, where the debt instrument is measured at the present value of the future payments discounted at a market rate of interest. Financial liabilities classified as payable within one year are not amortised.

Debt instruments are subsequently carried at amortised cost, using the effective interest rate method.

Trade creditors are obligations to pay for goods or services that have been acquired in the ordinary course of operations from suppliers. Amounts payable are classified as current liabilities if payment is due within one year or less. If not, they are presented as non-current liabilities. Trade creditors are recognised initially at transaction price and subsequently measured at amortised cost using the effective interest method.

Financial liabilities are derecognised when the charity's contractual obligations expire or are discharged or cancelled.

The costs of short-term employee benefits are recognised as a liability and an expense.

The cost of any unused holiday entitlement is recognised in the period in which the employee's services are received.

Termination benefits are recognised immediately as an expense when the charity is demonstrably committed to terminate the employment of an employee or to provide termination benefits.

In the application of the charity's accounting policies, the trustees are required to make judgements, estimates and assumptions about the carrying amount of assets and liabilities that are not readily apparent from other sources. The estimates and associated assumptions are based on historical experience and other factors that are considered to be relevant. Actual results may differ from these estimates.

The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and future periods where the revision affects both current and future periods.

The restricted funds of the charity comprise the unexpended balances of donations and grants held on trust subject to specific conditions by donors as to how they may be used.

Covidien historically provided an educational grant of £25,000 to provide travelling bursaries for consultants and colorectal surgeons in training that are members of the ACPGBI to obtain experience of laparoscopic colorectal surgery in the UK and Europe. During 2024, £nil of these bursaries were utilised. £7,532 remains available.

The Scottish Chapter restricted fund relates to a donation received for the benefit of the Scottish Chapter.

£1,000 remains available.

The Early Years Consultant Network (EYCN) fund is specifically for ACPGBI members in their transition to consultant life and through the first five years of practice. £1,354 remains available.