Versus Arthritis 2019-2020 Annual Report and Accounts

2019 ‑20 Annual Report and accounts We are v Ta ble of contents

6 Report from the chair and chief executive officer, including strategic report 7 Our ambitions 19 Financial and operational sustainability 26 Our approach to fundraising 28 Thank you 30 Financial review 40 Our structure, governance and management 44 Independent auditor’s report to the members and trustees of Versus Arthritis 47 Consolidated statement of financial activities 50 Notes to the consolidated financial statements for the year ended 31 march 2020 81 Board of Trustees 91 Legal and administrative information We exist so the world no longer tolerates the impact that arthritis has on people’s lives.1

We’re the 10 million people living with arthritis. We’re the carers, researchers, fundraisers, professionals, friends and campaigners all united by our goal of defying arthritis. Together, we’re making real headway, and we’ll never stop until no one has to tolerate living with the pain, fatigue and isolation of arthritis.

1 Throughout this report, we use the term ‘arthritis’ broadly to discuss arthritis and other musculoskeletal conditions that are disorders of the joints, bones and muscles. These conditions include osteoarthritis, rheumatoid arthritis, back pain, osteoporosis and rare, systemic autoimmune disorders such as lupus. As an organisation, we support people living with all of these conditions.

Versus Arthritis 2019–20 | We are Versus Arthritis 4 Arthritis steals so much from us – it can take away the Versus Arthritis is a charity inspired, driven and informed ability to work, to care for a family, to move without pain, by people with arthritis. The involvement of people with to live independently or just to feel like yourself. Yet arthritis runs across our organisation. You benefit from arthritis is often dismissed as ‘just aches and pains’ or our services, research and campaigns, and you’re actively ‘just a bit of wear and tear’. Arthritis is wrongly seen as involved in shaping them. You give us ideas, co‑design inevitable, insignificant or even untreatable. It’s none of solutions and make vital decisions on how and where we these things. That’s why Versus Arthritis challenges the channel our resources. climate of tolerance, telling the world that we will not We can only achieve our ambitions with the support and accept arthritis stealing life’s fundamentals from more hard work of Versus Arthritis volunteers in all four nations than 10 million people in the UK. of the UK. Many of our volunteers live with arthritis, and We’re calling on everyone to get involved and join us in their experiences, empathy and understanding of the the push to defy arthritis. Together, we can make change painful reality of this condition are invaluable. Others happen in homes and workplaces, in local communities, have seen first‑hand the impact that arthritis has on among national policy makers, in industry and in the family, friends, colleagues and communities. What all research community. of our volunteers have in common is a desire to make change happen through practical action. They defy We recognise that this push isn’t easy – it takes all of us arthritis by delivering our services, running local groups, working together. From the people living with arthritis campaigning on big issues, making sure our research is each day to their families, friends and colleagues. From always person‑focused and raising the funds we need to the volunteers leading the push in our services and keep pushing against arthritis. offering strength and support whenever people need it to our employees reaching out across our four nations. By giving us their time, experience and dedication, our From the researchers working toward new answers and volunteers defy arthritis every day, creating positive breakthrough treatments to the campaigners demanding change. Together, they are the cornerstone of what better answers and the funding partners who help make Versus Arthritis strives to achieve. our work possible. From the healthcare professionals To everyone who makes Versus Arthritis who we are, striving to deliver the best care to the runners, cyclists thank you. Without you, we could not achieve our and bakers who fundraise tirelessly to support our work. ambitions. Together, all of us can – and will – defy arthritis.

Versus Arthritis 2019–20 | We are Versus Arthritis 5 Repo rt from the chair and chief executive officer, including strategic report

At Versus Arthritis, our vision is to achieve a world that Working together with people with arthritis – as well no longer tolerates the impact that arthritis has on as with researchers, decision‑makers, healthcare people’s lives. For that reason, the coming together of professionals, volunteers, partners, supporters and our two legacy charities – Arthritis Research UK and funders – we have seen decisive progress from our Arthritis Care – was more than just a merger. It was a programmes, activities and services over the last year. transformation into a new charity that is both capable This progress continues to take us closer to fulfilling of reaching even more people with arthritis and that is our ambitions. operationally fit for the future. This annual report marks the second and final year of our The changes that we want to see guide everything that transformation. As such, it is a fitting point to both share we do with and for people with arthritis. Our long‑term the progress that we have made and look to the future as ambitions are that: we continue to push back and defy arthritis. In the following sections of this report, we discuss the headway that we have made in reaching each of our six ambitions, and we look ahead to the challenges and opportunities that lie before us.

1 2 3 Empowered S dupporte U nlimited The impact of arthritis is Every child and young person Pain and the impact of pain does not recognised, and as a result, people with arthritis is supported by us. limit the lives of people with arthritis. with arthritis are empowered and supported to demand more. 4 5 6 united connected imp actful I There is a galvanised community Wherever you are in the UK, there MSK research has an even pushing against arthritis. is a local touchpoint with us. greater impact on the quality of life of people with arthritis. S ection 1 Our Ambitions A MB TI S

I O N empowered a nd supported

Oi ur f rst ambition The impact of arthritis Changing how the agreed that arthritis should receive is recognised, and as public sees arthritis the same level of attention and support as cancer or dementia. That As a new charity, we need to invest to a result, people with represents a three percentage‑point make sure that arthritis is recognised arthritis are empowered increase from 59% of the public as a serious condition and that who agreed with this statement in and supported to demand we have a high enough profile to 2018–2019. We also saw well over more. create change. For that reason, in one million visits to our website as August 2019, we invested £1.6 million All too often, society dismisses arthritis people with arthritis sought more in advertising that was carefully as unimportant or as an inevitable part information and accessed our targeted to our audiences. This of ageing. However, we believe that just support materials. accepting arthritis is unacceptable, and campaign proved highly effective in through our work, we ask society to reaching the public Among the most important recognise arthritis as an issue worthy and changing attitudes. successes of the campaign is the number of people who have begun of national concern. To support that With this new push, we maintained to recognise Versus Arthritis as a aim, in August 2019, we launched a new the gains that we made in our charity. This year, spontaneous brand phase of our campaign to change the November 2018 to January 2019 awareness grew from 3% in March public’s perceptions of arthritis. efforts, which were recognised to 5% in September among the total by the Third Sector Awards when population and from 6% in March to we were named a finalist for the 8% in September among people with Communications Campaign of arthritis. This growth shows that we the Year. are continuing to build the charity’s During our August campaign, we saw profile, using our increased visibility more than 13,000 people sign up to and presence to reach more people declare themselves Versus Arthritis. with arthritis. Another 5,600 people signed up to To help us do even more in future receive our emails, and over 1,900 phases of this campaign, we are now people used our services as a result working to grow our supporter base, of the campaign. reuse ads to maximise production We also made real headway in value and tailor our communications changing attitudes – following our to our targeted audiences. August activity, 62% of the public

Versus Arthritis 2019–20 | Our amibitions 8 Campaigning to put arthritis In the study, the researchers found possible of the impact that arthritis at the forefront of the that weather conditions had a has on people in the UK. significant impact on people’s pain, Government’s agenda This report has become an important and these findings were reported in resource for healthcare professionals, We have also pushed to increase more than 900 pieces of coverage in policy makers and public health recognition among the Government outlets including CNN, the BBC and officials, and that is underscored by of the impact that arthritis has on The Independent. people’s lives. In February 2020, the fact that data from this report we launched our ‘Right on Time’ Also typifying our media success features in recent Government campaign to preserve people’s right was our #PainNoFilter campaign, guidance on improving MSK health. which asked people with arthritis to have a clear waiting period for This year’s report shows that more to use social media to reveal their NHS joint replacement surgery. than 18 million people in the UK experience of dealing with pain. When we launched the campaign, felt the impact of MSK conditions 6,000 people supported our petition #PainNoFilter created a vibrant – including arthritis and related in the first 24 hours. The number space for people with arthritis to conditions such as back pain – in of signatories grew to 10,000 show the impact that pain has on 2017. In the same year, arthritis and people, signalling the strong base their lives in a moving and compelling related conditions accounted for of our campaigns network that has way. The campaign saw more than more than 22% of the burden of ill developed and matured throughout 1,300 new visitors coming to our health in the UK. website and contributed to our 1.7 the year. During the campaign, MPs The high prevalence of arthritis and million engagements on our social received more than 9,600 emails other MSK conditions in society has media channels – such as Twitter and related to joint replacement waiting not always translated into recognition Instagram – during the year. times – a clear indication of the of arthritis as a priority within our impact that we are making. The campaign was also recognised healthcare institutions. However, In a short time, the campaign also for its excellence by the public at Versus Arthritis, we know that increased public awareness of relations community – #PainNoFilter a public health approach is critical the lengthy wait times for joint was named a finalist for the 2020 to tackling risk factors, reducing replacement surgery that people Superior Achievement in Branding, the number of people who develop with arthritis face. Coverage of ‘Right Reputation and Engagement arthritis, promoting good MSK health on Time’ appeared a variety of media (SABRE) Awards for not‑for‑profit and limiting the financial impact outlets, including the BBC, The organisations and for the 2020 of arthritis on the NHS. For that Sunday Telegraph and The Mirror, Chartered Institute of Public reason, we developed a collaborative, and we have ensured that the voices Relations (CIPR) Awards for a solutions‑focused approach to of people with arthritis are heard on not‑for‑profit campaign. Our use working with NHS England and this important national health issue. of social media as a whole was Public Health England (PHE). shortlisted for the Charity Times’ This collaboration culminated in 2019 Best Social Media Presence June 2019 with the Government’s Shedding new light on Award, and our organisation was publication of ‘Musculoskeletal the problem of pain highly commended by the 2020 health: 5 year strategic framework Communiqué Awards in the category Securing media interest is an for prevention across the lifecourse’. of Charity, Patient or Professional important part of increasing The guidance document is a joint Association of the Year. recognition of the issues that statement from PHE, NHS England people with arthritis face, and this and Versus Arthritis that outlines year saw notable success in our Turning awareness our commitments to promoting MSK communications work aimed at into lasting change health and preventing people from sharing people’s lived experiences. developing MSK conditions. This year, we published our ‘State In October, npj Digital Medicine of musculoskeletal health 2019’ Our work with PHE and the NHS is published the results of our ‘Cloudy report, our third annual report on proof of the benefits of collaboration. with a chance of pain’ study, which musculoskeletal (MSK) health in As we look ahead, we will continue to analysed millions of reports of daily the UK. Drawing on both qualitative work closely with health authorities to pain intensity from people in the UK and quantitative studies, and make sure that policy translates into real who live with arthritis and related incorporating real‑world evidence, change in the system and into better conditions. the report paints the clearest picture outcomes for people with arthritis.

Versus Arthritis 2019–20 | Our amibitions 9 Ee v ry child a nd young Person

O ur second ambition Ee v ry child and young What we learned in this research has We also continue to listen to young person with arthritis helped us to better understand the people to learn what matters most many challenges that young people to them, and this year saw the first is supported by us. with arthritis face. These include meeting of our Young People Versus In the UK, 12,000 children aged isolation, a lack of confidence and Arthritis Advisory Panel. Made up 16 and under live with juvenile uncertainty about the future. Our of people with arthritis aged 18 to idiopathic arthritis, and thousands information and support for young 25 from across the UK, the panel more live with other arthritis‑related people aims to help young people to provides vital input and advice on conditions. All too often, the unique do the following: our plans and priorities and shapes needs of younger people with the health information and website Ú to feel confident in their content that we create. arthritis go unmet because society identity wrongly assumes that arthritis is a condition of older age. Ú not to feel isolated from others because of their Empowering young people Supporting every child and young condition to manage their condition person with arthritis to live well with The benefits of listening to young their condition is a challenge that we Ú to feel confident and hopeful about the future people as we find new ways to have taken up in earnest. support them is evident in our Ú to be supported through development of our Arthritis Tracker, Listening to and learning having empowering a mobile app that helps young people from young people interactions with to track their arthritis symptoms and professionals from the health wellbeing. The app also signposts To help us provide children and service, the education sector young people to information, tips young people with the best support, and the wider world. and support from our website, and in 2019, we commissioned insight These learnings serve as the it connects them with our locally research to explore the impact available events and services. of arthritis on young people, to foundation for improving and understand their needs and to learn developing the support that we provide which of their needs are not yet to children and young people with being met. arthritis. Looking forward, we have set ourselves growth targets for our Young People and Families service and for our digital offer of support.

Versus Arthritis 2019–20 | Our amibitions 10 The inspiration for Arthritis Tracker Celebrating 10 years of our came from young people themselves Young People and Families who wanted a better way to keep Service in Scotland track of their symptoms. Young people also played a vital role in Our UK Young People and Families shaping the app – from testing the service has greatly evolved from interface and taking part in feedback its early beginnings in Northern sessions to sharing ideas about the Ireland, and in September 2019, our tools and features that would help Scotland service marked 10 years them most. of supporting young people with arthritis and their family members, Between its soft launch in November first as Arthritis Care and now as 2019 and the end of the year, more Versus Arthritis. than 500 people downloaded Arthritis Tracker, with young people We have supported more than 300 and healthcare professionals alike young people in that time, with many telling us that using the app is going on to become volunteers with making a real difference. Versus Arthritis, helping to galvanise our community and support other We are keenly aware that digital young people and their families. solutions like Arthritis Tracker are becoming an even more important way to support young people with arthritis during the ongoing COVID‑19 pandemic. Throughout the year, our Young People and Families services showed a growth in the number of services provided, only to be halted by the outbreak of COVID‑19 in March 2020, a peak month of planned activities. During the course of the year, we helped young people and their families 2,190 times, which is slightly less than what we had planned due to COVID‑19. However, we have since moved many elements of our face‑to‑face services to digital delivery, and these new approaches have been well received. L iving without limit

Oi ur th rd ambition Pa in and the impact of pain in the UK and our largest research competition open to innovators does not limit the lives of commitment to date: the launch of a around the world to find solutions for partnership between Versus Arthritis pain that we can deliver at scale. people with arthritis. and UK Research and Innovation. Arthritis can steal so much from We committed £12 million to this Managing pain people’s lives, from independence five‑year partnership – matched through movement and intimacy to the ability to work. by an additional £12 million in Research tells us that physical For many people living with arthritis, government funding – to create a activity can have a range of benefits, pain plays a major role in this theft. In new research platform, the Advanced from reducing pain to improving fact, 78% of people with arthritis say Pain Discovery Platform (APDP). that they experience pain most days, physical function. However, for many and the pain and disability of arthritis This initiative will bring together people with arthritis, pain is a barrier can significantly reduce people’s experts from across the fields of pain to being active, and some people may quality of life. research to combine cutting‑edge even fear that exercise will make their technology and science, and to use pain worse. People with arthritis have told us that artificial intelligence to understand To ensure that the benefits of getting help living with and dealing the deeply complex nature of pain. with pain is their primary concern. physical activity in managing pain We aim to meet this priority and to In arthritis research, bringing are available to more people with reduce the proportion of people treatments from bench to bedside arthritis, we have worked alongside living in pain while increasing the has often been slow, and our work health researchers and innovators to number of people who feel supported on the APDP will help speed up this scale up and implement the six‑week, to manage their pain. process to deliver real benefits to 12‑session ESCAPE‑pain programme people with arthritis. and to deliver it to people with osteoarthritis in a range of settings And because not all benefits will Investing today beyond the NHS, including leisure come through developing new in tomorrow’s and community facilities. solutions for pain medicines, we will assess ways to apply other technologies to help More than 14,000 people took part In a major step forward to make solve the problem of pain. As part of in the programme at over 230 sites, inroads into this important area, that work, we are exploring, together and participants have reported that September 2019 marked the single with the innovation foundation they have less pain, better sleep biggest investment in pain research Nesta, a global challenge prize: a and improved mobility. The scale‑up

Versus Arthritis 2019–20 | Our amibitions 12 of the programme has exceeded before. Importantly, 100% of those our targets, and our involvement in who responded said that they were the partnership was an important either satisfied or very satisfied factor in NHS England’s decision to with their experience of one‑to‑one select ESCAPE‑pain as an Academic meetings or workshops. Health Science Network national In Northern Ireland, four Health programme. and Social Care Trust areas Similarly, we saw success with Get commission us to deliver a series of Active for Arthritis, which we piloted self‑management courses. These over a three‑year period that ended courses are designed to help in September 2019. This programme people with long‑term health was designed to improve access conditions understand more about to physical activity and support for their condition and to develop people with arthritis in Wales. strategies to manage the impact that pain and other symptoms have An independent evaluation of the on their daily lives. programme’s impact returned impressive results: in a survey of Fully trained and accredited people with arthritis who attended volunteers – all of whom live with our sessions, 92% said they were long‑term health conditions of their more active afterward, and 96% said own – share experiences and help they felt better able to manage their each participant solve problems they condition. Encouragingly, 97% said face in creating and carrying out their they planned to stay more active. self‑management programmes. This peer support is an essential part of Helping people with our programme’s success. arthritis understand This year, we delivered 40 of their options these courses – and 214 sessions – that supported more than 500 Living Well with Arthritis, our local people. When surveyed about their service for adults, is delivered mainly experiences, 84% of participants by our volunteers – many of whom reported that their ability to manage have first‑hand experience of arthritis their fatigue had improved, 78% – who are supported by our staff. said that they felt more confident One specific approach of our in discussing their condition with broader Living Well provision can be their healthcare professionals, 86% commissioned by the NHS, and this reported an increase in activity is the case in five areas of England. levels, and 80% said that they felt This approach provides information more confident in managing the and peer support through one‑to‑one emotional impact of living with their meetings, group workshops and long‑term health condition. telephone‑based support calls. We delivered 1,027 of these one‑to‑one Living Well meetings, supported nearly 800 workshop attendees and held 287 phone calls. An independent evaluation found that, after taking part in Living Well, 85% of people said they better understood how to manage their symptoms, 80% said they had a better knowledge of how to access local services and 70% felt less socially isolated than they had

Versus Arthritis 2019–20 | Our amibitions 13 Gav l anised C ommunity

O ur fourth ambition Te h re is a galvanised Growing our community webpage views – a measure of how many individual pages of our website community pushing The number of supporters joining us people visited – far outpacing our in defying arthritis increased steadily against arthritis. target of 7.6 million views. over the year, and we are grateful for We know that we cannot reach their many contributions. Without Beyond our growing base of our goals without the support of a their support, we would not be able to supporters, there is also strong galvanised, active community. This achieve our aims as an organisation. evidence that Versus Arthritis is year, we made significant headway gaining greater awareness among We have also seen substantial growth in expanding and empowering that the public. In September 2019, our in how much people interact with us community to do even more with spontaneous brand awareness – a on social media. Our engagements and for people with arthritis. measure of how many people recall across our social media platforms us when asked to name an arthritis One major achievement has been the this year reached nearly 1.7 million, charity – had reached 5%, up from expansion of our campaigns network, significantly exceeding our target just 1% in the fourth quarter of the with the number of our campaigners of 170,000 engagements on these previous year. growing by an impressive 150% over platforms, which include Twitter, the previous year to 12,400 people, Instagram and Facebook. Making progress with spontaneous all of whom are pushing for positive awareness is vital for our success – Our online community grew, too, with change for people with arthritis. unless people are aware that there 11,950 registered users at the end of is a charity that they can contact for Thanks to this growing group, we the financial year, up 1,300 compared information, support and hope, they witnessed a 400% year‑on‑year with the previous year. More people cannot become supporters and part increase in the number of actions are interacting directly with us by of our galvanised community. that our campaigners took, with accessing our local services or 23,525 actions taken in the fourth calling our helpline, and our Arthritis Because our brand is only 18 months quarter of the year alone. That Virtual Assistant, which lets people old, we are not yet benchmarking number, largely driven by people’s access our information 24 hours a our brand awareness metrics against engagement with our ‘Right on Time’ day, seven days a week, had 14,500 those of established charities, as campaign, represents a 60% increase conversations last year. the results would not be meaningful. on actions taken during the previous It will take time for us to build In total, we carried out 2.2 million quarter. our recognition in the public’s interactions with people with arthritis, consciousness as we work to reach and we also recorded 10.8 million even more people.

Versus Arthritis 2019–20 | Our amibitions 14 Empowering healthcare professionals to create change Healthcare professionals play a vital role in improving quality of life for people with arthritis, and our investment in our MSK Champions programme is helping to build a community of professionals who are galvanised to create positive change for people with arthritis. In June 2019, we welcomed our second cohort of 14 MSK Champions – made up of GPs, surgeons, physiotherapists, nurses, podiatrists and other professionals – into our 18‑month leadership development programme delivered at the Ashridge Business School. During the programme, our Champions will learn how to improve services for people with arthritis and deliver better care. In addition to our growing ranks of MSK Champions, the past year also saw the expansion of our professional network and their uptake of our training offer. Our network included just over 8,000 members by the end of the financial year, up 28% on the fourth quarter of the previous year, meeting our annual target for healthcare professionals joining in with the push against arthritis. Over the last year, we also trained more than 8,000 healthcare professionals. This number was more than we had planned, and our success in this area was largely due to our online training offer, including digital webinars. Additionally, our training programme was shortlisted for the General Practice Awards for the year 2019. A LOCAL T ouchpoint

O ur fifth ambition Whe rever you are in the UK, During the fourth quarter of this year, we COVID‑19 pandemic, there is still so there is a local touchpoint started to design the business process much that we can celebrate: over the that will help us create an operational course of 2019–2020, we had more with us. model for this work, including our data than 33,000 interactions with people People with arthritis need a variety of and digital solutions. We also advanced with arthritis, and our local service support options, but access to support our communications strategy, our interactions were up by 2,328 compared – and the availability of that support – training workstream, our pilot objectives with the previous year. and our recruitment of local employees. varies widely across the UK. At Versus We also gathered together with our Arthritis, we believe that, wherever We are also aware that the ongoing volunteers, who lead the push against people with arthritis live in the UK, they COVID‑19 pandemic makes the need arthritis in their local communities, should have local access to services for local access to support and services during our annual volunteer conferences and support – including those options more important than ever before. in Wales, Scotland and Northern Ireland. that we provide – and opportunities to However, along with bringing about new We heard feedback from hundreds of get involved with our work. Our Local opportunities, COVID‑19 has affected these dedicated volunteers about what Touchpoints, which we are preparing to the local landscape and how we launch it means to be a part of Versus Arthritis. pilot in six locations across the UK, are our pilots. We continue to be inspired by their the first step to making this a reality. dedication to defying arthritis.Finally, we However, we are still moving forward with started a comprehensive review of our launching our programme at our pilot sites, branches and groups, which will help Developing our approach and our emphasis on digital elements of us to make these local hives of activity the programme will be stronger than we This year, we undertook intensive more sustainable, fully supported had originally planned. We will continue work – including co‑designing and better embedded within their to focus on the opportunities that our workshops, surveys and local communities. We conducted this review touchpoints provide for people with healthcare analyses – to develop a by surveying our volunteers, branches arthritis while monitoring the impact of the model for Local Touchpoints that can and groups, 182 of whom completed outbreak to ensure that we can meet the be tailored to different communities. our survey. Their responses are shaping challenges ahead. We have also selected six pilot our approach to better supporting our sites across the UK where we plan Celebrating our branches and groups in the future, to test our model: Argyll and Bute, volunteers’ work as well as our approach to our Local Belfast, Haverfordwest, Gateshead, Touchpoints programme, so that we can Birmingham and West Berkshire. Even though we were unable to deliver our face‑to‑face services during the make our system of local support even final month of the year because of the stronger.

Versus Arthritis 2019–20 | Our amibitions 16 Gre eat r Quality of life

O ur sixth ambition

MS r K resea ch has an even We have identified a number of Ú We will push for policy greater impact on the changes that we will make to our changes based on our research goals as we push to do even findings and strive for quality of life for people more for people with arthritis: increased recognition with arthritis. of research among Ú We will increase our profile decision‑makers in At Versus Arthritis, we have been and boost our brand government and in health funding research into arthritis and recognition and attribution organisations. We will boost related conditions for many years, for the research that we engagement in shaping and the outcomes of our work have undertake. We will build research and data strategies had an undeniable impact on the stronger relationships with so that we can deliver what lives of people with arthritis. key partners, strengthen is needed most. However, the scale of both the our financial sustainability research and the funding dedicated and align our research to Ú We will create more to arthritis have not always been support the delivery of all our opportunities for people proportionate to the size of the ambitions. with arthritis to take part in research, to feel valued for problem, and bringing treatments to Ú We will increase recognition their contributions and to the people who need them can be of the importance of research trust that research can meet a slow process. For that reason, we and the value of involving their needs. are seeking a more sophisticated people with arthritis. We approach to research so that we can will make research more In the longer term, we are creating deliver a greater impact. accessible, translatable and a movement to improve arthritis clear. We will share what we research as a whole. We are learn in research in different listening to people with arthritis and ways – beyond publications understanding how we can make in journals – by exploring the greatest difference for and with a variety of methods to them, and we are making sure that help information reach the voices of people with arthritis are researchers, people with amplified through the projects that arthritis, practices and policy we undertake. decision makers.

Versus Arthritis 2019–20 | Our amibitions 17 Delivering the right The tool has been so effective Lo eo king ah ad treatment at the right time that more than 20 healthcare Our plans for organisations across the UK have Even as we look to the future of now adopted it, and in May 2019, the future research, we are also invested in the National Institute for Health As we look to the future of Versus learning how people with arthritis can Research (NIHR) reported that using Arthritis, we know that we will get the best out of existing treatment STarTBack leads to people taking face challenges in a nation whose options. This is exemplified in our fewer days off work due to back pain. landscape has been profoundly work to help young people with NIHR also found that using the tool changed by the COVID‑19 pandemic. juvenile idiopathic arthritis (JIA) get improves people’s disability, pain and We also know that we will face new, the right treatment at the right time. depression measures. STarTBack, indirect challenges as a result of We are currently investing £500,000 says NIHR, creates real health Brexit and its impacts on the UK in a five‑year partnership with the benefits for people with arthritis at a economy and on the charity sector. Medical Research Council, Great lower cost to the NHS. We are actively working to manage Ormond Street Children’s Charity and the risks that we face from both of Olivia’s Vision to fund the CLUSTER Making real progress these realities, and we detail our study – a study that aims to predict by supporting careers approach beginning on page 40. which young people with JIA will in arthritis research Even in the face of these challenges, respond best to which treatments, we see fresh opportunities to reach By the end of the year, we had making years of trial and error with more people by finding innovative funded 322 live research awards, 31 ineffective drugs a thing of the past. ways to deliver information and of which were co‑funded with other support whenever people need it. And this year, we launched the organisations. Among co‑funded CLUSTER Consortium’s Patient awards, every £1 we spent generated We will continue to raise the public’s and Parent Network to get crucial another £1.51 in additional research awareness of arthritis as a cause feedback from young people funding from other organisations, worthy of their concern and ensure and their families about what is helping us to do more for people that people with arthritis know that most important to them in this with arthritis. they are not alone. We will redouble study. Through listening to their our efforts to reach and support We also supported 20 fellowships, perspectives, we will ensure that young people throughout their totalling £3.3 million, to support their voices are amplified in this journey with arthritis and to help careers in research. We are proud research project. them meet the future with hope and that the people we support are optimism. We will keep investing in making a real impact in the medical solutions for pain and researching Tailoring treatment community, a fact that was on clear better, faster treatments for arthritis, for back pain display during this year’s British and we will expand our presence Society for Immunology congress Another research innovation across the UK through our Local in Liverpool, where two researchers that continues to help healthcare Touchpoints so that every person whose work we have funded were providers tailor treatments to with arthritis can access our support recognised with awards for their individuals is STarTBack. Working where they live. with Keele University, we developed outstanding research. a simple tool to help doctors Finally, we will continue to inspire, understand individual people’s risk motivate, influence and engage our of having their back pain become community of thousands to join us chronic. because, while the challenge ahead of us is great, with all of us pushing In the 15 years since the STarTBack together, we can defy arthritis. tool first became available to healthcare professionals to personalise treatment for back pain, we have seen real success in reducing the impact that back pain has on people’s lives.

Versus Arthritis 2019–20 | Our amibitions 18 section 2 Fni ancial and operational sustainability

u I sT N s ATY ABIl I In our second year as Versus Arthritis, we continued our As part of our plan to diversify our potential income transformation into an efficient, sustainable organisation streams, we have invested in a new social venture – Arthr that both builds on the trust and credibility that we have Ltd – that will design, develop and sell products and developed and looks to the challenges and opportunities innovations to help people with arthritis live well with their that lie ahead. condition. Arthr Ltd will launch fully in 2020. As we prepare to meet the needs of people with arthritis More details about our income and our expenditures both now and in the future, the sustainability of our appear in the financial review section of this report that organisation is at the forefront of our planning. begins on page 30. In the sections below, we outline the approach that we are taking to ensure that our finances, our management of Our volunteers resources, our processes and our response to challenges This year, we saw a continued increase in our volunteers are fit for the future. delivering vital services to people with arthritis. It is thanks to our volunteers’ extraordinary efforts that Our financial sustainability and Versus Arthritis delivered more than 2,500 sessions to income‑generating activities people with arthritis during 2019–2020. Our trustees want to maximise the impact that we can The number of sessions we delivered this year was lower make for people living with arthritis. For that reason, in the fourth quarter due to the outbreak of COVID‑19 we have decided to operate at a deficit for a number of in March 2020. However, because of increases in the years. This approach has allowed us to transform our number of services delivered before the pandemic broke organisation and to make greater headway in reaching out, the 392 sessions we offered during the quarter were our six ambitions. comparable to the number sessions in the same period of 2018–2019. That is a true testament to the creativity, Our current reserve levels make it possible for us to enthusiasm and dedication of our volunteers in pushing operate at a deficit for a limited time as part of our back against arthritis. transformation period. However, to secure our future, we know that we must move toward sustainable funding in Given how important our volunteers are to everything the medium term. that we do, we are committed to giving them the right support to continue with their efforts. With that in We know that our financial sustainability as Versus mind, this year, we began work on an involvement and Arthritis impacts both people with arthritis who rely volunteering plan to help us shift toward an organisational on our services and our employees. It also impacts our culture in which we involve our volunteers in all of partners and suppliers who help us to reach our goals. our work to defy arthritis. We are developing training With these reasons in mind, by 2025, we aim to bring our processes for our volunteers to ensure that they are well spending in line with our income. supported, that we let them know how highly we value During the course of this year, we saw successes in securing them, and that they understand how they can be involved our financial present and future: at the end of March 2020, in shaping our work. before investment losses, we had a deficit of £23.89 million. This number was well within our planned deficit budget. Our processes However, we know that our income from anti‑tumour This year, we also made real progress in making our necrosis factor intellectual property is coming to an end. processes, systems and data more efficient. We have This makes growth in our legacy, voluntary and earned developed a clear understanding of the challenges that income more important than ever before. For that reason, we face related to the quality of our data, and we are we set a target of £16.9 million in net income for the working to improve both the quality and availability year. This target included funds raised through legacies, of our data using our ThankQ customer relationship mass market efforts, high‑value partnerships, statutory management system. funding, intellectual property and other activities. At the end of the year, we had achieved £20.2 million, which represented £25.2 million in income less £5 million in fundraising expenditure.

Versus Arthritis 2019–20 | Financial and operational sustainability 20 Our employees This year, we developed an action plan to improve the Our office in London was designed with sustainability efficiency of our payroll, strengthened our cybersecurity in mind, and it features natural and low‑energy lighting and identified risks that could impact our operations. sources, UK‑sourced furniture and bike storage for those who cycle to work. We are also committed to applying We are also making headway in managing our employees sustainability principles to any improvements we make to well across our organisation. In total, 97% of our our offices in the future. employees are now on our new employment terms, and in our fourth quarter, we saw a reduction in uncontrolled We recycle in each of our offices, and our robust technology turnover and an increase in internal appointments. means that we can often avoid printing documents. We comply with all relevant environmental legislation, Our environmental reporting and policy but we want to do even more in the days ahead, so we are monitoring our environmental impact and are committed We are also taking steps to make sure that we are to improving our environmental sustainability. operating in an environmentally sustainable way. We have reduced our office footprints, introduced hot‑desking and As we improve our environmental footprint and reduce encouraged flexible working. We also encourage online our carbon emissions, in 2019–2020, we started to track meetings, which help us to reduce our travel, and which our energy use in three key areas for the first time. have become crucial to our ways of working during the The table below shows our gas, electricity and fuel ongoing COVID‑19 pandemic. consumption for the year and converts our usage into greenhouse gas emissions.

Een rgy use disclosure Greenhouse gas emitted Unit Units used Conversion factor GHG Kg CO2e

Gas kWh 771,171 0.18385 141,780 Electricity kWh 311,679 0.2556 79,665 Fuel Business mileage 155,500 0.29082 45,224 Total GHG Kg CO2e for 2019/20 = 266,668

Purchased gas and electricity: we have based our estimates on actual utility invoices, which quote energy usage in kilowatt‑hours (kWh). Business mileage: we have calculated this through monies claimed for mileage through our expenses system. We do not own a vehicle fleet. Conversion factor: we have converted our usage into greenhouse gas emissions using rates, shown above, from the Department for Environment, Food and Rural Affairs.Intensity ratios: to measure our success in reducing our carbon footprint over time, we have set an intensity ratio as follows: income to Kg CO2e = £95 to 1 KgCO2e. We aim to reduce our environmental footprint, and we will use these figures as our benchmark to monitor our progress in future years.

Versus Arthritis 2019–20 | Financial and operational sustainability 21 Ensuring our future At the time of this writing, the UK faces continued To do more and better in the days ahead, at the time uncertainty related to COVID‑19. While we hope to see a of this writing, we have signed up to the Association of period of sustained recovery, we need to prepare for the Chief Executives of Voluntary Organisations’ (ACEVO’s) likelihood of further lockdowns at local or national levels. eight principles to address the lack of diversity in charity leadership. We have also committed to working together Despite the challenges before us, this continues to be a with our employees and volunteers to put into practice time of significant positive change for our organisation. the recommendations from ACEVO’s report, ‘Home During the two years since the merger of our legacy Truths: Undoing racism and delivering real diversity in organisations, we have successfully launched Versus the charity sector’. We are committed to giving this work Arthritis and completed our period of transformation. We the resources and capacity that it needs in order for us to made a substantial investment from our reserves in order develop into a truly diverse, inclusive organisation. to achieve this goal, and we have committed to having a balanced budget by the 2024–2025 financial year. At our board level, we anticipate having six vacancies within the next two to three years. We are committed As we look ahead, our path forward is taking shape. Some to using these recruitment opportunities to evolve into decisions have been easy to make – for example, the an organisation with a more diverse board. The board COVID‑19 pandemic has sped up our trend toward using encourages women, people from BAME backgrounds, more digital ways of working. We are confident that we younger people and people with lived experience of can continue to deliver digital support for people with arthritis to apply. arthritis, just as we have done with our new COVA virtual assistant and our Arthritis Tracker mobile app for young Today, we are at the beginning of our journey as a people with arthritis. new charity. The signs so far are positive – our brand recognition is above target, understanding of arthritis is However, we must deliver positive change for people with growing and we are engaging with even more people. arthritis within our financial means, and we can only do it with the help and support of the 10 million people in the However, we are not yet operating at a scale large enough UK who live with arthritis and the additional 8 million who to make the kind of impact that we ultimately want to live with related conditions. deliver. In the immediate future, our task as a charity with a newly formed board and organisational leadership team We need more donors to fund our work, more volunteers is to focus our activities where we can make the biggest to join us in providing support, more involvement from difference for people with arthritis and to ensure our people with arthritis in shaping our research efforts, more long‑term financial sustainability. people raising their voices to demand better healthcare, and more people campaigning to overcome the stigma surrounding arthritis that can stop people from living Section 172 statement well with their condition. Only with such support from As we carry out our work to achieve our ambitions, we a galvanised community can we achieve a world that keep in mind the interests of everyone who is affected by no longer tolerates the pain, fatigue and isolation that our decisions. We are also committed to performing our arthritis causes. duties under section 172 of the Companies Act 2006 – to We must also respond to the growing movement to end promote the success of Versus Arthritis for the benefit of racial discrimination in our wider society, and to play a our wider community. key role in improving diversity and inclusion in the UK In the table below, we report on six of the key issues, charity sector. In July 2019, we developed our action events and decisions that we have made during this year plan, but we acknowledge that we have not yet made and the impact that these have had on our beneficiaries, enough progress. volunteers, supporters, employees, partners and others.

Versus Arthritis 2019–20 | Financial and operational sustainability 22 Key issues, events and decisions At the beginning of the year, our trustees authorised our deficit budget to continue as we completed our transformation programme.