Executive summaries

Part 1: Annual progress 2013/14

The 11th Annual Report of the National Joint Registry for England, Wales and Northern Ireland (NJR) is the formal public report for the period 1 April 2013 to 31 March 2014 and comprises four distinct parts:

  • Part One contains news and information about the progress of the NJR
  • Part Two includes statistics on joint replacement activity for hip, knee, ankle, elbow and shoulder activity for the period 1 January to 31 December 2013
  • Part Three includes detailed statistical analysis on hip, knee and ankle joint replacement surgery using data from 1 April 2003 to 31 December 2013 and
  • Part Four reports indicators for hip and knee joint replacement procedures by Trust, Local Health Board and unit based on the 2013 calendar year

As part of a new approach to sharing information about NJR progress (Part One), clinical activity (Part Two) and hospital activity (Part Four), the National Joint Registry has a new, dedicated online annual report website ‘NJR
Reports’ to host and share all the NJR’s annual report data and information.

Some of the data can be found in this slimmer printed report – namely the executive summary for each part of the NJR annual report data and the full detailed, statistical analysis of outcomes following joint replacement surgery (Part Three). A short summary of the NJR’s progress over 2013/14 is included below, with further detail available at www.njrreports.org.uk.

The total number of procedures recorded in the NJR exceeded 1.6 million at 31 March 2013, with 2013/14 having the highest ever annual number of submissions at 205,686. This is against a backdrop of general improvement in data quality, although a high degree of monitoring and support to orthopaedic units is still required:

  • Overall compliance (case ascertainment) was recorded as 99.6%
  • Patient consent (to record their details in the NJR) was recorded as 91.8%
  • Linkability (the ability to link a patient’s primary procedure to a revision procedure) was recorded as 95.1%

Significant progress was made in the evolution of the NJR Steering Committee and its sub-committees in order to remain fit for purpose for the lifetime of the registry. In 2012/13, a key focus was a review of the registry’s governance, structure and operating model. This year the structure has moved forward with a revised operating model, a series of appointments to the steering committee and establishment of a new Medical Director post.

In recognition of the great increase in scope and responsibilities of the NJR, the strategic plan now includes the development of three additional strategies; research, data quality and communications to further support the delivery of its primary strategic themes; patient safety and outcomes, information availability and access to data and research. 

Another key achievement has been the work to establish a revised economic model from 1 April 2014. This not only represents a significant cost saving to the NHS but establishes a new, fair and proportionate cost contribution from orthopaedic device manufacturers for services provided through NJR Management Feedback to support post-market device surveillance. This model also includes provision of a new service to NHS procurement teams to enable review and benchmarking of implant price information against other providers. 

Collaboration with Beyond Compliance has continued, resulting in the service’s launch which now provides a way of following up new implants on the UK market so their use and performance can be controlled and monitored much more closely. 

International collaboration and the development of Unique Device Identifiers also progressed, with national collaboration focusing on supporting the Orthopaedic Data Evaluation Panel (ODEP) and the introduction of ODEP ratings for knee prostheses as well as the Getting It Right First Time initiative.

It should also be highlighted, the reports from the respective Chairmen of the Implant Performance Subcommittee and the Surgeon Outlier Sub-committee are available online. These report how outlier analysis is undertaken and include the high-level outcomes of the monitoring process for 2013/14.

The NJR remains committed to working for patients and driving forward quality in joint replacement surgery. Further progress and updates will be available at www.njrreports.org.uk and the main NJR website at www.njrcentre.org.uk