As part of its information services to its stakeholders, the NJR provide three key ‘Feedback’ services:
NJR Clinician Feedback is a secure, surgeon-only website that enables surgeons to compare and contrast their clinical practice with that of their colleagues at a local, regional and national level. In 2015/16 a number of enhancements were deployed on to the system, and more are planned for implementation in 2016/17.
2015/16: A key development last year was the implementation of the ‘Primary Procedure Status Report’ which was launched at the BOA Congress. The Primary Procedure Status Report uses three endpoints: ‘Still Viable’, ‘Patient Deceased’, and ‘Revised’. Users are able to apply a number of filters to the report and download the outputs to either screen, or as a pdf file or csv file. One surgeon at the BOA estimated that the report had saved him a month’s work for a hospital-led clinical audit on a particular brand and size range of device implanted into a specific patient demographic: the report took less than a minute to provide the required data.
In October 2015, surgeon-level Price Benchmarking reports for the EMBED services were also added to the service. These reports are only available to those surgeons whose Trust has subscribed to the EMBED service. For further information about EMBED reports, please see the section ‘Price Benchmarking’.
2016/17: A number of service enhancements are also planned for the next year. These include:
- A Revision Rate Report, similar to the Primary Procedure Report. Again, surgeons will be able to filter and download details of any revision procedure that they have carried out. The report will also use the same endpoints as the Primary Procedure Report. The report does not provide details of revisions of revisions although these procedures could be added in the future: currently there are very few revision of revisions in the database.
- Activity, as opposed to outcome, reports for ankle, elbow, and shoulder joint replacement will be added.
- The Annual Clinical Report will also be added to the ‘Reports’ section of a surgeon’s profile. This trust level report, which is sent to Chief Executives and Medical Directors, will be available to a surgeon where they have activity reported at a trust during the reporting period.
- Changes will also be made to the funnel plots so that all those included in the Annual Clinical Report are replicated in Clinician Feedback. For hips, a funnel plot for the last five years of activity only will be included.
NJR Supplier Feedback is a secure online subscription service for manufacturers and suppliers of orthopaedic implants. The service is not designed for marketing purposes, but is designed to help suppliers with post-market surveillance.
In addition to providing data about the use of implants in primary procedures, NJR Supplier Feedback enables suppliers to access data about the use of their own implants in revision and revision of revision procedures. Data is available for all joint types.
A number of different services are available dependent upon the subscription level, including an Implant Quality Monitoring (IQM) service which provides pre-formatted reports on individual implants and patient reported outcomes. Any device supplier wishing to register for a subscription service or to find out more about what the service provides should contact the NJR Service Desk.
NJR Management Feedback provides hospital-level reports to Trust, Health Board, and independent sector company Chief Executive and Medical Directors.
The service currently issues an Annual Clinical Report which provides a summary of the activity and outcomes of each hospital within a trust or private company. Those trusts that provide implant pricing information to the NJR were provided with the Price Benchmarking INFORM report and, from October 2015, EMBED reports were made available to those trusts who paid a subscription. Paying for the EMBED service means that surgeons within the trust are provided with surgeon-level EMBED reports, made available through NJR Clinician Feedback. For more information about INFORM and EMBED, please see the section ‘Price Benchmarking’.
More changes to the Annual Clinical Report are planned for 2016/17, including additional funnel plots, replacing the ‘Red, Amber, Green’ status with more easily read thermometer plots, making the funnel plots more readable, quarterly updates of the ‘counts’ and data quality reports, and six-monthly updates to the funnel plots.