Highlights: NJR Feedback services

As part of its information services to its stakeholders, the NJR provide three key ‘Feedback’ services:

The NJR delivers three key systems as part of its ‘Feedback’ reporting services to clinicians, trust and hospital management, and to suppliers.

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 2017/18 a number of enhancements were added to the service and these included:

• The ability for a surgeon to declare that they have downloaded their annual Consultant Level Report (CLR) and that they have used it for appraisal/revalidation purposes.

• The inclusion of reports about ankle, elbow, and shoulder joint replacement, including primary and revision procedure reports, and revision reports.

• The identification of the revising hospital and surgeon where either or both of these are different to the patient’s primary procedure.

• A level of re-branding and menu-restructuring to make the system more useable and easier to navigate.

Further enhancements are planned for 2018/19 and these include:

• Primary and revision procedure reports for ‘Lead Surgeons’, i.e. associate grade or trainee surgeons.

• Inclusion of funnel plots for Standardised Mortality Ratio (SMR), based on the last five years of data.

A number of changes were also implemented for the 2016/17 Consultant Level Report:

• The identification of the revising hospital and surgeon where either or both were different to the primary surgeon or hospital.

• Thermometer plots were added to funnel plots in order to observe movement in the funnel plot.  These replace the three historical plots previously included in the funnel plot itself.

Planned enhancements to the 2017/18 CLR include:

• The addition of columns that identify the date of any linked revision and the place at which it was undertaken.

• The addition of the number of primary procedures under observation in reports related to linked revisions and mortality.

• Inclusion of funnel plots where the consultant has acted in the role of ‘Lead Surgeon’.

• Addition of 90-Day SMR funnel plots (latest 5 year data set).

• Addition of a table showing revision of revisions.

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.  For 2018/19 it is planned to add aggregated PROMs scores to IQM reports.

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 includes an Annual Clinical Report and Price Benchmarking reports.

The Annual Clinical report provides senior management with information about the joint replacement activity in their organisation, including outcomes.  The 2016/17 data report included a number of enhancements, including:

• Replacing the ‘Red, Amber, Green’ status with more easily read thermometer plots.

• Adding details of shoulder, elbow, and ankle procedures (including one and three year revision rates)

• Providing ten year revision rates for hips and knees

• A report showing how many consultants had made a declaration via Clinician Feedback to the effect that they had downloaded and read their Consultant Level Report.  

• The addition of thermometer plots to replace the time series plots within the funnel plots.

• A new standardised revision rate (SRR) at hospital level for hips which excludes implants that have been withdrawn from the market.

• A list of the implants that have been excluded or withdrawn from the analyses.

• An SMR funnel plot for both hips and knees and based on the last five years of data to replace the ‘life of NJR’ funnel plot.