Work of the NJR Committees

NJR Data Quality Committee (DQC) 
Chair’s report 2025/26 - Mr Derek Pegg 

The committee membership comprises representatives from our specialist societies and from the British Orthopaedic Association, senior representation of the management team, and Lot 1 and Lot 2 contractor representatives. As ever, I am extremely grateful for all those that work so diligently in striving to maximise the completeness of joint replacement procedures recorded on the NJR. 

We have continued to focus on completing our annual Data Quality Audit for the current audit year, alongside supporting hospitals to complete audits for any outstanding years. The benefits of the automated Data Quality Audit process, first introduced in 2019, is that hospitals can review their data more regularly and complete audits in a timelier manner. 

There remain a few hospitals where compliance is poor and their engagement with the annual audit cycle has been consistently deficient. There are often multiple issues within such hospitals. The NJR will continue to support them as much as possible, to achieve the data quality standards many of their peers consistently manage. We have recently reviewed our escalation process that is in place for poorly compliant hospitals, to help clinicians access appropriate support. 

During 2025/26, new OPCS codes were introduced as part of the NJR Data Quality Audit to include hip hemiarthroplasty and DAIR procedures. Qualifying hospitals were again awarded our Quality Data Provider awards in line with the continued three-tiered criteria. From a total of 418 hospitals, 314 (75%) qualified for an award with 251 hospital teams receiving gold (60%), 49 receiving silver (12%) and 14 (3%) receiving bronze. It was encouraging that this year there was an increase in the number of hospitals qualifying for an award and within the highest category. Work is continuing to support those hospitals who did not qualify to ensure they meet the criteria for the next audit year. Last year’s audit has shown the most complete results of all audits we’ve conducted over the past 22 years. The overall compliance is now 97.73% for primary and revision procedures. 

During 2025/26, work was undertaken to review compliance for hip hemiarthroplasty procedures. As Hospital Episode Statistics (HES) data was unavailable, this work was completed using data from the National Hip Fracture Database, NJR records and Data Quality Audit. This identified eight hospitals who were not submitting hip hemiarthroplasty data into the registry, and we have worked with these hospitals to ensure these procedures are collected going forwards. 

An initial comparison of HES and NJR ankle data from April 2010 to April 2019 has also been completed this year. This has so far identified an initial 5,000 ankle procedures which have not been entered onto the registry. Work is ongoing to establish whether there are further missing procedures, prior to undertaking a spotlight audit with hospitals to support their work to enter all of these missing procedures. 

To ensure that the NJR can audit procedures added to the registry as part of the updates to the data collection forms, including the new form for Reoperations other than revision (RO), work is ongoing to establish appropriate mechanisms to audit Manipulation Under Anaesthesia (MUA) procedures and fixations of periprosthetic fractures. 

Future plans
During 2026/27 the following data quality activity is planned:
•    Continuation of work to identify mechanisms to audit periprosthetic fractures and MUA procedures collected as part of the MDSv8 RO form introduced last year.
•    Undertake a spotlight audit to identify ankle procedures which are missing from the registry and work with hospitals to enter these, in collaboration with BOFAS.
•    Continued work to support hospitals to improve compliance, through both the NJR escalation process and additional support where required.
•    Updates to the criteria for the Quality Data Provider awards, to encourage hospitals to complete their audits in a timely manner.

NJR Regional Clinical Coordinators Committee (RCC)
Chair’s report 2025/26 - Mr Derek Pegg

On behalf of the Regional Clinical Coordinators Committee (RCCC) I'd like to highlight the breadth of activity and impact achieved over the past year. Once again, it has been a privilege working with Regional Clinical Coordinator (RCC) colleagues, as well as senior members of the NJR Management Team and our contractor colleagues at both NEC and the University of Bristol. We were very pleased to welcome Mr Sameer Jain as a new member on the committee back in April 2025, to represent the British Hip Society. 

The RCCs play a vital role in supporting the work of the NJR. They provide clinical leadership, oversight and expert guidance across a range of priority areas. These include strengthening data quality and supporting underperforming hospitals, as well as this year contributing to national discussion on training and service improvement. Our RCCs are central to help drive forward quality standards, transparency and continuous improvement in joint replacement surgery.

This year, concerns were raised by the British Hip Society (BHS), alongside the Specialist Advisory Committee (SAC) and the British Orthopaedic Training Association (BOTA), regarding the potential unintended impact of the NJR surgeon performance analysis on UK joint replacement training. Specifically, it was suggested that some consultants may be less willing to allow trainees to lead procedures due to concerns about the impact of this on the consultant’s personal revision rates, and the risk of these procedures accumulating to the point of being identified as an outlier, when the resulting higher rates of revision are compared with those of their peers.

NJR analysis does not support this concern, but it was acknowledged this may be one of a number of factors stifling a trainee’s ability to perform joint replacement surgery and risking the capacity to achieve the minimum requirements for completion of training. RCCs discussed potential solutions, including enhanced training log-books to promote appropriate consultant supervision and help preserve training opportunities. Additionally, the NJR was able to support the BHS, British Association of Surgery of the Knee (BASK), and BOTA with an excellent article, published in December 2025, Journal of Trauma and Orthopaedics. You can find this here in the JTO - December 2025 (pages 32-25).

RCCs have continued to play a role in supporting any underperforming hospitals in their region, reinforcing the importance of strong clinical engagement in improving data quality and compliance, and in supporting areas of work such as the collection of patient consent, which remains a critical metric for the NJR. Through the recently revised NJR escalation process, referred organisations have more routinely engaged with improvement activities by their interactions with their representative RCC. In many cases, RCCs work closely with their regional NJR compliance officers to provide targeted clinical support and guidance. This has resulted in a number of hospitals successfully implementing action plans and demonstrating measurable progress against quality indicators over the reporting period. Observed improvements demonstrate the value of sharing best practice and the direct impact of RCC lead clinical engagement at a local level.

Looking ahead to 2026, the NJR is undertaking a comprehensive governance review to ensure that its existing structures, including committee arrangements, remain fit for purpose as the organisation continues to evolve. A particular theme of the review is going to be looking at the most effective way to engage the surgical community and support hospitals. For now, no RCC meetings have been scheduled for 2026 pending the outcome of the review. The findings will provide an important opportunity to strengthen engagement, enhance effectiveness and ensure that the RCC function continues to support the NJR's strategic priorities in the years ahead.

NJR Editorial Committee (EdCom)
Chair’s report 2025/26 - Mr Andrew Porteous

The NJR Editorial Committee brings together a range of contributors to plan and develop our Annual Report content. The committee membership includes: expert clinicians from the orthopaedic specialist societies for each joint, representatives of other key NJR committees (Implant Scrutiny, Data Quality and Research Committees), representatives from our data collection and statistical analysis reporting teams, as well as senior members of the NJR Management Team. Patient and industry representatives complete the report team and all members enable the content development and publication of the report each year. 

The NJR Report is the main focus of the work of the committee, but members are also responsible for the collective planning of the NJR plenary session at the annual British Orthopaedic Association (BOA) Congress, where the Annual Report is usually launched within a programme of presentations showcasing the wide range and impact of our work. 

The main work of the committee in producing the report commences once the relevant dataset has been defined and analysed by the teams from our contractors, NEC and the University of Bristol. Once completed and launched, the Annual Report is available in digital format on our dedicated website, which includes links to individual joint section reports, as well as the combined full report. 

Specific joint section reports and the complete AR23 report can also all be found on our dedicated website here.

The Editorial Committee has always supported the NJR’s research study programme and is delighted to see the expansion of research using NJR data and collaborative research being shaped by NJR Research Committee Chair, Professor Mark Wilkinson. We have included the publication of abstracts of key research projects this year for the 23rd Annual Report, as well as including podium presentation of four key research papers in the NJR plenary session taking place at the BOA 2026 Congress at London Olympia, on 23 September. Poster presentations of further NJR research will be shown on the NJR information stand in the exhibition area at the event. 

Summaries of recent NJR-supported research papers are also available on the report website - and we encourage you to explore these further here.

Each year we aim to make progress in reporting on our rich data resource to make it easier for clinicians to access meaningful information and enable them to make wise implant choices with the aim of improving patient outcomes. The analysis now contains detailed information on implant performance and survivorship up to a maximum of 22.75 years. Details of implant and hospital-level activity and performance can be found in the specific document in the Downloads area. Our interactive reports, filterable on joint type, are also available in the menu on this page. These interactive reports, with inherently more flexible search and analysis options, have been well-received by visitors to the NJR Reports website. 

Key to the success of the work of the Editorial Committee is the expertise and specialist perspective that each of the committee members brings. We have seen changes to the committee membership this year with a greater representation from our Regional Clinical Coordinator network, who bring the perspective of the needs of the hospital teams in their regions with whom they work closely, having recently welcomed Mr Jonathan Phillips and Professor Rohit Rambani on board as new members.

The 23rd NJR Annual Report will be formally launched at the BOA Annual Congress in London in September 2026, with each joint section available online thereafter. The NJR plenary session at the BOA will be held on Wednesday 23 September, from 08.30 - 10.00am in the Zenith Room, and we hope that you will be joining us for an informative and interactive session and to celebrate the report launch.

Research Committee (RC)
Chair’s report 2025/26 - Professor J Mark Wilkinson

The Research Committee is responsible for delivering the research agenda of the NJR. The committee’s aim is to enhance the understanding of the science of joint replacement, improve clinical practice, and benefit public health. Research provides the route to improved treatments and keeping patients at the centre of what we do is a guiding principle for all of our research activity. My thanks go to all members of the committee for their efforts in the past year and for their hard work which makes it possible to facilitate data access and to support these high-quality research outputs. The committee would like to thank Tim Chisnall for his service to the committee and wish him the best with his new role. 

Our business-as-usual activities continue throughout the year, including research application review, the data access portal, and publications outputs - please download the NJR Research Project Portfolio here that catalogues research projects, progress reports and NJR research updates, together with links to all publications related to NJR data. I would like to take this opportunity to highlight below some of this year’s particular highlights and developments.

Research fellowship scheme
We are pleased to welcome Jenna Shepherd in her appointment as Research Fellow to the joint NJR/Royal College of Surgeons of England Research Fellowship programme. Jenna is investigating optimisation of patient-reported outcome measures following shoulder replacement surgery.

In January 2023, the NJR Steering Committee also approved funding for the development of a Non-Clinical Researcher PhD fellowship. This award recognises the wealth of expertise within our specialty that lies with non-clinical scientists, without whom orthopaedics would have seen only a fraction of its current level of development over the decades. The award is aimed at non-clinicians who wish to study towards a PhD on any topic within the field of joint replacement, providing the project has at its core use of the NJR dataset to address the question of interest. Professor Claire Brockett at the University of Sheffield has been awarded this year’s funding to host a PhD studentship entitled “Evaluating interventions for end-stage ankle osteoarthritis”.

NJR annual research programme
Building on many high-quality publications over the years, we continue to develop our annual research programme. Current projects include: Performance of all-poly tibias; Surgeon volumes and ankle replacement surgery; Outcomes of cemented devices using different cements; and inequalities in joint replacement provision and outcomes. As projects complete, new topics are brought on-stream. All projects are delivered in a collaboration between the NJR Research Committee and our statistical analysis partners.

Artificial Intelligence (AI) research
The NJR recognises the strengths, and limitations, that artificial intelligence brings to our field of study. We continue to support a machine learning PhD studentship to address the limitations of current models in predicting implant and patient survival and in the development of transfer learning and federated learning models to better predict the outcomes of surgery. 

Submitting a research application
The Research Committee takes formal responsibility for the approval for the release of NJR data for research, through an impartial and objective process and has oversight of the use and reporting of this data by research groups. Its priority is to ensure that any research question justifies access to the data and offers potential benefits to patients. Research proposals should align to our priority framework and be feasible, ethical, relevant, and methodologically-sound.

The NJR Research Committee provides a framework for applicants to request data for research of public benefit. We aim to support applicants through the process of developing a robust research application that addresses the question posed. All requests must also be approved by the Healthcare Quality Improvement Partnership (HQIP) Data Access Request Group for final authorisation of data release. Subsequent to approval, data is made available for analysis through the NJR Data Access Portal. 

Further Information
In order to get a feel of the current and previous field of research being studied using NJR data, please visit the NJR Research Project Portfolio. If you would like to submit a research application, you can submit an expression of interest for consideration via research@njr.org.uk. Invited full applications are reviewed by the committee quarterly. Full details of the NJR’s research application pathway can be found here and please refer to the recording of our research webinar for full guidance. 

A full list of publications related to the use of the NJR dataset for research is included in the NJR Annual Report.

NJR Surgical Performance Committee 
Chair’s report 2025/26 – Professor Mike Reed

The Surgical Performance Committee (SPC) comprises its Chair, Vice Chair, NJR Medical Director, RCC Chair, surgeon representatives from the RCC committee, representatives of the Care Quality Commission (CQC), a patient representative, representation from the NJR Management Team and representatives of both Lot 1 and 2 NJR contractors.

We have continued with the schedule of two data reviews each year, assessing performance over the previous five and ten years, for both hospitals and surgeons performing hip and knee joint replacement. 

NJR Annual Clinical Report and Consultant Level Report
Further changes and updates were made once again this year to the Annual Clinical Report (ACR) which was provided for all trusts, health boards and independent hospitals; and also to the Consultant Level Report (CLR) provided for consultant surgeons. These reports are accessible through NJR Connect - Data Services.

Shoulder Outcomes
During 2025/26, the NJR agreed the indicators required for revision and mortality outcomes analysis for shoulder procedures. This analysis will be undertaken for both hospitals and surgeons.

Development of routines for mortality outcomes have commenced for surgeons and hospitals and an initial analysis was reviewed by the SPC and the NJR Shoulder and Elbow Working Group in June 2026. An initial analysis for revision outcomes for surgeons and hospitals will be available during 2026/27.

Prior to commencing any formal outlier notification process to surgeons or hospitals, or public disclosure of mortality outcomes, this data will be made available to surgeons and hospitals to view via NJR Connect. The NJR continue to work closely with BESS and other key stakeholder to implement this change and to ensure surgeons are supported to review their data. 

Implant mismatch “never events”
We are continuing to alert surgeons and hospitals to the continuing, but relatively rarely occurring, mismatches. This alert process is well embedded and is monitored regularly by the SPC. This currently covers side mismatch for knees, articulating size mismatch for hips, mixing of hip head and stems from different manufacturers, and mixing implants for primary shoulder procedures from different manufacturers. 

During 2025/26, the NJR introduced knee size mismatch as part of this process to identify size mismatches between the various femoral or tibial components.  The implant scanning tool, available for hospitals to check implant compatibility in real time in theatre has been in use over the past year, as adoption by more hospitals increases. It is hoped that use of this tool will help to reduce the overall numbers of “never events”. 

Mixed methods project
During 2025/26, the NJR has funded a mixed methods project (SOS-OPMax) which is being conducted and managed independently by the University of Bristol to explore the views of surgeons and hospitals around the NJR outlier process and to help develop an improvement tool to support surgeons. 

Future plans
•    Continued support for the outlier mixed methods project.
•    Development of routines for revision outcomes for shoulders, alongside development to make this data available to surgeons and hospitals.
•    Further work will be undertaken to roll out procedure outcomes at both trust and geographical levels, to help improve hospital performance.

NJR Implant Scrutiny Committee (ISC)
Chair’s report 2025/26 - Mr Colin Esler

The ISC comprises its Chair, Vice Chair, the NJR Medical Director, surgeon members from the RCC committee, a patient representative, representatives from the NJR’s core contractors: University of Bristol (our Lot 2 providers), NEC Software Solutions (our Lot 1 providers), representatives of the Medicines and Healthcare products Regulatory Agency (MHRA), representatives from the NJR Management Team and from the Orthopaedic Data Evaluation Panel (ODEP)/Beyond Compliance. 

Examining the data
The registry data is refreshed and analysed every six months. The committee assesses potential outlier implant performance and notifies the MHRA when there are concerns. In addition, the committee also responds to any queries and concerns raised by surgeons and regulators, undertaking additional analysis to investigate and report on these where necessary.

To date, the Patient Time Incidence Rate (PTIR) method has been used by the NJR to identify poor performance, (in line with other registries) however it became apparent that this method alone was not sensitive enough to identify failure in sub-groups or in the longer-term, and in some cases missing out on relatively early poor performance. Over the past few years, a new statistical methodology had been developed using Kaplan-Meier estimates alongside the existing method. This was introduced for hips, alongside PTIR in June 2026 and will be introduced for knees by the end of 2026. The aim is to move fully to using this methodology by the end of the 2026/27 financial year. 

An updated NJR Accountability and Transparency model for implant outlier monitoring will be published to reflect these changes, and associated engagement on this will take place with industry and key stakeholders.

A review of implant branding across the NJR continues, to ensure consistency across manufacturers and to also enable a more consistent stratification of implants as part of outlier analysis.

Future developments
A working group is currently developing the processes and methodology to enable us to monitor the performance of shoulder implants more closely, in line with the current processes for hip and knee implants. During 2026/27 a new shoulder component database allowing for improved analysis of shoulder constructs will be developed. This key development will ensure the NJR’s commitment to deeper levels of scrutiny in relation to implant performance.
 
The committee will continue to work closely with EPRD (the German registry) and ISAR (International Society of Arthroplasty Registries) on the development of an international shoulder component classification, having now agreed on adopting a comprehensive classification for hips and knees.

Implants and combinations identified as outliers
Details of implants and combinations identified as Level 1 outliers are again included in this year’s report. We encourage all surgeons to review this carefully to help inform their clinical decisions. Since the 2025 report, there has been six notifications to the MHRA for hip implants and five for knee implants (Persona PS). Details can be found here.

The X3 Rimfit cup which was previously reported to the MHRA is no longer a level 1 outlier.

NJR Medical Advisory Committee (MAC)
Chair’s report 2025/26 - Mr Tim Wilton

The Medical Advisory Committee (MAC) brings together the NJR Medical Director as Chair, along with presidents of the orthopaedic specialist societies, national clinical leaders, senior members of the NJR Management Team, alongside surgeon and patient representatives. Meeting three times each year through a combination of virtual and face-to-face formats, the Committee provides an important forum for informed discussion and professional advice across all key aspects of the NJR’s work.

The MAC continues to serve as a vital conduit between the NJR and the wider orthopaedic surgical community, enabling the exchange of insights, highlighting areas of progress, identifying any emerging concerns, and supporting the continual improvement of registry processes. I would like to thank all Committee members for their thoughtful contributions, professional expertise and sustained engagement over the past year.

I extend my sincere thanks to the presidents of the British Orthopaedic Association (BOA), the specialist societies, and our patient representatives for their valuable contributions and commitment. I would also like to welcome the incoming presidents joining the Committee this year as they take up their roles.

This has been another productive year for the MAC, with discussions characterised by collaborative problem-solving, careful consideration of evidence, and a shared commitment to patient safety, data integrity, and professional wellbeing. The Committee has continued to provide a trusted forum to explore complex and sensitive issues, whilst supporting the NJR in responding proportionately and transparently.

Supporting training and the interpretation of surgeon-level data
The impact of trainee surgeon performance has remained an ongoing area for discussion and action for MAC members. The Committee has considered concerns raised by trainer surgeons regarding the potential impact of trainee involvement on consultant-level reported outcomes. Review of NJR evidence did not support the perception that supervised trainee involvement leads to poorer outcomes. Members welcomed the steps taken by the NJR to address these concerns through professional engagement and publication. They reaffirmed the importance of sustaining high-quality surgical training alongside the fair and meaningful use of NJR data.

Strengthening processes for implant safety concerns
Another key focus during the year has been the strengthening of processes for identifying, recording and escalating concerns regarding implant performance. The Committee reviewed and supported a formalised approach, which would enable surgeons to raise concerns in writing directly with NJR leadership and the Implant Scrutiny Committee. This approach reflects learning from recent high-profile cases and provides greater assurance that early warnings are acknowledged, traceable and addressed through appropriate governance routes. The Committee also supported clear communication to promote awareness and consistent use of this process.

Local clinical governance and use of NJR reports
Members reported having noted variation in how Consultant Level Reports (CLRs) and Annual Clinical Reports (ACRs) are reviewed within local governance structures. While national policy recommends annual review as part of appraisal processes, the Committee highlighted the lack of consistently accessible guidance for organisations. MAC members supported further consideration of this issue as part of the wider review of external clinical reporting, with the aim of promoting clarity, consistency and effective governance.

Implant surveillance, thresholds, and analytical methodology
In response to wider system concerns regarding the timeliness of implant signal detection, the Committee received updates on work to strengthen surveillance processes. This includes transition to Kaplan–Meier analysis, exploration of artificial intelligence to enhance early risk identification, and engagement with system-wide investigations into signal detection and recall processes. Members emphasised the importance of the ongoing scrutiny of thresholds and careful consideration of how and when emerging concerns are communicated.

Reinforcing the purpose of Consultant Level Reports
The MAC continued to reflect on how effectively the NJR communicates the purpose of CLRs as tools for feedback and learning, rather than performance scorecards. While recognising extensive engagement to date, members identified opportunities to further refine messaging, improve clarity at the point of access, and broaden engagement with specialist societies and trainees. The Committee reaffirmed its commitment to supporting constructive interpretation of NJR data and addressing anxiety arising from any misunderstanding or misuse.

Understanding the impact of the surgeon outlier programme
The Committee maintained a strong interest in surgeon wellbeing and received updates on an independent study examining the impact of the NJR surgeon outlier programme on mental health and wellbeing. MAC members strongly support this work and have emphasised the importance of broad participation to ensure findings are balanced and representative, including perspectives from surgeons both identified and not identified as outliers. Specialist societies were encouraged to support engagement with the study to inform future development of proportionate and supportive processes.

Access to PROMs data and service evaluation
Access to Patient Reported Outcome Measures (PROMs) also remains an important focus. The Committee discussed ongoing challenges, particularly in shoulder surgery, including low national completion rates and limitations on sharing locally collected data due to consent constraints. Members recognise the implications for service evaluation, commissioning and potential duplication of effort and welcome continued work to expand national PROMs collection and to explore whether consent models might evolve to better support appropriate data sharing.

Closing remarks
The Committee has continued to play a central role in supporting the NJR’s mission to improve patient outcomes through high-quality data, robust governance and meaningful professional engagement. I am grateful to all members for their commitment, constructive challenge and collegial approach throughout the year.

I look forward to the Committee continuing its important work in the year ahead, supporting the NJR in responding to emerging challenges and opportunities with rigour, transparency and collaboration.

NJR Executive Committee (NJREC) 
Chair’s report 2025/26 - Professor Sir Paul Curran 

The NJR Executive Committee (NJREC) meets quarterly to provide additional operational and financial capability to the NJR Board’s broader strategic and governance roles. As such it facilitates faster decision-making across the large and complex range of NJR business activity. The committee is led by Chair, Professor Sir Paul Curran and in 2025/26 four meetings were held.

The committee membership comprises the NJR Chair, NJR Medical Director and NJR Director of Operations, and additional representatives comprising the NJR Board committee chairs, senior representatives of the NJR Management Team, as required, and representatives from NJR service delivery contractors. Please see the online appendices for a record of members.

The NJREC has delegated authority from the NJR Board for operational decisions that are under a financial threshold of £50,000 and for the review and approval of proposed projects and developments that constitute a change in the strategic direction of individual workstreams and previously agreed project plans. 

Given the expansion of the NJR’s work, as set out in our NJR Strategic and Annual Plans, the committee has consistently provided invaluable support to the NJR Board.
 

NJR Board
Chair’s report 2025/26 - Professor Sir Paul Curran

This section provides a brief outline of the work undertaken by the NJR Board (NJRB) and our committees during 2025/26.

Although brief, these sections illustrate the ever-increasing scope and complexity of our work and the valuable commitment made by all NJRB and committee members to ensure the work of the NJR meets the needs of our patient, clinical, regulatory and industry stakeholders.

NJR Board structure, governance and operating model
The NJRB is designated as an NHS England (NHSE) ‘Expert Advisory Committee’ and is responsible for overseeing the strategic direction and management of the NJR. Oversight of the NJR and its funding arrangements, rests with the NHSE Medical Directorate who provide delegated authority to the Healthcare Quality Improvement Partnership (HQIP) to ‘host’ the NJR on their behalf and so provide the NJR with its legal identity, data controllership and governance arrangements. HQIP also acts as service provider to the NJR, providing operational services including finance, human resources and procurement. 

A Scheme of Delegation between the HQIP Board of Trustees and NJRB provides a framework for defining the relationship between both organisations and facilitating the effective separation of legal governance and clinical leadership.

The NJR Chair meets with the NHSE National Medical Director for strategic level discussions at least twice yearly. Meetings between the NJR and NHSE Outcomes and Registries Programme (ORP) are also held regularly to discuss issues of alignment and partnership between both parties, related to development of the national Medical Device Outcome Registry platform and associated data sharing. The NJR Chair, Medical Director and Director of Operations represent the NJR.

The NJRB meets quarterly through a combination of virtual and face-to-face meetings and is responsible for setting our strategic direction and for overseeing the successful delivery of our work and closely managing the associated budget. The Board also oversees a supporting structure of our eight committees, each responsible for a dedicated area of our work and for ensuring the delivery of work plans and the development of activities against agreed objectives. All committees are accountable to the NJRB.

Key responsibilities of the NJRB are to ensure that:
•    Advice is provided to NHSE Medical Directorate and HQIP, as appropriate, on the NJR’s strategic direction, annual operational plan, work activity and financial position (including annual review of subscription charges and any proposed change). •    Appropriate advice is provided to NHSE Medical Directorate and HQIP on any financial and/or intellectual property implications associated with licensing of the ‘NJR’ brand, particularly related to international collaboration with other national orthopaedic joint registries.
•    Accurate, relevant and timely data collected by the NJR, is made available to relevant stakeholders (regulators, commissioners/providers of orthopaedic healthcare) in an appropriate format, in order to support clinical governance.
•    Appropriate stakeholders (regulators, professional societies and implant suppliers) are involved in and consulted on the work of the NJR as appropriate and informed of outcomes in joint replacement surgery.
•    The NJR budget is effectively managed and monitored.
•    The NJR committee structure is fit for purpose and all committees have clear terms of reference, agreed composition and defined purpose and responsibilities.
•    Outcomes achieved by brand of prostheses, hospital and surgeon, are monitored and, where they fall below expected performance, are highlighted to enable prompt investigation and follow-up by relevant stakeholders (implant suppliers, regulators, commissioners/ providers of orthopaedic healthcare).
•    Patient awareness of joint replacement outcomes is enhanced, to better inform patient choice and quality of experience, through engagement with patients, patient organisations and providers of care.
•    Evidence-based purchasing (quality and value) of joint replacement implants by healthcare providers is supported
•    Post-market surveillance of implants by key stakeholders (implant suppliers, the Regulator, and Beyond Compliance) is supported.
•    Delivery and quality of work by NJR contractors and the codes of conduct applied to NJR contractors in their relationship with key stakeholders, are effectively managed and monitored by the NJR Management Team.

The Annual Report on the work of the NJR is published in English and Welsh (and languages appropriate to any future countries that may be incorporated into the NJR), using patient-friendly language.