There are initiatives that are not included with the NJR but which are dependent upon NJR involvement and support.
The NJR continues its support for Beyond Compliance, an initiative set up to support the safe and stepwise introduction of new or modified joint replacements. An independent panel of experts, known as the Beyond Compliance Advisory Group, work with manufacturers of new or modified orthopaedic implants to assess the relative risk of any new product, and the rate at which it should be introduced to the market. Beyond Compliance collects and analyses outcomes data on the in-market performance of these implants. With the consent of the patient, Beyond Compliance collates data from NJR, national PROMs data, and data uploaded by the implanting surgeon. This data is made available to surgeons using the implant, to the manufacturer and to independent assessors from the Beyond Compliance Advisory Group, to provide real-time monitoring of the implant’s performance.
The Group monitors early performance of implants, in order that any potential problems relating to a product or its surgical use can be identified before large numbers have been implanted. The initiative supports graduated implant introduction, to reduce the likelihood of widespread dissemination of implants before any weaknesses are identified in real-world use.
Further information about Beyond Compliance and the details of the implants currently registered for the service can be found at the Beyond Compliance website www.beyondcompliance.org.uk.
During implementation of the new NJR data collection system (MDSv7) changes were made to allow hospitals to record patient consent to Beyond Compliance within the NJR system. This prevents hospital users from having to duplicate data entry or from having to access two separate systems in relation to a joint replacement patient. This development has been warmly received by Beyond Compliance stakeholders and hospital data entry users.
The Orthopaedic Data Evaluation Panel (ODEP) was established in 2002 to monitor National Institute for Health and Care Excellence (NICE) guidelines on primary hip implants. This was extended to knees in 2014 and the inclusion of shoulder implants in 2017.
ODEP assigns ratings to implants based on a simple and independently verified assessment of implant performance, assessed against national clinical guidelines. ODEP uses data from multiple sources to make those assessments, including data from the NJR.
The NJR enables manufacturers to access and review data on their implants via NJR Supplier Feedback, which can form part of the evidence submitted by manufacturers to ODEP as part of the assessment process. For further information about ODEP and ODEP ratings, please visit the ODEP website at www.odep.org.uk.
In 2017, NJR implemented a number of changes to its implant database, providing greater granularity on the classification of implants. NJR consulted ODEP on this development, recognising the potential uses of this data in providing greater distinction between products with different underlying characteristics within the same product brand. ODEP and NJR continue to work closely in the scrutiny of implant data to provide assurance regarding long-term patient outcomes.