Highlights: NJR Feedback services

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 2016/17, as in other years, the service continued to be developed in 2016/17 in order to provide more information to surgeons:  more enhancements are planned for 2017/18. 

Following on from the ‘Primary Procedure Status Report’ which was implemented last year, this year saw the implementation of the ‘Revision Procedure Status Report’.  The report uses the same 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.  This will enable surgeons to identify the outcomes of any revisions that they completed.  The report will identify revisions of revisions but will not be provide any information about subsequent revisions.  Currently the number of revisions of revisions in the database is insufficient to warrant the development of such a report.  It remains, however, an option for future development.

In addition to a consultant’s individual ‘Consultant Level Report’ surgeons now have access to the Annual Clinical Report for those Trusts and hospitals in which they have recorded activity in the reporting period.

A number of enhancements are also planned for 2017/18 and these include:

  • A general restructuring of the menu options and some re-branding to make the service easier to navigate
  • The inclusion of shoulder, elbow, and ankle reports.  These will be ‘counts’ rather than ‘outcomes’ reports
  • The ability to identify a revising consultant and hospital where they are different from the primary consultant and hospital.  This has been permitted in the interests of clinical audit
  • A facility for a consultant to acknowledge that they have downloaded and read their Consultant Level Report.  This has been developed in conjunction with the BOA and will be reported on in the Annual Clinical Report
  • Price Benchmarking EMBED reports will be made available to surgeons who work in those NHS England trusts and NHS Wales Health Boards which provide implant pricing to the NJR

The Consultant Level Report will also be enhanced to include the addition of a surgeon’s unique NJR ID to the front cover of the report, the identification of the revising consultant and hospital where these are different to the primary consultant for all tables showing ‘Linked/Attributable Revisions’ and changes to some funnel plots to aid clarity.

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, during 2017/18, EMBED reports will be made available to all NHS England trusts and NHS Wales Health Boards as part of the NJR subscription.  To date, EMBED has been attracted an additional subscription.  For more information about INFORM and EMBED, please see the section ‘Price Benchmarking’.

Further changes to the Annual Clinical Report are planned for 2017/18, including additional funnel plots, 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), ten year revision rates for hips and knees, and 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 report will, this year, be published in November.