National Joint Registry
The National Joint Registry (NJR) was established in 2002 to improve patient care by finding out more about joint replacement implants and surgery, carried out in both the NHS and independent healthcare sector in England, Wales and Northern Ireland.
Data collection began in April 2003 and the registry now holds over 1.5 million records and more records about certain procedure types than any other registry in the world. As a result of the increasing volume and quality of data it is possible to make accurate analysis available to all stakeholders and contribute significantly to good practice and patient safety.
The NJR has collected data about hip and knee joint replacements since 2003, ankle joint replacements since 2010 and elbow and shoulder joint replacements since April 2012. Northern Ireland joined the registry in February 2013.
NJR Annual Reports analyse the data submitted to the NJR, and highlight the aims and achievements of the National Joint Registry, its Steering Committee and its sub-committees and are released in September each year. The key analyses of the NJR's 10th, and latest, Annual Report - covering 2012/13 data -were presented at the NJR’s 10th Annual Report launch and 10th Anniversary Reception event on Wednesday 25 September 2013. The Annual Report was also discussed as part of the official programme at the British Orthopaedic Association Annual Congress in Birmingham on Thursday 4 October 2013.
The structure of the NJR Annual Report is divided into four main parts:
- Part One: a general outline of the work of the NJR for the financial year 1 April 2012 to 31 March 2013. In addition to summary statistics relating to the NJR's key data quality indicators, this section includes a summary of the major activities undertaken by the NJR and individual reports on the work of the sub-committees
- Part Two: a description of joint replacement activity reported to the NJR as having been carried out in the calendar year 1 January to 31 December 2012
- Part Three: an analysis of survivorship of hip, knee and ankle replacement procedures carried out between 1 April 2003 and 31 December 2012. Data from the Hospital Episodes Statistics (HES) service, Patient Episode Database for Wales (PEDW), and the English Patient Reported Outcomes Measures (PROMs) programme are also included in the analysis
- Part Four: a series of reports about clinical activity and outcomes at Trust-, Local Health Board- and unit-level
2013 report highlights
As well as a wealth of new data to help clinicians improve the quality and outcomes of hip, knee, ankle, elbow and shoulder joint replacements, this year's report includes:
- First analysis of English Patient Reported Outcomes Measures (PROMs)
- First nine months of elbow replacement and shoulder replacement data
- Second complete year of ankle replacement data
- Data from 1.4 million procedures
- Highest-ever patient consent rates (91%)
- In-depth study: Metal-on-metal resurfacing
- Trust-, Local Health Board- and unit-level activity and outcomes data for hip and knee procedures
Previous editions of the Annual Report can be downloaded here >>
Public and Patient Guide to the 10th Annual Report (published 2013)
The NJR has produced a Public and Patient Guide to its 10th Annual Report, and was among the first registries to publish a patient guide of this type. The document takes more than 200 pages of surgical data produced by the NJR and breaks it down into more accessible and relevant information for patients.
AIMS of the NJR:
As part of the development of the 2012-14 NJR strategic plan, its aims were reviewed to take into account maturity of the registry and the NJR's growing involvement, impact and engagement with its stakeholders. These aims continue to be met, either by the NJR alone or through its work with key stakeholders and partners.
The key aims of the registry are to:
- Monitor in real time the outcomes achieved by brand of prosthesis, hospital and surgeon, and highlight where these fall below an expected performance in order to allow prompt investigation and to support follow-up action.
- Inform patients, clinicians, providers and commissioners of healthcare, regulators and implant suppliers of the outcomes achieved in joint replacement surgery.
- Evidence variations in outcome achieved across surgical practice in order to inform best practice.
- Enhance patient awareness of joint replacement outcomes to better inform patient choice and patients' quality of experience through engagement with patients and patient organisations.
- Support evidence-based purchasing of joint replacement implants for healthcare providers to support quality and cost-effectiveness.
- Support suppliers in the routine post-market surveillance of implants and provide information to clinicians, patients, hospital management and the regulatory authorities.
ORGANISATION of the NJR:NJR Steering Committee
The NJR Steering Committee oversee the strategic direction and work programme of the registry and is a DH Committee of Experts. Membership includes representatives of the surgical profession, patient groups, orthopaedic implant suppliers, public health/epidemiology, NHS purchasing and supply agency, Medicines and Healthcare products Regulatory Agency, NHS Trust Management, Independent Healthcare Sector, and the Welsh Government.
HQIP supports the work of the steering committee, including the implementation of its strategic plans and development work on its behalf. HQIP manages the levy payment collections and holds the budget of the steering committee. The development team in HQIP, led by Elaine Young, supports the NJR.Regional Clinical Coordinators Network
Regional Clinical Coordinators are consultant orthopaedic surgeons who act as NJR local ‘champions' to ensure that the benefits of the NJR are understood and encourage compliance with NJR data requirements.NJR Centre
The NJR Centre manages the development and running of the NJR database for all data collection and analysis. It is managed by Northgate Information Solutions (UK) Ltd under contract with the Healthcare Quality improvement Partnership, (and previously with the Department of Health).Levy
The NJR is self financing and funded through a levy raised on the sale of hip, knee, ankle, elbow and shoulder replacement implants. The rate of levy is set by the NJR Steering Committee in consultation with the Department of Health. Participation
Data submission for NHS organisations to the National Joint Registry of England and Wales (NJR) has been confirmed as mandatory by the Department of Health and Welsh Government.
The NJR joins the rest of the National Clinical Audit and Patient Outcomes Programme (NCAPOP - commissioned and managed by HQIP), which has been confimed as mandatory with all other projects under the NHS Standard Contract for Acute Services as of 1 April 2011.
The NJR newsletter (Joint Approach) is published quarterly and is full of useful information. View the latest and previous copies here >> NJR Website:
Further details can be found on the NJR website
with regular updates published on the NJR News and Events page