National Joint Registry

The National Joint Registry (NJR) was established in 2002 to improve patient care by finding out more about hip and knee joint replacement implants and surgery, carried out in both the NHS and independent healthcare sector in England and Wales.

Data collection began in April 2003 and the registry now holds over 1 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.

Download the 8th Annual Report (2011) here >> 

The report, which covers the period 1 April 2009 to 31 March 2010, is divided into 3 main parts:

Part one - a general overview of the work of the NJR for the financial year 1st April 2010 - 31st March 2011. This provides statistical highlights of the data provided during 2010/11, summarises major developments, and outlines proposed work for 2011/12.

Part two - a description of hip and knee joint replacement activity as reported to the NJR in the calendar year 1st January - 31st December 2010. Also included here is limited reporting on ankle joint replacement surgery, which became part of the NJR as of 1st April 2010.

Part three - this provides an analysis of survivorship of hip and knee joint replacement surgery, using data submitted to the NJR from 1st April 2003 - 31st December 2010. Data from the Hospital Episodes Statistics (HES) service and the Patient Episode Database Wales (PEDW) is also included in the analysis.

Previous editions of the Annual Report can be downloaded here >>

UPDATE:  Public and Patient Guide to the 8th Annual Report (published 2011)

The NJR has produced a Public and Patient Guide to its 8th Annual Report.  The NJR is among the first registries to publish a patient guide of this type.  The document takes over 150 pages of surgical data produced by the NJR and breaks it down into more accessible and relevant information for patients.

Aims of the NJR:

In establishing the NJR, a clear set of aims were defined. These aims have remained constant and continue to be met with varying degrees of success, either by the NJR alone or through its work with key stakeholders and partners. To date, work has largely focused on improving data coverage and data quality. The latest Strategic Plan can be downloaded here.

The main aims of the registry are to:

• ensure patients obtain the best clinical care during and following their joint replacement operation
• improve surgical practice through identification of best practice
• highlight in real time any brand of prosthesis showing high failure rates, and allow prompt removal from the market, if necessary
• improve evidence-based purchasing of joint replacement implants for orthopaedic units/hospitals
• improve patient awareness of hip and knee joint replacement outcomes
• provide patients, clinicians, healthcare providers and commissioners, regulators and implant suppliers with evidence of which are the best performing implants.

Organisation of the NJR:

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).

NJR Steering Committee

The NJR Steering Committee oversee the work programme of the NJR Centre and performance manage its delivery. In 2005 the NJR Steering Committee was designated an Advisory Non-Departmental Public Body. 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 Assembly 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.

Levy:

The NJR is self financing and funded through a levy raised on the sale of hip and knee 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.

The NJR joins the rest of the National Clinical Audit and Patient Outcomes Programme (NCAPOP - commissioned and managed by HQIP), which saw confirmation earlier this year of the mandatory status of all projects under the NHS Standard Contract for Acute Services as of 1 April 2011.

NJR Newsletter:

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.