NJR Funding arrangement
Delivery of the NJR’s strategic work programme is funded through a mandated annual subscription charge which is based on the contractual costs of running the Registry and the work programme agreed. The charge is made up of a levy on each hip, knee, ankle, elbow and shoulder procedure carried out by each hospital or trust.
NJR's income is overseen by the NJR Steering Committee and is a restricted fund, spent in accordance with the agreed strategic plan.
The NJR Executive Committee undertakes an annual review of the pricing and resources required for delivery of NJR’s strategic work programme and to ensure continued value for money in the delivery of NJR’s range of products and services. This exercise is underwritten and agreed by the NJR Steering Committee and validated by NHS England.
Funding arrangement April 2003 to March 2014
Until 31 March 2014, the NJR levy payment on hip, knee, ankle, elbow and shoulder implants was collected from purchasing hospitals by orthopaedic device manufacturers. Manufacturers processed the levy on behalf of the NJR and then made the payment to the registry. In return for their role in administering the levy, manufacturers charged a supplier administration fee which was included in the calculation of the levy.
Therefore, the NJR levy comprised the NJR element (i.e. the amount per joint retained to run the NJR) and a supplier administration fee, with the applicable rate of VAT.
Current funding arrangement
From April 2014, the way that the levy charge is collected changed to the current subscription model, to enable significant NHS savings to be made across England, Wales, Northern Ireland and the Isle of Man.
With effect from the 1 April 2018, the NJR levy is a rate of £16.22 [gross], £13.52 [net] per procedure.
Each provider organisation is issued with an annual invoice directly from the Healthcare Quality Improvement Partnership (HQIP) for an NJR subscription charge based upon the provider's prior year's procedure volume.
Joint replacement operations subject to charge
Operations using the following implants are subject to the NJR charge:
- Hips: a one-piece (monobloc) acetabular cup or a modular acetabular cup outer component.
- Knees: any knee femoral component (including the femoral component of a unicompartmental or patellofemoral joint) or one-piece knee prosthesis.
- Ankles: the talar metal component.
- Elbows: a radial head component or an ulnar component. For clarity, this includes the Ulnar component (linked and unlinked), pre-assembled elbow system supplied as a unit, radial component monobloc, radial modular stem and radial lateral resurfacing head.
- Shoulders: a humeral stem. For clarity, this includes the humeral head and stem monobloc, humeral stem modular and humeral resurfacing component.