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NJR Implant price-benchmarking

Orthopaedic implants are used in significant volumes on a daily basis throughout the health service, and represent a high spend area with noticeable variation in pricing across organisations. In 2014, the National Joint Registry launched its implant price-benchmarking service to the NHS to help procurement teams and healthcare management understand in greater detail the pricing of hip and knee replacement implants in comparison to others.

The NJR's implant price-benchmarking service comprises a foundation ‘INFORM’ and advanced ‘EMBED’ reporting element. The service gives Trusts, Local Health Boards and providers the unique opportunity to benchmark the price they pay for orthopaedic implants against the ‘best’ national prices achieved. 

From 2017/18, the NJR’s enhanced implant price-benchmarking service EMBED is included as part of the standard NJR subscription charge for NHS Trusts.  This service offers greater capability to hospital procurement and healthcare management teams to drill down further into their pricing data, including the ability to give surgeons individual reports relating to their own implant use.  

The implant price-benchmarking service is for collaborative use by:

  • Procurement teams
  • Finance teams
  • Healthcare service management teams
  • Individual surgeons and orthopaedic departments

Is this available to independent (private) sector organisations?

Not yet, but work is currently taking place to see how the NJR's implant price-benchmarking service could become available to independent sector organisations. The base service originated from a Department of Health QIPP sponsored pilot programme and as such its has been prioritised for NHS organisations.


Why use the base INFORM price-benchmarking service?

 

This first set of tools allows procurement and management teams to benchmark against average and best quartile prices from the organisations currently providing data as well as features that allow the data to be presented by brand and by surgeon use.

Download the list of reports available in the foundation INFORM service (▼)

The base implant price-benchmarking service is free to Trusts and Local Health Boards and is included in the cost of the NJR subscription. See 'Accessing INFORM and EMBED' at the bottom of the page.


Why use the enhanced EMBED implant price-benchmarking service?

 

EMBED is the National Joint Registry’s enhanced implant benchmarking service. It helps NHS Trusts and local Health Boards understand in greater detail their use of joint replacement implants in the context of cost, evidence, and trends, in comparison to the national picture.

As healthcare providers experience increased pressure to control costs, this service provides information and resources to aid hospitals and surgeons understand local implant costs, in a clinical context, and how these compare to national benchmarks.  

EMBED provides data at a trust level allowing local procurement and management teams to drill into their pricing data.  The service also provides personalised data relating to implant use and costs to each individual surgeon.

The primary aim of the service is to provide insight to local organisations to support local dialogue.  The service provides clinicians, management, procurement and finance teams with an objective set of data and analysis to inform local review and decision making.  The need for such dialogue underpins the Getting It Right First Time (GIRFT) and NHS Improvement’s Model Hospital initiatives, providing local organisations feedback of their data, set within a national context.

EMBED is included as part of the standard NJR subscription charge for NHS Trusts in England and Wales.  

Download a list of the reports available in the advanced EMBED service (▼)
Download the EMBED information leaflet (▼)


VIDEO: Making the most of the NJR's pricing data

 

Richard Armstrong, Head of Health Solutions (Northgate Public Services), outlines how surgeons can better understand their pricing data and how this can be accessed. This video was presented as part of the NJR's 'mini-theatre' exhibition stand programme at the British Orthopaedic Association's (BOA) Annual Congress.

Download the presentation slides via the NJR website here (▼)



How much could hospitals identify in the way of savings? What are the benefits?

 

EMBED provides each Trust or Health Board with a local EMBED Report, providing comparison of their organisation to the national picture. This provides the local team within the hospital information regarding the costs of joint replacement implants, highlighting where potential cost saving opportunities may exist.  The service provides implant cost data alongside clinical data, providing a tool for providers looking to make efficiency and cost savings without compromising on the quality of joint replacement surgery afforded to patients. Trust EMBED reports are available through the NJR Management Feedback system.

The award winning pilot scheme, on which the service is based, demonstrated that savings could range from £50,000 per year to upwards of £200,000. Other key benefits include: 

For procurement

For surgeons

For service managers

For finance managers

Independent view of pricing competitiveness

Cost transparency

Target of 'Cost Improvement Programme'

Support planning

Develop targeted plans for savings

Clinical preference

Transparency to challenge costly preferences

Target of ‘Cost Improvement Programme’

Spotlight ‘loss-leading’ components

Assess practice against guidance

Build evidence

Inform funding for complex procedures

Clarify value-for-money

Combine cost with clinical information

Inform discussion with surgeons

Assess high-cost clinical choices

Inform discussion with surgeons

Common language for discussion

 

Inform effective team-working


Dr Paul Buss, Medical Director and Deputy Chief Executive, Aneurin Bevan University Health Board said:


"The NJR EMBED service has provided NHS Wales with a clear picture of hip replacement implant usage trends across all Health Boards in Wales. The information highlighted variation in approach and provided a platform for engagement with orthopaedic surgeon colleagues from across Heath Boards to discuss the rationale behind the trends outlined. Subsequently, in conjunction with lead surgeons and based on the evidence, NHS Wales have issued recommendations for a prudent procurement approach to hip replacement in the NHS in Wales. The work of the NJR has been incredibly helpful." 


Accessing INFORM and EMBED

 

Accessing both the INFORM and EMBED implant price-benchmarking services are dependent on the payment of the annual NJR subscription and any other additional charges that may apply (dependent on NHS or independent sector status). 

To participate in this service, each trust needs to submit their implant component prices, in confidence, to the NJR Price Benchmarking (PB) Support Service at njr.centre@nhs.net.

The pricing submission template, which includes detailed instructions, can be downloaded from the (top) right-hand side of this page under 'Downloads'. Trusts must submit one spreadsheet for each manufacturer. 

Once the pricing files provided to the NJR PB team have been verified and validated, the data is automatically matched to the NJR procedure data and reports are produced. Nominated users within each Trust are provided with access to Trust-level reports for circulation, as necessary. In addition, all surgeons within the Trust are able to review their own NJR-related practice with individual-level reports through the NJR Clinician Feedback portal.

Please email njr.centre@nhs.net to arrange for access and to find out who has been contacted in your hospital about the implant price-benchmarking scheme or who the current authorised user of the service is.


  
  
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