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Who oversees the consultant outcomes publication programme?
NHS England piloted consultant outcomes publication (COP) in 2013 for ten specialities, as stated in the then planning guidance for 2012/13 (then NHS Commissioning Board). Orthopaedics was one of the first ten specialties to publish data at individual consultant-level at and via NHS Choices

Since then, it has extended to thirteen specialties and the programme seeks to develop each year to include additional quality measures and present surgeon-level information to patients and the public domain as part of the delivery of the NHS openness and transparency programme. 

NHS England has also mandated publication of consultant outcomes through the NHS Standard Contract and individual consultant consent is not required for those surgeons identified as being in scope.

For orthopaedics, the initiative will continue to be developed in partnership with the BOA, the BHS, BASK and this year, BOFAS and BESS. The NJR is the supporting national clinical audit and its Surgeon and Hospital Profile system will continue to publish and present the information.

The Healthcare Quality Improvement Partnership continues to oversee the delivery of the whole consultant outcomes programme, working closely with NHS Choices, the Royal College of Surgeons, plus the specialist societies and clinical audit project teams for each specialty.

Who agrees on the activity measures and outcomes for publication?
The British Orthopaedic Association, specialist orthopaedic societies and the NJR continue to work together to agree on the proposals and plan for publication each year. The activity and outcomes indicators are also then agreed with the HQIP consultant outcomes publication team who manage the programme on behalf of NHS England.

When will the next round of indicators be published?
A refresh of the existing data as well as any developments for 2015 are planned for publication on Monday 30 November 2015 at and NHS Choices.

What will be added or changed for orthopaedic outcomes publication in 2015?

Additions and changes for the profiles include: 
  • Confirmed for 30 November 2015: inclusion of patient case-mix information covering gender, age, BMI, ASA 3+ and diagnosis other than OA
  • In development for 2015: Surgeon-level NJR compliance rates for primary and revision procedures (based on NJR data submissions compared to HES data) - subject to HES data release and data verification prior to publication

Additions introduced in 2014 also continue, including:

  • 36-month as well as 12-month practice profiles 
  • For hips only: Use of ODEP-rated hip cup and hip stem implants as a proportion of total practice (excluding no rating)
  • Indicator to show time passed since first procedure submitted as Consultant in charge
  • Ability for surgeons to add additional profile information (photo, specialty, qualifications, membership) to their profiles and this continues to be managed through NJR Clinician Feedback. Surgeons will be informed when this function is available prior to official publication
  • The design, context and information provided at to help patients use and understand the presented data. This will be done in partnership with the BOA and specialist societies and supporting patient groups including the NJR Patient Network
  • Ability to search consultant surgeons and hospitals by A-Z and by region
Why is the deadline for the verification of mortality data Friday 14 August? Hip and knee only
A minimum of eight weeks is needed to process the data and carry out the mortality analysis as well as undertake additional quality checks on the surgeon-level information in advance of publication on the NJR website. There is also a requirement to provide the assured data to NHS Choices a minimum of four weeks in advance of publication. This is to allow time for the processing and testing of the data in the Choices format before it goes live through Choices 'myNHS' website.

This cut of data also informs the latest round of outcomes analysis for the separate implant performance and surgeon and unit monitoring (activities related to potential outlier identification) and as a result there is a limited amount of flexibility in the overall programme of activity. The NJR cuts its data for these purposes twice a year, once in February and once in August.

The data for publication, displayed in its 'preview' format is likely to be available to surgeons to view via NJR Clinician Feedback in October. At this time, surgeons will also be able to submit any additional profiles information - including a photo, specialty areas and professional membership(s).

What is the deadline for the verification of procedure volumes? All joints
Please note that volumes data associated with consultant outcomes publication can be checked and amended up to 30 September 2015.

It should also be noted that data collection for the NJR is mandatory and ongoing. Activity and outcomes data can be accessed and validated at any time through a number of tools including reports available through the NJR Regional Coordinators, NJR Clinician Feedback and the Consultant Level Report.

The NJR Regional Coordinators are a local support and can offer advice and support in doing this and you can find out who your Regional Coordinator is here

How do Consultants know if they were in scope?
The ongoing and agreed definition of scope is any surgeon with one or more NHS-funded hip, knee, ankle, elbow or shoulder procedures recorded in England between 1 April 2014 and 31 March 2015 as Consultant in charge.  The NJR will write to all surgeons in scope each year to inform them of proposals for publication.

In addition to information published on the NJR website, BOA website, via eBulletins and additional email circulars, the NJR will write every year to all surgeons who are within scope of publication. This is based on current procedure data in the registry.

What is the individual consultant-level report referred to in correspondence?
This is a newer feature in NJR Clinician Feedback, introduced in 2014 for hip and knee surgeons. This Consultant Level Report has been developed for the purposes of appraisal and revalidation and is available to hip and knee surgeons with more than five procedures recorded as Consultant in charge (total practice).

The report can only be accessed by surgeons through NJR Clinician Feedback. Activity and mortality data in this report will help consultants to validate their recorded activity and mortality events in advance of the publication of NJR data for consultant outcomes publication and on an ongoing basis. Some of the data included in the report is not related to consultant outcomes though the NJR would encourage surgeons to validate all the data held in the database about their practice.

In the consultant level report there is:

  • 12-month and 36-month practice profiles
  • Use of ODEP-rated hip stem and hip cup prostheses
  • 90-day mortality rate and recorded mortality events 
When will the public facing profiles be available to preview?
The preview public facing profiles will be available through NJR Clinician Feedback for all surgeons in October, prior to their publication on 30 November 2015.  At this time, surgeons will also be able to submit any additional profiles information - including a photo, specialty areas and professional membership(s). Please stay up to date via the NJR website and the NJR eBulletin (sign up here).

How are small numbers of procedures displayed on the website?
Consultants in charge showing less than five procedures will have numbers masked on the NJR Surgeon and Hospital Profile site in accordance with the Office of National Statistics small numbers policy. This does not apply on the NHS Choices website.

How are new Consultants in charge identifiable to patients?
An indicator showing time passed since first procedure submitted as Consultant in charge will be included on the activity profiles.

What if records are too few, too many or incorrect?
Please speak to or email your local NJR Regional Coordinator in the first instance who will be able to advise you. This includes possible liaison with the hospital data manager to ensure that all records relating to 14/15 have been entered and whether any missing records can still found in the 'edit stack' i.e. they are being held back from submission to the NJR system because of incomplete or incorrect information.

As outlined in NHS England and HQIP’s previous correspondence to Medical Directors, data should be correct at point of entry, with validation designed to pick up any minor errors that may slip through. If a consultant finds data to be very inaccurate, this matter should be addressed within the Trust. The NJR would urge consultants to speak to their Medical Director as soon as possible about any required verification activity and find out more about the NJR's wider plans for checking the quality of data. Find out more here.

FAQs last updated 20 July 2015

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