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Who oversees the clinical outcomes publication programme?
NHS England piloted clinical 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 clinician-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 clinician's 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 the national clinical audit and it's 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 clinical outcomes programme, working closely with NHS Choices, the Royal College of Surgeons, along with 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 clinical 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 2018 are planned for publication after the surgeon review period between 26th November and 9th December 2018.

They will be published thereafter on, and in Spring 2019 on NHS Choices.

The data for publication, displayed in its 'preview' format is available to surgeons to view via NJR Clinician Feedback during the two week period. 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 9th December 2018.

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 NJR 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 2017 and 31 March 2018 as Consultant in charge.  The NJR will communicate directly with all surgeons in scope each year to inform them of proposals for publication..

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 after 9th December 2018.  During the two weeks prior to this date, surgeons will also be able to submit any additional profiles information - including a photo, specialty areas and professional membership(s).

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 17/18 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 14th November 2018

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