Enhancing data quality – through our NJR audit processes

NJR Data Quality Audit programmes

NJR data creates the ability to drive forward change, influence best practice, undertake important research and ultimately maximise patient safety and outcomes. High-quality data are the foundation of any joint replacement registry and now, with over 4.6 million procedure records, our valuable data is a fundamental driver to help inform improved quality of care for patients, so it is imperative that the data provides an accurate and complete picture.

The NJR’s programme of work to improve the quality of our data has been a key focus in recent years, driven through the NJR’s Data Quality Strategy. Key to this strategy has been our national programme aimed at assessing data completeness and quality within the registry and we conduct our audit programme to retrospectively check the quality of data within all hospitals reporting to the registry, on an annual basis.

The NJR’s Data Quality Audit has been running as an annual activity that comprises a local hospital providing an extract of data from the local hospital administration system, since 2014. This data is compared (or matched) against the submitted NJR registry data, and any missing records or discrepancies are reported to the hospital within an audit tool, for these to then be corrected.

Moving to an automated process some years ago enabled users to upload the PAS data file directly onto the registry via the system – and to then view the results of the audit on screen. This streamlined the process greatly for hospital staff in providing greater usability and more control of locally submitted data. This also enabled the accessibility to submit and check data at any time during the year, therefore maintaining quality compliance figures throughout the year and. Auditing in this way serves as an early alarm trigger for any potential missing or inaccurate records, enabling more timely action to address any instances.

NJR Data Quality Audit 2025/26

The deadline for the FY25/26 Data Quality Audit was 30 September 2026.

To qualify for a Quality Data Provider Award, hospitals needed to upload a clean set of audit data by 31 August 2026. 

NJR Data Quality Audit 2026/27

From 1 July 2026, the data quality audit for the year 2026/27 will be open to hospitals. 

For the 2026/27 audit, new ICD10 codes to audit fixation of periprosthetic fracture for hip and knee procedures have been included. These procedures are collected on the reoperations other than revisions (RO) form, that we introduced in June 2023.  

This is the first audit year these codes have been included and they should only be used to audit cases from 1 April 2026.  

Click here to see the new codes spreadsheet 

You can find a flowchart outlining our audit processes here.

Any queries regarding data quality audits can be addressed to Maggie Tate, Data Quality Officer for the NJR at Maggie.Tate@necsws.com

We have published a paper on how we have developed the NJR data quality audit programme here: https://online.boneandjoint.org.uk/doi/full/10.1302/2633-1462.39.BJO-2022-0051.R1

Other NJR Audits

Ankle audit

As the practice of ankle replacement surgery continues to grow worldwide, the importance of maintaining accurate and complete data on patient outcomes has never been greater. Since the collection of ankle replacement data began in 2010, the NJR has recorded nearly 13,000 ankle procedures, providing one of the most valuable sources of evidence for monitoring implant performance and supporting improvements in patient care.

Ensuring the accuracy and completeness of data remains a key strategic priority for the registry.

An annual automated data quality audit process for ankle replacement surgery was introduced in April 2020, but this only assesses more recent data submissions. Concerns have since been raised about the completeness and accuracy of historic ankle joint replacement records that pre-date the automated audit process. In response, the NJR Data Quality Committee (DQC) has proposed supporting a British Orthopaedic Foot & Ankle Society (BOFAS) initiative to review and improve the existing ankle replacement dataset.

The primary aim of this audit is to identify and address missing ankle joint replacement procedures within the registry. A comparison of Hospital Episode Statistics (HES) data with the current NJR ankle dataset has identified 2200 ankle procedures recorded in HES that are not currently reflected in the registry. Closing this gap will improve the completeness of registry data, strengthening our ability to support clinical practice, research, implant surveillance and patient safety.

At a later date a further audit may be developed to check for potential inaccuracies in any of the data.

The deadline for completing this audit is 31 March 2027.

If you have any questions, please email us at ankleaudit@njr.org.uk

Elbow audit

In 2023, we conducted a dedicated audit of elbow data, to ensure our data was the best it could be. We managed to almost double the number of elbow procedures on the registry.
You can find more about this audit here.

Shoulder audit

In 2024, we conducted a similar audit of shoulder replacement surgery with the aim of finding missing or inaccurate shoulder procedure records to investigate and try to resolve, to also be added into the registry.
You can find more about this audit here.

NJR Quality Data Provider Scheme

The ‘NJR Quality Data Provider’ (DQP) scheme offers hospitals public recognition for achieving excellence in supporting patient safety standards through their compliance with the mandatory NJR data submission quality audit process.

By awarding the NJR Quality Data Provider certificates annually at the end of the audit process, the scheme rewards only those hospitals that have achieved the highest standards.

You can find out more about the award achievement criteria here