hip cover image, NJR implant procurement

Many hospitals use NJR data to inform on best value and the ‘price-benchmarking’ service that we have introduced provides the unique opportunity to benchmark the prices of implants and set this against their performance outcomes in a clinical context when considering purchasing. This in turn supports the most cost-effective procurement of orthopaedic implants and national evidence consistently illustrates significant savings in implant costs as a result of using our NJR information services.

Orthopaedic implants are used in significant volumes on a daily basis throughout the health service and represent a high spend area across organisations. We wanted to help to make sure the NHS is getting value for money with this spend.

Implant components

The NJR’s implant price-benchmarking service, which was launched in 2014, gives hospitals the information they need to benchmark the price they pay for orthopaedic hip, knee, ankle, elbow and shoulder implants against the ‘best’ national prices achieved across all hospital implant procurement services. 

Since 2017, the NJR’s enhanced implant price-benchmarking service EMBED has been included as part of the standard NJR subscription charge for all NHS trusts. This service offers greater capability to hospital procurement and healthcare management teams to drill down into their pricing data, including the additional capability to give surgeons individual reports relating to their own implant use.  

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

  • Procurement and Finance teams
  • Healthcare service management teams
  • Orthopaedic surgery departments and individual surgeons

Why use the base NJR INFORM price-benchmarking service?

The INFORM service enables 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 provided to NHS trusts, Local Health Boards and Health and Social Care Trusts in Northern Ireland as part of the NJR subscription. See ‘Accessing INFORM and EMBED’ at the bottom of the page.

Why use the enhanced NJR EMBED implant price-benchmarking service?

EMBED is our enhanced implant benchmarking service. It provides the tools to enable hospitals to understand in greater detail their use of joint replacement implants in the context of cost, evidence, and trends, in comparison to the national picture.

The 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 which means that local procurement and management teams can 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 their decision-making. The need for such dialogue underpins the Getting It Right First Time (GIRFT) and NHS Improvement’s Model Health System initiatives, by providing local-level feedback of data, set against a broader national context.

EMBED is included as part of the standard NJR subscription charge for NHS trusts in England, Local Health Boards in Wales and Health and Social Care Trusts in Northern Ireland.  

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 Registries for NEC Software Solutions Ltd, (the NJR’s data management contractor), outlines how surgeons can better understand their pricing data and how this can be accessed.

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

EMBED provides each hospital with a local EMBED Report, enabling comparison of their hospital to the national picture. The report outlines hospital information regarding the costs of joint replacement implants, highlighting where potential cost-saving opportunities might be made. The service provides implant cost data alongside clinical data, which means that providers can consider how they might make efficiency and cost savings without compromising on the quality of the joint replacement surgery provided.

Other key benefits for hospitals include: 

For procurement teamsFor surgeonsFor service managerFor finance managers
Provides an independent view of pricing competitivenessProvides cost transparencyEnables targeted  ‘Cost Improvement Programme’Supports planning
Enables development of targeted plans for savingsClinical preference considered within cost-contextEnables transparency to challenge costly implant ‘preferences’Target of ‘Cost Improvement Programme’
Spotlights ‘loss-leading’ componentsAssesses practice against implant use guidanceBuilds clearer evidence of costs versus benefitInforms funding provision needed for more complex procedures
Clarifies value-for-moneyCombines cost with clinical informationInforms valuable discussions with surgeonsEnables scrutiny of high-cost clinical choices
Enables informed discussion with surgeonsProvides common terminology  for clear discussionInforms effective cross-team-working

“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.” 

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

Accessing INFORM and EMBED

Accessing both the INFORM and EMBED implant price-benchmarking services are dependent on the payment of the annual NJR subscription

To benefit from using 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 here. Trusts must submit one spreadsheet for each manufacturer. 

Once the pricing files are provided to the NJR, 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 Connect – Data Services portal.

Please email the NJR Service Desk to arrange access to reports or to find out who the current authorised user of the service is in your organisation.

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