How does the National Joint Registry's work benefit me? How can I become a part of the NJR's Regional Support network? Who are the working groups the NJR works with? We aim to answer all your questions whether it be in person at a conference, in our Annual Report and weekly reports or here on out website

NJR Working Groups

We work on some of the following specific NJR activities in smaller, regular working group meetings that are comprised of relevant representation of our team and stakeholders. The purpose of these smaller, more specialised and specifically focussed groups is to consider, align and improve the way that we do things; or to develop solutions to some of the challenges we encounter across our work. The status of these working groups is dependent on our NJR work priorities.

Data Alignment Working Group

The NJR Board (NJRB) agreed to develop a strategy for the alignment of outputs from across the NJR to ensure that data are reported in a consistent way regardless of where the analysis is conducted.

The group’s main purpose is to determine the scope of this exercise. Upon agreement of the scope, the group have been responsible for the monitoring of delivery of this work programme. The Chair of the group is Professor Mark Wilkinson. The Data Alignment working group reports to the NJREC.

The main functions of the group are:

  • To consider a scope for the programme of work to align outputs across the NJR, this will include but is not limited to NJR surgeon, unit and implant performance work-streams; NJR annual report; NJR supplier feedback reports; NJR clinician and management feedback; NJR online annual report; StatsOnline; Surgeon and Hospital Profile; NJR Annual research programme; Extracts for external research projects.
  • To agree where it is appropriate for outputs to align and where it may be rational and appropriate for differences to emerge.
  • To assess whether analyses are taking place in the right place (Lot 1 and Lot 2) and whether there is any duplication between analyses that can be resolved.
  • To assess the data management and analysis pathways to include organisation of the data, data cleaning and validation and extraction of the data.
  • To provide a written scope, to be signed off by the NJREC, detailing the agreed delivery requirements for this work programme.
  • To develop key performance indicators for the ongoing monitoring of this work programme.
  • To monitor and oversee the delivery of this work programme to completion.

Minimum Data Set Working Group (MDWG)

Our Minimum Data Set (MDS) is the specification of the data items that hospitals submit to the registry, and this is reviewed by a specialist group every few years to ensure we are capturing the right information and to update with newer developments such as robotic surgery which have been increasingly used in recent years.

The purpose of the MDWG is to review and provide guidance on any proposed changes to the NJR minimum dataset for the different primary and revision joint replacements covered by the NJR. The MDSWG reports to the Chair of the NJR Data Quality Committee, currently Mr Derek Pegg.

The main functions of the MDSWG are:

  • To review and consider:
    • The need to keep the MDS up to date and enable monitoring of changes in practice.
    • The need to be able to analyse the data collected.
    • The effect of changes on the structure of the database maintained and the subsequent effect on NJR structures and outputs.
    • The effect of any changes on the data already held in the database and whether such changes would lead to a restriction in the size of the dataset available for analysis.
    • To ensure standard definitions of interventions and end points of interest are maintained across all of the MDS forms.
    • Any cost and administrative changes that may be imposed by changes.
    • Scientific scrutiny of proposed changes
    • Any other factors that the group consider relevant.
  • To make recommendations on changes to the MDS to the NJR Board (NJRB).
  • To ensure version control is accurately recorded within the registry.

PROMs Working Group

The NJR Board (NJRB) agreed to develop a strategy for the collection of NJR-led patient-reported outcomes measures (PROMs) and a group was brought together to include our patient representatives to determine the viability of NJR-led PROMs activity including appropriate instruments, mode of administration, timing of collection and other practical considerations.

The PROMs working group reports to the NJR Research Committee. Professor Mark Wilkinson is the Chair of the group and the Research Committee

The main functions of the group are:

  • To assess the feasibility of delivery of a programme of PROMs data collection.
  • To develop links with key stakeholders including the national PROMs programme and key NHS delivery partners carrying out routine PROMs nationwide.
  • To evaluate possible modes of administration including paper-based and electronic methods.
  • To evaluate opportunities by reviewing PROMs activity in other territories.
  • To consider appropriate instruments for each cohort of patients, using the best available evidence.
  • To develop an outline of options and business case for pilot work.

Shoulder and Elbow Working Group (SWG)

The NJR currently undertakes outlier analysis for hips and knees for implants, surgeons and hospitals. Following work to improve the data quality for shoulder procedures within the NJR, it is recognised that the NJR could extend the scope of this work to include upper limb joints.

The purpose of our SWG is to explore the viability of reliable outlier analysis for shoulder and elbow implants, units and surgeons and develop proposals for their management within the NJR to promote patient safety. The SWG reports to the NJR Implant Scrutiny Committee (ISC). The Chair of the group is Professor Amar Rangan.

The main functions of the SWG are:

  • To explore the viability, timeline and processes in order for the NJR to manage upper limb outliers in relation to implants, hospitals and surgeons.
  • To review considerations for the inclusion of PROMs to support outlier status.
  • To assess the impact of any proposed process to manage shoulder outliers in relation to other NJR outputs including:
    • Outlier analysis for implants, surgeons and hospital.
    • Implant analysis included in the Annual Report and reported on at brand level.
    • Outputs including NJR supplier feedback data files and IQM reports.
    • NJR Price Benchmarking for trust and surgeon summary reports.
  • To agree criteria to confirm when an implant brand can be divided or merged.
  • To ensure any processes for the management of upper limb outliers are in scope with the purpose of the NJR.
  • To make recommendations on the process to manage upper limb implant, hospital and surgeon outliers to the NJR Board, NJR Surgical Performance Committee and NJR ISC Committees.
  • To evaluate any other factors that the group consider relevant.

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