NJR Regional Clinical Coordinators (RCCC) Committee

On behalf of the Regional Clinical Coordinators Committee (RCCC) I’d like to highlight the breadth of activity and impact achieved over the past year. Once again, it has been a privilege working with Regional Clinical Coordinator (RCC) colleagues, as well as senior members of the NJR Management Team and our contractor colleagues at both NEC and the University of Bristol. We were very pleased to welcome Mr Sameer Jain as a new member on the committee back in April 2025, to represent the British Hip Society.  

The RCCs play a vital role in supporting the work of the NJR. They provide clinical leadership, oversight and expert guidance across a range of priority areas. These include strengthening data quality and supporting underperforming hospitals, as well as this year contributing to national discussion on training and service improvement. Our RCCs are central to help drive forward quality standards, transparency and continuous improvement in joint replacement surgery. 

This year, concerns were raised by the British Hip Society (BHS), alongside the Specialist Advisory Committee (SAC) and the British Orthopaedic Training Association (BOTA), regarding the potential unintended impact of the NJR surgeon performance analysis on UK joint replacement training. Specifically, it was suggested that some consultants may be less willing to allow trainees to lead procedures due to concerns about the impact of this on the consultant’s personal revision rates, and the risk of these procedures accumulating to the point of being identified as an outlier, when the resulting higher rates of revision are compared with those of their peers. 

NJR analysis does not support this concern, but it was acknowledged this may be one of a number of factors stifling a trainee’s ability to perform joint replacement surgery and risking the capacity to achieve the minimum requirements for completion of training. RCCs discussed potential solutions, including enhanced training log-books to promote appropriate consultant supervision and help preserve training opportunities. Additionally, the NJR was able to support the BHS, British Association of Surgery of the Knee (BASK), and BOTA with an excellent article, published in December 2025, Journal of Trauma and Orthopaedics. You can find this here in the JTO – December 2025 (pages 32-25). 

RCCs have continued to play a role in supporting any underperforming hospitals in their region, reinforcing the importance of strong clinical engagement in improving data quality and compliance, and in supporting areas of work such as the collection of patient consent, which remains a critical metric for the NJR. Through the recently revised NJR escalation process, referred organisations have more routinely engaged with improvement activities by their interactions with their representative RCC. In many cases, RCCs work closely with their regional NJR compliance officers to provide targeted clinical support and guidance. This has resulted in a number of hospitals successfully implementing action plans and demonstrating measurable progress against quality indicators over the reporting period. Observed improvements demonstrate the value of sharing best practice and the direct impact of RCC lead clinical engagement at a local level. 

Looking ahead to 2026, the NJR is undertaking a comprehensive governance review to ensure that its existing structures, including committee arrangements, remain fit for purpose as the organisation continues to evolve. A particular theme of the review is going to be looking at the most effective way to engage the surgical community and support hospitals. For now, no RCC meetings have been scheduled for 2026 pending the outcome of the review. The findings will provide an important opportunity to strengthen engagement, enhance effectiveness and ensure that the RCC function continues to support the NJR’s strategic priorities in the years ahead.