NJR Surgical Performance Committee (SPC)

Chair’s report 2025 – Professor Mike Reed

The Surgical Performance Committee (SPC) comprises its Chair, Vice Chair, NJR Medical Director, RCC Chair, surgeon representatives from the RCC committee, representatives of the Care Quality Commission (CQC), a patient representative, representation from the NJR Management Team and representatives of both Lot 1 and 2 NJR contractors.

We have continued with the schedule of two data reviews each year, assessing performance over the previous five and ten years, for both hospitals and surgeons performing hip and knee joint replacement. 

NJR Annual Clinical Report and Consultant Level Report

Further changes and updates were made once again this year to the Annual Clinical Report (ACR) which was provided for all trusts, health boards and independent hospitals; and also to the Consultant Level Report (CLR) provided for consultant surgeons. These reports are accessible through NJR Connect – Data Services.

In addition, as part of NJR Connect reporting services, hospitals are now able to access a wider range of information around hospital performance, via Management Feedback. 

NJR Clinician Feedback now contains a tab for the Implant Library which was expanded during 2024/25 to show the KM survival graphically against the expected for the class of implant, and to include hip stem/cup combinations.

Implant mismatch, “never events”

We are continuing to alert surgeons and hospitals to the continuing, but relatively rarely occurring, mismatches. This alert process is well embedded and is monitored regularly by both the SPC and NJR Data Quality Committee. This currently covers side mismatch for knees, articulating size mismatch for hips, and mixing of hip head and stems from different manufacturers.

During 2024/25, the NJR introduced shoulder manufacture ‘mix and match’ for primary procedures as part of this process. The implant scanning tool, available for hospitals to check implant compatibility in real time in theatre has been in use over the past year, as adoption by more hospitals increases. It is hoped that use of this tool will help to reduce the overall numbers of “never events”. 

Future plans

Further work will be undertaken to roll out procedure outcomes at both trust and geographical level, to help improve hospital performance.

The NJR plans to expand our Accountability and Transparency model to include elbow, shoulder and ankle performance metrics for all hospitals and surgeons. Following the completion of the NJR shoulder audit in December 2024, it is anticipated that this will commence with shoulder outlier analysis.

During 2025/26, the NJR will be funding and providing support to the University of Bristol for a mixed methods project to support outlier surgeons and hospitals.