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About the NJR

The National Joint Registry (NJR), which covers England, Wales, Northern Ireland, the Isle of Man and the States of Guernsey, collects information on hip, knee, ankle, elbow and shoulder joint replacement surgery and monitors the performance of joint replacement implants. Hip, knee, ankle, elbow and shoulder joint replacements have become more common and are generally highly successful operations that bring many patients improved mobility and relief from pain. Many thousands of such operations take place in the UK each year and the NJR has been collecting data since April 2003 - data submission for NHS organisations has been mandatory since April 2011.

A wide range of implants can be used in the joint replacement operations and by collecting data on outcomes, the registry monitors the performance of these implants and the effectiveness of their use in different types of joint replacement, with a key focus on patient safety and improving clinical standards; benefiting patients, clinicians and the orthopaedic sector as a whole.

The NJR brings many benefits to the hospitals in which data is collected by providing an annual report on their performance and an NJR regional support network - an overview of these and other benefits can be found here.

The NJR is hosted by the Healthcare Quality Improvement Partnership (HQIP) and overseen by a Steering Committee (NJRSC), which is designated as an NHS England (NHS E) ‘Expert Committee’. The NJRSC Chairman reports directly to the NHS E Medical Director. NJR core services are managed under two contracts held with: Northgate Public Services: for collection and management of data and technology; and the University of Bristol: for provision of statistical support and analysis of data, to support NJR outcome monitoring, research activity and publications.

The NJR management team is responsible for overall operational and contract management of the NJR and for supporting the work of the NJRSC and its sub-committees and for communicating the work of the registry.


NJR mission statement


'The purpose of the National Joint Registry, which covers England, Wales, Northern Ireland, the Isle of Man and the States of Guernsey, is to collect high quality and relevant data about joint replacement surgery in order to provide an early warning of issues relating to patient safety. In a continuous drive to improve the quality of outcomes and ensure the quality and cost-effectiveness of joint replacement surgery, the NJR will monitor and report on outcomes, and support and enable related research.'


NJR goals


- Monitor in real time the outcomes achieved by brand of prosthesis, hospital and surgeon, and highlight where these fall below an expected performance in order to allow prompt investigation and to support follow-up action.

-  Inform patients, clinicians, providers and commissioners of healthcare, regulators and implant suppliers of the outcomes achieved in joint replacement surgery.

- Evidence variations in outcome achieved across surgical practice in order to inform best practice.

- Enhance patient awareness of joint replacement outcomes to better inform patient choice and patients' quality of experience through engagement. 

- Support evidence-based purchasing of joint replacement implants for healthcare providers to support quality and cost effectiveness.

- Support suppliers in the routine post-market surveillance of implants and provide information to clinicians, patients, hospital management and the regulatory authorities.


Timeline of data collection


  • The States of Guernsey joined the registry in November 2019

  • Isle of Man joined the registry in July 2015

  • Northern Ireland joined the registry in February 2013

  • Elbow and shoulder joint replacements collected on the registry since April 2012

  • Ankle joint replacements collected since April 2010

  • Hip and knee joint replacements collected since April 2003




The NJR Steering Committee (NJRSC) has responsibility for overseeing the strategic direction of the NJR. Find out more ►

The NJRSC is supported by the NJR Management Team, who are hosted at the offices of HQIP. Find out more ►








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