Changes to NJR Connect

System enhancements for NJR Connect – Data Services

Two new system enhancements – January 2026

1. Patient Implant Lookup
(Available in Clinician Feedback and Data Entry)

This tool provides Lead Surgeons (LS), Consultants in Charge (CIC) and Hospital Data Managers (HDM) with a look-up facility to securely search and retrieve historic NJR-recorded implant data for patients currently in their care using six mandatory criteria. Its goal is to aid surgical planning by providing verified information on previously implanted components, particularly useful in revision surgery scenarios where a patient may be uncertain of their implant history or was treated elsewhere.

Surgeon and HDM users will have access to a new tile – Patient Implant Lookup. Upon selecting this tile, you will be presented with terms and conditions – these must be accepted in order to proceed with the patient search. You will need to accept these terms and conditions each time you access this functionality.

The system will return results where the previous procedures have been entered in the registry, upon entering the required search criteria. You must also include any middle names for the patient, otherwise the search will not function.

The required search criteria is:

Patient NHS Number or National Identifier
Patient surname
Patient first name and any middle names
Patient date of birth
Joint (i.e. hip, or knee, or ankle, or elbow, or shoulder)
Side of procedure

Results can be downloaded.

If no results are returned it may be because:

The patient had not consented to the NJR processing their personal identifiers.
The patient is recorded as deceased.
The index procedure pre-dates the registry.
The operating hospital has not submitted details of the procedure.

If you need further assistance to find a previous procedure, please contact the NJR Service Desk at enquiries@njrcentre.org.uk.

We are always interested in your feedback as system users of NJR Connect – Data Services. Feedback so far has enabled us to further develop both the data entry and reporting systems and we plan to introduce regular enhancements across the year to constantly improve your user experience.

2. Data Entry

The NJR has introduced a new suite of forms to support the accurate capture of data for megaprosthesis procedures. These forms are designed to reflect different clinical scenarios and must be selected carefully to ensure correct submission.

Upon selecting ‘Operations, Create New Operation, MDS form’ you will see a new Megaprosthesis Procedure option in the drop-down list.

Please read the guidance accessible by clicking the link below.

Overview of Forms

There are three megaprosthesis specific forms:

M1: Primary megaprosthesis in a native joint
M2: Revision of an existing megaprosthesis to another megaprosthesis
MS: Revision of a conventional joint replacement to a megaprosthesis

The choice of form depends on the patient’s implant history and the procedure being undertaken. You can find more information on the forms and their use here.

System enhancements – June 2025

Pre-op scanning
Introduction of the following new compaibility checks:

Knee size mismatch:

A new knee size compatibility check has been introduced.
Never event warnings will be triggered where there is a size mismatch between the Femoral and/or Tibial components selected, but only where the compatibility information has been provided by the manufacturer. Where information has not been provided by the manufacturer a warning message to advise the user that the compatibility check cannot be carried out will be displayed.

Field Safety Notice:

The NJR has introduced a new check to alert users to components which are in scope of a manufacturer issued Field Safety Notice.

Data Entry

Introduction of a new knee size mismatch potential never event.
Never event warnings will be triggered where there is a size mismatch between the Femoral and/or Tibial components selected, but only where the compatibility information has been provided by the manufacturer.

Clinician Feedback
Consultant level reports/Surgeon level reports will be published in July 2025. The following changes have been implemented:

All joints: reoperations (introduced in MDSv8 in June 2023) are now included in the joint activity profile table with a breakdown of procedures carried out on the joint Reoperation page.
Hips: primary hemiarthroplasties (introduced in MDSv8 in June 2023) are now included in the hip activity profile table and separated out from Total hip primaries.
Due to the fact that the outlier data was cut in December 2024 rather than February 2025 the numbers shown for FY14/15 and FY24/25 in the ‘Count of revised primaries by year’ table are incomplete financial years.

System enhancements – March 2025

Clinician Feedback
Implant Library enhancements:
Implant Summary report – the Kaplan-Meier (KM) survivorship analysis for cement brands used in primary procedures is now included in the report.

A new menu option – KM graphs – will be available to Clinician Feedback Consultant-in-Charge and Lead Surgeon users.

This option allows you to generate and view Kaplan-Meier graphs for implants based on the following criteria:

You may also download your results as a pdf.

Data Entry
“Consent = No” pop-up message
When entering data into the registry in England and Wales, consent can be recorded as ‘Yes’, ‘No’ or ‘Not recorded’. In cases where a user selects ‘No’ for consent, a pop-up box will appear to confirm that the patient was asked for their consent and that this is the option recorded in the patient’s notes.

If the patient has actively declined consent, please click on Continue
If you don’t have a consent form, please click on Change. This will change the consent status to ‘Not recorded’.

System enhancements – September 2024

(Enhancements introduced on the 25 & 26 September)

Clinician Feedback
Alert events
Surgeon notifications – email notifications will only be sent where the mortality/revision event will be included in the outlier analysis.
The following revision events will no longer trigger a notification:

Revisions of revisions
Revision where the primary was more than 10 years ago
Revision where the indication for hip primary is failed hemiarthroplasty

The following mortality events will no longer trigger a notification:

Event where the indication for a hip primary procedure was trauma neck of femur, chronic trauma, failed hemiarthroplasty or metastatic cancer
Event where the indication for knee primary is trauma or previous trauma

Management Feedback
Unit data dynamic reports
Outcome summary report – outcome results now display the same control limits as the funnel plot reports, replacing the use of z scores:

Data Submission report – while retaining the use of z scores the layout of the thermometer plots has changed so that now ‘better than’ scores appear to the left of centre, and ‘worse than’ to the right.

ODEP implant usage – a new report showing the usage of ODEP-rated hip and knee implants in a rolling12-month period up to the end of the previous complete month. This report is refreshed monthly.

Pre-operative Scanning Website
Introduction of the following new compatibility checks:

Shoulder manufacturer mix and match – advises if the humeral and glenoid implants are manufactured by different companies.
Shoulder expiry date warning – checks that the implant sterility has not expired.
Unicondylar knee manufacturer mix and match – advises if the femoral and tibial implants are manufactured by different companies.
Unicondylar condyle/side – advises if there is a mismatch between the side/condyle of the procedure and the implant side

Information text for all compatibility checks has been updated to further enhance system compliance with NHSE clinical safety standards.

Data Entry
Introduction of shoulder manufacturer mix and match potential never events. Never event warnings will be triggered if the humeral implants/humeral accessories and glenoid implants/glenoid accessories are manufactured by different companies.

Data Quality Audit
Addition of a new status field in the ‘Unmatched Records’ PAS section: ‘Awaiting component requests from suppliers’ (i.e. items which are in the edit stack owing to missing component information with the NJR).

System enhancements – July 2024

(Enhancements introduced July 2024)

Disaggregation of Consent – a change to the reporting of the NJR consent rate. There will be three rates moving forwards – Overall, Elective and Trauma. This change will be rolled out across feedback reporting e.g. in this release it has been applied to the Management Feedback Data Submissions report. Later this year it will be applied to Consultant Level and Surgeon Level reports and Annual Clinical Reports.

Clinician Feedback
Outcome summary report – outcome results now display control limits instead of z scores:

Retired surgeons will be able to access aggregated “My Data” dynamic reports and the main body CLR/SLR reports from 2020 onwards (CLR/SLR prior to this date contain record level information and will not be made available).

ODEP report
A new dynamic report (under ‘My Data’ menu) showing the usage of ODEP rated implants in a rolling 12-month period up to the end of the previous complete month. Refreshed monthly.

Clinician Feedback and Management Feedback:
The ‘Patient status’ report has been re-named to ‘Patient data and status’.
The following information has been added to the download report:

NHS Number
ODEP rating (for procedures from 1 April 2023 onwards)
Age of patient at time of index procedure
Grade of first assistant

System enhancements – April 2024

(Enhancements introduced April 2024)

New user role
A new user group has been created for Allied Health Professionals (AHPs) e.g. physiotherapists, occupational therapists and other allied professions. All users in this group have level 1 access (aggregated dynamic reports) in Management Feedback to the hospital in which they work. Access requests for these users will need to be approved by the Hospital Data Manager.

Bulk Upload changes
Corrections have been made to Bulk Upload functionality to stop records presenting with errors when optional fields have not been completed.

Automated Data Quality Audit functionality
The Exported files of NJR Unmatched Records, Matched Records, and Partial Matched Records now include the Linked Record label.

Filters on the NHS Number field on Provider Unmatched, NJR Unmatched & Partial matched screens have been restricted to show the following options:

Contains
Starts with
Ends with
Is empty

Data entry
On clicking on any date field in data entry, the calendar will automatically appear.

Previous enhancements

Changes to access levels within Management Feedback (MF) and Clinician Feedback (CF)

All users associated with a hospital/trust/independent group (except bulk upload users) have been given access to Management Feedback dynamic reporting.

There are two levels of access

Level 1 – Unit data reports – aggregate level reports only
Level 2 – Unit data reports – all reports + ACRs

MF access level	Level 1	Level 2
ACR user	x	ACR only
Chief Executive Officer	x	x
Clinical Governance	x	x
Consultant in charge	x
Data Quality Lead	x
Data Quality uploader	x
Hospital Data Entry	x
Hospital Data Manager	x	x
Lead Surgeon	x
Medical Director	x	x
NJR Clinical Liaison Lead	x	x
Procurement and Finance	x	Implant reports only
Surgeon Data Entry	x

The table below provides a breakdown of the reports accessible in each category – Level 1 or Level 2

MF access level	Menu option	Report
1	Unit data	Hospital Summary
1	Unit data	Data submissions
1	Unit data	Activity
1	Unit data	Unit level funnel plots
2	Unit data	Surgeon level funnel plots
1	Unit data	Reasons for revision
2	Unit data	Patient Status
1	Unit data	Unadjusted Revision rate
2	Unit data	CLR Download status
2	Unit data	Shoulder metrics
2	Unit data	Procedure data extract
2	Reports	Annual Clinical Reports – ACR
2	Reports	Annual Clinical Reports – Addendum report (19_20) reason for revision
2	Reports	Annual Clinical Reports – Section 8 Addendum report (18_19)

Shoulder Metrics reporting
Dynamic report menu – My data/Unit data

A newly introduced set of activity-based outcome metrics and data quality metrics for primary and revision shoulder procedures can be found in Clinician Feedback and Management Feedback.

The report is available only to surgeons and units who carry out shoulder procedures.

The report is refreshed on a monthly basis up to the end of the previous financial quarter so the latest year will refresh to June/September/December/March e.g. in April/May/June the report will update to the end of March of the previous financial year.

Report tabs available

Consent
Time to submission
Primary demographics
Primary procedure numbers
Primary procedure breakdown
Completed OSS (Management Feedback only) – primary procedures only
Revision procedure numbers
Revision cause

Procedure data extract (MF – Dynamic report menu/Unit data)

This report allows the user to download all NJR data for the unit. This extract can be used to view and download both submitted and unsubmitted records. The downloadable version of this report contains additional procedure data not shown on the screen.

Password Expiry

The expiry period for surgeons has been increased from 90 to 180 days. Please note that following these time periods users have a grace period of 30 days in which they can reset the password themselves. After this, they need to contact the service desk to reset the password.

Users will always need to contact the service desk if they enter an incorrect password 5 times in succession.

Automated Data quality audit

The automated data quality audit tool has been enhanced to allow users to

(a) search for records using the NHS number in addition to local patient ID
(b) download records (all fields) in XLSX and PDF formats.

Data entry

A number of cosmetic changes have been made following the release of MDSv8.

The following process changes have been made:

Barcode scanning – workflow improvements have been made for implants that have 2 barcodes (primary and secondary). Once the primary is scanned the cursor will automatically move to the lot number field without interruption on the screen and the user can then scan the secondary barcode. The system will automatically decode and add the scanned implant.

Re-operation form – the UCS options screen will now only be displayed if the procedure type selected is ‘Fixation of periprosthetic fracture’.

Primary procedure (all joints) study id question – when creating the first primary procedure in an NJR record where patient consent = yes the user has to complete questions regarding participation in a study. In the first release of MDSv8 this question required the user to return to the patient details page to complete the information. These questions now appear as a pop-up:

and once completed and closed will populate the fields on the Patient Details page for the user.