NJR guidance for consultant orthopaedic surgeons
Contents
1. National Joint Registry www njrcentre org uk Working for patients driving forward quality ORTHOPAEDIC CONSULTANT OUTCOMES PUBLICATION 2014 NJR Guidance for consultant orthopaedic surgeons updated 14 July www njrsurgeonhospitalprofile org uk LY PLEASE READ IMPORTANT INFORMATION ENCLOSED Orthopaedic consultant outcomes publication 2014 2 NJR Guidance for consultant orthopaedic surgeons Contents 1 Background and about Surgeon and Hospital Profile 4 2 Definition of scope 5 3 Consent and requirements for opt in 5 4 Indicators and outcomes analysis for publication 2014 6 5 Data validation period 8 6 Data processing period and consultant public profiles 8 7 Validating consultant data recorded in the NJR 9 7 1 Hip and knee accessing data 9 7 2 Hip and knee validating data 10 7 3 Ankle elbow and shoulder accessing data 11 7 4 Ankle elbow and shoulder validating data 11 8 Local support NJR Regional Coordinator contact 12 Orthopaedic consultant outcomes publication 2014 3 NJR Guidance for consultant orthopaedic surgeons 1 Background and about Surgeon and Hospital Profile 2013 Consultant outcomes publication COP was piloted in 2013 for ten specialities as stated in NHS England s planning guidance for 2012 13 then NHS Commissioning Board Orthopaedics was one of the first ten specialities to publish data at individual consultant level at www njrsurgeonhospitalprofile org uk and2. site in accordance with the ONS small numbers policy Note on new Consultants in charge An indicator showing time passed since first procedure submitted as Consultant in charge will be included on the activity profile UNIT LEVEL ACTIVITY Unit level activity for corresponding hospital profiles will show Consultants in charge recorded as working at the units 12 month practice profile including unit level NJR compliance 36 month practice profile including unit level NJR compliance New for 2014 Use of ODEP rated prostheses excluding no rating as a percentage of total practice for hip cup and hip stem in primary procedures e 90 day risk adjusted mortality rate for elective hip and knee procedures trauma cases removed 2003 2014 Unit profiles are now planned to go live on the revised publication date of 30 September 2014 Orthopaedic consultant outcomes publication 2014 7 NJR Guidance for consultant orthopaedic surgeons 5 Data validation period Monday 2 June to Thursday 14 August 2014 The data validation period for consultant outcomes publication 2014 will run from Monday 2 June 2014 to Thursday 14 August 2014 NJR data will be processed for outcomes publication after this date any data submissions after Thursday 14 August will not be taken into account for this iteration of consultant outcomes publication Up until this date surgeons are able to validate their NJR data through a number of NJR services including For h
3. specialty practice e Commentary as appropriate on practice profiles For hip and knee replacement surgeons this commentary can also go alongside outcomes analysis Note Further information on these new functions will be published in advance of the public profiles being made available However given the NHS England requirement to publish data earlier than 16 October submissions to this service are very likely to go live after 30 September 2014 This is to allow for the moderation process In advance of this all surgeons within scope of the publication must take up the opportunity to validate their data as submitted to the NJR in advance of Thursday 14 August Please sign up the NJR eBulletin for regular updates or visit the NJR website at www njrcentre org uk Updates will also be available at www boa ac uk 7 Validating consultant data recorded in the NJR 7 1 HIP AND KNEE ACCESSING DATA USE NJR CLINICIAN FEEDBACK NJR Clinician Feedback is a secure website designed to provide surgeons with direct access to their NJR data It was launched in 2008 If you are not already registered please call the NJR Service Desk on 0845 345 9991 or email enquiries njrcentre org uk using a hospital email address Help using Clinician Feedback You may wish to contact your NJR Regional Coordinator and their details can be found at the end of this guidance It is also worth noting that once you have a user name and password to NJR Clinician
4. the HQIP National Clinical Audit manual gt e Gotothe HQIP style guide for COP developed with patients gt These documents are available at www hgip org uk consultant outcomes publication Orthopaedic consultant outcomes publication 2014 4 NJR Guidance for consultant orthopaedic surgeons Use of NJR Surgeon and Hospital Profile The service receives around 1 200 visitors per week and has had over 25 000 visits to date The average visitor is on the site for just over 5 minutes 2 Definition of scope Any orthopaedic consultant surgeon who has had one or more NHS funded hip knee ankle elbow or shoulder replacement procedure recorded between 1 April 2013 and 31 March 2014 in England as Consultant in charge 3 Consent and requirements for opt in Further to legal guidance issued by HQIP Surgeons within scope The public interest clause of the Data Protection Act 1998 overrides consultant s right to withhold consent for analysis about their practice being placed in the public domain On this basis consent from individual consultants practicing in England is not required for the 2014 iteration of consultant outcomes publication provided that all reasonable steps are taken to e Communicate to eligible consultants that their data are to be published e Ensure published data are adequate and accurate e Ensure that support and improvement mechanisms are in place for statistical outliers e Demonstrate that COP is necessary to
5. via NHS Choices The service was developed and completed in partnership with the British Orthopaedic Association BOA the British Hip Society BHS and the British Association for Surgery of the Knee BASK The National Joint Registry s NJR Surgeon and Hospital Profile system published information for more than 1 600 hip and knee consultant orthopaedic surgeons in July 2013 2014 NHS England has extended the publication of consultant outcomes in 2014 to new specialties NHS England has also mandated publication of consultant outcomes through the NHS Standard Contract This requires the existing ten specialities to repeat their data publication and extend as a minimum to one new quality measure For orthopaedics the initiative will continue to be developed in partnership with the BOA the BHS the BASK and this year the British Foot and Ankle Society BOFAS and the British Elbow and Shoulder Society BESS The NJR and its Surgeon and Hospital Profile system will continue to publish and present the information The Healthcare Quality Improvement Partnership continues to oversee the delivery of the whole consultant outcomes programme working closely with NHS Choices the Royal College of Surgeons plus the specialist societies and clinical audit project teams for each specialty HQIP has produced two pieces of guidance this year for those involved in outcomes publication These include mandatory and recommended improvements e Goto
6. 14 cup and hip stem in primary procedures POLICE provided Outcomes by Consultant in charge 2003 2014 90 day risk adjusted mortality rate for elective Funnel plot definitions procedures trauma cases removed recorded on the and appropriate NJR context provided KNEES Knee procedures by Consultant in charge Format 1 April 2013 to 31 March 2014 lls Activit Units where a surgeon works List y Total activity by primary for TKR UKR and Patello femoral and revision procedures no breakdown by Activity provider type by e 12 month practice profile and e 36 month practice profile Pie chart and table explanatory definitions Orthopaedic consultant outcomes publication 2014 6 NJR Guidance for consultant orthopaedic surgeons Knees cont d Outcomes by Consultant in charge 2003 2014 format 90 day risk adjusted mortality rate for elective Funnel plot definitions procedures trauma cases removed recorded on the and appropriate NJR context provided ANKLES ELBOWS SHOULDERS ACTIVITY ONLY Procedures by Consultant in charge 1 April 2013 to 31 March 2014 Units where a surgeon works List Total activity by primary and revision procedure no breakdown by provider type by Pie chart and table e 12 month practice profile and explanatory definitions e 36 month practice profile where applicable Note on small numbers Profiles showing less than five procedures will have numbers masked on the
7. 35 07931 168335 07951 693523 07931 661337 07951 693523 07951 629101 Tyne and Wear Maggie Tate maggie tate northgate is com 07508 055651 Warwickshire Chris Hipkiss chris hipkiss northgate is com 07931 661337 West Sussex Anita Cannon anita cannon northgate is com 07951 629101 West Yorkshire Maggie Tate maggie tate northgate is com 07508 055651 Wiltshire Marian Gibson marian gibson northgate is com 07983 457785 West Midlands Chris Hipkiss chris hipkiss northgate is com 07931 661337 Worcestershire Chris Hipkiss chris hipkiss northgate is com 07931 661337 Orthopaedic consultant outcomes publication 2014 14 NJR Guidance for consultant orthopaedic surgeons
8. Feedback you will also have access to the user manual Orthopaedic consultant outcomes publication 2014 9 NJR Guidance for consultant orthopaedic surgeons CONSULT YOUR INDIVIDUAL CONSULTANT LEVEL REPORT This individual consultant level report is published for every hip and knee surgeon with more than five procedures recorded 2013 14 It is available via NJR Clinician Feedback Not all of the data in this individual report is relevant to 2014 outcomes publication However it will provide the most up to date reflection of your practice as recorded in the NJR over 12 and 36 months What is relevant in this consultant level report for outcomes publication 2014 e Your 12 month and 36 month practice profile showing procedures carried out o 41April 2013 to 31 March 2014 o 1 April 2012 to 31 March 2013 and o 41April 2011 to 31 March 2012 e Use of ODEP rated prostheses 1 April 2013 to 31 March 2014 o Forconsultant outcomes the figure published will only exclude no rated prostheses In the Consultant report you will see a figure that combines pre entry and no rating However you will be able to see the percentage of No Rating usage by implant type in the stacked bar chart e 90 day mortality rate and recorded mortality events this includes all NJR data 2003 to March 2014 o The mortality events listed in the consultant report correspond to all procedures recorded in the NJR for elective and trauma surgery Please note that for con
9. achieve legitimate aims See the HOIP legal counsel and legitimate aims as part of the National Clinical Audit manual at www hgip org uk consultant outcomes publication gt Surgeons outside of scope For those consultant orthopaedic surgeons who are outside of the scope of publication for 2014 there will be the option to opt in to publication via the NJR Clinician Feedback service This applies to surgeons carrying out ankle elbow and shoulder procedures as well as hip and knee replacement operations This functionality will be available from 16 September 2014 when the public profiles are available to view via NJR Clinician Feedback Orthopaedic consultant outcomes publication 2014 5 NJR Guidance for consultant orthopaedic surgeons 4 Indicators and outcomes analysis for publication 2014 The British Orthopaedic Association specialist societies see section 1 and the NJR have agreed on the following plan for publication in 2014 HIPS i tin ch Hip procedures by Consultant in charge S 1 April 2013 to 31 March 2014 Activity Units where a surgeon works List Total activity by primary and revision procedures no penne breakdown by provider type by Pie chart and table EM e 12 month practice profile and explanatory definitions e 36 month practice profile Pie ch le Activity Use of ODEP rated prostheses excluding no du Dub Ur definitions and added for rating as a percentage of total practice for hip 20
10. ip and knee e NJRClinician Feedback e Individual consultant reports via Clinician Feedback for hip and knee surgeons For hip knee ankle elbow and shoulder e ReportsOnline using the NJR data entry system e StatsOnline e Direct reports requested through the NJR Regional Coordinators After Thursday 14 August no further data submissions can be incorporated This is to allow sufficient time for analysis preparation and testing prior to the launch of the data at www njrsurgeonhospitalprofile org uk In light of this the NJR requests that consultants within scope of the project consider the component parts of the validation process including validation of the data and any re submission of data to the NJR system 6 Data processing period and addition of consultant s narrative NJR data will be processed for publication between Friday 15 August and Monday 15 September 2014 All surgeons within scope of the publication must take up the opportunity to validate their data as submitted to the NJR in advance of Thursday 14 August 2014 Orthopaedic consultant outcomes publication 2014 8 NJR Guidance for consultant orthopaedic surgeons Public facing profiles will be available to review from Tuesday 16 September 2014 two weeks prior to publication on the revised date of 30 September 2014 At this time consultants should be able to add the following information to their profile e Information about qualifications membership and
11. mpey sue campey northgate is com 07983 457808 postcodes Manchester Inez Dunn inez dunn northgate is com 07951 693529 Merseyside Inez Dunn inez dunn northgate is com 07951 693529 Mio Wales Carol Maskrey carol maskrey northgate is com 07931 168335 Aberystwyth Orthopaedic consultant outcomes publication 2014 13 NJR Guidance for consultant orthopaedic surgeons Middlesex Norfolk North Yorkshire North Wales Northern Ireland Northamptonshire Northumberland Nottinghamshire Oxfordshire Shropshire Somerset South Wales South Yorkshire Staffordshire Suffolk Surrey Sue Campey Lorna Watson Maggie Tate Chris Hipkiss Inez Dunn Lorna Watson Maggie Tate Lorna Watson Marian Gibson Chris Hipkiss Carol Maskrey Carol Maskrey Lorna Watson Chris Hipkiss Lorna Watson Anita Cannon sue campey northgate is com lorna watson northgate is com maggie tate northgate is com chris hipkiss northgate is com inez dunn northgate is com lorna watson northgate is com maggie tate northgate is com lorna watson northgate is com marian gibson northgate is com chris hipkiss northgate is com carol maskrey northgate is com carol maskrey northgate is com lorna watson northgate is com chris hipkiss northgate is com lorna watson northgate is com anita cannon northgate is com 07983 457808 07951 693523 07508 055651 07931 661337 07951 693529 07951 693523 07508 055651 07951 693523 07983 457785 07931 661337 07931 1683
12. or all mortality events recorded This will assist you in locating the NJR record at the hospital However if required your local NJR Regional Coordinator can be approached to assist in providing relevant information in order to facilitate the identification of deceased patients 7 3 ANKLE ELBOW AND SHOULDER ACCESSING DATA Ankle elbow and shoulder surgeons can register on NJR Clinician Feedback for the purpose of seeing their public profiles from Wednesday 1 October or opting in to data publication However no other NJR data is available via this web portal at present Instead there are a number of ways that those who carry out these replacement procedures can gain reports on their NJR recorded practice These reports can then be used for the purpose of local audit and data validation e ReportsOnline using the NJR data entry system e StatsOnline e Direct reports requested through the NJR Regional Coordinators 7 4 ANKLE ELBOW AND SHOULDER VALIDATING DATA Carry out a local audit Please contact your NJR Regional Coordinator They will be able to run a report for you to show the procedures that have been submitted under your name as Consultant in charge Orthopaedic consultant outcomes publication 2014 11 NJR Guidance for consultant orthopaedic surgeons This list can then be checked against the local theatre system local performance management systems or your own surgeon log book if kept By foll
13. owing this local audit process any record needing to be amended would need to be put into edit stack on the NJR data entry system for the hospital data clerk administrator or manager to amend and re submit Find out if procedures already carried out are yet to be submitted Speak to your local hospital data clerk administrator or manager to find out which of your records are in the edit stack already i e not yet submitted to the NJR Your NJR Regional Coordinator can also run a report to show those records these are usually those records with a blank completed date on the system 8 Local support NJR Regional Coordinator contact Regional Email address Phone number Coordinator Avon Carol Maskrey carol maskrey northgate is com 07931 168335 Bedfordshire Marian Gibson marian gibson northgate is com 07983 457785 Berkshire Marian Gibson marian gibson northgate is com 07983 457785 Buckinghamshire Marian Gibson marian gibson northgate is com 07983 457785 Cambridgeshire Lorna Watson lorna watson northgate is com 07951 693523 Cheshire Inez Dunn inez dunn northgate is com 07951 693529 Cleveland Maggie Tate maggie tate northgate is com 07508 055651 Cornwall Carol Maskrey carol maskrey northgate is com 07931 168335 Cumbria Maggie Tate maggie tate northgate is com 07508 055651 Derbyshire Lorna Watson lorna watson northgate is com 07951 693523 Orthopaedic consultant outcomes publication 2014 12 NJR Guidance for consul
14. sultant outcomes only elective procedures will be included in the mortality analysis 7 2 HIP AND KNEE VALIDATING DATA IF THE VOLUME OF PROCEDURES NEEDS ADJUSTING too few too many incorrect Carry out a local audit Please contact your NJR Regional Coordinator They will be able to run a report for you to show the procedures that have been submitted under your name as Consultant in charge This list can then be checked against the local theatre system local performance management systems or your own surgeon log book if kept By following this local audit process any record needing to be amended would need to be put into edit stack on the NJR data entry system for the hospital data clerk administrator or manager to amend and re submit Orthopaedic consultant outcomes publication 2014 10 NJR Guidance for consultant orthopaedic surgeons Find out if procedures already carried out are yet to be submitted Speak to your local hospital data clerk administrator or manager to find out which of your records are in the edit stack already i e not yet submitted to the NJR Your NJR Regional Coordinator can also run a report to show those records these are usually those records with a blank completed date on the system IF 90 DAY MORTALITY EVENTS ARE RECORDED SOURCE THE IDENTIFIER TO ASSIST IN THE AUDIT AND VALIDATION PROCESS Your individual consultant level report on NJR Clinician Feedback gives an NJR reference f
15. tant orthopaedic surgeons Devon Dorset Durham East Sussex East Yorkshire Essex Gloucestershire Hampshire Herefordshire Hertfordshire Humberside Isle of Wight Kent Lancashire Leicestershire Carol Maskrey Carol Maskrey Maggie Tate Anita Cannon Maggie Tate Sue Campey Marian Gibson Anita Cannon Chris Hipkiss Marian Gibson Lorna Watson Maggie Tate Anita Cannon Anita Cannon Maggie Tate Inez Dunn Chris Hipkiss carol maskrey northgate is com carol maskrey northgate is com maggie tate northgate is com anita cannon northgate is com maggie tate northgate is com sue campey northgate is com marian gibson northgate is com anita cannon northgate is com chris hipkiss northgate is com marian gibson northgate is com Lorna watson northgate is com maggie tate northgate is com anita cannon northgate is com anita cannon northgate is com maggie tate northgate is com chris hipkiss northgate is com 07931 168335 07931 168335 07508 055651 07951 629101 07508 055651 07983 457808 07983 457785 07951 629101 07931 661337 07983 457785 07951 693523 07508 055651 07951 629101 07951 629101 07508 055651 07931 661337 Lincolnshire Lorna Watson lorna watson northgate is com 07951 693523 oop Marian Gibson marian gibson northgate iscom 07983 457785 NW postcodes London SW postcodes Sue Campey sue campey northgate is com 07983 457808 London N NE SE and central Sue Ca
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