NJR Centre Peoplebuilding 2 FAO: Orthopaedic consultant surgeon Peoplebuilding Estate Maylands Avenue Hemel Hempstead HP2 4NW NJR Service Desk: 0845 345 9991 21 July 2015 Fax: 0845 345 9992 Email: [email protected] Ref: COP2015/InScope Dear Colleague Consultant outcomes publication 2015 The NJR is preparing for the 2015 round of orthopaedic consultant outcomes publication (COP), which continues as part of NHS England’s overall transparency agenda. We are writing to share with you important information relating to this year’s iteration. If you are a new Consultant, and receiving this letter for the first time, we would encourage you to read the background to the NHS England initiative at www.njrcentre.org.uk and see the current published profiles on www.njrsurgeonhospitalprofile.org.uk. Any Consultant surgeon who has carried out at least one NHS-funded procedure in England (1 April 2014-31 March 2015) is automatically included for publication. Revision rates The registry would like to take this opportunity to assure colleagues that revision rates at surgeon- level will not be published. As you will be aware, the NJR has been working alongside the British Orthopaedic Association and specialist orthopaedic societies as the COP programme moves forward to ensure appropriate development and robustness of the surgeon and hospital profiles. The view of the NJR Data Quality Sub-committee and the NJR Steering Committee is that the quality of data submitted to the registry is not currently able to support the publication of individual surgeon revision rates into the public domain. The NJR has recently reviewed and refreshed its strategy for data quality in the registry, including the launch of a data completeness and quality audit programme at procedure level. This is intended to enable the NJR, and its stakeholders, to understand record submission, accuracy and identify missing data at unit-level in greater detail for the first time. However, the NJR would like to make clear that this data quality emphasis is part of improving reporting/analysis at all levels including, crucially, the ability to assess and track implant performance on a continuous basis. We would be very pleased to have your support in this programme of work and separate communication via the NJR and BOA websites, as well as direct to your hospital, will provide further detail in due course. Cont’d… Cont’d….2 of 3 Refresh of COP indicators 2015 Further to the publication of surgeon profiles at NJR Surgeon and Hospital Profile in 2014, and its simultaneous and further display via the NHS Choices/myNHS website, the NJR will be refreshing all of the existing surgeon indicators for the most recent time periods: Activity by procedure type for all surgeons 90-day mortality for hip and knee surgeons and Proportional use of all-rated ODEP prostheses for hip surgeons For clinical activity, this is specifically the 12-month financial year 2014-15 and 36-month financial years 2012-15. Surgeon profiles are due to be published on 30 November 2015 and you will be able to see your public profile in advance of that, through NJR Clinician Feedback as was the case last year. The likely timing for this preview is October and at that time you will be able to add optional profile information. The NJR will also refresh the hospital dashboards data, launched in March this year. If you have not had a chance to view the hospital profiles at www.njrsurgeonhospitalprofile.org.uk for the units in which you work then we would encourage you to do so. New COP indicator: patient case-mix for all joints You may already be aware that there is a requirement to continue to extend the surgeon-level indicator set, alongside team based measures. Indicators should be meaningful to the patient, representative of quality and/or designed to enhance the context of data already made available to patients and the public. On this basis, further to ongoing discussion and in light of the information already published on hospital dashboards, the registry has agreed to produce and publish surgeon case-mix profiles for all NJR data covering the proportion of patients treated who are: Male Under 60 years of age BMI greater than 35 At a higher risk of medical problems before or after surgery (ASA 3+) and Diagnosis other than osteoarthritis New indicator: surgeon-level compliance for all joints The NJR is currently also investigating the potential to produce surgeon-level NJR compliance rates for primary and revision procedures (based on NJR data submissions compared to HES data). Cont’d… Cont’d….3 of 3 However, this indicator is in early development and requires, in addition to clinical discussion and specification, formal process through the HSCIC in order to secure the necessary data. We will also be checking the accuracy of the data and until you have had the opportunity to verify the results, this indicator will not be published. Based on current timescales it may be difficult to do this in time for November – further developments and dates will be made available through the NJR and BOA to reflect progress. Data verification: what can you do to check the validity of your clinical activity (all joints) and outcomes data (hip/knee)? For all surgeons, please contact your NJR Regional Coordinator (see attachment A) to discuss how to access the clinical activity and patient case-mix data relating to the format of the surgeon profiles due to be published under the consultant outcomes programme. Volumes associated with your clinical activity can be checked and amended up to 30 September 2015. However, for hip and knee surgeons, if you would like to view and verify mortality events that will inform the mortality analysis, please do this before 15 August 2015. In relation to mortality outcomes, hip and knee surgeons may also wish to access NJR Clinician Feedback and your Consultant Level Report (within ‘General reports’). Please note that in the case of hips, all trauma, failed hemi-arthroplasty cases and [from November 2014] metastatic cancer are removed from mortality analysis. Finally, the NJR is keen to encourage surgeons to regularly access their data through all available means and to remind them that, on an ongoing basis, their data should be submitted in an accurate and timely manner. Any issues relating to data submission or accuracy can be discussed with your NJR Regional Coordinator at any time and the relevant data corrections made – again, please see attachment A. Yours sincerely Martyn Porter NJR Medical Director Encl: Attachment A - NJR Regional Coordinator contact sheet Local support – NJR Regional Coordinator contact list County Regional Coordinator Email address Phone number Avon Carol Maskrey [email protected] 07931 168335 Bedfordshire Lorna Watson [email protected] 07951 693523 Marian Gibson/Anita marian.gibson@northgate- 07983 457785/07951 Berkshire Cannon is.com/[email protected] 629101 Buckinghamshire Marian Gibson [email protected] 07983 457785 Cambridgeshire Lorna Watson [email protected] 07951 693523 Cheshire Inez Dunn [email protected] 07951 693529 Cleveland Maggie Tate [email protected] 07508 055651 Cornwall Carol Maskrey [email protected] 07931 168335 Cumbria Maggie Tate [email protected] 07508 055651 Derbyshire Lorna Watson [email protected] 07951 693523 Devon Carol Maskrey [email protected] 07931 168335 Dorset Carol Maskrey [email protected] 07931 168335 Durham Maggie Tate [email protected] 07508 055651 East Sussex Anita Cannon [email protected] 07951 629101 East Yorkshire Maggie Tate [email protected] 07508 055651 Essex Sue Campey [email protected] 07983 457808 Gloucestershire Carol Maskrey [email protected] 07931 168335 Hampshire Anita Cannon [email protected] 07951 629101 Herefordshire Chris Hipkiss [email protected] 07931 661337 Lorna Watson/Marian [email protected]/ 07951693523/ Hertfordshire Gibson [email protected] 07983 457785 Lorna Watson/ [email protected] / 07951 693523 / Humberside Maggie Tate [email protected] 07508 055651 Isle of Man Chris Hipkiss [email protected] 07931 661337 Isle of Wight Anita Cannon [email protected] 07951 629101 Kent Anita Cannon [email protected] 07951 629101 Maggie Tate/ [email protected] 07508 055651/ Lancashire Inez Dunn /[email protected] 07951693529 Leicestershire Chris Hipkiss [email protected] 07931 661337 Lincolnshire Lorna Watson [email protected] 07951 693523 London (NW postcodes) Marian Gibson [email protected] 07983 457785 London (SW postcodes) Sue Campey [email protected] 07983 457808 London (N, NE, SE, central) Sue Campey [email protected] 07983 457808 Manchester Inez Dunn [email protected] 07951 693529 Merseyside Inez Dunn [email protected] 07951 693529 Mid Wales (Aberystwyth) Carol Maskrey [email protected] 07931 168335 Middlesex Sue Campey [email protected] 07983 457808 Norfolk Lorna Watson [email protected] 07951 693523 North Yorkshire Maggie Tate [email protected] 07508 055651 North Wales Inez Dunn [email protected] 07952 693529 Northern Ireland Inez Dunn [email protected] 07951 693529 Northamptonshire Lorna Watson [email protected] 07951 693523