Implant and unit-level activity and outcomes. 14th Annual Report. HIPS KNEES ANKLES ELBOWS SHOULDERS PROMs

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1 HIPS KNEES ANKLES ELBOWS SHOULDERS PROMs Implant and unit-level activity and outcomes th Annual Report 0 National Joint Registry for England, Wales, Northern Ireland and the Isle of Man ISSN 0-X (Online) Surgical data to December

2 Part. Implant performance

3 The implant scrutiny group reports Level outlier implants to the MHRA. Since the committee s formation in 009 there have been four hip stems, five hip acetabular components and 9 hip stem/cup combinations reported. Six knee brands have been notified. An implant is considered to be a Level outlier when its Patient Time Incident Rate (PTIR) is more than twice the PTIR of the group, allowing for confidence intervals. These are shown as the number of revisions per 00 patientyears. As of March 0, we have started to identify the best performing implants, these would have a PTIR less than half that of their group, allowing for confidence intervals. Hip implant performance Table Level outlier stems reported to MHRA. Stem name Numbers implanted Latest PTIR Notified as outlier Last implanted ASR,.9 00 July 00 Corin Proxima 0. 0 September 009 S-ROM Cementless stem,00. 0 March 0 S-ROM Cementless MoM*, May 0 *S-ROM Cementless stem with MoM articulation - ASR socket, Pinnacle with MoM liner or Ultima cup Table Level outlier acetabular components reported to MHRA. Cup name Numbers implanted Latest PTIR Notified as outlier Last implanted ASR,. 00 July 00 Ultima MoM cup December 00 MA,9.9 0 June 0 Delta One TT. 0 March 0 Trabecular Metal Shell. 0 March 0 Table Level outlier stem/cup combinations. Combination Latest PTIR Notified as outlier Last implanted ASR Resurfacing Head ASR Resurfacing Cup.9 00 July 00 Metafix Stem Cormet 000 Resurfacing Cup.9 00 February 0 CPT Adept Resurfacing Cup. 0 May 00 Corail ASR Resurfacing Cup.9 0 June 00 CPT BHR Resurfacing Cup. 0 September 00 Accolade Mitch TRH Cup.0 0 January 0 Summit Cementless Stem ASR Resurfacing Cup. 0 August 009 CPT Durom Resurfacing Cup. 0 September 009 S-Rom Cementless Stem ASR Resurfacing Cup. 0 February 00 CPCS BHR Resurfacing Cup.0 0 May 00 Anthology BHR Resurfacing Cup. 0 August 0 SL-Plus Cementless Stem Cormet 000 Resurfacing Cup. 0 April 00 Bimetric Cementless Stem MA.9 0 June 0

4 Table (continued) Combination Latest PTIR Notified as outlier Last implanted Corin Proxima Cormet 000 Resurfacing Cup.9 0 September 009 Synergy stem BHR cup. May 0 CPT Exceed ABT Cemented. 0 February 0 Exeter V0 Trabecular Metal Shell. 0 March 0 Note: Combinations which no longer have a PTIR falling in to the outlier category are not shown. Best performing hip implants There are no hip implants or combinations performing statistically less than half their expected PTIR. Knee implant performance Table Level outlier implants reported to MHRA. All of these implants have been discontinued. Knee brand Latest PTIR Notified as outlier Last implanted JRI bicondylar. 009 June 00 Tack August 00 St Leger.9 0 August 00 Journey Deuce.0 0 June 0 SLK Evo. April 0 Journey Oxinium.0 0 July Best performing knee implants There are no knee implants performing statistically less than half their expected PTIR.

5 Part. Unit performance

6 This section shows indicators for hip and knee joint replacement procedures by Trust, Local and unit (hospital). This was first included in 0 and is part of the Government s transparency agenda. It is based on procedures carried out during the calendar year and submitted to the NJR by February 0. Note: Part Four information (excluding outlier analysis) is based on the actual operation date ( January to December ) whereas data in Part One is based on the date the procedure was submitted ( April to March 0).

7 Part. Unit outlier analysis methodology

8 Unit outlier analysis covers all primary procedures performed from April 00 to March 0. The outlier analyses made use of funnel plots from statistical process control methodology. These aim to distinguish normal variation between units (which is to be expected) from unusual differences (termed special cause variation), which may indicate the need for further investigation. Funnel plots enable units of different sizes to be compared; performance indicators based on smaller numbers of patients will have greater variability and this in turn is reflected by wider control limits. Summary of the methodology for unit revision rates: The standardised revision ratio (SRR) is plotted against the number of expected revisions. The SRR is the total number of revisions divided by the number of expected revisions for that unit s caseload in respect of the age group, gender and the diagnosis of the patients. If the SRR is, the number of revisions is compatible with the number expected for that unit Control limits for funnel plots are normally set at 9% and 99.% (approximates to or standard deviations). Our normal six-monthly review process focuses on those above the upper limit of the latter. One might expect, however, that one in 00 would be outside the 99.% limits (above or below) just by chance. In the following table we have highlighted in red () units above the upper of the 99.% control limits. Previously we have reported on those units above the 99.99% control limits but this has been removed from this year s report Summary of the methodology for unit mortality rates: The standardised mortality ratio (SMR) is plotted against number of expected deaths. The SMR is the number of actual deaths within 90 days of primary joint replacement divided by the number of expected deaths in this period. The number of expected deaths has been calculated after adjustment for patient characteristics (age, gender and ASA grade of patients). Analysis for hips has excluded operations undertaken for trauma, failed hemi-arthroplasty and, since November 0 (when recording of this began), hips implanted for metastatic cancer Control limits are as for revisions above Any units identified as potential outliers in Part Four have been notified. All units are provided with an Annual Clinical Report and additionally have access to an online NJR Management Feedback system which is updated annually. In earlier Annual Reports, the NJR have reported outlying hospitals based on all cases submitted to the NJR since April 00. To reflect changes in hospital practices and component use, the NJR now also reports outlying hospitals based on only the last five years of primary operation data. This five year cut of data excludes from analysis the majority of withdrawn outlier implants, and metal on metal total hip replacements, and thus better represents contemporary practice. Please note for the data in following table:, and Linkability are: Red if lower than 0% Amber if equal to or greater than 0% and lower than 9% Green if 9% or more Linkability for some hospitals will be lower than expected if they have private patients from outside England and Wales Part Four data covers procedures carried out between January and December Outlier analyses are: Red if units are above the upper of the 99.% control limits (approximates to standard deviations (SDs)) The table uses the following footnotes: Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). Outliers with respect to revisions (at any time) following primary operations performed from 00 onwards [from April 00 to March 0 inclusive]. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). Outliers with respect to revisions (at any time) following primary operations performed from 0 onwards [from March 0 to March 0 inclusive]. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

9 Trust/Local /Company Abertawe Bro Morgannwg University 9% (%) Morriston 9 0 9% 99%. 0% 9. Mortality 0 Mortality 0 Neath Port Talbot 9 9% 99%.9 %. Princess Of Wales % 9%. % 0. Aintree University s NHS 9% Aintree University Sefton Suite 90% 9%.9 0%. University Aintree 9% 99%. %. Airedale NHS 9% Airedale General 9 % 9%. %. Aneurin Bevan % Nevill Hall 0 9 9% 00%. % 0. Royal Gwent 9% 00%. % 0. St Woolos 9 % 9%.0 %. Ysbyty Ystrad Fawr 00% 00%. 0%. Ashford And St Peter's s NHS 99% Ashford 9 % 00%.9 9% 0. St Peter's 9 00% 00%. %. Barking Havering And Redbridge University s NHS Trust 0%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 9

10 Trust/Local /Company (%) King George 9 90% 00%. %. Mortality 0 Mortality Queens % 90%. 9%. Barnsley NHS 9% Barnsley District General 0 % 99%. %. Barts Health NHS Trust 9% Gateway Surgical Centre 0 00% 99%.0 0%. Newham General 00% 00%. %. The Royal London 99% 99%. 0%. Whipps Cross University 0 99% 9%. %. Basildon And Thurrock University s NHS 9% Basildon University 0 % 00%. 0% 0. Bedford NHS Trust % Bedford South Wing 0 9% 00%. %. Belfast HSC Trust N/A Musgrave Park 99% N/A. N/A N/A Royal Victoria 9% N/A. N/A N/A Betsi Cadwaladr University 09% Abergele 9 % 99%.0 0% 0., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable

11 Trust/Local /Company (%) Glan Clwyd General % 9%. %.9 Mortality 0 Mortality Wrexham Maelor 9 9% 9%. % 0. Ysbyty Gwynedd 9% 9%. % 9. Blackpool Teaching s NHS % Blackpool Victoria 0 % 00%. % 0. Bradford Teaching s NHS N/A Bradford Royal Infirmary 0 9% 99%. %. Brighton And Sussex University s NHS Trust 9% Princess Royal 0 % 99%. %. Royal Sussex County % 9%. %. Sussex Orthopaedic NHS Treatment Centre Buckinghamshire Healthcare NHS Trust 90% 9 9 9% 00%. 9% 9.9 Stoke Mandeville % %. %. Wycombe 9% 9%. 0% 9.9 Burton s NHS % Queens Burton Upon Trent 9 9% 99%. 0% 0. Calderdale And Huddersfield NHS 9%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

12 Trust/Local /Company (%) Calderdale Royal 9% 99%. % 9. Mortality 0 Mortality Huddersfield Royal Infirmary % 9%. %.9 Cambridge University s NHS % Addenbrooke's 9 9 9% 99%. % 9.9 Cardiff and Vale University 09% Llandough 9 9 9% 9%. %. University of Wales 00% 00%. % 9. Central Manchester University s NHS 0% Manchester Royal Infirmary % 9%. %.0 Trafford General 9 % 9%. %. Chelsea And Westminster NHS 9% Chelsea & Westminster 9 9% 99%.0 %. West Middlesex University 9 00% 00%. % 0. Chesterfield Royal NHS 9% Chesterfield Royal 9 9% 9%. % 9. City s Sunderland NHS Foundation Trust 9% Sunderland Royal 9 9% 99%. %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

13 Trust/Local /Company Colchester University NHS 9% (%) Colchester General 0 9% 00%. %. Countess Of Chester NHS % Countess Of Chester 99% 99%. 0%. County Durham And Darlington NHS 9% Bishop Auckland 0 90% 00%.9 %. Mortality 0 Mortality Darlington Memorial % 9%. % 9. University Of North Durham 0 9% 9%. %. Croydon Health Services NHS Trust % Croydon University % 9%. 0%.9 Cwm Taf % Prince Charles 90 99% 99%. %. The Royal Glamorgan % 00%. %.9 Dartford And Gravesham NHS Trust % Darent Valley % 00%. 0%. Queen Mary's Sidcup 0 00% 00%.0 %. Derby s NHS 90% Royal Derby 9 0 9% 9%. % 9., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

14 Trust/Local /Company Doncaster And Bassetlaw s NHS % (%) Bassetlaw 9% 9%. % 9. Mortality 0 Mortality Doncaster Royal Infirmary 9 9% 99%. % 0. Dorset County NHS 9% Dorset County 0 9% 99%. % 0. East And North Hertfordshire NHS Trust % Lister % 00%. %.0 Lister Treatment Centre 9 9% 99%. % 0.9 East Cheshire NHS Trust 9% Macclesfield District General 9 9% 00%. % 0. East Kent s University NHS 0% Queen Elizabeth The Queen Mother 9 90% 9%. 9%. William Harvey (Ashford) 9% 9%. % 0. East Lancashire s NHS Trust 9% Burnley General 0 9% 9%. 0% 0. Royal Blackburn Infirmary 9% 9%. %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

15 Trust/Local /Company East Sussex Healthcare NHS Trust % (%) Mortality 0 Mortality Conquest 9% 9%. %. Eastbourne District General 0 9% 9%. %. Epsom And St Helier University s NHS Trust % Epsom % 00%. 0%. St Helier 00% 00%.0 0%. The Elective Orthopaedic Centre 09 99% 99%. % 9.9 Frimley Health NHS % Frimley Park 99% 99%.0 0% 9. Heatherwood 9% 9%.0 % 9. Wexham Park 0 % 9%. 0%. Gateshead Health NHS % The North East NHS Surgery Centre 99% 99%. %.0 George Eliot NHS Trust 99% George Eliot - Acute Services 9 9% 99%. % 9. Gloucestershire s NHS % Cheltenham General 9 9 9% 00%. %. Gloucestershire Royal 0 % 00%. %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

16 Trust/Local /Company Great Western s NHS % (%) The Great Western 9 9% 9%. %. Guy's And St Thomas' NHS % Guy's % 9%. %. Mortality 0 Mortality St Thomas' 0 % %. %. Hampshire s NHS 90% Basingstoke and North Hampshire 9 % 9%. % 0. Royal Hampshire County 0 9 9% 9%. %. Harrogate And District NHS % Harrogate District 99 9 % 9%.0 % 9. Heart of England NHS 0% Good Hope 0 9 % 99%. %. Heartlands Solihull 99 % 9%. % 9. Hinchingbrooke Health Care NHS Trust 9% Hinchingbrooke 9 99% 99%. % 0. Homerton University NHS 9%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

17 Trust/Local /Company (%) Homerton University 9 9% 9%. %. Hull And East Yorkshire s NHS Trust % Castle Hill 9% 9%. % 9. Mortality 0 Mortality Hull Royal Infirmary 9 % %.0 %. Hywel Dda % Bronglais General 99% 00%. % 0.9 Prince Philip 9 99% 00%.9 %. West Wales General 9 00% 9%. %. Withybush General 0 9% 99%. 0% 9. Imperial College Healthcare NHS Trust % Charing Cross 9 9 9% 9%. %. St Mary's 0 % 9%. % 0.9 Ipswich NHS Trust 9% Ipswich 0 99% 99%. % 0.9 Isle of Man Secondary Healthcare Directorate N/A Noble's 0 9% 99%.9 %. Isle Of Wight NHS Trust 0%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

18 Trust/Local /Company (%) St Mary's 00% 00%. % 0. James Paget University s NHS 9% Mortality 0 Mortality James Paget University 9 % 9%. % 0.9 Kettering General NHS 9% Kettering General % 9%. % 0. King's College NHS % King's College (Denmark Hill) 00% 00%. %. Orpington 00% 99%. % 0.0 Princess Royal University 0 % %. 0%. Kingston NHS % Kingston % 90%. %. Lancashire Teaching s NHS 9% Chorley and South Ribble 0 00% 00%. % 0. Royal Preston 9 00% 9%. %. Leeds Teaching s NHS Trust %, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

19 Trust/Local /Company (%) Chapel Allerton 00 % 00%. %. Mortality 0 Mortality 0 Leeds General Infirmary 00% 00%. 0%.9 Lewisham and Greenwich NHS Trust % Queen Elizabeth Woolwich % 99%. %. Riverside Treatment Centre % %. % 9. University Lewisham % 00%.0 9%. London North West Healthcare NHS Trust 9% Central Middlesex 9 9% 99%. % 9. Ealing 00% 00%. % 9. Northwick Park % 9%. 9%. Luton And Dunstable NHS 9% Luton & Dunstable 00% 00%. %. Maidstone And Tunbridge Wells NHS Trust 9% Maidstone District General 0 00% 00%. 0%.0 The Tunbridge Wells 9% 99%. %. Medway NHS 0% Medway Maritime 0 0 0% 9%. % 0., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 9

20 Trust/Local /Company Mid Cheshire s NHS 9% (%) Leighton % 00%. % 0. Mortality 0 Mortality Mid Essex Services NHS Trust 9% Broomfield % 9%. % 0. Mid Yorkshire s NHS Trust 9% Dewsbury and District 9% 9%. % 9. Pinderfields General % 9%. 9% 0. Pontefract Elective Unit (Treatment Centre) 9 9% 9%. %. Milton Keynes NHS % Milton Keynes 9 9% 9%. % 9. Norfolk And Norwich University s NHS 9% Norfolk & Norwich % 00%. %.9 Northampton General NHS Trust % Northampton General (Acute) 0 0 9% 99%. %. North Bristol NHS Trust % Southmead 9% 9%. 0% 9.9 North Cumbria University s NHS Trust 9%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable

21 Trust/Local /Company (%) Cumberland Infirmary % 9%. %. Mortality 0 Mortality 0 West Cumberland % 99%. %.0 Northern Devon Healthcare NHS Trust 9% North Devon District 9% 9%. %.0 Northern Lincolnshire And Goole s NHS % Diana Princess Of Wales 9% 99%. 9%.0 Goole and District (Acute) 00 9% 99%. 9%. Scunthorpe General 9 9% 9%. % 0.0 North Middlesex University NHS Trust 9% North Middlesex 00% 9%. 9% 0. North Tees And Hartlepool NHS 9% University Of Hartlepool 9 00% 00%. %. University Of North Tees % %. %. Northumbria Healthcare NHS 99% Hexham General % 99%.9 %.9 North Tyneside General 9 99% 99%.0 %. Northumbria Specialist Emergency Care 9 % 9%. %.9, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

22 Trust/Local /Company (%) Wansbeck 9 9% 9%.0 %. Mortality 0 Mortality Nottingham University s NHS Trust 9% Nottingham City 90 9% 99%. 0%.9 Queens Medical Centre Nottingham University Oxford University s NHS Trust % % 9%. %. Horton General 9% 9%. %. John Radcliffe 00% 9%. % 9.9 Nuffield Orthopaedic Centre 9 % 9%. 0% 9. Pennine Acute s NHS Trust % Fairfield General 9% 00%. %. North Manchester General 9 9% 00%. % 9.0 Royal Oldham % 99%. % 9. Peterborough And Stamford s NHS 9% Peterborough City 9 9% 9%. % 0. Plymouth s NHS Trust % Derriford 99 9% 9%. % 9.9 Poole NHS 0% Poole 9 0% %. %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

23 Trust/Local /Company Portsmouth s NHS Trust 9% (%) Mortality 0 Mortality Queen Alexandra 00% 00%. % 0. Robert Jones And Agnes Hunt Orthopaedic NHS 90% Robert Jones & Agnes Hunt Orthopaedic 0 9% 99%. % 9. Royal Berkshire NHS 9% Royal Berkshire 0 9% 9%. % 0. Royal Bolton NHS Foundation Trust 9% Royal Bolton 09 9% 9%. 0% 9.0 Royal Cornwall s NHS Trust % Royal Cornwall (Treliske) 0 9 % 9%. %. St Michael's 9% 9%.0 %. Royal Devon And Exeter NHS 9% Royal Devon & Exeter (Wonford) 9 9% 9%. % 0. Royal Free London NHS 0% Barnet % 9%. %. Chase Farm 99 % 9%. %. The Royal Free 99% 99%. % 9., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

24 Trust/Local /Company Royal Liverpool And Broadgreen University s NHS Trust 9% (%) Mortality 0 Mortality Broadgreen 9 % 99%. 9%. The Royal Liverpool University % 9%. %. Royal National Orthopaedic NHS Trust % The Royal National Orthopaedic (Stanmore) % 9%.0 0%. Royal Surrey County NHS N/A Royal Surrey County 00% 00%.0 % 9. Royal United Bath NHS Trust % Royal United 0 9% 99%. %. Salford Royal NHS % Salford Royal 9% %. % 0. Salisbury NHS 0% Salisbury District 9% 9%. 9%. Sandwell And West Birmingham s NHS Trust City 9% Sandwell General 0 9% 9%. 9% 9.9, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

25 Trust/Local /Company Sheffield Teaching s NHS % (%) Northern General 0 % 99%. %. Mortality 0 Mortality Royal Hallamshire 9% 00%. 0%.9 Sherwood Forest s NHS 9% Kings Mill 9% 99%. %. Shrewsbury and Telford NHS Trust % Royal Shrewsbury 9% 00%. %. The Princess Royal 99 00% 99%. %.0 South Devon Healthcare NHS % Torbay 90 % 9%. %. South Eastern HSC Trust N/A Ulster Dundonald % N/A. N/A N/A Southend University NHS % Southend % 00%. %. Southern HSC Trust N/A Craigavon Area 90% N/A. N/A N/A Southport And Ormskirk NHS Trust 9%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

26 Trust/Local /Company (%) Ormskirk & District General 9 % 00%.0 % 0.0 Southport and Formby District General South Tees s NHS % 00%. 9%. 9% Friarage 00% 00%. % 9. Mortality 0 Mortality The James Cook University 90 99% 00%. % 9.0 South Tyneside NHS 90% South Tyneside District 9 % 00%. %. South Warwickshire NHS % Warwick 99 9% 9%. 0% 0. St George's Healthcare NHS Trust % St George's (Tooting) 0 00% 9%. 9%. St Helens And Knowsley s NHS Trust 9% Whiston 9 9% 9%. % 9. Stockport NHS 9% Stepping Hill 9% 9%. % 0. Surrey And Sussex Healthcare NHS Trust % East Surrey % 9%. 9%. Tameside NHS % Tameside General 9 99% 99%. % 0., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

27 Trust/Local /Company Taunton And Somerset NHS % (%) Mortality Musgrove Park 0 00% 00%. %. The Dudley Group Of s NHS 9% Russells Hall 9 9% 00%. 0% 0. The Hillingdon NHS 9% Hillingdon 9 % 9%. %. 0 Mortality Mount Vernon Treatment Centre % %.0 % 9. The Newcastle Upon Tyne s NHS % Freeman 99% 99%. 0%. The Royal Victoria Infirmary 9 % 90%. %. The Princess Alexandra NHS Trust 0% Princess Alexandra 0 % 9%. % 0. The Queen Elizabeth King's Lynn NHS % The Queen Elizabeth 9 9% 99%. %. The Rotherham NHS % Rotherham District General 9 9% 9%. % 9. The Royal Bournemouth And Christchurch s NHS 90%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

28 Trust/Local /Company (%) Royal Bournemouth 9 9% 99%.0 0%. The Royal Orthopaedic NHS 9% Royal Orthopaedic 9% 9%.0 %. The Royal Wolverhampton s NHS Trust 99% Mortality 0 Mortality Cannock Chase 99 9% 99%.0 % 9. 0 New Cross 9% 99%. %.0 The Whittington NHS Trust % The Whittington 9% 99%.0 0%. United Lincolnshire s NHS Trust % County Louth 0 99% 99%. 9%. Grantham and District 00 9% 99%. %. Lincoln County % 9%. %. Pilgrim 9% 99%. % 0.9 University College London s NHS 9% University College % 9%. %. University Birmingham NHS Trust % Queen Elizabeth Birmingham 0 % 90%. % 9. University Of South Manchester NHS %, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

29 Trust/Local /Company (%) Wythenshawe 9% 00%. % 0. University s Bristol NHS Bristol Royal for Children % Mortality 0 Mortality Bristol Royal Infirmary 9 % %. %. University s Coventry And Warwickshire NHS Trust 9% Of St Cross 0 9% 9%.0 9%. University (Coventry) 99% 99%. %. University s Of Leicester NHS Trust % Leicester General 9 9% 00%. 0% 9. University s Of Morecambe Bay NHS % Furness General 9 9% 99%. % 0. Royal Lancaster Infirmary 9 99% 00%. 0%. Westmorland General 00% 9%.9 9% 9.0 University s of North Midlands NHS Trust % County 0 9% 99%. % 9. Royal Stoke University 9 0% 00%. % 0. University Southampton NHS 90%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable

30 Trust/Local /Company (%) Mortality 0 Mortality Southampton General 99 9% 9%. % 0. 0 Walsall Healthcare NHS Trust 9% Manor 9 00% 9%. % 9. Warrington and Halton s NHS 9% The Cheshire and Merseyside Treatment Centre 0 9% 9%.0 %. Warrington 0 9% 9%. %.9 Western HSC Trust N/A Altnagelvin Area 9% N/A. N/A N/A Western Sussex s NHS Trust % St Richard's 9% 00%. 0%. Worthing % %. %.0 West Hertfordshire s NHS Trust 9% St Albans City 9 9% 9%.0 9% 9. Watford General 9 9% 9%. 9%. Weston Area Health NHS Trust % Weston General 0 9 9% 9%. %. West Suffolk s NHS Trust % West Suffolk 9% 00%. %. Wirral University Teaching NHS 9%, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

31 Trust/Local /Company (%) Arrowe Park 9% 9%. %. Mortality 0 Mortality Clatterbridge 9 9% 99%.9 %.0 Worcestershire Acute s NHS Trust 90% Alexandra 99% 00%. %. Kidderminster Treatment Centre 9% 9%.0 % 0.0 Worcestershire Royal 9 % 9%. %. Wrightington Wigan And Leigh NHS 9% Royal Albert Edward Infirmary % 00%. %. Wrightington 99% 99%. %. Wye Valley NHS Trust % Hereford County 00% 00%. 0% 0. Yeovil District NHS 9% Yeovil District 9% 00%. % 0. York Teaching NHS 9% Bridlington and District 9% 99%. % 0.0 Scarborough General 9% 9%. %. York 9 % 99%. %. fivetwo Group, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

32 Trust/Local /Company (%) Kingsbridge Private (Belfast) % N/A. N/A N/A Mortality 0 Mortality Aspen Healthcare Limited Claremont (South Yorkshire) 0% 9%.9 %. Highgate (London) 9 0 9% 9%.9 %. Holly House (Essex) 9% 9%.0 % 9.0 Parkside (Greater London) 9% %. %. Benenden Healthcare Society Benenden (Kent) 9% 9%.9 % 0. BMI Healthcare BMI Alexandra Cheadle (Cheshire) 9 00% 9%. %.0 BMI Bath Clinic (Avon) 9 99% 9%.9 0%. BMI Beardwood Private (Lancashire) 9% 99%. % 0.0 BMI Bishops Wood (Middlesex) 9 9 9% 9%. % 9.9 BMI Blackheath (Greater London) % 9%.0 %. BMI Bury St Edmunds (Suffolk) 9% 9%.0 % 0. BMI Chaucer (Kent) 0 9% 9%. %. BMI Chelsfield Park (Kent) 00% 9%.0 9% 9. BMI Clementine Churchill (Middlesex) % 9%.9 %.9, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

33 Trust/Local /Company (%) BMI Coombe Wing (Surrey) 0% 00%. %. Mortality 0 Mortality BMI Esperance (East Sussex) 9% 9%.9 9% 9.9 BMI Fawkham Manor (Kent) 00% 9%.0 %. BMI Garden (Greater London) 9% 9%. %. BMI Gisburne Park (Lancashire) 0 9% 9%. %. BMI Goring Hall (West Sussex) % 99%.0 % 0. BMI Hampshire Clinic (Hampshire) 9 0 % 9%.0 % 9.0 BMI Harrogate (North Yorkshire) 9% 9%.9 %. BMI Highfield (Lancashire) 0 9% %. %. BMI Huddersfield (West Yorkshire) 0 00% 00%. % 9. BMI Kings Oak (Middlesex) 9 9% 9%.9 % 0. BMI Lancaster (Lancashire) 00% 00%. 9% 9. BMI Lincoln (Lincolnshire) 9 9% 00%.0 0% 9. BMI Manor (Bedfordshire) 9 00% 9%.0 %. BMI Mount Alvernia (Surrey) 0 9% 9%. %. BMI Princess Margaret (Berkshire) 0 99% 9%. 9%. BMI Priory (West Midlands) 9 9% 9%.9 0%. BMI Ridgeway (Wiltshire) 9 0 9% 9%. %. BMI Runnymede (Surrey) 90 00% 90%. %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

34 Trust/Local /Company (%) BMI Sandringham (Norfolk) 9% 9%. % 0.0 Mortality 0 Mortality 0 BMI Sarum Road (Hampshire) 0 % 9%.9 %. BMI Saxon Clinic (Buckinghamshire) 9% 9%.9 %. BMI Shelburne (Buckinghamshire) % %.9 %. BMI Shirley Oaks (Surrey) % 00%. 0%. BMI The Beaumont (Lancashire) 00% 00%.0 %.0 BMI The Cavell (Middlesex) 00% 0%.9 % 9. BMI The Chiltern (Buckinghamshire) 9 9 9% 9%.0 % 9.0 BMI The Droitwich Spa (Worcestershire) BMI The Edgbaston (West Midlands) 99% 99%.0 %.9 % %. %.0 BMI The Harbour (Dorset) 0 9% 9%. %. BMI The London Independent (Greater London) 9 9% 9%.0 %. BMI The Meriden (West Midlands) 00% 9%.9 %. BMI The Park (Nottinghamshire) % 9%.0 %. BMI The Sloane (Kent) % 9%. 0%.0 BMI The Somerfield (Kent) 0 99% 9%. %. BMI The South Cheshire Private (Cheshire) 0 00% 99%. % 9.0 BMI Thornbury (South Yorkshire) 99% 9%.9 %., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

35 Trust/Local /Company BMI Three Shires (Northamptonshire) (%) 99% 9%.0 %. BMI Werndale (Carmarthenshire) 0 00% 00%.0 %. Mortality 0 Mortality 0 BMI Winterbourne (Dorset) 9 9% %.0 %.0 BMI Woodlands (County Durham) 9% 9%.9 %. Care UK Barlborough NHS Treatment Centre (Derbyshire) Emersons Green NHS Treatment Centre (Avon) North East London NHS Treatment Centre (Essex) 90 00% 00%.0 % 9. 00% 00%.9 % % 00%. % 0. Peninsula NHS Treatment Centre (Devon) 9 9% 99%.9 % 9. Shepton Mallet Treatment Centre (Somerset) Southampton NHS Treatment Centre (Hampshire) Circle % 00%.9 % 0. 9% 99%.0 %.0 Circle Bath (Avon) 0 % 9%. %.0 Circle Reading (Berkshire) % 9%. %. Nottingham NHS Treatment Centre (Nottinghamshire) Bupa Group 9% 9%. % 9., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

36 Trust/Local /Company (%) Bupa Cromwell (Greater London) % 9%. %. Mortality 0 Mortality East Kent Medical Services Ltd Spencer Private s - Margate (Kent) 9% 9%.0 0%. Fairfield Fairfield (Merseyside) 9% 9%. %. Foscote Court (Banbury) Trust Limited Foscote Private (Oxfordshire) 99% 99%.9 % 0.0 HCA International Ltd London Bridge (London) 90% %. %. The Lister (London) 00 % 0%.0 0%. The Princess Grace (London) % 9%.9 %. The Wellington (London) 9% 9%. %. Healthcare Management Trust Sancta Maria (West Glamorgan) 99% 9%.0 % 9. St Hugh's (North East Lincolnshire) Horder Healthcare 00% 00%. % 9. Horder Healthcare (East Sussex) 99% 99%.9 0% 0. The McIndoe Centre (West Sussex) 00% 00%.0 %. Of St John And St Elizabeth, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

37 Trust/Local /Company of St John And St Elizabeth (Greater London) Kent Institute of Medicine and Surgery The Kent Institute of Medicine And Surgery (Kent) King Edward VII Sister Agnes King Edward VII Sister Agnes (Greater London) North West Independent North West Independent (County Londonderry) Nuffield Health Nuffield Health Bournemouth (Dorset) (%) 9 9% %.0 % % 99%. %.0 Mortality 0 Mortality 0 % 9%.9 %. 9% N/A.9 N/A N/A 00% 9%.0 %. Nuffield Health Brentwood (Essex) % 9%.9 %. Nuffield Health Brighton (East Sussex) 9 % 9%. 0% 9. Nuffield Health Bristol (Avon) 99% 9%.9 %. Nuffield Health Cambridge (Cambridgeshire) Nuffield Health Cheltenham (Gloucestershire) Nuffield Health Chichester (West Sussex) 99% 9%.9 % % 9%.9 % 9.9 0% 9%.9 9% 0., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

38 Trust/Local /Company (%) Nuffield Health Derby (Derbyshire) 9 9% 9%.9 %. Mortality 0 Mortality Nuffield Health Exeter (Devon) 9 00% 9%.9 % 9.9 Nuffield Health Guildford (Surrey) 9% 9%.9 % 9.9 Nuffield Health Haywards Heath (West Sussex) Nuffield Health Hereford (Herefordshire) 9% 9%. 9% % 99%.9 %. Nuffield Health Ipswich (Suffolk) 0 00% 9%.0 0%. Nuffield Health Leeds (West Yorkshire) Nuffield Health Leicester (Leicestershire) Nuffield Health Newcastle-upon-Tyne (Tyne & Wear) Nuffield Health North Staffordshire (Stafordshire) % 9%.9 %. 0 9% 99%.0 % % 99%. % % 9%.0 %.9 Nuffield Health Plymouth (Devon) % 99%.9 9%. Nuffield Health Shrewsbury (Shropshire) % 9%. %. Nuffield Health Taunton (Somerset) 0 9% 9%.0 % 9.9 Nuffield Health Tees (Cleveland) 9 99% 00%.9 %. Nuffield Health The Grosvenor (Cheshire) 99% 99%.9 % 9., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

39 Trust/Local /Company Nuffield Health The Manor (Oxfordshire) Nuffield Health Tunbridge Wells (Kent) Nuffield Health Warwickshire (Warwickshire) Nuffield Health Wessex (Hampshire) (%) 9% 9%.9 %. % 9%.0 % 0. 0 % %.9 %. Mortality 99% 9%. %. Nuffield Health Woking (Surrey) 9 9% 9%. % 9. Nuffield Health Wolverhampton (West Midlands) Nuffield Health York (North Yorkshire) 0 00% 99%.9 % 9. 9% 9%. 9% 9.0 Vale (Glamorgan) 9 9% 9%.9 %. 0 Mortality One Ashford Healthcare Ltd One Ashford Willesborough (Kent) 00% 99%.0 % 9.9 Orthopaedic Spine and Specialist Orthopaedics and Spine Specialist (Cambridgeshire) Ramsay Health Care 9 9% 9%. % 9.9 Ashtead (Surrey) 00% 99%.9 % 0. Duchy (Cornwall) % %. % 9. Euxton Hall (Lancashire) 00% 00%.0 %. Fitzwilliam (Cambridgeshire) 90 99% 99%.0 % 9.0, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable

40 Trust/Local /Company (%) Fulwood Hall (Lancashire) 0 00% 00%.0 %. Mortality 0 Mortality Mount Stuart (Devon) 99% 9%.9 %.9 New Hall (Wiltshire) 0 9% 9%. %. North Downs (Surrey) 0 00% 9%. 0% 9. Nottingham Woodthorpe (Nottinghamshire) 9 99% 99%. %. Oaklands (Lancashire) 00% 00%.9 %. Oaks (Essex) 9 00% 99%. % 9. Park Hill (South Yorkshire) 0 00% 99%. 0%. Pinehill (Hertfordshire) 9% 99%. %. Renacres Hall (Lancashire) % 00%.9 %.9 Rivers (Hertfordshire) 9% 9%. %.9 Rowley Hall (Staffordshire) 9 00% 99%.0 % 0. Springfield (Essex) 0 9% 9%. %.9 The Berkshire Independent (Berkshire) 9% 9%.0 % 0. The Yorkshire Clinic (West Yorkshire) 9 9% 9%.0 %. West Midlands (West Midlands) 00% 9%. 9% 9. Winfield (Gloucestershire) 99% 99%.9 %. Woodland (Northamptonshire) 90% 9%.0 %.9 Clifton Park (North Yorkshire) 0 9% 9%.9 %.9, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable

41 Trust/Local /Company Horton NHS Treatment Centre (Oxfordshire) Spire Healthcare (%) Mortality 0 Mortality % 00%. % 9. Dunedin (Berkshire) 0 00% 9%. % 9. Elland (West Yorkshire) 0 00% 00%. %. Fylde Coast (Lancashire) % 9%. %. Methley Park (West Yorkshire) % 99%.0 %. Regency (Cheshire) 0 99% 99%.0 0% 0. Spire Alexandra (Kent) 9% 9%. 0% 9. Spire Bristol (Avon) 0 00% 99%.9 %. Spire Bushey (Hertfordshire) % 90%. %. Spire Cambridge Lea (Cambridgeshire) 0 00% 00%. %. Spire Cardiff (Glamorgan) 9% 9%. %. Spire Cheshire (Cheshire) 9 00% 9%.0 %. Spire Clare Park (Surrey) 9 % 9%. %. Spire Gatwick Park (Surrey) 9 9% 9%.9 %. Spire Harpenden (Hertfordshire) 9% 9%.0 %. Spire Hartswood (Essex) 9 00% 9%.9 %. Spire Hull and East Riding (East Yorkshire) 0 0 9% 9%.0 %. Spire Leeds (West Yorkshire) 99% 9%.9 9%., consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

42 National Joint Registry for England, Wales, Northern Ireland and the Isle of Man th Annual Report Trust/Local /Company (%) Spire Leicester (Leicestershire) 0 99% 99%.0 % 9. Mortality 0 Mortality 0 Spire Little Aston (West Midlands) 00% 99%.9 % 9.0 Spire Liverpool (Merseyside) 00% 99%.0 %. Spire Manchester (Lancashire) 0 9% 9%.9 %. Spire Montefiore (East Sussex) 0 9% 9%.9 % 9. Spire Murrayfield (Merseyside) % 99%.9 0%. Spire Norwich (Norfolk) 9% 9%.9 % 9. Spire Parkway (West Midlands) 9% 99%. %.9 Spire Portsmouth (Hampshire) 9 00% 9%.9 %. Spire Roding (Essex) 9% 9%.0 %. Spire Southampton (Hampshire) 0 9% 9%. %. Spire South Bank (Worcestershire) 0 9% 9%. % 9. Spire Sussex (East Sussex) 00% 9%.0 0% 9. Spire Thames Valley (Berkshire) 99% 9%.9 % 9. Spire Tunbridge Wells (Kent) 00% 9%. % 9. Spire Washington (Tyne & Wear) 99% 9%.9 %. Spire Wellesley (Essex) 9 9% 9%.9 % 9. Spire Yale (Wrexham) 9% 9%.9 % 0. St Anthonys (Surrey) % %. %.9 St Josephs, consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable.

43 National Joint Registry for England, Wales, Northern Ireland and the Isle of Man th Annual Report Trust/Local /Company (%) St Josephs (Gwent) 9% 9%.0 %. Mortality 0 Mortality The London Clinic The London Clinic (London) 0 00% %. % 0.0 The New Victoria Limited The New Victoria (Surrey) 9% 9%.0 0% 0. The Ulster Independent Clinic Ulster Independent Clinic (Belfast) 99% N/A.9 N/A N/A Please note for the data in following table:, and Linkability are: Red if lower than 0% Amber if equal to or greater than 0% and lower than 9% Green if 9% or more Linkability for some hospitals will be lower than expected if they have private patients from outside England and Wales Part Four data covers procedures carried out between January and December Outlier analyses are: Red if units are above the upper of the 99.% control limits (approximates to standard deviations (SDs)), consent and linkability are red if lower than 0%, green if 9% or more and amber in between Only) - the percentage of cases submitted to the NJR compared to HES/PEDW. Rate - percentage of cases submitted to the NJR with patient consent confirmed. Outliers with respect to mortality following primary operations performed from 00 onwards. Units above the upper of the 99.% control limits (approx SDs) are flagged in red (). figures were unavailable. 0

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