Surgeon Profile - NJR Surgeon and Hospital Profile

SURGEON PROFILE

This section shows the types of procedure in which the surgeon specialises.

HOSPITALS IN WHICH THE SURGEON HAS ACTIVITY RECORDED IN NJR

This lists all hospitals in which the selected surgeon has hip, knee, ankle, elbow or shoulder procedures recorded on the National Joint Registry for the period 1 April 2020 to 31 March 2023, where surgery is recorded in the name of the selected surgeon (they are the Consultant in Charge of the patient but not necessarily the operating surgeon).

Bristol Royal Infirmary
Southmead Hospital

12-MONTH PRACTICE PROFILE (1 YEAR)

Practice profile shows the total number of procedures recorded on the National Joint Registry for the period 1 April 2022 to 31 March 2023, where surgery is recorded in the name of the selected surgeon (where they are the Consultant in Charge of the patient but not necessarily the operating surgeon).

Data for 1 April 2022 - 31 March 2023

Operation Type	Operation Subcategory	Procedures Recorded for this Surgeon	National Average
Knee Primary	Total knee replacement	10	56
Knee Revision	-	Fewer Than 5	6
Total	-	10+	62


Time from first procedure submitted to the NJR as Consultant in Charge	0-6 months

Time from first procedure submitted to the NJR as Consultant in Charge

0-6 months

36-MONTH PRACTICE PROFILE (3 YEAR)

Practice profile shows the total number of procedures recorded on the National Joint Registry for the period 1 April 2020 to 31 March 2023, where surgery is recorded in the name of the selected surgeon (where they are the Consultant in Charge of the patient but not necessarily the operating surgeon).

Data for 1 April 2020 - 31 March 2023

Operation Type	Operation Subcategory	Procedures Recorded for this Surgeon	National Average
Knee Primary	Total knee replacement	10	115
Knee Revision	-	Fewer Than 5	13
Total	-	10+	128


Time from first procedure submitted to the NJR as Consultant in Charge	0-6 months

Time from first procedure submitted to the NJR as Consultant in Charge

0-6 months

KNEES

This area includes a range of quality measures and information for surgeons carrying out first-time knee replacements.

ABOUT THE PATIENTS WHO WERE TREATED

<p>This information display shows overall characteristics for first-time knee replacement patients treated by this surgeon between 1 April 2003 and 31 March 2023. Against each characteristic you will be able to see whether this surgeon has treated a greater or fewer number of patients of a particular type. This surgeon is represented on the chart by the black marker (<img src="Images/RedVerticalLine.jpg" style="width:3px;height:15px">).</p><p>The types of patients a surgeon treats can explain variation in patient outcomes after surgery. Please click on the “How to interpret this chart” button for further information.</p><p>For surgeons in England and Wales, the NJR has collected data since 2003. For Northern Ireland information has been collected since February 2013, for the Isle of Man since July 2015 and for Guernsey since November 2019.</p><p></p>

This information display shows overall characteristics for first-time knee replacement patients treated by this surgeon between 1 April 2003 and 31 March 2023. Against each characteristic you will be able to see whether this surgeon has been responsible for a greater or fewer number of patients of a particular type. This surgeon is represented on the chart by the black marker ().

The types of patients a surgeon treats can explain variation in patient outcomes after surgery. Please click on the “How to interpret this chart” button for further information.

For surgeons in England and Wales, the NJR has collected information since 2003. For surgeons in Northern Ireland since February 2013, for surgeons in the Isle of Man since July 2015 and for surgeons in Guernsey since November 2019.

Data for 1 April 2003 - 31 March 2023

Click on the

to find out more about the quality measure and its source data

Percentage Of Patients Who Were:	This Surgeon	National Average
Male	50%	44%
Under 60 years of age	40%	17%
Severely Obese (BMI of 35 or greater)	22%	23%
At higher risk of medical problems before or after Surgery (ASA 3+)	30%	17%
Diagnosed with conditions other than Osteoarthritis	0%	3%

KNEES - 90-DAY MORTALITY

This shows the 90-day mortality rate following surgery for this surgeon based on the type of patients this surgeon has seen. The data is risk adjusted to take account of the fact that different surgeons may operate on higher-risk or lower-risk patients (e.g. because of demographics in the patient population they work with). It should be noted that the mortality rate after hip and knee replacement surgery is influenced by many factors outside the control of the operating surgeon. Case-mix adjustment is a useful tool but as with any methodological approach it cannot account for all differences including those that may be due to random events.
The analysis comprises primary operations carried out between May 2018 and May 2023 (follow-up has been censored at this time point). The unit of analysis is the primary implant but where there were bilateral primary procedures (on the same day), only one has been included in the analysis. Instances have occurred in which a primary procedure was performed on a patient within 90 days of a previous primary procedure (of the same type, i.e. hip or knee) although not on the same day. Whilst both sides were included in the analysis, in a small number of cases the patient died within 90 days of both the first and the second primary procedure, leading to the patient’s death being counted twice for the given consultant.

Data for May 2018 to May 2023 Surgeon risk adjusted 90-day mortality

What does this mean?

This shows 90-day mortality following knee surgery for this surgeon, based on the type of patients this surgeon has seen.

The surgeon you are reviewing is highlighted as an orange triangle. Progression along the horizontal axis (x axis) means that the surgeon has done more cases and/or cases at a higher mortality risk such as older patients. Progression along the vertical axis (y axis) means the surgeon has had more deaths.

The vertical axis figures are presented as a standardised mortality ratio. This means the values do not represent percentages of patients who have died, but they represent the proportion of deaths compared to the national average. The data is also risk adjusted to take account of the fact that different surgeons may operate on more higher-risk or lower-risk patients e.g. because of demographics in the patient population they work with.

Surgeons on the central (green) horizontal line (at national average ratio figure of 1) have had exactly the average expected mortality
Surgeons either side of the central green line but below the upper red line have had a level of mortality that is within the expected range
Any surgeons that appear above the top red line which represents a Control limit (99.8%) have a mortality rate that is higher than expected.

The overall 90-day mortality rate following primary knee replacement surgery is approximately 0.21%.

Surgeon: James Richard Alexander Smith

GMC: 7049862

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