• Ivor Vanhegan, Andrew Sankey, Warwick Radford, Simon Ball, and Charles Gibbons.
• Specialist Registrar (ST8) and Honorary Clinical Lecturer (UCL), Trauma and Orthopaedic Surgery Department, Chelsea and Westminster Hospital, London SW10 9NH.
• Brit J Hosp Med. 2019 Sep 2; 80 (9): 537-540.

BackgroundSatisfaction of the best practice tariff criteria for primary hip and knee replacement enables on average an additional £560 of reimbursement per case. The Getting it Right First Time report highlighted poor awareness of these criteria among orthopaedic departments.MethodsThe authors investigated the reasons for non-compliance with the best practice tariff criteria at their trust and implemented a quality improvement approach to ensure successful adherence to the standards (a minimum National Joint Registry compliance rate of 85%, a National Joint Registry unknown consent rate below 15%, a patient-reported outcome measure participation rate of ≥50%, and an average health gain not significantly below the national average). This was investigated using quarterly online reports from the National Joint Registry and NHS Digital.ResultsInitially, the trust had a 31% patient-reported outcome measures participation rate arising from a systematic error in the submission of preoperative patient-reported outcome measure scores. Re-audit following the resubmission of patient-reported outcome measure data under the trust's correct organization data service code confirmed an improvement in patient-reported outcome measure compliance to 90% and satisfaction of all criteria resulting in over £450 000 of additional reimbursement to the trust.ConclusionsThe authors would urge others to review their compliance with these four best practice tariff criteria to ensure that they too are not missing out on this significant reimbursement sum.

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