Update on the National Registry for Hearing Implants – September 2025
It continues to be a busy time for the NRHI steering group, working towards our eventual goal of a registry for all implanted hearing devices. The primary aim of the registry remains to improve safety and outcomes for hearing implant users in the UK.
Rollout!!
As previously reported, the CI arm of the Registry finally ‘went live’ on Monday 24th March 2025 for five early adopter sites (St Thomas’, NECIP, Cambridge, Birmingham Adults and Childrens). After a successful pilot, the remainder of English CI centres were able to access the NRHI from 8th May, with all centres entering their data by 8th June 2025. Several training webinars were delivered over May to support teams to ‘onboard’ and start entering data. A huge thank you to all CI Teams for their support and engagement with the Registry – your efforts and enthusiasm are appreciated!
Teams *in England* are now expected to enter data for all new CI recipients. If any problems, glitches, queries (or suggestions) are encountered, please continue to report these using the ‘feedback’ tab at the bottom of the registry site, or email: england.support.NRHI@nhs.net. These are regularly reviewed by the NRHI team. Supporting resources are available in the registry platform and on the BCIG website ‘NRHI’ tab in the members area.
Please note that consent is not required to enter data for NHS patients in England. For private patients, we ask that data is still entered wherever possible, however consent is required for this group. This can be obtained and recorded by locally agreed process.
Work is still ongoing behind the scenes with the respective devolved governments to establish arrangements allowing roll-out for Welsh, N. Irish and Scottish sites.
Background to the NRHI
The NRHI has been developed under the NHS England ‘Outcomes Registry Programme’ (ORP). This overarching National programme aims to capture key data on all types of implanted medical devices. The data collected by the ORP is on two levels. Firstly a single ‘core dataset’ for all implantable medical devices, which will cover details of the device used (including unique device identifier or UDI), patient, date & place of surgery and surgeon. When standing alone, this element is also known as ‘MDOR’, or the Medical Device Outcome Registry. Secondly, individual specialties may set up additional outcome datasets, with clinical information relevant to the specific type of device.
For the NRHI a suite of outcome datasets have been developed for cochlear implants - these include relevant clinical information, complications, and in future will include patient-reported outcomes (PROMs and PREMs). Other registries being developed in parallel with the NRHI include neural implants, breast and cosmetic implants, and pelvic floor implants.
Trusts in England have already received notice that they are required to complete core ‘MDOR’ datasets for all type IIb and III medical devices. This will include cochlear implants, ABI, active bone conduction implants and MEI (as type III) and other bone conduction implants (as type IIb). The ORP have funded development of a national online portal for data submission. They will also support ongoing data analysis and reporting.
A note on transferring patients
For patients that move clinic, you can search for pre-existing NRHI entries using their NHS number, name and/or DoB. If a previous entry exists, the information visible depends on user role. ‘Data entry’ roles will only be able to view that an NRHI treatment entry exists and where it was created, but will not be open these treatment records. ‘Clinicians’ (currently limited by ORP to doctors with a GMC number) will be able to see some further detail including the type of implant and date of insertion. Either role will be able to create new treatments & forms linked to the patient, in order to add any future NRHI records required. We hope to be able to expand access to the ‘clinician’ role shortly.
Next Steps
Work has now begun on data analysis and reporting. A committee has been established for reporting and outlier analysis, led by Debi Vickers. The present focus is on developing a ‘dynamic reporting’ dashboard where sites can view, filter and interrogate their own data and national (summarised) data in real time as it is submitted. The first pages of this are looking really good and are almost ready to move into build phase; we are hoping to have some parts of the dashboard live by BCIG 2026.
Once the dashboard is up and running, work will begin on a ‘static report’ published annually. For the first year, there is unlikely to be enough outcomes data to allow for detailed analysis and establishment of thresholds for outlier detection – this work will build over time. Therefor the first static report will focus on descriptive analysis of the data, with future reports building over time.
Datasets for the ABI and BCHI/MEI implant types are in the final stages of confirmation. Work will begin soon on extending the platform to collect this data, and to engage with ‘BCHI only’ sites in England to ensure good compliance with data entry.
Work is ongoing to define requirements for Patient reported outcomes (PROMs and PREMs), including consultation with manufacturers regarding how these can contribute to post-market surveillance. A full consultation on PROMs is planned for later in the year.
Work is ongoing to define data flow to manufacturers, including exploration of the possibility of single point of registration.
Keep in touch: please feel free to email Katherine, Kate, Jenny, Debi or Dan if you have any registry-related questions or comments!
Katherine.wilson23@nhs.net
Katehanvey@nhs.net
dav1000@medschl.cam.ac.uk
Jenny.townsend@wales.nhs.uk
Dan.jiang3@nhs.net