National Neuromodulation Registry (NNR)
The National Neuromodulation Registry (NNR) was established in the UK in February 2018 as a national initiative led by the Neuromodulation Society of the UK and Ireland (NSUKI) to address a recognised gap in long‑term outcome data and safety surveillance for implantable neuromodulation therapies. At the time, neuromodulation—including sacral nerve stimulation (SNS) for bladder and bowel dysfunction—was already an established and effective therapy, but there was limited routine capture of real‑world outcomes, complications and device performance beyond individual centres. The registry was therefore designed as a national, standardised dataset linking patient, procedural and device information with longitudinal outcomes, enabling a more systematic approach to monitoring safety, effectiveness and service delivery across the NHS.
In recent years, the scope of the registry has expanded to include pelvic floor disorders, such as urinary and faecal incontinence, treated with sacral nerve stimulation. These procedures involve implantable devices and long‑term management, meaning that outcomes are dependent on patient selection, programming, follow‑up and device performance over time. As such, registry participation provides one of the few mechanisms to generate robust, real‑world evidence on durability, complication rates and patient‑reported outcomes for these therapies across large populations.
Neuromodulation interventions are costly, and the NHS and NICE increasingly require evidence of clinical effectiveness, safety and value to support commissioning decisions and equitable access. A national registry provides a central, independent repository of such evidence, enabling monitoring of outcomes, supporting regulatory reporting (including to MHRA), and informing service planning and policy. It also aligns with wider NHS strategy following the Cumberlege review, which emphasised the need for national, patient‑identifiable registries to improve device vigilance and patient safety, now being delivered through programmes such as the NHS Outcomes and Registries Programme.