About the National Neonatal Audit Programme (NNAP)

The NNAP supports professionals, families and commissioners to improve care provided by neonatal services who look after babies born too early, with a low birth weight or who have a medical condition requiring specialist treatment.


Established in 2006, the National Neonatal Audit Programme (NNAP) is commissioned by the Healthcare Quality Improvement Partnership (HQIP). The NNAP is funded by NHS England, the Scottish Government and the Welsh Government, and is delivered by the RCPCH. We are currently contracted to deliver the NNAP to the end of March 2025.

The NNAP assesses whether babies admitted to neonatal units in England, Scotland and Wales receive consistent high quality care. We identify areas for quality improvement in relation to the delivery and outcomes of care.

Scope of the audit

NNAP uses a range of measures to monitor neonatal care and highlight where improvement is required. These measures can vary from year to year and are categorised into the following themes:

  • Outcomes of neonatal care
  • Optimal perinatal care
  • Maternal breastmilk feeding
  • Parental partnership in care
  • Neonatal nurse staffing
  • Care processes
  • Overall network performance

Aims of the audit

The NNAP has set out a series of supporting objectives, and approaches to stimulating healthcare improvement, which include:

  • High quality data outputs that identify areas for action and support stakeholders’ improvement initiatives.
  • Sharing best practice and quality improvement resources
  • Collaboration and engagement with regional and national initiatives
  • Parent and public engagement

The NNAP has section 251 approval to collect patient identifiable data without explicit patient consent. This data is processed and reported by the NNAP team at RCPCH, with HQIP (Healthcare Quality Improvement Partnership) and NHS England as the joint data controllers.

HQIP may approve the sharing of pseudonymised NNAP data for the purpose of academic research if stringent data protection policies and arrangements can be demonstrated by requestees and the aims of the research are approved.

Further information about how data collected for the audit is used and our privacy notice can be found on the NNAP privacy notice - Your baby's information page.

Governance structure of the NNAP

A diagram outlining the project management and governance structure of the NNAP can be downloaded below.


The Understanding Practice in Clinical Audit and Registries (UPCARE) tool is a protocol to describe the key features of clinical audits and registries designed by HQIP. It provides a "one-stop" summary of the key information about how clinical audits and registries have been designed and carried out. It aims to help people understand the methods, evaluate the quality and robustness of the data, and find information and data that is most relevant to them.

The NNAP UPCARE tool at both programme and workstream level can be downloaded below.