NNAP data flow and methodology

Data flow in the NNAP

This diagram shows the NNAP data flow, in which neonatal units enter clinical data onto BadgerNet, with relevant data transferred to and interpreted by NNAP, and results used by units and networks to inform local quality improvement.

For more information:

• Detailed diagram of data flow
• Health Research Authority Confidentiality Advisory Group (CAG) letters of support for the NNAP data flow and required amendments - go to Downloads

Privacy and data protection

The NNAP is granted a deferral from the NHS National Data Opt-Out (NDO). The NDO should not be applied to the confidential patient information used without consent for the NNAP.

Please note that parents still have the right to choose for their baby’s information to not be used for the purpose of the NNAP by informing staff on the neonatal unit where they are receiving care. This should be recorded by the neonatal unit within the BadgerNet clinical system using the opt out check box.

For more information:

• CAG deferral outcome letter, December 2022 (PDF)
• Privacy notices ('Your baby's information)
• Understanding NDO on the NHS Digital website and list of programmes to which the NDO should not be applied

Outlier management policy

The NNAP manages outliers according to the NNAP Outlier management policy and in line with HQIP guidance for the detection and management of outliers in England, Scotland and Wales.

The performance indicators subject to outlier analysis are selected by the NNAP Methodology and Dataset Group and endorsed by the NNAP Project Board.

For the 2025 data year, the NNAP conducts outlier identification and management on the following measures at unit level:

• Does a baby born at less than 34 weeks’ gestational age have their cord clamped at or after one minute?
• Does a baby born at less than 34 weeks’ gestational age receive any of their own mother’s milk in the first two days of life?
• Does a baby born at less than 30 weeks gestational age receive medical follow-up at two years gestationally corrected age (18-30 months gestationally corrected age range of acceptable ages)?
• Does an admitted baby have one or more episodes of bloodstream infection, characterised by one or more positive blood cultures taken, after 72 hours of age?
• Does a baby born at less than 32 weeks’ gestational age have a complete intraventricular haemorrhage (IVH) scan within 28 days of birth? (Missing data outlier)

The NNAP also conducts outlier analysis (identification only) on further metrics that are not subject to the outlier management process as outlined in the NNAP Outlier management policy.

The NNAP team will write to inform services who are identified as an outlier for these further metrics, with no requirement to respond or follow the outlier management process. It is hoped that these notifications will support services with local improvement activities. 

Excellent and outstanding outliers will be identified only for selected measures.

For more information:

• NNAP outlier management policy for 2025 data (PDF)

Trust quality account information

The NNAP is included in the NHS England Quality Accounts list, which is available from the Healthcare Quality Improvement Partnership (HQIP) website.

HQIP also publishes the National Clinical Audit and Enquiries Directory which should answer most questions relating to the NNAP.

All neonatal units in England, Wales and Scotland are eligible to participate in the NNAP. The audit expects 100% case ascertainment from participating units. To find the list of participating units for the latest published year of results, see NNAP extended analysis on 2024 data report.

The table below summarises NNAP data collection periods and expected report publication dates.

Methodology and statistical analysis plan

The purpose of this document is to provide a detailed methodological overview of the data and measure development steps and analyses contained in the NNAP annual reports. It is not designed to relate specifically to any one report year but will be periodically updated annually to ensure that it is in line with the latest NNAP methodology. 

• NNAP Methodology and statistical analysis report (November 2025)