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NNAP Healthcare Improvement Strategy

Audits team
The overarching aim of this strategy is to assess whether babies admitted to neonatal units in England, Wales and Scotland receive consistent, high quality care in relation to the NNAP audit measures, which are aligned to a set of professionally agreed guidelines and standards, to identify areas for improvement and to empower stakeholders to use audit data to stimulate improvement in care delivery and outcomes.

To achieve the aims of the NNAP Healthcare Improvement Strategy aims, the NNAP sets out four approaches to stimulating improvement:

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

The overall success of the strategy will be monitored against identified improvement goals which reflect existing national priorities and are consistent with quality improvement ambitions.

These goals are:

  1. Reduce the difference between the networks with the most negative and most positive treatment effect1 for mortality until discharge home (3.8% based on 2021 results) by 0.3% per year over 10 years period, without increasing mortality in the network with the lowest observed rate.
  2. For babies born at less than 34 weeks gestation, increase the proportion receiving all reported perinatal optimisation measures (appropriate to their gestational age at birth) by 3% per year over a ten-year period based on an estimated baseline proportion of 7.7% observed in the NNAP 2021 data*.
  3. For babies born at less than 32 weeks gestation, increase the proportion discharged home from neonatal care having experienced no serious complication of prematurity (late onset bloodstream infection, NEC, BPD and serious preterm brain injury and mortality) by 1% per year over a ten-year period based on an estimated baseline proportion of 49.7% observed in the NNAP 2021 data*. 
  4. By 2032, to eliminate statistically significant case mix adjusted differences in the delivery of the following neonatal care process between ethnicities :
    •    Proportion of babies born at less than 34 weeks gestational age (GA)who have their cord clamped at or after one minute.
    •    Proportion of babies born at less than 34 weeks GA with normal temperature on admission taken within an hour of birth.
    •    Proportion of admissions where there is a documented consultation with parents by a senior member of the neonatal team within 24 hours.
    Compliance for each ethnic group should be within a 95% confidence interval of the national mean.

*2021 proportion updated based on data available in April 2025. 

You can download the full strategy below.