National Neonatal Audit Programme (NNAP) measures

The audit reports on key measures of the process and outcomes of neonatal care and supports professionals, families and commissioners to improve the care provided to babies requiring specialist treatment. In particular, we report outcomes of neonatal care, measures of optimal perinatal care, maternal breastmilk feeding, measures of parental partnership, neonatal nurse staffing, and other important care processes.

The NNAP Project Board conducts a regular review of the NNAP dataset and audit measures in close consultation with the wider neonatal community, taking note of the publication or amendment of any relevant professional guidance and/or standards.

The NNAP project team notifies participating neonatal networks and units of any changes to the audit dataset, prior to those changes being implemented.

2024 audit measures

The final set of measures that the NNAP will report for the 2024 data year are confirmed. In line with the requirements of our contract to deliver the NNAP, reporting is streamlined to 10 headline performance metrics, some of which are composite (or bundled) metrics, which support the NNAP Healthcare Improvement Strategy and improvement goals.

We will continue to report component measures sitting behind these 10 performance metrics on at least a quarterly basis to enable and support local monitoring and quality improvement activity, and final, full year results for the component measures will be published annually. We will distinguish in our public facing reporting, and our ‘direct to unit’ reporting between assured annual data (data for assurance) and frequent reporting (data for improvement).

The 10 performance metrics are summarised below:

  1. Mortality until discharge
  2. Optimal perinatal care composite metric (Component measures: antenatal steroids, antenatal magnesium sulphate, birth in a centre with a NICU, deferred cord clamping, normal temperature on admission, breastmilk feeding in the first 2 days of life)
  3. Clinical outcomes composite metric (Component measures: bloodstream infection, BPD, NEC, preterm brain injury)
  4. Parental consultation within 24 hours of every admission
  5. Parental inclusion in consultant ward rounds
  6. Breastmilk feeding composite metric (Component measures: breastmilk feeding at day 14, breastmilk feeding at discharge home)
  7. Follow-up at two years
  8. On-time screening for retinopathy of prematurity
  9. Neonatal nurse staffing
  10. Non-invasive breathing support

You can read the full detail of the metrics and component measures, inclusion criteria, data source and how they are derived in the updated 2024 measures guide which can be downloaded below.

Changes to the 2024 measures

There are no significant changes in the measures since 2023. There is one minor change to Normal temperature on admission where the denominator now includes babes admitted to a neonatal unit within 12 hours of birth (previously 1 hour).

2023 audit measures

We have made a number of changes to the 2023 audit measures guide:

  • Updated denominator text to account for missing cases.
  • Updated clinical outcomes composite metric to clarify that PHVD is not included.
  • Updated place of birth attributions to improve accuracy and clarity.
  • Updated information relating to outlier identification and management.

Download the 2023 measures guide below.

ROP screening calculator

Our Excel calculator is designed to help you plan timing of first retinopathy of prematurity (ROP) screening appointment for eligible babies. This is based on the ROP screening guideline (2022).

Download the ROP screening calculator below

Audit measures from previous years

Download guides to audit measures for 2022 and 2023 below

Data dictionaries

The full data dictionary for the 2023 reporting year was published in December 2023 and can be found below