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.

The full NNAP data dictionary for the 2021 data year can be downloaded below.

2022 audit measures

We have made a number of changes to the audit measures to be reported for 2022 data, summarised below. We’ve made these changes to align as closely as possible with other measurement programmes, and in particular MatNeoSIP, and in line with current guidance and guidelines. We have also changed the cohort of babies included for some of the measures to improve the timeliness and frequency of reporting.

Key changes for the 2022 data year:

  • The new measure of antenatal steroid administration looks at whether eligible mothers receive a full course of antenatal corticosteroids within 1 week prior to delivery. The lower gestational age cut-off has been extended to include babies born from 22 weeks gestational age, in line with the overall NNAP inclusion criteria.
  • The measure of birth in a maternity service on the same site as a NICU has been expanded to include babies born at less than 800 grams or born as a multiple at less than 28 weeks as well as all babies born at less than 27 weeks gestational age.
  • The upper gestational age cut-off for the measure of deferred cord clamping has been increased from less than 32 weeks to less than 34 weeks gestational age.
  • A new measure of type and duration of respiratory support has been introduced, answering the question ‘What proportion of babies born at less than 32 weeks gestation only receive non-invasive respiratory support* during the first week of life? ‘
  • The measure of on time retinopathy of prematurity (ROP) screening has been updated in line with the new screening guideline published in March 2022. (You can download the ROP screening calculator below.)
  •  A single measure relating to nurse staffing will be reported, as follows: ‘What proportion of nursing shifts are numerically staffed according to guidelines and service specification?'
  • A new measure of breastmilk feeding will be introduced, to align as closely as possible with the MatNeoSIP intended measure of breastmilk feeding in the first 24 hours of life, taking into account the constraints of available data. We will continue to report rates of breastmilk feeding at 14 days and at discharge, but the gestational age cut-off will be increased from less than 32 weeks to less than 34 weeks.
  • The inclusion criteria for the following measures has changed from babies discharged within the calendar year to babies first admitted during the calendar year; antenatal steroids, antenatal magnesium sulphate, birth in a centre with a NICU, deferred cord clamping, temperature on admission, type and duration of respiratory support (new measure), parental consultation within 24 hours of admission, breastmilk feeding within 2 days (new measure).

For more information about these changes, and all other measures within the 2022 data year, download the guide to the 2022 audit measures below.

ROP screening calculator

This Excel calculator is designed to help you plan timing of first ROP screening appointment for eligible babies based on the new screening guideline published in March 2022. You can download the calculator below.

Audit measures from previous years

You can download guides to the audit measures below.

Data dictionary

The full data dictionary for the 2021 data year can be downloaded below