About the National Neonatal Audit Programme

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), 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 from April 2017 to April 2021.

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.

What we measure

The NNAP Project Board conducts a regular review of the NNAP dataset and audit measures in close consultation with colleagues from the Neonatal Data Analysis Unit (NDAU) based at Imperial College London and the wider neonatal community, taking note of the publication or amendment of any relevant professional guidance and/or standards.

As part of the review of the dataset and audit measures, the Project Board will liaise with colleagues at Clevermed and the NDAU and agree whether any related amendments are required within the fields and functionality of the Badgernet system. The NNAP project team will notify participating neonatal networks and units of any changes to the audit dataset prior to those changes being implemented.

2019 audit measures

For the 2019 data year (1 January 2019 to 31 December 2019) we have introduced a new measure focussing on breastmilk feeding at 14 days of life.

To see more information about this new measure, all 2019 measures and their definitions, download the full guide to the 2019 audit measures at the end of the page.

2018 audit measures

The NNAP will conduct outlier analysis on the following measures for 2018 data:

  • Are all mothers who deliver babies between 24 and 34 weeks gestation inclusive given any dose of antenatal steroids?
  • Are mothers who deliver babies below 30 weeks gestation given magnesium sulphate in the 24 hours prior to delivery?
  • Does an admitted baby born at less than 32 weeks gestational age have its first measures temperature of 36.5°C to 37.5°C within one hour of birth?
  • Is there a documented consultation with parents by a senior member of the neonatal team within 24 hours of admission?
  • Do all babies born weighing less than 1501g, or at gestational age of less than 32 weeks, undergo the first retinopathy of prematurity (ROP) screening in accordance with the current guideline recommendations?
  • How many babies born at less than 30 weeks gestation received medical follow up at two years gestationally corrected age (18-30 gestationally corrected age range of acceptable ages)?
  • Network level only: Is an admitted baby born at less than 27 weeks gestational age delivered in a maternity service on the same site as a designated NICU?
  • Network level only: Broncopulmonary dysplasia or death, combined rate

Download a full guide of the 2018 audit measures below.

Audit measures from previous years

You can download guides to the audit measures in 2017, 2016, 2015 and 2014 below.

Data flow

A diagram describing the flow of data in the NNAP can be downloaded below.

Two-year follow up

NNAP is auditing the health status of babies <30+0 weeks gestation at birth.

The electronic form available on the Neonatal.net is the preferred method, but if a paper version is required, it can be downloaded below.

Outlier methodology and policy

The NNAP identifies outliers using the methodology described in the NNAP Statistical Analysis Plan (SAP) for 2017 data. The final SAP for 2017 is available for download below.

The NNAP manages outlier identification using the 'RCPCH detection and management of outlier status for clinical indicators policy'. Download this policy below.

NHS quality accounts

The National Neonatal Audit Programme 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 of your 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 and the number of patients included in the audit for the latest published year of results, please consult the annual report (Appendix A). 

Unit level results by NNAP measure can be found on NNAP Online.