What is the National Neonatal Audit Programme (NNAP)?
The NNAP was established in 2006 to assess whether babies admitted to neonatal units in England, Wales and Scotland receive consistent high-quality care. In 2022 the NNAP will look at 19 measures of care and outcomes for babies admitted to neonatal units. More information is available here.
How does NNAP decide on the audit measures?
NNAP develops measures in association with stakeholders in neonatal care through its representative bodies, including parental representation. Suggestions for measures are typically reviewed by the Methodology and Dataset group. When a fully developed proposal has been written, a final decision is made by the programme’s Project Board, with review by the Maternity and Infant Health Independent Advisory Group, convened by the HQIP. Measures are aligned as closely as possible to national guidance and guidelines, and the measurement strategies of other national initiatives such as the Maternity and Neonatal Safety Improvement Programme in England and the Maternity and Children Quality Improvement Collaborative in Scotland.
How is the quality of the data submitted to NNAP being assured?
Quarterly feedback of NNAP data is delivered to neonatal units and networks, with a summary statistical description of performance on each measure. For units, lists of patients with missing data are provided at the same time to the unit leads, providing regular opportunities to correct erroneous data and validate their data as the year progresses. At year end, NNAP conducts a data quality survey whereby units are asked to state whether data items for certain measures have been validated.
Do parents have to consent for the data to be used in the NNAP?
The Royal College of Paediatrics and Child Health (RCPCH) hold Section 251 support to receive patient identifiable information without consent in England and Wales. An application is underway with the Public Benefit and Privacy Panel for Health and Social Care for access to identifiable data in Scotland. In England, the national NHS opt-out process applies. In all nations, parents can inform neonatal staff if they wish to opt-out. Staff must then inform Clevermed so that data for the specified patient are not transferred to the RCPCH. A parent information leaflet and privacy notice for England and Wales, with information on how the data is used and how a parent can choose for their baby’s information not to be used, is available here. A privacy notice for Scotland will be published when approval is received. It is recommended that all neonatal units make this information leaflet available to parents.
Does NNAP provide individual patient data for research or quality improvement?
The NNAP is commissioned by the HQIP, who, along with NHSE and Digital Health and Care Wales, act as joint data controllers (for English and Welsh data respectively). The NNAP is managed by the RCPCH, who acts as the data processor. The NNAP is responsible for ensuring that the data collected as part of the audit is used to its full potential to facilitate improvements to care quality and neonatal outcomes, and also for enabling access to third parties wishing to use it for research. Data is available to view and download from NNAP Online. This interactive reporting tool enables you to view and compare the audit's results for a specific neonatal unit or network since 2014. However, some researchers may wish to access patient-level data, or request a novel analysis, for which formal application to HQIP’s Data Access Request Group (DARG) is necessary, following consultation with the NNAP team at RCPCH. Refer here for the NNAP data and the HQIP data access request process.
Does NNAP link to other datasets?
The NNAP is working to develop linkages with other datasets in order to enhance its own reporting, and support the work of others.