Sir,

National audit programmes inform the commissioning of services and the development of guidelines by the National Institute of Clinical Excellence. Accurate data and reports are important to set local targets and evaluate service quality. The National Neonatal Audit Programme (NNAP), established in January 2006 and funded by the Healthcare Quality Improvement Partnership (HQIP), contains a data set evaluating the occurrence and timeliness of screening for retinopathy of prematurity (ROP).

Paediatric ophthalmologists have expressed concern about inaccurate NNAP reports, but to our knowledge these concerns have not been published. The NNAP 5-year trends of the proportion of eligible babies receiving ROP screening (2007: 38%, 2011: 82%) and first screening occurring on time (2009: 27%, 2011: 87%)1 indicate that NNAP reports are likely to be inaccurate and may have a high proportion of missing data, although trends may be improving. There has been frustration about eye teams not being allowed to contribute to data upload, and about the impossibility of correcting uploaded data before the publication of the annual report. Neonatal unit (NNU) staff upload data via the UK National Neonatal System (UKNNS, previously Standardised Electronic Neonatal Data System, SEND). A ‘dashboard’ summarises data for each month of the calendar year (Figure 1). The Neonatal Data Analysis Unit (NDAU) at Imperial College London analyses the data and collates the NNAP report.

Figure 1
figure 1

‘Dashboard’ summarising ROP screening data on a monthly basis.

Full size image

We recently carried out our annual ROP screening audit.2 All babies whose first screening was due in our unit were assessed within the NNAP time window. However, the ‘dashboard’ showed one baby as not having been screened. We verified the screening status and updated the data on UKSNN, resulting in 100% compliance (Figure 1). However, the 2013 NNAP report shows two discrepancies with the dashboard: a greater number of babies eligible for ROP screening, and missing data for four infants. Our data update in August 2013 had occurred after NDAU had analysed the data for the annual report in February 2013.

In 2014, NDAU will feed data back to NNUs before analysis to allow an update before publication. Ophthalmologists involved in ROP screening may wish to carry out their local audit in January of each calendar year, so that NNU staff can upload correct data before the NDAU analysis in February.