US tech giant Palantir has been awarded a £330m contract to help run the NHS’s new Federated Data Platform (FDP). The data analytics company will operate the FDP in collaboration with Accenture, PwC, NECS and Carnall Farrar. The IT contract is the largest to have ever been awarded by the NHS to a private-sector supplier.
Conceived in 2021, the FDP is an overarching IT framework for the NHS designed to unite operational data currently siloed across 42 different care systems. This information “could be the number of beds in a hospital, the size of waiting lists [for] elective care services or the availability of medical supplies”, explained NHS England’s medical director, Professor Sir Stephen Powis, in a recent blog post. Supporters of the initiative argue that pooling all this data in a single place will lead to significant new efficiencies for the service, as well as yield new insights into population health.
Announcing the contract award to the House of Commons today, Health Secretary Victoria Atkins said that 26 trusts have so far piloted a version of the FDP, with clinicians describing its introduction as “game-changing.”
FDP’s public outreach campaign criticised
NHS England has been criticised by MPs and privacy activists for failing to adequately explain to the public how their data will be used by the FDP. Currently, patients are unable to opt out of any data collection and processing when undertaken by the NHS for the purposes of providing care. However, they are able to block data collection for “secondary use purposes” under the National Data Opt Out scheme, which is how most data will be collected under the auspices of the FDP. In August, the UK’s national data guardian Dr Nicola Byrne called on the NHS to radically improve its public outreach campaign explaining the purposes of the FDP if it did not want a significant number of patients withholding their data in protest.
“In the past, some people have registered type one and national data opt-outs as a way to demonstrate their lack of trust in how a specific programme or initiative is handling their confidential data,” said Byrne. “If opt-out rates now rise considerably further, it would be to the serious detriment of health research and planning nationally.”
In her statement, Atkins said that “ongoing public engagement is planned throughout the period of the contract”, and that there will be clear rules about who can access data contained within the FDP and how that data is processed. “Only authorised users will be granted access to data for approved purposes, for example, NHS staff and those supporting them,” she said, before adding that a separate contract has been awarded to another vendor, IQVIA to supply “privacy-enhancing technology” as an additional safeguard. The FDP will not go live, continued Atkins, until this technology is in place.
Palantir and the NHS: an opaque relationship
The nature of Palantir’s partnership with NHS England has also been repeatedly criticised since the two began working together shortly before the pandemic (the company had not responded to a request for comment at the time of publication). Concerns were raised when Palantir founder Peter Thiel compared the British public’s support for the NHS to “Stockholm syndrome”, and the opacity of the contracts agreed between Palantir and NHS England has also been questioned.
Details about the contract Palantir signed to help run the Covid-19 Data Store were released mere hours before law firm Foxglove was ready to take legal action to force their release. The NHS subsequently promised future deals would be more transparent. Still, as recently as last week, the British Medical Association wrote to then-health secretary Steve Barclay that it had “no faith in the FDP, the tendering process and the organisation” as a commercial partner of the NHS.
Palantir’s practice of initially offering public sector clients services free of charge, or for a minimal fee, came under the microscope last month when a National Audit Office report highlighted that it had secured IT contracts worth £10m relating to the Homes for Ukraine rehoming scheme for refugees fleeing the conflict in eastern Europe. Palantir was awarded two contracts to run a system it initially built for free, despite officials noting at the time that better and more cost-effective software may be available elsewhere.
The National Audit Office report said Gareth Rhys Williams, the government’s chief commercial officer, wrote to Palantir in February “noting his concern about the practice of offering services to public sector customers for a zero or nominal cost to gain a commercial foothold, contrary to the principles of public procurement which usually require open competition”.
The FDP risks becoming a “half-billion-pound flop” if criticisms about the efficiency, transparency and cost of Palantir’s relationship with NHS England are not adequately addressed by both parties, argues Foxglove’s director, Cori Crider. “Foxglove has fought for years to defend patient trust and public value in the use of NHS data, and we aren’t letting up now,” Crider told Tech Monitor. “We’ve written legal letters seeking the urgent commitments NHS patients need and, if we have to, we will take the government to court again.”