NHS weighs exit from £330M Palantir data contract

After sustained public backlash and a June report by members of the U.K, parliament, NHS England is now reconsidering its data handling contract with U.S. company Palantir.

Palantir provides an off-the-shelf tool known as the Federated Data Platform (FDP) to help hospitals, trusts and GPs within the NHS system, to have a single platform where different kinds of information including diagnostic data, bed scheduling and discharge information can be accessed. The contract which began in 2023 is valued at £330 million over a maximum seven-year period. While Palantir’s involvement with the NHS has been controversial since the beginning, benefits from the tool have either not materialized or have been hard to assess.

On June 16, Ayub Bhayat, director for data analytics at NHS England and the senior responsible officer for the FDP, told the Parliamentary Health and Social Care Committee that they are undertaking a contract review process to be completed by the autumn, “through which we will ask how we exit and how can we exit,” the contract.

According to NHS England statistics, 170 of 214 NHS trusts, which provide direct services to patients, have signed up to use the FDP, with 139 live and 137 reporting benefits. All but one of the integrated care boards, which plan health services across hospitals and practices in a region have also joined.

NHS England initially claimed a 15 percent decline in delays to discharging hospital patients but reporting in the Financial Times and the campaign group Foxglove have called the numbers into question. Following this, the NHS website added a caveat saying that they “draw conclusions about cause and effect as other variables have not been controlled for,” according to Foxglove.

Benefits of the FDP may not be uniform. While it could benefit less digitally mature parts of the national network, many places already have advanced capabilities and could see marginal benefits, Sarah Scobie, Deputy Director of Research, Nuffield Trust told the Parliamentary Health and Social Care Committee.

The Greater Manchester Integrated Care Board, for example, “has what it needs, and the technology that we have can match anything that the Palantir FDP can do,” Matt Hennessy, Chief Data and Analytical Officer Network told the committee.

The local alternative also has the advantage that it has worked to gain public trust, says Hennessy. This is important because the NHS, unlike most health systems in the world, elicits a great sense of public ownership, says Sharifa Sekala, Director of the Centre for Global Health Law at the University of Warwick. Despite all its faults, people see it as an institution that has an obligation to do good, she says. As a result, privatization has always been a thorny issue. In 2016, for example, NHS England disbanded a program to collect data from primary care centers after 1.5 million people opted out over concerns about how it was being shared with private companies.

Public attitude to data sharing survey 2024 still shows high trust in the NHS and willingness to provide data for research, but this wanes if the big tech companies are involved.

Palantir, in particular, has been a lightning rod of criticism that other companies who are equally embedded in the NHS system have not faced, says Sekala. Reasons for the opposition to Palantir range from its CEO Alex Karp’s support for Donald Trump to its technology being deployed for U.S. immigration enforcement and its involvement in conflicts across the world. “Is it a good idea to be giving a company like that that doesn’t have the best interests of the UK at heart a very significant role, not only in the NHS but in the Ministry of Defense, in policing, in financial regulation?” says Donald Campbell, advocacy director at Foxglove.

This question has become more salient with doubts swirling about the procurement process and the kind of access engineers at Palantir had to sensitive patient data.

Pressure from a range of groups including the British Medical Association, Amnesty International, the Good Law Project as well as investigations by the Financial Times and Foxglove increased pressure on lawmakers. This culminated in the early June parliamentary report by the Science, Innovation and Technology Committee about digitized government services. Expressing particular concern about Palantir, the report warned that the public sector could get locked into being “increasingly reliant on a small number of technology providers for the delivery of essential public services.”

“Palantir should not have such a significant role in the UK public sector, and that it is far from the only company capable of providing the data analysis ‘middleware’ required by public bodies,” the report concluded.

The report recommended the UK government use the break clause, when the time comes in 15 February 2027, and should “either develop an in-house replacement or seek an alternative developed by UK-owned and UK-based providers that are more compatible with UK values.”

This is not a straightforward process. While the Greater Manchester ICB claims to have a system more capable than the FDP, the needs of an ICB are different from those of hospitals, trusts and GPs, Hennessy told the Parliamentary committee. “There are a variety of providers for the underpinning databases, and there are a variety of providers for orchestration between them,” Nigel Shadbolt, Executive Chair, Open Data Institute told the committee. But getting them together will take time, he added.

Regulators must resist a self-imposed sense of urgency and take the longer view while making decisions, says Sekala. People have come around to the increasingly digitized nature of care, but to gain public trust the government will have to have transparent processes and open communication about the benefits of digitization, she says.