\n\t If recent reports are to be believed, the private company Palantir is set to become NHS England\u2019s operating system of choice for health data, being seen as the favourite to win the contract for a new \u2018Federated Data Platform\u2019 (FDP). In effect, this would mean the company being able to process vast amounts of information, spanning GP and hospital records to social care data.\t<\/p>\n\n\n\n
This has led to concerns, provoked by Palantir\u2019s global track record. The American firm, co-founded by former Donald Trump donor Peter Thiel, has been extensively employed by Immigration and Customs Enforcement<\/a> authorities in the US, notably under the Trump administration. The company has a history of building and supporting predictive policing software, as well as helping both the NSA and GCHQ to \u2018spy on the whole world<\/a>\u2019 by creating tools that have bolstered mass surveillance programmes.<\/p>\n\n\n\n More recently, the company has been working on an ad-hoc basis on the UK\u2019s beleaguered \u2018Homes for Ukraine<\/a>\u2019 scheme.<\/p>\n\n\n\n Even ignoring Palantir\u2019s history of scandals, its track record within the NHS is at best questionable, and its encroachment into health infrastructure has been accompanied by a glaring lack of transparency and honesty from both the Government and NHS England.<\/p>\n\n\n\n Despite Palantir\u2019s original involvement in the NHS being sold to the British people as a \u201cshort-term, emergency COVID response\u201d<\/a>, it seems that neither Palantir nor the Government was ever committed to a time-limited partnership.<\/p>\n\n\n\n Indeed, the likely award of this new single platform contract for integrated health data would not only cement Palantir\u2019s position in our health service for good, but would represent a huge step towards the company\u2019s proprietary platform \u2013 Foundry \u2013 becoming the \u2018operating system for the NHS<\/a>\u2019.<\/p>\n\n\n\n Some even argue the decision is a \u201cdone deal\u201d, given that key requirements in the pre-tender documents clearly favour Palantir as the incumbent provider. <\/p>\n\n\n\n The FDP contract is currently still in pre-engagement, with the formal bidding process due to begin in August after delays and the work to start in November. This is one month before Palantir\u2019s last major NHS contract, worth some \u00a323 million, is set to finish. The FDP is currently estimated to be worth \u00a3360 million over five years, up from an initial \u00a3240 million, which NHS England told Byline Times<\/em> was because the organisation was previously looking at a three-year contract.<\/p>\n\n\n\n The award has been described as \u2018a must-win deal\u2019 for Palantir by sources with inside knowledge of the company\u2019s expansion plans. <\/p>\n\n\n\n The FDP will compile a raft of different datasets into a single \u2018point-of-use\u2019 and \u201cnear real-time\u201d intelligence gathering that NHS England has planned for years \u2013 central to the Government\u2019s new top-down reorganisation and digitisation of the NHS.<\/p>\n\n\n\n The new FDP is described in the pre-award notice as \u201can ecosystem of technologies and services implemented across the NHS\u201d that will act as \u201can essential enabler of transformational improvements\u201d, consisting of five use cases.<\/p>\n\n\n\n Some of these are areas in which Palantir is already working \u2013 in others the firm is either being heavily promoted by the Department of Health and Social Care (DHSC) and central NHS bodies, or is heavily promoting itself \u2013 adding further speculation that this is anything but a true \u2018open procurement\u2019 process, but rather one that favours Palantir.<\/p>\n\n\n\n The language of the FDP contract seems to lean towards the firm. The data platform will manage access to data based on \u201cpurpose-based access controls\u201d \u2013 language used specifically to describe the functionality of Palantir products<\/a>.<\/p>\n\n\n\n \u201cIf this new Federated Data Platform requires access to data to be managed by \u2018purpose-based access controls\u2019, then this is functionality unique to Palantir \u2013 quite distinct from the \u2018roles-based access controls\u2019 commonly used in NHS systems\u201d, says Phil Booth, of the campaign group medConfidential.<\/p>\n\n\n\n Despite this, NHS England has said that it has held \u201cpre-market engagement sessions which were well attended by a large number of suppliers\u201d \u2013 allegedly numbering more than 80. This point was reiterated by Lord Syed Kamall, a minister at the DHSC, who stated on 20 June<\/a> that he had \u201cbeen in conversation with NHS England, particularly the transformation directorate, and it has been quite clear with me that it is an open tender. There is no preferred bidder\u201d.<\/p>\n\n\n\n Palantir is already involved in several of the functions that the FDP will take on, including \u201ccleansing<\/a>\u201d elective care waiting lists<\/a> across 30 hospital trusts. “A company that mainly supports cops and spies isn\u2019t a healthcare company and shouldn\u2019t be given this extremely sensitive access,\u201d said Cori Crider, legal director of Foxglove, a data and transparency non-profit. <\/p>\n\n\n\n \u201cBut there\u2019s a more basic question with this federated data platform. And that question has nothing to do with Palantir. Who do you trust with your most sensitive health records? We and our partners are clear: if the Government aren\u2019t willing to talk to people or honour their choices over what they want done with their health records, we\u2019ll see them in court\u201d.<\/p>\n\n\n\n \u201cA company that mainly supports cops and spies isn\u2019t a healthcare company and shouldn\u2019t be given this extremely sensitive access.\u201d <\/p>Cori Crider, legal director, Foxglove<\/cite><\/blockquote><\/figure>\n\n\n\n NHS England maintains that the provider awarded the FDP contract will not be able to access individual patient data.<\/p>\n\n\n\n \u201cSafe and secure use of patient data allows the NHS to build services that are more responsive to patients, and the software we are seeking to use for the FDP will put the NHS in control of its data and ensure that sensitive patient information is kept in a secure environment that meets the highest national standards,\u201d an NHS spokesperson said.<\/p>\n\n\n\n NHS documents seen by Byline Times<\/em> already refer to Palantir\u2019s Foundry platform in terms of being the \u2018NHS National Data Platform\u2019, and the software is touted as being applicable to at least 18 use cases within NHS settings. Most of these tasks are an extension of the firm\u2019s COVID-related work.<\/p>\n\n\n\n The use of Palantir Foundry also seems to have stepped outside the lawful basis provided by the Control of Patient Information (COPI) Notices drawn up during the pandemic for data processing. The powers afforded to NHS England by the COPI Notices, due to end on 30 June, are limited to COVID-only processing \u2013 such as NHS England\u2019s giant COVID-19 Data Store \u2013 and supply chain work for vaccine distribution. <\/p>\n\n\n\n But the documents seen by Byline Times<\/em> also reference a Palantir-run \u2018Flu Dashboard\u2019, for seasonal flu vaccinations;<\/em> a tool that will evidently be used in wider NHS settings<\/a> that have nothing to do with pandemic-related work. When quizzed in the House of Lords on the legality of Palantir processing data on non-COVID vaccinations, Lord Kamall gave a vague<\/a> response. <\/p>\n\n\n\n Another key feature of the FDP is intended to be care coordination of Integrated Care Systems (ICSs). The 42 ICSs, each with their own respective governing Integrated Care Board (ICB), will become legal entities on 1 July and will subsume the current Clinical Commissioning Groups (CCGs) as part of the Government\u2019s new approach to integrated health, social care \u2013 and data.<\/p>\n\n\n\n Palantir already advertises a \u2018Foundry for Integrated Care Systems<\/a>\u2019 package, which includes \u201ca set of applications that empower every ICS to provide truly joined-up care by removing barriers to collaboration\u201d. <\/p>\n\n\n\n The NHS Confederation, a healthcare members\u2019 organisation which acts as<\/a> the \u201conly independent network for integrated care systems\u201d, and caters to \u201call 42 ICSs across the country\u201d has also heavily promoted Palantir as a key potential partner in the future of the ICS infrastructure, and the company has co-hosted<\/a> NHS Confederation webinar events which \u201cexplore strategies ICSs can adopt to deliver joined-up care\u201d.<\/p>\n\n\n\n In an article on<\/a> the NHS Confederation website written by two Palantir health leads, it\u2019s argued that Palantir could be crucial to ICS infrastructure \u201cto ensure decisions can be made and metrics are tracked across trusts, primary, social, and community care, leaders across the many diverse constituent organisations need to hold a single source of truth<\/a>\u201d \u2013 a phrase favoured by NHS England and Palantir alike.<\/p>\n\n\n\n Booth argues that the ICSs are being pushed by NHS England management into adopting Palantir, on the basis that \u201cYou\u2019ll get to see things in your area or region, and NHS England and DHSC will get to see everyone\u2019s data to monitor and drive things centrally\u201d.<\/p>\n\n\n\n And yet, healthcare researchers have complained about NHS England management restricting access<\/a> to datasets on Foundry \u2013 while Palantir employees, as data processors, retain access to it all. The National Data Guardian (NDG) \u2013 which provides statutory oversight and guidance on confidential patient and user data \u2013 remains unsatisfied with who is accessing<\/a> information on NHS England\u2019s COVID Data Store.<\/p>\n\n\n\n In the run-up to the latest reorganisation of the NHS in England, as first reported by The Citizens<\/a> in April, Palantir has also now poached several senior NHS tech leads. Harjeet Dhaliwal, former deputy director of data services at NHS England, joins former NHSX AI Lead Indra Joshi among the firm\u2019s ranks as Palantir looks to become a permanent fixture in the NHS.<\/p>\n\n\n\n And another, previously unreported, conflict of interest is the appointment last June of Paul Howells<\/a>, now director of health and care partnerships for Palantir, who formerly held a position as \u2018leader of the national data programme\u2019 for the NHS Wales Informatics Service.<\/p>\n\n\n\n Former NHS employees are not allowed to lobby the health service for six months on behalf of their new employer.<\/p>\n\n\n\n Palantir poaching Government talent is nothing new. There is also a revolving door<\/a> between the US firm and the Ministry of Defence, currently its largest public-sector supplier, with \u00a371 million in work<\/a> awarded since 2015. An investigation<\/a> by the Bureau of Investigative Journalism also found Palantir had been engaging NHS chiefs in a charm offensive since at least summer 2019.<\/p>\n\n\n\n Despite this, Palantir\u2019s work was only ever sold to the public as a \u201cshort-term\u201d COVID-19 response. Following its original contract, for which Palantir ostensibly charged only \u00a31 for ad-hoc work building NHS England\u2019s COVID-19 Data Store, the company has been awarded a further \u00a325 million within the NHS and by the DHSC, most of which was tied to continued Data Store work, cementing Palantir in the health ecosystem<\/a> until December 2023. <\/p>\n\n\n\n The company made a \u00a322 million profit<\/a> from that deal, which gives an indication as to why the Thiel-backed company is so fervently pursuing permanent installation in the NHS and access to patient data.<\/p>\n\n\n\n The contracts for the initial COVID-19 Data Store work were only released to the public on the eve of legal action being taken<\/a> on the deals, and the Government was taken to court again<\/a> following the award of a further \u00a323 million contract. Under threat of judicial review, the Government eventually said that it wouldn\u2019t extend the deal without consulting the public, saying future deals \u201cwill be transparent\u201d<\/a>. This now appears not to be the case. <\/p>\n\n\n\n When asked in the House of Lords to list \u201cthe projects that have been given access to the Palantir Foundry parts of NHS England\u2019s COVID-19 Data Store\u201d, Lord Kamall only highlighted six use cases, not the 18 mentioned in the NHS\u2019s own Foundry product catalogue, seen by Byline Times<\/em>.<\/p>\n\n\n\n It\u2019s also worth noting that NHS England and DHSC seem to have spent at least \u00a337 million on Palantir software since 2020<\/a>, as per the AdviceCloud public spending tracker. This exceeds the amount that the firm has officially been awarded through published contracts, though it\u2019s unclear whether this represents further work, expensive renewals and maintenance, or whether the NHS is running over budget on Palantir. <\/p>\n\n\n\n
\n\n\n\nA \u2018single source of truth\u2019<\/h2>\n\n\n\n
\n\n\n\nDigital disaster<\/h2>\n\n\n\n