Frontline doctors are urging the Government to rethink its plans for a new £480 million patient database with US firm Palantir.
The Doctors Association UK has called on the Government to pause what would be the largest-ever NHS data centralisation project to ensure the best deal for patients.
Dr David Nicholl, spokesperson for the Doctors’ Association UK, said the deal would go against “key NHS values of ensuring we’re working together”.
He said: “DAUK remains concerned the Government is prepared to sign a nearly £0.5 billion deal which has not been subject to sufficient public scrutiny.
“This deal represents a poor deal for taxpayers and for patients.
“It goes against the key NHS values of ensuring that ‘we’re working together for patients’.
“The plans for an enforced opt-in to the FDP mean that basic issues of informed consent are being ignored.
“It is time to put a pause on all of this and engage in some proper scrutiny to get the best deal for all patients.”
In a letter published on our website, more than 160 doctors have signed a letter calling for a pause in the process.
The letter said: “Please pause these plans and take steps to ensure public trust, value for money, a trustworthy partner and patient consent.
“We all need an NHS data platform that treasures patient trust, ensures patients’ data remain a public asset and that benefits the health service for decades to come.
“Now is the moment to pause and to get this right. We all want better for NHS patients.”
Martha Dark, director of campaign group Foxglove, which has been working with DAUK on the issue, said: “We’re now seeing a groundswell of doctors come out against the government’s half-billion pound NHS IT deal with Palantir. If doctors and hospitals don’t use this system, and patients don’t trust it, the FDP will fail, simple as that.
“We all badly want to see the NHS have the investment it needs – in staff, and in tech that doctors and patients can trust.
“Government should read the writing on the wall, pause this deal, and go back to the drawing board for real solutions.”
Read the letter in full below.
Letter to the Secretary of State, Steve Barclay: Pause the Federated Data Platform
11 November 2023
Dear Steve Barclay,
We are frontline NHS doctors with extensive, first-hand experience of the inner workings of the NHS.
Health data plays a critical role in patient care. We grapple with the challenges of managing health
data well, making sure it is used to help our patients while maintaining their trust. Patient data is an
enormous asset to the NHS, and it must remain a public asset that benefits the health service and
patients for decades to come.
We understand you are due to sign a £480 million contract with Palantir for the Federated Data
Platform[1] (FDP). This would be the largest NHS data centralisation project in history.
Many of us have worked in the NHS long enough to witness previous, expensive NHS IT projects –
from Care.Data to General Practice Data for Planning and Research (GPDPR) – fail. These projects
failed because of patient distrust. We urge you to take immediate action to prevent history
repeating itself.
We are asking you to pause these plans and first take steps to ensure public trust, value for
money, a trustworthy partner and patient consent before making a decision.
1. Ensure patient trust – seek patient consent.
The FDP can only succeed if it maintains public trust in the health service by ensuring patients have a
say in how their data flows into it and is used within it. We are concerned by recent flip flopping
about whether patients can opt out of sharing data in the FDP for uses beyond their direct care.
Health ministers initially said reforms to patient choice and clarity around the application of opt-out
within FDP was a high priority for NHS England.[2] The FDP FAQ on the NHS website originally said
the National Data Opt Out (NDOO) would apply to relevant data in the FDP. It was later updated to
say patients cannot opt out of sharing their health data[3] with the FDP at all, even for uses beyond
their care. The FAQ says this is because patient data will go through an ‘anonymisation’ process.
However, given the data in a patient’s NHS record is incredibly detailed, we are concerned it could
be re-identifiable even after anonymisation.
Polling from YouGov, quoted on BBC One on Sunday, is a good temperature check on these plans. It
found that almost half of adults in England who have not yet opted out are likely to do so should the
Federated Data Platform be introduced and run by a private company.[4] That would be disastrous
for the NHS. To ensure patient trust, patients need a say and urgent clarity is needed about whether
and how patient consent will apply to the FDP.
2. Ensure patient trust – choose a trusted partner.
We urge you to consider whether Palantir is the most suitable, trustworthy and fairly procured
supplier for the FDP.
The FDP contract award is yet to be announced, but Palantir is widely reported to be the
frontrunner.[5] Palantir has a controversial reputation and has been heavily criticised for its work
with military, security, intelligence, and police agencies.[6]
Palantir’s leaders have made public remarks that alarm us. Palantir chair Peter Thiel told the Oxford
University Union that British love for the NHS was “Stockholm Syndrome”[7] adding: “In theory, you
just rip the whole thing from the ground and start over”. Last Sunday, Palantir’s CEO Alex Karp told
the BBC, when asked whether data in the FDP could be sold in the future: “by the UK government, not by me. I
don’t have the ability to do it”. [8] If patients think there is a risk their health data could
be sold without their consent, they will rightly be concerned about giving us the information we
need to provide care.
Palantir doesn’t have a long background in the NHS, indeed they began working as an NHS supplier
at the start of the pandemic. Procurement policies were suspended and Palantir secured a £1
contract to run an emergency Covid Datastore without competition. That contract has been
renewed multiple times, giving £60 million for Palantir[9] without competition from other suppliers.
The design of the FDP procurement process appears to give an unfair advantage to Palantir. 36 NHS
trusts were enrolled in pilots of Palantir’s Foundry software that serve as test runs for the FDP. No
other bidder, such as Quantexa [10] and a UK consortium had such an opportunity to test its systems
in NHS hospitals. It seems they have struggled to compete against Palantir’s advantage.
Palantir’s controversial reputation and any perception of their unfair advantage in the procurement
process could lead patients to withhold critical information and to mistrust the NHS. We urge you to
consider a more trustworthy supplier and review the procurement.
3. Ensure value for money, benefit for the NHS and sign a contract for a system that works.
We have concerns about value for money, benefit to the NHS and effectiveness of the FDP. Please
address these concerns during a pause.
Of the pilots that ran, 11 of the 36 were suspended or paused in March.[11] According to the FDP
FAQ webpage, only one has restarted. We are concerned that such a large amount of money could
be spent on a product that seems to have failed in approximately one third of its test cases.
Colleagues at some of the pilot trusts reported troubling details about the pilots. Liverpool Heart and
Chest Hospital reported that the Palantir pilot: “didn’t meet our needs”.[12] The New York Times
reported that Palantir’s Foundry at Milton Keynes University Hospital Trust[13], didn’t work with the
hospital’s systems, forcing staff to enter data manually.
Lastly, we understand that the directors from pilot trusts were recently asked by NHS
executives[14] to sign a letter supporting the FDP. Only 16 officials signed[15], suggesting most
trusts who trialled Foundry did not feel able to endorse the FDP. Please provide more information
about these failed pilots, guidance on what lessons have been learned and assurances that this new
system will work as it needs to for patients.
We do not write this letter lightly. We all see the urgent need for a better IT solution for the NHS
that harnesses the benefits of patient data to improve care nationwide. But as it stands, with
respect, we don’t feel the FDP is that solution.
Please pause these plans and take steps to ensure public trust, value for money, a trustworthy
partner and patient consent. We all need an NHS data platform that treasures patient trust,
ensures patients’ data remain a public asset and that benefits the health service for decades to
come.
Now is the moment to pause and to get this right.
We all want better for NHS patients.
Yours sincerely,
1. Dr Helen Salisbury, General Practitioner
2. Dr Susan Overal, General Practitioner (Retired)
3. Vassili Crispi, Neurosurgery SHO – Brain Tumour Junior Research Fellow
4. Omer Karim, Consultant Urological Surgeon
5. Jackie Applebee, General Practitioner
6. Mark Bailey, Locum Respiratory Consultant and Clinician-who-codes
7. John Puntis, Consultant Paediatrician (Retired)
8. Shiela Puri, Doctor
9. Prof Joe McDonald, Consultant Psychiatrist, former NHS Trust Medical Director
10. Dr Anna Eleri Livingstone, General Medical Practitioner
11. Dr Andrew Meyerson, A&E Doctor
12. Amar Mashru, Consultant in Emergency Medicine & Prehospital Emergency Medicine
13. Dr Marcus Baw, GP, data and GP IT specialist. Immediate past chair of RCGP Health
Informatics Group
14. Iain Wilson, Clinical Nurse Specialist
15. Siobhan Tierney, Principal Clinical Psychologist
16. Dr Coral Jones, General Practitioner
17. Dr Veronika Wagner, Associate Specialist
18. Dr Tony O’Sullivan, Consultant Paediatrician (Retired)
19. Dr Jonathan Fluxman, General Practitioner (Retired)
20. Dr. Helen Groom, General Practitioner (Retired)
21. Jack Czauderna, Family Doctor (Retired)
22. Maureen O’Leary, Consultant Psychiatrist (Retired)
23. Aman Khan, Consultant A&E
24. Dr Jane Thomas, Consultant Psychiatrist
25. Tracy L Jackson, Consultant Gynaecologist
26. Joanna Wright, Consultant Neonatologist
27. Pat McHugh, Consultant Anaesthetist
28. Dr Christine Clayton, General Practitioner
29. Dr Judith Atkinson, General Practitioner (Retired)
30. Dr Matt Kneale, Co-chair, Doctors' Association UK
31. Dr Tony O'Sullivan, Consultant Paediatrician (Retired)
32. Alison Bliss, Consultant Paediatric Anaesthetist
33. Dr Louise Irvine, General Practitioner
34. Annie Swanepoel, Consultant Child and Adolescent Psychiatrist
35. Glenis K.Scadding, Hon. Consultant Allergist & Rhinologist
36. Paul Hobday, General Practitioner (Retired)
37. Ruth Suckling, Consultant Emergency Medicine
38. Adam Moliver, NHS Consultant (Retired)
39. Alice Arrowsmith, Consultant Anaesthetist (Retired)
40. Dr Jonathan Dare, Psychiatrist (Retired)
41. Michael Beverly FRCS Orth DPhil, Consultant Orthopaedic Surgeon
42. Jane Flint Bridgewater, Consultant Cardiologist and Founding Trustee of Cardiovascular Care
Partnership UK (British Cardiovascular Society Patient Voice) (Retired)
43. Dr. Robert Primhak, Consultant Paediatrician (Retired)
44. Francesco Pezzella, NHS Consultant
45. Jeff Gawler, Consultant Neurologist (Retired)
46. Mr David Sedgwick, Consultant General Surgeon (Retired)
47. Dr Mary Gibbs, Out-of-hours GP
48. Richard Buxton, Orthopaedic Surgeon
49. Robert Scott-Jupp, Consultant Paediatrician
50. Jean Daniel Dubois, Consultant Oncologist (Retired)
51. Miriam Taegtmeyer, Professor
52. sir richard Thompson, Consultant (Retired)
53. Roger Fisken, Consultant Physician (Retired)
54. Helen Pepper, General Practitioner (Retired)
55. Raymond Brown, Paediatrician (Retired)
56. Stephen Jarvis, Professor Emeritus
57. Dr .R.L.Symonds, NHS Consultant (Retired)
58. Naomi Walker, Consultant
59. Adrian Timothy, Consultant Oncologist
60. Andrea Franks, Consultant Dematologist (Retired)
61. Dr Margaret K Cook, Consultant Haematologist (Retired)
62. Edwin Gale, Professor Emeritus
63. Jessica Kirker, Consultant Medical Psychotherapist (Retired)
64. Dr David Levy, Consultant in diabetes and endocrinology (Retired)
65. John Ridyard, Consultant Physician (Retired)
66. Katie O'Gorman, Consultant Child Psychiatrist (Retired)
67. Dr Sebastian Hendricks, Consultant Audiovestibular Physician and Paediatrician
68. Richard L M Newell, Consultant Orthopaedic Surgeon (Retired)
69. Dr Afifa Alihassan, CT3 Psychiatry
70. Dr Delia Parnham-Cope, Consultant A&E
71. Lindsay Forbes , Clinical Professor of Public Health
72. Dr Sylvia Berney, Consultant Haematologist (Retired)
73. William Shatwell, Consultant Radiologist (Retired)
74. Professor John S Yudkin, Emeritus Professor of Medicine, UCL
75. Mick Venables, Consultant Psychiatrist (Retired)
76. Dr Duncan Davidson, Consultant Neurologist (Retired)
77. R J Grieve, Professor
78. Julie Murphy, Account Handler
79. Dr Jane Roderic-Evans, General Practitioner (Retired)
80. Daniel Zahedi, FY2 Doctor
81. Dr Steve Brennan, Hospital Physician (Retired)
82. Paul Revell, Consultant Haematologist (Retired)
83. Helen Venning, Paediatrician (Retired)
84. Bob Postlethwaite, Paediatrician (Retired)
85. Ann Sandison, Consultant Histopathologist
86. Cathy White, Consultant Paediatric Neurologist
87. Toby Moss, Doctor
88. Joan Keating-Majorel, Doctor (Retired)
89. Dr Lamiz Fayker, Doctor
90. Rafif Mansour, General Practitioner
91. Lucy Baxter, General Practitioner
92. Dr Ahamed Masum, Doctor
93. Magda Alobaidi, Consultant Haematologist
94. Sana Ali, Doctor
95. Jasmine Fulcher, NHS Doctor
96. Talal Khan, Doctor
97. Naomi Adelson, General Practitioner
98. Alia Hussain, Anaesthetist
99. Caroleen Bray, Psychologically Informed Consultant and Training Practitioner
100. Miriam Al-Kashi, General Practitioner
101. Azelea Rushd, Doctor
102. Dr Jessica Potter, Consultant in Respiratory Medicine
103. Ahmed elsemary, Staff grade psychiatrist
104. Dr Rachel Hallam, Junior Doctor
105. Basil Abdel Hadi, General Practitioner
106. Iram Zaman, Consultant Psychiatrist
107. Nuha Mahmood, Junior clinical fellow ED
108. Yash Bajpai, Senior clinical fellow Anaesthetics
109. Afrah Al-Maliki, General Practitioner
110. Georgia Twigg, Occupational Therapist
111. Katharina Amanda Adler, General Practitioner
112. Megan Charles, Psychotherapist
113. Cassie Fairhead, Doctor
114. Tajrina Choudhury, Physician Associate
115. Amy Lineham, Psychiatry Trainee
116. Dr Sam Freegard, General Practitioner (Retired)
117. David Nicholl, Consultant Neurologist
118. Dave Kirby, NHS General Medical Practitioner: treasurer, Doctors in Unite.
119. Isky Gordon, FRCR, FRCP, Emeritus Professor Paediatric Imaging
120. Dr David Church, Locum General Practitioner, south Gwynedd
121. Amanda Owen, Doctor
122. Dr Martin Blanchard, Academic / NHS Consultant Psychiatrist UCL (Retired)
123. Syed Gulzar Ali, Doctor
124. Isar Elkair, Doctor
125. Geevithan Kumaran, Anaesthetic Registrar
126. Wakaas Janjua, Doctor
127. Dr William Ricketts, Consultant Chest Physician
128. John Macdonald, General Practitioner (Retired)
129. Clare Campbell, General Practitioner (Retired)
130. Carol Dezateux, Professor and Honorary NHS consultant
131. Dr Ahamed Masum, Psychiatry Trainee
132. Dr Bryony Hopkinshaw, Paediatric Registrar
133. Sarah Methven, Consultant
134. Yasmin Shah, Speech and Language Therapist (Retired)
135. Stephen Branscombe, Biomedical Scientist NHS (Retired)
136. Sabriye Mehmood, General Practitioner trainee
137. Ban Al-Saffar, Consultant Physician
138. Anisa Ali, Psychiatrist
139. Dr Rebecca Radmore, Doctor
140. Brendan O'brien, General Practitioner (Retired)
141. Helen Zealley, Director of Public Health (Retired)
142. Tabrez Noorani, Junior doctor
143. Dr Farhana Rahman, General Practitioner
144. Mohamed Dewji, Senior Medical Director
145. Faiza Ali , Pharmacist
146. CHARLES MERRILL, Emergency Medicine Consultant (Retired)
147. Judith Burchardt, Doctor
148. Dr Margaret Jackson, General Practitioner and medical educator
149. Cecilia Ettedgui, Doctor
150. Neil Calderwood, General Practitioner Trainee
151. Dr Peter Michael Simmons, General Practitioner (Retired)
152. Ailsa Bell, Doctor
153. Dr Jose Catalan, Consultant Psychiatrist (Retired)
154. Linda Winkley, Child and Adolescent Psychiatrist
155. Dr Rachel Jones, Consultant
156. Humaira Maka, Medical Student
157. Shireen Lawrence-Wooldridge, Doctor (Retired)
158. Isaac Akanbi, Specialty Doctor in Radiology
159. Dr Molly Davey, Anaesthetist – Core Trainee
160. Dr Barbara Vogel, General Practitioner ST3
161. Penelope Jarrett, General Practitioner
[2] https://committees.parliament.uk/publications/41191/documents/202610/default/
[4] Figures are from YouGov Plc. Total sample size was 1,756 adults. Fieldwork was undertaken
between 20th – 21st May 2023. The survey was carried out online. The figures have been weighted
and are representative of all England adults.
[5] https://www.ft.com/content/3f6f24f8-9e5c-42c3-8ae6-bfef5f953524
[6] https://nopalantir.org.uk/about-palantir/
[8] https://www.bbc.com/news/technology-67254010
[9] https://www.theregister.com/2023/06/20/palantir_nhs_england_deal/
[11] https://questions-statements.parliament.uk/written-questions/detail/2023-03-07/160180/
[12] https://techmonitor.ai/policy/why-cant-the-nhs-quit-palantir
[13] https://www.nytimes.com/2023/09/29/world/europe/uk-nhs-palantir.html
[14] https://www.digitalhealth.net/2023/10/nhs-trust-medical-directors-asked-to-publicly-back-fdp/
