The biggest IT contract in the history of NHS England has been awarded to the controversial US tech firm Palantir and its partners.
The contract for the “federated data platform” – valued by the NHS at £330m over seven years – has been under consideration for months, with the announcement of the winner made on Tuesday after weeks of delay. The other partners in the winning consortium are Accenture, PwC, NECS and Carnall Farrar.
Privacy campaigners have raised concerns about giving the contract to Palantir, whose origins are in the US intelligence industry. Its founder, Peter Thiel, is a backer of Donald Trump and has accused the NHS of making people sick.
NHS England is believed to have chosen Palantir on account of its work improving access to data during the pandemic, helping to bring the waiting lists down and make operations more efficient.
These are the key questions which explain the background to the deal:
What is the £480m contract actually for?
The platform is to help NHS trusts manage data in their hospitals, connecting up information held by different trusts and allowing the health service to draw conclusions about population health. The platform is also intended to help individual hospitals manage their data better and drive improvements in treatment and waiting times. The purpose is not to replace existing IT systems but to help them “talk” to each other better. It is not intended to cover GP medical records at this stage.
Why did Palantir win the contract?
Palantir started working seriously with the NHS during the pandemic, taking on the work for just £1. It was given follow-on contracts worth about £60m and is now embedded in the system, having apparently proved its worth to NHS digital chiefs. The company has also taken on some former NHS officials, including the former AI chief Indra Joshi.
It is already quite embedded within the NHS, with pilots of its Foundry software rolled out across many hospital trusts. A few suspended use, mostly over concerns about whether they have the capacity to begin operating with the new software. But others demonstrated efficiencies by using the new Foundry system, including a 28% waiting list reduction at Chelsea and Westminster NHS foundation trust.
It is also politically well connected. Fleetwood Strategy, a firm co-founded by Rishi Sunak’s election guru, Isaac Levido, has carried out consultant lobbying for Palantir this year, as did Global Counsel, co-founded by New Labour architect Peter Mandelson, in 2022.
Why does the UK think such a contract is necessary?
The government believes there are huge savings and improvements to be made by harnessing the power of technology in the NHS. Chris Whitty, the chief medical officer for England, recently made the case in the Times that it was dangerous for NHS systems to be so fragmented.
Nevertheless, some experts think the £480m contract is scratching the surface of the technological change that the NHS needs and that the deal will need to be expanded in the near future.
What is the controversy over privacy?
The storage and use of medical data within the NHS has always been controversial. A previous project to link up and store all patients’ medical records in a single database, Care.data, was cancelled in 2016 over concerns that not enough privacy safeguards had been put in place.
The £480m federated data platform contract is different because it largely relates to hospital data and patient information, with the software used to optimise care and treatment. The NHS and Department of Health have repeatedly stressed that the contract is for the provider of software and that the health authorities would remain in control of the data.
But health ministers recently admitted that the NHS would not require any further consent from UK patients to use their health data gathered during the pandemic in its new operating systems.
The national data guardian for health and adult social care in England, Dr Nicola Byrne, has urged NHS England to “avoid common pitfalls around trust and transparency that have frustrated previous initiatives”.
What are the particular concerns around Palantir?
Palantir has been viewed with suspicion in the UK over its history arising from the US spy industry and links with the CIA. Thiel, its founder and chair, who was a notable financial backer of Trump, has claimed the UK has “Stockholm syndrome” when it comes to its affection for the health service. In contrast, Palantir’s chief executive, Alex Karp, has said he wished the US “had a healthcare system that served the poor and underserved as well as I perceive the British system does”.
David Davis, the Conservative former Brexit secretary, who previously led the campaign against ID cards, is one of those with serious privacy concerns about Palantir’s bid. He is among at least a dozen MPs and peers across the political spectrum who have pressed the government for more reassurances about how patient data will be treated as the new data operating system is built.
After the award of the contract, Amnesty International called for the government to require Palantir to “give cast-iron guarantees that they won’t monetise health data collected from the NHS”.
Earlier this year, a spokesperson for Palantir said: “Whether our support for the Covid vaccine rollout, the 28% waiting list reduction we’ve helped deliver at Chelsea and Westminster NHS foundation trust, or the development of software proved to help speed up cancer diagnosis, data privacy and security are always paramount in all of our work.
“As a software company, we don’t collect or monetise data – we simply provide the tools to help customers organise and understand their own information. And precisely because our software is used in some of the most sensitive information environments in the world, it is built to ensure data-sharing is controlled, auditable and in accordance with customer-defined purposes only.”