'Stitch-up': NHS England awards Palantir £25m contract in closed process

Critics complain 12-month deal lacks transparency, skips over provision for patient consent, and excludes other potential bidders

NHS England has awarded a new £25 million contract to US data mining and analytics company Palantir, to transfer existing NHS projects into a planned new federated data platform (FDP).

The award has sparked criticism from medical and legal groups, who say it lacks transparency, skips over provision for patient consent, excludes other potential bidders, and could cause the NHS to be locked into the services of one large US provider for years to come.

They also criticise the scope of the project for being ill-defined, raising fears of uncontrollable costs.

The 12-month, £25 million contact awarded to Palantir is to "transition" existing NHS projects into the new FDP. Critics argue that awarding it to Palantir gives the company an unfair advantage in its bid for the much larger seven-year £480 million FDP contract itself, which aims to create a unified access point for patient data across the NHS in England. Bids for that contract close in September.

"The government should consult on and design alternatives for managing patient data that better use existing NHS capacity and taxpayer funds," concluded advocacy groups Foxglove and Doctors' Association UK in a joint report, sent to MPs this week, as reported by Pharmaforum.

"The government should consult on and design alternatives for managing patient data that better use existing NHS capacity and taxpayer funds. If external support is required, any system should avoid locking in the NHS into one monopoly provider."

Palantir was previously awarded a £23 million contract for managing Covid-related data.

"With every fat cheque handed to Palantir, it looks more and more like the £480 million FDP contract isn't a competition - it's a stitch-up," said Foxglove CEO Cori Crider.

Trust is the crux

Foxglove and Doctors' Association UK also said the award fails to address patient consent, which could erode public trust in a third-party-managed data system. This could lead to increased opt-outs by NHS patients, as occurred with the disastrous GPDPR plan in 2021, which ordered GPs to extract patient data from GP IT systems and hand it over to researchers, resulting in a mass opt-out by patients concerned about their confidentiality.

Their report cites polling from YouGov which found that 48% of UK adults who have not yet opted out are likely to do so if the FDP is run by a private company. This would severely hamper the potential use of NHS data for medical research.

"The crux of the doctor-patient relationship is trust, and while GPs are supportive of safe and consensual uses of patient data - such as for direct care and legitimate research purposes - we want to see it done in a way that won't damage the confidence that patients have in the profession, and the care they receive," said Dr David Wrigley, digital lead of the British Medical Association's GP committee.

A controversial choice

Palantir is a highly controversial choice for an NHS partner. The secretive company, founded by tech billionaire and Republican Party donor Peter Thiel and funded by the CIA, has a background in government and corporate surveillance. It won an initial NHS contract in 2020, for or a token £1, to aid in the distribution of vaccines and ventilators during the Covid pandemic.

At the time, critics argued this was its foot-in-the-door, strategy, and that "mission creep" was inevitable. NHS England has since expanded the use of Palantir's Foundry software to several other parts of the health service's operations, including the £23 million Covid data management contract. Last year, a leaked paper disclosed Palantir's strategy of "buying its way" into the NHS should its bids be blocked.

In March, NHS England's deputy chief executive and chief financial officer Julian Kelly sent a letter to NHS trusts ordering them to begin uploading patient information to a new centralised database called "Faster Data Flows" which is based on Palantir's Foundry.

The 12-month transition deal announced this week was awarded to Palantir without an open tender process. NHS England, the government body that oversees the budget and commissioning for the NHS in England, said that while it was not an open process, it was a "compliant tender process", according to HSJ.

All of this, and the fact that the data already effectively formatted for its systems, would seem to give Palantir a significant advantage in its bid for the lucrative FDP contact.

A consortium of UK suppliers, which claimed it could create a similar system for much less than £480 million, but reportedly was not given an opportunity to compete.