Pause plans for data sharing contract to ensure trust and patient consent, plead doctors’ leaders

Doctors’ leaders have urged the secretary of state for health and social care to reconsider awarding the £480m contract to run NHS England’s federated data platform (FDP) to what most insiders believe will be US spy technology company Palantir.

In a letter dated 11 November, the Doctor’s Association UK (DAUK) asked the secretary of state 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.”

This follows a 1 November letter from the BMA warning the secretary of state that “the BMA has no faith in the FDP, the tendering process, and the organisation we understand to be the preferred commercial partner.”

The FDP will bring together huge amounts of patient data currently held separately by NHS trusts and integrated care systems (ICSs) in an attempt to improve officials’ decision making. It will not involve data held by GPs.

On 31 October, chief data and analytics officer for NHS England Ming Tang told a digital health, AI, and data conference that the procurement process for the FDP was complete but awaiting full business case approval. Last week, rival bidders and campaigners understood that Palantir, the current supplier for FDP, and Accenture have already been chosen, that the approval had been met, and that an announcement is expected imminently.

The BMA letter, from Latifa Patel, chair of the BMA’s representative body, warned that the FDP could fall victim to the same lack of support that sank the NHS’s last two attempts to pull an array of patient data together into one place—care.data, which cost £8m before being scrapped in 2016, and GP Data for Planning and Research (GDPR), which was abandoned in 2021.

“The public and the profession have not been adequately consulted and reassured and the scope and scale of the programme do not appear to have been sufficiently established,” the BMA letter warned, adding that “speculation about the role, purpose, and scope of Palantir as well as their existing involvement within the NHS data architecture has cultivated fear among patients of how their confidential data will be handled.”

DAUK expressed concern at “recent flip flopping about whether patients can opt out of sharing data in the FDP for uses beyond their direct care.” A recent update to the FDP page on the NHS website said that “patients cannot opt out of sharing their health data with the FDP at all.” The website said patient data will go through an “anonymisation” process. DAUK, however, wrote that “given the data in a patient’s NHS record are incredibly detailed, we are concerned it could be re-identifiable even after anonymisation.”

Palantir was created by Paypal founder and conservative activist Peter Thiel with co-founder and chief executive Alexander Karp in 2004 with seed funding from the CIA’s venture capital fund In-Q-Tel. Palantir’s early customers were the US National Security Agency, the FBI, the CIA, and the US Marines, who used it in operations in Afghanistan.

The company started working 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. The company has taken on some former NHS staff, including the former AI chief Indra Joshi, but faces opposition from DAUK as well as the BMA and health data privacy campaigners MedConfidential over how patient data will be handled.

Sam Smith, of MedConfidential, said NHS England had failed to answer many questions, including whether the new contract will respect the existing wishes of those patients who had opted out of supplying their data under the previous failed GDPR contract.

“Any announcement is a start line, not a finish line,” said Smith. “NHS England can make a decision only for NHS England. NHS England can bully trusts and ICSs into going along with it, but as separate legal entities, ICSs and trusts get to make their own decisions. There are cheaper alternatives to the FDP which would free up hundreds of millions of pounds which could go on providing care.”

The BMJ asked both NHS England and Palantir for comment on the BMA letter and speculation that an announcement is imminent. At time of going to press, neither had responded.