The rollout of the Federated Data Platform (FDP) is under way in the region after being adopted by Cambridge University Hospitals NHS Trust, despite concerns about both the software and the involvement of Palantir, the controversial company behind it.
The plan to roll out the FDP into the NHS England service was announced in March 2024, when the UK government allocated £182,242,760 for the procurement of the technology, while noting “the contract value could increase to a forecasted amount of £330m”, depending on the take-up.
The Cambridge Biomedical Campus, located at the southern end of Hills Road on the southern edge of Cambridge. Addenbrooke’s front enrance. Picture: Keith Heppell
Now named the NHS Federated Data Platform (NHS FDP), the system is intended to “enhance patient care and increase efficiency”. It “securely connects data, breaks down information silos, and provides insights to assist in decision-making, reduce costs, and improve patient outcomes”.
The first part of the NHS FDP to be adopted for the Cambridge trust is Optica, which Cambridge University Hospitals NHS Foundation Trust (CUH) says will be in use by the end of the year.
NHS trusts and community provider organisations use Optica to bring care teams together to ensure patients have all the care, equipment, medication and support they need before and after their discharge from hospital.
To achieve those goals, the FDP platform has access to your data, including your name, date of birth, address, gender, NHS number, and “living habits”.
This has raised concerns because until now, this data has been used only by the NHS and not by an outside agency. There are also questions because Palantir provides services not just to the healthcare sectors, but also to the UK’s military and police sectors.
The US tech company, initially funded by the CIA in 2003, specialises in AI-powered military and surveillance technology and data analytics. Headquartered in Denver, it provides its military technologies to customers including the US military, ICE (the US Immigration and Customs Enforcement agency), the UK Ministry of Defence and the Israeli government.
Nurse typing on digital tablet in hospital or surgery
Concerns over the handling of sensitive data focus on whether there are sufficient assurances Palantir will not use NHS data for any other purpose, and whether the NHS could – in some future scenario, such as a government instruction – itself make its data available to the police or the military.
Palantir’s CEO, Alex Karp, has stated that the company “does not buy, sell, or transfer the data it handles and that the data ultimately belongs to the government client”.
From Palantir’s point of view, the integration is going well.
Palantir Technologies’ special advisor Stephen Childs told the Cambridge Independent: “Cambridge University Hospitals NHS Foundation Trust represents the best of the NHS and we’re proud to be helping it harness technology to deliver better care. Optica, as part of the NHS Federated Data Platform, will enable patients who are ready to leave hospital to be matched with the onward care they need. Where already deployed, it’s currently reducing the longest unnecessary hospital stays by an average of 17.2 per cent and we look forward to seeing what it can do in Cambridge.”
Palantir’s office in Palo Alto, California, USA. Picture: iStock
Yet questions remain. In late August, a Chatham House report on the issue stated: “Palantir insists it does not conduct surveillance directly, but provides lawful software for clients to manage and interpret data. Yet critics point out that without robust oversight, such tools could enable predictive policing, discriminatory targeting, or unchecked state surveillance.”
When questioned about the use of Palantir’s software, a CUH spokesperson said: “CUH is one of 130 NHS trusts which have followed the recommendation from NHS England to sign up to the NHS Federated Data Platform. We are working with our Integrated Care Board to use Optica to enable medically fit patients to return home more quickly. We aim to have this in place by the end of 2025.”
Asked about the worries people may have about a US company having such intimate access to patient records, a Department of Health and Social Care spokesperson said: “For too long, the NHS has been held back by sluggish systems that do not work with each other, leading to frustration for both patients and staff, poor communication and unnecessary red tape. The NHS Federated Data Platform brings together information from different systems across the NHS, improving efficiency and patient care.
“This is part of our 10 Year Health Plan to make the NHS fit for the future, so it delivers for patients in Cambridge once again.”
However some trusts – including in Leeds and Manchester – have apparently declined the offer to introduce the NHS FDP platform, ostensibly due to technical challenges.
Surveillance camera with digital world.
Freedom of Information (FOI) enquiries by Corporate Watch, along with accounts gathered from health workers by No Palantir in the NHS, suggest that “many local NHS trusts and bodies are refusing to comply with the rollout of the FDP, describing Palantir’s technology as a step backwards on existing systems”. The report, published in August, alleges: “Only 34 trusts (just under 15 per cent) were actively using the platform and its products.”
The next step towards encouraging trusts to take up the FDP platform is a “grey area”, according to relevant sources. Officials are engaging with the trusts concerned “to understand where it can enhance the local investment they have made in systems that currently meet their local needs”.
Meanwhile the NHS says that 130 NHS trusts out of 202 in the UK have signed up to the NHS Federated Data Platform, which includes the Optica component.
A spokesperson for the Cambridge branch of Keep Our NHS Public, following a meeting with NHS officials, told the Cambridge Independent: “Whilst The FDP isn’t mandated, all trusts and ICBs have been asked to provide plans for how they will maximise the benefits of the NHS FDP in the next two years.
A surveillance camera on a bus.
“In our area, CUH, North West Anglia Foundation Trust and the ICB (Integrated Care Board) have signed up for the dual purpose of improving the way we co-ordinate complex discharges and standardising the gathering of activity data for reporting purposes. There is likely to be further opportunities around public health monitoring (PHM) but those require further study.”
There are also concerns among healthcare workers as to whether Palantir is a suitable NHS partner.
One healthcare worker told the Cambridge Independent: “Within the NHS, there are several causes for concern, including the rollout of Federated Data Platform software from Palantir – primarily a military/surveillance technology company – which raises serious data governance, privatisation and ethical concerns for the NHS.
Health workers at Addenbrooke’s Hospital hold regular vigils on Friday evenings in support of health workers in Gaza. Picture: Mike Scialom
“There has also been a systematic suppression of any expression of solidarity [with Palestine] and censorship within the NHS, from a regulatory level, down to employers, including at CUH.”
Keep Our NHS Public (KONP) Cambridge said: “We are aware of some CUH staff being very concerned by the use of Palantir-provided software. The group Health Workers for a Free Palestine, supported by KONP, and who protest outside Addenbrooke’s every Friday evening from 6-7pm, are also highlighting this issue internally through staff communication channels. CUH seems to be stifling any discussion about Palestine.”
Israel has been “destroying all the health infrastructure in Gaza”, the group points out, aided by its military technology.
Palantir, for the purposes of this article, clarified which technology it supplies to the IDF. In a statement to the Cambridge Independent the company said: “These claims assert that Palantir is the (or a) developer of the ‘Gospel’ – the AI-assisted targeting software allegedly used by the IDF in Gaza, and that we are involved with the ‘Lavender’ database used by the IDF for targeting cross-referencing. These statements are not true. Both capabilities are independent of and pre-date Palantir’s announced partnership with the Israeli Defense Ministry. Additionally, we have no involvement with the Lavender database used by the IDF for targeting identification. We have no relationship to these programs and their use, but are proud to support Israeli defense and national security missions in other programs and contexts.“
Cambridge for Palestine protest outside Cambridge Union for talk by Peter Thiel, co-founder of Palantir, which supports Israel’s military. Picture: Mike Scialom
On predictive policing the Palantir spokesperson said: “As a matter of company policy, Palantir does not permit its software to be used for racial profiling.”
A spokesperson for CUH, asked about the “stifling of discussion” on the issue, stated: “We have not been made aware of these concerns within CUH. CUH actively promotes an open and transparent culture which is essential for patient safety and our ability to improve the care we provide on an ongoing basis.
“Staff, patients, and visitors are encouraged to provide feedback, raise concerns, and contribute to service development. In addition, a dedicated Freedom to Speak Up (FTSU) programme provides a safe and confidential channel for staff to raise concerns without fear of reprisal, promoting a culture where staff feel valued and listened to.”