NHS trusts operating on fewer patients with Palantir FDP, warns Foxglove

Almost a third (30%) of English hospital trusts using Palantir’s Federated Data Platform (FDP) are carrying out fewer patient operations than before they started using it, according to data obtained from the NHS by campaigning group Foxglove.

The findings, revealed via freedom of information (FOI) requests, challenge claims by the UK government and Palantir that FDP is increasing overall surgical procedures across hospitals, said Foxglove. 

The NHS data indicates that 41 trusts are currently utilising Inpatient CCS, Palantir’s FDP module, which is designed to assist hospitals in managing patient operation scheduling. Of these, 13 trusts – approximately 30% – reported a decrease in the total number of operations performed compared with the period before they adopted the FDP tool.

Collectively, said Foxglove, these 13 trusts recorded 9,073 fewer operations after implementing Inpatient CCS, when compared with the equivalent timeframe before its adoption. This marks the first public release of data detailing whether individual trusts using FDP have experienced an increase or decrease in surgical volumes.

According to Foxglove, NHS England had previously only published the cumulative total of additional operations across all trusts using FDP. Foxglove argues this approach was potentially misleading as it obscured instances where performance had declined at a significant number of trusts that had adopted the technology.

Foxglove head of strategy Tim Squirrell said: “Foxglove’s investigation has shown that the flagship claim made by NHS England and Palantir about the benefits to hospitals of the Federated Data Platform needs a serious health warning.

The big claim that the FDP is delivering more operations for hospitals across the NHS is covering up a much less positive reality – a third of the trusts using FDP’s operations scheduling tool, Inpatient CCS, are actually delivering fewer operations than before they started using Palantir’s kit

“We now know that the big claim the FDP is delivering more operations for hospitals across the NHS is covering up a much less positive reality – a third of the trusts using FDP’s operations scheduling tool, Inpatient CCS, are actually delivering fewer operations than before they started using Palantir’s kit.”

The campaigning group has argued that attributing performance improvements to FDP without providing the underlying data prevents effective public and parliamentary scrutiny of the platform. It also says NHS England has not published comparative data for trusts that are not using Palantir’s tools, which makes it difficult to isolate the impact of FDP.

“Palantir can’t have it both ways. If it expects us to believe that FDP is responsible for improvements in some hospitals, it must also accept that things are getting worse as a result of its tools in others,” Squirrell added. “To date, ministers and Palantir have failed to provide the information we all need to decide whether the FDP is really helping or not. We shouldn’t have to go through a series of time-consuming FOI requests to access the crucial information that allows us to work out if this tool is truly delivering for the NHS or not.”

Questions regarding the value for money of Palantir’s services have also been raised in other government departments. Civil servants recently opted to bring a multimillion-pound Palantir contract for housing Ukrainian refugees in-house.

The Palantir contract for the NHS is valued at more than £300m. “Ministers may want to consider whether NHS patients across England will agree that this ropey evidence is enough to justify giving this US tech giant another massive contract in one of our most important public services,” Squirrell said.

However, Tom Bartlett, former deputy director of data engineering at NHS England, who led the 150-person team that built the FDP, argued that focusing solely on specific nationally commissioned products might miss the broader strategic intent of the FDP.

“The FT and Foxglove are right that the benefits are concentrated in a handful of trusts. NHS England is right that the platform is delivering results where it is properly adopted. The benefits need to be measured properly if we are to understand how well the nationally developed products are working, and although NHSE have commissioned this, we won’t see the results for years,” Bartlett stated.

Bartlett emphasised that the primary use cases for the FDP are expected to be generated by clinicians developing solutions locally. He highlighted significant, often overlooked, data risks within the NHS. 

“Across the NHS, boards are running enormous risks they seem unaware of. Walk into any ward, theatre or clinical team base, and you will see whiteboards and spreadsheets containing patient information, in full view of anyone who visits and liable to being accidentally deleted, not connected to any other hospital system. No one is even asking the question about this monumental risk – just look at any Trust Board Assurance Framework or Corporate Risk Register, and you will not find it.”