That NHS England patient data platform procurement, FDP, is live. And worth up to £480m
References to Palantir use cases, 'unique tools' litter the tender docs as critics mull legal action
NHS England has kicked off the formal competition for its Federated Data Platform, giving suppliers just one month to bid for the increased contract value of up to £480 million ($581 million) over seven years, as rights groups threaten legal action.
Promised as a data store for NHS operational and population health analytics, the repository is seen as vital to the health system's post-Covid recovery and reform to the NHS — one of the world's largest health providers.
It is said to be a "must-win" deal for Palantir, the US spy-tech firm which built the Covid data store, from which some functionality will be transferred to the new platform.
They haven't really consulted on whether they're going to do this thing. They decided they were going to do this thing, and now they are consulting to justify it
Privacy campaigners and legal groups have been critical of the procurement process and patient privacy assurance around the deal, which has seen Palantir awarded a series of contracts without competition to build the early iterations of the data platform NHS England sees as the key for the future of the service. NHS England has an annual budget of around £152.6 billion ($184 billion).
Legal campaigners at Foxglove said the group and its "partners at Just Treatment, the Doctors Association UK and the National Pensioners Convention have serious concerns about this proposed Federated Data Platform. Almost nothing has been revealed about what it will do, how it will work, what data it will hoover up and how patient trust and consent will be protected."
It added: "We have already written a legal letter with our partners asking for urgent answers to our questions about the Federated Data Platform. If we're not satisfied with the government's response, we will see them in court."
The value of the contract has been expanded from £360 million ($436 million) over five years, to up to £480 million ($581 million) over seven years at a time when nurses and paramedics are striking to get pay rises commensurate with inflation.
The contract notice said potential suppliers would have until 9 February to submit their bids, giving them little time to capture the complex technical and operational requirements laid out in the notice. Palantir started work on the Covid-19 data store commissioned by NHS England, a non-departmental government body which does not deliver care, in March 2020.
In documents provided to suppliers, seen by The Register, NHS England said it planned to "replace the COVID-19 Datastore (provided by Palantir)."
"The platform will be a cloud-based Software as a Service (SaaS) solution, which will enable the use and sharing of data using a safe and secure environment. The platform will be available to NHS Bodies consistently, with structure and functionality being common across users, and allowing data held within consistent structures to be findable across the platform, but (importantly) with data governance and ownership retained at organisational level..., with information governance matters controlled by the relevant organisation (as controller under UK GDPR)," it said.
The document said the Covid-19 Datastore "includes some capability within scope" of the Federated Data Platform requirements. These services are provided under that call-off contract recently extended to Palantir until June 2023 without competition.
Examples given of the "current landscape" include Optica, a patient discharge application built on the Foundry platform from Palantir. They also include the Improving Elective Care Co-ordination for Patients (IECCP) programme, which started life at Chelsea and Westminster Hospital in a system also built with Palantir.
The hospital's chairman, Matthew Swindells, was hired by consultancy Global Counsel — which has Palantir as a client — in September 2019. Swindells, a former national director for operations and information at NHS England, was excluded from "any decision making in relation to Palantir", according to trust documents.
Among the five "initial" use cases for the new Federated Data Platform and associated services include elective recovery, that is reducing the backlog of vital, but not urgent, operations, which are currently at record highs. They also include plans to support "organizational interfaces" including patient discharge.
NHS England has said of the procurement that "competition is open to all suppliers and will abide by all the core principles of the regulations including transparency, non-discrimination, equal treatment and proportionality. These principles apply to all suppliers who decide to bid for the NHS England Federated Data Platform."
NHS England has been keen to promote the new procurement. Timothy Ferris, national director of transformation, and chief data and analytics officer Ming Tang said in a blog that, "procuring a federated data platform will not only provide the cutting-edge software to trusts and ICSs to continue to innovate but the connectivity will enable us to rapidly scale and share innovative solutions that directly addresses the challenges most pressing for the NHS.
"This will transform the way the NHS delivers its services enabling organisations to communicate and collaborate more effectively and provide better care for patients," they said.
One observer speaking to The Register pointed to inconsistencies in the procurement documents which they claimed were telling. For example, the suppliers' prospectus said access to data would be restricted by "a mechanism to scope the outcome, reason and time for access together with the data that can be accessed." It also specifies the access controls needed by the user to perform the work and should be implemented using a "Policy Based Access Control (PBAC) model."
However, later in the same document NHS England said, "access to the Use Case data and applications will then be tightly controlled using purpose-based access controls" [our emphasis].
Purpose-Based Access Controls are also a set of "unique tools within Palantir Foundry," which allow the platform to restrict access to data in applications including healthcare.
In late 2021, NHS England agreed to further public consultation before it expanded its use of the Palantir data store following the threat of a judicial review. Data privacy and legal group Foxglove, which helped in drafting the legal letters, told The Register last week it had not seen any of the consultation promised during the last legal round over the COVID data store.
It said today: "As everyone can see, the NHS is engulfed in a deep crisis. Dropping half a billion pounds on a data dashboard is not going to magically put more doctors and nurses on wards, more beds in hospitals or conjure new GP appointments out of the ether. At best, this is a distraction from the real problems the NHS is facing – at worst it risks eroding trust in the health service at the worst possible time."
In a web page promoting the new platform, the NHS England said it would "actively engage and involve people in decisions about how data is used with the platform, and how we best meet our duty of transparency and open communication." It also promised to publish "clear and accessible information about who is accessing data, and for what purpose." It also made a commitment to "be clear about people’s rights and choice to opt out (where applicable)."
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Sam Smith, coordinator at independent lobby group medConfidential, told The Register: "What are they consulting on? They haven't really consulted on whether they're going to do this thing. They decided they were going to do this thing, and now they are consulting to justify it. If you are in hospital, your data goes into [the platform], and the question is who will have access to it and how will you know?"
He added that there was so little clarity on nearly half a billion pounds of public money, "everybody is guessing, which is not a good start."
"Clearly, they think this tender is in a position to put out, but we have got these simple questions that show this is just a shambles. It's going to be driven by the suppliers. And it's clear from the mistakes in the tender that there is an incumbent supplier with a mortal lock on this thing. Good intentions are not enough. NHS England needs to actually deliver what it can today, to give some reason to believe the promises for tomorrow," Smith said. ®