Palantir has won a landmark contract with the NHS worth up to £330 million over seven years to join up the healthcare service’s fragmented datasets – that could, if executed properly, prove transformational.
Siloed data and sometimes crippling data assurance requirements even for palpably helpful and innovative programmes continue to hamper efforts to ensure more integrated thinking across the NHS's sprawling set of organisations and capabilities and The Stack welcomes the contract.
The NHS said on November 21 that "each NHS organisation will be the data controller for their ‘federated’ platform instance. The use of the data will always remain under the full control and protection of the NHS. The software provider will not hold or have access to NHS data" – ensuring that each organisation takes a joined up view on this data "controlling" will no doubt be a key challenge when it comes to deployment and use.
The contract for the NHS’s “Federated Data Service” includes support from Accenture, PwC, NECS and Carnall Farrar. Investment from the NHS in the platform and project is expected to be £25.6 million in year one.
“By bringing together real time data, such as the number of beds in a hospital, the size of elective waiting lists, staff rosters, the availability of medical supplies and social care places, staff can plan and maximise resources such as operating theatre and outpatient clinic time to ensure patients receive more timely care” the NHS said – inking the deal 17 months after publishing a well-received data strategy.
“All data within the platform is under the control of the NHS and will only be used for direct care and planning. It will not be used to access data for research purposes and GP data will not feed into the national version of the software platform” NHS England said November 21 – adding that the Federated Data Platform will also be the first use case in the NHS of Privacy Enhancing Technology (NHS-PET), a nationally assured and funded privacy tool available to all NHS organisations.
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Fellow US software firm IQVIA meanwhile has won a parallel contract to build and run the NHS’s Privacy Enhancing Technology (NHS-PET) platform, in a three-year deal with options to extend. The NHS said that there will be"be role-based access controls in place to ensure that individual users (who meet specific requirements) will be able to access data relevant and necessary to their role" and that the new Palantir-based platform will "create and maintain an audit trail documenting all individuals’ users’ access, including the data they access. Those audit trails will be reviewed to ensure that data is being accessed and used for legitimate purposes. The contracts between data controllers (NHS) and data processors (software provider) will contain specific clauses relating to inappropriate use of data, and all contracts in relation to the federated data platform will be published."
Dr Jeanette Dickson, Chair of the Academy of Medical Royal Colleges, said: “We saw first-hand over the pandemic that the effective use of data driven healthcare can transform the way we deliver patient care and improve clinical efficiency. The Academy has long identified the importance of using data and technology better, to boost clinical capacity and improve patient care.
“This is why the development of a federated data platform for the NHS is very welcome, provided it handles data in the promised safe and secure manner. Clinically led pilots suggest we have much to gain by fully embracing the platform’s potential to help link data better for elective recovery and care coordination.
“So with the proper checks and balances in place, we see no reason why not to press ahead with this exciting development”.
Tim Mitchell, President of the Royal College of Surgeons of England added: “We know that data systems are currently fragmented across NHS Trusts, making it challenging to connect and share information and resulting in surgeons spending time chasing referrals, scheduling appointments, and waiting for test results.
“We welcome the development of a Federated Data Platform which will enable NHS Trusts and Integrated Care Systems to bring together operational data, currently stored in separate systems. This will support staff to access the information they need – in one place."
Healthwatch England chief executive Louise Ansari struck a more cautious note, saying: “We welcome the aspirations of the programme to tackle long waits by people for planned operations and outpatient appointments, improve the way patients are discharged from hospital and increase uptake of vaccinations. People continually tell us that they want different parts of the NHS to get better at sharing their clinical information so they don’t shoulder the burden of having to repeatedly tell their story to clinicians and admin teams.
“The success of any new IT programme in the NHS relies on high public confidence in the ethical use of data, transparency over how their data will be used and in what circumstances they can opt out of data sharing. The public also needs strong assurances that their data will be protected, as our past surveys show that NHS IT security breaches can severely reduce public confidence. That’s why ongoing engagement with the public will be vital as the FDP programme is rolled out, to ensure their views, concerns or experiences of data use can inform implementation at local, regional and national level”.
The contract comes less than two years after a House of Commons Health and Social Care Committee report warned that the NHS’s “basic IT infrastructure” is still deeply lacking, with 20% of all the UK’s healthcare trusts still largely paper-based, saying that while there is “enormous potential for technology to support a transformation in NHS care that will bring benefits for patients and staff alike.. this potential will not be realised while many providers still struggle with basic IT infrastructure.”
That report called on NHS England, the government organisation that manages the health service, to produce a "roadmap" for better use of technology. It comes in the wake of a November 2021 review of NHS IT organisations by Laura Wade-Gery that emphasised how digital transformation is currently fragmented across the NHS, siloed between different agencies and is “often overshadowed by requirements of the day-to-day” and after an initial NHS Data Strategy laid out aggressive efforts to tackle what the strategy described as “cultural, behavioural and structural barriers” to the broader sharing of healthcare data. That report espoused the vision of a "modern architecture in which data can be accessed real-time through APIs via a national gateway" but acknowledged that this "cannot be achieved when the data is held in silos within individual electronic patient record (EPR) systems" (and, of course, on paper...)