NHS England has instructed NHS Digital to collect patient-level identifiable data about admission, inpatient, discharge, and outpatient activities from acute care facilities on a daily basis, for a pilot program designed to accelerate the recovery of elective waiting lists.
It has also told NHS Digital to use Foundry, a Palantir product, for the collection. The NHS previously used Foundry to power its store of health information in the pandemic.
Palantir is a clandestine, CIA-funded data-mining company set up by Paypal billionaire Peter Thiel. It is known for supporting the CIA’s intelligence operations in Afghanistan and Iraq, and in recent years civil rights groups have criticized it for providing its software to the US Immigration and Customs Enforcement, to track down illegal immigrants.
UK-based groups like openDemocracy have heavily criticized the Government for its work with Palantir, but so far it shows no sign of backing down.
According to NHS Digital board meeting papers (page 163) (pdf), the Faster Data Flow collection project will extract identifiable record level patient data from acute Trusts in England every day. The data collected will include:
- NHS number
- Local patient identifiers
- Date of birth
- Data about admission, inpatient, discharge and outpatient activity
Since NHS England owns the contractual relationship with Palantir, the new project will create a complex relationship where NHS Digital will act as the data controller for the collection, NHS England as the data processor, and Palantir as a sub-processor.
Patients will not be able to opt out of the data collection, as the information will be anonymised – in compliance with the Information Commissioner Office’s Anonymisation Code of Practice – before being disclosed.
However, the same document also mentions that the strategy requires data to be pseudonymised to deliver everyday services.
Palantir: A controversial history
The Government’s decision appears to be an extension of NHS England’s use of Palantir, which was threatened with a court review in 2021.
The NHS contracted Palantir in 2020 to assist with the response to Covid-19. However, the relationship faced legal challenges and the Government eventually backed down from expanding it. Since then, the firm has been looking for new ways to grow its relationship with the National Health Service.
Founded in 2003 with support from the CIA, Palantir helps organizations in analyzing large volumes of data from governments and other sources to gain insights. However, civil liberties organizations – in the UK and elsewhere – are worried about Palantir’s track record of supplying its tools to government agencies.
Privacy advocates have cautioned NHS leaders against repeating past failed efforts to utilise patient data correctly.
“We’re very concerned that this latest move to force more patient data into Palantir has been done with zero public input or consent,” said Foxglove director Cori Crider.
“That’s not what we were told would happen in our case, and we’re seriously concerned about it’s wrong. The Government will be hearing from us shortly.”
An NHS England spokesperson said: “By collecting data in a more streamlined way the NHS is better able to plan and allocate resources to maximise outcomes for patients, whilst ensuring that data control remains with the NHS at all times.
“Ultimately, it will help all NHS organizations to better understand their waiting lists and pressures in near real time, work as systems, and the burden of manual reporting on staff will be significantly reduced.”
The new Palantir data project is referred to as the Faster Data Program in the NHS Digital board documents. Despite a several-month delay in the £360 million procurement, a separate Federated Data Platform is still formally on the agenda.
Earlier this year, Palantir allegedly discussed ‘hoovering up’ small businesses that provide services to the NHS in order to ‘take a lot of ground and take down a lot of political resistance,’ making that competition a ‘must-win.’
The firm has also hired Indra Joshi and Harjeet Dhaliwal in recent months, who were previously key members of NHS England’s data science and AI teams.