NHS Federated Data Platform Debate
Full Debate: Read Full DebateZubir Ahmed
Main Page: Zubir Ahmed (Labour - Glasgow South West)Department Debates - View all Zubir Ahmed's debates with the Department of Health and Social Care
(1 day, 15 hours ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Parliamentary Under-Secretary of State for Health and Social Care (Dr Zubir Ahmed)
It is always a pleasure to serve under your chairmanship, Dame Siobhain. I am grateful to the hon. Member for Newton Abbot (Martin Wrigley) for securing this important debate and for his and other hon. Members’ contributions to it. Of course, we should also welcome the hon. Member for Solihull West and Shirley (Dr Shastri-Hurst) to his place in his first debate on the Front Bench.
We have heard a lot about concerns and insights and interpretations about the NHS’s technological architecture. Some would have us think that the FDP is synonymous with just one company. It is not. The FDP is fundamentally an NHS construct. It consists of multiple contracts awarded to a number of consortia, including Palantir, Accenture, PwC, Carnall Farrar and the North of England Care System Support. Each of those have different responsibilities to make sure that there is training, health expertise and security in the FDP.
Ultimately, the FDP is a federation of local trusts and ICBs within NHS England, each with their own version of the FDP and their own abilities to decide which information they put there on the basis of their own service needs and governance arrangements. Although there should be scrutiny of Palantir and of any contract, we should also provide clarity about what the FDP is delivering for the NHS. It is my duty to make sure that the FDP is improving patient and clinical experience and improving patient outcomes.
Making the best use of data generated by the NHS and social care is essential to transforming services, improving outcomes for patients and making sure that we use resources in the best manner possible. Lord Darzi’s independent investigation into the NHS found that, despite huge volumes of data, fundamentally:
“The last decade was a missed opportunity to prepare the NHS”
to use the latest technologies.
The FDP is part of an infrastructure—it is not the infrastructure or the only infrastructure—resolve that gap. It is improving efficiency and generating savings across the health service worth up to £2.4 billion, according to independent estimates. Those independent estimates are being further bolstered by a commissioned study by Imperial College that will look at the economic impact of the FDP. It is an important tool for us being able to make the NHS fit for the future on clinical efficiency, transparency of data and outcomes for patients up and down the country.
Before I go into more detail about what the FDP does, it is important that I say what it does not do. For instance, it is not synonymous with the single patient record, the NHS app or—necessarily—with linking primary care data with secondary care data.
Dr Ahmed
I am going to carry on for a bit longer.
The hon. Member for Aberdeenshire North and Moray East (Seamus Logan) tempts me with his speech, and he knows that I cannot resist his temptation. He spoke about Scotland and he will know that I am an NHS surgeon in Scotland. I hope he thinks that I can speak with some authority about the NHS in Scotland, so let me tell him a few things about the digital architecture in the NHS there.
The NHS app has been running successfully in England for over eight years. Three out of four people in the NHS in England have that app. To clarify, the app is not Palantir; it has been devised organically on the ground by NHS England—by clinicians and by technologists. It now serves millions of patients to book test results, screenings and appointments—including GP appointments —to end the 8 am rush.
The hon. Member for Aberdeenshire North and Moray East spoke about the MyCare app in Scotland. That remains a far-fetched dream rather than a reality. The limit of the ambition of that app seems to be, as I understand it, a dermatology service in one part of Scotland called Lanarkshire, for those who are not familiar with Scotland. It is a million miles away from what has been developed down here in England.
Dr Ahmed
I will not; I am going to carry on—and I will tell the hon. Gentleman something further. The NHS in England was quite happy to use the expertise of technologists up and down the country, including in Scotland—including, in my own constituency of Glasgow South West, a company called Cohesion Medical. His Government in Scotland, who have been in government for over 20 years, refused that offer. That is why my patients and constituents in Scotland are unable to access simple digital services. It is why my patients and my constituents under NHS Scotland are 30 times more likely to wait over two years for treatment. It is why my patients and my constituents in Scotland are unable to access optimal stroke therapy and lung cancer screening.
The NHS federated data platform in England connects health information held in different systems, helping to manage activity to improve productivity and outcomes. By connecting critical data streams, it can accelerate diagnosis pathways, streamline discharge processes and ensure faster, more co-ordinated care that reduces waiting times for all patients.
I will briefly describe a couple of examples. North Tees and Hartlepool NHS foundation trust uses an FDP product called OPTICA to map the patient’s journey from being admitted to going home. It used to be done with spreadsheets, which were not always updated. Because of that, discharges were delayed, medicines were not sorted on time—in some cases time-critical medicines, causing real patient harm—and patients were therefore impacted. OPTICA lets the trust see all that information in one place in real time. It has reduced the number of long stays by a third, and despite a 7% increase in admissions over that time, we are improving services overall.
Order. May I just say that the hon. Member had very generous time allocated to him during this debate? If the Minister does not want to take an intervention, he does not need to.
Dr Ahmed
At the Mersey and West Lancashire teaching hospitals NHS trust, they are using the FDP to better manage the lists for planned surgery. That allows surgeons like me to operate on more people each day, and it is cutting waiting lists. This has been achieved through better use of data. It is a timely reminder that in England we are improving productivity in the national health service, getting more operations done per list and getting closer to pre-covid levels of activity. The same cannot be said for Scotland under the SNP Government.
Seamus Logan
Rather than giving so much of his speech to cheap political points about Scotland, can the Minister answer the question that was put to him several times by several Members: are the Government considering a review of the break clause next year?
Dr Ahmed
If the hon. Gentleman had read the details of any contract that the Government have negotiated, whether it is this one or the previous one, he would know that the break clause is there for a reason. Of course we evaluate value for money at those times. He used the word “cheap”, but let me tell him something: it is not cheap to have to wait over two years for NHS treatment in Scotland, which is 30 times more likely to happen than in England. That is why on 7 May the NHS in Scotland can get an upgrade with Anas Sarwar as First Minister and Jackie Baillie as Health Secretary.
The FDP is helping people get the care they need more quickly and more efficiently. As a programme, it is a success. The FDP has exceeded every single target since its go-live date in March 2024, and 137 NHS trusts are actively utilising the platform and have reported benefits. The programme is significantly exceeding its benefits forecast, with external independent experts validating these results.
NHS England publishes data on how the FDP has benefited patients and the NHS. The data collected up to the end of March will be published in May. I can share the figures with Members now. Since the go-live date in March 2024, more than 100,000 additional patients have been supported to undergo procedures in theatres, partly due to increasing theatre utilisation. Nearly 94,000 people have been supported on their cancer journey, with 7% seeing a reduction in the time taken to diagnose their cancer. There has also been a 14% decrease in delays to discharging patients staying in hospital for more than seven days, freeing up hospital beds for those who need them most.
The last Government awarded the Palantir contract on the basis of a successful bid that was deemed to be significantly better, and by a significant order of magnitude, than those of its competitors. It was judged the most economically advantageous and likely to deliver the best-quality outcome for patients. The contract was awarded with an overall value of up to £330 million over a maximum of the seven-year term. So far, £210 million has been invested, as we scale up. The benefits of the FDP are exceeding those we forecast, as I have already outlined, but—
Dr Ahmed
If the hon. Gentleman will allow me, I think I will answer his point shortly; in the interests of time, we have to be careful about interventions.
We live in a fast-paced technological world, and that means that we always look to the next possible provider to provide value for money, so it is right that there are break clauses in the contract to allow evaluations to take place. I can reassure all hon. Members that, as a clinician and a Minister, my north star is always patient safety and quality, and of course value for money. If, at the point of the break clause, we evaluate and find that there are other providers that can do the job better, then of course that needs to be looked at and reflected upon. More generally, as the Minister for Health Innovation, Patient Safety and Life Sciences, I would not be doing my job properly if I did not try to champion British business at every opportunity or to champion British small and medium-sized enterprises to become British plcs. I hope hon. Members will take that as read.
The contract has extension provisions and will be reviewed in line with standard contract management processes. We will decide later this year whether to extend it. NHS England will be transparent about the process and the evidence used, as we have been throughout our regular performance reviews for this contract and the FDP.
On digital sovereignty, our priority is to give patients the care they need. As Members will no doubt understand, for some essential IT services, it is simply not possible to develop in-house solutions, as we seek the best from the market. I reflect on my own practice in Glasgow, in the Queen Elizabeth university hospital, which the hon. Member for Aberdeenshire North and Moray East seems to think has found a panacea of publicly delivered technology. I can tell him that when I walk into that hospital, I login through Microsoft Windows. Then I open a programme built by a North American tech company to order test results. Then I open another programme built by a North American tech company to look at the results of those tests. Finally, if I want to check X-rays, I open a fourth programme built by a North American technology company to evaluate CT scans, MRI scans and X-rays.
Dr Ahmed
In the interests of time, I will continue. I apologise to my hon. Friend.
In the future, our goal is to see a vibrant UK market in digital and technology, which would give the NHS more choices and help to improve standards. Of course, I would be unashamedly pro-British about my ambitions for that mix, because that is the way that we not only serve our NHS but also support economic growth. At the moment, what matters is who controls the data and how that is governed. I appreciate the sensitivities around that, I really do. Rightly for the FDP, this is a matter for the NHS and UK regulators.
I have also been asked about vendor lock-in and whether it is possible to remove companies like Palantir from the NHS. The answer is unequivocally yes, it is possible. Of course, it would take time and planning to safely transition from one supplier to another, as it always does in the NHS, when patient safety is the primary concern. At the moment, there are unfortunately only a small number of companies that can do what we genuinely need them to do at the scale that we need them to do it, but the contract has multiple measures built in to allow greater freedom of choice. That includes making sure that the NHS owns the intellectual property for all products and that it is possible to migrate them to other providers.
Data security is also at the heart of our health innovation programme. Protecting personal data is at the heart of the FDP and the health innovation strategy. Most importantly, we have separated church and state, in terms of service provision and data security. A separate company, IQVIA, provides the highest standard of privacy-enhancing technology for that data in the FDP, which means that we can remove personal identifiers from the data where they are not required, ensuring that privacy is maintained throughout. NHS England and NHS organisations retain full control as data controllers, including over decisions about how data is used, who can access it and which products are deployed. Palantir does not own the data, the products or the intellectual property, nor can it use the NHS data for its own purposes.
The FDP is a secure data environment. Security is built into its design and operation, and it has been through national, technical and cyber-assurance, with external oversight. It should also be understood that the FDP is only for health and care purposes; it cannot be legally used for non-health purposes such as immigration enforcement, as has been promulgated.
As Members will expect, my position on the owners and executives of Palantir is very much the same as that of my right hon. Friend the Secretary of State—we are no fan of their politics. However, the FDP, and the principles that underpin it, are critical to the future of the NHS. Palantir operates strictly within a UK-regulated contract where the NHS controls all data, access is tightly governed and information can be used only for agreed purposes that benefit patients. I would expect any member of staff who did not in all conscience feel that they could work with Palantir to raise that with their employer.
I raised the issue of patient trust. We know that over 50% of the public do not have confidence in this system, so they might not share vital health information with their clinicians. As a result, will the Minister include that point in the consultation? He has only 10 months until this first period ends, so can he say more about the public perspective on the Government consultation?
Dr Ahmed
My hon. Friend will know that no NHS system or pathway can ever work without the confidence of the public, and that needs to be reflected in any evaluations that take place. I have heard my hon. Friend’s concerns loud and clear, as well as those of Members across the House. It is right that we look to maintain the highest standards for our NHS. It is also true that the FDP has a role to play in delivering for the NHS and helping people get the care they need more quickly and efficiently. Those are real outcomes that will improve people’s lives, all through the better use of data.
Members on both sides of the House often rightly challenge me to go further, faster on rare diseases, rare tumours and rare cancers. None of that is possible in modern medicine without data, and the analysis of data. Just as I have a responsibility to ensure that we get value for money out of all contracts in the national health service, and that we evaluate them regularly, Members also have a responsibility to be careful not to aggregate different components of the NHS and present them as a monolithic technological solution.
The FDP is, and will continue to be, an important component of delivering patient care in the NHS in England. Of course, who contracts with the FDP will be open to question as we go forward and think about future contractual arrangements. It would be disingenuous to suggest that the FDP is somehow the only technological solution or database in the NHS; there are many others that do good work—whether that is the single patient record, the health data research service, the NHS app or clinical systems for NHS primary care providers. We must be careful not to conflate one technology with the next, and in doing so, alarm citizens and patients about what is happening with their data.
I can assure Members across the House that in my ministerial service—just as in my 20 years of clinical service—my north star is transparency, patient safety, quality and providing the best care to all patients up and down the country.