The FDP programme is an ambitious attempt to connect the many different data systems in the NHS.

The NHS is not a single organisation, but multiple organisations, an ecosystem which has grown to be flexible to the needs of local populations, and particular groups but using different systems to record its data.

This means there are challenges in working consistently at scale and sharing information and learning between systems. It can even make it difficult for local clinicians to easily understand all the different parts of a patient’s journey, with medical information and operational information being held on different systems.

The FDP will provide software to link these different systems. It will give us a consistent technical means of linking the clinical, administrative and reference data which the NHS generates as part of its operations.

This will make it much easier for health and care organisations to work together to understand patterns, solve problems, plan services for local populations and ultimately to deliver better care for the people they serve.

Taking the lessons learned from our COVID-19 response, we know that bringing information together can help us to transform the way our workforce uses data to support and plan care, and that if we do this in a way that reduces the burden on local providers, it frees up more clinical time to care for patients.

FDP platform software is our solution to this challenge.

FDP platform software will ‘sit on top of’ existing data and IT systems and connect them, making it easier for staff to access and link the information in those systems, in one safe and secure environment.

The software will be ‘federated’ across the NHS. This means that every hospital and Integrated Care System (ICS) will have their own version of the platform which can connect and collaborate with other data platforms as a “federation” – making it easier for health and care organisations to work together, to compare data, and analyse it at different geographic, demographic and organisational levels and to scale and share innovative digital solutions.

The federated data platform is not a data collection, it is software which will help to connect disparate sets of data.

A ‘federated data platform’ refers to software which will enable NHS organisations to bring together operational data – currently stored in separate systems – to support staff to access the information they need in one safe and secure environment. This could be the number of beds in a hospital, the size of waiting lists for elective care services, staff rosters, or the availability of medical supplies.

The FDP will allow staff to plan theatre time to maximise use, drawing together information on clinical need, wating times, staff rotas, and other operational data.

Similarly, it will allow the management of handoffs between health and social care, facilitating all the different decisions and activities needed, from alterations to a home, to agreement of a domiciliary care package and equipment. The basic admin and clinical data needed to make these decisions are brought together from different systems.

Every hospital trust and integrated care system (ICS) will have their own platform, with the capability to connect and share information between them where this is helpful. For example, to discharge a patient from hospital into a care setting (when the appropriate data sharing agreements are in place).

In some cases, NHS organisations may need to link data to understand what factors are driving poor outcomes in different population groups. For example, local Population Health Management teams often link data to understand current health and care needs and predict what local people will need in the future. Health problems are complex, and, in many cases, a single health issue may be influenced by interrelated social, environmental, and economic factors. By linking data, local health and care services can then design new proactive models of care. In this instance the data controller would be a local integrated care board (ICB) or ICS responsible for planning and commissioning services which meet the needs of their population.

Initially, these solutions will focus on supporting five key NHS priorities:

1. Elective recovery – to address the backlog of people waiting for appointments or treatments which has resulted from the COVID-19 pandemic alongside Winter pressures on the NHS.
2. Vaccination and immunisation – to continue to support the vaccination and immunisation of vulnerable people whilst ensuring fair and equal access and uptake across different communities.
3. Population health management – to help integrated care systems proactively plan services that meet the needs of their population.
4. Care coordination – to enable the effective coordination of care between local health and care organisations and services, reducing the number of long stays in hospital.
5. Supply chain management – to help the NHS put resources where they are need most and buy smarter so that we get the best value for money.

Any future national use cases will go through an extensive process of identification prioritisation and scrutiny, in line with the principles of data minimisation as set out in the UK General Data Protection Regulation (GDPR).

A federated data platform will also provide trusts and ICSs with the capability to develop their own digital tools that address their most pressing operational challenges and enhance their ability to make informed and effective decisions.

We are procuring a combination of technology and services to connect and protect data enabling innovation to be scaled across the NHS.

NHS England is conducting a fair, open and transparent procurement in line with Public Contracts Regulations 2015.

We are using the Competitive Dialogue Process, detailed in Public Contracts Regulations 2015. ​

There is no “front runner”. This process is open for any supplier(s) to participate subject to passing the standard selection criteria and minimum requirements. ​

All bids are evaluated against the same objective evaluation criteria and scoring methodology that has been shared with all suppliers. The evaluation criteria has been developed to mitigate against incumbent advantage. ​

Independent evaluators have been selected from across the NHS and have a range of skills and experience relevant to the question they are evaluating.

The procurement documentation clearly define the FDP-AS requirements and project scope, which is agnostic to any existing solution 

The FDP-AS scope is for cloud-delivered data analytics software and associated services – NHS England retains budget control over when and what it pays for.​

The value of the procurement has not changed. The Public Contract Regulations require a maximum value of any contract that is advertised, which is up to an estimated £480m over 7 years, this funding is expected to provide funding for up to 240 NHS organisations (Trusts and ICSs) – this equates to a cost of c £300K per NHS Organisations per year for 7 years.

FDP-AS is not a ‘like for like’ replacement of the contract that NHS England currently has with Palantir for the provision of Foundry. ​

We have deliberately reassessed our data analytics requirements over those that emerged during the pandemic and have not stipulated the solution to deliver these requirements. Any supplier can respond with their solution. ​

The requirements have been designed the FDP-AS requirements without input from the incumbent supplier.
The FDP-AS requirements are to utilise open standards and aligned to the UK gov Technology Code of Practice
Vendor lock-in is a risk with any technology procurement, particularly for cloud-based/SaaS services​.

The commercial structure NHS England has chosen preserves competition in key areas of the requirement and provides NHS England rights to ensure data offload and other exit obligations are enabled by the FDP supplier.​

Open standards will mitigate against bespoke integrations with other NHS systems and will support the exit and transition provisions.

The Marketplace solution-exchange capability will enable publishing and reuse of code and applications across the FDP landscape.

FDP will enable frictionless Data and Code sharing across tenants that adheres to all security and privacy constructs by implementing a canonical data model, a common policy-based access control mechanism and configurable deployment pipelines.

All potential suppliers will be treated equally

The procurement rules and measures that we have chosen mitigate against unfair incumbent advantage. ​

NHS England has a duty to treat all suppliers the same regardless of the public perception of any organisation, or the opinions held by any of their shareholders. ​

NHS England cannot exclude any supplier that is lawfully established and able to bid from participating in the procurement. ​

We are confident that our procurement process does not enable any supplier that does not meet our strict standard selection criteria (which includes e.g. mandatory and discretionary exclusions relating to illegal activity, social and environmental breaches) and robust Information Governance requirements to continue through the process.

There are four planned procurements, that will drive a competitive, innovative market for each distinct area:

• Procurement 1: Federated Data Platform and Associated Services (The core platform), with ICS integration: to design, support, and enable a shared workspace through which NHS organisations can be connected, so that FDP users can have access to applications to support planning, direct care, population health management or research, whilst supporting each NHS organisation’s information governance responsibilities.​
• Procurement 2: Privacy-enhancing technology (PET) – this is an essential part of making the federated data platform operational, however FDP will be one of many ways that the PET is used. This procurement is buying PET capability for the NHS.
• Procurement 3: Marketplace – allowing the development of a ‘market’ for applications from multiple suppliers – accelerating development and adoption of best-in-class operational tools across the NHS, and thereby reducing duplication in development effort across suppliers.​ Operational tools that enable marketplace application release and management: to monitor and optimise the marketplace platform to meet the changing demands of the service.
• Procurement 4: Product Development and Supporting Services (previously referred to as Training, deployment support, and implementation) – providing a comprehensive support model and service wrapper.

This approach has been developed with external procurement specialists and scrutinised and approved following a red team review with No.10.

For procurement 1 we are using ‘Competitive Dialogue’ as this is an open procedure that allows NHS England to engage in dialogue with the market to support the best possible solution being developed. It allows us to incorporate a proof-of-concept stage which will allow NHS England to test the deliverability of the proposed solutions.

Procurement updates are regularly published on the NHS England website.

The NHS has been responsible for many examples of technological innovation but is not a manufacturer and does not have the expertise or capacity to develop large, sophisticated applications of this kind. As we do not have the skills in-house to build what we need (and build it in desired timescales) we must turn to experts in industry and procure the best software available on the market to support the NHS and deliver the best services possible for patients. The NHS uses external suppliers for a range of software, for example electronic patient records for primary care.

The Federated Data Platform will connect the NHS to enable transformational improvements and outcomes for patients.

It will enable ICSs to deliver better outcomes for population health, tackle inequalities, co-ordinate care, speed up diagnosis, plan local services, support research into new treatments and boost innovation, ensuring the NHS can continue to offer cutting-edge care, save lives and deliver better outcomes for our patients. Through the initial five use cases, FDP will provide the following functionality:

Population health and person insight

• Providing data and segmentation tools to enable population health management locally
• Linking between datasets to drive population insight

Vaccination and immunisation

• Real time information to support supply and workforce planning and operational decision making
• Monitoring and supporting intervention around equality of immunisation and vaccination programmes

Elective recovery

• Improving workflow and transparency around waiting list management
• Single tool to manage the backlog and maximise utilisation of existing capacity

Care coordination

• Enabling ICSs to optimise end-to-end services for patients, understanding capacity across the whole system.
• Focus on organisational interfaces (e.g. virtual wards, anticipatory care, and discharges).

Supply chain

• Aligning supply and demand
• Increasing visibility of where stock is needed to optimise management of the supply chain
• Spend analysis to drive value

A connected and more efficient NHS ultimately means a better service for patients and service users. The FDP will:

• connect teams and organisations who need to work together to provide patient care;
• help local teams better prioritise waiting lists, manage theatre capacity and identify their staffing needs;
• help local health and care teams to understand the health of the people in their community, and what preventions and services might support those people;
• make it easier to see where critical supplies are, how much is available, where there are shortages;
• support levelling up as local innovations will be more easily scaled and shared via the ‘marketplace’;
• embed the highest standards of data security and protection; and
• reduce the reporting burden on frontline staff.

NHS England is currently running pilot FDP use cases, including supporting elective care and improving hospital discharges. Benefits from the pilot programmes are already being realised:

• local trials have enabled trusts to remove up to 16% of their waiting list through error identification; and
• a discharge pilot helped one trust reduce the number of patients staying 21 days or more to 12% over twelve months. The national average is 20%.

NHS England is working towards contract award in Autumn 2023. Following this there will be a 6-month mobilisation and implementation period. Within this time products supported by the current COVID-19 Data Platform (provided by Palantir) will be transitioned to the federated data platform.

We want to make sure that the public trusts how their data will be used within the federated data platform. As part of our plans we:

• are actively engaging and involving patients and the public in decisions about how data is used with the platform, and how we best meet our duty of transparency and open communication,
• have published clear and accessible information, and will continue to do so, including details about who will accessing data and for what purpose. Where possible, public information will be co-created with the public/patient groups and representatives. The existing web copy was produced in conjunction with Med Confidential and useMYdata,
• will be clear about people’s rights and choice to opt out (where applicable).
• have undertaken a series of public deliberation events and national research to understand the views of the public in relation to how their data is used, and to understand their expectations regarding how they are key informed about its use,
• will engage with the public for the life of the programme, ensuring alignment to other data programmes, the development of a national data pact and engagement related to the national data strategy,
• will engage the public, in a range of ways, to understand their views and sentiment regarding patient data are tracked and monitored monthly, through a public survey,
• will continue to work closely with stakeholder groups who represent and champion the voice of the public and patients.

Technological protections

As part of the service, NHS Privacy Enhancing Technology (NHS-PET) will provide robust protection and deliver a standard approach to support safe data access and use.

This is a standalone service that discovers, protects and supports the audit and governance of data uses. PET will enable the sharing of data in alignment with the security and privacy constructs defined by information governance requirements.

Rules on access and confidentiality

We are committed to keeping patient information safe, being transparent about how it is used and building public trust and confidence. The FDP will not give people access to patient data which they do not need to see as part of their role in the NHS. As happens currently, there will be clear rules on who can access, what they can see, and what they can do. Only authorised users will be granted access to data for approved purposes, and they will have to be people working in health and social care, usually trained clinicians and their support staff, or analysts.

All uses of data within federated data platforms must be ethical, for the public good, and comply with all existing law. This includes the Common Law Duty of Confidentiality, the UK General Direction on Data Protection (UKGDPR), and the Data Protection Act 2018, where it applies. Data cannot and will not be used for marketing, or insurance purposes. The use of the FDP will not alter these fundamental rules.

The only data used in the FDP will be that which the NHS or social care organisations can legally collect or access.

The supplier of a federated data platform will only operate under the instruction of the NHS when processing data on the platform. The supplier will not control the data in the platform, nor will they permitted to access, use or share it for their own purposes. Their contract will make strict stipulations about confidentiality, and there will be governance in place to monitor delivery and usage of the FDP. There are already many suppliers of IT services working for the NHS who handle confidential patient information. The tender documentation is clear that bidders to provide the FDP must be experts in protecting data and adopting rigorous protocols for secure operating practices.

Direct care

First and foremost, the federated data platform will support data to be used to support the direct care of patients.

Secondary purposes

It will also be used for analysing activity, auditing quality, planning service delivery, and service analysis to improve patient outcomes. This data would be accessed through an internal Secure Data Environment (SDE) within the FDP platform, and each SDE would need to comply with the Department of Health and Social Care’s secure data environment policy guidelines.

SDEs are data storage and access platforms, which uphold the highest standards of privacy and security of NHS health and social care data as they only allow approved users to access and analyse data, and only highly summarised data can be removed. Access to NHS health and social care data within federated data platforms will be carefully controlled.

Separate ‘federated’ platforms for each NHS organisation (NHS Trusts or ICS) will enable effective management and access to data in a safe and secure way. Each NHS organisation will be the data controller for their own ‘federated’ platform, meaning that they will determine what information is used based on the challenges and priorities they need to address. The use of data will always remain under the full control and protection of the NHS.

Personal data used for direct care purposes (e.g., to manage diagnosis, to schedule a treatment or appointment, and to manage a patients discharge from hospital) will be required to be held in identifiable form. Only users who are working on direct care purposes (such as a clinician, bed manager or discharge coordinator), will be able to access identifiable patient data – this is the principle which applies now to existing NHS systems. Personal data held for direct care purposes will be held within the Trust instance of their federated data platform and the data cannot be used for any other purpose or in any other instances on the federated data platform.

Where personal data is used for secondary purposes, such as to plan and improve health and care services, de-identification techniques will be used; only very high-level, summary data, which is not identifiable, would be used at a national level.

Data made available for analysis in federated data platforms must protect patient confidentiality using techniques such as data minimisation and de-identification. De-identification practices mean that some obvious personal identifiers like name or date of birth are removed from datasets to protect patient confidentiality, but the data remains personal data. This includes techniques such as anonymisation, and pseudonymisation.

Data Protection Impact Assessments

Each trust instance and individual use case will require a Data Protection Impact Assessment (DPIA), which will be published. A privacy notice will also be written and published which will detail the types of data used for each use case. These information governance (IG) documents will be required to be approved by participating organisations before personal data can be accessed.

National data opt-out

The national data opt out  policy sets when a person can opt out of their confidential patient information being used for purposes other than their individual care for planning and research. This policy will apply to relevant data in the FDP.

Cyber security

NHS England are working closely with the National Cyber Security Centre to ensure that information is protected from the threat of a cyber-attack and all data will be held in line with the Office for National Statistics Five Data Safes.

Palantir provides NHS England with data management platform services (Foundry) which were procured to provide the national organisations responsible for coordinating the response to COVID-19 with secure, reliable and timely data – in a way that protects the privacy of our citizens – in order to make informed, effective decisions.

We learned huge lessons through our COVID-19 response and started to use data to work smarter – to anticipate the virus, protect the most vulnerable, put resources where they were needed and deliver the largest vaccination programme in NHS history. Such an efficient and effective response was only possible because of investment in digital systems. The opportunity now is to apply what we have learned to both managing our elective recovery and our long-term challenges.

The investment in a federated data platform will provide local health and care organisations with a technical architecture that enables them to make the most of the information they hold to transform care and improve outcomes for patients.

NHS England has recently awarded a 12 month transition contract to Palantir to support the successful transition from the current Palantir Foundry platform to the new Federated Data Platform and Associated Services (FDP-AS) supplier. The Foundry platform was used during Covid-19 pandemic to support reporting and vaccination programmes, more recently it has also been used to test the viability of a number pilots for FDP.

This is to provide the safe and smooth transition and exit service of critical products that were developed to respond to the Covid-19 pandemic (for Covid-19 and elective recovery purposes), to alternative provisions, including the transition of products to the new FDP-AS supplier following completion of the procurement process and contract award.

There are no plans to include GP data in the National FDP tenant. Locally, and based on local agreements between GP Data Controllers and ICBs, GP data already forms an essential part of local population health planning and management. The FDP will have the capability to include local primary care data onto local tenants of FDP. There are no plans however to flow this data nationally as we are exploring with the Bennett Institute the potential to extend the use of OpenSAFELY type virtual solution to support national uses of GP data.

Key lessons have been learned from previous data programmes including the need for a) transparency and b) data to be held in secure environments with the correct checks and balances in place. We are ensuring that trust and transparency lessons have been learnt both in terms of design, but also in how we act i.e. timely publication of information and documentation, open publication of use cases and Data Protection Impact Assessments.

An ambient data campaign, featuring real-life case studies, is helping to build public awareness about how NHS data is currently used. This is laying down an essential foundation level of awareness, from which we can start to have more detailed conversations about data, without triggering public concern.

NHS England works in close collaboration with trusts and tailors the approach based on the needs and operational pressures of each. This means the implementation of pilot programmes, such as IECCP, can be scaled-up or down, and adjusted as needed. In a small number of cases, it has been necessary to pause the progression of pilot activity – this represents a responsiveness to the priorities of individual trusts. This should not be interpreted as the pilots having failed.

Throughout the deployment of our pilots, NHS England will continue adapt to support varying Trust needs, react and respond to changing demands, and be flexible in our approach. This will help us to develop a better understanding about the conditions required for success; this is helping to shape the planning for the roll-out of the FDP.

In March 2023, a parliamentary question was received asking how many pilots were paused – the reported sites are listed in Table 1 below. Table 1 has been updated to show the current position as of 1 August 2023.

Table 1

It’s important to note that this position will continue to evolve as our engagement with sites continues.