Organisational attendees

• Office of the National Data Guardian
• Understanding Patient Data
• Academy of Medical Royal Colleges
• NHS Frimley Integrated Care Board
• Information Commissioner’s Office
• NHS England
• Department of Health and Social Care
• Academy of Medical Royal Colleges
• Royal College of General Practitioners
• Healthwatch
• Royal College of Surgeons
• NHS Confed
• NHS England
• Patients Association

Apologies received

• National Voices
• UNISON
• Nottingham University Hospitals Trust
• Association of Medical Research Charities

Open actions and decisions recorded

Meeting notes

Welcome and introductions

The Chair welcomed all members to the call and noted any apologies.
Introductions of new members took place as well as noting any conflicts/declarations of interests.

Minutes and actions from previous meeting

The Check and Challenge members approved the minutes and actions from the last meetings on 20th September 2024.

The chair took the group through the open actions.

The group asked for further clarification on the FDP programme statement provided regarding the FDP not being impacted by CrowdStrike and queried the potential future impact on the wider NHS. The FDP SRO assured the group that quick and appropriate management was utilised and, as with any incident, a lessons learnt approach is followed to identify any areas for improvement. The FDP Programme Delivery Director provided the group with an overview of indicative activities underway to ensure future events continue to be identified and mitigated. The group discussed the notion of malicious vs non-malicious cyber incidents and whether security measures include the consideration of both possibilities. The FDP Programme Delivery Director assured the group that a number of measures are put in place to protect against both malicious and non-malicious cyber incidents, including appropriate liaison with supporting teams and organisations. The FDP Programme Delivery Director agreed to share a summary on how the FDP environment stays as clean as possible and the testing that takes place before any software is released.

Action: FDP Programme Team to share a statement on security measures taken regarding keeping data safe on the FDP.

NHS Federated Data Platform Programme update

The FDP Programme Delivery Director provided an update to the group.

The FDP Programme is nearing the completion of its’ transition activities for all FDP pilot sites and national products transitioned onto the FDP. National transition has included the transition of Vaccinations which has been the largest and most complex transition with several thousand users. The migration for Vaccinations has been a success and the team are now starting activities for the autumn/winter booster campaign. In terms of local transition, 37 local sites have transitioned to the FDP with the final few remaining incubator sites are due to complete at the end of September 2024.

The FDP Programme has been working hard with the Demand Team to sign up new Sites onto the programme and are now at 79 Acute Trusts who have formally signed up to the programme. This exceeds the target of 71 Trusts, with the programme now focussing on ensuring local sites can adopt their products of choice to best suit their needs.

The FDP Programme Delivery Director referenced the recent media coverage on the legal utilisation of PET. The FDP Programme Delivery Director assured the group that all processing within PET is aligned to the FDP IG Framework of which this group have reviewed and commented on, and through each phase PET goes through a process of DPIA and identifying the legal basis for processing. PET is used for treating national flows. At the point that PET is used for local FDP products, the programme will work with local sites to ensure a legal basis is identified for PET to process data, of which development will be shared with this group.

In regard to communication and engagement, The FDP SRO and NHSE Medical Director for Transformation have been meeting with external stakeholders to provide key updates on the FDP programme as part of ongoing engagement. The programme continues to attend a number of events, such as the Healthcare Excellence Through Technology Conference. The third instalment of the FDP bulletin is now available, and the programme continues to work with organsiations to identify and develop case studies for the FDP.

In response to the Check and Challenge Group previously requesting more information on the System offer for the FDP, the FDP Director of Delivery handed over to the FDP System Offer Lead for an update on the FDP system offer development.

The FDP system offer currently focusses on four key priority areas:

• Improve outcomes in population health
• Reduce health inequalities
• Enhance productivity and value for money
• Help the NHS support broader social and economic development

The FDP system offer is currently being tested with ICBs and sessions are underway to start discussions on alignment to longer terms strategies in areas of work such as community, digital, and prevention.

The FDP system offer is being developed in two core phases. The first phase is focussed on providing ICBs with access to an FDP system tenancy to provide opportunity to become familiar with the platform. The first phase will also include exploring how the system will ingest its’ own local data and will enable PET for registration purposes only. The second phase is a co production piece on how the FDP programme understands system needs and how the FDP could meet those needs through its’ capabilities. The programme is aiming for 42 ICBs to be signed up to the programme by November 2024. The programme is meeting with ICBs on an individual basis to ensure relationships are built and discussions are happening with the most appropriate individuals. To support the FDP system offer development, a number of groups and forums are being established to support systems in each stage of the process of engaging with, and adopting, the FDP as well as informing product development.

Members of the group commented on being pleased to see the framework and approach. The group queried whether the programme is connected with the ICS NHS Confed Network. The FDP System Offer Lead confirmed that NHS Confed has been engaged with and the team are working through how to continue this engagement.

Members of the group reflected on their own regional direction and outlined recent joining of the FDP programme which has been done as a system approach.

The group queried whether there are particular themes or patterns in sequencing regarding ICB and Trust sign up of the FDP. The FDP System Offer Lead advised that this is currently a varied landscape with drivers being both ICBs and Trusts, but a commonality is ICBs approaching the FDP with product and solution needs which the programme are currently reviewing to understanding commonalities and appropriate approach to development.

A member of the group commented on the concept of the FDP for systems sometimes being challenging to understand, but being able to focus on something practical will help with this. This includes the potential for FDP to be badged as a technical programme, and how the understanding of the FDP as a transformation programme could help unlock discussions on how organisational priorities and challenges can be supported by the FDP. NHS Confed representative offered to support in providing insights from the ICS network.

FDP Solution Exchange

The Deputy Director of Service Integration, FDP, provided an overview of the solution exchange.
The FDP Solution Exchange aims to improve outcomes for patients and maximise the potential of the Federated Data Platform by creating and growing a vibrant product development community to stimulate and support innovation and continuous improvement across the NHS.

At the moment the FDP has a number of products which are in use every day. However, the foundation data that all products utilise can be used for more, which means there are a number of areas where the FDP could meet solution requirements. The Solution Exchange is about developing additional products under use cases to meet problems identified by organisations, and the intent is to provide a suite of products people have made available themselves that are taken through appropriate processes and scaled up to be available to everyone for free. The long-term ambition will be for third parties to also demonstrate available products.

The FDP Solution Exchange went live at the end of July 2024. Since going live, it has been the fourth most visited part of the FDP which is resulting in the programme receiving expressions of interest from organisations and developers. The FDP programme has built an assurance process so that all products undergo appropriate testing and assurance processes to ensure they are safe and trusted products. At the moment, the FDP programme team are developing the Solution Exchange space to ensure it is as accessible as possible, including improved navigation and user experience.

The FDP Deputy Director of Service Integration provided a demo of the system to the group.
The group queried how the FDP Solution Exchange will support challenges that reach across a number of health and care sectors. The FDP Deputy Director of Service Integration advised that with the local tenancy on the FDP there is opportunity to bring in additional data sets that might not be directly aligned to secondary care and the FDP programme team are exploring how this can enable a broadened offer to focus on multiple pathways.

The group queried if there is an integration with SDE and the FDP. The FDP Programme SRO advised that the FDP and SDE focus on different things. The SDE is for research and is used as an analytical layer to identify challenges and identify where organisations and sectors may need the application of products, but the FDP is looking at solution rather than the analysis layer.

A member of the group commented on the potential challenge in narrative regarding a product development mindset and how this balances with a federation of data mindset. This is potentially apparent in a local landscape where there is strong product development locally but the interweave of FDP language could impact on the feeling of it taking away from existing development environments. The member of the group offered to liaise with the FDP Programme SRO to explore this further.

The group queried whether there is an opportunity for the FDP and Solution Exchange to feed into the 10-year plan. The FDP Programme SRO confirmed that the programme is linked into the Data and Digital 10-year plan which is part of a wider piece of strategic work.

The group referenced the recent Darzi Review, and queried whether there is more that could be done on digital twin to support the identification and mitigation for areas that may be missing data. The FDP Programme SRO advised that initial discussions have commenced to explore digital twins and advised that the team are working hard to use the FDP as a vehicle to address knowledge of pockets of missing data in the NHS. A member of the group advised on their interest and current involvement in digital twin work and offered the group further information and discussion.

The group queried, based on the Darzi Review, the connection between regulation and monitoring self-awareness of system understanding within the review. The FDP Programme SRO advised that their input is into a part of the 10-year plan, and this may be part of wider discussions taking place.

Action: Check and Challenge Group Member to link in with FDP Programme SRO to discuss possible support in the development of narrative setting for product development within organisations.

Large scale public engagement update

The Large-Scale Public Engagement Lead provided an update to the group on the outputs of Cohort 1.
The Department of Health and Social Care and NHS England is partway through delivering a major programme of large-scale public engagement over 2024-25 which is a key enabler to delivering ongoing transformation efforts such as the roll out of the FDP.

Cohort 1 was delivered in three tiers; Core deliberation in which 3x discussion sessions took place for 120 people, inclusive engagement in which 1x discussion session took place for 88 people, and deliberative polling in which a 10-minute survey was shared with 2,000 people.

The overarching ‘problem’ statement discussed as part of Cohort 1 was ‘what does the health and care system need to do for you to feel confident in how your data is being used’. The discussion was further split into three key areas: governance and data access committees, the value of data for research, and the data pact. Discussions were also supported with a range of case studies.

An overview of key findings was provided to the group on the three discussion areas and how the Large-Scale Public Engagement Team are interpreting results, this included key messages such as:

• We must ensure that health and care data is used only for the public good, with benefits going back into the NHS. However, we need to understand the very real fears that the public have about cyber security and fraud.
• The public didn’t think all decisions related to their local SDE needed explicit approval by their regional Data Access Committee. They were equally supportive of more efficient and consistent processes, as they were of the need for local input. This is a more pragmatic approach than previous assumptions and paves the way for ‘federated’ decision making across SDE network. We need to have clear, robust, and transparency principles that guide governance across the SDE network. The public must be part of decision making.
• The NHS can realise the value of our health and care data, prioritising benefits to health and care, but also generating a small financial profit which is retained by the NHS. This value capture must be clear to the public to mitigate concerns about data access and use by external organisations. The engagement did not include specific value-capture models or how the NHS should ‘use’ the value it generates.
• We can promote tools like the data pact to build public confidence in data use but give it more teeth to hold people accountable for failings. We must make it accessible and communicate it widely to maximise the impact.

In terms of next steps, following a steer from the Secretary of State, the second cohort of engagement is due to be delivered from November-December 2024 and will focus on the linking of primary and secondary data, with a focus on the GP health record.

The group queried how participants were questioned on profits and the NHS, and how informed participants would be to respond. The Large-Scale Public Engagement Lead advised that scope and influence were considered as part of designing the engagement. The discussion came up naturally within the session as part of asking participants to prioritise a number of topics such as wider benefits, financial surplus, making the UK an attractive place for research etc. The Large-Scale Public Engagement Lead offered to share the discussion guidance to provide further information on this.

Action: Large Scale Public Engagement Team to share the wording of the question asked as part of the discussion exercise, regarding NHS financial benefit.

Patients Association foundry work

The Patients Association representative provided an ad-hoc update to the group on recent work with Palantir.

The Patient’s Association has released a guide to Palantir’s Foundry software. This guide, developed in collaboration with patients and Palantir Technologies, addresses the key questions and concerns that patients have about the Foundry software, which supports the NHS Federated Data Platform.

As part of this work, the Patients Association conducted focus groups with patients. These discussions revealed several areas of interest, including data access, security measures, and the potential benefits of the system. Based on these insights and information about Foundry provided by Palantir, the Patients Association created a comprehensive guide that covers a range of topics.

The guide explains how Foundry integrates and presents data from various sources. It outlines the data processing and control mechanisms, as well as the permissions system that governs data access within the platform. The Patients Association has also included examples of how Foundry has been used in the NHS so far and explored its potential future applications. The guide also details the security features of Foundry, explaining how data is protected and how potential breaches are prevented and addressed.

Check and challenge survey results

The FDP Programme Delivery Director provided an overview of the FDP Check and Challenge Survey Results.

The survey was completed by 6 members of the group and provided good insight into areas that are working well as well as areas for improvement.

Based on the survey results, the FDP programme team provided a set of recommendations, including:

• Review of the Terms of Reference to ensure the group are happy that appropriate representation is maintained to fulfil the purpose of the group.
• Continue providing regular updates on how the groups’ contributions and feedback are being fed into the Programme and the result of that.
• Meeting paper scheduling and forward planner to be reviewed and developed to ensure papers are shared in good time and the group have visibility on key topics due to be discussed in future meetings.
• Introduce a regular presence and sharing of experiences from Organisations who have implemented the FDP or are in the process, ensuring balanced viewpoints.

The group queried whether there would be a discussion on the day that the meeting takes place and opportunity to submit a preference. The FDP PMO Lead advised that a poll will be circulated to members of the group to indicate their preference on the most appropriate day for the meeting to take place on.

Action: FDP Programme Team to circulate a poll to Check and Challenge Members to review meeting dates going forward.

Any other business and close

The next meeting is due to take place on Friday 18 October.

The group queried whether the FDP Programme Team will be regularly sharing programme metrics. The FDP Programme Delivery Director advised that the team are finalising publication of metrics which will be published on the NHS England website, but the team will look to include regular updates as part of this meeting.

The chair thanked all for their attendance and closed the meeting.