The $400 Million NHS-Palantir Contract: A Fight Over Trust, Tech, and Britain’s Health Data Future

The UK government has just six months to decide whether to terminate a contract worth more than $400 million between its National Health Service (NHS) and U.S. software firm Palantir Technologies. If one major regional NHS system can already operate successfully without Palantir, politicians across the country are asking: why can’t the rest of the nation do the same?

In 2023, the UK commissioned Palantir to build a “federated data platform” (FDP) designed to consolidate and organize the fragmented tangle of health data generated across the country. Per Palantir and NHS leadership, the new system is already cutting patient wait times, reducing hospital length of stay, and helping facilities maximize use of operating theatres. But amid growing backlash over Palantir’s work in war zones and the U.S. administration’s immigration crackdown, the NHS deal has become a national flashpoint, drawing mass protests, public petitions, parliamentary inquiries, and reported internal rebellion among NHS workers. Other European nations, which are increasingly seeking to reduce dependence on U.S.-made technology, are also reevaluating their own partnerships with Palantir.

The regional health care board for Greater Manchester, a large area in northern England, has repeatedly refused to adopt Palantir’s FDP, choosing instead to keep using a homegrown platform it has spent nearly a decade developing. The board argues it has no need for Palantir’s service: its in-house tool is functionally superior and far more trusted by the local public. “Even a technically strong platform will struggle to deliver real value if clinicians, data controllers, patients or the public do not trust it,” Matt Hennessey, chief data and analytics officer at NHS Greater Manchester, told WIRED. “If we were to fully adopt the FDP … it would be a retrograde step.”

This claim, which is disputed by Palantir and other FDP advocates, has become the centerpiece of a national debate over whether the government should use an existing break clause to end the contract early next February, rather than letting it run through 2031.

For decades, NHS workers have relied on a messy patchwork of disjointed digital systems, spreadsheets, paper files, and whiteboards to track patient care. When a patient moves between different care settings, their medical records are often left behind, with occasionally deadly consequences. Without a way for different providers to share information effectively, NHS leaders have long been forced to make funding and resource allocation decisions based on incomplete, scattered data. Palantir’s FDP was built to solve exactly this problem.

The NHS began rolling out the FDP in early 2024. The platform combines a national pool of health data to help identify system-wide care gaps, plus a network of local databases that individual regions can use to run analysis and build tools tailored to their specific needs—such as waitlist management or discharge planning. All components share the same core technical infrastructure, which in theory makes it easy for tools built in one region to be adopted quickly anywhere else in the country.

“You can lift and shift. That’s the real power of the FDP,” said Tom Bartlett, an independent IT consultant who previously oversaw the national FDP rollout as deputy director of data engineering at NHS England. “The other advantage is that you’ve got a unified surface for artificial intelligence to work across.”

Within the sprawling NHS system, two types of organizations can access the FDP: local trusts that run hospitals and community care, and integrated care boards (ICBs), which plan and commission health services at the regional level. Both groups use data for different purposes, but share the core goal of improving patient care. NHS data shows 139 of roughly 200 local trusts are currently live on Palantir’s technology, while 35 of England’s 36 ICBs actively use the system.

“It is clear that thousands more patients are benefitting from the FDP every month,” a spokesperson for the Department of Health and Social Care told WIRED.

Even so, trusts across parts of England have resisted full adoption of the FDP, including in Greater Manchester, where anonymous sources report trusts only use the platform for very limited purposes. “They’re not going all in,” said Andy Haywood, chief digital and data officer at research institute Health Innovation Manchester. “On official spreadsheets they’re counted as users, but not in the sense of putting all their data into it.” (Palantir disputes this claim, saying Greater Manchester’s trusts use the FDP extensively.)

Greater Manchester—the birthplace of the NHS in England’s industrial north—is also the only region whose care board has repeatedly and categorically refused to adopt Palantir’s platform. Instead, the Greater Manchester ICB, which serves a population of roughly 3 million people, has stuck with its homegrown Analytics and Data Science Platform (ADSP). At a May 2025 meeting, despite pressure from national NHS leadership to adopt Palantir’s technology, the board concluded that its “local capability exceeds anything the FDP currently offers” and that many of ADSP’s core functionalities are “two–three years” ahead of Palantir’s system. The board’s resolve has only strengthened since then.

ADSP draws on primary care data that is not available on Palantir’s platform, and because it was built in-house, it can be reconfigured far more easily to meet changing local needs. “Because the ADSP is a collection of modular technologies, if we found that our data visualization software had become less than best in class, we could swap it out,” Hennessey told WIRED. ADSP also benefits from deep public trust built up over years of local use, Hennessey added, meaning people are far more willing to share the sensitive health data the platform needs to function effectively.

Palantir says there is little independent evidence that ADSP has directly improved patient care or cut costs, and argues its own platform is widely trusted by NHS staff. “Thousands of doctors, nurses, and other NHS staff use the [FDP], with many on the record as to its benefits,” Stephen Childs, head of health care partnerships at Palantir UK, told WIRED.

Even so, Greater Manchester’s claim that it built a superior domestic alternative has reshaped the national debate over ending Palantir’s contract early. In June, a bipartisan group of UK politicians published a report warning that the country’s reliance on Palantir represents an “unacceptable point of weakness,” giving a single foreign vendor overwhelming leverage over the nation’s health system. The report called on the government to activate the break clause and pursue domestic alternatives. The following month, a separate parliamentary committee made the same argument, drawing heavily on Hennessey’s testimony about Greater Manchester’s experience.

“[Palantir] is evidently not the only show in town,” wrote MP Layla Moran, chair of the committee.

But FDP proponents argue there is actually no viable alternative to Palantir that can unify data across the entire fragmented NHS system, from local trusts to regional ICBs to national governing bodies. They argue MPs’ calls to end the contract are based on a narrow comparison focused only on care board needs, ignoring the FDP’s benefits for hospitals and direct patient care settings.

“The claim that the ADSP achieves superior results really doesn’t make sense … [The FDP] does completely different things,” said Bartlett. “To frame the use case as analytics is a complete misrepresentation of the whole goal of the product.” (Hennessey notes that Greater Manchester ICB has only ever claimed its technology is superior to Palantir’s for regional care board use cases, not across the entire NHS.)

Bartlett argues that the outsized scrutiny directed at the Palantir deal, compared to other expensive NHS projects, shows political objections are skewing efforts to assess the FDP’s true performance and value. “There’s an anti-Palantir campaign,” he claims.

Palantir has long insisted it is not a political organization. “Our values are that technology can help transform public services and save lives,” says Childs. But controversy over the company’s alignment with NHS values persists: in 2023, Palantir cofounder Peter Thiel said the UK should “rip the whole [NHS] from the ground and start over.” More recently, Palantir published a fiery bullet-point manifesto based on a new book by CEO Alex Karp, which one British MP described as “the ramblings of a supervillain.”

“The NHS is a values-based organization,” said Jessica Morley, a health data researcher at Yale University’s Digital Ethics Center. “Palantir is essentially antithetical to all of those values.”

The MPs who recommended terminating the contract in June insist they are not “ideologically-motivated,” but they also voiced concern over a “clear mismatch with UK values.” This public backlash has also reinforced Greater Manchester ICB’s continued refusal to use the FDP: the care board acknowledged in April that it had not begun a scheduled review of its decision on the FDP “because it’s clear that the public concerns have heightened rather than diminished.”

Those who argue political bias has distorted discourse around the FDP, distracting from its importance to the NHS, warn that ending the contract risks wasting years of progress, with potential harm to patient care. “If the break clause got triggered, we’d go backwards, because there is no alternative,” claims Bartlett. “The trusts that were previously using paper would go back to paper.”

But even if the FDP were technically superior to existing NHS technologies, Hennessey argues, any value assessment must account for the political controversy surrounding Palantir—because the platform’s success depends on public willingness to share sensitive data and clinician willingness to use it. “You can have the most amazing thing,” he says, “but if people don’t trust it, then you have something that’s operationally redundant.”