England patients can't opt out of Palantir NHS data platform, trusts can still walk

Patients in England can’t stop their data being processed in the Palantir-built NHS Federated Data Platform (FDP). Health minister Preet Kaur Gill told MPs that the National Data Opt-Out does not currently apply to products used in the NHS FDP, and that in most cases this is because the data is used for direct care purposes.

Gill also drew a sharp line between what patients can control and what hospital leaders can. While patients cannot opt out of the main mechanism for products used in the NHS FDP, trusts running hospitals and other services can choose whether to use the FDP at all by procuring locally, as long as any alternative meets applicable standards and supports national priorities.

So yes, there is a path to exit. It just is not a patient-controlled one. Gill said patients can only opt out of secondary uses of data, including “planning and research.” That matters because the political fight around Palantir’s role has been less about whether there is a theoretical opt-out somewhere, and more about whether public confidence survives when familiar safeguards seem not to reach the thing people are most worried about: the NHS FDP itself.

The controversy has already escalated on the operational details. Last month, NHS England confirmed it had changed policy so some Palantir staff can access identifiable patient data through a new “admin” role. A briefing document seen by the Financial Times and confirmed by The Register warned that granting access could create a “risk of loss of public confidence” in NHS England’s assurances about safeguarding patient data. In other words, even if the platform is described as compliant, the optics and governance design are now a first-order risk, not a footnote.

NHS adoption has not been small. NHS England statistics say 168 of 214 NHS trusts have signed up to use the FDP, with 123 live and 80 reporting benefits. All but one of England’s 42 integrated care boards have joined; Greater Manchester is the exception. Those numbers explain why the minister’s “trusts can go it alone” message is consequential: if most trusts are already on board, any local procurement decision becomes a patchwork test case for whether alternatives can be implemented at speed and with confidence.

This is also where Parliament’s timing enters the picture. Gill told MPs that the government will decide this year whether to extend Palantir’s current FDP contract beyond its February 2027 expiry, with renewal effectively on the table well before then. In parallel, Parliament’s Science, Innovation and Technology Committee said last week the NHS should end Palantir’s involvement, and MPs have tabled 40 written questions about the supplier in the last month. Palantir’s wider profile is part of the backdrop, since it also works with intelligence agencies and US Immigration and Customs Enforcement (ICE), making the procurement question inherently political even if each contract term is negotiated as a technical one.

There is another governance signal too: Gill pointed to the project’s rating. She noted the NHS FDP was among just 14 percent of major government projects to get a green rating from the National Infrastructure and Service Transformation Authority, indicating the NHS FDP is “on track.” That line is doing work. If the FDP is meeting transformation benchmarks, defenders can argue the system is not just politically convenient, it is operationally deliverable. Critics can counter that a “green” rating does not automatically resolve the trust and safeguarding concerns raised by identifiable-data access.

Finally, the minister leaned on transition planning, which is usually what comes up when an organization expects scrutiny and possible termination. Gill said the contract includes an exit management process covering intellectual property rights, plus controls to support transition and continuity of services in the event of termination, ensuring that operational delivery and patient services are protected. She added that, in principle, another supplier could provide equivalent functionality in the future, but that it would take planning, time, and resources to run a compliant procurement and then move services and data across safely.

For executives, the takeaway is uncomfortable but actionable: the NHS FDP decision is not simply “keep Palantir or drop Palantir.” Patients are mostly stuck under the current opt-out framework, so the real control levers sit with boards and procurement teams at trust level, and with government on contract renewal by February 2027. If you are a leader in a similar system, you should assume the next fight will be about governance design and exit readiness as much as about the vendor itself.