Thread by @ncarding

Never done a thread before but making an exception for FDP and Palantir.

My thoughts summarised below, see if you can make it to the end 👇

1: FDP - in principle - is a GOOD IDEA. NHS staff and patients are frustrated by poor access to data on a daily basis.

2: Local NHS staff dislike @NHSEngland telling them what to do - we often hear complaints about big programmes failing because they were implemented top-down rather than bottom-up.

FDP is not mandated, meaning NHSE is not technically "forcing it" on local orgs.

3: The question, therefore, is: Will local orgs use FDP?

In several areas there is strong desire to use locally developed platforms that offer similar/same/better capabilities than FDP 👇

But other areas have nothing like such capabilities yet.hsj.co.uk/technology-and…

4: It all depends on how good is the software vs how disruptive its implementation is & what is local need for it?

SO....how good is the software?

Unfortunately, only a minority of trusts have told us of benefits after piloting FDP-esque software. hsj.co.uk/technology-and…

5: ...and several trusts told us they have paused or abandoned the pilot because of a lack of resources or it disalignment with local priorities.

The other important reason is that it takes time to implement FDP and for benefits to emerge.

This means....

6: ....NHSE has gambled on FDP being worth the money, rather than wait for the majority of pilot trusts to implement and see what benefits occur.

It's a risky - maybe irresponsible - tactic.

That said, the NHS is constantly criticised for being too slow at using new tech.

7: In terms of the £330m price tag - this depends on which way you're looking at it.

Broken down over 7 years and across more than 200 orgs, it amounts to a few hundred thousand pounds per org annually.

This seems quite cheap, but only if IT IS USED BY ALL ORGS.

8: In terms of Palantir's involvement, I understand why people are concerned about their other work & how this aligns with the NHS' values.

The way in which they first became an NHS supplier (access to leaders & offering tech for free) has also left a bad taste in some mouths..

9: ...but this seems to me more a fault of the process and the people running it.

Palantir just saw an opportunity and jumped at it.

If we don't like their methods then change the system to stop it happening again.

Now we come to data & privacy concerns...

10: The NHS has form on mismanaging patients' data.

But NHSE say Palantir can't access the data. They also know they can't afford any data breaches - this would ruin FDP.

I've seen nothing to suggest a data breach is more likely with Palantir than other big NHS tech suppliers.

11: For me, the real question is: WILL NHS ORGS USE FDP?

FDP needs virtually 100% uptake, good implementation, and easily quantifiable benefits.

Therefore, NHSE needs to improve its comms about FDP. This has fallen short so far - as @NDGoffice has said.
hsj.co.uk/technology-and…

13: In conclusion....

- FDP has noble aims and may work, but MANY hurdles ahead.

- History has taught us the NHS struggles with large tech transformations.

- Palantir's involvement is not, per se, as problematic as actually getting local orgs to use FDP.

AND FINALLY...

14: ...@HSJnews has reported on FDP since spring 2022 when NHSE first announced its plans.



We will continue to report on all aspects of FDP - the pilots, benefits (or lack of), Palantir, uptake, data & privacy, etc.

All tips welcome & in confidence.hsj.co.uk/expert-briefin…