The UK government has six months to decide whether to terminate a deal worth more than $400 million between the country’s National Health Service and American software company Palantir. If one part of the NHS is already doing without Palantir, politicians are asking, why can’t the rest of the country?

In 2023, the UK commissioned Palantir to develop a “federated data platform” (FDP) that could ingest and organize the tangle of health data produced across the country. According to Palantir and the NHS, the new system is already cutting wait times and the length of hospital stays, and maximizing the use of operating theatres.

But lately, as Palantir technology is deployed in theaters of war and the US administration’s immigration crackdown, its deal with the NHS has become a flashpoint in the UK, drawing protests, petitions, parliamentary inquiries, and a reported rebellion among NHS workers. Other European nations, increasingly at loggerheads with the Trump administration, are also reevaluatingtheirrelationships with Palantir in a bid to minimize their dependence on US-made technology.

The health care board for one part of England, Greater Manchester, has repeatedly declined to adopt Palantir’s FDP, choosing to stick with a home-spun platform developed over the best part of a decade. The board claims it doesn’t need Palantir, that its own platform is functionally superior and more trusted by the public. “[Even] a technically strong platform will struggle to realize value if clinicians, data controllers, patients or the public do not trust it,” Matt Hennessey, chief data and analytics officer at NHS Greater Manchester, tells WIRED. “If we were to fully adopt the FDP … it would be a retrograde step.”

That claim—disputed by Palantir and other FDP advocates—has fed into a national debate over whether the government should seize an opportunity next February to terminate the NHS contract early, instead of allowing it to run until 2031.

For decades, NHS workers have used a combination of digital systems, spreadsheets, paper, and whiteboards to keep track of patients. Sometimes, when a patient moves from one care setting to another, their treatment records are left behind with occasionally deadlyconsequences. Without a way for different types of care providers to share information effectively, NHS administrators have had to base funding and resource allocation decisions on an incomplete patchwork of data. Palantir’s FDP is meant to change all that.

The NHS began to roll out the FDP in early 2024. The platform consists of a national pool of health data meant to help identify care deficiencies, and a bunch of local databases that individual regions can use to perform analyses and develop tools specific to their needs—say, waitlist management or discharge planning. The various components all share the same underlying technology scaffolding, in theory making it possible for tools developed in one corner of the country to be readily adopted in another.

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

Within the sprawling NHS, two types of organizations can access the FDP: trusts that run hospitals and local care, and integrated care boards (ICBs), responsible for planning and commissioning health care services at a regional level. Both use data for different purposes, but share the ultimate goal of improving patient care.

NHS figures show 139 of roughly 200 trusts currently “live” with Palantir’s technology, while 35 of England’s 36 ICBs are actively using 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 tells WIRED.

But trusts in different pockets of England have resisted the FDP, including in Greater Manchester, where sources claim they are using it for limited purposes only. “They’re not going all in,” claims Andy Haywood, chief digital and data officer at research institute Health Innovation Manchester. “On the spreadsheet they go down as using it, but not in the sense of putting all their data in it.” (Palantir claims that trusts in Greater Manchester are using the FDP extensively.) Greater Manchester—the birthplace of the NHS in the industrial north of England—is also the sole region whose care board has repeatedly and categorically refused to adopt Palantir’s platform.

Instead, Greater Manchester ICB, which covers a population of around 3 million, has stuck with its homegrown Analytics and Data Science Platform (ADSP). At a meeting in May 2025, despite pressure from the national unit of the NHS to adopt Palantir’s technology, the board concluded that its “local capability exceeds anything the FDP currently offers” and some of its functionalities are “two–three years” ahead. The board’s resolve has only hardened since.

The ADSP is fed with primary care data that is not available on Palantir’s platform, and because the system was developed in-house, it can supposedly be reconfigured more easily. “Because the ADSP is a collection of technologies, if we found that our data visualization software had become less than best in class, we could swap it out,” Hennessey tells WIRED.

The ADSP also benefits from a deep public trust in the platform fostered over multiple years, Hennessey claims, meaning people are more likely to volunteer the sensitive health data required for this kind of platform to function.

Photograph: Joel Khalili

Palantir says there is scant independent evidence to suggest the ADSP has contributed directly to improving patient care or saving costs—and that its own platform is widely trusted. “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, tells WIRED. But the claim that Greater Manchester has developed a superior system in-house has nonetheless colored an ongoing debate over whether the UK government should break off Palantir’s contract next February.

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,” handing a single foreign vendor overwhelming leverage. The report argued for the government to activate the break clause and seek out domestic alternatives. The following month, a separate parliamentary committee made similar arguments, drawing from testimony provided by Hennessey on the situation in Greater Manchester. “[Palantir] is evidently not the only show in town,” wrote MP Layla Moran, chair of the committee.

But proponents of the FDP argue that, in reality, there is no viable alternative to Palantir, able to thread together data from across the country and the many sub-components of the NHS—from trusts to ICBs to national bodies. They argue MPs’ calls to break the Palantir contract are based on a narrow assessment of the value the FDP can provide to care boards, compared to Greater Manchester’s platform, and ignore its potential benefits in hospitals and other settings where treatment is administered.

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

Bartlett argues that the level of scrutiny directed at the Palantir deal compared to other expensive NHS projects signals political objections are interfering with attempts 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 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 recent book by CEO Alex Karp, which one British MP described as “the ramblings of a supervillain.”

“The NHS is a values-based organization,” claims 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 in June that the government terminate Palantir’s contract with the NHS insist they are not “ideologically-motivated.” But they also voiced concern over a “clear mismatch with UK values.”

The public debate around Palantir has also fed into 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 believe politics has infected the discourse around the FDP, distracting from its importance to the NHS, warn that breaking the contract risks squandering several years of progress, with potential consequences for 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 superior to existing NHS technologies, Hennessey argues, any value assessment must take into account the political heat surrounding Palantir because its success hinges on the public’s willingness to feed it their data and doctors’ 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.”