Greater Manchester’s Refusal to Adopt Palantir Is Fueling a Wider NHS Fight Over Data, Trust and US Tech

Greater Manchester is the only English region whose health board has flatly refused to adopt Palantir’s NHS data platform, turning a local technology decision into a national test of whether the UK should keep a more than $400 million contract with the US software company. The dispute matters because ministers must decide within six months whether to end the deal early or let it run to 2031.

At stake is more than procurement. The row now sits at the intersection of patient care, data sharing, public trust, and Britain’s growing unease about reliance on American technology firms at a moment when Palantir’s software is also used in military and immigration contexts overseas.

The National Health Service signed Palantir in 2023 to build a “federated data platform,” or FDP, intended to connect the fragmented information systems that still shape much of English health care. Supporters say the system is already helping hospitals and regional planners reduce delays, improve bed management, and make better use of theatres. Critics say the NHS has become too dependent on a single foreign vendor, while opponents in Greater Manchester argue they already have a better homegrown alternative.

The clash has made Greater Manchester a rare and highly visible exception in a national rollout that, on paper at least, has been widespread. It has also become one of the strongest arguments for politicians and campaigners who want the government to trigger an exit clause next February rather than extend the contract to the end of the decade.

Why Greater Manchester matters in the Palantir debate

Greater Manchester matters because it is the one part of England’s NHS leadership structure that has consistently said no to Palantir’s platform, despite pressure from the centre to sign up. The region’s refusal gives sceptics a real-world example to point to when they argue the NHS does not need to be locked into one supplier.

The area covers roughly 3 million people and is overseen by a single integrated care board, or ICB. That board has instead kept faith with a data system built over many years in-house: the Analytics and Data Science Platform, commonly called ADSP.

In the view of local leaders, the issue is not simply whether Palantir’s product works. It is whether a platform can be trusted enough by clinicians, patients, and data controllers to become the foundation of care planning. In health care, that distinction can determine whether a system is used broadly or merely accepted in name.

“If we were to fully adopt the FDP … it would be a retrograde step,” said Matt Hennessey, chief data and analytics officer at NHS Greater Manchester, arguing that the region’s current platform is both more trusted and more capable in its own setting.

Palantir rejects that assessment, saying the Greater Manchester system lacks evidence of delivering comparable results. The company argues the public debate has become politically charged in ways that distort how the technology should be judged.

How did the NHS get here?

The NHS has spent decades wrestling with broken lines of communication between hospitals, primary care, community services, and regional planners. Patient information is often stored in disconnected digital systems, as well as on spreadsheets, paper files, and even whiteboards. That fragmentation can delay treatment, undermine planning, and in the worst cases leave crucial records stranded when a patient moves between care settings.

It is also a management problem. If data is incomplete or inconsistent, then decisions about staffing, funding, and capacity can be based on partial evidence rather than a full picture of need. The federated data platform was meant to address exactly that issue.

Work on the platform began rolling out in early 2024. The model has two main layers: a national pool of health information designed to surface gaps or patterns across the system, and local databases that individual regions can use for their own analysis and tools. In theory, software built in one part of the country can be reused elsewhere because it runs on a shared technical foundation.

Tom Bartlett, an independent consultant who previously helped oversee the national rollout at NHS England, described one of the main selling points as portability and scale.

“You can lift and shift. That’s the real power of the FDP,” Bartlett said, adding that the platform also creates a surface where artificial intelligence tools can operate across the NHS.

That promise is central to the case for the platform: one system, many uses, fewer repeated builds, and a better chance of standardising how data is turned into decisions.

What exactly is Palantir’s federated data platform?

The FDP is not a single dashboard. It is a bundle of shared technologies and databases designed to make different parts of the NHS more interoperable. Trusts that run hospitals and local services can use it, as can integrated care boards responsible for planning and commissioning services in their regions.

Palantir and the NHS say the platform has practical benefits already. Those include cutting waiting times, shortening hospital stays, and helping operating theatres run more efficiently. The Department of Health and Social Care says the rollout is expanding and that more patients are benefiting each month.

According to NHS figures, 139 of about 200 trusts are now live with the system, and 35 of England’s 36 ICBs are using it in some form. That represents substantial penetration across a health service that has historically struggled to standardise digital infrastructure.

But “live” can mean different things. In Greater Manchester, critics say usage is limited and does not amount to full adoption. Palantir disputes that characterization, insisting the region’s trusts are making extensive use of the platform.

That disagreement matters because the government’s decision is likely to hinge not only on whether the technology exists, but on how extensively and effectively it is used across the NHS’s sprawling structure.

How is Greater Manchester doing things differently?

Greater Manchester is relying on ADSP, a locally developed platform that the board says already does more for its needs than Palantir’s product. Unlike a centrally procured system, ADSP was assembled in-house and can be adapted or swapped in component parts as needs change.

Hennessey says that flexibility is one of the platform’s main strengths. If one piece no longer meets the region’s needs, the board can replace it without dismantling the entire system. He argues that the local setup also includes data that Palantir does not currently ingest, including primary care data.

The region’s defenders also stress trust. They say ADSP has benefited from years of careful public-facing work and from the credibility that comes with a locally built platform. In health data, trust is not a soft issue. It is what determines whether patients are willing to allow sensitive information to be used and whether clinicians will rely on the outputs in day-to-day work.

At a board meeting in May 2025, the board concluded that its “local capability exceeds anything the FDP currently offers” and said some of its functions were ahead by “two–three years.” Since then, its position has hardened rather than softened.

In April, the board acknowledged it had not even begun a scheduled review of the decision, saying public concern over Palantir had intensified rather than faded. That is a striking admission in a system that increasingly treats data infrastructure as a form of clinical infrastructure.

Why does trust matter so much?

Trust matters because health data platforms only work if clinicians, administrators, and the public feed them information and use their outputs. A technically sophisticated platform can still fail if the people expected to depend on it are uneasy about who built it, how it will be governed, or what other purposes the company may serve.

That is the core argument from Greater Manchester: data architecture is inseparable from public legitimacy. Even if the technology is strong, the region says the social licence required to make it work is harder to sustain when the vendor is seen as politically controversial.

Hennessey argued that if clinicians, patients, or the public do not trust a system, it may be unable to deliver value regardless of its technical merits.

Palantir responds that the FDP is already trusted by thousands of NHS staff and that many doctors and nurses have publicly praised it.

What is driving the national backlash against Palantir?

The backlash has several causes. Some critics object to the concentration of power in one supplier. Others are alarmed by Palantir’s ties to law enforcement, war-related uses, and immigration enforcement in the United States. Those associations have made it harder for the company to present itself as a neutral vendor of enterprise software.

In the UK, the debate intensified after the government’s contract began drawing protests, petitions, parliamentary scrutiny, and reports of discontent among NHS workers. The question has spread beyond technology circles and into the wider arguments over sovereignty, values, and dependence on foreign platforms.

Palantir has said it is not a political organisation and insists that its mission is to improve public services and save lives. But the company’s critics say the gap between that message and some of the rhetoric from its leadership has been hard to ignore.

Peter Thiel, Palantir’s cofounder, previously suggested the UK should tear down and rebuild the NHS from scratch. More recently, the company published a pointed manifesto based on remarks from chief executive Alex Karp, prompting one British MP to describe it in highly critical terms.

Jessica Morley, a health data researcher at Yale University’s Digital Ethics Center, framed the issue more bluntly.

Morley said the NHS is rooted in values that, in her view, are fundamentally difficult to reconcile with Palantir’s approach and public image.

That kind of critique goes beyond buying software. It asks whether the supplier itself can ever be separated from the data architecture it helps control.

Why are MPs talking about a break clause?

Because the government may have a chance to exit the contract early. The current deal reportedly includes a point next February at which ministers could choose to terminate it rather than let it continue until 2031.

In June, a cross-party group of MPs and peers warned that dependence on Palantir created an “unacceptable point of weakness” and left the NHS vulnerable to a single foreign vendor with too much leverage. They urged ministers to use the break clause and develop domestic alternatives.

In July, another parliamentary committee echoed that concern, drawing in part on Greater Manchester’s testimony. Its chair, Layla Moran, said Palantir was not the only option available.

In the committee’s view, the fact that one major regional board had rejected the platform was evidence that the market was not as closed as Palantir’s supporters claim.

Yet supporters of the FDP argue the critics are comparing unlike things. They say Greater Manchester’s ADSP and Palantir’s FDP serve different functions, at different scales, for different users. What works for one ICB may not solve the broader problem of connecting data across trusts, regions, and national bodies.

Is Greater Manchester’s system really a replacement?

Not necessarily. That is the key dispute. Palantir’s defenders say the ADSP may be useful for local analysis, but that does not mean it can replace a platform designed to operate across an entire national health service.

Bartlett says calling the Greater Manchester system a superior substitute misunderstands the FDP’s purpose. In his view, the debate is being flattened into a narrow comparison of analytics tools rather than a broader assessment of national interoperability.

Bartlett argued that judging the platform only as a local analytics product “is a complete misrepresentation” of what it is meant to do.

Hennessey’s counterpoint is that the board has never claimed its system is universally better in every NHS setting. Rather, he says it is the stronger choice for a care board because it is built around local needs, local data, and local trust.

Who benefits if the FDP works as promised?

Supporters say the beneficiaries would include patients, clinicians, administrators, and policymakers.

• Patients could see better continuity of care if records move more smoothly between providers.
• Clinicians could access more complete information when making treatment decisions.
• Administrators could base resourcing and capacity decisions on fuller data.
• Regional planners could use shared tools to reduce duplication and improve efficiency.

That is the optimistic case. But the political challenge is that the same system can look different depending on where you stand. To its advocates, Palantir is a rare chance to modernise an overloaded NHS. To its critics, it is a symbol of over-centralisation and over-reliance on a contentious US firm.

The debate is therefore as much about governance as it is about code.

Timeline: How the Palantir-NHS dispute escalated

What happens next?

The immediate future depends on political judgment as much as technical performance. Ministers must weigh the risk of staying tied to Palantir against the risk of abandoning a system that many NHS organisations say is already delivering improvements.

If the government triggers the break clause, it would need to explain how the NHS can maintain momentum while replacing a platform that has already been embedded in many trusts and nearly all ICBs. If it does not, critics are likely to treat that as an endorsement of continued dependence on a company many consider a poor fit for the health service.

There is also a broader strategic question. Other European governments are reassessing their own relationships with US technology firms amid tensions with Washington. The NHS dispute is now part of that wider effort to decide how much digital infrastructure should be locally controlled and how much can be safely outsourced.

For Greater Manchester, the issue is more immediate. The board appears committed to its own platform and unconvinced that adopting Palantir would improve outcomes enough to justify the trade-off in trust and flexibility. For the rest of the country, the region has become the clearest proof that a different model is possible.

That does not settle the argument. It sharpens it.

At its heart is a question that no procurement document can answer on its own: can a national health service modernise its data systems if the people expected to use them do not believe in the company behind them?

For now, Greater Manchester’s answer is no. The rest of the NHS, and the government in London, still have months to decide whether that answer should matter everywhere else.

Table note: The contract value, live deployment figures, and decision deadlines referenced above are drawn from the source reporting and NHS/department statements cited in that reporting.