Buying the Flagship NHS Data Platform Was the Easy Part

A third of NHS trusts performed fewer operations after adopting Palantir's platform. The lesson every leader needs about averages hiding failure.

Buying the flagship NHS data platform was the easy part. A third of trusts now do fewer operations

There is a particular kind of number that is true and misleading at the same time. The NHS had one. For months, the headline claim about Palantir's Federated Data Platform, the big data system the government bought to help hospitals run more smoothly, was that it had helped trusts carry out more operations. Add up every hospital using the scheduling tool, and the total goes up. Good news, on paper.

Then the campaigning group Foxglove filed a series of freedom of information requests and looked underneath the total. What they found is that almost a third of the English trusts using the platform's operations-scheduling module are now doing fewer operations than before they switched it on. Thirteen of the 41 trusts using the tool went backwards. Between them, they recorded 9,073 fewer operations after adopting it than in the equivalent period before. The national total still rose, because the trusts that improved improved by enough to cover for the ones that declined. The average looked healthy. A third of the patients behind it did not.

I want to be careful here, because this is not a "Palantir bad" story (I have plenty of those if you are interested), and it is not even mainly a story about Palantir. Tom Bartlett, the former NHS England deputy director who led the 150-person team that built the platform, made a reasonable point in the same article: judging a broad data infrastructure by one nationally commissioned product probably misses the wider intent. He may be right. But notice that we can only have that argument because Foxglove forced the per-trust data into the open. NHS England had only ever published the cumulative total of additional operations across all trusts, which is exactly the shape of number that hides its own worst cases.

This should worry any leader who has signed off on a big technology purchase, whether in healthcare, banking or local government. If the only figure you report is the aggregate, you have built a dashboard that flatters you. Averages are generous to failure. One strong site can carry several weak ones, and you will never see the weak ones until someone outside your organisation goes digging.

Foxglove's head of strategy Tim Squirrell put the principle bluntly: if a tool gets the credit when things improve, it has to accept the blame when they get worse. You cannot claim the upside as proof and dismiss the downside as noise.

There is a deeper lesson in why those 13 trusts went backwards, and the honest answer is we do not fully know, because the comparison data for trusts not using the tool has not been published either. That gap is a bigger problem than it sounds. Without it you cannot tell whether the platform caused the decline, or whether those trusts were already struggling and the software simply landed in the middle of a harder situation. A tool dropped onto a broken process leaves the broken process in place. It just runs that process faster, and now there is a vendor logo attached to the outcome.

That is what organisations keep getting wrong about AI and data platforms. Buying the system is the easy, board-friendly move. The £300m-plus contract gets signed, the press release goes out, the cumulative number ticks up. The hard part, which no one puts on a slide, is the local work: the scheduling habits, the staffing, the trust between teams, the messy human reasons one hospital makes a tool sing and another makes it sigh. Same software, very different results, because the software was never the main variable.

So there is one thing worth doing this week if you run anything at scale. Find your headline metric, the one you quote upwards. Then break it down per team, per site, and look specifically for the units going the wrong way while the total goes up. Do not wait for an FOI request to do it for you. If your dashboard only shows the aggregate, it is almost certainly hiding your worst performers, and those are the people who most need help.