The Download: The story of the covid-19 data store

In early March last year — during the same week as the UK’s first covid-19 death was confirmed — a handful of business chiefs arrived at 10 Downing Street for a hastily arranged meeting.

Seated around a large table in one of the building’s meeting rooms were prime minister Boris Johnson, Sir Simon Stevens, Sir Patrick Vallance and several other NHS senior figures and government aides and advisers. 

The business chiefs squeezed into the packed room. Social distancing was out of the question.

Attendees at the event included leaders of some of the largest technology companies in the world, such as Microsoft and Google, but also major logistics firms including Uber and Deliveroo.

Mr Johnson opened the meeting by saying the government needed help from the sectors represented to combat the oncoming pandemic, and that one of the biggest “asks” was for support to manage data integration in order to collect the most real-time and accurate information - upon which potential life-and-death decisions would be made.

At that point Louis Mosley raised his hand.

“The thing I remember most vividly from that meeting is the uncertainty,” says Mr Mosley – nearly 12 months after his first trip to Downing Street.

Mr Mosley is the UK head of data firm Palantir. It may not be a company you’ve heard of unless you follow health tech closely, but it has played a critical role in analysing information contained in the NHS covid-19 data store, which was first launched by NHSX and NHS England/Improvement. 

In a special podcast with HSJ, Mr Mosley recalls: “People were very frightened. We didn’t know what we were facing, but there was that sense that we needed to come together.”

The covid-19 data store project has been – according to leaders in government and the NHS – one of the biggest success stories during the pandemic. Public awareness of its influence, however, lies in the shadows of other much-lauded patient-facing transformations such as remote consultations and online care services. 

That lack of recognition is a pity, because the data store and the insights it has enabled has been intrinsically linked with almost every operational decision made by NHS and the government during their handling of the pandemic.

Whether it was working out where to send ventilators, identifying trusts at risk of running out of personal protective equipment, modelling the pandemic’s impact on hospitals’ capacity, or – more recently – allocating vaccine supply, the supporting information for every decision can be traced back to the data store.

Several tech companies, including Microsoft, ANS Group, and Faculty – more used to being rivals than partners – have helped develop and run the data store. Palantir acted as the “plumbers”, as Mr Mosley puts it. This means connecting different datasets in their Foundry platform, which “scrubs” the data in order to provide a “single source of truth”.

“That was incredibly important, because as long as you had different versions of the truth you might have different groups making decisions that might be contradictory or overlapping,” Mr Mosley says.

“We had to get everyone working from the same understanding of what was happening. That meant NHS England/Improvement could share the truth with the Cabinet Office and Number 10.”

Within 10 days of starting work, Palantir had managed to glean meaningful insights from 150 data sources in the data store.

The data store’s impact

It is difficult to exaggerate how important the data store has been in the last 12 months.

Asked for examples of where it has had a specific impact on the NHS response, Mr Mosley highlights the period when hospital chief executives feared running out of ventilators.

“There was huge concern about the availability of ventilators,” he says. “In order to answer the question of where they were needed, you also need to know who is in what bed, what oxygen capacity does the hospital have, and can they connect beds to more ventilators.

“From April and onwards, every ventilator was allocated by the data store.”

Even when hospitals were past the peak of covid-19 inpatients and the need for ventilators reduced, the next challenge was just around the corner.

“The next crisis was PPE,” Mr Mosley says.

“We ended up allocating about six billion items of PPE through the data store, and despite all the concerns and public outcry the NHS never ran out of PPE [this claim has been disputed as many parts of the system did suffer severe shortages]. The challenge was much more around how it was allocated.”

The critics

Throughout the data store’s existence, privacy campaigners have criticised the NHS and government for not being transparent about the role of the companies involved and what safeguards are in place to protect people’s data.

Additionally, reports of Palantir offering its service for £1 before going on to win a £20m two-year contract with NHSE/I have fuelled claims of a “privatisation of the NHS’ data assets” and an unease about the role of security firms like Palantir in handling patient information. Only today, there is new legal action against the government over how the firm was selected.

Mr Mosley confirms that Palantir worked for free in the first three months of the pandemic, but argues that is usually the way the firm begins its relationship with a client.

“There’s a phase where typically you try our tools for free – in the same way that HSJ might offer one month’s free subscription to new readers,” he says.

Asked specifically about the fairness of Palantir being asked into the covid NHS work early on, whereas other firms were not, Mr Mosley does not comment directly, but instead highlights the strengths he thinks the firm has. 

In relation to data use, he adds: “Some people think we’re a data company in the way that social media companies are, and that therefore the data is where our value is. But we don’t own data or derive any value from it. We sell software to help organisations make the data they own more useful to them.

“The interpretation that we were offering this free because we’d get some benefit from the data itself was completely not the case and a perception we needed to change.”

Referring to the contractual process, he adds the software Palantir uses in its work with the data store is the same as it uses with its other clients.

“It’s not the case that we’ve had privileged access to information and subsequently built something bespoke to sell,” he says.

He emphasises that all NHS data has been “scrubbed” to make it “de-identifiable” prior to being processed by Palantir, at which point it is merely a “statistic”.

The data store’s next challenge

NHSE/I’s two-year contract with Palantir, agreed late last year, suggests that the data store is here to stay.

Currently, the data store is again proving instrumental in helping the delivery of the vaccination programme to pinpoint where supplies of the vaccine and supporting equipment should be prioritised.

Once the pandemic is over, Mr Mosley says he does not know what the NHS’ specific intentions for the data store and Palantir’s data platform are - but he expects both to play a similarly important role in the restoration of elective care services.

The data store’s effectiveness in that programme will depend on what happens with the temporary information-sharing rules put in place during the pandemic, as the continuation of those rules will be hard to justify when covid-19’s significance diminishes.

Mr Mosley merely points to the “de-identifiable” nature of the data processed by Palantir when asked for his view on future data-sharing changes.

However, he adds that the NHS needs to be ready for a future in which patients rely on wearables and devices at home to be monitored and that all that data must be “synced up” to patient records across primary and secondary care.

Click here to listen the full podcast.

• Article amended at 12.05pm on 25 February to clarify that Palantir’s role in the data store has been to integrate and analyse the store’s datasets within its own Foundry platform. It only does so for certain types of data within the data store upon authorisation from NHSE/I. The firm cannot access any data in the store without NHSE/I’s approval.