Most of 40 Trusts Do Not Use Palantir Waiting-List Tools

More than 20 of the 40 NHS trusts behind a national claim about Palantir-powered waiting-list tools no longer use either of the two workflows, according to a Financial Times analysis published on 3 October.

That means at least 21 trusts, or at least 52.5% of the group. It does not mean that 21 trusts abandoned the wider Federated Data Platform. Some stopped one module, some paused an implementation, and others continued to use Palantir software for theatres, referral validation or discharge.

The finding exposes a measurement problem rather than a simple deployment retreat. NHS England's headline number records cumulative activity. It does not show whether a trust retained the workflow that produced it.

The 40-trust denominator is historical

At the end of March 2026, NHS England's uptake page counted 37 trusts using the inpatient waiting-list module, 39 using the inpatient theatre module and 16 using the outpatient tool. There is overlap between those groups.

The same page reported 87,842 inpatient and 218,389 outpatient requests to remove entries from waiting lists. Together that is 306,231 requests. The counters run from the first trust adoption to the reporting cut-off. They do not say how many of the contributing trusts still use the relevant workflow.

The published methodology also draws an important boundary. Each suggested removal adds to the count, but NHS England has no pre-adoption record of removals for comparison. The figures therefore show work performed through the products, not how many removals would otherwise have gone undone.

That distinction matters because waiting-list validation is often a clean-up exercise. Palantir told the FT that the two tools tend to be used most heavily when first installed, as trusts correct historic data errors. Lower later use can be consistent with a product completing its initial task. It can also reflect migration to a local system or failure to become part of routine work. The cumulative counter cannot distinguish those outcomes.

One product contains separable workflows

NHS England's data protection assessment for Inpatient CCS shows why the withdrawal count cannot be treated as a platform exit. The product contains two waiting-list modules, called Waiting List Overview and Elective Alerts, alongside Patients and Booking Management and Theatre Session Management.

A trust can stop using the waiting-list view and keep scheduling theatres on the same platform. It can also retain an FDP instance while using a separate application for referral-to-treatment validation, cancer pathways or discharge.

Ashford and St Peter's Hospitals illustrates a different category. Its 2026 freedom of information response says RTT and Inpatient CCS were live. NHS England had supplied a go-live date for Outpatient CCS, but the trust said it did not recognise that product as ever having entered live operational use. Implementation had been paused while it waited for a newer version with capacity and room-booking functions.

That is not a terminated platform deployment. It is a national rollout record colliding with a trust's narrower definition of live use.

Other cases go further. East Suffolk and North Essex told an FOI requester in February that its FDP instance was inactive after the trust changed electronic patient record system on 2 October 2025, with no plan to restore the data flows. University Hospitals of Derby and Burton listed four FDP products, including RTT, in 2025, then listed three in January 2026 without RTT. One is wider technical withdrawal. The other is module retirement while the platform remains.

The outcome comparison is still missing

No published evidence located for this audit compares referral-to-treatment lists, long-wait cohorts, theatre use or administrative hours before and after the affected trusts stopped a waiting-list module.

NHS England does publish adoption comparisons. Its theatre measure subtracts a pre-adoption weekly average from cases recorded after adoption. But the methodology now states that other variables were not controlled and cause and effect cannot be inferred.

The Office for Statistics Regulation said in July that NHS England had added that caveat on 6 June. It asked for clearer public wording, trust-level results, consideration of control groups and an independent evaluation focused first on Inpatient CCS and the OPTICA discharge product.

Until that work supplies an exit cohort, neither side can use module retirement as an outcome verdict. A trust leaving the tool after cleaning its list may be evidence of completion. A trust returning to an older system because the workflow added little would indicate weak retention. The current public metrics do not separate them.

Central capacity does not remove local cost

The commercial exposure is national. NHS England said the platform would cost at least £25.6 million in its first year and up to £330 million across seven years. Its contract explainer says only the first three years are committed, through March 2027, with later extensions available. The service is funded for up to 240 NHS organisations.

Public documents do not identify a per-module credit when a local workflow stops. Inactivity at one trust therefore does not establish that the national payment falls. Nor is nationally funded software costless to deploy. Barnsley Hospital's January FOI response identified about £22,000 locally: roughly £10,000 for technical resource, £2,000 for training and £10,000 for virtual-server and networking infrastructure. It created no additional roles.

The audit result is narrower than a backlash headline. More than half of a 40-trust benefit group had moved away from the waiting-list workflows by the FT's October snapshot. The platform may still carry other useful work at many of those trusts. What NHS England has not yet published is the retention measure needed to tell successful completion, migration and abandonment apart.

Sources

• Financial Times, trust-level waiting-list analysis, 3 October 2026
• NHS England, FDP uptake and benefits
• NHS England, benefits methodology
• NHS England, Inpatient CCS data protection assessment
• Office for Statistics Regulation, FDP metrics findings
• NHS England, FDP contract explainer
• NHS England, FDP contract award announcement