My Medical Gateway Blog

Palantir’s £330m NHS data contract promises efficiency, but has it reduced waiting lists? This analysis examines the Federated Data Platform, NHS digital inefficiencies and real waiting list trends. Despite claims of improved performance, evidence suggests only marginal impact. With NHS waiting lists still around 7.2 million cases, likely closer to 9 million, capacity constraints.- not data – remain the core issue.

The Guardian’s reporting on Palantir’s £330 million NHS Federated Data Platform contract has focused heavily on civil liberties and hypothetical future misuse. But there is a more immediate and practical question: what is Palantir actually doing inside the NHS, and has it made any real difference to waiting lists?

In 2023, NHS England awarded Palantir Technologies the contract to build and operate the Federated Data Platform (FDP). This followed its earlier involvement during Covid, where its software was used to coordinate national resources such as beds, ventilators and PPE.

The FDP is not a single centralised database. It is a system designed to connect multiple existing NHS data sources – hospital records, waiting lists, staffing data and equipment availability – into a single operational view. The idea is to allow hospitals, trusts and integrated care boards to see, in near real time, where capacity exists and where bottlenecks are forming.

In theory, this enables better decisions: scheduling operations more efficiently, reducing discharge delays, reallocating resources and ultimately improving patient flow. And the problem that Palantir is trying to solve is real. The NHS is not just under pressure, it is operationally inefficient at a basic level.

Around 95% of NHS staff report dealing with process inefficiencies, losing an average of five hours per week to delays, duplication and workarounds. At the patient access level, the system is equally strained. In December 2025, GP practices received over 30 million calls, with more than 3.3 million going unanswered. Even when calls are answered, only around 60% are picked up within two minutes.

Booking systems are no better. The NHS runs over 100 million outpatient appointments annually, yet around 7.6% result in missed appointments – roughly 650,000 every month – costing close to £1 billion per year in wasted capacity. This is the environment in which the FDP is being deployed. And to be clear, a platform that improves visibility and coordination in a system like this should generate some gains.

Palantir’s own figures reflect that. As cited in the Guardian, it claims its software has helped deliver 100,000 additional operations, reduce discharge delays by 12% and remove 675,000 patients from waiting lists. On the surface, those numbers sound significant, but they need to be placed in context.

The NHS waiting list stood at around 7.2 million cases in December 2022, before the Palantir contract. It then rose to a peak of 7.7 million in September 2023, around the time the FDP was being rolled out. Since then, it has edged down slightly to roughly 7.3 million by late 2025 – leaving the system broadly where it started, with the true figure likely closer to 9 million.

In other words, despite the introduction of the platform, there has been no structural reduction in waiting lists. At best, there has been stabilisation. That is not entirely surprising when you look at how the system actually works.

The NHS processes enormous volumes of patients every month. Even before the pandemic, roughly 1.7 million patients were added to waiting lists monthly and a similar number treated and removed. Today, monthly treatment volumes exceed 1.6 million. Against that scale, a claim of 675,000 patients “removed” is difficult to interpret without understanding the net effect. Patients are constantly flowing in and out of the system.

The same applies to the 100,000 additional operations. In isolation, it sounds material. In a system delivering tens of millions of procedures annually, it is incremental. This points to the central issue: the NHS waiting list is not primarily a data problem, it is a capacity problem. There are not enough clinicians, not enough operating theatres and not enough downstream social care capacity to discharge patients efficiently. Bed occupancy remains persistently high, which in turn restricts new admissions and delays elective procedures.

A data platform can improve how existing resources are used, it can reduce idle time, highlight inefficiencies and support better coordination. But it cannot create additional capacity.

The slight improvement in NHS waiting lists since 2023 is far more plausibly explained by increased clinical activity, targeted recovery funding and policy interventions than by any single technology platform. A key driver has been the expanded use of the independent sector. NHS spending on treating patients in private hospitals has roughly doubled in recent years, rising from around £1.1 billion pre-pandemic to over £2.6 billion annually by 2024–25, with a significant share directed towards routine elective procedures such as cataracts, orthopaedics and diagnostics. This has provided immediate, real-world capacity that the NHS itself lacks. There is no clear evidence that Palantir has been the primary driver of waiting list reductions; the marginal stabilisation observed is far more consistent with capacity expansion than with improvements in data coordination alone.

This is where the narrative around Palantir becomes overstated. The FDP may well make the NHS more manageable and marginally more efficient, and hopefully it may reduce friction at the edges of the system. What it does not and cannot do is change the core constraint.

For MMG, the conclusion is straightforward. The NHS digital infrastructure is undeniably inefficient, and modernisation is necessary. The case for better data, better coordination and better operational visibility is strong. But framing a data integration platform as a solution to waiting lists risks misdiagnosing the problem. Palantir is addressing how the system is organised. Waiting lists are driven by how much care the system can actually deliver. Until that gap is closed, efficiency gains – however real – will remain marginal.