A health data opt-out that doesn't opt you out, and no patient-facing access audit

The National Data Opt-Out does not apply to the Palantir-built Federated Data Platform, which 168 of 214 trusts have joined. The justification runs through direct-care purposes and an unpublished section 254 direction that Parliament has questioned, and the BMA voted to oppose the rollout in June 2025. The Single Patient Record, in the Health Bill and reaching the NHS App from 2028, will centralise further, and medConfidential warns that opt-out reform will weaken what remains. Patients still cannot see who has accessed or received their record. Data usage reports have been promised since the care.data era and never delivered, and medConfidential's volunteer register is the only tracker.

Two national health-data collapses, care.data and GPDPR, each cost millions of opt-outs and years of research capability. The same pattern is repeating with the FDP and the Single Patient Record at the moment the government is betting the NHS's future on data.

A statutory single opt-out covering all secondary uses including FDP-hosted products, and a patient-facing data-usage report in the NHS App showing every access and release, independently audited.

// State-led: Instrument: statutory single opt-out plus NHS App usage-report mandate.

The FDP and Single Patient Record centralise now, the opt-out fails to cover them, and patients cannot audit access, so a third collapse of public trust is live risk.