If the NHS Federated Data Platform were switched off, the answer is not a national panic replacement. It is a targeted continuity programme: identify which workflows are genuinely FDP-dependent, preserve the source systems of record, and rebuild only the valuable coordination layer on open, trust-owned, interoperable architecture — in the Community Edition at £1 per instance (optional support), no Palantir contract.
The key distinction: Cancer360 is not the cancer system of record. NHS England describes it as a tool that brings data from cancer registers, diagnostic booking/results, inpatient/outpatient booking and treatment-management systems into one cohesive workflow & performance view. Somerset Cancer Register describes itself as the single electronic cancer patient record and lead cancer system for England. So switching off FDP loses the cross-system operational view, not the clinical record.
| Layer | Example | Role | If FDP off |
|---|---|---|---|
| Clinical / pathway record | Somerset Cancer Register · EPR · PAS · theatre & community systems | Holds the record, pathway data and audit / submission capability | Survives |
| Operational aggregation layer | Cancer360 · Shared PTL · Inpatient / Outpatient CCS (FDP) | Pulls data from multiple systems into a joined-up workflow & performance view | Lost / degraded |
| Analytics / improvement layer | Local BI · Power BI · Fabric · open data platform | Dashboards, trend analysis, bottleneck detection, management reporting | Survives |
| National assurance layer | Cancer waiting times · elective recovery metrics · NHSE returns | National monitoring and policy-level oversight | Survives |
The right question is not “can we replace FDP?” but “for each trust, which patient-flow, elective, cancer, discharge or validation process would actually fail, degrade or become more manual if FDP were removed?” Reported usage is uneven, so only the top two categories require significant mitigation.
139 trusts reported “live”, but only 85 recorded activity across the eight monitored apps in the year to June 2026; 54 recorded no login activity and 46 used only one of the eight apps.
No dependency → decommission. Low → local BI / manual fallback. Moderate → parallel-run then withdraw. High → formal service transition with safety review. Only high + moderate need significant action.
Enough time to protect service continuity — the source systems already exist — but not to safely build a full national replacement. So the objective is continuity, protecting high-dependency trusts, and moving to open architecture over time.
| FDP app | System of record (survives) | commvita continuity module | Impact |
|---|---|---|---|
| Cancer 360 | Somerset Cancer Register | /cancer-pathways | high |
| Shared PTL | PAS / EPR waiting list | /rtt-ptl | high |
| Inpatient CCS | EPR / ADT / bed mgmt | /flow | moderate |
| OPTICA | EPR / ADT + discharge | /discharge-hub | moderate |
| Crisis Response | Community / urgent-response systems | /virtual-ward | low |
The eight monitored FDP applications, each mapped to the surviving system of record and the commvita continuity module that rebuilds only the valuable workflow — preserve the record, don’t re-key it.
| FDP app | System of record (survives) | commvita continuity module | Status |
|---|---|---|---|
| Cancer 360 cancer pathway operational view | Somerset Cancer Register / local cancer system (the cancer record & audit) | Cancer Pathways — 2WW / FDS / 62-day tracking, MDT, pathway-delay & action lists /cancer-pathways | ☉ Demonstrated |
| Shared PTL shared tracking list across an ICS | PAS / EPR waiting-list modules | RTT PTL Dashboard — patient-level PTL, breach prevention, IS capacity, GIRFT, equity ranking /rtt-ptl | ☉ Demonstrated |
| RTT Validation clock & data validation | PAS / EPR waiting list | RTT PTL — clock status, long-waiter cohorts, validation status, booking risk /rtt-ptl | ☉ Demonstrated |
| Patient Led Validation validation via patient contact | PAS waiting list + contact record | PIFU & Waiting Well — patient-initiated validation, keep-in-touch, contact outcomes /pifu · /waiting-well | ● Live (/pifu) |
| Inpatient CCS capacity, coordination & flow | EPR / ADT / bed management | commvita Flow + Bed Board — discharge-delay dashboards, criteria-to-reside, escalation /flow · /bed-board | ● Live (Flow) |
| OPTICA discharge / transfer optimisation | EPR / ADT + discharge record | Discharge Hub — SAFER, D2A pathways, delayed-discharge reason coding, onward capacity /discharge-hub | ☉ Demonstrated |
| Outpatient CCS outpatient capacity & productivity | PAS clinic booking + outcome coding | DNA Analysis + Waiting Well — DNA, utilisation, follow-up backlog, PIFU, capacity mismatch /dna-analysis | ☉ Demonstrated |
| Crisis Response community urgent / crisis response | Community & urgent-response systems | Virtual Ward + Community Nursing — referral routing, response-time tracking, caseload visibility /virtual-ward · /community-nursing | ● Live (Virtual Ward) |
Design the March-2027 contingency as three parallel tracks — make sure no pathway is unmanaged, rebuild only what is used, and move to open architecture without swapping one lock-in for another.
Make sure no patient pathway is left unmanaged: a trust-by-trust dependency register, a clinical safety risk assessment per active app, a named fallback process per workflow, local business-continuity plans, a data export & retention plan, and a user comms & training pack.
Rebuild only what is actually used: cancer pathway dashboard, PTL & RTT validation, theatre utilisation, discharge & patient flow, outpatient productivity, and a crisis-response operational view — each an existing commvita module, owned by the operational team, not a central platform.
Avoid replacing one lock-in with another: an open data model, common definitions, a modular application catalogue, a trust-local deployment option, a national aggregation layer, transparent benefit measurement, open APIs and a supplier-neutral procurement model.
The replacement should be open, modular and sovereign — not a like-for-like proprietary command platform. FDP Exit & Continuity ships in the Community Edition — the open, FDP-parity base at £1 per instance (optional support), a repackaging of already-shipped commvita modules, not a rebuild. There are three editions, sequenced by adoption risk: own your platform → govern your organisation → run your health economy. Each is additive; the Population Platform includes governance & assurance in full.
The open platform foundation, core utilities, developer toolkit, the FDP-parity operational products — the continuity catalogue below — and operational flow: commvita Flow & OPEL, bed board, discharge and winter pressures. Self-hosted, open standards, no Palantir contract. /flow /bed-board
Board assurance & BAF, risk, incidents, information governance, AI governance, workforce assurance & learning (CPD, competencies, mandatory training), audit/evidence, and statutory readiness & operational command — On-Call Manager, EPRR & business continuity, safe staffing / CHPPD and the bank & agency cascade. The governance system of record, sold to boards; no clinical-accreditation dependency. /board-assurance-framework /eprr /safe-staffing
The clinical record across primary care, adult social care, mental health, pharmacy, dentistry and the other community services, with clinical operations, population health and the intelligence layer — plus governance & assurance in full. /patients /population-health /outcome-intelligence
| Community Edition module | What it does | Where in commvita |
|---|---|---|
| Cancer Pathway 360 | Cross-system cancer pathway operational view over the local cancer record | /cancer-pathways |
| Elective Recovery & PTL | Patient-level PTL, RTT clock RAG, breach prevention, inequality-weighted ranking | /rtt-ptl |
| RTT Validation | Clock validation, long-waiter cohorts, validation & booking risk | /rtt-ptl |
| Theatre Productivity | Utilisation, on-time starts, case-mix, GIRFT benchmarking | /theatre-productivity |
| Outpatient Flow | DNA, clinic utilisation, follow-up backlog, PIFU | /dna-analysis |
| Discharge & Inpatient Flow | SAFER, D2A, delayed-discharge coding, cross-setting capacity, closed-loop actions | /discharge-hub · /flow |
| Community / Crisis Response | Urgent community response, virtual ward, caseload visibility | /virtual-ward · /community-nursing |
| Population Inequality & Outcomes | CORE20PLUS5, deprivation, outcome & equity gaps | /health-inequalities · /deprivation-mapping |
| Workforce Experience | Complexity-adjusted caseload, workaround index, staff-confidence pulse | /workforce-intelligence |
| Benefits Realisation & Audit | Counterfactual benefit measurement, audit & assurance | /outcome-intelligence |