If the app was in development, that means it wasn’t yet ready for medical use. Testing, Caldicott argues, is different from “direct care,” and nullifies the argument that the company had “implied consent” from patients. In a letter to Professor Stephen Powis, medical director at the Royal Free Hospital, Caldicott said: “Given that Streams was going through testing and therefore could not be relied upon for patient care, any role the application might have played in supporting the provision of direct care would have been limited and secondary to the purpose of the data transfer.”