UK industry clinical trial recruitment falls for fifth consecutive year

As pharmaceutical research advances and new treatment modalities emerge, the ability to translate scientific innovation into clinical trials is increasingly important. However, the number of people participating in industry-sponsored clinical trials in the UK has fallen for the fifth consecutive year, prompting calls for further action to improve clinical research delivery.

According to the Association of the British Pharmaceutical Industry (ABPI)’s latest annual clinical trials report, just 17,618 people took part in industry clinical trials in the NHS during 2025/26, down from 19,507 in 2024/25 and 31 percent lower than in 2022/23. Industry-sponsored studies accounted for just 3.8 percent of interventional clinical trial participants, compared with consistently higher than 10 percent before the COVID-19 pandemic.

The findings come despite improvements in trial set-up, particularly at the regulatory approval stage. In August 2026, all studies received an approval decision within 60 days. However, delays in opening studies to recruitment and enrolling the first patient remain a concern.

During 2025/26, an average 35 percent of studies opened to recruitment within 60 days of approval, against a target of 90 percent. Furthermore, only 53 percent recruited their first patient within 30 days of opening.

The report identifies some progress through the UK’s Commercial Research Delivery Centres (CRDCs), which are outperforming the wider UK clinical research ecosystem on trial set-up and delivery. In 2025/26, 75 percent of CRDC studies opened to recruitment within 60 days of approval, compared with 58 percent across all UK sites.

Improvements to the National Contract Value Review process have also reduced the time required to finalise contracts and costing for participating trial sites from 65 to 25 days.

Joe Edwards, Executive Director of UK Competitiveness at the ABPI, said the continued decline in recruitment, despite the progress made by the government, regulators and NHS in accelerating trial set-up, was worrying.

The full benefit is only realised by patients, the NHS and the economy when speed is followed by recruitment.”

- Joe Edwards, Executive Director of UK Competitiveness, ABPI

He added: “The full benefit is only realised by patients, the NHS and the economy when speed is followed by recruitment. Companies invest in clinical trials where every site can open quickly and recruit reliably. The UK must now deliver that across the whole trial, not just at the first site.”

The government has committed to doubling the number of people participating in industry clinical trials by 2026 and doubling it again by 2029. The ABPI supports this ambition and has outlined five recommendations to improve the UK’s clinical research environment.

These include expanding clinical research delivery metrics and funding across all sites, establishing a UK-wide service to use NHS data to identify and enrol suitable trial participants, and improving the measurement of participant diversity. The organisation also called for greater reinvestment of industry trial income into research staff and facilities.

The report found that the UK ranked seventh globally for starting Phase I industry clinical trials in 2025, fifth for Phase II and seventh for Phase III.

Improving recruitment and accelerating trial delivery will be essential for the UK to remain competitive in attracting industry-sponsored clinical research and investment.