UK industry clinical trial recruitment falls for fifth year

The number of patients taking part in industry-sponsored clinical trials in the UK has fallen for a fifth consecutive year, despite improvements in how quickly studies are approved and set up.

According to the ABPI, 17,618 people participated in industry trials in the NHS in 2025/26, which is a drop from 19,507 the previous year.

On top of this, industry-sponsored studies now account for just 3.8% of participants in interventional trials, compared with more than 10% before the pandemic.

The figures raise concerns about the UK’s ability to attract clinical research, particularly as the government aims to double trial participation by 2026 and again by 2029.

Faster approvals, slower recruitment

Although regulatory decisions are becoming quicker, getting studies open to patients remains a significant challenge.

All studies received a regulatory decision within 60 days in August 2026. However, only 35% of studies opened to patients within 60 days of approval on average in 2025/26, falling well short of the 90% target.

Some NHS centres are performing better than others. Commercial Research Delivery Centres, funded through the VPAG Investment Programme, opened 75% of their studies within 60 days, compared with 58% across all UK sites.

“Companies invest in clinical trials where every site can open quickly and recruit reliably,” said Joe Edwards, Executive Director of UK Competitiveness, ABPI.

“The UK must now deliver that across the whole trial, not just at the first site.”

UK attracts more early-stage trials

There are, however, signs that the UK is becoming more competitive in attracting international research.

National Institute for Health and Care Research (NIHR) figures show that UK sites recruited 100 global or European first participants into commercial international studies in 2025/26, almost double the 53 recorded the previous year.

Trial set-up times have also improved. Government data published in October showed the average time had fallen to 100 days in January–March 2026, compared with 169 days in 2024/25.

Commenting on the NIHR figures in May, Dr Maria Koufali, Industry Director, NIHR Life Sciences, said the UK was “becoming faster, more predictable, and increasingly attractive for global life sciences investment”.

What needs to change?

To address falling recruitment, the ABPI has outlined five recommendations aimed at making it easier for patients to access clinical research and improving the UK’s research infrastructure.

These include creating a UK-wide service that uses NHS data to identify and enrol eligible patients, improving reporting on participant diversity and reinvesting industry trial income in research staff and facilities.

Whether these measures can reverse five years of falling recruitment remains to be seen, as the UK works towards its target of doubling clinical trial participation by 2029.