In February, the Government published the National Cancer Plan, the first dedicated cancer strategy for England in a decade. With a new Government now responsible for the Plan’s implementation, it is vital that the Plan remains a priority and that its ambitions are delivered at pace. In this series, we offer our perspective on a few key features within the Plan and what actions are needed to translate its commitments into genuine improvements for people affected by cancer.
In this article, Policy Manager Emily Eagles focuses on clinical research, exploring whether the National Cancer Plan’s proposals on clinical trials are enough to create a truly research-powered NHS.
In February, the Government published its long-awaited National Cancer Plan for England, which aims to boost cancer survival to be among the best in the world by 2035.
We were pleased that alongside measures to improve cancer care (which we’ll discuss in future articles), the Plan set out concrete steps to boost research, development and innovation across the NHS.
This is vital. Future tests and treatments won’t reach patients by chance; they need to be built on long-term scientific discovery and a strong clinical trials system.
But in recent years, following shocks like the COVID-19 pandemic, the clinical research environment in England has struggled. In 2023, an influential government-commissioned review by Lord O’Shaughnessy found that the UK had fallen behind other comparable countries on several criteria.
But while the report spurred action to speed up clinical trial set-up times, we’ve been clear that much more is needed – having recently launched our new Unlock Cancer Breakthroughs campaign. For now, the National Cancer Plan’s clinical research commitments are genuinely good news and signal some positive steps forward.
The headline proposal, to establish a ‘Cancer Clinical Trials Accelerator’, is particularly promising, with the potential to streamline the way trials are delivered, and speed up the arrival of innovative treatments and diagnostics for patients who could benefit.
Below, we’ll discuss what the Plan sets out, and why the work to make it a success is only just beginning. But first, some context.
The context – a struggling clinical research environment
The UK has real strengths to build on: a diverse patient population, rich health data and a research community that links academia, industry and the NHS. But recently, some companies have been put off running clinical trials here.
The 2023 O’Shaughnessy Review was a wake-up call – the country had fallen behind international comparators, both in terms of the number of commercial trials launched and the patients enrolled on these trials.
This prompted several measures to improve things: in April 2025, the Government introduced a goal to cut trial set-up time to under 150 days, and this was backed across the NHS 10-Year Health Plan, the Life Sciences Sector Plan, and now the National Cancer Plan.
Then, in April 2026, the Medicines and Healthcare products Regulatory Agency (MHRA) and the Health Research Authority (HRA) introduced one of the largest packages of clinical trial reforms in two decades, designed to fast-track lower-risk studies and speed up the assessment of first-in-human trials.
Encouragingly, these measures have already begun to bear fruit. MHRA trial approval times fell from an average of 91 days in 2023 to 41 days in 2025. As a result, when we look at the steps involved in setting up trials as a whole, data from March 2026 shows the average setup time for commercial interventional clinical trials was down to 122 days, compared to 169 days for the same 6-month period in 2025.
There are also more regulatory improvements are in the pipeline, including the MHRA’s work to further streamline its processes – in particular, looking at how to embed highly specialised oncology expertise into approval processes and ease overly complex regulatory pathways.
This momentum is hard-won, and it will be important to sustain it because there’s still further room for improvement. And that’s where the National Cancer Plan could make a real difference.
Further accelerating clinical trials
The Plan’s research commitments centre around a new Cancer Clinical Trials Accelerator, which will provide the biotech and pharmaceutical industry with coordinated access to leading cancer expertise. It will form part of the NIHR’s new Life Sciences Industry Hub, and offer organisations running commercial trials a single point of entry, clear ownership of timelines, escalation, and research infrastructure.
This has huge potential, not only to improve the speed, scale and reliability of cancer trials in England, but also to support investment from industry. And if done right, it could help make the UK a more internationally competitive place to run a cancer trial.
This ambition matters – as well as delivering progress for people with cancer, clinical trials are also key to delivering the Government’s growth mission, with non-commercial research alone having boosted the UK economy by an estimated £72.7 billion over the past decade.
Delivery will be key
Of course, there are caveats too, and while the Accelerator is welcome, the real test will be in how it’s delivered. Success will depend on funding and attention being targeted effectively, not dissipated across an already complex system.
So, we want to see greater clarity on precisely what the Accelerator will be responsible for, how it joins up with the wider trial set-up landscape – for example, the measures currently aiming to reduce trial set-up times – and how progress will be measured.
We also need to make sure that non-commercial trials get the same attention. In 2023/24, the majority of patients (95%) who took part in an interventional clinical trial participated in a trial with a non-commercial sponsor. Non-commercial trials often include trials for rare, hard-to-treat and paediatric cancers, and non-pharmaceutical approaches such as surgery and radiotherapy. With so much Government energy focused on the commercial environment, we need assurances from DHSC and NIHR that non-commercial trials will see similar improvements in set-up times, and that the Accelerator works for them too.
National leadership
Beyond the Accelerator, the Plan also brings a welcome focus on national leadership, with Government setting out six clear priorities – including prevention and diagnostic tools, personalised medicines and progress on areas where less progress has been made, including rare and CYP cancer. Similarly, new leadership roles have provided a useful signal of importance to the wider research and funding community. For example, the Plan commits to appointing new NIHR speciality leads to drive forward the rare cancer research portfolio.
Done well, this leadership will help tackle the knottiest issues in cancer research and have the most impact for people affected by cancer. For example, the focus on rare and less common cancers, which together account for around 47% of diagnoses but whose small patient populations make trials harder to design and run, could provide a new national drive for research in this space.
Building a research culture across the NHS
But while the measures in the Plan, and Government action to date, are very welcome and necessary, they are not sufficient. We also need to see a genuine research culture developed within the NHS, where many trials still get stuck.
Financial pressures mean NHS organisations are being asked to do more with the same or smaller budgets, and research is not yet fully embedded as a core part of what they do. This can mean research budgets get squeezed, dedicated research time is cut, and standard care is prioritised over research when capacity is tight. In 2023, 4 out of 5 (78%) respondents to our clinical research workforce survey said they felt that a lack of capacity and prioritisation was a substantial or extreme barrier to delivering research in the NHS on time.
The consequences are visible: a declining clinical research workforce, both in absolute numbers and as a share of the overall NHS workforce; the highest proportion of vacant clinical academic posts since 2007; and a 6% decline in medically trained research staff between 2012 and 2022.
In cancer, trials often need additional input from departments like pharmacy and radiology – so these gaps can be more disruptive. There are real concerns that complex cancer trials could be pushed down the priority order as sites work to hit set-up targets with lower-risk trials.
Looking to the future
The measures in the National Cancer Plan – particularly the new Accelerator – along with the recent reforms at the MHRA are creating the conditions for faster, better trials.
But we will only reap the rewards if the NHS has the capacity, funding and culture to deliver them. That means securing sustainable R&D funding, protecting non-commercial research from de-prioritisation, and serious workforce planning to reverse the decline in staff numbers.
We cannot assume the current momentum on clinical trials will be automatically sustained. The National Cancer Plan sets out some really welcome steps, along with lofty ambitions, but these will only be realised if Government builds a truly research-powered NHS. To do this, the Government must unlock cancer breakthroughs. We will continue to highlight the importance of further action through our new campaign, and look forward to seeing how the National Cancer Plan ambitions are achieved.
