The UK is set to implement sweeping changes to its clinical trial regulations in early 2026, marking the most significant overhaul in two decades. These changes aim to streamline the approval process, reduce administrative burdens, and enhance transparency, positioning the UK as a leading destination for global clinical research.
The Medicines and Healthcare products Regulatory Agency (MHRA) is spearheading these reforms, which include a combined regulatory and ethics review process, a new notification scheme for lower-risk trials, and enhanced transparency requirements. The goal is to create a more efficient and flexible regulatory environment that fosters innovation while safeguarding patient safety.
Streamlined Approval Process
The updated regulations embed a single application route for clinical trial approvals, combining the MHRA and Research Ethics Committee (REC) reviews. This streamlined process aims to provide a decision within 30 calendar days following validation, with an additional 10 days after the applicant responds to any requests for further information. According to the MHRA, a pilot study showed this approach could halve the time from application to recruiting the first patient.
For lower-risk clinical trials, a new notification scheme will allow sponsors to notify the MHRA about eligible trials where the risk to participants is similar to standard medical care. This scheme aims to expedite the approval of notifiable trials without compromising patient safety, though REC approval will still be required.
Enhanced Transparency
The new regulations introduce legally binding requirements for trial registration and results reporting. Sponsors must register new trials in a World Health Organization (WHO) public register by the earlier of either the date on which the first participant is recruited or 90 days after the date of approval. Furthermore, sponsors are required to publish a summary of results on the same public registry within 12 months of the trial ending, presented in a format understandable to laypersons.
Good Clinical Practice and Safety Reporting
The updated regulations emphasize compliance with the overarching principles of good clinical practice (GCP), aligning with the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines. While full compliance with the guidelines will not become a legal requirement in the UK, adherence to these principles is essential for ensuring the quality and integrity of clinical trial data.
To avoid duplicative safety reporting, the new regulations remove the requirement to list serious adverse events and serious adverse reactions in annual safety reports. Instead, sponsors will provide an appropriate discussion on how safety concerns have been evaluated and interpreted, ensuring that reporting obligations are proportionate to the risk.
Industry Response
The Association of the British Pharmaceutical Industry (ABPI) has welcomed the MHRA's move as a significant step forward for UK clinical trials. The ABPI particularly supports new guidance to help researchers involve people with lived experience in clinical trials and recruit a diverse cohort of participants.
Looking Ahead
The MHRA and the Health Research Authority (HRA) are developing comprehensive guidance to accompany the new legislation, covering topics such as requesting approval for a clinical trial, modifications to trial approvals, notifiable trials, safety, research transparency, simplified consent processes, and trial closure. This guidance is expected to be published in January 2026, coinciding with the implementation of the updated regulations.
