Boosting clinical trials – will the National Cancer Plan deliver?

In February, the UK Government unveiled its National Cancer Plan – a comprehensive strategy to enhance cancer survival rates in England by 2035. The Plan emphasizes the importance of research, development, and innovation within the NHS. While other measures to improve cancer care will be discussed in future articles, this article focuses on clinical trials and their potential to create a truly research-driven healthcare system.

Despite setbacks caused by the COVID-19 pandemic, the National Cancer Plan's proposals are encouraging and signal positive progress. The headline proposal – the establishment of a 'Cancer Clinical Trials Accelerator' – aims to streamline trial delivery, accelerate the arrival of innovative treatments, and provide patients with better options.

The Plan builds upon the UK's strengths, including a diverse patient population, extensive health data, and a well-connected research community. However, recent years have seen the clinical research environment in England struggle. A 2023 government-commissioned review by Lord O’Shaughnessy highlighted that the UK had fallen behind other comparable countries in several key areas, such as the number of commercial trials launched and patient enrollment.

This prompted several measures to improve the situation, including a target to reduce trial set-up time to under 150 days and a significant reform package introduced in April 2026 by the Medicines and Healthcare products Regulatory Agency (MHRA) and the Health Research Authority (HRA). These reforms have already begun to show results, with MHRA trial approval times falling from an average of 91 days in 2023 to 41 days in 2025.

Consequently, the average setup time for commercial interventional clinical trials dropped from 169 days in 2025 to 122 days in March 2026. The National Cancer Plan's research commitments center around the Cancer Clinical Trials Accelerator, which will provide biotech and pharmaceutical companies with coordinated access to leading cancer expertise.

The Accelerator will be part of the NIHR's new Life Sciences Industry Hub and offer a single point of entry for organizations running commercial trials, along with clear ownership of timelines, escalation, and research infrastructure. This initiative has the potential to improve the speed, scale, and reliability of cancer trials in England, as well as attract investment from industry.

Additionally, it could make the UK a more internationally competitive place for running cancer trials, benefiting both patients and the nation's economy, which has seen non-commercial research alone contribute an estimated £72.7 billion over the past decade. However, the success of the Accelerator depends on effective funding and attention, ensuring that it is not dispersed across an already complex system.

The Plan's research commitments need greater clarity on what the Accelerator will focus on, how it will integrate with existing trial set-up measures, and how progress will be measured. Furthermore, non-commercial trials, which often involve rare, hard-to-treat, and pediatric cancers as well as non-pharmaceutical approaches like surgery and radiotherapy, should receive equal consideration.

In 2023/24, the majority of patients (95%) who participated in interventional clinical trials were involved in non-commercial trials. The National Cancer Plan's implementation will determine whether it successfully delivers progress for people with cancer and contributes to the government's growth mission.