The State of Clinical Trial Outsourcing in the UK: Optimizing Site Selection, Resources, and Performance

Hear leading UK clinical operations experts tackle today’s most critical challenges in clinical trial outsourcing, CRO selection, and site optimization—insight essential for any trial leader planning or delivering studies across the UK and global markets.

Speakers

• Moderator: Sverre Bengtsson
• Fiona Shields, Head of UK Clinical Operations, Novartis
• Divya Chadha Manek, Director of Clinical Operations, EyeBio
• Suki Balendra , Director of Strategic Partnerships, Paddington Life Sciences
• Lucy Clossick Thomson , Head of Clinical Operations, Purespring Therapeutics
• Sarah Dealey, Director of Country & Site Operations, Biogen
• Janette Rawlinson , Patient Advocate and Research Partner, Various national/international patient organizations

Episode Overview

This episode features a candid panel discussion recorded live at COG UK. Senior clinical operations leaders from industry, biotech, NHS, and patient advocacy discuss the evolving landscape of clinical research in the UK, with direct implications for clinical trial outsourcing, CRO selection, and study delivery optimization.

The panel explores why, despite a growing number of clinical trials, recruitment rates are falling and UK sites are receiving lower enrollment allocations. Experts dissect how conservative site targets, performance metrics, and resource constraints are impacting site selection decisions and sponsor strategies - a topic critical for clinical operations, outsourcing, and vendor management professionals handling global studies.

Key areas include how to build more resilient and accountable sponsor–site partnerships, approaches to decentralizing trial delivery, tailoring CRO selection and outsourcing models to increase reliability, and deploying operational best practices that enable faster site activation, improved patient recruitment, and consistent protocol delivery. Patient advocacy and the unique role of NHS/industry collaboration also feature prominently, offering perspectives on how to bridge structural gaps and better utilize the UK’s world-class data sets and patient diversity for clinical study optimization.

Key Moments

• 00:02 – UK clinical trial landscape: why are trial numbers up while patient recruitment falls?
• 00:04 – How conservative site targets and accountability metrics created a downward cycle in UK site enrollment
• 00:06 – Industry and NHS perspectives: site reliability, consistency, and the barriers to delivering clinical trial outsourcing at scale
• 00:09 – Site activation delays, site resourcing challenges, and why “winner” sites dominate CRO selection
• 00:12 – The role of site resources: how local limitations shape CRO/vendor selection and operational risk
• 00:14 – Linking UK’s data resources to clinical operations: innovative models and the potential for pre-screened “virtual waiting rooms”
• 00:15 – Cross-department bottlenecks in the NHS: pharmacy, imaging, IT, and their impact on sponsor/outsourcing models
• 00:20 – Accountability frameworks: how stronger governance and direct engagement are reshaping site and sponsor performance
• 00:25 – Public vs. private sites: operational differences, business-model thinking, and implications for clinical trial outsourcing strategy
• 00:34 – Phase 2/3 trial expansion and later-phase access, but persistent resource and recruitment hurdles
• 00:37 – Global benchmarking: incentives in Germany, site performance metrics (e.g. CRDCs), and lessons for UK outsourcing

Top 3 Takeaways

1. Site Selection and CRO Selection Must Go Beyond Track Record:
2. Both industry and patient advocates agree, defaulting to the same high-recruiting “winner” sites creates systemic access barriers. Effective clinical trial outsourcing requires nuanced CRO selection and site engagement to widen participation while balancing quality and speed.
3. Operational Resource Gaps Drive Underperformance:
4. Resource and cross-functional support deficits (in pharmacy, imaging, IT) are major blockers to timely site activation and successful outsourcing outcomes. Top-performing sites, public or private, function with strong business-like governance and clear lines of accountability.
5. Collaboration and Accountability Are Key to Clinical Study Optimization:
6. Breakthroughs in UK delivery now hinge on true partnership: flexible, site-by-site support models; integrated data utilization; transparent performance measures; and shared responsibility among sponsor, site, and CRO. This is the path to accelerated timelines and sustainable clinical operations best practices.

Links & Resources

• The PBC Group – Clinical Outsourcing & COG Event Series
• ABPI: UK Clinical Research Reports
• NIHR: Clinical Research Delivery Initiatives
• Health Data Research UK
• Novartis
• EyeBio
• Paddington Life Sciences
• Purespring Therapeutics
• Biogen

Quotes

“Conservative site targets and performance metrics have led to sponsors giving UK sites much smaller allocations—the more conservative we are, the less opportunity we get.”

— Sarah Dealey

“We go to the same sites because they have the expertise and resources, but to unlock UK potential, industry must think outside the box—linking rich data assets to new trial delivery models.”

— Fiona Shields

“Sites that succeed act like a business: clear accountability, strong timelines, and a customer-focused approach. That’s true globally, not just in the UK.”

— Divya Chadha Manek

“To make trials truly accessible, we must involve patient advocates deeply—from trial design to targeted outreach—ensuring protocols and trial models fit real patient needs.”

— Janette Rawlinson

“Accountability and true partnership are what will raise UK performance. Sites and industry must align, with clear expectations and shared responsibility for outcomes.”

— Suki Balendra

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