From Competition to Collaboration
To deliver more commercial clinical trials in the UK, maybe the answer isn’t more competition — it’s more collaboration.
Primary care has already shown that working at scale — through PCNs, federations and partnerships — delivers consistency and resilience.
So why not apply the same idea to research?
Imagine a provider collaborative with a central team managing setup, contracting, data sharing and oversight across multiple practices. A Joint Venture Agreement (JVA) could formalise this, avoiding the need for separate companies — and the VAT and governance headaches that come with them. The central team would handle governance, budgeting and monitoring, while local practice teams deliver patient-facing work. Funding could be pooled and shared fairly — rewarding engagement, delivery and reach, not just whoever gets picked for a single study.
Everyone takes a smaller slice of a much bigger pie.
We’ve already seen this work in practice. During COVID, many practices seconded staff to central vaccination centres — matching capacity to need and being paid fairly for it. Why not the same for research?
Great work is already under way to link databases, speed up contracting and improve feasibility — and that’s hugely positive. But this goes a step further: beyond data and process, toward a new delivery model combining shared workforce, governance and funding — making research part of routine general practice rather than an occasional add-on.
Superhubs, local hubs and mobile teams could deliver studies flexibly — including remote and telephone activity — making trials faster and more inclusive. Working at scale also helps reach under-doctored areas and reduce inequalities. Patients stay within the NHS research family, building trust and participation. And the preparation work — coding, pre-screening, data checks — improves data quality for all patients.
Of course, this won’t happen overnight. It will need:
• clear data-sharing agreements
• workforce planning and flexible research roles
• a live capacity & capability matrix
• strong governance and digital integration
• new funding and contracting models
• and, above all, cultural alignment — seeing research as our network’s work, not my practice’s study.
Six big areas to focus on next:
1️⃣ Workforce & Skills – shared teams, training and defined research roles.
2️⃣ Data & Digital Readiness – interoperable systems and clear governance.
3️⃣ AI & Automation – tools to identify participants, track data and reduce admin.
4️⃣ IMP & Logistics – flexible ways to handle medication and monitoring.
5️⃣ Contracting & Governance – shared templates, faster processes, consistent quality.
6️⃣ Network Models – federations and superhubs that deliver at scale, fairly and efficiently.
If we can align incentives, share infrastructure and build trust, UK general practice could become the best place in the world to deliver commercial clinical research — efficient for sponsors, rewarding for practices, and good for patients.