Turning the NHS App into a Research Engine

The UK government has announced an ambitious plan to make clinical trials more accessible by using the NHS app to match patients in England to research studies. If successful, this could mark a long-overdue revival of Britain’s clinical trial ecosystem — a system that, despite moments of brilliance like the RECOVERY trial during Covid-19, has struggled in recent years to maintain global leadership.

It’s a smart concept. In theory, millions of patients could be matched with trials relevant to their conditions and interests, notified via smartphone, and signed up with minimal friction. It’s simple, scalable, and speaks to a public already shown to be willing to support medical progress, as seen during the Covid-19 vaccine rollout. But a digital solution alone won’t be enough.

The challenge isn’t just building the tech. It’s earning public trust, embedding equity in recruitment, and — most critically — ensuring the NHS has the operational capacity to deliver what’s promised.

From Digital Potential to Real-World Impact

The proposed expansion of the NIHR’s Be Part of Research service through the NHS app signals that ministers want to move the UK’s trial infrastructure from paper-heavy and bureaucratic to dynamic, responsive, and patient-centric – a shift that also echoes broader calls for digital reform across the NHS.

This is long overdue. According to the Association of the British Pharmaceutical Industry, the UK saw a 27% drop in the number of patients entering clinical trials between 2018 and 2023. New industry-sponsored trials fell by 38%. While global life sciences are accelerating, Britain has been falling behind.

Ministers hope that a tech-enabled recruitment model will reverse this trend. And the centralised nature of the NHS does give the UK an edge over insurance-based systems. But history suggests the main obstacle isn’t infrastructure — it’s execution.

Trust, Inclusion, and Consent

Success will depend on trust. Automatically matching patients to trials based on health records and pushing notifications to their phones must be done with complete transparency and watertight data safeguards. Patients must feel informed and in control. However beneficial a study may be, perceived intrusion into personal data could backfire.

Equity is another challenge. Black and South Asian communities, young people, and lower-income groups remain underrepresented in clinical research. That’s not just a diversity gap — it’s a scientific flaw. The NHS app must go beyond passive alerts. It needs to actively engage underserved populations and reduce barriers to participation.

Ministers say NHS-led trials won’t offer compensation, but many commercial studies do. If the government wants to widen access, it must address the financial hurdles that prevent low-income patients from taking part.

Naming, Shaming, and Funding: A Risky Lever

The strategy includes publicly naming NHS trusts that underperform on research targets, while rewarding high achievers with funding. While this could foster accountability, it risks punishing already stretched providers that struggle due to systemic pressures — not apathy.

Performance data must be contextualised. If published bluntly, it could demoralise staff and distort priorities. We need collective solutions, not crude league tables.

Streamlining Trials — Without Sacrificing Oversight

At present, it takes 250 days to set up a clinical trial in the NHS, compared to 100 in Spain. Ministers want to reduce this to 150 days by March 2026. That’s a welcome step — fewer delays mean quicker access to innovations and a more attractive environment for investment.

But the process must not compromise on ethical review, safety, or public engagement. Bureaucracy can be burdensome, but much of it exists for good reason. The answer isn’t to cut corners, but to design smarter systems that preserve trust while eliminating waste.

A Chance to Lead Again

Health Secretary Wes Streeting says the UK should lead the next era of life sciences. It’s a bold aspiration — and not unrealistic. The UK has world-class universities, a single-payer health system, and a track record of major medical breakthroughs. But it also faces major headwinds: overstretched staff, underfunded research infrastructure, and persistent public scepticism around data privacy.

The NHS app offers a practical opportunity to connect citizens directly to the future of medicine. But it must be rolled out ethically, inclusively, and with meaningful safeguards. Technology creates potential; whether that potential translates into real progress depends on how the system supports it.