By Clive Collett, Head of Policy and Engagement
When we launched the Make it Public strategy in 2020, our vision was that trusted information from health and social care research studies is publicly available for the benefit of all.
The strategy covers the whole UK. We lead it with our partners in Scotland, Wales and Northern Ireland, and work with others across the research system to make research transparency the norm.
Since then, the proportion of clinical trials registered publicly has reached its highest level (94% of clinical trials that received ethics approval in 2024) since we started measuring it.
But there is still work to do if we are to fully realise our vision.
We have learned a lot about where change is harder, what needs more attention, and how we can make transparency more useful for the people it is meant to serve.
We are now reviewing and refreshing the strategy, drawing on that learning and on the views of people who do research, take part in it or use its results.
This blog looks at progress since the strategy was launched, what we have learned and the five priorities that will guide the refresh. We will share opportunities to contribute as the work develops.
What has improved
One of the biggest changes has been in clinical trial registration. When Make it Public began, getting trials registered on a public registry, a website that lists clinical trials, was one of the main challenges we wanted to address.
Registering a trial before it starts lets anyone see what is planned, what question the trial is trying to answer and who is responsible for it.
It also creates the public record where the results should later appear and lets people check that the trial reported what it said it would measure.
That helps avoid waste. If studies are hidden, researchers may repeat work that is already happening, and people may be asked to take part in research that does not add new knowledge.
Of the 1,346 clinical trials that received ethics approval in 2024, 94% have given us a registration number and another 2% are in the process of registering. For trials of medicines, the figure is 98%. These figures tell us whether a trial is registered, but not whether it was registered before the first participant joined, which is when registration matters most.
Since January 2022, when a trial of a medicine applies for approval, we pass details from the application to the UK-based ISRCTN registry to start registering it. This saves researchers entering the same information twice. But the sponsor, the organisation responsible for the trial, such as a drug company, university or NHS trust, must still check and complete the record.
Since 28 April 2026, the law has required sponsors of trials of medicines to register their trial before the first participant joins, or within 90 days of approval if that is sooner. Within 12 months of the trial ending, they must also publish a summary of the results on the registry and offer participants a summary written in plain language. The Medicines and Healthcare products Regulatory Agency (MHRA) can take enforcement action, up to and including prosecution, if a sponsor does not register a trial or publish its results.
Sponsors can ask to delay publication, for example to protect commercially sensitive information.
Other clinical trials, such as studies testing medical devices, surgical procedures or other healthcare interventions, must also be registered as a condition of ethics approval. Since April, we have asked their sponsors to follow the same timings. But these are UK-wide policy expectations, not legal duties. Registration can also be harder for these trials because established registries do not accommodate them in the same way as trials of medicines. For research that is not a clinical trial, we encourage the same transparent practices but do not require registration with an established public registry.
Where we need to keep improving
Registration is an important first step, but it is not the whole story. People also need to know what a study found.
This year we published data on the percentage of studies sharing a summary of their results for the first time.
Of the clinical trials that ended in 2023, 32% told us they had published a summary of their results on a public registry within 12 months. 44% told us they had not. We do not know about the other 24%, because their sponsors did not send us a final report that we ask for at the end of a study.
The picture for participants is similar.
52% told us they had shared, or were sharing, the results with the people who took part. 24% told us they had not, and for the other 24% we do not know.
These trials ended before the new law came in, so the figures show how well sponsors met our expectations rather than the law.
The new legal requirements include deadlines for publishing trial results, and we will report on compliance with these requirements going forward.
We know this matters to patients, participants and the public. Sharing findings is one way of recognising the important contribution people make to research and it helps reduce research waste.
That is why reporting results, and telling participants what a study found, will be at the centre of the new Make it Public strategy.
Looking across all health and social care research
Make it Public was intended to support transparency across all health and social care research, not only clinical trials.
Progress has been strongest for trials, where the requirements are clearer and the systems better support them. Each year, Research Ethics Committees also review around 2,500 studies that are not clinical trials, such as surveys, interviews and studies using health records or tissue samples. We know much less about whether their findings are made public.
Some of the tools are already in place. When a study reviewed by a Research Ethics Committee ends, the sponsor should send us a final report, including a plain language summary of the findings, which we publish on our research summaries webpage.
There is room for improvement. Nearly a quarter of final reports for clinical trials are still missing, and we do not yet have the same clear picture for research that is not a clinical trial. The new strategy will consider how we can improve reporting and what would help researchers share findings in ways that people can use.
The way people create, share and find information is also changing. Artificial intelligence and other digital technologies may make research information easier to produce and access, but they also raise questions about accuracy, trust and how people find reliable sources. The new strategy will consider what useful and trustworthy research transparency should look like in this changing context.
What we have learned about making change happen
What we said in 2020 and where we are now
What we said we would do: Register clinical trials on sponsors’ behalf
Status: Partly done
Where we are now: In place for trials of medicines since 2022. Sponsors of other trials still register them themselves.
What we said we would do: Make sure all clinical trials are registered
Status: Partly done
Where we are now: 94% of clinical trials approved in 2024 told us they are registered or registering, rising to 98% for trials of medicines. (We do not know whether every trial was registered within 6 weeks of the first participant joining, which was the condition that applied to these trials.)
What we said we would do: Measure transparency through a standard final report
Status: Done
Where we are now: In place since 2021, but we did not receive one for 24% of trials that ended in 2023.
What we said we would do: Remind researchers and sponsors when reporting is due
Status: Partly done
Where we are now: Our teams follow up overdue registrations and final reports, which raised final report returns for 2023 trials from 68% to 76%. Prompts for publishing results are planned for our new online service.
What we said we would do: Get more trial results published
Status: Not yet
Where we are now: 32% of trials that ended in 2023 told us they had published a summary of results on a registry.
What we said we would do: Make sure participants are told what studies found
Status: Partly done
Where we are now: 52% of trials that ended in 2023 told us they had shared, or were sharing, results with participants.
What we said we would do: Publish how sponsors perform and highlight poor performance
Status: Partly done
Where we are now: We have published lists of unregistered trials each year since 2024, and results data for the first time in 2026. A list of sponsors who have not reported results, or not told us, is due in 2027.
What we said we would do: Take account of a sponsor’s record when reviewing new studies
Status: Not yet
Where we are now: We have achieved this outcome for trials of new medicines by working with MHRA to update the law to use their existing inspection mechanism to achieve this. This approach is not an option for other types of research that we review. Further work is needed to better understand how we could do this effectively.
The new strategy is a chance to take stock of progress, test whether the objectives set in 2020 are still the right ones and decide where change is most needed.
A clear lesson from the last 6 years is that change is easier when it is built into existing systems and processes.
Registration is highest for trials of medicines, where it is built into the application system. Registration of other trials has also risen without that help. Our experience suggests that following up with sponsors and publishing compliance data, including lists of trials that are not registered, can improve performance. We will apply the same approach to results reporting, including publishing which sponsors have not reported results or told us whether they have.
As we build the new online system researchers will use to apply for and manage their studies, we want to make reporting results easier, including prompts when results are due on a registry.
We can make progress easier to sustain by reducing the burden on researchers and making transparency the easy thing to do. But making it easy is not enough on its own. Clear rules, and being open about who is not following them, matter too.
Next year, alongside our data on trials that ended in 2024, we will publish for the first time a list of sponsors who have not reported their results or have not told us whether they have.
For trials of medicines, the law now allows the MHRA to take a sponsor’s record into account. For other types of research, we will use the strategy refresh to hear different perspectives and decide whether any further action is needed and, if so, what approach would be proportionate and effective.
What comes next
Working with our standing Make it Public group made up of a diverse range of members from across government, charity, life sciences sectors, public contributors and academics, we have set out 5 priorities that will guide our review of the Make it Public strategy.
We will test them with researchers, sponsors, patients, participants, the public and our partners across the UK:
- getting more trials registered and their results reported – including whether publishing data on who is meeting expectations is enough, and what should happen when sponsors do not
- making it easier to be open – using our new online service, plan and manage health and care research, and working with the ISRCTN registry and funders so researchers are asked for the same information fewer times
- extending transparency beyond clinical trials – including whether the summaries we publish of each study reviewed by a Research Ethics Committee could act as a public record for studies that are not trials
- making information useful – understanding what participants, the public, researchers and funders each need from research information
- our role in sharing data and tissue – looking again at our 2020 decision to leave this to others, and deciding whether we should lead, co-ordinate or point people elsewhere
We will use what we hear to test whether the objectives set in 2020 are still right, where they need to change and which actions should come first. We plan to publish the new strategy in spring 2027.
We will share more about the refresh as the work develops. Please subscribe to our newsletters and look out for opportunities to contribute your views.