COG UK 2026 Meeting Review

The Clinical Outsourcing Group returned to London for COG UK 2026, bringing together circa 300 senior clinical research professionals for two days of strategic discussion, regulatory insight, and peer exchange. Chaired throughout by Sverre Bengtsson (CEO, Digital Trial Solutions), the event addressed the central question facing UK clinical research: how to convert a moment of genuine geopolitical and regulatory opportunity into lasting competitive advantage.

Strategic Foundations and Operational Excellence

The conference opened with a keynote panel examining the UK's position as a clinical research destination at a moment when shifting US administration policies are prompting international sponsors to reassess their trial placement strategies. Fiona Shields (Head of UK Clinical Operations, Novartis) and Divya Chadha Manek (Director, Clinical Operations, EyeBio) brought complementary perspectives on how sponsors are weighing the UK's post-Brexit regulatory environment against longstanding concerns around approval timelines and NHS capacity. Suki Balendra (Director, Strategic Partnerships, Imperial College Healthcare NHS Trust), Lucy Clossick Thomson (Head of Clinical Operations, Purespring Therapeutics), and Sarah Deeley (Director, Country & Site Operations, Biogen) explored the operational realities of UK trial delivery, while Janette Rawlinson (Patient Advocate/Consultant) anchored the discussion in the patient experience — reminding delegates that competitiveness ultimately rests on the ability to recruit and retain willing participants.

Adeyemi Adeyi (Director, Medical Monitoring, Aixial Group) followed with a keynote introducing the "One Team, One Study" operating model, positioning CROs as fully integrated extensions of sponsor organisations rather than downstream service providers. His framework for aligned goal-setting, shared governance, and transparent communication resonated with attendees who described persistent challenges breaking down organisational silos across the clinical trial lifecycle.

Karolin Kroese (ECMC Programme Lead, Cancer Research UK) and Neil Bhattacharjee (ECMC Project Manager, Cancer Research UK) then examined how strategic infrastructure across NHS trusts, academic centres, and national research networks is beginning to address equitable access to early phase trials. Their presentation on trial identification databases and multi-site referral pathways demonstrated how coordinated approaches can simultaneously improve recruitment efficiency and demographic representation.

Milena Kanova-Petrova (SVP & Global Head, General Medicine, Premier Research) closed the morning with a compelling argument for grounding global trial strategy in site-level reality. Drawing on multinational programme experience, she demonstrated how misalignment between strategic intent and site-level execution remains one of the most predictable and underappreciated sources of trial delay — and how sponsor and CRO roles can be better aligned to reduce complexity at scale.

Partnership Strategy

The late morning brought together a panel of clinical operations leaders from emerging biopharma companies to share candid experiences of vendor selection when teams are lean and investor scrutiny is intense. Chaired by Nara Daubeney (CEO, Phaim Pharma), the discussion featured Graeme Duncan (Head of Clinical Development, Neurocentrx), Claire Herholdt (VP Clinical Operations, Levicept), Bradley Norton (VP Clinical Operations, Gylden Pharma), Sarah Whalley (Director, Clinical Operations, U-Ploid Biotechnologies), Deirdre Flaherty (VP Product Strategy & Clinical Operations, Alchemab Therapeutics), and Julia Vassiliadou (VP Clinical Operations, F2G). Cultural fit, communication responsiveness, and the capacity to scale alongside company growth emerged as criteria valued as highly as technical capability, generating lively audience debate about how smaller organisations can negotiate effectively with larger CROs.

Jamie Cole (Director, Sales, Optum) demonstrated how closer collaboration with primary care — supported by comprehensive GP data through Optum's Recruit solution — can address pressures across the full trial lifecycle. Moving from protocol design through to retention, Jamie showed how coded primary care data enables targeted cohort engagement at scale, strengthens viability assessments, and reduces administrative burden for sites operating within NHS infrastructure.

Suki Balendra (Director, Strategic Partnerships, Imperial College Healthcare NHS Trust) returned to the stage to address diversity with greater specificity, examining how NHS partnerships — designed as genuine strategic collaborations rather than transactional site relationships — can address the structural barriers that have historically prevented equitable representation. Her session challenged the room to reframe diversity from a compliance obligation to a scientific and commercial imperative.

Vendor Selection and Site Strategy

A panel chaired by Antonella Chiucchiuini (Director, Fair Market Value Lead, Takeda) tackled one of the most persistent sources of friction in clinical trial delivery: misalignment between what sites believe their contributions are worth and what sponsors and CROs are prepared to pay. Jay Panchmatia (Industry Consultant, Global Site Contracts, Budgets & Payments) drew on decades of experience at GlaxoSmithKline and TFS HealthScience to offer a frank assessment of where current practices fail all parties. Rachel Wodarski (R&I Business Manager, The Christie NHS Foundation Trust) provided the NHS site perspective on standardised benchmarks that rarely reflect true delivery costs, while Vivek Talwar (Senior Manager, Product Management, Medidata) demonstrated how technology platforms can support greater transparency across the negotiation table.

Ben Dudley (Chief Commercial Officer, MMS) explored three technology use cases reshaping trial planning and execution — data-driven modelling tools that optimise trial design, real-time analytics enabling dynamic decision-making, and AI applications transforming workflows and forecasting. Notably, Ben resisted overselling, acknowledging that the value of each depends heavily on implementation discipline and organisational readiness.

Kate Greenwood (Senior Improvement Delivery Manager, HRA) provided a timely update on the HRA's work to streamline study set-up as part of the UK Clinical Research Delivery Programme, outlining initiatives designed to standardise procedures, improve timeline predictability, and reduce administrative burden for sponsors navigating NHS site activation. Audience questions probed the gap between policy ambition and operational reality with considerable energy.

International and Partnership Strategy

Day One concluded with three sessions that broadened the geographic and therapeutic lens. Joab Williamson (VP Operations, Faron Pharmaceuticals) brought rigorous analytical thinking to the problem of repeated failures in challenging indications, presenting a structured "pre-mortem" methodology drawn from historical HR-MDS trial analysis conducted with Yale. His framework for systematically identifying predictable risks before study initiation offered a practically minded approach applicable well beyond oncology.

Hans-Jürgen Gruss (CMO, Kadence Bio) delivered one of the day's most candid presentations — an unvarnished account of conducting Australian trials from UK headquarters. While acknowledging the genuine appeal of R&D tax incentives and streamlined ethics approvals, Hans-Jürgen detailed the structural challenges that standard narratives omit: incompatible time zone governance, Australian-specific compliance requirements, and intellectual property complexities that frequently necessitate the creation of Australian legal entities. For delegates actively evaluating international expansion, the session served as a vital counterpoint to prevailing promotional discourse.

Day One closed with a rare disease panel chaired by Emma Kinloch (CEO, Salivary Gland Cancer UK), examining strategies for generating high-quality patient data across small, geographically dispersed populations. Rebecca Cosgriff (Scientific Director, Data Partnerships & Portfolio Strategy, LifeArc), Professor Palak Trivedi (University of Birmingham), and Andy Thurstan (Senior Director, Patient Services, Wave Life Sciences) explored how natural history studies, NHS registries, and patient organisation networks can be leveraged to build datasets that support trial design and regulatory interactions — a prerequisite for attracting sponsors to indications where commercial incentives are often limited.

Financial and Clinical Strategy

Day Two opened with a C-suite panel providing a frank assessment of the UK biotechnology investment landscape, chaired by Sverre Bengtsson (CEO, Digital Trial Solutions). CEOs from across the UK biopharma sector — Neil Murray (ReNewVax), Nataly Hastings (Cellestial Health), Sam Windsor (Ignota Labs), David Brennan (Aurum Biosciences), Yvanne Enever (PHARMExcel), Ryan Geiser (Axiom Therapeutics), and Ross Breckenridge (Arjuna Therapeutics) — shared candid experiences navigating a markedly more risk-averse capital market. The panel examined how investor sentiment varies across therapeutic areas and development stages, and explored innovative financing structures including milestone-driven funding and strategic collaborations.

Liam Spencer (Senior Regulatory Project Manager, Lumis International) examined how regulatory scientific advice can improve outcomes in a development landscape where clinical trials account for 60-70% of R&D costs and carry a 90% attrition rate. Drawing on personal case experience, Liam outlined the types, benefits, and risks associated with seeking scientific advice at different stages, and explored how early regulatory engagement can clarify expectations, resolve design uncertainties, and ultimately strengthen the pathway to market authorisation.

Joseph Milne (Director, Clinical Research, Scottish Brain Sciences) provided a comprehensive account of what distinguishes Alzheimer's trials from other therapeutic areas — complex diagnostic criteria, heterogeneous disease progression, informed consent challenges with cognitively impaired participants, and substantial caregiver burden. His exploration of how sponsors can identify and cultivate relationships with experienced principal investigators offered practical guidance for clinical operations teams working in neurodegenerative disease.

Jay Panchmatia returned for a dedicated solo presentation on clinical trial site budgeting and payments, sharing 20 years of hands-on experience from GlaxoSmithKline and TFS HealthScience. His practical walkthrough of country-specific budget template design, alignment of internal cost structures with market expectations, and the role of Medidata Grants Manager as a platform for managing global study budgets provided actionable implementation guidance rather than abstract principles.

Regulatory Updates and Legal Strategy

Kingyin Lee (Head of Clinical Trials, MHRA) delivered the morning's most anticipated presentation, providing an authoritative update on the MHRA's modernisation agenda. Outlining current and forthcoming regulatory enhancements — including AI deployment to support assessment, new approaches to novel trial designs, and streamlined review processes — Kingyin offered important context for organisations planning UK clinical development programmes. Questions from the floor probed the pace of change and the practical experience of sponsors navigating the evolving framework.

Myrthe Trompert (CEO, Salvius Legal) and Fiona Malaj (Legal Consultant, Salvius Legal) addressed the contractual architecture underpinning clinical trial relationships, sharing key insights into how sponsors can position themselves through planning, negotiation, and contract execution to reduce costs, gain leverage, and protect against overruns. Real case studies illustrated the practical stakes when contracts are inadequately prepared, while a discussion of GDPR and AI governance in clinical trial contracting gave delegates a forward-looking perspective on emerging legal challenges.

Mastering Bid Defence

Diane Chisholm (Head of Global Clinical Operations, Owkin) opened the afternoon with a keynote challenging the conventional framing of bid defence as reactive damage control, arguing instead for proactive frameworks that transform competitive challenges into opportunities to demonstrate enhanced value and strengthen relationships. Diane then led an interactive panel with Daizy Moumi (Associate Director, Clinical Operations, Complement Therapeutics), in which both speakers shared candid case studies from sponsor and vendor perspectives. The session generated the highest levels of audience participation of the conference, suggesting that bid defence remains an area where the gap between best practice and common practice is both significant and costly.

Technology and Regulatory Strategy

Duncan Hall (CEO, TRI) addressed the inconsistent application of Risk-Based Quality Management to early phase studies — arguably the area where it matters most, yet where reliance on manual processes remains most prevalent. His roadmap for implementing flexible, structured monitoring frameworks that improve visibility, drive efficiency, and enable better decision-making across diverse study designs gave attendees practical next steps rather than theoretical frameworks.

Mireille Lovejoy (Director, Clinical Risk Management & Process Excellence, GE Healthcare) provided step-by-step guidance for smaller biopharma companies navigating the enhanced sponsor oversight requirements of ICH E6(R3). Her cost-effective strategies for gap analysis, SOP updates, and risk-based quality monitoring — designed for organisations without extensive regulatory infrastructure — addressed a genuinely pressing need, as evident audience engagement confirmed.

The conference closed with a panel examining AI in clinical research with the sceptical rigour the topic demands. Karthik Maddi (Global Associate Director, Clinical Development, Pharmanovia) and Shikta Das (Scientific Lead Real World Evidence, Oncology, AstraZeneca) moved beyond generalities to examine specific, validated implementations: automated data cleaning, predictive recruitment models, and signal detection systems. Their distinction between augmented intelligence supporting human decisions and AI operating more independently provided a conceptual framework that helped clarify the regulatory acceptance landscape — and grounded a conversation that, at other conferences, can easily drift toward the speculative.

Key Takeaways

COG UK 2026 demonstrated that the UK clinical research community is navigating a moment of genuine strategic opportunity — one that requires deliberate action rather than passive optimism. Several themes emerged consistently across presentations:

• The UK's moment — but the window may be finite. Geopolitical shifts and a changing US regulatory environment are redirecting sponsor attention toward the UK. Capitalising requires coordinated action across regulators, NHS infrastructure, and the commercial sector.

• Integration over transaction. From the "One Team, One Study" model to the vendor selection panels, the conference reinforced a clear directional shift toward genuine collaboration across organisational boundaries as the differentiator in the current environment.

• Regulatory modernisation is real, but communication must improve. The MHRA and HRA presentations were well-received, yet audience questions revealed a persistent gap between the narrative of improvement and the lived experience of sponsors and sites in the field.

• AI is maturing, but unevenly. Validated AI applications are delivering measurable benefits, yet adoption remains highly inconsistent. Regulatory acceptance, data quality, and change management were identified as the primary constraints on broader deployment.

• Diversity requires structural solutions. Representation cannot be achieved through recruitment incentives alone — equity must be embedded in trial design, site selection, and partnership models from the earliest stages of development.

• Financial models must evolve. From site payments to biopharma funding structures, the economics of clinical research are not sustainably aligned with programme ambition. The field continues to search for models that reward quality and genuine partnership over lowest cost.

COG UK 2026 welcomed a senior and highly engaged audience of C-suite leaders, VPs, Directors, and senior management spanning emerging and established biopharma, NHS research delivery, academic medicine, and the full spectrum of clinical development service providers.

COG UK brings together leaders from across the UK and international clinical research ecosystem to advance operational excellence and strategic innovation in clinical trial delivery.

Find out more: www.thepbcgroup.com/cog-uk