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Clinical research sites are at a transformative juncture, facing heightened demands to deliver trials with greater speed, efficiency, and quality than ever before. As the industry embraces rapid innovation, digital transformation, and more complex protocols, pressures are intensifying at the site level, where budget constraints, funding cuts, and operational demands continue to grow. Today’s research sites must navigate a multifaceted landscape, contending with fragmented communications, persistent technology changes, and the need to recruit and retain skilled talent, among other obstacles.
In response to these mounting changes, WCG undertook our third annual comprehensive survey of hundreds of clinical research sites worldwide. The result is WCG’s 2025 Clinical Research Site Challenges Report, our yearly report which showcases the top obstacles facing sites today and offers actionable recommendations for overcoming these barriers.
Here is a sneak peek into WCG’s 2025 Clinical Research Site Challenges Report:
One of the questions we asked sites in our survey was “What are the top three issues impacting your site today?” Here are the results:
- Complexity of Clinical Trials – 35%
- Study Start-up – 31%
- Site Staffing – 30%
- Recruitment & Retention – 28%
- Long Study Initiation Timelines – 26%
- Trial Delays & Cancellations – 23%
- Sponsor-Provided Technology – 20%
- Trial Financial Management & Payments – 19%
- Physician Interest & Engagement – 19%
- Patient Access Challenges – 13%
- Site Technology – 9%
- Ethical/Regulatory Review – 7%
The complexity of clinical trials continues to be the leading challenge faced by sites, maintaining the top position from 2024 into 2025. In 2025, 35% of sites identified this as their primary challenge, compared to 38% in 2024. Some contributing factors of this persistent challenge may include increasingly complex protocol designs, a higher number of endpoints, stringent inclusion/exclusion criteria, burdensome technology requirements, and frequent protocol amendments.
Study start-up has remained a consistent top challenge for research sites, with 31% of sites citing it as a top issue in 2025, compared to 35% in 2024. Sites of all sizes continue to struggle with study start-up processes, such as coverage analysis, budgets, and contracts, as these are often the largest drivers of delays during start-up and require highly specialized skills to complete.
Site staffing continues to be a top challenge for clinical research sites, with 30% of sites identifying site staffing as one of their top concerns, a figure nearly unchanged from 31% in 2024. This trend underscores the persistent difficulties research sites face in recruiting, training, and retaining qualified personnel amid increasing trial complexity and competition for skilled staff.
Recruitment and retention continue to be major challenges for clinical research sites, with 28% of sites saying it is one of their top challenges, compared to 36% in 2024. This is an 8% improvement from 2024; however, recruitment and retention remain critical challenges for many sites, highlighting the need for more effective strategies to attract, enroll, and retain participants.
10 Recommendations for Sites to Address These Top Site Challenges:
To overcome their primary challenges, research sites must embrace a culture of resilience, innovation, and adaptability. As a driving force behind scientific progress, clinical research sites thrive when they proactively evolve to meet the demands of a changing landscape. By focusing on these critical areas, research sites can strengthen their capabilities, drive impactful results, and continue to advance clinical research to bring therapies to market that can improve and save lives:
- Focus on the Participant Journey: Prioritize an exceptional participant experience by implementing diversity, equity, and inclusion (DE&I) strategies, and harnessing data and technology to optimize recruitment, enrollment, and retention.
- Invest in Staff Training and Retention: Prioritize comprehensive staff training and implement strategies to enhance retention through ongoing educational opportunities and professional networking.
- Enhance Operational Efficiency: Streamline, document, and standardize routine workflows while actively tracking key metrics against industry benchmarks to uncover opportunities for continuous improvement.
- Build Relationships and Communicate with Purpose: Cultivate relationships and foster open, proactive communication with sponsors and contract research organizations (CROs) to help ensure better collaboration and timely response to your site’s needs.
- Leverage Technology for Success: Invest in technology systems that optimize your workflows and streamline research operations and designate an information technology liaison to oversee research-related technology systems at your site.
- Accelerate and Streamline by Strategically Outsourcing: Analyze your site’s workflows to pinpoint areas where gaps or bottlenecks exist and explore opportunities to outsource non-core functions like study start-up, study identification, and data entry to clinical services companies.
- Clearly Define Roles and Responsibilities: Clearly define and communicate the roles and responsibilities for each trial to your site staff, ensuring everyone is well-informed and equipped to work together effectively.
- Ensure Quality and Compliance: Adopt a quality management system and identify best practices to ensure regulatory requirements are met and quality metrics are evaluated.
- Engage in Strategic Partnerships: Participate in forums and conversations with sponsors, CROs, and service providers to build stronger relationships and enhance transparency about operational needs, technology solutions, and best practices.
- Think Innovatively: Innovate for the future, not from the past. Launch pilot projects to test new ideas, experiment, and discover better solutions for tomorrow.
Interested in getting deeper insights into the current landscape of clinical research sites? Visit the WCG website to get your free copy of the full 2025 Clinical Research Site Challenges Report today!
