Good research and patient access to new medicines depend on each other (in the UK and globally). Links between the routine use of medicines in the NHS and the ability of the UK to compete for medical research are growing. This is because global pharmaceutical research and development (R&D) is changing. Companies are refocusing their pipelines towards specialised and stratified medicines in order to meet the unmet needs of patients. Healthcare systems are increasingly demanding ‘real world’ evidence about the value of medicines. NHS patients need to be able to benefit from the best medicines if the UK is to be a global centre for this expanding area of clinical research.