The UK’s MHRA warned that inadequate electronic health record (eHR) systems are undermining clinical trial feasibility in the NHS, potentially leading to site rejection during sponsor site selection. The regulator said noncompliant systems tied to Good Clinical Practice requirements can also cause failures in marketing authorization applications or publications if trial data cannot be reconstructed. The guidance clarifies requirements for eHR development and implementation, including audit trails and the ability for investigators to demonstrate medical oversight when eHR systems are used in trials. The warning lands as sponsors increasingly demand compliant data capture and traceability, especially for decentralized or hybrid trial models where digital records become the backbone of protocol adherence and data audit trails. For biotech organizations and CRO partners, the MHRA note raises operational stakes: eHR readiness could become a gating factor for UK patient recruitment and for maintaining UK competitiveness in clinical research.