Research governance in England needs improvements to ensure participant and site confidentiality in healthcare workforce research.

Sensitive healthcare workforce research relies on credible assurances of confidentiality for participating staff and organizations. Yet, National Health Service (NHS) research governance processes can compromise these assurances even before recruitment begins, particularly through processes such as site documentation, local principal investigator (PI) requirements, research passports, and portfolio reporting. These risks are especially important for studies examining organizationally sensitive topics such as bullying, speaking up, or patient safety issues, where perceived employer awareness may reduce participation or encourage self-censorship. From March 2026, the Health Research Authority introduced reforms for staff-only studies, including streamlined site set-up, reduced site visibility, and fewer requirements for local PIs or research passports in remote studies. However, further changes are needed to better balance transparency, oversight and confidentiality. Potential improvements include dedicated pathways for sensitive organizational research, restricted-access portfolio reporting, and more centralized governance documentation. Future changes should be co-designed with researchers and NHS research and development departments to protect confidentiality and improve research productivity, while maintaining ethical standards and accountability.