Pan-European collaboration is important for many clinical trials and essential for trials that are investigating treatments for rare diseases. That was the message delivered today by the European Medical Research Councils (EMRC), the membership organisation for medical research councils across Europe based at the European Science Foundation (ESF) in Strasbourg, which is coordinating two trials in rare diseases and about to launch a review of how best to implement clinical trials that are initiated by investigators. This ‘forward look’, will draw upon the experiences of the two trials that are underway.