A role for independent peer review: reflections on the gateway review process

Healthcare organisations face constant pressure to change in order to pursue quality and performance improvements. As a result, professionals are often said to be experiencing change fatigue. This can be problematic for policy implementation initiatives. This paper reflects on an informal Gateway Review of Leicester, Leicestershire and Rutland's Integrated Point of Access Programme to make the case for independent peer review of healthcare management change programmes in order to work towards reducing change fatigue and its impacts. Peer review has been identified as an effective but underused process across health and social care provision and management. With this in mind, the Gateway Review outlined here is used to exemplify some of the practical benefits and challenges of external peer review. Based on this experience, a number of learning points and recommendations are outlined for those undertaking or thinking about undertaking peer review in healthcare management.