Professor Barry McCormick explores a novel approach to improving quality. He argues that pathway peer review offers a high-quality and complementary addition to the market regulation of the NHS. It utilises the benefits of professional insight and self-regulation in what is argued to be a cost-effective way.

At the Health Foundation, the drive to find new ways of doing things that will improve the delivery of healthcare is central to our work. We are interested in solutions that have the potential to make lasting and widespread improvement to health services. Many of these emphasise the importance of internal motivators (for example, professionalism, organisational development and leadership), alongside external ones (for example, regulation, economic incentives and performance management).

Health Foundation thought papers present the authors' own views. We would like to thank Professor McCormick for his work, which we hope will stimulate ideas, reflection and discussion.

A research report, entitled ‘Quality of NHS care and external pathway peer review’, accompanies this paper. Available from: