Care pathways: have they a place in 'the new National Health Service'?
OBJECTIVE
To discuss the use of Integrated Care Pathways (ICPs) as tools for ensuring cost-effectiveness and high quality patient-focused care. To examine how electronic pathways combining process, practice and audit might be effectively used by Primary Care Groups as a tool to integrate care within the 'New National Health Service'.


RESULTS
It has been argued that for doctors pathways lead to 'cook book medicine' and for nurses they move practice away from patient-centred care back to a disease/task-based model. This article explores the origins of pathways, addresses the concerns of critics and goes on to describe a pathway strategy.


CONCLUSIONS
Pathway development offers the potential to create a coherent plan of care and treatment (across primary/secondary care) which incorporates evidence-based practice and reduces fragmentation and duplication whilst aiding co-ordination and communication. The incorporation of clinical indicators and measurable goals ensures the audit process is embedded.
Lowe
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Chelsea and Westminster Healthcare Trust, UK.
D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration; D003362:Cost-Benefit Analysis; D019091:Critical Pathways / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D010348:Patient Care Team / Q000458:organization & administration; D018802:Patient-Centered Care / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D019984:Quality Indicators, Health Care; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom