The paper first defines integrated care pathways (ICPs) and demonstrates the important role for ICPs revealed by the NHS ‘Information for Health’ (IfH) strategy and related documents. Following a review of the main features of ICPs, the paper continues by considering their status in the UK and how their profile is raised by the IfH document. This discussion explores the relationship of ICPs to electronic patient records, seamless care, and the quality initiatives raised by the organizational changes broadcast in the White Paper, ‘The New NHS’. The paper then summarizes the main reasons for the limited uptake of ICPs and suggests that the clinical and cultural barriers could be more readily overcome if the production of electronic, computerized ICPs were more facile. It concludes by advancing a simple model for electronic ICP production and offers a hierarchical approach to incremental design and development.
References
1.
Department of Health. ‘The New NHS: modern, dependable’. Cm 3807. London: HMSO, 1997.
2.
Department of Health. ‘Our healthier nation’. Cm 3854. London: HMSO, 1998.
3.
NHS Executive. ‘A first-class service’. Wetherby: Department of Health Publications, 1998.
4.
NHS Executive. ‘In the public interest’. Wetherby: Department of Health Publications, 1998.
5.
Norris AC. Care pathways and the new NHS. Journal of Integrated Care1998; 2: 78-83.
6.
Johnson S (ed.). Pathways of care. Oxford: Blackwell, 1997.
7.
Department of Health. ‘Promoting clinical effectiveness; a framework for action in and through the NHS’. London: HMSO, 1996.
8.
NHS Executive. ‘Information for health’. Wetherby: Department of Health Publications, 1998.
9.
Bridge G, Norris AC. Care pathways and their relationship with UK healthcare strategy. European Health Managers Conference, Dublin, June 1998.
10.
Bridge GE, Care pathways in the quality management of healthcare. MSc thesis, University of Southampton, 1997.
11.
Bridge GE, Norris AC, Melhuish PJ. Care pathways in the quality management of UK healthcare. Proceedings of the second APAMI/Fifth HIC97 Conference on Health and Medical Informatics, Sydney, August, 1997; Paper 113: 1-9.
12.
NHS Executive. Modernising health and social services: National priority guidelines 1999/00-2001/02. Wetherby: Department of Health Publications, 1998.
13.
Department of Health. A policy framework for commissioning cancer services: expert advisory group on cancer to the chief medical officers of England and Wales (the Calman-Hine Report). London: HMSO, 1995.
14.
Tingle J.Clinical guidelines and the law. In Johnson S (ed.), Pathways of care, chapter 12. Oxford: Blackwell, 1997.
15.
Favor G and Ricks R.Automation of Pathways. In Johnson S (ed.). Pathways of care, chapter 15. Oxford: Blackwell, 1997.
