Developing Care Pathways. The Toolkit By Kathryn de Luc. Abingdon: Radcliffe Medical Press. 2001. 43 pp. £30.00 (sold with Handbook, pb). ISBN: 1-85775-499-9

Care pathways have been developed in many areas of medicine. Such pathways can be a helpful way of ensuring that clinicians implement good practice guidelines. They can also be helpful as a way of empowering patients with the knowledge of what treatments they can expect and within what time-frame. Developing Care Pathways has been written to facilitate the development of care pathways: explaining what they are and how to go about producing one.

Unfortunately, in spite of being in two volumes — a handbook and a toolkit — what has been produced is a simplistic account of care pathways, long on the obvious and short on how to overcome any difficulties. The book was disappointing in two main aspects. First, there was insufficient material provided as to the evidence that care pathways actually improve the process of care. It would have been useful to have evidence both for and against the use of such pathways rather than simply seeing them as a good thing. Second, it would have been useful to have had much more information about problems that exist in implementing pathways. For example, how does one overcome clinician resistance? Is the extra paperwork that will almost inevitably be involved be justified by the result? Are care pathways completed accurately by staff? Are deficiencies in care highlighted by care pathways remedied to bring about improved patient results?

Although this book may be useful for someone who knows nothing about care pathways as an introduction to the concept, anyone who has had experience of developing their own care pathway will probably not learn anything new.