Service user involvement and integrated care pathways

Understanding patients' experiences of their interactions with health services is an important step in building quality from within. The purpose of this article is to look at the possibilities for involving service users in the development of the National Health Service in England through the structure of integrated care pathways (ICPs).

A systematic literature review was undertaken to identify how patient experiences have been attained and used in three clinical areas: cataract care, hip replacement and knee arthroscopy. The information was weighted according to methodological criteria and synthesized according to the typical stages of each pathway. Key issues were summarised thematically across each pathway.

The findings relate to the use of patient views and experiences within organisational structures, service development, methodological research, education and training. The article identifies important issues of practical significance for involving service users in the planning and development of patient focused ICPs: such as the diversity of patients, perspectives of continuity, information and patient support and the need for methodological research.

The review is limited in that the literature across all three pathways tends to report findings of small studies undertaken in one clinical service or setting and most studies are not randomised or controlled.

The literature identified by the review contains important messages for both NHS policy and future research to involve service users in the planned expansion and plurality of NHS care.