Attitudes towards Integrated Care Pathways in the UK NHS: A Pilot Study in One UK NHS Trust

Abstract

Background: Integrated care pathways (ICPs) offer an increasingly common approach to the standardization and integration of health-care practice in hospitals. The questionnaire study reported here was the final phase in a systematic investigation of the attitudes of health-care professionals towards ICPs in one acute UK NHS Trust. Method: A total of 314 health-care professionals working in a medium-sized NHS hospital in the UK completed a survey questionnaire, representing 34% of those approached. Results: Ten dimensions of attitude to ICPs were uncovered. Junior staff had less positive attitudes than senior staff on all dimensions. Across all professional groups (doctors, nurses, professions allied to medicine), staff were more unhappy with the idea of ICPs than with the evidence they are based on or the quality of the documentation itself. Conclusions: The investigation provided information about how widespread the dislike of ICPs was in the Trust and details of what was giving rise to staff unease. This enabled the authors to make recommendations to the Trust about the future development and implementation of ICPs in the Trust. The most central of these was that investing time and effort in changing the presentation of ICPs will not meet with success until more fundamental aspects of staff unease have been addressed. Overall, respondents from this Trust felt uneasy about ICPs because they do not like the idea of being told what to do. Therefore, if the ICP development programme is to continue at this hospital and be successful, the hearts and minds of those expected to use ICPs must be won over.