Care pathways: some social scientific observations on the field

In an earlier companion paper published in the journal, I drew on an ethnographic analysis of the care pathway field to argue that the growing popularity of pathway methodology can be explained, in part, by its effectiveness in aligning clinical and management interests in offering a single solution to shared health service problems. This breadth of appeal disguises tensions between clinical and management agenda which creates challenges in inscribing this multiplicity of interests into the pathway design and implementing the methodology in practice. This helps to explain the challenges of pathway development and implementation and the range of interventions to which the term ‘pathway’ is applied. In this paper I consider how pathway leaders have responded to these concerns and offer an alternative response, informed by social science