An effective way of implementing new NHS initiatives into improved clinical practice, Integrated Care Pathways (ICPs) concentrate on patient-centred multidisciplinary care. Sue Middleton and Adrian Roberts explain how to use ICPs to deliver appropriate patient care in a team environment without compromising clinical freedom, as well as describing the relationship between ICPs and Clinical Governance. The introduction of Clinical Governance has led to increased interest in ICPs as the tool by which nationally defined guidelines and standards can be made locally applicable, leading to continuous quality improvement. Whilst research about the impact of ICPs is thin, there is increasing evidence from audit and evaluation in Trusts that ICPs lead to real improvements in standards and outcomes for patients.