Care pathways could be a powerful tool to improve efficiency in the NHS, according to the Association of Chartered Certified Accountants.

In a booklet published next week, ACCA says care pathways are being developed by clinicians because they represent meaningful groups of activities, but 'to complete the picture, finance directors need to change the structure of their costing models'.

ACCA spokesman Tom Jones said care pathways could provide more information about activity as experienced by patients. In turn, he argued, they could reveal scope to improve effectiveness and reduce waste.

'If you build in the information technology, you can see where decisions are being made and where things do not need to be done. You see people coming in and out of the system,' he said.

'The NHS is very good at sharing problems around - for example, dealing with waiting lists but pushing people into accident and emergency.

'This could actually solve problems, by giving a better understanding of a complex resource chain and showing the real cost of things.'

Mr Jones said such techniques had been used in US managed care organisations to 'ship costs out' but insisted it should be used in the NHS to free up resources to improve patient care.

The booklet predicts that care pathways could become a standard tool for benchmarking, moving away from healthcare related groups. It adds that care pathways can be costed using standard techniques. ACCA plans to publish further work on this.

Managing Care Pathways: the quality and resources of hospital care. ACCA, 29 Lincoln's Inn Fields, London, WC2A 3EE. Free.