This month, 28 care pathways have been updated with the latest evidence. Highlights include:

The ‘Brain tumour’, ‘Dysphagia’, ‘Female urinary incontinence’ and ‘Skin warts’ pathways all received updates in line with the National Institute for Health and Care Excellence (NICE) cancer recognition and referral guideline regarding indications for suspected cancer referral and updates on urgent referral and direct access tests.

The ‘Melanoma’ pathway has undergone extensive content changes, to incorporate recent recommendations from the National Collaborating Centre for Cancer (NCC-C) on the assessment and management of melanoma. Updated information on the assessment of melanoma, differential diagnoses, and advice on self-assessment and preventative lifestyle measures were also added.

The ‘Perinatal mental health (PMH)’ pathway has undergone substantial content and structural changes to incorporate the updated National Institute for Health and Care Excellence (NICE) guideline on the management of antenatal and postnatal mental health in both primary and secondary care.

The ‘Obesity in children’ pathway was updated with the National Institute for Health and Care Excellence (NICE) guidelines, providing detailed information on the maintenance of a healthy weight, prevention of obesity, and management of obesity and overweightness in children and adolescents. Updated recommendations on surgical intervention for obesity, including surgical techniques, and additional recommendations for the prevention and management of obesity in children and adolescents were also included.

The full list of pathways receiving an update is:

• Acne
• Anogenital herpes
• Bacterial meningitis in children and adolescents
• Bell’s palsy in adults
• Brain tumour
• Bronchiolitis
• Chronic obstructive pulmonary disease (COPD)
• Coeliac disease
• Dysphagia
• Female urinary incontinence
• Headache in adults
• Kidney Stones
• Lower UTI in females
• Lower UTI in males
• Male lower urinary tract symptoms
• Melanoma
• Methicillin-resistant Staphylococcus aureus (MRSA)
• Obesity in children
• Osteoporosis
• Perinatal mental health (PMH)
• Post-exposure prophylaxis
• Red eye
• Skin warts
• Thyroid disorders
• Ulcerative colitis
• Vasectomy
• Venous leg ulcers
• Worms

Changes in the information landscape can be identified by different sources, including regular searches for national clinical guidelines, recently published quality-appraised secondary literature, and user feedback. The impact of new information is assessed to determine a time-frame for updating the care map. Practice-based knowledge from clinical experts is then added where appropriate.

Download the report below for a brief summary of changes for all care maps updated in this publication.

Map of Medicine: Update to Map Pathways [January 2016]