The delivery of chronic disease care within new models of integration is an increasing reality. Currently, there is no clear evidence that community or tiered systems of care delivery are superior to existing diabetes services in terms of hard outcomes; however, it is apparent that they offer other potential benefits that can enhance the system of care. Examples include better communication between primary and secondary care, shared IT to enable clearer care planning and greater user satisfaction.Integrated care pathways (ICPs) are tools designed to ensure that the system of care is functioning and incorporates all the relevant factors necessary for good care, and that evaluation of the system itself can be reviewed -as a form of performance management. This article looks at how in practice we can monitor, measure and learn from ICPs.