What would be the best way to achieve the following:-

META + A causes /home/billhp/GambasFolder/GambasExec/Accounts.gambas to run

At present I know I can add an item in Application Launch Menu and then set META + A but I don't need the entry in Application Launch Menu!

I would suggest checking out the Custom Shortcuts functionality in System Settings > Shortcuts & Gestures.

Yes, thanks. Had a look at it and didn't get anywhere!

I see three main items:-
1 Custom Shortcuts
2 Standard keyboard Shortcuts
3 Global keyboard Shortcuts

Can't see how to create a shortcut for an item without it being in the Application Launcher

You want to use Custom Shortcuts, Edit -> New -> Global Shortcut -> Command/URL, and then set a "Trigger" (Meta+A) and an "Action" (whatever you want to run).

I've always wanted to improve the GUI for that module, but unfortunately I don't have enough time.

Thank you very much, it is now quite obvious!