The UK National Institute for Health and Care Excellence (NICE) has just published a strategy document for 2021 to 2026. Good news, but …
If you search for rehabilitation, disability, disabled, holistic, biopsychosocial, or psychological they are all absent. There is much focus on being scientific, quick etc. One small ray of hope lies in this: “There will be an increased push for integrated guidelines that extend across the health, social care and public health interface.” Unfortunately all past experience, for example the guideline on stroke rehabilitation, suggests they are institutionally unable to handle interfaces between different components of illness, and complex interventions.
Their strategy has a touching faith in technology as the solution – it is one of four pillars – but this reveals a lack of understanding of the human and personal aspects of healthcare – there is no mention of the importance of inter-personal relationships.
They acknowledge that guideline development needs improving, but again foucus on speed and flexibility, rather than taking a holistic approach to the evidence base, as rehabilitation experts have suggested. (here) They will still focus on “the relative effectiveness of new technologies, medicines and interventions.“
In summary, their strategy is based around a reductionist approach within a biomedical model, not an multi-factorial approach based within a holistic biopsychosocial model of illness. It is a 20th century approach to a 21st century set of problems.