To achieve personalised care in the UK, we need the International Classification of Functioning

We live in an era of personalisation. Music playlists, online shopping and even ‘smart’ car parks – these are among the products, services and experiences becoming more tailored to our individual preferences.

Here at Circle, the patient always comes first in whatever we do. So it’s not enough to treat them solely based on classifications of their diseases and related health problems. We need to also factor in their wishes and circumstances.

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We need to give patients personalised care, too.

Historically, the UK healthcare system has been relying on the International Classification of Diseases (ICD) as the standard diagnostic tool for epidemiology, health management and clinical purposes. But this can only go so far. After all, patients with the same clinical picture or the same physical limitations might have very different needs in everyday life. For instance, a partially-paralysed stroke sufferer might receive much support from his relatives at home while another lives alone in a second-floor flat without a lift.

The good news is, the same group that developed ICD have also created a more sensitive measurement system. The World Health Organization (WHO) has devised the International Classification of Functioning, Disability and Health (ICF). It’s not only a classification of health, but also health domains – domains that help us describe stages of the disease, changes in body function and structure, mental abilities and patients’ levels of capacity and performance in their daily lives.

This steers us on how to deploy just the right resource to the individual for the degree of their functional impairment. Circle Rehabilitation is versatile with its multidisciplinary teams, advanced equipment and state-of-the-art facilities. We can us ICF –in tandem with ICD – to provide the personalised rehabilitation that patients deserve. That’s the golden ticket.

Our vision is this trend will shakeup healthcare, for the better. And we at Circle want to bring this trend to the UK, to our rehabilitation centres, to our patients.

The common approach in Europe is to fine-tune the rehabilitation to get the patient as functional as possible. Relieving the health system long term means widening rehabilitation goals to include health, mobility, communication, employment, but also self-actualisation and social lives.

But widespread adoption of ICF across the UK won’t come overnight. That’s why at Circle Rehabilitation, we are making a step-change. We are working on a project to develop straightforward questionnaires for our practitioners (consultants, nurses and therapists) to discuss and agree on patients’ SMART objectives. With ICF as the common ‘language,’ staff would efficiently assess patients’ progress against these sets of initial goals.

While ICD focuses on diagnosis and treatment of specific diseases, our ICF-based questionnaires would guide us on precise function impairment and recovery. Let’s say we have a scenario of four patients each with a different ailment: Parkinson’s, a brain tumour, pelvis fracture and spinal injury. ICF would help us ensure we develop the right therapy programme to care for their various needs. And it could even enable the mix of musculoskeletal and neurological patients to rehabilitate together on some therapies, for example for getting back to walking. Group therapy uses resources efficiently and helps motivate patients.

In the past, disability began where health ended. Once a person was ‘disabled’ they were put into a separate category. We want to move away from this kind of thinking. In line with WHO, we want to not only diagnose the reason for impairments, but also spread the use of ICF as a tool for measuring functioning in society. ICF acknowledges every human being can experience a decrement in health and thereby experience some form of disability.

Remember, in healthcare, we’re not working for diseases. We’re working for people.

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