‘People at the heart of care’: how Buurtzorg does it
The UK government yesterday published its “ambitious 10-year vision for how we will transform support and care in England”. We are glad that it presents the Buurtzorg way as an example of how that vision can be realised.
The White Paper, People at the Heart of Care, bases its proposals on three objectives:
- People have choice, control, and support to live independent lives.
- People can access outstanding quality and tailored care and support.
- People find adult social care fair and accessible.
We share those intentions, even if – because we believe that personal autonomy is underpinned by social interdependence — we wouldn’t express it in quite the same way.
There is also much that could be said — and has been said by others — about unfulfilled past promises, the resource gap undermining social care now, and the gap between the White Paper’s stated intentions and the level and fairness of future funding.
However, the White Paper – like the creation of integrated care systems and primary care networks – presents opportunities to those willing and able to grasp them. That is the spirit in which we welcome it.
The title of Chapter 4 – ‘Providing the right care, in the right place at the right time’ – could sum up how Buurtzorg Nederland has grown from a single neighbourhood team 15 years ago to be an international beacon of great community-based care today.
The White Paper states (paragraph 4.45):
“There are great examples of different models that have been implemented to meet people’s needs. For example, Shared Lives schemes have been scaled up across the country to offer greater flexibility and more community-based care.”
“Similarly, to improve outcomes and provide more personalised care, providers and commissioners have looked to the Buurtzorg model, founded in 2006 in the Netherlands by a small team of professional nurses.”
“The model integrates health and care services. It involves small, autonomous, neighbourhood-based teams that provide a range of care and support services to people in their homes, building a care and support plan around a ‘self-managing’ client, involving the person’s informal and formal support networks.”
We represent this approach in our Onion Model graphic:
Buurtzorg began when four friends gathered around a kitchen table in the Dutch city of Almelo 15 years ago and is now the leading Dutch provider of community nursing and home care.
Its more than 900 neighbourhood teams are supported by 22 regional coaches and a back office of just 50 people whose role is to support the ‘frontline’ professionals as simply, responsively and efficiently as possible, with IT and other services.
As well as providing great care – as evidenced in many ways, including top marks in the most recent official inspection – Buurtzorg has repeatedly won the Dutch Employer of the Year award while cutting costs by halving the average number of hours of professional input.
Since 2015 we have been working with Buurtzorg to support NHS, local government and charitable health and social care providers to learn from this extraordinary success. Although we have supported several highly promising ‘test and learn’ experiments, some of which are beginning to grow to scale, we can also relate to the White Paper’s observations about the obstacles involved:
“We know that the challenges of embedding new and innovative models in a system are significant,” it says (4.46), adding (4.47) that “wider system and structural issues” are “making innovation and the adoption of new models harder to implement, embed and, importantly, scale”.
The White Paper goes on to announce funding of £30 million for an ‘Innovative Models of Care’ programme.
During 2022, alongside expansion of our existing consultancy work, we will be supporting the creation of a Buurtzorg Care UK social enterprise. We are already in discussion with prospective partners and we would be glad to hear from more. Perhaps, together, we can make very good use of some of that new fund!
If that sounds worth a chat, please drop me a line at email@example.com.