A highly successful Dutch model of care at home – known as BUURTZORG – is being explored in West Suffolk through a “Test and Learn Site”, one of only a handful in the England, in partnership with West Suffolk CCG, West Suffolk Councils and Suffolk County Council, with support from the East of England LGA and the UK Buurtzorg partner, Public World.
The BUURTZORG Model of Care at Home
The Buurtzorg model grew from the vision of nurse Jos De Blok to tackle ongoing concerns in the provision of care, such as: the fragmentation of prevention, treatment, and care; the impact of demographic change; a shortage of care providers; lowering quality and increasing costs of care; and a lack information about the quality of outcomes in relation to the cost of care per client. Buurtzorg started in 2006 with a team of four nurses working closely with GPs and delivering community care services. By 2015 it had grown to over 9,000 nurses working in 800 teams working with 70,000 patients. The nurses are supported by around 45 back office staff.
The key to the approach is that the model empowers individuals – in this case nurses – to deliver all the care that patients need. Nurses work in self-managing teams of up to twelve professionals who provide care for 40-50 clients in a specific locality. The nurses are ‘generalists’ taking care of a wide-range of patients and conditions. They are highly qualified; 70% to bachelors level. Their role includes:
- Assessment of clients’ needs
- Care delivery
- Mapping networks of informal care
- Coordination of care between providers
- Promotion of self-care, self-management of conditions, and independence.
Buurtzorg is a non-profit enterprise and is 90% funded through health insurance, which is mandatory in The Netherlands. It has led to:
- Overhead costs of 8%, compared to a national average of 25%
- Lower staff turnover, lower sickness rates, high staff satisfaction
- Lower costs of care per client, 40% less than national average
- High patient satisfaction
- 30% fewer A&E visits for clients
- A € 9 million profit in 2014
Can the BUURTZORG Model of Care at Home work in an English context?
This is a key question that the coalition of health, social care and housing partners in West Suffolk are seeking to answer. The partners are establishing a Buurtzorg “test and learn site” in the area, one of only a handful in the country, with the support of the East of England LGA and the UK Buurtzorg partner, Public World.
The primary aim of the West Suffolk ‘Test and Learn Site’ will be to identify a way to adapt the model to our own context without losing the essential features of the Buurtzorg experience – the focus on mobilising and strengthening the capabilities of the client and the networks around them through self-organised teams of autonomous responsible professionals.