Integrated home-based care in the Netherlands: Buurtzorg study visit January 2016

27 representatives from across a range of the vanguard and pioneer sites travelled to Almelo in Holland to see first-hand the innovative way care is being delivered to people in their own homes by social enterprise Buurtzorg.

The delegation was made up of nurses, GPs, senior managers and local government representatives all interested in seeing how the Buurtzorg model works in Holland and, most importantly, how elements could be taken and adapted in the NHS.

The NHS European Office, in partnership with NHS England’s new models of care team, organised the visit which forms part of the European Office’s programme to help NHS colleagues develop links and share learning with organisations that have developed enhanced models of integrated and ‘out of hospital’ care.

About the Buurtzorg model

Jos de Blok and three of his nursing colleagues set out to simplify the health care system in Holland to show that a patient-centred way of working could deliver better services at a reduced cost, by empowering nurses, cutting back on management overheads and encouraging patients’ self-support and independence. In 2006 they set up their own social enterprise, Buurtzorg, specifically to look after older people in their homes.

The client comes first

  • Care decisions start with the client’s changing needs.
  • Care plans are co-created with clients and families and make use of informal and formal support networks.
  • The focus is on using and building the client’s capabilities and securing independence.
  • Interventions have a temporary character until they work.

Self-managing teams of nurses

  • Nurses have professional freedom with responsibility.
  • Each team has a maximum of 12 staff who work at a neighbourhood level (10-20,000 population)
  • The team handles every aspect of care and business, from client assessment to staff recruitment.

Supporting independent teams

  • Team members and teams share information, knowledge and advice via Buurtzorgweb, a user-friendly IT system.
  • The back office takes care of admin, billing and payroll, freeing nurses to nurse.
  • For 800 teams and 9,500+ nurses there is one back office of 45 staff.
  • 15 coaches support the 800 teams - an intentionally small ratio to avoid building dependency.

Buurtzorg impact

Buurtzorg has grown from four nurses initially to more than 9,000, delivering better care at a lower cost per client.

Benefits include:

  • Better outcomes for clients
  • Better experience for client, carers, families and staff
  • Shorter more impactful interventions
  • Consistent care package that reduces the number of professionals involved
  • Reduced unplanned hospital admissions
  • Faster discharge from hospital
  • Economic impact locally and across wider system.

Download copies of the presentations here:

Buurtzorg overview

Buurtzorg plus: integrated care teams (nurses, physios and OTs)

Adapting and adopting the Buurtzorg model - Brendan Martin, Public World

Transitioning from a traditional model to a Buurtzorg-style model (Zorgaccent) - Irma Harmelink, Board Chairman, Zorgaccent

IT support for the Buurtzorg teams: Buurtzorg and Ecare - Nicole Keizer, Ecare

More information on Buurtzorg Plus is available here.

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