A team of four nurses from Southern Health visited Buurtzorg, Holland to learn more about how nursing care in the community was being delivered there. This is part of the Better Local Care philosophy to tailor the care in local populations to meet the need of the community,
The team were successful in their bid application [to the NHS European Office] to visit the Buurtzorg nursing team in the Netherlands. The purpose of the trip was to look at how the Buurtzorg staff worked as a team to manage their case load of clients. Several other teams from across the UK also attended the trip.
Unlike here in the UK, healthcare in Holland is purchased through insurance so many aspects of their services differ because of this but the principles that they applied to their daily working routine had many benefits which the nurses from Southern Health felt could easily be transferred into localities back here in the UK.
One of the most obvious differences between the Buurtzorg team and how our nurses work was the management structure. It was also clear from the offset that they were integrating community nursing and social care on a very regular basis – with the Buurtzorg nurse doing everything for the patient in one visit, rather than the client having more than one person dealing with their care.
Paula Hull, Deputy Director of Nursing & AHPs for West ISD, of the nurses who went to the Netherlands told us, ”They have a keyworker system that means they are each assigned a case load and the nurses are dedicated to their individual cases. They each have a buddy to manage leave and sickness but the continuity of care that they are providing their patients, is something we would aspire to achieve.”
Not only is this pertinent to the Better Local Care way of working but it also supports the NHS Five year Forward View to bring health and social care teams together. Buurtzorg has received international publicity because of their success through innovative ways of working.
Debbie Taylor, a practice nurse from New Milton, also went on the trip and tells us she learned a lot from the Buurtzorg team. “They were really friendly and welcoming and we were able to see how they operate and took some really good ideas away that we would love to apply in our locality. We discussed some of the challenges they were still facing that we have managed to overcome and were able to share our experiences; for example, our links to GP’s and referral processes are far smoother than theirs at this stage but they are working to improve this and I think they have a very strong ethos and team so no doubt it will continue to thrive.”
The Buurtzorg approach to nursing and social care was developed in 2007 and started out with just 4 nurses and one team leader. Now there are close to 9,500 nurses supporting neighbourhoods of between 5,000 and 10,000 people. The nurses are grouped into teams based on postcode areas and they are supported by a coach but essentially manage their own workloads, clients, care plans and education budget.
Paula said, “The main principles they work on are the strength of the professional voice and the role of the keyworker. I was really impressed by the confidence of the clinical staff and I would love to work on building up to this level of confidence with our clinicians.”
“It was great to meet nurses from other Trusts too as we are now linking up with their teams as well to share best practice and learning which will help us to improve the services we are all providing”.
There has been a significant reduction in hospital visits from the clients that the Buurtzorg nurses are supporting and the staff sickness levels are considerably lower than those of the UK. Paula tells us there are plans to start piloting some of the ways of working they saw whilst on their visit, in localities within the Better Local Care communities.
We will be watching this space and let you know how those pilots go!
Find out more about the Buurtzorg Community Nurse model here