What is the Buurtzorg model?
Buurtzorg, Dutch for ‘neighbourhood care’ is a nurse-led model of holistic homecare that supports independent living in a community setting and is driven by a belief in ‘humanity over bureaucracy’. The model originates in the Netherlands and since 2006, its use has grown to include areas of care such as mental health and children and families social work; it is no longer only used as a homecare model of support.
Buurtzorg has been applied in a number of areas in Scotland, with the initial pilots making way for a wider roll out of adaptations of the model. Having test sites helped to highlight the importance of planning and learning, and of creating a strong sense of trust between practitioners and NHS management, but also between the Buurtzorg nurses and their service users and other professionals.
What does it involve?
A team (maximum 12 professionals) is based in a local area and supports and cares for people. This group of professionals is responsible for all services provided, including assessment, and developing and implementing care plans. The team has its own office in the area and spends time in the local community, getting to know GPs and other professionals. They work together to decide how to organise the work, share responsibilities and make decisions.
What are the principles?
Self-directed teams
Each team creates its own ‘personality’ and works effectively for the good of the people and community it supports.
Minimal bureaucracy
There is a focus on more time with people and less time on paperwork. In the Netherlands, effective IT systems were put in place to make this happen.
Outcomes evaluation
The model is based on measuring positive outcomes for people and professionals, balanced with efficiency and cost savings.
Why is it important?
Teams are self-managing, which allows for autonomy of roles and helps to reduce bureaucracy and burnout. Ultimately, Buurtzorg has the potential to support the integration of health and social care, where professionals work within communities to improve the lives of people and reduce costs on the system.
What does this mean for me?
Lesley-Anne Exon, Staff Nurse, Forres Neighbourhood Care Team (NHS Grampian)
Google the words ‘Buurtzorg model’ and you will be read about self-directed teams, blurring roles and holistic care. To me it means flexibility, autonomy, adaptability, creativity and the freedom to work in a person-centred manner, doing things with people rather than to them. It allows me to use the best of my abilities, my judgement and experience to find solutions that can make a real difference in a person’s life.
Just over a year ago, the team I work within was asked to visit a gentleman who lives alone and was struggling with what was thought to be a chest infection. Very quickly we identified that he was vomiting after every meal, losing weight and he was also falling at home. A very proud gentleman, he isn’t one to ‘bother the doctor’. He is partially sighted and hard of hearing so finds telephone consultations with the GP challenging. His chest infection transpired to be lung cancer and without any local family or friends the team became his main source of support.
We contacted social services to arrange care at home (our team provided personal care support in the interim) and a falls alarm. We monitored his nausea and liaised with the GP until an effective anti-emetic was found and arranged for his medications to be delivered to his house. On the odd occasion he didn’t receive them we contacted the pharmacy and collected and delivered them ourselves.
He was then referred to the local cancer support centre where we asked them to arrange for him to get help with his finances and simple things like opening and responding to mail. We organised Wiltshire Farm Food deliveries and his hospital transport. When he has an early appointment a member of the team will help him get dressed and out. When he needs end of life care he has asked us to provide it and to me that is the greatest compliment.
Everything I have listed could have been done by various other agencies, but we have become his single point of contact. He is very honest about how much he values our support, to him we are invaluable. And to me that is invaluable.
Guides and information
Kreitzer MJ (2015) Buurtzorg Nederland: a global model of social innovation, change, and whole-systems healing. Global Adv Health Med, 4, 1, 40-44
Monsen K (2013) Buurtzorg: nurse-led community care. Creative Nursing, 2013.
