Buurtzorg is a pioneering healthcare organisation established 12 years ago with a nurse-led model of holistic care in the Netherlands.
Buurtzorg Nederland was founded in 2006 by Jos de Blok and a small team of professional nurses who realised that modernisation of care systems had undermined their relationships with patients. They set up Buurtzorg to look after people at home.
The Buurtzorg model starts from the client perspective and works outwards to assemble solutions that bring independence and improved quality of life. The principle underpinning the model is that the nurse acts as a “health coach” for the individual and their family, emphasising preventive health measures but also delivering necessary care themselves or calling on others to do so. The rule is that nurses must spend 61% of their time in direct contact with the people they support.
In this way the professional seeks to build a solution involving the client and their formal and informal networks. Self-management, continuity, building trusting relationships, and networks in the neighbourhood are all important and logical principles for the teams.
Buurtzorg relies on the principle of self-managing teams which have professional freedom with responsibility. A team of 12 work in a neighbourhood, taking care of people needing support as well managing the team’s work. A new team will find its own office in the neighbourhood, spend time introducing themselves to the local community and getting to know GPs and other professionals. The team decide how they organise the work, share responsibilities and make decisions.
Resources needed
Clients pay for their healthcare services. Buurtzorg’s back-office of 45 staff keeps overheads low, (8% as opposed to 25% in comparable organisations) taking care of payroll and invoicing to free up the rest of the organisation to focus on care.
Evidence of success
Buurtzorg’s empowering approach for nurses and clients proved popular with both. In 10 years there are over 10,000 nurses, in 850 teams in towns and villages all over Holland. In 2016 Buurtzorg is also active in 24 countries. Impressive financial savings have been made. Ernst & Young documented savings of around 40 percent to the Dutch health care system.
Difficulties encountered
One issue is funding: the Dutch model is tailored to payments by health insurance companies, not a state healthcare system.
Another is the scrapping of hierarchies and specialisms within the nursing teams: a Buurtzorg nurse might administer wound care but may also help someone to wash or get dress
Potential for learning or transfer
The good practice has already spread to 24 countries which proves it is transferable. It is actually also studies through the Interreg 2 Seas TICC project, aiming at enhancing its transferability
