The UK’s Royal College of Nursing – the voice of nursing in the UK – has reiterated its support for the uniquely bureaucracy-free and entirely nurse-led (self-managed) approach to community nursing care pioneered by Buurtzorg in the Netherlands.
Its demonstration of nursing capability and self-management in delivering even better patient care is a great boost to the profession’s morale, both in the UK and internationally
“The RCN welcomes the remarkable success of the Buurtzorg model,” it wrote in an updated Policy Briefing released in August, following the visit to the UK by founder Jos de Blok in July (see ‘How to build bureaucracy-free health services in the UK: learning from Buurtzorg’).
“Its demonstration of nursing capability and self-management in delivering even better patient care is a great boost to the profession’s morale, both in the UK and internationally,” the paper states.
The RCN concurs with another report on Buurtzorg by influential health think-tank The King’s Fund, that a “fresh look” at nurses’ professional roles is needed.
This ‘fresh look’ can only achieve meaningful results if the central plank of the Buurtzorg model – its emphasis on nurses as self-management agents of change – is maintained throughout
But the RCN stresses that the key plank of Buurtzorg’s approach mustn’t be lost in such a re-evaluation: “This ‘fresh look’ can only achieve meaningful results if the central plank of the Buurtzorg model – its emphasis on nurses as self-management agents of change – is maintained throughout.”
The briefing paper highlights that Buurtzorg has made three breakthroughs:
- Higher levels of patient satisfaction
- Significant reductions in the cost of care provision
- The development of a self-management structure for nurses.
The 40% reduction in client costs compared to other home care organisations would translate into €2 billion savings per annum in the Netherlands ($49 billion savings in the US).
Can Buurtzorg work for hospitals too?
Buurtzorg is currently working with Dutch hospitals to apply its approach in acute care settings. Jan de Blok estimates that “up to 50% of care provided in the Dutch hospital system could be done more effectively and cheaply in the community nursing sector.”
The RCN briefing also points out that the seminar they co-hosted when Jan de Blok visited the UK “coincided with news that Guy’s and St.Thomas’ NHS Foundation Trust is scoping a ‘Buurtzorg-style’ pilot in London, demonstrating strong interest within the NHS for tapping into the success of the model”.
The paper also highlights challenges with applying the model to the UK, such as differing CPD requirements and whether its 24/7 care commitment could lead to work patterns that infringe the EU Working Times Directive. Questions of career progression in the absence of a managerial structure also arise: “without any managerial grades based on experience or time served, it is not entirely clear how Buurtzorg keeps its more established employees.” Buurtzorg has grown from a small team in 2006, to approaching 10,000 nurses today.
The Buurtzorg Nederland (home care provider) model – Observations for the United Kingdom (UK) – Updated edition (RCN Policy and International Department, Policy Briefing 02/15, August 2015)