Implementing an adapted Buurtzorg model in an inner city NHS trust

For the last 30 years, successive government policy in the UK has advocated the expansion of primary care and community services. Paradoxically, over this same period, there has been a decline in one of the cornerstones of home-based care, and that is district nursing services (Drennan, 2019), to the extent that it is variously described as ‘in crisis’ and ‘endangered’ (Queen's Nursing Institute (QNI), 2018) and criticised for failures in quality and reach (Maybin et al, 2016). In many parts of the country, recruitment and retention of nurses is a major problem. A Dutch model provided by the social enterprise, Buurtzorg, offers solutions for addressing these problems (de Blok, 2015) through re-assertion of a patient-centred relationship-based nursing model combined with self-managing nursing teams.

The Dutch Buurtzorg organisation is a social enterprise that uses a patient-centred model of care combined with self-managing teams of visiting nurses. The central principles in the patient-centred model of care are ‘self-management, continuity, building trusting relationships and building networks in the neighbourhood’ (Buurtzorg International, 2019). The self-managing teams of about 12 have ‘professional freedom with responsibility’ in deciding together how they work, provide care to their patients and share responsibilities. A new team will set up its own office in the neighbourhood and introduce themselves to the GPs and other services in the neighbourhood. The teams are supported by coaches, not managers, and back-office teams, which deal with financial and administrative matters.