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Dutch model offers new approach to home care


Jos de Blok (2)

Jos de Blok, director Buurtzorg Netherlands

It is the fastest growing organisation in the Netherlands and for three years running has been named the country’s top employer. Not-for-profit organisation Buurtzorg Nederland, founded and developed by community nurses, is transforming home care in the Netherlands and is quickly garnering attention worldwide, including in Australia.

Since its development in 2006, the Buurtzorg or “neighbourhood care” model has attracted the interest of more than 25 countries including the National Health Service in England. Sweden, Japan and the US state of Minnesota have already begun introducing Buurtzorg nurse-led teams in their jurisdictions.

Speaking to Australian Ageing Agenda ahead of his keynote address to the Leading Age Services Australia (LASA) National Congress in October, founder and director Jos de Blok said his home care model has been shown to deliver higher quality care at a reduced cost. A 2010 Ernst and Young report said costs per patient were approximately 40 per cent less than comparable home care organisations and surveys have shown that patient satisfaction is the highest in the country.

At the heart of the nurse-led model is client empowerment by making the most of the clients’ existing capabilities, resources and environment and emphasising self management.

“The model is much more focused on self-support and working with high qualified nurses that have skills in coaching and supporting patients to do the things that they are able to do themselves,” Mr de Blok told AAA.

While the costs per hour are higher from employing registered nurses, savings are made through lower overhead costs and a reduction in the overall number of care hours required per client.

Notably, the Dutch approach represents a challenge to the wisdom of low-skill, low cost staffing models which have tended to dominate health and aged care systems in Australia and overseas by demonstrating how a high-skill professional model can deliver greater efficiency.

The model also demonstrates the benefits of handing control over to the nurses that run the service.

Under the model, Buurtzorg nurses form self-organising or autonomous teams that provide a complete range of home care services supported by technology and with minimal administrative oversight. “The nurses organise all the work themselves, so there is no management structure and no hierarchy,” said Mr de Blok. The small teams of up to 12 nurses work in close collaboration with patients, doctors, allied health professionals and informal community networks to support the patient.

The emphasis on continuity of care and patient-centred care strengthens the quality of client-staff relationships and has been shown to improve both patient satisfaction and nursing staff morale.

“We have received a lot of attention from all sides – from politicians, from insurance companies but mostly from nurses themselves. In every region in the country groups of nurses came to ask us if they could start a team themselves in the neighbourhood they worked in, so they resigned at the other organisation and they have come to work for Buurtzorg,” he said.

Since its development Buurtzorg has experienced rapid growth and currently employs more than 8,000 nurses in the Netherlands, working in 700 neighbourhoods caring for palliative care clients, people with dementia and older people with chronic disease.

Mr de Blok said the model is based on World Health Organisation principles on integrated community-based care and is universal in its application. “In the last three to four years we have had interest from people in 25 countries. We have already started an organisation in Asia for Japan, China and Korea and in the US we have a team in Minnesota and a few years ago we started in Sweden.”

Mr de Blok will deliver a keynote address on the Buurtzorg model at the LASA National Congress, which runs 20-22 October at Adelaide Convention Centre.

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One Response to Dutch model offers new approach to home care

  1. Toni August 3, 2014 at 1:40 pm #

    I love the model, but where would we find the nurses? From countries that are poorer than us and have fewer medical resources? The other problem is that our services are rationed – so that only some people who need services get them. It sounds a bit like a cooperative organisation running a community options model with true consumer choice.

    I doubt any Australian government would fund the model in the form in which it has been successful, as it would mean funding not-for-profit organisations only – and that would be outside the current policy settings of both the major political parties. However, I would not be surprised if they created a bastardised form in the guise of innovation, and then wondered why it did not work the same.

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