Buurtzorg (“care in the community”) is what would be called in the UK a social enterprise which was established in Holland in 2006 as all parties involved started to realise that the demand of providing care by nurses/carers in the community, caring for the clients in their own home environment, was significantly increasing. This created a situation in which the nature of providing care subsequently started to change too.
“Buurtzorg” is in essence a home care organisation working with small and flexible teams; a community nurse and community carers providing care to the clients within their own living environment or house. E.g. clients being subject to ill health, clients returning home from hospital or on behalf of their GP; injecting insulin, caring for surgery wounds and dealing with pain relief. Supporting in palliative care is also possible. Each client is allocated a personal nurse/carer. The nature of this “Buurtzorg” is to promote the client’s independence and to increase the opportunity to remain living in their own home as long as possible.
The fully autonomous teams work throughout the Netherlands and all have the authority to take any decision for whatever issue that may arise during their daily involvement with their clients. They therefore have the ability to organise the job without too much management involvement and unnecessary bureaucracy. Decisions are taken by the nurses/carers working closely with the clients. Although there is one office only within the organisation dealing with administrative issues for the whole of all the teams throughout the Netherlands. The staff are well-qualified and undertake activity personally which is in other systems are often delegated to unqualified people. This reduces the number of different staff involved in the care of an individual.
The consequence is that the nurses are challenged to have the courage to take the responsibility in taking tough decisions and that working hours are irregular. The nurse/carer is in a direct contact to the client’s GP, (hospital) specialist, or social worker; whoever as professional is involved.
Clients do not pay for “Buurtzorg”. This is funded by general funds within the Dutch healthcare system. A study by KPMG in 2015 showed that care provided in this way was not more expensive. Care appeared to be higher quality and much more satisfying for staff.
Differences with regular care and general characteristics of “Buurtzorg”;
- Nurse/carer and client actively work on creating the best possible solutions within their own (professional) support network that results in increasing the client’s independence and quality of life.
- Providing care is the responsibility of the carer/nurse.
- Professional care is based on professional standards and is all evidence based and monitored.
- Providing care is based on achieving the maximum of effectiveness; care delivered within the exact the time needed; not more and not less time spent and custom made and custom offered care based on the client’s wishes.
- Hardly any overhead costs.
- Nature of the care provided is often practical by nature, therefore the provided care is “transparent, visible and measurable”.
- Aim-purpose “Buurtzorg”: to create the opportunity for clients to live in their own home as long as possible and to avoid that they have to be cared for in elderly homes or hospitals.
- “Buurtzorg” is highly focused on the client’s availability of (professional) network in the community.