The Scottish Government – as in other parts of the UK – is looking at restructuring the operations of their Health Service and more local, primary care, holistic and person-centred models are being looked at.
It is refreshing to see that one service overseas seems to tick all the boxes, and the Government is looking closely at it to see what lessons can be learned. The service is Buurtzorg Nederland, and was founded in 2006 by Jos de Blok. It is a community-based home care carried out by nurses, with a minimal management structure and high levels of autonomy entrusted to the nurses to carry out the tasks which each individual may need done.
The strengths of the service are:
- It is preventive
Each nurse is daily aware of each person’s needs and capabilities, and work in ay which promotes and encourages independence and gaining coping skills. - It is cost effective
Although the staff costs are higher for professional nurses than for traditional home carers, the lower management costs counterbalance this. A more responsive service prevents escalation of the problems. Less care hours are needed: this helps avoid the damaging escalating costs and mushrooming demand which seem to plague many parts of our health system in this country. - The service is flexible in how it is operated
Each nurse is a member of a team of ten, allocated a ‘territory’ in a city or town, and gets to know and be known by local people. Communication is quick and effective, and needs are known as precisely as possible. - The nurse spends as much time as needed with each individual client
Carrying out low level tasks, clinical support and simple contact time over a cuppa, as needed. Service user’s confidence is increased, rather than being decreased by a ‘flying visit’, further reducing the amount of support required. Health workers in this country frequently say that allaying anxiety is often a primary need: here, it is unlikely to be a problem. - The service has proved its effectiveness
Having now extended to many towns in its home country, to Japan, Scandinavia, and parts of America since its commencement in 2006.
A KPMG case study in 2012 found that the service produced:
‘A reduction in hours of care, improved quality of care and raised work satisfaction for their employees.’ Let us hope that these sorts of outcomes can become common as we work through the crises in our current health and care services.
References
http://buurtzorgusa.org/about.html
Tony Clarke – QCS Expert Scottish Care Contributor
