Saturday, 21 March 2015

Buurtzorg - could child protection learn from a new approach to community nursing?

There was a very interesting item on this morning’s BBC Today Programme concerning neighbourhood health care services in the Netherlands. Mark Thompson, a senior lecturer in information systems at Cambridge’s Judge Business School, was interviewed about Buurtzorg, a home care nursing service with a difference!

Mark has also written about Buurtzorg in the Guardian.

Apparently what makes Buurtzorg very different from traditional health care organisations is the absence of a middle management tier. This results in huge cost savings and, it is said, leaves nurses free to care for their patients rather than struggling to serve the needs of a bureaucracy. Nurses have the autonomy to meet their patients’ needs, rather than having to satisfy organisational targets. This is said to result in greater independence and quality of life, with patients actually requiring less hours of care because the care they receive is more tailored to their circumstances. It is claimed that the result is greatly reduced costs and greatly improved quality.

What seems to me to be absolutely crucial is that Buurtzorg nurses work in small self-organising teams, which offer mutual support. Administration is taken care of by “… a simple and streamlined organization with modern IT technology…” which is designed to reduce administrative overheads and to support the care process through information sharing and communication. These features have led to comparisons being made to Amazon and Spotify, organisations that have famously used IT to reduce overheads in retailing.

Regular readers of this blog will remember that I have been banging on about Lean for some years. Lean is the idea that organisations should focus on undertaking activities that are value adding and should abhor waste and unnecessary overhead. That seems to me to be exactly what Buurtzorg is seeking to do.

Buurtzorg could be a very useful model for children’s services and child protection. We should be asking how much effort (which equals cost) is going into parts of these services which are not value adding; and we should be thinking about how we can reduce it. We should be asking how we can get rid of waste and unproductive overhead and redirect resources to meeting the needs of the child, not the organisation. Some struggling children's services in England, in places like Birmingham and Rotherham, might be greatly improved if only they could be leaner. They might be greatly improved if they tried to learn from Buurtzorg.

If you want to learn more about Buurtzorg, one of its originators, Jos de Blok, has given a presentation on the initiative to the health care think tank, the King’s Fund.

You can also find out more information at: