by Ben Lukins, Programme Manager, Healthcare Improvement Scotland. Follow Ben on Twitter @blukins1.
At the start of December we held a workshop exploring the evaluation of neighbourhood care at a national and local level. The workshop was well-attended and included academics with evaluation backgrounds, staff from some of the Scottish test sites, representatives from Buurtzorg, staff from the Public Health Agency in Northern Ireland and individuals from our national partners.
The importance of reflecting the local context was recognised and it was acknowledged that there was a richness in the qualitative information, drawn from staff’s experiences. The group reflected that the evaluation was about looking at how the principles of Buurtzorg had been applied and not about evaluating the principles themselves.
Buurtzorg principles in Scotland
We spent time determining the principles that were being applied in Scotland and agreed on the following:
- Putting the person at the centre of holistic care.
- Building relationships with people to make informed decisions about their own care, which promotes wellbeing and independence with active involvement of family, neighbours and the wider community, where appropriate.
- Everyone, including support functions, enabling person-centred care at the point of delivery.
- Small self-organising, geographical-based teams.
- Professional autonomy.
The group decided that an evaluation toolkit should be produced. This toolkit will provide resources at different levels for addressing different aspects, allowing the local sites to pick and choose what was appropriate to their circumstances. The use of the toolkit will allow learning to be pulled together at a national level to determine whether the models of neighbourhood care had been successful, and draw out the learning for other areas interesting in testing this work.
As a starting point the group discussed and defined what they saw as the common drivers for this evaluation:
- Workforce and culture
- Impact on the wider system
- People who use services
- Mechanisms for delivering support
There was also discussion about possible additional drivers: workload/demand and supply of resources.
The group agreed that these drivers should be the starting point in developing the toolkit and that the next step would be for a smaller working group to take this forward, ensuring that the wider evaluation group and Scottish test sites were kept updated and given opportunities to contribute to and shape this work.
The working group will have its first meeting early this year.