On 27th June we held our latest national learning event on the neighbourhood care work being tested across the country.

With representation from Health and Social Care Partnerships and national organisations, the aim of the workshop was as much about exploring the challenges to developing this model of care as it was about sharing learning and increasing knowledge across Scotland.

After welcomes and introductions from Ruth Glassborow (Director of Improvement Support and ihub), Chris Bruce provided some background on how Scotland became involved in learning from the Buurtzorg model in the Netherlands, with an overview of the work so far.

All agencies and partners involved in developing local models – using the principles of Buurtzorg (and in the spirit of self-organisation) – have worked together to develop tests and start building a national learning community.

The testing principles in Scotland

• Promote independence
• Continuity of support and carer – reduce fragmentation
• Self-organising, flexible teams, focused on people
• Back office / organisation focused on staff and people
• Opportunities – accelerate integration at point of care, empower nursing and social care workforce, change commissioning practice

Each of the eight neighbourhood care test sites (Borders, Dumfries & Galloway, Highland, Stirling and Clackmannanshire, Angus, Aberdeen City, Western Isles and Cornerstone) gave an update on what they hoped to achieve from the model, what their progress has been and what challenges they’ve faced so far.

Common themes

There were a number of common themes across the test sites when discussing developments: governance, communication, engagement, change management and recruitment.

There was a feeling that some aspects of clinical and corporate governance were making testing more difficult than it needed to be. Should we take a risk proportionate approach, rather than risk averse? Do we have to be (more) brave?

Isn’t this the realistic approach to medicine?

The sites highlighted a need for regulations to be simple, straightforward, scaled-down, and to learn from the 3rd sector. Cornerstone rewrote and reduced their policies and procedures from more than a hundred to single digits.

The Cornerstone approach:

Start with nothing, then see what you actually need.

the workforce

There was agreement that for a lot of people working in the service there is strength to be drawn from the common goals of the neighbourhood care models.

It’s a way of working that empowers staff, promotes autonomy and self-management. It’s a model that can offer increased satisfaction for those working in it, leading to better recruitment, retention and less absence.

The importance of buy-in from all staff (including those in corporate and leadership roles) is hugely important to progress.

We are trying to introduce change in a complex environment. And for some this will lead to uncertainty, around themselves, their role, their workplace. Sharing success from the testing can help reassure people that this can work in Scotland.

Communication

Part of this will come from our internal and external communications, information sharing and engagement.

We will continue to develop the self-managing network for learning and sharing best practice across the test sites, as well as building a digital platform for updates and charting progress.

We’ll have key messages that can be use locally and nationally to help spread the word.

What ties all of this together is building trust between all the different agencies and people involved in health and social care.

Let’s talk about how we should co-operate together instead of competing; with other professionals, with informal carers and other organisations. How we make younger people enthusiastic for the profession and much more. 

Jos de Blok, Buurtzorg founder

We want people to see the successes from the test sites and for them to want to be a part of it.

We want to share people’s stories, share learning and promote success more widely.

So check back over the coming months when we’ll update you more regularly on the work of the individual test sites, hopefully looking at the practical aspects of the models as well as the broader themes and issues.