Updates from the Neighbourhood Care national partners meeting

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.

buurtzorg onion model

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.

Realistic Medicine Scotland

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.

Putting the Buurtzorg Principles into Practice: our third learning network workshop

 

by Ben Lukins, Programme Manager, Healthcare Improvement Scotland. Follow Ben on Twitter at @blukins1

Our third learning network event took place on 13th October and allowed test sites to share their progress to date and further explore applying the principles of Buurtzorg. It was well-attended, with representatives from health, social care and the third sector and from across Scotland taking part in a lively day of discussions. You can view the Twitter highlights from the day in our Storify.

Sharing early learning from the test sites

Staff from the test sites shared their reflections on developing models of neighbourhood care and their motivations for change. The strong desire to deliver the best care possible to people resonated with everyone and fuelled the enthusiasm for the day. The discussions which followed reaffirmed the importance of this, and people acknowledged that it was acceptable to apply the principles of Buurtzorg in different ways across the different sites.

Enablers and challenges

Discussion about the enablers and challenges of progressing the work highlighted the strength drawn from the common goals of the work: improving care for individuals, and empowering staff. Groups discussed the importance of protecting the test sites and the challenge of doing so, in particular regarding regulation and inspection. People also felt that it was necessary to address misconceptions about obstacles which in fact may not exist, or may be easily addressed. Continue reading “Putting the Buurtzorg Principles into Practice: our third learning network workshop”

Evaluating the application of the Buurtzorg principles in Scotland

evaluation

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.

Continue reading “Evaluating the application of the Buurtzorg principles in Scotland”

Meet Ben Lukins!

ben_bwI would like to take the opportunity to introduce myself as the Programme Manager with Healthcare Improvement Scotland, responsible for coordinating the work on applying the principles of Buurtzorg to develop Scottish models of neighbourhood care.

I have been reflecting on how quickly time has flow by since coming into post in September. From the offset I was keen to immerse myself in Buurtzorg to understand the model, and to think about how we as a national body could best support the local work in Scotland.  A key part of this has been meeting with a number of people from different organisations, backgrounds and professions who have been part, or are keen to be part, of this work.

This has been a great opportunity to listen to myriad perspectives and thoughts. I have been struck by the enthusiasm of those I have talked to, many of whom are motivated by achieving the best possible outcomes for people, as well as making the role of those providing care truly fulfilling. The Buurtzorg model resonates so powerfully for so many, as it brings to the surface the reason they came into the caring profession, drawing from the richness that comes from building and sustaining meaningful relationships. Continue reading “Meet Ben Lukins!”

Testing an innovative model of care in the community: Buurtzorg

Buurtzorg Tests for Scotland: 1st July first gathering of tests co-production community from Nick Wilding on Vimeo.

Video highlights from the first Buurtzorg workshop

In this article we look at Buurtzorg, a Dutch model of community care, and talk about the work that we are supporting to test the principles of Buurtzorg in Scotland.

Where did Buurtzorg come from, and what does it involve?

Buurtzorg, which means neighbourhood care, is a delivery model for community care which was established in the Netherlands in 2007 to improve quality of care and outcomes for people. It puts the person at the centre of care and promotes staff autonomy and the provision of holistic care in the community.

Care is delivered by skilled generalist registered nursing teams, with a maximum of 12 nurses in a team. The teams organise themselves, and have a structure that promotes self-management, which gives nurses more freedom to respond to the needs of individuals. Regional coaches are available to support teams, although they work with a number of teams and do not act as managers.

The model was developed in response to a fragmented landscape of home care provision in the Netherlands, in which people were receiving care from multiple practitioners and providers. Rather than carrying out fixed tasks for people in isolation, the Buurtzorg model takes a holistic approach and looks at what patients and service users can learn to do for themselves again, reducing the need for care in the future. Its focus on neighbourhoods allows teams to use informal networks and work together with a range of professionals, such as GPs and pharmacists, and to engage in preventative activities. Continue reading “Testing an innovative model of care in the community: Buurtzorg”