Neighbourhood Care Steering Group – 22 August Blog

On the 22nd August the newly formed Steering Group met for the first time.

The steering group combines the Delivery Group (members of national organisations that support the Neighbourhood Care programme) with the Learning Network (project leads from the health and social care organisations that are testing the Neighbourhood Care principles (inspired by Buurtzorg). The steering group will meet every six to eight weeks and work in a Break Through Series Collaborative. By working in this way it’s hoped that there will be more opportunities for closer working, easier sharing and increased opportunities for support.

The 22nd was an opportunity for all members of the Steering Group to share their current progress, challenges and support required. You can read more about the day’s activities in our flash report. Please feel free to share this with your teams.

Nc pic

Our next Steering Group meeting is on 3rd October. Between now and then the LWiC team and National Partners will have met to discuss how best to plan the support that is required in order to assist local teams to develop their own local models of care to deliver the principles. This will be discussed further with the Steering Group on 3rd October.

Scottish Borders HSCP, Aberdeen City HSCP, Argyll & Bute HSCP and NHS Highland have live case loads and so will continue to be supported by Buurtzorg Britain and Ireland (previously Public World) and a plan of training events has been developed from now until the end of the year that is tailored to their needs.

As well as the Steering Group, the Scottish Social Services Council (SSSC) are supporting 10 individuals (including representation from HIS, Scottish Government, Care Inspectorate and Cornerstone) from the steering group in Action Learning Sets (ALS). ALS are a structured method of supportive coaching that helps the participants deliver outcomes that are important to them and the overall aim of the programme.

At the last steering group meeting test sites shared their current/planned measures that they will use to evidence their team’s improvements and outcomes. The LWiC team has collated this information and cross-mapped the measures to the original outcome framework/logic model. The next steering group meeting will provide an opportunity to discuss and define these measures in more detail, as well as discussing why sites have chosen these specific measures and whether there is an opportunity to develop a common set of measures between all sites.

We look forward to keeping you further informed after the next steering group meeting J

Follow us on Twitter: @LWIC_QI, @mratgmurray, @turnersara99

 

 

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Highlights from the Neighbourhood Care Learning Network Event

 

On 11 May 2018 we held our latest neighbourhood care learning network event at the Care Inspectorate Offices in Hamilton. The session was well -attended by representatives from the neighbourhood care test sites, national organisations and third sector organisations. The purpose of this meeting was to discuss neighbourhood care and regulation, with a focus on questions raised by the test sites before the meeting. We also took the opportunity to discuss measurement ideas and learn what plans were already in place for local evaluation.

Sharing learning from the test sites

After introductions, staff from each test site provided an update on the neighbourhood care work in their area. There has been a lot of activity across the test sites with positives discussed on this way of working, offers of support and an eagerness from sites to arrange visits to learn from one another. Common challenges faced by the sites include those around culture and shifting perceptions, but the passion for the concept and success stories continue to drive this work forwards and motivate the teams.

Care Inspectorate – from enforcers to enablers

Catherine Agnew from the Care Inspectorate gave an informative presentation about the role of the Care Inspectorate in supporting services as enablers of innovation, rather than the traditional perception of enforcing regulation. There is acknowledgement that services for the public are evolving with the integration of health and social care. In support of this, the Care Inspectorate have developed regulatory sandboxes, where normal regulatory requirements are waived to support innovation which has the potential for public benefit.

Attendees discussed the new health and social care standards in Scotland and were pleased to note that the principles of the Buurtzorg model mirror these standards (Dignity and respect; Compassion; Be included; Responsive care and support; Wellbeing).

Evaluation

We facilitated a group discussion on evaluation and undertook an exercise to look at measures, how important these are and how easy they are to use. Representatives from the test sites rated examples and entered them into a prioritisation tool, which could help the teams to look at work priorities and measurements in their areas. They highlighted difficulties with measuring face-to-face contact time, although this is an important measure to show effectiveness of this model and the test site representatives acknowledged that this is a measure that is important to care givers: ‘more time with the person needing care’.

They are aware that while test sites will have different measures and there will be local variation, there is a need to have some standardisation for comparisons. Evaluation should be meaningful in a local context for individuals, their carers and staff. However, an element of evaluation will be required for national interest to look at areas such as cost saving, avoiding hospital admissions and reducing length of stays, etc.

Prioritisation matrix

The King’s Fund has recently published a paper on transformational change in health and care in response to the growing pressures and demands on the health and care system. The paper highlights four case studies that have been recognised as successful transformation initiatives, led by staff that directly provide care and service users. One of these successful initiatives is the Buurtzorg Nederland model.

Next steps

The test site representatives agreed to try a new approach to the learning network, with an option to move to the IHI model of a breakthrough series collaborative alongside action learning sets facilitated by the Scottish Social Services Council in the future. Once logistics have been further discussed, options will be presented to the group to take forward. Members of the group were happy to share their plans for evaluation with the Living Well in Communities (LWiC) team and there are steps to visit each site. Further information will be available soon.

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. Continue reading “Updates from the Neighbourhood Care national partners meeting”

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”