Holistic community nursing model may be adopted following trial success

Improved autonomy of 'Buurtzorg' care model impresses staff at leading trust
Joan Norris and Yasmin Kamara

Improved autonomy of 'Buurtzorg' care model impresses staff at leading trust

A radical style of community nursing may be adopted by an NHS trust after a trial proved rewarding to nurses and empowering to patients.

Nurse Yasmin Kamara spends time with patient Joan Norris

Guy’s and St Thomas’ NHS Foundation Trust was the first trust in England to test an approach to district nursing based on the Dutch nursing model known as 'Buurtzorg'.

This week an independent evaluation of the new model of working reported positive results. The trust is now looking at how it could be introduced more widely.

Holistic care boosts independence

Neighbourhood nurses supported by a coach rather than managers make decisions and offer patients substantial nursing and personal care. In addition to giving medicine and dressing wounds, this may involve washing, dressing, meal preparation and shopping. The level of care reduces over time as patients become independent and take control of their care. 

The trial began with a team of six neighbourhood nurses in Brixton, south London. Each patient was within a 20-minute walk of the team office. A second team of seven nurses was introduced in Southwark in 2017.

Good for professional development and job satisfaction

A review of the trial by the Centre for Health and Social Care Research at Kingston University and St George’s, University of London, found nurses benefited from professional development and job satisfaction. However, they encountered challenges in adapting to working as self-managing teams.

Neighbourhood nurse Yasmin Kamara said: ‘It's every nurse’s dream to work in this way. We take as long as is needed with patients, until they feel empowered to become less reliant on health and care workers and can begin to take control of their own care.

‘For many of our patients we become like a family to them. It’s very rewarding.’

Care model gives control to community nurses

Trust head of adult community nursing Cepta Hamm said: ‘I never doubted the skills of my community nurses, this was always about giving them back the control to determine what care needs to look like.

‘When I first joined the trust my nurses said to me ‘you need to give us the time to care’. That is what spurred me on to explore this model of nursing.

‘They now tell me this is the best job they’ve ever had and they would not want to work anywhere else, that makes me so proud.'

Buurtzorg, which means ‘neighbourhood care’, was created by Dutch nurse Jos de Blok in 2006 after he and his colleagues became dissatisfied with the delivery of healthcare in the Netherlands.

Further information

The Guy’s and St Thomas’ NHS Foundation Trust Neighbourhood Nursing Team Test and Learn project of an adapted Buurtzorg model: An early view

In other news