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English ‘Buurtzorg’ pilot impresses patients and nurses

A Dutch case study investigates the feasibility of easing the district nurse workload

A Dutch evaluative mixed methods case study investigates the feasibility of easing the district nurse workload

The district nursing (DN) workforce in many parts of the UK is contending with funding and staffing challenges, which compromise the care delivered and policy objectives of promoting more care out of hospitals. 

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The Dutch social enterprise, Buurtzorg, is a model of patient centred care and self-managing nurse teams which delivers high levels of patient and staff satisfaction.

This evaluative mixed methods case study investigated the feasibility and outcomes of such a model through one pilot team in England using interviews, documentary analysis and patient records. 

For patients and carers the pilot neighbourhood team care system was preferable to previous experiences of district nursing as they felt they received better continuity in care, improved support and clinical care for multiple long-term conditions and proactive case management.

For the neighbourhood team nurses, self-managing meant that they could make operational and clinical decisions that made them more responsive, accessible and efficient and offered a more attractive working environment (on issues that the DN nurses reported as problematic). 

There were challenges to being self-managing in a large NHS organisation. From the pilot data it was not possible to quantify, cost or compare with the standard DN service. 

This model holds promise but requires further evaluation over a longer time period.

Drennan V, Calestani M, Ross F et al (2018) Tackling the workforce crisis in district nursing: can the Dutch Buurtzorg model offer a solution and a better patient experience? A mixed methods case study. BMJ Open. 8, 6. doi: 10.1136/bmjopen-2018-021931.

Compiled by Vari Drennan, professor of healthcare and policy research at Kingston and St. George’s, University of London

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