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Scottish health board plans to trial 'holistic' Dutch community nursing model

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Scotland is to become the latest country in the UK to pilot a nurse-led model of community care from the Netherlands, with early discussions taking place at one if its health boards on how the prototype can be adapted.

NHS Borders said it wanted to test a version of the Dutch model – which uses teams of up to 12 district nurses to deliver care in people’s homes – to see how a more “holistic” approach to care could be provided in the future.

“We are aiming to provide a more holistic approach to patient care and to reduce the amount of people coming into people’s homes”

Erica Reid

Named the Buurtzorg – or “neighbourhood” – model, it sees management functions shared between members of the nursing team and requires nurses to spend at least 60% of their time with patients.

The typical caseload for a team is 40 to 60 patients in a local area – although most nurses in Holland work part-time under the model – and nurses co-ordinate care from other healthcare professionals, such as GPs and allied health professionals.

As exclusively revealed by Nursing Times in July, around a dozen other organisations are also currently looking at how the Buurtzorg approach could be adapted for England, including Guy’s and St Thomas’ NHS Foundation Trust and a consortium in West Suffolk.

In addition, at a community nurse conference last month, Northern Ireland’s chief nursing officer Charlotte McArdle said her country was likely to begin trialling the model.

The nurse leading the piloting programme at NHS Borders said the health board was working closely with its local council and partners in social care to develop plans.

It was hoped the model could provide a solution to the fragmented way care was currently being delivered in the community in Scotland and ensure only the minimum number of workers visited patients’ homes, she said.

“The person in the community who needs care sometimes experiences care that is fragmented with multiple people coming into their homes, sometimes focussed on time-limited tasks,” she told Nursing Times.

“We are aiming to provide a more holistic approach to patient care and to reduce the amount of people coming into people’s homes through that,” said Erica Reid, the programme director for piloting Buurtzorg at NHS Borders.

“For example, instead of a nurse just going in to a person’s home to give an insulin injection and then a paid carer coming in to make breakfast, with Buurtzorg the nurse may give the insulin injection and then make the breakfast,” she said.

“[Nurses] find the holistic nature of [Buurtzorg] appealing and the way it has a focus on enabling people to get back to self-management”

Erica Reid

However she stressed that access to support workers was “crucial” for some patients who sometimes needed care provided by both support staff and nurses, and it was important to work with social care organisations in developing the pilot.

NHS Borders has more than 50 nurses in its community nursing teams covering five areas across the region. Ms Reid said nurses she had spoken to so far about testing the Dutch model had shown enthusiasm for the idea.

“They find the holistic nature of it appealing and the way it has a focus on enabling people to get back to self-management, and they are attracted by the fact they would be coordinating the care,” she said.

Details of exactly how the model will be adapted to suit the NHS Borders region are expected to be made available in the coming months, Ms Reid told Nursing Times.

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Readers' comments (3)

  • michael stone

    I hope this is good news - I've mainly read good reports of this model's application abroad.

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  • seconded

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  • michael stone

    ANONYMOUS 25 OCTOBER, 2016 11:51 PM

    I am a little concerned, that the reason the model seems to work (which seems to me to be because the nurses make their own operational decisions in a much more 'bottom-up' manner, and are not very 'hedged in' by dictats from above and 'managerial oversight') might be thwarted over here by an undue emphasis on exactly those things (which I might express as 'too much interference from outside the actual nursing teams').

    Do you second that as well - or am I overly 'cynical' ?

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