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Hancock talks up potential of Dutch community nursing model

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Health and Social Care Secretary Matt Hancock has indicated he wants to see an increase in the adoption of community nursing models similar to one pioneered in the Netherlands.

Speaking at a primary care conference today, Mr Hancock cited the Buurtzorg model as a way of better balancing healthcare resources from hospital to community settings.

“People have talked for years about wrap-around care. With Buurtzorg that is happening”

Matt Hancock

He also highlighted in his speech that “nurses effectively self-manage” patients under the Buurtzorg system.

“Compared with other models, the Dutch model delivers higher-quality care at a lower cost. I want to see it grow,” he told the audience of GPs and other primary care clinicians.

The Buurtzorg or “neighbourhood care” – approach is based on small, self-managing teams of community nurses who spend at least 60% of their time with patients.

The nurses, usually part-time, cover a neighbourhood of no more than 5,000 people with a typical team caseload of between 40 to 60 patients in a local area.

The model is already being piloted in various parts of the UK, either at organisation or national level, as previously reported by Nursing Times.

For example, in January, Guy’s and St Thomas’ NHS Foundation Trust is looking to roll out a new nurse-led model of community care, based on key elements of Buurtzoorg.

It followed a pilot where patients and staff said quality of care improved, according to an evaluation.

Meanwhile, £2m was set aside in Wales for 2018-19 and 2019-20 to fund a Buurtzorg pilot. Similar trials have also been considered or begun in West Suffolk, South East Scotland and Northern Ireland.

Addressing the National Association of Primary Care conference today in Birmingham, Mr Hancock highlighted the need to correctly balance investment between prevention and treatment.

He said: “We need to look at places where people have got this shift of resources right, and managed to rebalance the system between primary and community care on the one hand and secondary care on the other. Like Buurtzorg in the Netherlands.

“Under this Dutch model, nurses work in small self-governing teams to provide a range of care and support,” he noted. “They lead the assessment, planning and co-ordination of patient care.

“They’re trained to have a flexible skill set, which allows them to deliver a range of treatments including wound care, diabetes monitoring, IV infusion and end-of-life care – and also to navigate the system,” he said.

He added: “The nurses effectively self-manage. This enables them to gain managerial experience while delivering clinical care. People have talked for years about wrap-around care. With Buurtzorg that is happening.”

Mr Hancock’s speech covered primary care provision in England in general, including workforce pressures.

While focusing on existing targets to boost GP numbers, he also highlighted goals to increase care provision and capacity by other members of the general practice team.

“Increasing the numbers of GPs isn’t, on its own, enough to meet the growing health challenges we face as a nation,” said the health secretary.

“GPs are part of a team, and through them manage the health of our country,” he said. “So, GPs working in, and leading, mixed teams of nurses, pharmacists, physios and other healthcare staff is the way forward.

“We are on track to increase the number of other clinical staff working in primary care by 5,000 by 2020 to 2021 – and have recruited more than 3,000 since 2015,” he told the conference.

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