Northern Ireland is likely to begin piloting a nurse-led community care model based on one used in the Netherlands in the near future, according to the country’s most senior nurse.
Health and care trusts will be able to pilot a version of the Buurtzorg community nursing model, Northern Ireland’s chief nursing officer Charlotte McArdle has indicated.
“Our five health and social care trusts will have the opportunity to pilot something”
Professor McArdle outlined the move in a presentation on future strategies for community and primary care nursing at a conference in London yesterday.
“A team of our senior nurses have been out to the Netherlands to look at the Buurtzorg model,” she told delegates at the Queen’s Nursing Institute annual conference.
“They have come back completely enthused by what they’ve seen and each of our five health and social care trusts will have the opportunity to pilot something in this space,” she said.
Professor McArdle said a workshop would be held in October “to consider the feedback from the Buurtzorg visit, the model of care and how we begin to test those principles in our nursing teams”.
“I would anticipate at this stage, without wanting to the pre-empt the workshop, that there will be prototypes in Northern Ireland of Buurtzorg, in terms of taking the principles and trying to apply it,” she added.
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 the UK, including Guy’s and St Thomas’ NHS Foundation Trust and a consortium in West Suffolk.
The Buurtzorg – or “neighbourhood care” – model uses teams that have a maximum of 12 district nurses to deliver care in people’s homes. The typical caseload for a team is 40 to 60 patients in the local area, although most nurses involved in the model in Holland work part-time.
Nurses are self-managed and co-ordinate care with other healthcare professionals. However, they must also spend at least 60% of their working time with patients and no more than 40% on other activities such as meetings and travelling.
“I do really value the role that community nursing plays”
Professor McArdle also used her speech to outline a new district nursing framework for Northern Ireland, which she noted had “been a long time in the making”.
The CNO for Northern Ireland told delegates she viewed “community nursing in its entirety” as being a “real central tenant of how we move forward with health and social care in Northern Ireland”.
“We have been developing this district nursing framework to modernise the service and try to align it and standardise it, because everyone I speak to has a different view of a district nurse,” she said. “Not everybody recognises that district nursing actually is a specialist qualification.”
She stated that the document – titled A District Nursing Service for Today and Tomorrow: A Framework 2015-25 – was underpinned by four key principles. These were person-centred care, integration, efficiency and effectiveness, and expertise, she told delegates.
“The vision for district nursing is to achieve an innovative, collaborative transformational service, which is world class in delivery and that looks after patients 24 hours a day, seven days a week no matter where you live,” said the CNO for Northern Ireland.
“That’s a vision that has been developed by engagement with frontline nurses, district nurses and district nursing team leaders and managers all the way up in the system,” she added.
Professor McArdle said she wanted the framework to act as an “engine room for change” so in future “we will have nurses with the right skills in the right place supporting patients and their families to make decisions about their own care and make sure we’re focused on positive outcome”.
“I do really value the role that community nursing plays. In particular, I would like to see a refocus on the district nursing role in terms of recognition for the expertise that it brings and the specialist qualification that it has,” she told delegates.
She added that Northern Ireland’s Department of Health was also in the final stages of preparing a framework for primary care nursing, though she not reveal any details.
“Community and district nursing is the way to go, it’s where we need to focus on”
However, she stated: “I see primary care particularly as an area that remains very much underdeveloped and a bit isolated and removed from the mainstay of the professional body, and I think we need to address that.”
Professor McArdle added that Northern Ireland was also testing out service models such as providing “acute care at home”, that took pressure off hospital beds and was better for patients.
It was also looking to make nursing homes more patient-centred via an education, training, development and partnership programme with nursing homes registrant staff.
In addition, trusts were working on electronic caseload analysis for district nursing, said Professor McArdle.
She told delegates: “We have to get this right. I believe community and district nursing is the way to go, it’s where we need to focus on.
“It will provide the maximum number of opportunities to create the change we need in the system,” she said.