Writer of leaders for The Information Daily, Healthcare Innovation Monitor and Public Service Digital.


Buurtzorg Nederland community care model. Better care for less money with better outcomes? Spotting the wood among the trees.

Some people in the USA are trying to copy the Buurtzorg Nederland community care model. No doubt there are people in the UK who wish they could do the same. They are wasting their time

A few weeks ago The Leader was invited to sit in on an Web TV interview with Andy Street the MD of John Lewis. The interviewer asked why no one had managed to copy the highly successful John Lewis business model.

They have tried said Mr Street and very largely failed. Failed because you can’t copy the model. To succeed you need to have the same set of values. Just trying to copy the model does not work.

Hold that thought.

Buurtzorg Nederland is a Dutch home-care organization celebrated for its innovative use of independent nurse teams to deliver care packages. Buurtzorg is Dutch for “neighbourhood care”

A 2009 study for the Dutch Ministry of Health found that Buurtzorg Nederland’s productivity was 6.4% higher than comparable care organisations, while overhead costs and sick leave were less than half, and labour turnover 50% less. Patients improved in half the time, and experienced one third fewer visits to the hospital emergency department.

Buurtzorg was developed following market-based reforms to the Dutch care system which were intended to reduce costs but which triggered a high degree of regulation which in turn resulted in fragmentation of patient care, more paperwork and less time spent caring for patients.

Buurtzorg was created in response to this situation and has achieved its objectives of improved patient outcomes, reduced costs and greater patient and nurse satisfaction by enabling nurses to form self-directed teams that provide the home care services with minimal managerial and administrative oversight and in collaboration with patients, their families, physicians and the community.

Buurtzorg replaces a market-based system where organisations are reimbursed purely for the hours of care delivered rather than the outcomes achieved.

Buurtzorg carers have a relatively high level of professional training and this supports a self-help, self-organising and self-managing approach. Consequently management and administration is minimal, with a tiny administrative team supporting carers responsible for more than 70,000 patients.

This lean organisation is enabled by a bespoke ICT system tightly integrated into the administrative and managerial processes of the organisation, minimising the need for reporting and bureaucracy.

Buurtzorg is an excellent example of service re-design and digital transformation, achieved by giving people space and scope to the job that they are qualified to do in the way that they want to do it. If the same team member to supervisor ratio (better than 142:1) were achieved across the whole UK sector, the savings would be huge, and could happen while productively was simultaneously increased.

The Leader has noticed that in the USA some people are trying to copy the Buurtzorg model. No doubt there are people in the UK who wish they could do the same.

Don’t waste your time. As Andy Street pointed out it is having the fundamental values and sticking to them over time that accounts for the success not imitating the model.

Buurtzorg Nederland: a model for future public services? Is free of charge to Socitm Insight subscribers and can be accessed via the Socitm Insight Group on the Knowledge Hub at

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