Adapting and adopting the Buurtzorg model Early lessons from the UK experience Presentation by Brendan Martin, Public World bmartin@publicworld.co.uk NHS England study visit 26 - 27 January, 2016. Almelo, The Netherlands

Buurtzorg vision to Support Independence Text Buurtzorg strives to provide solutions for clients who require care but want to maintain their independence and improve their quality of life. The Buurtzorg Onion Model serves as the starting point. People want to control their own lives as long as possible ·  People always strive to maintain or improve their own quality of life ·  People seek social interaction ·  People seek ‘warm’ relationships with others (friends) Personal situation By kind permission of Buurtzorg 2015 2 All content © Public World 2015

Key challenges of adapting Buurtzorg to British contexts Climate and culture: trust in enabling freedom with responsibility at the frontline Risk perception: self-managed teams and management control Knowledge: learning to integrate around client, mobilise informal networks and work in self-managed teams Structures: institutional and financial separation of health and social care Regulation: complex governance and safeguarding arrangements Business case: outcome-based not activity costing, and higher unit costs but overall savings Resources: costs of experiments and transition All content © Public World 2015 3

Why Britain needs freedom and responsibility at the front line “The patient must be first in everything that is done: there must be no tolerance of substandard care; frontline staff must be empowered with responsibility and freedom to act in this way under strong and stable leadership in stable organisations.” Francis Report into Mid Staffs, February 2014, paragraph 1.118 All content © Public World 2015 4

Public World Buurtzorg - test & learn support pathway Check and review point Check and review point Developing a shared understanding Scoping and creating the test site(s) Training and establishing the team(s) 1. 2. 3. Agreeing the scope 5 days team training Introduction to Buurtzorg model of care 2.5 days coach training Compliance and governance framework Creating environment to support the teams Ground rules inc. HR policies Assessment of current situation and ambition 1 day training for managers & leaders Configuration of Test Test Plan Define outcomes & benefits Test team(s) visit Buurtzorg team Understanding & adapting the model in context Benchmark data Metrics and evaluation criteria Desired outcomes and benefits Determine Governance arrangements Public World’s role and deliverables Individual mindsets Check and review points Readiness of organisational architecture Leadership & strategic view Review Learning Revise activities

Public World Buurtzorg - test & learn support pathway Check and review point Check and review point 4. Supporting the test sites 5. Scaling Support for the teams & Mid-Office Rolling existing new teams into the model Guiding the process for teams to flourish Consolidation learning into wider system Challenging & reducing processes Supporting teams to act on learning and adapt solutions from other teams & tests. Evaluation against desired outcomes & benefits Individual mindsets Check and review points Readiness of organisational architecture Leadership & strategic view Review Learning Revise activities