Name of the project and Sub-Objective of the PEOPLE project NEIGHBOURHOOD CARE AND NEIGHBOURHOOD CARE WEB / BUURTZORG AND BUURTZORGWEB E-health & independence (SO2)and Social & e-inclusion (SO4)

Objectives of the project (1) Developing an innovative, small-scale concept for home nursing and care. To this end, Buurtzorg provides a number of services to GPs aimed at increasing the cohesion in care provision; Buurtzorg [neighbourhood care] wishes to promote the combining of functions by neighbourhood care teams and GP's practices. This contributes to improved care quality, makes the work more enjoyable and leads to the more effective organisation of care. It also gives GPs more influence on the manner in which care at home is carried out;

Objectives of the project (2) Care should be provided entirely by highly educated district nurses and district nurses in small, autonomous 'Buurtzorgteams' [neighbourhood care teams] which makes improved use of their problem-solving capacities and the staff's professionalism; Keeping management costs and overhead as low as possible which enables better care to be provided at lower cost which provides an appealing perspective to the clients, professionals and insurers; Offering better, more durable and effective solutions to clients for the implementation of modern, supporting ICT applications which enable administrative costs to be kept to a minimum.

Beneficiaries (involved & concerned) Buurtzorg Nederland is the initiator of the new, neighbourhood-oriented home care concept and together with ICT company ECare it has developed and implemented the supporting ICT system Buurtzorgweb [neighbourhood care web].

Results of the project (1) A neighbourhood-oriented home care concept which closely involves the neighbourhood with the care professional as the case manager using a supporting, web-based neighbourhood platform and ICT functionalities (Buurtzorgweb) for care registration and communication in the chain and with clients and informal care providers. A neighbourhood scan has been developed to catalogue and publish the facilities per neighbourhood on the neighbourhood platform's website. Communities for e-learning have also been founded to keep staff expertise up to scratch on the basis of knowledge circles; The basis for the concept has proven itself in 75 neighbourhoods where small teams of 10 to 12 staff provide help with high levels of customer satisfaction, as is the case in the province of Noord- Brabant. In 2008, 750 staff started working for Buurtzorg in 75 teams which provided care to 2,000 clients;

Results of the project (2) Nivel has compared Buurtzorg clients' experiences to those of clients of other home care organisations. The clients are enthusiastic, the quality of care is described as high. The good telephone accessibility, the professionalism and the safety of the care provided are conspicuous. Buurtzorg received the highest score from clients of all home care institutions (308 in total). The Nivel researchers conducted interviews with staff, informal carers, clients and GPs, and analysed the interviewed clients' surveys. The clients' experiences were compared to those of well over 9,500 clients of 307 other home care organizations;

Results of the project (3) Buurtzorgweb provides immediate support to the staff in their daily work and transforms them from digitally illiterate people into pioneers in the field of e-health. It raises the selfdirecting capacity of the home care staff and moreover the system leads to considerable savings. The website is initially used for registering hours and scheduling. Furthermore, the site provides all manner of functionality which helps the staff with their daily work such as a digital social map so that they can quickly see which facilities exist in the client's vicinity. It also allows the staff to chat, discuss and exchange knowledge with one another; The concept is now being scaled up to 150 neighbourhoods due to the further development of Buurtzorgweb with financial support from the government.

Strengths of the project o Self-directing capacity of carers as point of departure; o A demand-oriented and personal approach to clients; o Small, autonomous teams which guarantees personal, flexible service whereby a limited number of carers visit people at home; o Neighbourhood-oriented approach which enables more knowledge of the neighbourhood's social networks and the improved utilisation of and cooperation with informal care; o Low overheads which create low organisational costs and more room for arrangements and own responsibility for carers in the care provided to clients.

Success factors of the project (1) Utilisation of ICT functionality and the neighbourhood platform which allows more rapid communication with the carers in the chain, clients and informal care providers in the neighbourhood and allows the work to be carried out more efficiently. This enables clients to be helped better and more cheaply on the basis of a small-scale home care concept; The return of permanent contacts per neighbourhood and cooperation with GPs who are very enthusiastic about and satisfied with the accessibility and the Buurtzorg teams' permanent contact;

Success factors of the project (2) Explicitly steering towards less care than indicated instead of depleting budgets. Having a good eye for what the client really needs linked to professional judgment: is what the client wants, feasible and desirable from a care perspective; The concept is supported and stimulated by the government, insurers, political parties and the municipalities.

Problems occurred (1) Large-scale home care organisations are not sufficiently open to Buurtzorg's small-scale concept. That is why a foundation was started by a social entrepreneur based in the professional group. This is a shame in a way, however simultaneously it is also a good means of properly and purely demonstrating the strength, viability and advantages of a different, small-scale way of organising home care. These fellow organisations have responded aggressively and have attempted to obstruct Buurtzorg's work and block channels to hospitals. The dismantling of organisations by focusing on professional points of departure and care values is encountering hostility; Difficulty being accepted by care offices due to suspicion;

Problems occurred (2) The change in criteria from a production-driven to a more context-driven approach takes time to sink in at care offices and insurers; Changes to government regulations and the new definition with regard to focusing on clientprofessional relationship take time; Pre-financing the supporting technological system requires substantial investment from the organization which makes a subsidy essential.

Conclusions (for the future) The Buurtzorg concept for the small-scale organisation of home care is feasible, in part thanks to the supporting ICT of the Buurtzorgweb, and provides quality improvement and cost reduction in home care which allows more people to be helped in a very demand-driven, customer-friendly manner.

Replication of the project  Buurtzorg supported by Buurtweb will be rolled out in 150 neighbourhoods in the Netherlands with support from the government;  Large-scale home care organisations can learn from the Buurtzorg concept and broaden the concept on the basis of this by reorganising into smaller-scale neighbourhood teams using ICT;  Buurtzorg wishes to contribute to narrowing down the debate concerning the effects of the current structure of the care system.