They say you should never waste a crisis, and by any standards social care is in one. So how to turn adversity into opportunity?
My answer to that question has grown from the experience of looking after my mum in the last years of her life, when I had a close-up look at the state of home care in London.
What I saw was a failing system propped up by a largely compassionate and committed workforce, an army of low paid women in low status jobs, most of whom do the best they can for their vulnerable clients despite being poorly supported themselves.
Having spent the previous 20 years or so supporting public service employers and workers worldwide to improve services through better staff involvement, I was convinced I could apply what I had learnt to Britain’s home care challenge.
So my colleagues and I imagined the kind of home care we would want and looked around the world to see if there were any practical examples that matched our vision.
We didn’t have to look far. Just across the North Sea in the Netherlands we found a social enterprise called Buurtzorg — it’s Dutch for ‘neighbourhood care’ — that had started with a similar vision to ours and turned it into a spectacularly successful reality.
Now my social enterprise, Public World, is Buurtzorg’s partner in Britain and Ireland. We have already supported the creation of four self-organised teams in London and Kent, with more on the way in other parts of England and Scotland.
From one team of four nurses in 2007, Buurtzorg has grown to 14,000 staff in more than 900 neighbourhood teams and several offshoot ventures in domestic help, mental health, maternity and youth services.
For Buurtzorg, the boundary between health and social care is artificial, just as it is for the people they look after — or rather the people they help to take better care of themselves with the support of their families, neighbours and friends.
That last point is one of the secrets of Buurtzorg’s success and financial sustainability. Of course Buurtzorg’s caregivers apply all their varied qualifications to the needs of their clients, but they aim also to minimise and reduce dependence on professional support by promoting self-care.
That means investing a lot of time upfront, getting to know their clients, their families and their wider social environments, and mobilising their capacities to help. This reduces the number of hours of care needed in the longer term.
Buurtzorg has the same enabling attitude to its frontline workforce as they have to their clients – the company has been named Holland’s best employer four years out of the last six.
The self-managed teams know they can rely on Buurtzorg’s small back office — just 50 people — to support them with HR, IT and administration services, and 20 regional coaches to help solve problems.
High performance comes from support not command. With an overhead of just eight per cent of turnover, Buurtzorg has managed to combine quality jobs and services with financial efficiency.
“We started working with different countries and discovered the problems are the same. The message every time is to start again from the patient perspective and to simplify the systems,” says Buurtzorg founder Jos de Blok.
Working closely with Jos and his colleagues, we have set up a Buurtzorg Academy to support organisations that want to provide truly client-centred, relationship-based care in financially sustainable ways.
If you think we can help you, please get in touch via firstname.lastname@example.org.