In many countries, most social care is carried out by unqualified workers on low pay. The economic rationale: why pay for health professionals when you don’t have to?

But a Dutch approach to social care is turning that argument on its head - why use anyone who is not a healthcare professional? And remarkably, it is showing that using qualified nurses ends up being cheaper.

‘Buurtzorg’, meaning ‘neighbourhood care’, allows nurses to act as a ‘health coach’ for their patients, advising them on how to stay healthy, caring for their needs and using their initiative.

This proactive process has enabled the Dutch healthcare system to reduce costs by around 40%, while the time it takes to administer care has been slashed by a staggering 50%.

These impressive figures have not gone unnoticed, with a host of other countries around the world considering a similar style of community care.

Retirees participate in a yoga class in Sun City, Arizona, January 7, 2013. Sun City was built in 1959 by entrepreneur Del Webb as America?s first active retirement community for the over-55's. Del Webb predicted that retirees would flock to a community where they were given more than just a house with a rocking chair in which to sit and wait to die. Today?s residents keep their minds and bodies active by socializing at over 120 clubs with activities such as square dancing, ceramics, roller skating, computers, cheerleading, racquetball and yoga. There are 38,500 residents in the community with an average age 72.4 years. Picture taken January 7, 2013.   REUTERS/Lucy Nicholson (UNITED STATES - Tags: SOCIETY TPX IMAGES OF THE DAY)ATTENTION EDITORS - PICTURE 25 OF 30 FOR PACKAGE 'THE SPORTY SENIORS OF SUN CITY'SEARCH 'SUN CITY' FOR ALL IMAGES - RTR3CITB
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A proactive approach to healthcare

The old adage of ‘prevention is better than cure’ is the central principle underpinning the Buurtzorg model.

In the capacity of ‘health coach’ for the patient and their family, the nurse will focus primarily on preventative health measures. But that’s not to say that necessary care isn’t delivered when an issue arises.

What separates Buurtzorg from other healthcare providers is the freedom for nurses to use their initiative in administering care, without the burden of hierarchical management structures.

The golden rule is that nurses must spend at least 61% of their time with patients - admin tasks are seen as very much a secondary concern.

To achieve this, nurses are supported by an IT operation that facilitates ‘real time’ information, which is directly connected to the care process and reduces admin costs.

A social care revolution

The impact Buurtzorg has had on social care in the Netherlands has been astonishing.

Founded by Dutch nurse Jos De Blok in 2006, Buurtzorg has evolved from a team of four nurses into an operation that deploys units of up to 12 nurses, who are responsible for between 40 and 60 people within a particular area.

There are now around 900 teams in the Netherlands, supported by no more than 50 administrators and 20 trainers.

Buurtzorg has delivered savings of around 40% to the Dutch healthcare system. Costs per hour are higher, but that is offset by the fact that fewer hours are required to conduct care.

A case study by KPMG found that “Buurtzorg has accomplished a 50% reduction in hours of care, improved quality of care and raised work satisfaction for their employees”.

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Dutch export

Ageing populations have led to spiralling global care costs, so it’s perhaps not surprising that other countries are beginning to see the benefits of Buurtzorg.

Indeed, community care schemes are already being trialed in the UK and Sweden, while a host of other countries - including Austria, Germany, Japan and the US - are also set to launch pilots soon.

If potential obstacles in the form of funding and legacy admin systems can be negotiated, there’s every chance neighbourhood care could eventually become commonplace around the world.