Integrated Care in The Community

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Social innovation


Health services across the 2Seas region are under continuing pressure as the population ages and public funding decreases. A number of initiatives across Europe have been highlighted as good practice, and yet the occurrence of these or similar ideas being implemented in a different country is low. This project will identify the ‘blocking’ points in transferring a good practice from one area to another and present a method to overcome these barriers and ensure that good practices are fully transferrable. The project will be looking at creating large scale systemic change in the health and social care sectors. This methodology will be created and tested via the implementation of the Buurtzorg community nursing model into new geographic and cultural contexts. There is a serious need to address the clinical, social and financial challenges in health and social care so that citizens take more control of their care, supported by a technological and digital revolution. The objectives of this proposal are to change the way traditional health and social care services work and to develop a methodology to support the integration of health and social care teams and services, increase community capacity and improve workforce recruitment and retention as per local, national and EU policy and strategy. We will be learning from the Dutch Buurtzorg model (Self Managing Neighbourhood Nursing Teams) and exploring with partners from other regions whether the model is transferable into their local systems. Technology will play a key part in relation to communication between professionals, patients and citizens. Buurtzorg uses small self-steering teams (with a maximum of 12 nurses) who attend to an area of approximately 15,000 inhabitants and work together to ensure continuity of care. As a result, the professionals build durable relationships with their community, which further strengthens their ability to find local solutions for patients’ problems. Although the teams are independent and self-steering, they are supported by a centralized service organization which provides management information to both the team and the organizations’ leadership in order to minimize local overhead and maximize the professional’s face-to-face time with patients.

Creation date: 26/05/2016

Bloc onglets

Bloc 1

Overall objective

To enable large scale systemic change in the health and social care sectors, providing services better suited to meet the needs of our ageing population.

Bloc 2


• A fully tested and evaluated model describing how to overcome barriers preventing implementation of systemic change in health and social care provision. • Successful implementation of the Buurtzorg model in the UK, France and Belgiu

Bloc 3

Expected result

• Better home nursing/social care for patients, shown by quality of care satisfaction surveys • More motivated workforce • Better staff retention amongst service providers • Greater uptake of European good practices in health and social care

Bloc 4

Cross-border added-value

This project will be taking a Dutch model of good practice, evaluating it and implementing it in the UK, France and Belgium. In doing so it will be analysing the barriers that have prevented this good practice being implemented previously and design a model to overcome these. The project would not be possible without cross-border cooperation as the good practice exists in one country only, and to date has not been implemented in any of the others, even though there is a clear desire and need to do so. The end results will only be achievable through working with each other to understand and overcome the barriers.