Buurtzorg: reinventing the care industry through trust

Jos de Blok

After the awful events overnight in Paris, it occurs to me that we need to focus on positive news in the face of horror. I was lucky enough to attend Meaning Conference in Brighton last week; a conference focused on people and organisations who want to build better businesses and believe that business has a role to play in the global challenges we face. I had been really looking forward to hearing Jos de Blok, founder of Buurtzorg a Dutch care organisation which has been much hailed by the ‘teal’ community. Here’s the learning I took away from a very inspiring, and often funny presentation.

About Buurtzorg

Buurtzorg was set up by former district nurse Jos de Blok to address two key issues in the care sector:-

  • Low moral and performance among nursing staff
  • Expensive but also poor levels of care

The premise was to empower district nursing teams and healthcare workers in their own locality to organise self-managed units in direct contact with the local services such as GPs and hospitals, effectively cutting out all the middle management in between. His vision was to return the sense of independence with which district nurses and healthcare professionals once worked with at a community level.

Jos de Blo

Jos de Blok on the Meaning stage

Every team is responsible for its own clientele and for their own financial results. The support office where coaches work with the teams in both business and personal development is simple and part of De Blok’s own home. The Buurtzorg teams throughout the country also work from simple locations. Each team of around 12 is made up of on average 70% registered nurses (much higher than the national average in care providers), they serve around 10-12,000 people, are paid well and are highly motivated.

Once he set up in 2007, nurses flocked to his brand, clearly keen to find a better way of delivering homelier.  Today there are 800 different teams, 9700 nurses who serve 70,000 patients. The Dutch government is replicating his model nationwide, he’s invited to consult and build similar programmes all over the world, and needless to say he’s welcomed worldwide as an inspiring speaker. Year on year since inception Buurtzorg has been voted top employer and also topped the lists in client satisfaction. They are delivering higher care, better wages at 35% less in overall cost. Just by cutting out management, bureaucracy and buildings.

I took away three important points from listening to De Blok.

A Different Kind of Leadership

There has been a lot of discussion around the type of leadership needed in future organisations, especially within the ‘teal’ community. Frederik Laloux’s renowned book Reinventing Organisations (if you haven’t read this seminal text, grab a copy today) only flaw is perhaps to leave the description of this new form of leadership a little loose – perhaps because he wasn’t clear when he wrote it exactly what would emerge in the future.

Jos de Blok

Jos de Blok, Buurtzorg

There’s still leadership at Buurtzorg, but it is a form of leadership that is slowly emerging from the ego-centric, heroic leadership of the past. There’s no doubt that Jos De Blok is the source of inspiration and vision in this organisation – it would never have happened without him. His spirit and ideals are intrinsic to the company, yet you get the feeling it could survive without him. Although he is clearly the organisation’s charming and engaging front-man, once he put the structures in place he has allowed it to run as a fully empowered organisation where employees run their own units without interference. De Blok operates almost like a ‘fairy godmother’ or benevolent wise guide who magically creates Disneyworld and then steps back and lets people play in it as they choose.

Trust in the inherent goodness of people

One of the things that struct me the most about De Blok was his deep belief in the goodness of humankind. At a time when we are often deeply critical of the morale or service we are shown by nursing staff in the NHS – I’m thinking of 2 experiences in Ashford Hospital Middlesex which were both appalling – Jos De Blok made a simple statement of belief:

People don’t go into the nursing profession to cause harm; they come into the profession because they care deeply and passionately about people’s welfare. If you trust people to do their job, they will take responsibility and be accountable.”

His faith in the inherent goodness of human nature, and the clearly happy and inspired team around his, was a humbling reminder of what can be achieved if you bestow trust and empower people to be their best selves.

The Shackles of Middle Management

We know it. We know that middle management is responsible for waste and cost. It’s not a war on management – they are in place because that’s the way we have allowed public and private business to operate. It’s what we were taught in business school and it has created a lot of employment and business over the years. Where would consultancy be without middle management? What is apparent is that in certain industries – and public care is undoubtedly one – is that rather than being an empowering force, they are restrictive and disempowering. Layers of bureaucracy impede rather than add to quality of care and efficient delivery. The very control structure put in place to ensure quality, impedes it.

The Buurtzorg ‘experiment’ has taken the best from a previous model in history and reinvented homecare it for the 21st century. It’s lean, cost-effective, delivers top class care, and happy staff and patients. Of many presentations at Meaning, this one was perhaps the most inspiring because it brings to life a real living breathing new business model of better business.

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