Why Buurtzorg social care doesn’t work in the UK – yet!


John Seddon wrote to all those people listed as interviewees in the report A Blueprint for Children’s Social Care. Every reply John received stated clearly that the interviewee did not concur with the report’s recommendations.

Dear Interviewee

I’m writing to you because you were listed as an interviewee in A Blueprint for Children’s Social Care: Unlocking the potential of social work. Your listing as an interviewee suggests you might concur with the report’s recommendations, but I am aware some of the interviewees do not.

I read the Blueprint owing to reading about the controversy surrounding its authorship in Private Eye. My first concern was that the Blueprint portrayed the UK pilots of Buurtzorg as successful. If Buurtzorg Netherlands sets the standard, then the UK results are negligible, even nil and dysfunctional. The most important lesson learned was that senior management of the UK pilots had no idea of the change in philosophy – and therefore their behaviour – and frequently served to undermine what they regarded as ‘projects’.

I shared these findings with Brendan Martin (Buurtzorg UK) and Jos de Blok (Buurtzorg Netherlands) last summer. It was in the form of a podcast. Brendan was reported by Private Eye to have withdrawn support for the Blueprint arguing that structure is the wrong starting-place. He’s right. Jos is aware that the problems the UK pilots have experienced are evident in other countries.

No surprise. Many counties copied the UK’s New Public Management agenda and have similar specification and inspection regimes. My colleagues in Scandinavia report the same issues with the Buurtzorg pilots there.

The Blueprint represents a manifesto for training people to operate in a new structure. If this goes ahead, we will waste millions. And get nowhere. Care service is not a training problem – as is believed by politicians since Ed Balls – it is a system problem. Private Eye reports that Frontline has received £72m for training; what has changed?

Social workers leave because the system gets in the way of their purpose. We need to change the system. Worse, the care we provide is frequently ineffective yet it ticks the boxes of current control systems. It’s the control systems we have to change and we can only do that by redesigning the system.

That’s what happened in Buurtzorg Netherlands and that’s what’s also happened in many UK care services. In both cases it started with leaders change the way they think about the design and management of the system. I describe the differences in how that process occurred for Jos de Blok and UK leaders in the podcast.

But the consequences are the same. There are already many UK care services with results comparable to Buurtzorg. It should be no surprise, because they are systems designed to give each and every care recipient the support that exactly matches their needs.

Matt Hancock says we need care services to work as systems, where needs of care recipients matter more than silos and, he says, this change should not take long. The evidence is already here. It doesn’t take long when leaders understand what is required and, vitally, understand why their current controls are working against the purpose.

It is perhaps counterintuitive to believe that giving people precisely what they need results in lower cost in care services and other systems, greater capacity, and, most importantly, better lives. But the evidence is incontrovertible. We won’t get there with a new structure and years of training in new team roles.

You can have the best of both. As we share the same ambition, we are collaborating with Buurtzorg UK. We will help leaders get through the thinking challenge and Buurtzorg will help people realise the values and practices of outstanding person-centred services.

When leaders get it, change is fast. The podcast describes how they get it.



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Radix is the radical centre think tank. We welcome all contributions which promote system change, challenge established notions and re-imagine our societies. The views expressed here are those of the individual contributor and not necessarily shared by Radix.

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