Tackling staffing shortages in health and social care – lessons from Buurtzorg

Alongside rising demands and reducing budgets, there is another critical challenge facing health and social care here in the UK.

Alongside rising demands and reducing budgets, there is another critical challenge facing health and social care here in the UK.  Challenges in retaining and recruiting a sustainable workforce threaten our ability to deliver an effective service both in the present and into the future.

Staff are the lifeblood of the health and social care sector and without enthusiastic and dedicated staff we cannot face the demands ahead.  But staff shortages in both health and social care are an all too common reality.

The Office for National Statistics reported that in 2016 health and social work accounted for 15% of vacancies in the whole UK economy.

But the challenge doesn’t end there.

Not only are we struggling to attract people into the sector but we also struggle to retain them.
The ‘State of the adult social care sector and workforce in England, 2017’ report produced by Skills for Care reported that the staff turnover rate was 27.8%, with turnover rates increasing steadily, by a total of 4.7 percentage points, between 2012/13 and 2016/17.  The report noted that ‘this level of turnover and churn indicates that employers are struggling to find, recruit and retain suitable people to the sector’.

With increasing demands and pressures on staff likely to exacerbate the challenges of recruitment and retention in the sector, now is the time to develop new, innovative approaches to workforce.

When we first started out on the journey towards our Buurtzorg Test and Learn one of the powerful messages we heard was how the model had resulted in an increased sense of shared values across the organisation, resulting in more satisfied employees.  Under this model staff satisfaction is high, and the organisation has been numerously named Dutch employer of the year.

At one of our early workshops in 2016 we had a visit from a Buurtzorg nurse.  In her words she described how she, like many of her colleagues, joined Buurtzorg to escape a ‘time and task’ approach to care.   “The care was really fragmented” she stated when talking about her role before joining Buurtzorg. “A care worker for washing and clothing, a nurse assistant for the stockings and a nurse for the wound care.  There was no time to connect with the client.  No one had a holistic view.”

This is a situation not dissimilarly described by health and care workers here in the UK, and in testing the model here in West Suffolk we are as interested in the workforce element of the model, as we are in the holistic approach to care.

One of the question we will be seeking to answer over the next year is “does the model improve the satisfaction of workforce to feel that they are able to deliver the best possible care and are valued for the work they do?”

We began recruiting to our Buurtzorg team in the summer.  This started with an engagement campaign going out to talk to groups of professionals, student nurses and running drop in events in health and care workplaces, and we received generally positive messages from those we spoke to.

We mitigated some of the obvious challenges of recruiting to a 12 month project by offering secondments and permanent contracts.

Never the less recruiting to our Buurtzorg Test and Learn team has been and continues to be challenging.

We now have half our team recruited, and we will aim to start small in the New Year growing our case load as we grow our team.

We know that change doesn’t always come quickly. There is a shortage of community nurses in Suffolk, and the model is as yet unproven here.

But these early recruitment challenges only demonstrate further why we must drive change in the system to not only deliver more personalised, preventative care but also to bring about changes to the system which better support and meet the needs of our workforce.

One team member said she joined the team because the model offered the “freedom to provide the best care possible for a patient; a human, rather than task orientated approach to nursing”, and that she hoped that this way of working “would help with retention of staff, enabling a stable workforce”.

With the team now in place, the model is becoming more tangible, more human.  Time will tell if this model is able to attract and retain the staff we so desperately need to sustain the sector.

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