Cambridgeshire’s Neighbourhood Cares Pilot
Early intervention is at the heart of the Buurtzorg model of care, pioneered in Holland. At Cambridgeshire County Council we’re aiming to learn from its successes and tailor it for our setting. Early signs are that it’s having a transformational effect for our residents.
Cambridgeshire County Council’s Neighbourhood Cares Pilot (NCP) is based on the Buurtzorg model of care developed in Holland. The model involves the creation of self-managing nursing teams to meet the short-term health and social care needs of residents in a defined community. The approach aims to shift as much resource as possible to the front line and to develop solutions in partnership at a local level, building on the strengths of local communities. Underpinning all of this is the evidence that such an approach can reduce demand on more acute services elsewhere in the system.
In Cambridgeshire, the pilot is working in two places with a population of 10,000 – one in an urban setting (Soham) and the other in a more rural setting (St Ives). Following the completion of a comprehensive training and induction programme for the NCP teams – of which I am a member – the pilot went live from October 2017.
Initial findings: early intervention works
Over the course of the year and a half since we started working on Neighbourhood Cares, we have faced challenges but experienced a huge shift in the way we work and transformed the lives of the people we work with.
An interim evaluation report, published in late 2018 suggests that the pilot has prevented the escalation of needs, impacted positively on clients’ quality of life and on the development and harnessing of community assets. The report shows that our teams have prevented crises by preventing hospital admissions or readmissions, instances of carer breakdown and deteriorations in mental health.
Those engaging with the services delivered through the pilot have responded positively to the shift in approach. Being community based, the teams are accessible, responsive and seen as different to other services: clients know they can phone us up and they will receive a response.
I want to provide an example of this by telling Bill’s story. Bill is 81, his wife Kathy is 80 and has dementia. Their daughter Claire has learning disabilities and is supported by the Cambridgeshire Learning Disability Partnership (LDP). Their GP first referred Bill to the Neighbourhood Cares Team (NCT) as he was struggling in his role as carer for both his wife and daughter. On top of this, Bill had recently been diagnosed with lung cancer. At the NCT, we knew the family dynamics well which meant we were well placed to facilitate a response to this change in health and circumstances.
When Bill required a hospital admission on a Friday afternoon, our relationship with the GP surgery, district nurses and local voluntary services prevented unnecessary hospital admission or residential or nursing respite care for Kathy. Kathy continued to be supported in her home of over 40 years and we were able to work closely with LDP to ensure that Claire also continued to receive the support she needed. The peace of mind that this provided Bill whilst he was in hospital – that those he had previously cared for were being looked after, with little disruption – was invaluable.
It has also changed the way in which we, as social workers, go about our day-to-day roles. We have been freed to up to act more nimbly and respond to clients’ needs more quickly and appropriately. The level of autonomy we have been given as NCP teams has also impacted on job satisfaction.
Where next for the Neighbourhood Cares Pilot?
There has been recognition across the council, and those involved in this work, that there are further potential benefits if we can use the lessons from this pilot as the basis for wider transformation of the whole system. It is at this scale that the benefits of this community-rooted, preventative approach will really start to be felt, as other budget holders see demand fall.
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