State of the Nation: Global Perspectives
Series 3 / Episode 6
Episode 6: Lessons from the Dutch Neighbourhood Care Model
In Episode 6 of State of Our Nation: Global Perspectives, Kari Gerstheimer speaks with Brendan Martin, founder of the social enterprise Public World. Brendan has spent decades researching and supporting public service reform across more than 70 countries.
In this conversation Brendan reflects on his personal journey into social care and shares insights from the Buurtzorg Model. The discussion explores how relationship based care, workforce autonomy and community connections can transform social care systems.
A Personal Journey into Social Care
Brendan’s interest in social care began through his professional work examining public service reform and labour relations around the world. However, his personal experience arranging home care for his mother brought the realities of the British domiciliary care system into sharp focus.
He saw a workforce that was committed and compassionate but often constrained by systems that prevented relationship based care. This experience led him to focus his work on finding better ways to organise care services that support both workers and the people they care for.
As Brendan explains, the goal should be simple. Build a system around caring and compassionate workers rather than one that frustrates them.
Understanding the Dutch System
The Netherlands operates a more integrated approach to health and social care than the UK. Care is funded through a regulated insurance system that covers both health and care needs, supported by local municipal services.
This structure allows greater flexibility and innovation among care providers. Within this environment, Buurtzorg has become a leading example of how care can be organised differently.
The Buurtzorg Model
Buurtzorg, which means neighbourhood care, was founded by district nurse Jos de Blok and colleagues who wanted to restore professional autonomy and person centred care.
The model is built around small neighbourhood teams of around 10 to 12 nurses and assistants. These self managed teams support approximately 50 to 60 people in their local area, providing both clinical and social care.
Teams take responsibility for every aspect of care. They work with individuals, families and communities to help people live with as much independence and meaning as possible. The wider organisation exists primarily to support these teams with coaching, digital tools and administrative support.
This structure has enabled Buurtzorg to grow to hundreds of teams across the Netherlands while maintaining a strong focus on relationships and local care.
Lessons from Introducing the Model in the UK
Brendan and his colleagues have spent the past decade supporting organisations across the UK to learn from the Buurtzorg approach. Projects have taken place in NHS organisations, local authorities and charities.
These experiences have shown strong enthusiasm for more relational and person centred services. Care workers are capable of working with greater autonomy and responsibility when supported to do so.
However, scaling these approaches has proved difficult. Organisational cultures, funding structures and regulatory pressures often create barriers to sustained change.
Examples from Scotland, Cambridgeshire and London show that the model can improve collaboration, empower staff and strengthen community connections. Yet achieving long term system wide change requires leadership commitment and structural reform.
Rethinking Leadership and System Design
One key lesson from Brendan’s work is that leadership must move beyond traditional command and control models. Instead, organisations should focus on enabling frontline teams to deliver high quality care.
Clear responsibilities, strong learning cultures and transparent data systems are essential to support this shift. Successful organisations often begin with small pilot teams and expand gradually as confidence and learning grow.
Advice for Social Care Reform
Looking ahead, Brendan argues that reform should begin with the fundamental relationship at the heart of care.
Rather than designing systems from the top down, policymakers should start by asking what good care relationships should look like. From there, organisations can design workforce structures, leadership models and funding arrangements that support those relationships.
The ultimate goal is simple. Enable people to live meaningful lives in their own homes and communities, supported by a workforce that is trusted, valued and empowered.
Episode 6 of State of Our Nation: Global Perspectives is out now.
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You can find the series on Spotify Apple Podcasts, or listen to each episode on our website. Just click on the link to the right.
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Promo graphic of Kari and Andy for State of our Nation Podcast
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