Learning from neighbourhood care test sites in Scotland
This report provides insights into the learning from 12 teams across Scotland that participated in a learning network focused on supporting the development of neighbourhood care models during 2018-19.
Neighbourhood care developments were guided by principles developed by health and social care organisations in Scotland, which were inspired by the success of the Buurtzorg nursing care model in the Netherlands.
From March 2016 to March 2019 the ihub Living Well in Communities team supported seven organisations across Scotland to develop and test neighbourhood care models which reflected local need and context. Visit the neighbourhood care programme web pages for more information.
In the report, we bring together learning from local evaluation reports, case study evaluations and local stories and intelligence.
This learning suggests that the neighbourhood care model is primarily being implemented through the development of locally based neighbourhood care teams, typically comprising health and social care staff.
In many areas, multidisciplinary team (MDT) huddles were an important operational element of the approach. Staff reported that this supported them to deliver person-centred care through better care co-ordination and flexibility of care delivery to meet complex needs. The approach helped build relationships with people to enable them to make informed decisions about their care and promote self-management and a preventative approach to care by linking people to existing community resources.
Staff reported a number of challenges relating to the implementation of neighbourhood care principles and the development of new models within complex health and social care settings. These included difficulties for teams becoming self-organising and difficulties for professionals to work out with traditional boundaries. Other reported challenges were the lack of supporting systems, infrastructures and resources, bureaucracy, workforce sustainability issues, complexity of caseload and expectations.
In the coming years, partnerships will continue to develop models that support integration at the point of care.
A clear commitment from leaders for the development of appropriate infrastructures to support such models with sustainable workforce is crucial. In some areas, significant service redesign will be required to support implementation. Partnerships should consider the type and range of community resources required to support such models and collaborative commissioning approaches to deliver it.
It is also important that the development of the model is not done in isolation and is linked to other developments across Scotland that are seeking to embed integration of community health and social care services at the point of care.