The scaling-up of Neighbourhood Care: From experiment towards a transformative movement in healthcare

To meet present and future challenges in healthcare, radically new approaches are needed that contribute to transforming the healthcare system. In the Netherlands this transition was envisioned by the Transition Programme Long-term Care (2007–2010) as “a fundamental change towards a more human centred, affordable and socially embedded healthcare system”. One of the experiments in this programme was Neighbourhood Care (in Dutch “Buurtzorg”): small-scale, self-managed teams of nurses who provide high-quality homecare in neighbourhoods. This article looks at Buurtzorg from the perspective of transition studies, building on the framework of ‘deepening, broadening and scaling-up’ transition experiments. We analyse how Buurtzorg could rapidly develop from a local experiment to a network of more than 800 teams and also spread to different care domains and abroad. The rapid development of Buurtzorg is explained by identifying their strategic activities, the alignment of contextual factors and their strategic position as outsider towards the regime. We conclude that Buurtzorg has become a ‘symbol’ in a transformative movement that can contribute to a future transition in healthcare. This case study contributes to theoretical and practice-oriented knowledge on how a transition experiment in a social domain can surpass the experimental phase, identifying key strategic activities for niche-mainstreaming.

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