Buurtzorg home nursing aims to help solve China’s elderly care problem
Elderly people needing care is a burning social issue in China. It is estimated that by 2026, about 45 million elderly Chinese will need help because their children do not (or cannot) support them. Also, there is a huge shortage of care workers and nurses in China and the cost of care is likely to ‘explode’ in the next decade. Buurtzorg Neighbourhood Care Asia, a Social Enterprise registered in Hong Kong, offers a solution, based on a model that is successful in The Netherlands.
Buurtzorg is a leading European community-based home nursing provider with around 10,000 nurses and 4,000 trained caregivers providing patient-centric home nursing services in Holland, Sweden, UK, Germany and France. The key strength of Buurtzorg’s offering is that care is provided at people’s homes and in neighbourhoods – a model that is also being rolled out in Asia Pacific since 2015.
“China’s central government is fully aware how serious the situation is; it developed a smart strategy how to cope with it, with a focus on supporting elderly at home and in communities (97%) and only 3% to be cared in institutions. Yet, until now, everybody seems to focus mainly on offering nursing homes and far too little on care at home and in communities. I am convinced our approach can help solve China’s problem”, says Stephan Dyckerhoff, President of Buurtzorg Neighbourhood Care Asia.
China: 4,000 clients, seven cities
Buurtzorg has made huge steps in four years since the launch in Asia, where it is now active both in China/Taiwan as well as in Japan and India). The company is adapting and rolling out the Dutch success model further in China and has served already 4,000 clients in 7 cities. Buurtzorg aims to serve 50.000 clients in 20 cities by 2025. The company strives to operate one integrated station per community, taking care for the elderly living in that community. There are different types of care offers according to the individual needs. There is a Mini-Nursing Home for temporary stays, a Day Care Center, a Home care/nurse station and a Medical Nurse Station.
The outcome? “We offer a superior patient-centric care model allowing elderly a life in best possible condition, dignity and independence at home, with better care outcomes than before and with a satisfied care staff. Our business model is based on a low overhead cost due to limited management, rigorously standardized processes and smart ICT. Our model allows for better salaries and working conditions for nurses and care workers in a low margin market; our model helps attracting and retaining those scarce resources”, says Dyckerhoff, who points out that good public health management expertise can help holistically (prevention, cure and care) manage health and wellbeing challenges of elderly in communities at minimized total cost for China.
Quite a change
The Buurtzorg approach offers quite a change for China, where home nursing is not known and where the role of the community nurse does not exist. “The existing culture does not help either. Nurses are used to work in hierarchies in hospitals and are not familiar with making decisions by or taking any initiative by themselves – which is one of the pillars of our success. Also, nurses in China do not – as a rule – perform ADL work (like support with personal hygiene).”
Build profession of community-nurse
To maintain a varied structure of services offerings Buurtzorg aims to stepwise build the profession of community-nurse that is crucial to the company’s success. Each team consists of several nurses and care workers and one lead nurse that leads with less hierarchy and more self-responsibility.
Dyckerhoff states that the government will need to mobilize the private sector to build capabilities and capacities to offer the elderly care that is needed in China. “The key instrument to this is a Long Term Care Insurance (LTCI) that will need to be adapted to sustainably mobilise the private sector.”
Unfortunately, new players such as Buurtzorg need a lot of stamina to succeed. According to Dyckerhoff, “foreign companies are not yet acting on a level playing field with Chinese companies: It took us four years to get the right (medical) license, for local companies it takes just months. We have similar experiences with LTCI eligibility. To be successful, we need the right partners and contacts – the power of guanxi – as well as a lot of patience.”
Aggressive local players
Also, the Buurtzorg president is concerned about the ‘attraction’ that LTCI poses for those who want to make quick and easy money. “Aggressive local players ‘loaded’ with venture capital are grasping the opportunity and are ‘buying’ LTCI clients. The more, the faster, the better, with no focus on quality of care at all. Once they go IPO it will become a mess – which is not in the interest of clients.”
The alternative, Dyckerhoff insists, is well-organised elderly care at community level. But there is a challenge there. “Cities, districts or central governments who understand such concepts have little execution power at this stage as elderly care is organised on the lowest government level, where short term solutions are more popular than sustainable long-term solutions.”
Contribute to solutions
So what keeps Dyckerhoff and his staff motivated to continue? “It is the belief that we will in the long term contribute to solutions of one of the most burning social issues in China. And experiences like the 92-year-old lady, coming to our office yesterday to handover a JinQi flag, a sort of formal appreciation to thank me for the outstanding care she received from our care worker. This worker, she explained, helped her to regain independence and continue her life at her home in the neighbourhood where she had always lived!”
ATTENTION, contact info:
Stephan Dyckerhoff, firstname.lastname@example.org