Trust Works #2: How Buurtzorg Revolutionised Home Healthcare

What if we could turn bureaucracy into software?

In 2006, Jos de Blok asked this simple question and created Buurtzorg, a home healthcare organisation that turned the traditional healthcare model upside down. His radical idea? Trust nurses to do what they do best - care for patients.

A Different Kind of Healthcare

Imagine a healthcare organisation with:

• No managers telling nurses what to do
• No complex protocols dictating every minute
• No marketing department
• No HR department
• Just nurses, caring for patients, supported by technology

Today, Buurtzorg has over 15,000 healthcare professionals working this way, proving that sometimes the simplest solutions are the most powerful.

At the core is a strong purpose: to help people live meaningful, autonomous lives.

"It's an ethical imperative for neighbourhood nurses to make themselves irrelevant" - Jos de Block

Three Principles That Changed Everything

Buurtzorg runs on three beautifully simple ideas:

• Humanity above bureaucracy
• Simplicity above complexity
• Practical above hypothetical

No fancy management theories. No complicated matrices. Just these three principles that everyone can understand and follow.

How It Actually Works

Today there are more than 950 small teams of 10-12 nurses, each caring for their own neighbourhood. Each team:

• Decides who they hire (and fire)
• Plans their own work
• Manages their own training
• Takes care of their clients their way

The entire operation is supported by:

• A small team of coaches (not managers) who help when needed
• A simple intranet where nurses share knowledge and compare notes
• A tiny headquarters of fewer than 50 people

No middle management. No bureaucracy. Just nurses doing what they do best.

Does It Really Work?

The results are stunning:

• Staff satisfaction score of 8.7 out of 10
• Consistently ranked as Best Employer
• 50% reduction in hours of care needed per patient
• 40% savings for the Dutch healthcare system

As KPMG found in their 2012 study, Buurtzorg's approach of letting nurses provide all the care (rather than splitting tasks between nurses, assistants, and cleaners) might cost more per hour, but it results in fewer hours needed overall. Why? Because experienced professionals can spot problems early and solve them properly the first time.

Trust + Technology

Remember Jos de Blok's original question about turning bureaucracy into software? Buurtzorg replaced administrative overhead with a simple intranet where teams can:

• Share knowledge with each other
• Compare their performance
• Find solutions to common problems
• Make decisions together
• Stay connected with the wider organization

It turns out that when you trust professionals and give them the right tools, they don't need layers of management to do great work.

Beyond The Netherlands

The idea is spreading:

• 24 countries have adopted elements of the Buurtzorg model
• 10 international partnerships are in place
• 2 organizations have completely transformed themselves
• The Buurtzorg Academy helps others learn this approach

What This Means for the Future of Work

Buurtzorg shows us that even in healthcare, where quality and safety are paramount, less control can lead to better results. Their success raises some powerful questions:

• What if we trusted professionals to manage themselves?
• What if we replaced bureaucracy with technology that helps rather than controls?
• What if we focused on humanity first?

As Jos de Blok and Buurtzorg have shown, when you trust people to do their best work, they usually do. And then some.

Sometimes the best way to help people live meaningful, autonomous lives is to start with the people helping them.