Transforming the care profession through self-managing teams

Bringing the Buurtzorg concept of 'self-managing teams' to the UK health and care system, transforming & creating jobs for carers and nurses

Photo of Paul Jansen
0 2

Written by


  • Yes, I fulfill all of the eligibility criteria.

Initiative's representative name

Paul Jansen

Initiative's representative date of birth


Initiative’s representative gender

  • Man

Which eligible market are you based in?

  • UK

Where are you making a difference?


Website or social media url(s)

Web: Twitter: @buurtzorgbi Facebook: Linkedin:

When was your organisation founded?


Focus areas

  • Reskilling and upskilling the workforce

Project Stage

  • Established (successfully passed early phases, have a plan for the future)
  • Scaling (expanding impact to many new places or in many new ways) 

Yearly Budget: How much capital do you need to accomplish your proposed project?

  • $250k - $500k

Organisation Type

  • Social enterprise

1. Founding story: Share a story about the "Aha!" moment that led the founder(s) to get started or the story of how you saw the potential for this to succeed

When our founder Brendan Martin looked after his elderly mother in her final year, he noticed how the care professionals - who would visit her home on a daily basis - were hindered rather than supported by 'the system' (low trust in the professional, organisational bureaucracy, poor IT, ...). He suspected that having carers manage themselves while being trusted and supported in doing the right thing, would avoid a lot of problems, create better outcomes and attract more people into the profession. He hooked up with Buurtzorg in the Netherlands who had proven just that, and brought their model to the UK. He also realised that working in this self-managed way may represent the future direction of jobs in many other sectors outside care.

2. The problem: What problem surrounding employability or financial capability are you helping to solve?

Frontline jobs in community health and care suffer from high workloads, unfulfilling job designs focused on time-and-task with no opportunity to engage with the client or show one's initiative, as well as poor pay. As a result many vacancies exist, turn-over is high, and the quality delivered often low, with dissatisfied clients (patients) and poor clinical outcomes. With an ageing population, the need for good quality care will only increase.

3. Your Solution: How are you planning to solve this problem? Share your specific approach.

Our solution is based around Buurtzorg's model of self-managing teams. Buurtzorg (meaning neighbourhood care) was set up by Ashoka fellow Jos de Blok in Holland to improve care by empowering frontline staff. Small teams work in local communities and are empowered do what is needed to deliver good care. They have huge degrees of freedom and responsibility for the planning, recruitment, performance management, and making all decisions required to do this well. They are supported by a coach, clever IT and a small back office. There are no (middle) managers involved. Since 2016 we have worked in the UK with the public sector to translate this model to the UK context and have gathered evidence - through several pilots - that here also it results in better jobs and better care. The next step in our strategy involves creating a care organisation that will offer great jobs through self-managing teams. Through trusting the professional and empowering them to bring all their skills and creativity to the table we will attract more in the profession. It will create more capacity in the system and be better aligned with current expectations of the Gen Y/Z workforce entering the job market.

4. How are you innovating or using unique approaches to solving the problem?

Our model of self-managing teams supported by coaches not managed by managers is hugely innovative, especially in the care sector. Buurtzorg Netherlands demonstrated that this works at scale: today 10,000 professionals look after 80k patients, while showing best clinical outcomes, job satisfaction and patient satisfaction (at lower cost). We have learnt that also in the UK this approach works, with people applying specifically because of the job richness, and with better outcomes for clients being demonstrated. Most of our pilots are independently evaluated. Our home care teams in Newham for instance demonstrated how their freedom resulted in much better outcomes for clients and staff, see

5. Employability: how is your organization or project teaching people to develop the skills that they need to survive in the future job market?

We will create jobs in our own newly set up care organisation as well as support other organisations in adopting our model. As part of this we will train and support care professionals: - with the development of skills and tools to self-manage. These include tools for decision-making, effective meetings, conflict management, etc. - with defining the boundaries of self-management through 'the framework'. - with determining team roles and tasks and why they should rotate. - with the role of the coach and the back office, providing tools, techniques and models. The confidence and breadth this will bring to the care professionals and their roles will not only improve their work directly, but also enrich their skillsets and experience for future roles in other organisations. It is worth noting that self-management is used also by Netflix, Zappos, Patagonia, Goretex and many others.

5a. Please describe which future-oriented skills your organization is focused on fostering and how you have measured / plan to measure progress

The future-oriented skills we intend to foster include: - being part of a self-managing team in the broadest sense - consensus based decision-making in a team - solution-focused conversations - client-centred working - effective team meetings - performance managing as a team - performance managing each other - team-coaching Our progress to date has been measured through the teams created as part of pilots (within client organisations) and their evaluations. Future progress will include the creation of our own teams and the staff feedback on how well they feel equipped in the role.

7. Marketplace: Who else is addressing the same problem? How does the proposed project differ from these approaches?

As said, our model is based on Ashoka fellow Jos de Blok in the Netherlands. Other organisations that provide similar self-management techniques or provide care based on self-managed models have often been inspired by Buurtzorg too. Examples include Helen Sanderson Associates, Cornerstone Scotland. To date these initiatives are small and - if anything - are helping our cause.

8. Impact: How has your project made a difference so far?

The direct impact: in the UK we have worked with over 30 organisations and created well over 40 teams, with another 50 teams on the cards for the next 12 months. When our own care provider offering comes on-stream, we will add significantly to this number. We have been influencing nationally the conversation about the how care is organised and how care jobs are being defined and structured. Very few organisations in the UK will not have heard of Buurtzorg. We intend to build on that. Our turnover to date, as social enterprise consultancy, has been in the region of £354k. For a care provider entity the financial order or magnitude will naturally be rather different.

9. Financial Sustainability Plan. Can you tell us about you plan to fund your project and how that plan will be sustainable in the short, medium, and long term?

We are currently carrying out the financial modelling of our care provider plan. We have seed-funding committed by Buurtzorg Nederland, and our currently seeking investment from (social) investors for the starting up and working capital required to build the care provider entity and its infrastructure.

10. Team

Brendan Martin - founder and CEO. He has led the introduction of the Buurtzorg approach into public service environments in Britain and Ireland since 2015. Paul Jansen - COO. Paul is an expert in social enterprises in health and social care and has an Exec MBA from INSEAD. Tania Eber - Principal. She is an experienced Organisational Development Consultant and Coach, as well as a former GP. Jos de Blok - CEO Buurtzorg Nederland. Envisaged board member of the new UK care provider.

Help Us Support Diversity! Are you a member of an under-served , under-represented, or marginalized group in your country of residence? (yes/no) (this question is optional – if you choose to fill it out, the response will not be shared with your fellow contestants)

  • This does not apply to me

How did you hear about this challenge?

  • Ashoka page or contact

Evaluation results

1 evaluation so far

1. OVERALL Evaluation:

Yes, absolutely! - 0%

Yes/maybe - 100%

Maybe - 0%

Maybe/no - 0%

No - 0%

2. Is this entry INNOVATIVE?

Yes, absolutely! - 100%

Yes/maybe - 0%

Maybe - 0%

Maybe/no - 0%

No - 0%

3. Does this entry have SOCIAL IMPACT?

Yes, absolutely! - 100%

Yes/maybe - 0%

Maybe - 0%

Maybe/no - 0%

No - 0%

4. Is this entry VIABLE financially and operationally?

Yes, absolutely! - 0%

Yes/maybe - 100%

Maybe - 0%

Maybe/no - 0%

No - 0%


Yes, absolutely! - 100%

Yes/maybe - 0%

Maybe - 0%

Maybe/no - 0%

No - 0%

6. FEEDBACK: Highlights

IMPACT POTENTIAL: You use specific numbers and evidence to describe what your project has achieved so far (or plan to achieve in the future) – and you have a concrete plan for future impact. You have specific tools for measuring impact. - 100%

QUALITY OF INNOVATION: You have a great understanding of the problem, have researched existing solutions, and have developed unique, thoughtful solutions - 100%

FINANCIAL AND OPERATIONAL SUSTAINABILITY: You have given a great deal of thought to not just the idea itself but how to make it work operationally and financially in the present and future; your plan is specific and you value sustainability. - 100%

CHANGEMAKING ACTIVATION: You have a good plan on how to activate changemakers and empower them to innovate through your product or programming - 0%

Other option - 0%

7. FEEDBACK: Areas for Improvement

IMPACT POTENTIAL: make sure to provide specific instances of your social impact (or how you plan to measure impact) – it may be helpful to describe the beneficiaries, the main activities/products, and provide evidence of (or plan for) impact evaluation - 0%

QUALITY OF INNOVATION: make sure to describe how your solution is unique and innovative – it is helpful to include the research you have done on past solutions and how your solution is different from (and/or builds upon) these. - 0%

FINANCIAL AND OPERATIONAL SUSTAINABILITY: make sure you have provided descriptive information about your financial sustainability plan. Where do the funds come from now and do you have a concrete plan for future sustainability? - 0%

CHANGEMAKING ACTIVATION: make sure you describe your plan for how to empower others to become changemakers through your programming, service, or product - 0%

WRITING STYLE. Try to be concise, descriptive, and specific. Avoid jargon. - 0%

Nothing stands out! I thought it was great. - 0%

Other option - 100%


Join the conversation: