TICC

TICC has secured more than €4.8 million of European funding in this €8 million cross-border partnership involving 14 organisations from the UK, France, the Netherlands and Belgium (see below for partner details). The project was approved and funded by the EU Interreg 2 Seas Programme 2014-2020 (co-funded by the European Regional Development Fund) which has supported the project over four years.

The aim of the TICC project has been to create systemic change in health & social care, providing services that are better suited to our ageing population by addressing their holistic needs. Its product includes a methodology to overcome blocking points in transferring socially innovative service models from one area to another. This was tested via the implementation of the Buurtzorg integrated care at home model, which consists of self-managing teams of up to 12 staff working at neighbourhood level handling every aspect of care and business.

This model significantly reduces overheads, simplifies IT, and supports professionals through coaching rather than management, providing better outcomes for people, lower costs, fewer unplanned hospital admissions, and consistency of care. TICC was to enable other health/social care organisations to implement new ideas; increase staff productivity, recruitment and retention; and improve patient satisfaction while decreasing costs, emergency admissions and staff absences.

For more information:

• https://publicworld.org/what-we-do/bringing-buurtzorg-to-britain-and-ireland/
• https://publicworld.org/what-we-do/transforming-integrated-care-in-the-community/

The 2Seas area faces clinical, social & financial challenges in health and social care as the population ages & public funding decreases. Recruitment & retention of the health and social care workforce in the 2Seas area is challenging & the situation will further deteriorate as the existing workforce ages. This has an impact on quality as perceived by patients. A number of initiatives have been highlighted as innovative but rarely get transferred from one country to another. The causes of these blockages need to be identified & a method developed for overcoming the barriers to transferability. The systems that have developed in the 2Seas region over the last 20 years have led to the fragmentation of care & a task-driven, activity-based approach & remuneration.

TICC will enable countries in the 2Seas area (& later, beyond) to implement successful health & social care innovations quickly in a cost effective, sustainable way.

Three new countries adopting integrated neighbourhood based self-managing teams providing holistic person-centred care.

• Changes to existing patient data gathering systems to create better communication between nurses, care-workers & citizens
• Publications to stimulate entrepreneurs & leaders to create new organisations or transform existing organisations, ensuring this is not solely an institutional response.

TICC Research provided a valuable insight to other models of care provision and understanding of the pressures on particularly the community nursing services across Europe and the United Kingdom. The principles to ensuring better outcomes and improved patient experiences are what we know, but have become lost in the systems and organisations within which we work. So, the emphasis was on realigning our focus to support some Key Principles as imbedded in the Buurtzorg model:

• Continuity of care – smaller teams supporting neighbourhoods with skills and competencies based on population health information.
• Keeping it simple – working to reduce complexity, processes, communication and IT.
• Coffee and care - recognising and promoting the value of time spent on building therapeutic relationships.
• Supporting collaborative working within the communities in which our patients and families live.
• Supporting patients and families with education and skills development where appropriate to support self-management.
• Providing a working environment where our nurses and AHP’s have the autonomy to make decisions and put in place interventions that best support patients and enjoy once again coming to work.

• Buurtzorg Concepts (NL)
• Kent County Council (UK)
• Kent Community Health NHS Foundation Trust (UK)
• Medway Community Healthcare (UK)
• Soignons Humain (FR)
• Public World (UK)
• Zorgbedrijf Antwerpen (BE)
• Emmaus Elderly Care (BE)
• Eurasante (FR)
• VIVAT homecare (FR)
• Lille Catholic Hospital (FR)
• HZ University (NL)
• La Vie Active (FR)

• Université d’Artois 
• East of England Local Government Association 
• Provincie Antwerpen 
• Wit-Gele Kruis van Antwerpen 
• Familiehulp  
• Landelijke Thuiszorg Zuiderkempen
• Christelijke Mutualiteit 
• Heist-op-den-Berg 
• OCMW Heist-op-den-Berg 
• Vlaams minister van Welzijn, Volksgezondheid en Gezin 
• Sociaal Huis Mechelen 
• Zorgnet-Icuro; NHS (England) 
• Canterbury Christ Church University 
• Centre communal d’action sociale de Lomme 
• Conseil départemental du Nord

TICC aimed to enable health and social care organisations to implement nurse-led community care. This study provides new insights into the extent to which some of the Buurtzorg principles can be adapted for community nursing in the UK, France, and Belgium.

Findings based on the TICC project showed that the model could have benefits for both care staff and patients. For care staff, there are indications that TICC contributes to a lower number of sick leave days and a high degree of job satisfaction, but at a higher cost. However, no contributions were found on empowerment, exposure to psychosocial risk factors, or staff retention.

For patients, benefits of TICC are a reduced length of care, increased health-related quality of life and patient satisfaction. No effects were found on patients’ autonomy and social participation. The burden of informal caregivers does not seem to be alleviated.

Our findings are consistent with previous studies which have found that factors such as relationships, communication between staff, and organizational culture are very important during implementation of health care programs.

This study provides useful knowledge that can be used for the further evaluation of the implementation of the TICC model in other areas. There are some principles from the Buurtzorg model that can be adapted in the Interreg area within community nursing. For instance, promoting greater independence among patients, improving access and continuity of care, more flexible work for community nurses, forming effective inter-professional partnerships and empowering frontline staff. To conclude, the findings of this study indicate that a person-centred approach contributes to an improvement in the provision of individualized and coordinated patient care

After intense years of implementation, data collection, analyses and reporting, Transforming Integrated Care in the Community (TICC) project has come to an end. In other words, the most important phase has started. Disseminate, share findings and knowledge gained in recent years, in order to support other organizations and individuals.

Would you like to gain insight into how TICC partners have been creating systemic changes in health and social care? Download the final publications to learn everything about the implementation and evaluation of a new organisational model of homebased care services inspired by Buurtzorg!

The TICC program of work has contributed to shaping the strategic direction within MCH to incorporate some of the key principles to work towards over the coming years in developing integrated neighbourhood teams including reshaping the mid office and back office with a focus that includes releasing time to care.

As a provider working with our external colleagues we will continue to highlight and endorse the value of holistic rather than task focused care and provision that enables services to support continuity of care as key focuses to shaping the health and care teams for the future, not only for our patients but also for our much-valued staff if we are to ensure our ability to retain community nurses.

We will continue with developing the collaboration with the range of informal and formal networks available to our patients and their families to be able to best support them in achieving their optimum health and wellbeing outcomes.