Learning from a decade of ‘test & learn’ initiatives in Britain
Caroline Alexander, then chief nurse for London, opens Public World’s seminar with Buurtzorg’s founder Jos de Blok and Tom Sandford, then RCN England director, in 2015
2025 marks 10 years since Public World began our first ‘test & learn’ project inspired by the success in the Netherlands of the neighbourhood care model developed there by Buurtzorg.
Buurtzorg’s founder, Jos de Blok, joined us for our first workshop with Guy’s & St Thomas’s NHS Foundation Trust (GSTT) and spoke at a seminar we organised, which the Royal College of Nursing was kind enough to host. 
That event was an afterthought on our part, organised and publicised with barely a week’s notice, and yet the RCN meeting room was so packed, with many standing, that I got into trouble for exceeding its capacity of 90 or so!
It certainly established wide interest in the approach, and we went on to run many such events and ‘test & learn’ projects all around Britain, from introductory seminars in the Outer Hebrides to a five-year learning and development partnership in Kent.
Some of these initiatives failed to grow to maturity, despite good results, because of organisational, systemic and cultural barriers, while others, such as at the Thistle Foundation in Scotland, continue to go from strength to strength today.
But whether they’ve persisted and flourished or not, every one of our 40+ projects to introduce the ideas and practices of self-organised team work in the NHS, social care and social housing has yielded valuable learning, which we continue to capture in our Humanity at the Heart learning and development approach.
The decade landmark seems like a good time to draw together and share a full account of the experience and its lessons, not least so it might inform government policy on neighbourhood-based preventative care.
So we’ll be doing that in various ways this year, starting with a workshop on Tuesday 18 March at Friends House in London’s Euston Road, for which a very few places are still available. (If cost is a barrier, give me a shout here as we always reserve some free tickets and a couple remain unclaimed.)
The workshop will explore the experience through various lenses: the perspective of people working in self-organised teams and people served by them; the roles of organisational managers and leaders; and both actual systemic barriers and challenges and potential solutions and financial savings.
We will have first-hand stories from the GSTT experience, Thistle and Newtide Homes, with evaluation and analysis from academics Rose Rickford, Fiona Ross and Colin Talbot, while representatives of Frontier Economics will share their modelling of positive returns on investment based on data from our East London NHS FT ‘test & learn’.
New Local chair Katie Kelly will reflect on how enabling and supporting local government staff to work with greater freedom and responsibility facilitated asset-based community development (ABCD) at East Ayrshire district council, where she was depute CEO.
And there will be international dimensions too, with Public World’s Dr Steve Commins joining us from the United States and Dr Fletcher Tembo sharing his experience of community-based development in Malawi.
In addition, our special guest from Melbourne will be Felice Borghmans of Alfred Health, which provides a comprehensive range of healthcare services in Australia, including a large network of community programs.
We’re proud that Dr Borghmans is coming from the other side of the world to learn from our experience with a study visit that will also involve a day with a range of stakeholders at Thistle in Edinburgh, where we have supported the learning and development of 20 self-organised teams and their coaches.
It’s not too late for you to join us too – please do! — but if that is impossible don’t worry because there will be more sharing of our learning to come in various forms over the coming months. Watch this space!