Alieke van Dijken, Buurtzorg – How Buurtzorg is delivering great service to patients

In: BlogDate: Feb 22, 2016By: Claire Lickman

Alieke van Dijken is a Community Nurse at Dutch organisation, Buurtzorg.

Buurtzorg was started in 2009 by four nurses in the Netherlands, and now has more than 9,000 nurses looking after 80,000 patients, with just 45 back office staff.

In this short video, Alieke explains how it works.

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Alieke van Dijken, Buurtzorg

Really think about what is the heartbeat of your organisation, and then from there, build it up. A lot of layers, bureaucracy, you just don’t need it, and you really can get rid of it.

We have no managers at all. I work in a team with 10 nurses, no managers. All those 850 teams: no managers.
We have Jos de Blok, the Director, and his wife, she’s Co-Director, that’s it. And all the so-called ‘management tasks’, well, we do it by ourselves. We have of course a kind of framework within the work, so we know about some targets, we can ask for help for contracts and stuff for new colleagues, and then we have this back office – only 45 people in the back office for a 10,000 organisation. And then you have an overhead cost of just 8% – instead of like 25, 30, 40% sometimes in Holland.

We have those coaches, and they are really not managers. They are going alongside the teams, and we can ask them for help if we need some help in whatever area it should be – we can ask them. Maybe when we have problems working together with each other and we cannot sort it out together, we can ask our coach. Maybe if there are some big projects all over the country, and as a team we don’t have the overview, we could ask our coach and they can give advice. But there is no decision-power with this coach, it’s all in the team, and it gives us a lot of freedom to choose what you really think is your job.

That’s what I’m so happy for, because now I have my job back – I can just take good care of clients.

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The organisation was built around patient care, with no managers – instead, small teams all work together to organise their workload, decide for themselves how much time they need to spend with a patient, and issues are resolved between them. As Alieke says, the Buurtzorg’s ‘onion’ style of management “gives you the freedom to choose how to do your job.”

You can read more about Buurtzorg in Henry’s blog.

Click here to download her Powerpoint presentation (PDF).

Claire Lickman

Claire is Head of Marketing at Happy. She has worked at Happy since 2016, and is responsible for Happy's marketing strategy, website, social media and more. Claire first heard about Happy in 2012 when she attended a mix of IT and personal development courses. These courses were life-changing and she has been a fan of Happy ever since. She has a personal blog at

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