How caring communities become part of the health system of the future in the Netherlands. Developments, bottlenecks, and impact.
Authors: Stouthard Lian 
Published: January 2024

In the past decade the Netherlands has seen major reforms in health- and social care. These reforms accomplished a shift from a social democratic welfare state to a ‘participation society’; people with care and support need to live at home longer and have to rely on their informal network for support. In order to provide an answer to the retreat of state organized support we see an increase of citizens initiatives for care, wellbeing and support in The Netherlands.
The growing movement of citizens initiatives, or ‘caring communities, is diffuse. ‘They vary in target groups, activities, organisation and goals. However, they have in common that they are filling the gap care and support provisions that the government has left behind. In order to get a better image of this movement, their impact and the challenges they face in collaborating with the Dutch care system, Vilans and the Dutch umbrella organization of citizens initiatives (NLZVE) bundled their forces in a variety of research projects.
This collaboration started in 2020 with the ‘Monitor on the Movement of Caring Communities’. In co-creation with key figures from the movement of caring communities we developed a survey. The results of this survey (n=346) gave us insight in the activities, goals, partners and bottlenecks of these initiatives and initiated new participatory action research projects. These focused on reliable and sustainable financing for citizen initiatives, how initiatives measure their impact and how caring communities and ‘system parties’ work together.
Together with different initiatives we explored different financing models and their pros and cons. The lack of sustainable financing options for citizen initiatives is a bottleneck for the development of these initiatives and for durable collaboration with the system parties. Simultaneously we found that many initiatives struggle to show their impact. This impact is often implied (i.e. less loneliness or a healthier population) but hardly mapped. We found that the lack of a clear message about the impact of an initiative hinders a durable financial model. Municipalities and other financiers need to know what the effect of their investment is. To help the movement of caring communities better map their impact and organize sustainable financing we developed, through co-design, two different tools.
Another bottleneck for caring communities is the collaboration between these communities and the ‘system’. Caring communities often exist because of discontent with and/or inaccessibility of care and wellbeing services. However, we see that when initiatives want to expand their services (i.e. in the field of home- or social care) they have to collaborate, or in some cases even become part of, the care system. Our project focused on how these worlds come together without both of them losing their strengths and identity. The lessons learned will, together with the survey outcome and both tools, presented during the oral presentation. Additionally we will present our next steps, which include a qualitative and participatory research project on the impact of citizens initiatives and a data driven approach to identify the complete movement of caring communities in The Netherlands.