With the government continuing to focus on improving the patient experience and moving care closer to home, this article considers the leadership function of the district nurse (DN) and the role played by the DN in influencing organisational effectiveness. A transformational leadership style can help create a cohesive team that is able to embrace change, but caring for staff is an area that is often overlooked. Supporting staff, especially when things go wrong, generates a more understanding ethos that helps remove the blame culture. This article describes the changes made to one trust’s community nursing strategy and the DN’s crucial role in communicating the vision to the wider team, thereby influencing and improving patient outcomes.