Elaine Haycock-Stuart and Susanne Kean explore the differences of opinion between senior and front line staff about who has the greatest responsibility for delivering high quality services, in a second article looking at team relationships

UK government policy emphasises the role of leadership in meeting the NHS healthcare quality agenda. As care is delivered increasingly in the community, it is important to evaluate the quality of nursing care provided to patients and families in community settings. However, few quality indicators have been designed for use in this sector. A study was undertaken to examine the effects of nursing leadership in the community on quality of care, and the results suggest that there is tension between nurse ‘leaders’ and ‘followers’ about the value of leadership. While nurse leaders see the leadership role as critical to improving quality through workforce planning and organisation, front line staff perceive individual nurse’s skills as more pertinent to the quality of community nursing care.