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Background: Following the implementation of the Coordination reform, there has been concern about levels of competence in community health services. There have been few empirical studies on the reform and on how concerns regarding competence are dealt with. Objective: The aim of our study is to develop a greater understanding regarding the need for competence in home care following the implementation of the Reform. Method: Two focus group interviews with 11 nurses and two individual interviews with municipal managers, all employed in the same municipality. Result: Even if discharged patients were more sick and in need for more help than before, the nurses found that they were still able to take care of patients in an effective manner. The nurses’ competence was found to be adequate, though not sufficient. Cooperation between nurses and lower-skilled staff was described as a challenge. The way home care was organised resulted in some frustration among the nurses, who felt that their competence was not being utilised in the right place at the right time. There seemed to be a diversity of opinion among participants when it came to understanding the aims and challenges that home care nursing is facing. Conclusion: Competence in home care nursing needs to be developed and strengthened. This means an increased budget, more skilled employees, and organisational routines that make cooperation easier and the use of nurses’ competence more targeted. To develop a shared understanding of the Coordination Reform and its aims and challenges among all staff should be an integral part of the agenda for managers.

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