District nursing in inner city areas faces many challenges, particularly with regard to sustaining the nursing workforce, and ensuring nurses gain satisfaction and enjoyment from their work. The Dutch Buurtzorg model of self-managing teams offers a potential solution to address these problems. In this article, the authors, as nurse leaders, reflect on their experience of implementing a ‘test and learn’ pilot of such a model in the NHS in London, and then on a further scaling up of the model. This paper offers insights related to such issues as governance and assurance as well pragmatism in supporting a process of change. It is hoped that these reflections will guide other nurse leaders in setting up and sustaining this excellent model of team management and care.