The prescribing of medication is by far the most common form of medical intervention. However, it has been shown that up to 50% of medicines are not taken as prescribed, that medication-related problems can occur, and that up to 7% of hospital admissions can be due to adverse drug reactions. A new approach termed 'medicines optimisation' has been developed that is intended to focus attention on outcomes rather than process in relation to improving quality, the benefits, and value patients receive from their use of medicines. This article describes the role that community nurses can play in achieving the ambitions of the medicines optimisation agenda.