A study examined the changing nursing competencies considered essential to meet the patient/client needs in hospitals and community settings in the United Kingdom. First, literature on the following topics was reviewed: required competence at the point of nursing registration; changing nurse roles and competencies; adult nursing in community settings; contemporary mental health nursing; multidisciplinary and interagency working; and shared learning proposals and practices. Next, 630 nurses practicing in community health settings (285 mental health and 345 adult nurses) were surveyed. Most of the 419 (66.5%) of nurses who completed questionnaires gave education high priority; however, they also called for creation/maximization of opportunities for shared learning within an explicitly practice-led, research-based, and employment-focused framework. There was considerable debate around the development of a flexible, collaborative framework at the interface between health and social care. Nurse managers and educators expressed concerns about skills development in both the adult and mental health branches, and managers complained that Project 2000 graduates lacked basic managerial skills. (Eleven tables and 293 references are provided. Included in the 14 appendixes constituting approximately 30% of this report are the following: list of interviewees by job title; interview and focus group questions; questionnaires; competency lists; and information about the study samples.) (MN)