This study describes an attempt to develop and validate a measure of patient satisfaction with a district nursing service in a south-west London inner city borough. The patients were 126 house-bound elderly people living alone and dependent upon district nursing services. The patient satisfaction measure was derived from an earlier North American questionnaire assessing satisfaction with hospital nursing services. The results indicated that the measure chosen reflected multiple dimensions of patient satisfaction that were differentially sensitive to factors such as the degree of personalization of care and the impact of disruptions to the service. Scores on the questionnaire were also related in a systematic way with the number and type of spontaneous comments made about the service. Overall the results suggest that self-report questionnaire measures of satisfaction can be devised that are sensitive to variations in the style and level of community nursing offered to older house-bound people.