This report summarises our evaluation of three Neighbourhood District Nursing (NDN) Pilots at Cwm Taf Morgannwg University Health Board, Powys Teaching Health Board and Aneurin Bevan University Health Board. These pilots were funded by Welsh Government (Wales Pilot of the Buurtzorg Approach Neighbourhood District Nursing) in 2017 to test Neighbourhood District Nursing in Rural, Valley and Urban locations.The pilot NDN teams provide home-based nursing care to people living within a defined geographical area linked to named primary care teams.As part of the NHS in Wales, NDN teams incorporate the principles of the Welsh Government Prudent Healthcare initiative. NDN staff encourage people to look after and be responsible for their own health and well-being with support from the health service, statutory public teams and voluntary teams. We used a realist approach to evaluate the three NDN pilots. It comprised of a realist review (n=37 published documents) , and mixed methods including service data, pilot documents (n=85), patient stories (n=4) and staff/stakeholder interviews (n=29). The purpose of the evaluation was to understand the mechanisms of change and provide a robust evidence-base to transfer the principles across Wales. Based on our findings we make eight recommendations about the model, its delivery and sustainability going forward.