The ever-changing modern health care environment places high demands on leadership skills. The purpose of this study was to describe the causes that effect leadership within the health care services carried out in a municipality. Data was collected by interviewing four health care managers, three registered nurses, eight enrolled nurses and one auxiliary nurse. A qualitative approach based on a content analysis method was conducted in the analysis of the interviews. Latent content deals with relationship aspects and interpretation of deeper underlying meaning of text. Five codes were identified which characterize mutual comprehensions on leadership: assumptions, behaviour, progress, communication and well-being. Leadership changes based on ``Transformational Theory`` could allow greater collaborative governance and feelings of self-efficacy to the provision of health care services. The importance of leadership in the success of community health is obvious. However, large scale changes in structural, cultural, attitudinal and shift of power within the organization are necessary, likewise in decision and policy-making processes. For successful outcomes defining attributes and related concepts to approach cost, quality and good health services must also be taken into consideration.