Pressure damage is seen as a measure of the quality of nursing care, but are all skin lesions pressure damage? Aim: To promote accurate diagnosis of skin damage and therefore accurate reporting and resource allocation in a community nursing service. Method: Educate nursing staff to examine the history of any patient with a skin lesion and identify the mechanism of injury before reaching a diagnosis, rather than “seeing and reporting”. Teaching was delivering via formal and informal education, prompt cards and peer review meetings. Results: There was an increased understanding of the causes of skin damage in the community and improved accuracy of incident reporting. Multiagency and multidisciplinary working increased. Conclusion: The focus on pressure ulcers as a quality measure has led to an increase in the understanding that not all skin lesions are pressure ulcers. Accurate diagnosis leads to improved treatment strategies and resource allocation for patients with pressure ulcers and for those who develop other skin problems.