Nurse-led collaborative care models which bridge community and hospital settings represent a paradigm shift within hub and spoke vascular care models in New Zealand. We present the development and implementation of such a service in the spoke locality of Te Tai Tokerau, New Zealand, a region of significant rurality and high deprivation with disparate health outcomes particularly for indigenous Māori. A mixed methods approach was employed in development and evaluation of the care model, which involved a move from medical focus to a collaborative care model with nurse specialists (CNS) as keyworkers. The nursing team function as a central point of contact for patients and health care professionals across the care continuum. Through collaborative working in the community and outpatient settings, CNS engage with at-risk populations and their health care teams, providing education on vascular conditions, lifestyle modifications, vascular assessments and treatment plans. For patients requiring specialised interventions or acute care, the model seamlessly transitions to the hospital setting, where CNS coordinate inpatient assessments, functioning as a conduit between hub and spoke localities. Key components of the model include advanced practice nursing competencies, collaborative care planning and utilisation of mobile and telehealth technologies to facilitate remote consultations and monitoring. Data analysis demonstrates more effective utilisation of outpatient clinic appointments, reduced wait times for first specialist assessment, faster access to surgical interventions, reduced length of inpatient stay, increased patient satisfaction and value added for multidisciplinary team members. Our results highlight the effectiveness of the nurse-led model in optimising vascular care delivery particularly to underserved rural communities and has reproducibility for similarly challenged regions.