This paper offers health commissioning agencies and general practice fundholders a practical guide to developing and using health and race standards in their contract quality specifications. It draws on collective experiences of district health authorities over the years 1992-1995. Standards for acute and community providers are specified in the fields of: ethnic monitoring of patients; religion; communication; patient choice; diet; staffing; and patient complaints. The authors define targets and monitoring mechanisms and give examples of both. A number of general principles worth keeping in mind about developing and implementing health and race standards are listed. They are: named purchaser lead; provider ownership; contract compliance; community support; and feedback to local communities.