This toolkit aims to support purchasers and providers who seek to develop culturally competent services. It aims to: enable individual health authorities and trusts to assess how far they have progressed towards cultural competence, and to decide priorities for further action; identify ways of ensuring that the health needs of black and minority ethnic communities are viewed as an integral part of the commissioning process; identify examples of good practice already being achieved by purchasers and providers; propose the adoption of some quality standards in service provision; and point to useful sources of further information. It lays emphasis on the point that except in a few cases where genetic factors are relevant, health experience is determined by factors associated with ethnicity (e.g. racism, social and economic circumstances and discrimination) rather than ethnicity itself. The toolkit is an attempt to move beyond victim blaming, which is inherent in assuming that ethnicity is itself the cause of poor health, towards the achievement of health gain through positive action.