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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. 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