Nine years after the first human rights legislation came into effect, many public sector organizations struggle to demonstrate meaningful and sustainable outcomes for protected groups. The workforce stubbornly fails to reflect the diversity of the communities it serves. Equality stakeholders report that services ignore the specific needs of their section of the communities, resulting in poor outcomes. To redress this, National Health Service (NHS) North West developed an evidence-based strategy, supported by the introduction of tools and best practice methods. It applied cultural change management, defined the leadership competencies required, and introduced a consistent and objective framework for measuring outcomes across a range of 13 key areas. Three years into the strategy, outcomes include the national adoption of a leadership competency framework and outcome-based performance measurement tool, as well as demonstrable improvements in the cultural competencies of NHS bodies in the region. Within 18 months, the number of primary care trusts able to evidence tangible “achieving” outcomes affecting at least three equality target groups has doubled.