The Health Equality Framework (HEF) is an outcome measurement tool to record any work that learning disability nurses and other clinicians undertake to improve or stabilise the health and --well-being of adults who have learning disabilities. Learning disability nurses in the four NHS boards of the Learning Disability Managed Care Network (LD MCN) in south east Scotland have successfully implemented the HEF across community and inpatient services. The Scottish Government commissioned the LD MCN to evaluate the HEF implementation process. After episodes of care by nurses, a reduction in exposure to the determinants of health inequalities was noted. The range and quality of demographic and epidemiological data available to boards have been extended with clearly identified themes, trends and service gaps. The evidence can be used to inform and influence service improvement, public health initiatives and practice education.