Purpose – The purpose of this paper is to describe the first 15 months of operation of an innovative specialist national public health observatory for intellectual disability. Design/methodology/approach – The paper provides a narrative account of aims and achievements of the service. Findings – In the first 15 months of operation the observatory has: made available to those involved in commissioning health and social care services, a wealth of information on the health needs of people with intellectual disabilities; identified specific improvements that could viably be made to increase the quality of future information; and begun working with local agencies to support them in making the best use of the available information. Originality/value – People with intellectual disabilities experience significant health inequalities. This paper describes an innovative approach to helping local agencies make the best use of available information in order to commission services that may reduce these inequalities.