Introduction

The focus of the early 2000s was on developing the specialist role in public health for those from backgrounds other than medicine and ensuring that this was embedded in appointments and training and development processes, providing equivalence with public health doctors. From 2004, attention shifted to development of the rest of the public health workforce – practitioners delivering public health programmes on the ground (eg health promotion and health visiting staff) and the front-line so-called ‘wider workforce’, who could have an impact on the population's health through their roles (eg teachers, social care and health service staff) (Donaldson, 2001).

Rise of interest in developing and recognising specific public health practitioner disciplines and functions

Practitioners have been a much more complex group to both understand and support strategically, being diverse in function and in employing organisations, and being numerically much greater than specialists. Whereas some practitioners would remain, along with public health specialists, in Primary Care Trusts (PCTs) following the 2002 health service reforms (DH, 2002a), many were located in provider health organisations, local authorities, primary care and the voluntary and independent sectors.

The spur for the public health skills and knowledge development of practitioners and the wider workforce was, as with specialists, in response to government policy, this time the White Paper Choosing health: making healthier choices easier (DH, 2004b). There had been earlier recognition, in the Treasury reports of 2002 and 2004 (Wanless, 2002, 2004), that addressing only the development needs of specialists would not deliver the wholesale changes to population health which would ensure that the health service could be affordable in the future: the so-called ‘fully engaged scenario’ whereby the whole population took more responsibility for health and prevention and adopted healthier lifestyles. The 2004 White Paper was in response to this challenge and addressed the development of practitioners and the wider workforce.