This article analyses the concept of leadership in relation to the UK Government's current approach to 'modernizing' the NHS in England. Focusing on public health in primary care, the authors consider current developments in the public health workforce, in particular attempts to differentiate between public health 'specialists' and 'practitioners' by different levels of leadership function. It looks at leadership in policy, theory and practice, and draws attention to a number of key challenges along the leadership path. The concept of 'leadership skills' as a taught competence is questioned, and Shelton and Darling's (2001) 'quantum skills' model of leadership is provided to suggest new ways in which public health leadership in a primary care context might be approached. Whilst this article focuses on public health and primary care in England, the complexity of primary care settings and public health delivery in other international contexts extends its relevance to non-UK settings.

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