Relevance of UK Public Health Knowledge and Skills Framework to Practitioners

By Professor Darren Shickle, Professor of Public Health at University of Leeds
Darren Shickle is Professor in Public Health and Head of the Academic Unit of Public Health in the Leeds Institute of Health Sciences. He is also an Honorary Consultant within Public Health England. Current projects include involvement in trailblazer application for public health apprenticeships.

In 2016, the United Kingdom adopted a new version of the Public Health Knowledge and Skills Framework( The earlier version of the Framework categorised nine levels of workforce, however, a review recommended simplification of language and levels. The new Framework contains 70 competencies categorised within 13 functions. While the new version is shorter and simpler to read, the lack of levels means that:

  • It is not clear as to whether all competencies should apply to all levels of the public health workforce;
  • Whether all the levels are expected to demonstrate the competencies to the same depth; and,
  • Indeed who should be included within the public health workforce for the purposes of the Framework.

The Framework User Guide suggested that the aim of the framework is “to set out the functional areas in which individuals, teams and organisations operate, to deliver on public health outcomes… to provide a set of statement that describe what functions an individual might carry out in the course of their work. The combination of functions will vary from individual to individual, and from role to role”.

In order to assess the utility for and applicability to specific parts of the public health workforce, I interviewed 51 practitioners within the Yorkshire and the Humber region, in small groups of a median of 3 people. I wanted to measure the extent to which public health practitioners possess and use these competencies.

While it was recognised that a lot of the knowledge and skills were “probably more about what a public health role at maybe a more senior level will look like”, a common response was that “we’re all leaders aren’t we?” It was also said that “you don’t have to have a job title manager to be a leader … it’s about sort of promoting the importance of that sort of mind-set.” It was also suggested that “it’s good to get people in early and thinking that way and then obviously observing and shadowing more senior people”.

Most participants were content that with sensitive interpretation and top-up training, they could provide some evidence for all competencies, although none had used the Framework in this way up to now.

Practitioners applying for registration with the UK Public Health Register are assessed against the previous Public Health Knowledge and Skills Framework. UKPHR are currently undertaking a review of the practitioner registration to see if they need to be modified in light of the new Framework.

Some participants with less senior roles had more difficulty in providing evidence for all Framework knowledge and skill competencies, and hence there will be a threshold of seniority, below which competency in only defined areas of expertise might be expected. While the Framework may be applicable to the core workforce (practitioners, advanced practitioners, specialists etc.), it might not be applicable for the wider public health workforce. Separate research would be needed to identify the competency required of these parts of the workforce. Competency frameworks already exist, for example, for health promotion practitioners or epidemiologists in communicable disease surveillance.

An Expression of Interest has been submitted to the Institute of Apprenticeships to establish a public health practitioner apprenticeship programme. This would be a level 6 degree apprenticeship. Group participants were supportive of apprenticeships and a prospective training programme that allowed apprentices to rotate between training opportunities so that they could develop proficiency and document experience for all of the Framework competencies.

The more detailed analysis of the interviews across all of the knowledge and skills contained within the Framework will hopefully be published in a journal paper in due course.