Commissioning and public health.

Improving the nation's health is a major challenge. It has a long history within the specialty of public health medicine, with is commitment to knowledge and actions. But achieving a balance between these activities has been a source of considerable tension within the specialty. The commissioning function, with its related dimensions of purchasing and contracting, provides the best chance for decades of aligning public health knowledge with the action that can produce health improvement. The concept of public health management seeks to bridge knowledge and action, drawing on a range of skills. But there is a long way to go before the necessary skills and capacities are demonstrated in practice. The organizational and personal development agenda remains very large. Yet, what is occurring in the NHS has not been achieved anywhere in the world. Describes one practical approach to strategic health development and commissioning. But it will require sustained commitment if it is to succeed.