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One of the three major shifts within the UK government’s 10-year plan for the National Health Service (NHS) is moving from sickness to prevention, recognising that prevention starts with children and young people.1 Paediatricians, as child health specialists, can and do shape the health of future generations, beyond treating the illness immediately in front of them. While all paediatricians have a responsibility to engage with public health and prevention, experience across the breadth of paediatric practice shows that effective training, service development and cross-agency working rely on clearly identified clinical leadership roles. To produce paediatricians capable of delivering this ambition, we believe it is time to develop new training opportunities and recognised pathways in paediatric public health medicine (PPHM).