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Nerves and cells

UK career framework for pain nurses

Pain is a complex and multidimensional phenomenon that does not discriminate and can affect anyone at any stage in their life time.

The International Association for the Study of Pain (IASP) now define pain as “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage,” (IASP 2020). This new definition recognises that regardless of the cause of the pain it is a personal experience that if influenced by biological, psychological and social factors. Pain can be described in a variety of ways by onset and duration (procedural, acute, chronic/persistent, Cancer related), by mechanism (peripheral, central, thermal etc) or indeed if it is nociceptive, neuropathic or nociplastic. Its incidence within the UK varies across these domains.

Globally pain is the leading cause of disability with chronic pain conditions heavily featured in the top ten causes of disability (Mills, Nicolson and Smith 2019). Within a UK population this translates into up to 50% of individuals being affected by chronic pain (Fayaz et al 2016). Due to the complexity of pain it essential that the nursing workforce Is equipped with the knowledge and skills to support individuals living with pain.

There are a range of career pathways available within the nursing workforce and more specifically within pain management. It is important that those working in or interested in a pursuing a career within pain management are aware of the variety of roles and career progression that is available to them. 

The UK Career Framework for Pain Nurses was produced by the Royal College of Nursing (RCN) Pain and Palliative Care Forum with nursing representatives from across the United Kingdom. 

This resource builds on the original pain knowledge and skills document and this updated version now highlights the range of career pathways within pain nursing and minimum recommended education requirements, in addition to knowledge and skills. It provides a guide for pain services and employers to develop local career development frameworks for the nursing workforce. 

Registered nurses, nursing associates and unregistered healthcare assistant working with individuals experiencing pain can map their career development, as well as assess their skills and knowledge based on this resource and linked resources.

Please note that recommended qualifications stated at each level of this framework are a guide and that we recognise roles and responsibilities vary across the four nations and different workplaces.

Framework at a glance:

Pain

References:
Fayaz, A., Croft, P., Donaldson, J., Jones, G. (2016) Prevelence of chronic pain in the UK: a systematic review and meta-analysis of the population studies. BMJ Open 6
Mills, S., Nicolson, K., Smith, B. (2019) Chronic pain: a review of the its epidemiology and associated factors in population-based studies. British Journal of Anaesthesia 123 (2) E273 – E283

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UK Career Framework For Pain Nurses

The UK Career Framework for Pain Nurses showcases not only the range of career pathways within pain nursing but also outlines the knowledge and skills recommended for each level of practice. 

This framework is intended to guide the development of the pain nursing workforce of the future. Discrepancies between this framework and current practices are expected across the UK. Despite this, we recognize that individual and organizational efforts should focus on channelling resources and creating the necessary structures to move beyond these differences, for the benefits it brings to patient care. For this reason, this document has been based on a variety of similar pain related knowledge frameworks in an attempt to standardise practice across the UK.

The UK Career Framework for Pain Nurses does not intend to be linear or prescriptive but to demonstrate the range of opportunities that nurses working within care can consider in their career development. Transition between pathways is possible and, therefore, practitioners can consider exit points in a different pathway. In addition, employers may also opt to combine roles to answer the specific needs of patients and services in their local areas. For instance, a Clinical Nurse Specialist / Advanced Practitioner – pain (in the Clinical Practice Pathway) may also be a Clinical Academic Training Fellow (in the Clinical Academic Research Pathway). In such cases, it is fundamental that educational requirements for both roles are taken into consideration.

The role titles in this Framework are an attempt to consolidate existent variations within the pain nursing and the wider nursing profession. However, it is essential that priority is given to the description of each role, the level (according to the Skills for Health Career Framework) and the recommended education requirements, as these define best the scope, knowledge and skills of the practitioner. Education requirements are recommended as an entry point or completion in each post.

We recommend that nursing workforce career development plans and strategies in each pain service are aligned with this framework. 

Elements of Professional Practice

Professional Practice is underpinned by the Nursing and Midwifery Code. For each role and level of practice within the UK Career Framework for Pain Nurses, the knowledge, skills and capabilities required are organised under the principals of Essential Pain Management, Recognition, Assessment and Treatment. These requirements are further influenced and should be used In combination with the Elements of Professional Practice which is based on the four pillars of advanced and clinical practice. The Elements of Pillars of advanced clinical practice will vary in strength depending on the pathway and level of practice.

In addition to the scope within this pillar provided by HEE's Multi-professional framework for advanced clinical practice in England, the project group identified sub-themes that may be useful to support professional development:

  • Clear vision
    The NHS Leadership Academy state that clear vision is communicating a compelling and credible vision of the future in a way that makes it feel achievable and exciting. This requires a process of developing a shared vision with an emphasis on co-design.

  • People management
    • Understanding and managing the working relationships of a team to ensure individual performances are augmented and the vision and desired outcomes are achieved.

  • Team working -  inter team working
    • The cooperation and collaboration of each team member in working together to achieve a common aim.

  • Compassion in Leadership
    • The ability to inspire and empower others by understanding, empathy and kindness.

  • Coaching
    • Coaching is about “learning on the job” and designed to enable people to develop their own skills and competence in a focused, structured, measurable and supported way. This is also supported by mentorship and supervision

  • Questioning
    • Good questioning skills can assist leaders to gain different perspectives on a situation which can then inform and develop a solution.

  • Providing Feedback
    • Successful feedback describes actions or behaviours that the individual can do something about.

  • Influencing
    • The ability to influence is to have an impact on the behaviours, attitudes, opinions and motivation of others to affect positive performance.

  • Service change/redesign
    • The process in the development and improvement of services. Practitioners should understand local, regional and national future agendas, horizon scanning, data intelligence, risk and opportunities, and innovation to be better equipped to redesign services.

  • Managing services
    • The ability to administer and coordinate consistent provision of high quality and effective services.

  • Authenticity
    • The ability of the leader to build honest relationships and trust which then leads to engagement and improved individual and team performance.

  • Openness
    • Openness and honesty when things go wrong: the professional duty of candour.

  • Quality improvements
    • Quality improvement (QI) is a systematic, formal approach to the analysis of practice performance and efforts to improve performance.

  • Listening
    • Active listening builds trust and inspire teams. When people feel like their feelings and concerns are understood they are able to participate in solving problems, be engaged and committed to their work

  • Staff engagement 
    • Staff engagement occurs when the goals of the organisation are aligned with staff goals and how they spend their time.

  • Collective leadership
    Collective leadership entails distributing and allocating leadership power to wherever expertise, capability and motivation sit within organisations.

Further information about these subthemes is available here.

externalBetter Health Better Care (Scotland)

externalFoundation of Nursing Studies programmes

externalKings Fund Leadership development courses

externalNHS Improvement - Ward Leaders Handbook

externalNHS Leadership Academy

externalNHS Long Term Plan (England)

externalNIHR Leaders Support and Development Programme

externalRCN leadership programmes

In addition to the scope within this pillar provided by HEE's Multi-professional framework for advanced clinical practice in England, the project group identified sub-themes that may be useful to support professional development:

  • Personal and professional development
    Practising safely and effectively within the boundaries of professional practice. The nurse champions their own continuous learning to develop skills and knowledge and is encouraged by the employer to do so.

  • Patient Education
    • The primary role for the nurse with the intent to foster healthy lifestyle behaviours in people living with pain. They should be able to offer education on the use of self management, non-pharmacological and pharmacological strategies as per the level indicated in the framework. The ultimate goal of the pain nurse should be educating and supporting the patient to self-manage.

  • Teaching
    • Helping learners acquired knowledge and skills in a variety of settings, applying theories, models and methodologies of learning.

  • Course design
    • Design or re-design of a course that the teacher/instructor is (or will be) teaching.

  • Positive Learning Environment
    • A welcomed and friendly environment, led by principles of effective communication and mutual respect for diversity, that motivates learners is learner-centred.

  • Providing Feedback
    • Successful feedback describes actions or behaviours that the learner can do something about.

  • Receiving feedback
    • Feedback received by the teacher/instructor from the learners, describing their learning process with the teacher/instructor teaching

  • Facilitate Learning
    • Helping learners develop the intellectual tools to form connections between concepts and obtain knowledge.

  • Self-directed learning
    • The learner identifies their own learning needs and learning objectives, implementing the actions required to achieve the learning outcomes and improve knowledge

  • Academic assessment
    • A form of feedback that allows the learner to understand if learning is occurring. Academic assessment can be formative or summative.

  • Workforce development
    • Practitioners may be involved in developing stroke educational programs and workforce development plans and strategies.

Further information about these subthemes is available here.

externalNMC - Standards for education

externalNMC Standards for supervision and assessment

In addition to the scope within this pillar provided by HEE's Multi-professional framework for advanced clinical practice in England, the project group identified sub-themes that may be useful to support professional development:

  • Searching the literature
  • Critical appraisal
  • Systematic Review & evidence synthesis
  • Developing research questions
  • Writing protocols
  • Quantitative design & analysis
  • Qualitative design & analysis
  • Mixed methods design & analysis
  • Grant writing
  • Recruiting participants
  • Data collection
  • Project management (including managing budgets)
  • Writing for publication (including report writing and dissemination)
  • Public speaking
  • Research ethics
  • Leading research teams
  • Research governance
  • Knowledge translation
  • Patient & Public Involvement
  • Audit and service evaluation

externalChief Scientist Office Scotland

externalHealth and Care Research Wales

externalHSC Public Health Agency Northern Ireland

externalInternational Institute for Qualitative Methodology

externalMixed methods webinar series

externalNIHR Applied Research Collaborations

externalNIHR Good Clinical Practice

externalNIHR Learning and support

In addition to the scope within this pillar provided by HEE's Multi-professional framework for advanced clinical practice in England, the project group identified sub-themes that may be useful to support professional development:

  • Influence policy and practice standards
    The nurse is able to identify and interpret wide policy documents that guide professional practice
  • Legal and Ethical dilemmas and decision-making
    The nurse is able to understand the legal and ethical frameworks related to consent, confidentiality, the principles of the Equality Act (or equivalent in country of practice), Mental Health Act (in country of practice), bioethical principles, and the implications for clinical practice. Reflection on ethical and legal dilemmas within practice is required.

externalEFIC core pain curricula

externale-LfH - e-Learning for Pain Management

externalFaculty of Pain Medicine - Core Standards for Pain Management

externalFaculty of Pain Medicine - Essential Pain Management UK

externalFaculty of Pain Medicine - Opioids Aware

Clinical Practice Pathway

Clinical practice pathway

The Clinical Practice Pathway is based on the Four Pillars of Advanced Clinical Practice of England, Scotland, Wales and Northern Ireland. We acknowledge the various titles and roles in the UK that may not align with the titles used in this framework. Thus, it is paramount that priority is given to the description of each role, the level (according to the Skills for Health Career Framework) and the recommended education requirements, as these define best the scope, knowledge and skills of the practitioner.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Professional Doctorate/Doctor of Philosophy, Completion Pain Specific education or EFIC Diploma; Independent prescriber; Clinical Assessment Skills; Practice Assessor / Supervisor training.

The consultant role practices at the highest level of advanced clinical practice. These roles blend direct care, education, research and leadership and management. These practitioners are at the forefront of services. They are leaders in pain nursing.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 7 / Level 8

Recommended education requirements at entry point or for achievement during post: Master’s degree (e.g. advanced practice); Completion Pain Specific education or EFIC Diploma; Independent prescriber; Clinical Assessment Skills Practice Assessor / Supervisor training.

This practitioner provides care at an advanced level, adhering to the scope of practice and the 4 pillars of Advanced clinical/nursing practice. They have the critical knowledge in pain management, constantly seeking evidence-base to support their practice. They show innovation and are strongly involved in service improvement and service change. This practitioner may lead or co-lead specific education and training programme. They have strong links with research teams and are the interface between different fields.

Download the Knowledge and Skill competency frameworks for Level 7 and Level 8.

Skills for Health Career Framework: Level 7 

Recommended education requirements at entry point or for achievement during post: working towards or has completed Master’s degree (e.g. advanced practice); Completion Pain Specific Education or working towards EFIC Diploma; Independent prescriber; Practice Supervisor training.

This practitioner provides care at an advanced level, adhering to the scope of practice and the 4 pillars of Advanced clinical/nursing practice. They have the critical knowledge in pain management, constantly seeking evidence-base to support their practice. They show innovation and are strongly involved in service improvement and service change. This practitioner may lead or co-lead specific education and training programme.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 6

Recommended education requirements at entry point or for achievement during post: Completion degree program in health care discipline, Completion or undertaking Pain Specific module. 

This professional works alongside the experienced level 7 professional in a development role.  They have a critical understanding of theoretical and practical knowledge within pain management, usually through a pain management specific course. They have added responsibilities such as supporting or providing training to non-specialist pain professionals within their areas. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 5

Recommended education requirements at entry point or for achievement during post: Diploma or Degree; and professional registration such as Nursing and Midwifery Council. 

Working in an acute or community setting, providing care to people experiencing pain. This professional is part of a multidisciplinary team. They have factual and theoretical knowledge in pain management to assess and use decision-making skills to deliver care. They contribute to service development and personal development. They may delegate, supervise staff or provide training to junior members of their team or unregistered staff. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 4

Recommended education requirements at entry point or for achievement during post: Foundation degree, Higher National Diploma,  NVQ 4 or SVQ 4. 

Those working at level 4 required factual and theoretical knowledge in broad contexts regarding pain assessment and management. They should be able to work within systems and protocols relating to pain management but still able to make judgements, plan activities of care and contribute to service and personal development. They may delegate and have supervisor responsibility to junior unregistered staff. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 3

Recommended education requirements at entry point or for achievement during post: Care Certificate, NVQ level 3 or SVG level 3, Higher National Certificate. Completion of NCFE CACHE level 2 Certificate in Healthcare Support Services, NCFE CACHE level 3 Diploma in Healthcare Support.

Those working at level 3 require knowledge of facts, principles and awareness of pain assessment and management concepts. They may carry out a wider range of duties than the person working at level 2 and will have more responsibility, with guidance and supervision available when needed. They will contribute to service development and responsible for their own personal development. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 2

Recommended education requirements at entry point or for achievement during post: Completion or working towards care certificate, NVQ level 2, SVQ level 2, GCSE grades A – C, Scottish standard grades credit level. Working towards NCFE CACHE level 2 Certificate in Healthcare Support Services, NCFE CACHE level 3 Diploma in Healthcare Support.

Those working at level 2 require basic factual knowledge regarding pain assessment and management. They will perform clinical or administrative duties according to established protocols, procedures or systems of work. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 1

Recommended education requirements at entry point or for achievement during post: GCSE grades D - G, Scottish standard grades foundation or general level.

Those working at level 1 are at entry level and will require a basic general knowledge regarding pain assessment and management. They may undertake a limited number of set skills in relation to pain assessment under direct supervision. They are new starters to work in the healthcare setting and will likely progress to level 2 rapidly. 

Download the Knowledge and Skill competency framework for this level.

Traditional Academic Pathway

Traditional academic pathway

The Traditional Academic Pathway is based on the UK Professional Standards Framework for Teaching and supporting learning in higher education. Consultation of the full document is recommended. We acknowledge that titles between academic institutions may differ.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Pain-specific course or EFIC Diploma, Post Professional Doctorate/Doctor of Philosophy. Experience researcher supervising pre-doctorial students. 

Those working at this level will have achieved the highest standard of practice in academia and will be experienced educators and researchers. They will be working at the Principal Fellow level as outlined by UK Professional Standards Framework for teaching and supporting learning in higher education. (Link to framework - https://www.advance-he.ac.uk/knowledge-hub/uk-professional-standards-framework-teaching-and-supporting-learning-higher-education).

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Pain-specific course, or EFIC Diploma, Post Professional Doctorate/Doctor of Philosophy. 

Those working at this level will be working towards or have obtained status of Principal Fellowship of the Higher Education Academy. They will be working at the Principal Fellow level as outlined by UK Professional Standards Framework for teaching and supporting learning in higher education. (Link to framework - https://www.advance-he.ac.uk/knowledge-hub/uk-professional-standards-framework-teaching-and-supporting-learning-higher-education).

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 7

Recommended education requirements at entry point or for achievement during post: Completion degree program in health care discipline, completion of Master levels study and recognised teaching qualification. Completion of Pain Specific module or EFIC Diploma. Pre-Doctorial studies. 

Those working at this level will be working towards or have obtained Senior Fellowship of the Higher Education Academy. They will be working at the Senior Fellow level as outlined by UK Professional Standards Framework for teaching and supporting learning in higher education. (Link to framework - https://www.advance-he.ac.uk/knowledge-hub/uk-professional-standards-framework-teaching-and-supporting-learning-higher-education).

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 6 / Level 7

Recommended education requirements at entry point or for achievement during post: Completion degree program in health care discipline, completion or working towards completion of Master levels study and recognised teaching qualification. Completion of Pain related module.

Those working at this level will be working towards or have obtained Fellowship of the Higher Education Academy. They will be working at the Fellow level as outlined by UK Professional Standards Framework for teaching and supporting learning in higher education. (Link to framework - https://www.advance-he.ac.uk/knowledge-hub/uk-professional-standards-framework-teaching-and-supporting-learning-higher-education).

Download the Knowledge and Skill competency frameworks for Level 6 and Level 7.

Skills for Health Career Framework: Level 6

Recommended education requirements at entry point or for achievement during post: Completion degree program in health care discipline, Completion or undertaking Pain Specific module.

Those working at this level will be working towards or have obtained Associate Fellowship of the Higher Education Academy. They will be working at the Associate Fellow level as outlined by UK Professional Standards Framework for teaching and supporting learning in higher education. (Link to framework - https://www.advance-he.ac.uk/knowledge-hub/uk-professional-standards-framework-teaching-and-supporting-learning-higher-education).

Download the Knowledge and Skill competency framework for this level.

Clinical Academic Pathway

Clinical Academic Pathway

The Clinical Academic Pathway reflects the established Clinical Academic Career Framework for Nursing, Midwifery and Allied Health Professions. Below we summarise the main points in this framework. Practitioners at any level of the Skills for Health Career Framework (i.e. levels 5 to 9) can pursue this pathway.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Doctor of Philosophy and post-graduate certificate in research supervision; accredited leadership training, Pain-related course or EFIC Diploma,.

The Clinical Professor leads service transformation in the whole organisation and/or across healthcare systems. They provide clinical and professional leadership nationally, lead research programs national and internationally, manage and supervise research teams. They have a sustained an international reputation in research.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Doctor of Philosophy and post-graduate certificate in research supervision; accredited leadership training, Pain-related course or EFIC Diploma.

Those working at this level have developed advanced theoretical and practical knowledge, allowing them to provide expertise and leadership in their clinical practice. They have a national and international reputation. The Consultant Practitioner works on the development across services and/or the wider organisation.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 7 / Level 8

Recommended education requirements at entry point or for achievement during post: Professional Doctorate/Doctor of Philosophy and some post-doctoral experience. Pain-related course or EFIC Diploma.

Those working at this level have developed highly specialist knowledge, skills and expertise in pain management and the pain nursing. Within research, they may be a Chief Investigator on grant applications, advancing delivery of evidence-based practice. The advanced practitioner builds stroke clinical and research network, develops own practice, whole services and teams.

Download the Knowledge and Skill competency frameworks for Level 7 and Level 8.

Skills for Health Career Framework: Level 7

Recommended education requirements at entry point or for achievement during post: Completion of Professional Doctorate/Doctor of Philosophy. Pain-related course or EFIC Diploma.

Those working at this level have developed specialist knowledge and skills in pain management, acting as a clinical resource to staff and students in stroke nursing. Within research, they may be a Co-Investigator, contributing to research development in their field. They deliver and facilitate academic education, including mentoring and supervising doctoral students. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 7

Recommended education requirements at entry point or for achievement during post: Working towards completion of Master’s degree or Master’s Clinical Research or Master’s degree (advanced practice or pain management). They may also be working towards completion of doctorial level studies. Pain-related course or EFIC Diploma.

Those working at this level have consolidated skills and expertise in pain management and is an agent for change, developing and implementing local and national policies and/or guidelines. They are able to translate research findings and implement evidence-based practice as well as support research projects in their clinical areas. In addition, in this role, they have developed their research knowledge and skills and take a lead in an activity within research (e.g. Data collection) within their local services.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 6 / Level 7

Recommended education requirements at entry point or for achievement during post: Working towards completion of Master’s degree or Master’s Clinical Research or Master’s degree (advanced practice or pain management). 

Those working at this level have consolidated skills and expertise in pain management and is an agent for change, developing and implementing local and national policies and/or guidelines. They are able to translate research findings and implement evidence-based practice as well as support research projects in their clinical areas. 

Download the Knowledge and Skill competency frameworks for Level 6 and Level 7.

Leadership and Management Pathway

Management pathway

The Leadership and Management pathway stems from the need to value, recognise and consider the management and leadership skills and knowledge of registered nurses with stroke expertise in organizations and teams, at local, regional and/or national level. The role of the practitioner in this pathway has a stronger emphasis on management and leadership in comparison with the other pillars of advanced clinical practice.

Skills for Health Career Framework: Level 8

Recommended education requirements at entry point or for achievement during post: Master’s degree (eg. advanced practice or healthcare education or Business Administration); accredited leadership training at postgraduate level. Pain-related course or EFIC Diploma.

Those working at this level leads an organisation and team, setting its strategic goals. Such roles include but are not limited to, Clinical Lead/Director / Matron for Pain Services. 

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 7 / Level 8

Recommended education requirements at entry point or for achievement during post: Master’s degree (e.g. advanced practice); Completion Pain-related course or EFIC Diploma; Independent prescriber; Practice Assessor / Supervisor training. accredited leadership training at postgraduate level.

The lead nurse or Senior Clinical Nurse Specialist provides leadership to a service, ensuring it delivers high-quality care. They monitor the quality of care delivered to patients and have responsibility and accountability for staff satisfaction.

They show innovation and are strongly involved in service improvement and service change. They will lead specific education and training programme. They have strong links with research teams and are the interface between different fields.

Download the Knowledge and Skill competency frameworks for Level 7 and Level 8.

Skills for Health Career Framework: Level 7 

Recommended education requirements at entry point or for achievement during post: working towards or has completed Master’s degree (e.g. advanced practice); Completion Pain-related course or EFIC Diploma; Independent prescriber; Practice Supervisor training. Completion or working towards completion accredited leadership training at postgraduate level.

As with clinical nurse specialist role they may be responsible for managing an area, teams and resources. 

They show innovation and are strongly involved in service improvement and service change. They may lead or co-lead specific education and training programme.

Download the Knowledge and Skill competency framework for this level.

Skills for Health Career Framework: Level 6

Recommended education requirements at entry point or for achievement during post: Completion degree program in health care discipline, Completion or undertaking Pain related module. 

This professional works alongside the experienced level 7 professional in a development role.  They have a critical understanding of theoretical and practical knowledge within pain management, usually through a pain management specific course. They have added responsibilities such as supporting or providing training to non-specialist pain professionals within their areas. In addition to the previous skills at level 5, they have added responsibilities such as delegating, supervising or providing training to a team of nurses.

Download the Knowledge and Skill competency framework for this level.

Demonstrating Evidence

The aim of this Career framework is to provide nurses a clear path for developing as specialists in pain management. However, it can also be used as a foundation for demonstrating competence and skill across the domains outlined in the framework. Given there is already a wide variation in the availability of competency frameworks from local documents and national advanced practice portfolios we have not provided an additional competency framework to supplement this document. However, we would suggest that this is used in combination with the other widely available frameworks to demonstrate specialist knowledge in relating to pain.

This can be used for practitioner’s own development but also used towards professional revalidation, a basis for appraisals or a tool to start career progression discussions with practitioner’s line manager.

There are a variety of ways in which you can collect and present the evidence, this may include:

Evidence of Quality Improvement work - Have you been involved with work in your area that has led to an improvement in patient care? For example, by collecting or collating audit information. 

Reflection - Practitioners are encouraged to regularly write up anonymised reflective accounts relating to patients they have seen or from appropriate learning situations (for example using NMC reflective documentation)

Mini Clinical Examination assessments (Mini-CEX) - practitioners can include a number of mini–Clinical Examination assessments in their portfolio. A mini-CEX should be used where an assessor gives formal feedback regarding a consultation. 

Case Based Discussion - Practitioners will discuss numerous cases with their assessor. Practitioners are encouraged to keep notes on all their significant discussions and to write up formal case based discussions. 

Multisource feedback (MSF) - practitioners can request feedback from different clinicians’ practitioners and service users. 

Academic Assignments - these can be used to demonstrate knowledge and understanding of specific topics or concepts. 

Appraisals / Professional Development Reviews / Job Plans - Evidence of meetings with line managers can be used to show progress through the different career development frameworks. 

Acknowledgements

Project Working Group

  • Martin Galligan Project Lead Lecturer Practitioner Royal Marsden NHS Foundation Trust
  • Julie Gregory Forum Chair Pain and Palliative Care / Clinical Educator Royal Blackburn Teaching Hospital
  • Karin Cannons Nurse Consultant, Frimley Health NHS Foundation Trust
  • Zoe Thomson Lead CNS Inpatient Pain Service Forth Valley Royal Hospital
  • Sue Jenkins Senior Lecturer / Programmes' Director Cardiff University
  • Niamh Molloy Clinical Nurse Specialist in Pain Management, University Hospital Waterford
  • Siobhan Jones Headache Nurse Consultant North Cumbria Integrated Care NHS  Foundation Trust 

Consultation Contributors

Thank you to the RCN Pain and Palliative Care forum for their supporting in developing this document and the project team We would also like to thank those that took part in the consultation and review of the career framework, without their comments and insights we would not have been able to complete this project. 

  • Felicia Cox
  • Dr Donna Brown
  • Ofrah Muflahi
  • Adebukola Lawal
  • Professor Laserina O’Connor
  • Emma Davies
  • Christine Waters
  • Geinor Bean
  • Dr Helen Makins.

We would also like to say a special thank you to Erica Gleeson and the New Zealand Pain Society on which the original Pain Knowledge and Skills framework was based on, thank you for your continued support in the design and development of this framework. 

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