Introduction

Focus of framework

Clinical Nurse Specialists (CNS) are registered nurses who practice at an advanced level within their specialty area.  They are a crucial part of the multi-disciplinary neurology team, providing expertise in a number of areas within neurology, including, but not exclusive to diagnosis, treatment and rehabilitation of patients living with neurological conditions in Scotland.

The Scottish Government’s Chief Nursing Officer Directorate published Transforming Nursing Roles paper 8 (TNR Paper 8) in August 2021. This outlined that there is clear demarcation of roles for CNS across Scotland and job titles are often not aligned with clear education pathways and provisions. 

To address this, this framework will promote a national approach for advanced nursing within neurology, providing structure for the knowledge and skills required for career pathway in advanced neurology practice.  The framework is aligned with TNR Paper 8 and recognises that additional sub-specialist competency requirements will be decided at the local level depending on service needs.

Aim and outcomes

The Framework for Specialist Nursing in Neurology is designed to outline the knowledge and skills essential for delivering high-quality neurology nursing service. The framework is intended to be used by healthcare practitioners, managers, and educators to understand and develop knowledge and skills across the clinical pillar of practice at level 5, level 6 and level 7.  For further information please refer to the Career Framework for Health model.

The outcome and impact of using the framework:

• Describing the knowledge and skills required within the service:
  The framework can be used by individuals developing their current and future practice; organisations reviewing or developing their services for their local populations; and educators ensuring knowledge and skills meet the needs of the service.

• Providing career pathways:
  The framework allows individuals and their managers to identify the necessary knowledge and skills, helping them to assess their own competence and prepare for career advancement within the services.
• Recruitment and succession planning:
  Organisations developing neurology services can use the framework to define the knowledge and skills required for practitioners working in these services across Scotland. Consideration of service models in other areas that may be transferable to their own service. Recruiting the right people who aspire to develop their careers within the service can aid succession planning.

Background and strategic alignment

"Neurological conditions" refers to a broad collection of disorders that represents 10% of the burden of disease in Scotland. They are an important health issue which has increased in relevance with Scotland's ageing population, with projections indicating it will have the third highest impact in terms of burden of disease in Scotland by 2040.

To tackle the challenges present within services for pwNC, the Scottish Government developed the Neurological Care and Support in Scotland: A framework for action 2020-2025. Specialist nurses have been identified to be a key resource in improving patient care, changing services, and implementing specific Scottish Government initiatives throughout neurological care, however, specialist nurses have often been poorly defined with little standardisation.

The Scottish Government’s Chief Nursing Officer Directorate published Transforming Nursing Roles paper 8 (TNR paper 8) in August 2021. The paper provides strategic oversight, direction and governance to CNSs across Scotland, with a particular focus on ensuring consistent career pathways for these professionals. It states that there is currently a lack of clear demarcation of roles for CNS across Scotland and job titles are often not aligned with clear education pathways and provisions.  

The overarching aim is for CNS roles to be reported under umbrella specialities and sub-coded to identify specific roles for individuals. Achievement of such alignment would allow accurate reporting of workforce data across professional groups and build further national consistency.