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The RAT structure is at the heart of the Essential Pain Management resource (Morriss et al., 2017). This was developed to standardise not only the education of pain but to also give professionals a simple structure which they can use in the assessment and management of a person experiencing pain. The RAT structure consists of: 


Recognise and acknowledge that someone is in pain, by listening and exploring their experience.


Respond to their reports of pain and document a pain assessment at both rest and movement. Taking into consideration the physical, psychological, and social impact that this may have on the person.


Provide sensible supportive care. Give analgesia in a timely manner. Observe for effect and side effects. Communicate care given to other staff in the care team and relatives. 

Morriss, W., Goucke, R., Huggins, L., O’Connor (2017) Essential Pain Management: EPM Lite Instructor Manual. Faculty of Pain Medicine & Australian and New Zealand College of Anaesthetists. Available at: 

Further guidance on assessing and managing pain across all clinical settings can be found in the RCN Pain Knowledge and Skills Framework (2015)

Signs of pain

• Vocalisation - shouting, crying, groaning.

• Facial grimacing or frowning.

• Changed body language.

• Aggression.

• Withdrawal.

• Emotional changes.

• Physical changes, eg. rocking, rubbing a limb.


If not identified early, untreated pain can lead to:

• distress

• reduced ability to move

• loneliness

• depression

• sleep disturbances

• falls

• nausea/vomiting

• constipation

• confusion

• long-term (chronic) pain.