The drive to establish clinical academic careers in nursing in the United Kingdom has gained momentum in recent years, spearheaded by opportunities presented by the Higher Education England/National Institute for Health Research integrated clinical academic pathway. However, embedding clinical academic careers within a healthcare organisation is challenging. This paper outlines the approach that one large NHS Trust has taken to developing a framework for clinical academic careers in nursing. The internal and external resources that are drawn upon to support the implementation of the framework are outlined and some of the practical challenges of making the framework a reality are discussed. The development, implementation and sustainability of the framework are dependent on professional, managerial and research leadership together with close collaboration between the healthcare organisation and higher education institutions.