The author ofthis article responded to a need to address a service deficit
for individuals with spinal cord injury, by setting up a nurse-led
outpatient clinic to review, assess, advise and help patients develop
problem-solving strategies to enable them to maintain their level
of independence in the community, prevent unnecessary admissions
and minimize the development of more serious complications that arise
as a consequence of ageing with a spinal cord injury. The clinic sessions
provided an efFective service which demonstrated its value by achieving
the following outcomes: provided a practical problem-solving approach
to changes in physical function; prevented unnecessary hospitalization;
and identified issues that required referral for additional
specialists/services. Unfortunately, despite its short-term success, there
were a number of issues (staflSng and funding) which prevented the
continuation and further development of the service. However, although
not yet currently published, the key themes of the National Service
Framework (NSF) for individuals with neurological conditions advocate
the type of approach to patient care that has been reflected within this
clinic (lifelong support fi-om specialist practitioners and person-centred
care). Hopefully the publication of such an influential document will
support the development of future initiatives within this specialist field.