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Introduction Patients with a spinal cord injury (SCI) have higher risk of cognitive impairment (CI). The true incidence of CI in this group is unclear due to the difficulty in administering commonly used assessments, which rely on hand function.Methods A 16-question online survey was sent to registered clinicians at each of the 11 UK Spinal Injuries Centres. Online focus groups were performed to gain patient perspectives.Results 41 questionnaire responses were received. 68% thought CI was more common after SCI. 15% reported not using screening tools due to a lack of guidelines and physical impairments affecting the ability to complete assessments. 93% would find a standardised assessment tool useful.People with SCI reported cognitive issues post injury but a lack of information or assessments, with care focusing primarily on physical elements of their SCI. Furthermore, they recognised a difference in the approach to SCI management between centres within the UK.Discussion Clinicians feel there is a higher incidence of CI after SCI. Currently available tools are not always appropriate. Furthermore, not all SCI centres have a dedicated neuropsychology service and rely on local/regional memory services. Clinicians and patients want a more standardised approach, particularly since CI increases care needs and reduces rehabilitation engagement.hamishpatel@doctors.org.uk