The formation of a service to appropriately deal with vulval problems inevitably requires time, enthusiasm and resources. Vulval disease may be the subject of shame and embarrassment, with some women delaying seeking advice for months or years because of fears about the source of the condition or the examinations and investigations that may be necessary. Clinics should have clear clinical and operational guidelines. Usually, the lead clinician would be responsible for these guidelines. All women with suspected vulval problems should have prompt access to a clinic specialising in the management of such disorders. This would usually be hospital-based but delivering care in a community setting may be more appropriate, depending on local needs. To facilitate audit, a clinic pro forma which captures the required dataset should be designed. Clinics should be adequately staffed by appropriately trained individuals including a specialist gynaecology nurse.