Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff
Open accessAbstract
BACKGROUND: In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. METHODS: We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS) Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. RESULTS: The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%). Respondents considered the NHS tinnitus referral process to be generally effective (67%), but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%), nor was the opportunity to access specialist counselling provided by clinical psychology (35%). To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. CONCLUSIONS: Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved access to psychological services through audiologist training, and 3] ongoing support from tinnitus support groups, national charities, or open access to the tinnitus clinic for existing patients.
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Within the UK healthcare system, tinnitus patients encounter dual obstacles in accessing psychological interventions: a shortage of mental health professionals and inefficient referral pathways to psychological services.
“Within the UK healthcare system, for instance, tinnitus patients encounter dual obstacles in accessing psychological interventions: a shortage of mental health professionals and inefficient referral pathways to psychological services (Gander et al., 2011; McFerran et al., 2018).”
From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Gander et al., 2011
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Lee, G. J. C., Liew, J. J. P., & Teng, A. W. L. (2026) · Journal of Otorhinolaryngology Hearing and Balance Medicine · doi:10.3390/ohbm7020030
- Authors
- Gander, P. E., Hoare, D. J., Collins, L., Smith, S., & Hall, D. A.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Gander, Phillip E
- Venue
- BMC Health Services Research
- Published
- 2011-07-06
- Volume
- 11
- Issue
- 1
- Pages
- 162-162
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC3144449
- OpenAlex
- W2013486245
- Cited by
- 65
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 8 · 2017: 9 · 2016: 6 · 2015: 5 · 2014: 1 · 2013: 7 · 2012: 3
- FWCI
- 2.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lancaster EPrints (Lancaster University) (submittedVersion)
- Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- Nottingham University Hospitals NHS Trust
- University Hospitals Birmingham NHS Foundation Trust
- National Institute for Health and Care Research
- University of Nottingham
- University of Bristol
- Sheffield Teaching Hospitals NHS Foundation Trust
- Royal National Institute for Deaf People
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Keywords
- tinnitus, referral pathways, audiology services, National Health Service, general practitioner referral, access to specialist care, psychological counselling, service equity
- MeSH terms
- Audiology, England, Female, Health Personnel, Humans, Male, Referral and Consultation, State Medicine, Tinnitus, Health Care Surveys
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