Tinnitus services in the United Kingdom: a survey of patient experiences
Open accessAbstract
BACKGROUND: Tinnitus service provision in the United Kingdom has been investigated from the healthcare provider's perspective demonstrating considerable regional variation particularly regarding availability of psychological treatments. An audiological-based tinnitus service, however, was reportedly available for all tinnitus patients in the UK. The aim of the current study was to define and evaluate nationwide tinnitus healthcare services from the patients' viewpoint. METHODS: Secondary analyses were performed on data from a 33-item questionnaire provided by the British Tinnitus Association. The questionnaire had been distributed via email and social media. RESULTS: Responses from 937 participants who had or had previously experienced tinnitus were analysed. All but one person had at some time consulted their GP. About one in five received medication in primary care. The majority were referred to secondary care, generally an ENT surgeon or audiovestibular physician; some were referred directly to audiological services. In secondary care the majority underwent audiometric testing and over half underwent MRI scanning. Drugs were prescribed less frequently in secondary care. About one third of patients were referred onwards from diagnostic services in secondary care to receive therapeutic interventions for tinnitus. Therapy was generally delivered by an audiologist or hearing therapist. Just under two fifths of people discharged from secondary care returned to their GP, with most returning within one year. Over a third of this group were re-referred to secondary care. Few patients saw a psychologist (2.6%) though some psychological treatments were delivered by appropriately trained audiologists. Negative counselling from healthcare professionals in both primary and secondary care settings was reported. CONCLUSIONS: Although the UK has developed a national service for patients with tinnitus many people find it difficult to access, being blocked at the primary care level or after secondary care diagnostic services. Many of those discharged from secondary care return to their GP within a short space of time and are re-referred to secondary care creating an unsatisfactory and expensive revolving-door pattern of healthcare. Despite psychological treatment modalities having the best evidence base for successful tinnitus management, only a minority of tinnitus patients ever get to meet a psychologist.
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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 McFerran et al., 2018
The Abstract Conclusions report that patients can be blocked at primary care or after secondary-care diagnostic services, and the Conclusions call for alternative referral pathways while noting that only one in forty access psychological services. These passages support an access and referral problem, but they do not identify a shortage of mental health professionals as its cause. (LLM, conf=0.85)
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Beukes, E. W., Andersson, G., Manchaiah, V. K. C., Allen, P. M., & Baguley, D. (2018) · Advances in medical technologies and clinical practice book series · doi:10.4018/978-1-5225-8191-8.ch006
Measurement of Human Resource Demand of Medical Institution Inspection Based on Task Analysis
Liu, Y., Zhou, C., Chen, X., & Chen, G. (2021) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s305659
A Framework for Designing and Evaluating Internet Interventions to Improve Tinnitus Care
Beukes, E. W., Andersson, G., Manchaiah, V. K. C., Allen, P. M., & Baguley, D. (2021) · IGI Global eBooks · doi:10.4018/978-1-7998-8052-3.ch007
Castilho, G. L., Dias, N. H., & Martins, R. H. G. (2022) · doi:10.22541/au.165784145.52111957/v1
Chamouton, C. S. (2021) · doi:10.47749/t/unicamp.2021.1237298
Howlett, P., & Murphy, D. (2025) · Exploration of Digital Health Technologies · doi:10.37349/edht.2025.101165
Carmody, N., Tegg-Quinn, S., Hunter, M., & Eikelboom, R. H. (2025) · Speech Language and Hearing · doi:10.1080/2050571x.2025.2594338
“McFerran et al. (2018) also reported mixed satisfaction with treatments and emphasized that positive GP interactions helped reduce anxiety and improve access to care.”
Howlett, P., & Murphy, D. (2026) · Journal of Hearing Science · doi:10.17430/jhs/216757
“NHS approximately £750 million annually [9] and many individuals experience significant difficulties in accessing tinnitus treatment [10].”
Audiometric Profile in Cases of Tinnitus and Its Relationship with Masking and Matching
Silky, S., & Singh, V. (2026) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-026-06444-5
Simões, J. P., Engelke, M., Goedhart, H., Vesala, M., Schlee, W., & Marcrum, S. C. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15114043
“…and equitable access to healthcare [44,45], the limited number of specialized healthcare providers to support individuals burdened by tinnitus [46], and the emergence of programs leveraging communal aspects, capitalizing on (online) community-building and peer-to-peer support emerges as an…”
- Authors
- McFerran, D., Hoare, D. J., Carr, S., Ray, J., & Stockdale, D.
- Affiliations
- Essex County Hospital (GB)
- University of Nottingham (GB)
- Royal Hallamshire Hospital (GB)
- British Tinnitus Association (GB)
- Corresponding author
- McFerran, Don
- Venue
- BMC Health Services Research
- Published
- 2018-02-13
- Volume
- 18
- Issue
- 1
- Pages
- 110-110
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC5809968
- OpenAlex
- W2806240330
- Cited by
- 58
- References
- 35
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 11 · 2020: 11 · 2019: 8 · 2018: 4
- FWCI
- 5.48
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- University College London
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Keywords
- tinnitus, patient experience, health care access, primary care, secondary care referral, psychological intervention, re-referral, tinnitus management, United Kingdom
- MeSH terms
- Aged, Counseling, Female, United Kingdom, Health Personnel, Humans, Male, Middle Aged, Primary Health Care, Referral and Consultation, Tinnitus, Patient Satisfaction, Health Care Surveys, Secondary Health Care
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