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Table 1 Clinician opinions on how services could be optimised: topics, sub-topics, and example quotes. N refers to the number of respondents who made a suggestion relating to the sub-topic

From: An evaluation of paediatric tinnitus services in UK National Health Service audiology departments

Topics

Sub-topics

n

Example Quotes

More experience

More experience/time to develop services

3

“Experience, this is a new service”

“This service is new to the department so there are many improvements that will be made as the service is developed”

“More experience/confidence”

More patients

3

“We need greater exposure to children with tinnitus in order to gain greater competency in dealing and talking through tinnitus with children and families”

“Encourage ENT to ask more children if they hear noises in their ears. More patients will lead to more experience”

“Only a few children are referred”

Improved organisation

Improved organisation (general)

2

“More coherent strategy”

“An organised approach”

Improved scheduling

2

“More time to book appointments close together. To see children in a separate clinic - it is difficult to see them when they are mixed into adult clinics”

“Shorter waiting times”

Funding/ commissioning

3

“At the moment there is no commissioned service so it is very ad hoc

“More funding for staff and time”

Improved connections with mental health /paediatric services

8

“We hope to work on improving our network with local mental health professionals”

“Direct Audiology links with CAMHS”

“Access to paediatric CBT”

“Direct access to relaxation/anxiety/stress management”

“Confidence that CAMHS services understand tinnitus and how this can be managed as part of a wider mental health support plan”

Access to therapeutic devices

1

“Access to provide patient with supportive devices or offer direct purchase”

Child-friendly resources and environment

Child-friendly resources (general)

5

“More child-friendly resources”

“Interactive material”

“More visual tools for explanation for young children”

“A teen leaflet”

Child-friendly assessment resources

2

“Some good history sheets aimed at younger children…at the child’s level of understanding”

“Child-friendly tinnitus questionnaire to help outcome measures”

Child-friendly environment

3

“Child-friendly counselling room”

“Child-friendly environment - more toys/posters/playmats etc”

Staff improvements

Training (general)

4

“Staff to attend the annual paediatric training course”

“Training specific to paediatrics”

“Need more staff trained in this area”

Training in delivery of psychological therapies

3

“Learning how to teach relaxation and mindfulness techniques”

“More staff trained in all aspects of behavioural therapies or a referral route for this”

Improved staff knowledge/ interest

2

“Improving interest on the subject within the team”

“Networking with other clinicians would be very useful”

Additional staff expertise

1

“Having a child psychologist on board”