Key points Dizziness and balance disorders affect a large population and contributes to a significant workload to an already stretched ear, nose and throat (ENT) outpatient service Vestibular rehabilitation (VR), a kind of physical therapy, is the mainstay of treatment for dizziness. However, across Europe this service is often delivered by varying specialties including audiology, ENT, physiotherapy and neurology. We highlight our experience in creating a VR-trained physiotherapy led service with multi-disciplinary support from ENT and audiology Results on the outcome of a large patient cohort (objective and subjective measurements of dizziness) over a 29 month period are strongly favourable for this service’s positive impact Wait times for patients to be seen are significantly shorter and a more comprehensive assessment with longer appointments are carried out for patients attending VR clinics as compared to ENT clinics