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Feature article - Yorkshire & Humber's public health Framework for gambling related harm reduction

In January 2018, Public Health England (Yorkshire and Humber) with Leeds City Council, organised a problem gambling masterclass. This enabled the sharing of current work in Leeds, Sheffield and Doncaster. The Gambling Commission spoke about local and national regulation, and treatment providers also presented.

Following this masterclass, the Yorkshire Humber Association of Directors of Public Health established a problem gambling working group, at present it is chaired by the Leeds Director of Public Health. This has provided an opportunity to share activities and learning at place level but also to cover a wider range of topics relevant to gambling-related harm such as licensing, children and young people, migrants and students.  Even during a short time, the degree of interest has risen substantially.

The Yorkshire and Humber group decided to translate the Commission’s Measuring Gambling Related Harms: A framework for action(Wardle et al 2018) into a public health framework of practical actions, providing a consistent approach to harm across the region.

A starting point has been a vision that councils and partners would take action:

  • To reduce the exposure of vulnerable people and groups to gambling products;
  • To reduce consumption of gambling products;
  • To reduce gambling related harm – to individuals, families, and communities;

Yorkshire & Humber’s Framework for gambling related harm reduction offers a “pick and mix” menu of actions under the headings:

  • Leadership and partnership
  • Influencing the regulatory environment
  • Reducing exposure of vulnerable people to gambling products
  • Improving identification and recognition of problem gambling
  • Self-management and support
  • Providing effective treatment
  • Promoting and maintaining recovery
  • Protecting children & young people from gambling related harm
  • Addressing gambling-related debt
  • Workplace health and wellbeing
  • Building and sharing the evidence base

The challenge was to develop a Framework that addressed the very different resource and capacity of councils in the Yorkshire & Humber region which include cities such as Leeds and Sheffield, market towns, seaside towns, and rural areas.

The “pick and mix” approach reflected that councils may have different starting points for taking action, and the amount of traction may depend on who is leading the work in each authority e.g. financial inclusion may make good progress on debt but not regulation;

licensing may make headway on regulation but not on treatment; public health may fully comprehend treatment pathways but fail to get engagement on planning.

The Framework is intended to be a practical document to enable councils to make a start. We could easily be paralysed into inaction by the enormity and complexity of a comprehensive harm-reduction programme - which may be unachievable within existing resources.

This area of work is dynamic and iterative. The Framework is therefore a snapshot in time of actions that appear to be relevant in 2019. It will need to be updated in line with a number of developments currently in the pipeline, led by the government and bodies such as Public Health England, the Local Government Association, the Commission, Gambleaware, which will change the landscape of this work, for the better.

The Framework is available on the Yorkshire & Humber Public Health Network website

By Myrte Elbers (Public Health – Leeds City Council) and Magda Boo (Public health – Sheffield City Council)

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