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ABSG Progress Report on the National Strategy to Reduce Gambling Harms – Year Two

ABSG - Year two Progress Report on the National Strategy to Reduce Gambling Harms

5 - Clarification of referral pathways required

ABSG has noted weaknesses in the current arrangements. These are driven in part by funding arrangements and geographical coverage, but also lack of full agreement on triage assessments and cut-off thresholds for referrals between the different organisations providing treatment and support services. Whilst there is commitment in principle to joint-working between the NHS and the third sector in some parts of the UK, there is an urgent need for more work to improve the level of integration and mutual trust that is essential to effective referral pathways – both into gambling treatment and support services – and between the providers currently offering these services.

GambleAware’s Annual Treatment Statistics for 2019/20, shown in the following table, indicate that over 90% of those accessing treatment and support from the current system self-refer. No other service or source provides a significant number of referrals. This suggests that mainstream providers may not know where to signpost those who need help. This suggests that referral routes need to be strengthened, both between providers in the gambling-specific services provided by GambleAware and the NHS, but also with the wider network of organisations who provide supporting services and come into contact with people who may need more specialist treatment or help.

The data in Table 2 also supports concerns about the accessibility of treatment, with a relatively small number accessing treatment when compared to numbers estimated to be problem or moderate risk gamblers.

Table 1: Referrals to GambleAware funded treatment services 2019/20138

Referrals fromNumberPercentage (%)
Other service or agency1522.0%
Mental health NHS Trust700.9%
Other primary health care650.9%
Probation service230.3%
Social services160.2%
Others (including): Drug misuse services, Carer, Independent sector mental health services, Jobcentre Plus, A&E department.170.2%

Data in Table 2 also shows a very low number of onward referrals. In total, fewer than 100 clients (1.6%) were referred on for other forms of treatment over twelve months. Again, this appears to show a treatment system operating largely independently of wider services, rather than in a joined-up manner that would characterise a genuinely national treatment system.

Table 2: Reasons for exit from GambleAware funded services 2019/20139

Reason for exitNumberPercentage (%)
Completed scheduled treatment3,90566.3%
Dropped out1,54226.2%
Discharged by agreement3305.6%
Referred on to other services (assessed and treated)821.4%
Referred on (assessed only)130.2%
Not known130.2%

One of the consequences of the delay to NICE guidelines is that there is still ambiguity on referral protocols. Efforts have been made by the partners but this ambiguity makes it difficult to have confidence that service users are always directed to support that best meets their needs. In the meantime, we recommend that progress is accelerated towards establishing clear referral pathways between all partners responsible for delivering treatment and support services for those experiencing gambling harms. What is required going forward is a clear map of a gambling treatment ‘ecosystem’ with roles defined and understood.

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Need for more integrated treatment services
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Triage and completed treatments
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