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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

4 - Need for more integrated treatment services

ABSG have previously referred to the challenges which GambleAware as a third sector organisation face in creating and sustaining an effective well-functioning treatment and system. Advice in 2019128 and the first Progress Report in 2020129 advocated for a central coordinating role for statutory health and care services working alongside the third sector. ABSG welcomes the on-going commitment shown in GambleAware's recently published five-year strategy to collaborate with NHS partners130. In particular, the strategy states that in the ‘mid-term’ NHS/Statutory services will take a greater lead on treatment for gambling harms and in the ‘long-term’ NHS/Statutory services will lead the market, with on-going support from the third sector131.

Making these changes would place treatment provision on an equal footing with other more established addictions services, access a wider range of professional expertise, more treatment options and greater opportunities to employ for those with lived experience to work within multi-disciplinary teams132,133.

It would also ensure that those in need of help could more easily and readily access a clear treatment pathway. Projects are underway which will provide insights into how more joined up provision could be achieved, such as the Primary Care Gambling Service (Case Study 6) and the Gambling with Lives Effective Care Pathways project (Case Study 7), led by people with lived experience.

It is disappointing to note that the recent announcement of a grant allocation to local authorities in England did not make reference to improving uptake of treatment services for gambling addiction alongside drug and alcohol misuse services134.

Case study 7: Gambling with Lives – Effective Care Pathways

Gambling with Lives is leading a collaborative project aimed at developing a pilot care and treatment pathway in Manchester that would inform care and treatment provision nationally. The pilot pathway would deliver integration of gambling treatment services with other statutory and third sector services in the city and is designed for long-term integration within the developing Integrated Care Systems. This project places people with lived experience at the centre of the design and delivery of the work.

Care pathways135 are an established methodology for ensuring that people accessing services do so at the right time and in the right place to meet their needs136, and ensuring quality and consistency across services137. The project has involved defining what those with gambling disorder and affected others need from services with reference to research evidence and feedback from those lived experience, looking at critical success factors along the pathway, testing individual pathway features with ‘early adopters’, evaluating and agreeing a final pathway ready for piloting.

One area of concern is the continued use of the term ‘National Gambling Treatment Service’ to describe GambleAware-funded services. This appears to be a misnomer, with no equivalents in other third sector-led addiction services. We are concerned this branding of a ‘national service’ creates confusion with NHS services and gives the impression that the desired levels of integration have already been achieved. It creates a risk that national statutory organisations do not take the optimal leadership role in providing integrated treatment services.

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The evidence base for treatment is developing but incomplete
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Clarification of referral pathways required
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