ABSG Progress Report on the National Strategy to Reduce Gambling Harms – Year Two
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.
128 The Responsible Gambling Strategy Board’s advice on the National Strategy to Reduce Gambling Harms 2019–2022, RGSB, 19 February 2019
129 ABSG Progress Report 2020, ABSG, 26 June 2020
131 (Page 9) GambleAware Organisational Strategy (opens in new tab), 2021-26
132 IAPT positive practice guide for working with people who use drugs and alcohol, DrugScope (opens in new tab), NHS National Treatment Agency for Substance Misuse, January 2012
133 Alcohol Care Teams (opens in new tab), NHS England
134 Public health grants to local authorities 2020-21 (opens in new tab), Gov.uk, March 2020
135 The care pathway: concepts and theories: an introduction, Schrivers et al, 2012
136 Project design phase for Treatment Pathway collaboration project, National Strategy to Reduce Gambling Harms Actions Map, Gambling Commission (accessed 14 April 2021)
137 Clinical pathways as a quality strategy, Potter et al, 2019
The evidence base for treatment is developing but incomplete Next section
Clarification of referral pathways required
Last updated: 28 June 2021
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