Report

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

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Published
7 July 2021

Last updated
27 July 2023 - Changes

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Contents

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

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• Executive summary
• Recommendations
• Introduction
• - Introduction
• - Background
• - Impact of Covid-19 on partnership working
• - Trends in gambling
• - Gambling Act Review
• - Online harms
• Delivery and governance
• - Delivery and governance
• - Progress involving people with lived experience of gambling harms.
• - Mixed picture of national strategic co-ordination of implementation
• - Metrics for measuring harm
• - Evaluation of policy
• - Funding
• - Research
• Prevention and education
• - Prevention and education
• - Improved regulatory protections
• - Suicide and gambling
• - Improved profile of gambling harms as a public health issue
• - Increased engagement from the financial services sector
• - Gambling is not yet fully integrated with local public health activity
• - Increased education and awareness raising activity
• Treatment and support
• - Treatment and support
• - Expansion of treatment and support services in new areas
• - The evidence base for treatment is developing but incomplete
• - Need for more integrated treatment services
• - Clarification of referral pathways required
• - Triage and completed treatments
• - Lack of independent quality assurance
• - Follow-up support
• Conclusions
• Annex 1: Priority Metrics for measurement of National Strategy to Reduce Gambling Harms

6 - Triage and completed treatments

Despite best efforts by the partners, this data illustrates the lack of clearly agreed criteria and thresholds for movement through referral pathways that continue to present challenges in the current treatment and support system.

GamCare currently receives calls to the National Problem Gambling Helpline and, when appropriate, offer an onward referral for assessment by one of the network’s treatment providers. At this stage a second assessment is made by the provider. There is also an agreed pathway in place with the Gordon Moody Association with data sharing agreements and software portals to facilitate this.

Although the current system may work for some, a two-stage triage process is not consistent with established best practice as it means that an individual can pass through several stages until a clear referral can be made. Individuals can move in and out of harm quickly – so a timely triage system is important. Evidence from other addictions services suggests that access to highly specialist expertise at the triage stage can lead to better outcomes in the longer term¹⁴⁰,¹⁴¹. Adoption of a combination of widely used standardised assessment measures are needed such as the PGSI, Enhanced Core 10, GAD-7, PHQ-9. The CORE-10, GAD-7 and PHQ-9 are routinely used within IAPT and mental health services so will align with referral routes into IAPT/mental health provision. We note that progress is being made towards agreeing use of screening and other clinical tools.

The GambleAware National Treatment Statistics for 2019/20 suggest that the number of completed treatments appears to be lower than might be expected. Overall, 26.2% of clients leave the service before the scheduled endpoint of seven sessions. Those who are unemployed have the highest attrition rate at 32% and are the least likely to complete treatment (61%)¹⁴². Affected others who use the service have a lower rate of leaving the service before completion at 13%

Research into the treatment of alcohol and drug use, however, suggests that treatment outcomes generally improve as retention in treatment increases. Treatment completion is also linked to better outcomes¹⁴³. From this research it has been suggested that if clients fail to complete treatment, attrition typically occurs early on in treatment and that retention may be one amongst a number of indicators of a mismatch between the treatment offered and the needs of the client seeking help.

An important next step in the process of developing effective treatment responses for gambling is a more joined up and integrated approach that is centrally co-ordinated by statutory services in collaboration with third sector providers, playing to each other’s strengths and with investment in a wider range of interventions such as social prescribing, bringing recovery communities together and agreeing education and training standards. Such an approach would provide improved co-ordination of services, triage and treatment retention.

References

¹⁴⁰ The public health burden of alcohol and the effectiveness and cost-effectiveness of alcohol control policies: an evidence review (opens in new tab), Burton R, Henn C, Lavoie D, et al, Public Health England, 2016

¹⁴¹ Alcohol Care teams, Identification and Brief Advice, Moriarty KJ. Frontline Gastroenterology, 2020: “Alcohol assertive outreach teams (AAOTs) and specialist treatment for dependent drinkers were cost-effective; every £1 invested brings an annual return of £3, which rises to £26 over 10 years. Psychosocial interventions for dependent drinkers can save the overall UK economy £5 for every £1 invested”.

¹⁴² Annual Statistics from the National Gambling Treatment Service (Great Britain) 1st April 2019 to 31st March 2020 (opens in new tab), GambleAware, October 2020

¹⁴³ Relationship between drugs treatment, retention and outcomes, Hser et al, 2004 (opens in new tab)

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Lack of independent quality assurance

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Last updated: 27 July 2023

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