Progress Report on the National Strategy to Reduce Gambling Harms
Embedding treatment in NHS provision
Over the past year, practical progress has been made through the opening of new clinics in Leeds, with new services open in Manchester and Sunderland, and a specialist clinic for children and young people in London78. NHS England has committed to opening up to 14 clinics across England.
The creation of these clinics has started to embed the process of treating gambling harms within the NHS. This is a positive start – but there are still weakness in commissioning, referral pathways and infrastructure. The focus for next year must be on:
- Creating integrated care pathways and a screening item screening tool for use by primary care, third sector and local authorities so that treatment services are readily accessed by those who need them.
- Clear commissioning agreements need to be developed in terms: of cut-offs for treatment pathways between treatment providers; staffing qualifications, training, skills and supervision arrangements for health professionals providing treatment in third sector providers; governance arrangements to ensure good quality treatment provision across all treatment providers.
- More evaluation - NHS clinics can lead by example on good practice for evaluating the impact of their services. Evaluation should include outcome evaluation strategies such as standardised assessment measures of mental health, gambling severity and risk. Establishing an outcome/pathway following treatment would be a relatively low-cost and efficient method to provide basic outcome data that is currently lacking. Inclusion of standardised assessment measures could be simple and straightforward and follow a similar model to the NHS Improving Access to Psychological Therapies (IAPT) services where assessments are completed at prescribed intervals and data collated nationally.
- The creation of equivalent services through the NHS in Scotland and Wales. Scotland and Wales favour an approach of embedding treatment in existing addiction and other support services, rather than setting up bespoke services for gambling. The Scottish and Welsh Government’s approach to tackling gambling is aligned with the goals set out in the National Strategy, which highlight the need to provide treatment and support services alongside preventative and education interventions to remove or reduce the harms resulting from gambling. We welcome the Scottish and Welsh Government’s work to reduce inequalities and the causes of inequalities as part of their national Public Health Priorities. This provides an opportunity to learn about the relative strengths and weaknesses of different intervention approaches.
- Creating targeted education and training programmes for NHS staff working in primary care, mental health and addictions services as part of building capacity in the wider health and care workforce. This would ensure early identification, signposting to specialist centres and some treatment and support can be delivered at this level.
Case Study 6: NHS Northern Gambling Service79
The NHS Northern Gambling Service (also known as the Northern Gambling Clinic) is part of Leeds and York Partnership NHS Trust. It provides specialist addiction therapy and recovery to people affected by gambling addiction. This NHS service comprises a team made up of registered psychologists, therapists, psychiatrists, and mental health nurses and people with lived experience. The team works in collaboration with other services, including third sector specialist services, GP practises, local authority services, and debt advisory services, signposting to support and advice where this is needed.
The services are delivered in parallel with services provided by GamCare and funded by GambleAware.
Through clinics in Leeds, Salford and Sunderland, these services can be accessed by people across the North of England and Northern Midlands. It is used by people with gambling addictions who may also be experiencing depression, anxiety, trauma, and suicidal feelings. The support offered is also available to people affected by someone else’s gambling – such as family, partners, and carers.
The core programme includes eight to ten sessions of cognitive behavioural therapy (CBT), sessions with family and friends, follow up after these sessions have ended, support with tackling all the impacts of gambling addiction, and connecting with others who have had similar experiences.
76 NHS Long-Term plan, NHS England, January 2019
77 NHS Mental Health Implementation Plan 2019/20 – 2023/24, NHS, July 2019
78 NHS to launch young people’s gambling addiction service, NHS England, 2019
79 Northern Gambling Service, NHS Leeds and Yorkshire NHS Foundation Trust
Last updated: 18 August 2021
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