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The National Institute for Health and Care Excellence (NICE) has issued new guidance that recommends general practitioners (GPs) in the UK to ask patients about their gambling habits during health checks and appointments. Published on 28 January 2024, the guidance aims to help healthcare professionals identify and address gambling-related harms, which can affect individuals’ health, finances and relationships.
GPs and other healthcare professionals in England are now advised to ask about gambling during health appointments, similar to how they address smoking and alcohol consumption. This is particularly important for patients with depression, anxiety, or a history of addiction, self-harm or suicidal thoughts.
Certain groups may be at higher risk for gambling problems, including those with post-traumatic stress disorder (PTSD), personality disorders, or attention deficit hyperactivity disorder (ADHD). NICE also advises healthcare professionals to consider the influence of medications that may affect impulse control and difficult home environments.
Patients who may be at risk are encouraged to complete the Problem Gambling Severity Index (PGSI) questionnaire available on the NHS website. A score of 8 or higher suggests the need for support from a specialist gambling treatment service. NHS England has opened 15 gambling clinics since 2019, with seven new clinics opened in 2024, aiming to treat approximately 3,000 people each year.
NICE stresses that stigma and fear of disclosure should not prevent individuals from seeking help. The guidelines suggest a tailored approach to treatment, considering factors like ethnicity, religion and vocation, including services for specific groups such as veterans. It is also recommended that treatments for gambling addiction be provided separately from those for alcohol or substance dependence.
Baroness Fiona Twycross, Minister for Gambling, welcomed the guidance, acknowledging its role in providing better access to support for those affected by harmful gambling. She said, “We welcome this guidance from NICE on identifying, assessing and managing gambling-related harms, which will support those experiencing harmful gambling to get access to the right support.”
Additionally, the government plans to introduce a statutory levy, which will generate £100 million annually to expand support and treatment options. “The Government’s plans to introduce a statutory levy, which will generate £100 million each year, will provide the investment needed to further expand the support and treatment on offer for those in need,” she added.
National Clinical Director for Primary Care, Dr Claire Fuller, said, “We welcome NICE’s decision as gambling can have a massive impact on people’s lives and the lives of the people that care for them, and as healthcare professionals, we need the right tools to help tackle gambling-related harms.”
“Over the past few years, the NHS has made significant progress in expanding treatment for gambling addiction with the rollout of 15 specialist clinics across the country. So, if you’re worried about your gambling, there is support available, and you can directly refer yourself to your local NHS gambling clinic.”
The Gambling Survey for Great Britain (2023) found that 2.5% of adults have a gambling problem, with young men being most at risk. Gambling addiction can have devastating consequences, affecting not just individuals but their families and communities as well. The new guidelines from NICE aim to help healthcare professionals identify those in need of help earlier and ensure they receive the treatment they require.
NICE’s Chief Medical Officer, Professor Jonathan Benger, emphasised the devastating impact gambling-related harm has on individuals and their loved ones. Expressing hope that the new guidelines will be useful, he said, “Our useful and usable guideline will help healthcare professionals and others to identify those needing help earlier and ensure they get the treatment and support they need.”
NHS England’s gambling clinics offer a range of services, including access to psychologists, psychiatrists, and support for families and friends. NICE’s guidance is part of a broader effort to improve care for those struggling with gambling addiction, and NHS England is working with the Department for Culture, Media & Sport (DCMS), the Department for Health and Social Care (DHSC), and other partners to implement the new guidelines.
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