UK health organisation issues new gambling harm guidance for GPs 

Guidelines published by the National Institute for Health and Care Excellence (NICE) suggest that GPs should routinely ask all patients at risk of gambling-related harm about their habits. 

First published in draft form in 2023, NICE’s guidelines note that GPs should assess which patients to speak to regarding gambling-related harm via several risk factors. 

Those draft guidelines were ratified today, 28 January, which will align gambling-related harm initial care with how GPs look for alcohol and smoking addictions in patients.

Factors include patients who already attend appointments about mental health issues, such as depression and suicidal thoughts, alongside those who have potential addiction issues, such as alcohol or drug dependence. 

Other factors taken into account when assessing whether a patient is at risk of gambling-related harm also include those suffering from post-traumatic stress disorder (PTSD), personality disorder or attention deficit hyperactivity disorder (ADHD). 

Once all patients at risk have been identified, GPs should encourage them to analyse the severity of their respective gambling-related harm through an NHS questionnaire using the Problem Gambling Severity Index (PGSI). 

Patients who score eight or higher are recognised as being in the harmful gambling bracket and are advised to seek specialist treatment. 

NICE guidance explains that GPs and all other health and social care practitioners must ensure that those identified as at risk of gambling-related harm are able to access all support and treatment services, while using a tailored approach to meet the needs of each individual. 

The guidance, which will not be implemented immediately, details how gambling treatment services should also consider involving the partners or family members of patients. 

NICE has explained that it is “working closely” with the Department for Culture, Media and Sport (DCMS), the Department for Health and Social Care (DHSC) and NHS England on how to implement the guidelines. 

The draft guidance, issued in October 2023, also recommended that healthcare professionals ask patients whether they have access to blocking software among other tools to restrict gambling activities, as well as asking if they would be willing to participate in cognitive behavioural therapy (CBT). 

As outlined in the draft, the NICE cited research that shows CBT can identify triggers of gambling-related harm more effectively. 

However, there is no mention of CBT in the published guidance. 

Professor Jonathan Benger, NICE chief medical officer, explained: “Gambling-related harm has a devastating impact on those who experience it, and the people close to them.  

“Our useful and usable guideline[s] will help healthcare professionals and others to identify those needing help earlier and ensure they get the treatment and support they need.” 

Dr Claire Fuller, NHS England clinical director, added: “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.” 

A Betting and Gaming Council spokesperson said: “BGC members voluntarily contributed over £170m over the last four years to tackle problem gambling and gambling-related harm, including £50m in 2024, funding an independent network of charities currently caring for 85% of all problem gamblers receiving treatment in Britain. 

“Each month around 22.5 million people in Britain enjoy a bet, on the lottery, in bookmakers, casinos, bingo halls and online, and the overwhelming majority do so safely and responsibly.

“The most recent NHS Health Survey for England estimated that 0.4% of the adult population are problem gamblers.”