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Spotlight on innovative local public health approaches to reducing gambling harm

30 January 2020

Approaches and schemes being run through Great Britain to reduce gambling harm

Public health teams and local authorities across Great Britain are taking innovative and varied approaches to implementing the National Strategy to Reduce Gambling Harms and make real progress towards preventing gambling harm.

These initiatives can start from a variety of sources – financial inclusion teams, public health teams, health and social care as well as licensing departments – but success depends much on engagement and participation across a wide range of other bodies too – statutory, third sector partners, gambling operators, regulators and treatment providers, front line staff and management.

Here are just a few examples of some of that activity, and details about similar projects can be found in the Reducing Gambling Harms resources on the Gambling Commission website.

Scottish Public Health Network

The Scottish Public Health Network (ScotPHN), hosted by NHS Health Scotland, undertake work of national importance work on behalf of the Scottish Directors of Public Health and have a remit to support knowledge exchange between those working in public health across Scotland. ScotPHN have started a 3-year pathfinder programme to look at how local communities and stakeholders can work together more effectively to tackle gambling harms in the City of Glasgow.

The project will put into practice the Whole System Approach (WSA) to place and community defined by the Public Health Reform Team in Scotland to helps us to better understand all of the factors, individual, social, economic, environmental and cultural, that influence a person, family or community’ experience of gambling harm and find sustainable local solutions.

Bringing together local communities, experts by experience and experts in practice, policy and research, the project will use the WSA to find the areas where action will have the greatest impact addressing local priorities. A coordinated action plan to prevent and reduce gambling harms in the City will be codesigned and implemented.

Information to help us assess the impact of the project and sustainably feed this back into the local system, will be gathered. Learning will be shared and spread to inform and support practice and policy locally, nationally and internationally.

The project will bring together key partner from across the whole system, including:

  • NHS Greater Glasgow & Clyde
  • the Health and Social Care Alliance (the ALLIANCE)
  • the Glasgow Centre for Population Health
  • leading academics from the University of Glasgow
  • Council’s Licensing Board
  • the Integration Joint Board
  • Health & Social Care Partnership
  • Community Planning Partnership.

The City’s Public Health Oversight Board will provide strategic oversight for the project through the Community Planning Partnership.

Through a whole system, coordinated approach to address gambling harms across the City, the project aims to:

  • Improve the health and wellbeing of people who live, work and play in Glasgow and reduce inequalities;
  • Raise awareness of the harms associated with gambling, reduce the stigma associated with gambling harms and encourage people experiencing harm to seek help, support and treatment;
  • Improve awareness of, and access to, help, support and treatment of those experiencing gambling harms, raising awareness of gambling harms with front line staff and employers in a range of settings and developing pathways to help, support and treatment delivered locally, equitably and sustainably to meet whole family needs.
  • Raise the profile of gambling harms as a public health issue within the local community, the public health community, partner organisations and Scottish Government.
  • As early adopters, test and share learning from use of WSA in practice to address a public health issue.
  • Support collaborative action on our national Public Health Priorities.

Multi-agency governance arrangements have now been finalised. The project team are starting to build a local picture and map the local system. If you feel that you could contribute to this work and would like to be part of the systems network, or you’d like to keep up to date with progress, please get in touch at nhs.healthscotland-scotphn@nhs.net.

Greater Manchester Combined Authority

The ten local authorities across Greater Manchester (with a combined population of 2.1m) are working together to reduce gambling harms. They are starting on a 3-year programme of work which reflects the aims of the National Strategy. Its aims are:

  • Improve support for those already experiencing harm.
  • Improve prevention programmes to reduce those at risk of experiencing harm.
  • Collect evidence from services and service users to better understand gambling harm and the impact of interventions.
  • To share learning and inform work elsewhere.

This wide ranging, public health focussed project has 5 key strands:

  • Evidence and evaluation – e.g. embedded screening across front line providers, research using secondary care data, gathering industry data to understand prevalence and demographics for online gambling, primary research into student gambling.
  • Awareness raising and stigma reduction – particularly for front line staff across a wide range of agencies, plus social marketing to the wider population.
  • Addressing the non-remote regulatory environment – e.g. each Licensing Authority’s Statement of Licensing Policy to reflect best practice with a focus on ensuring operators safeguard vulnerable groups.
  • Harm prevention activities – eg education activity across the school and college network, work with sports clubs across Greater Manchester as well as with larger employers to better protect their employees from gambling harm.
  • Treatment provision – this will include establishing robust pathways into partner support networks (including mental health services) as well as collaboration with the Northern Gambling Clinic as it establishes its satellite clinic in Manchester.

Wigan Council

Wigan has published an article on their website (opens in new tab) about a harmful gambling awareness process across the workplace, including their wider partner network - an example of how corporate health and wellbeing policies can improve the workplace for everyone.

The work was initiated by their Welfare Reform group which led to the creation of a Problem Gambling Working Group. With the advice and support of their regional GamCare treatment provider (Beacon Counselling Trust (opens in new tab) they have been able to create a multi-agency team, e.g. licensing, public health, housing, Department of Work and Pensions, children’s services and the third sector, to start to make major changes to the way the citizens of Wigan are better protected from gambling harm. The objectives of the work are as follows:

  • Raise awareness amongst the workforce about the risks of harmful gambling, providing them with the necessary tools to be able to have a conversation about gambling and provide them with the knowledge and information on the assets available to refer or signpost residents towards.
  • Raise awareness amongst residents about harmful gambling and promote the support that is available to help individuals and families affected by harmful gambling.
  • To embed the gambling harm screening tool into targeted Council and partner organisation triage/assessment processes where problem gamblers may present themselves, to help identify and provide support earlier.
  • To develop indicators for monitoring the implementation of the programme to measure and demonstrate impact.

Yorkshire and Humber

The Association of Directors of Public Health Yorkshire and Humber have published a framework to reduce gambling harms (opens in new tab). It is a significant and challenging framework which involves a wide range of agencies, including gambling operators, treatment providers, housing, debt advice, employment support and mental health and employers.

Each has an opportunity to play their part. The framework identifies 11 potential ‘areas for action’ using current available evidence and is flexible enough to work for both urban as well as rural parts of the region.

The framework checklist covers 11 areas for action:

  • Leadership and partnership
  • Influencing the regulatory environment
  • Reducing exposure of vulnerable people to gambling products
  • Improving identification and recognition of problem gambling
  • Self-management and support
  • Providing effective treatment
  • Promoting and maintaining recovery
  • Protecting children and young people from gambling related harm
  • Addressing gambling related debt
  • Workplace health and wellbeing
  • Building and sharing the evidence base.

Sheffield City Council

Staying in Yorkshire, Sheffield City Council’s Joint Strategic Needs Assessment (JSNA) includes a chapter on gambling harms, identifying it alongside more ‘traditional’ harms such as alcohol and drugs.

Prioritising gambling harms within the needs assessment pushes it up the priority list for commissioners and service providers, when making decisions about which services to offer.

It helps to embed gambling harm alongside other issues where there is often proven co-morbidities or related concerns, for example drug and alcohol dependencies as well as mental health problems.

Devon County Council

Rural Councils will be interested to read of the progress made by Devon County Council’s (DCC) Scrutiny Committee in producing a Spotlight Report (opens in new tab) about gambling harm and action plan to address the issues. The report recognises the challenges that the County faces and was initiated due to the concerns of Councillors. Whilst the County itself does not have a role in regulating gambling premises, as the report identifies, harmful gambling will have an impact on allocating budget for services to support vulnerable people. The aims of the programme include:

  • Increasing the visibility of the dangers of problem gambling (including cross agency training)
  • Understanding the scale of the problem by collaborating on insight and intelligence with partners.
  • Continuing to support responsible gambling across sectors.
  • Taking action when people need help with their gambling behaviour.

An update on their progress (opens in new tab) after the first year can be found here. Amongst the achievements are:

  • The JSNA now reflects the available data on gambling harms.
  • DCC’s Public Health teams are working with coroners to improve the coding of death certification following suicide to establish more accurately as to whether gambling is involved, where for example debt appears to be a contributory factor.
  • Local gambling support services have been compiled and are being disseminated to relevant agencies.

Swindon Borough Council

Swindon Borough Council conducted a Rapid Health Needs Assessment (opens in new tab) to establish the scale and costs of gambling harms in the city as well as a broader range of factors to help them take a public health approach to the issue. The assessment asked 5 questions:

  • Discover the scale and cost of gambling related harm in Swindon.
  • Identify areas of Swindon with higher numbers/proportions at greater risk of gambling related harm.
  • Identify treatment services available in Swindon.
  • Establish the extent of any prevention activities in Swindon, particularly in relation to children and young people.
  • Recommend any improvements to data collection.

What is the evidence and how do we find it?

As with most public health initiatives, much depends on the data to evidence the extent of the problem. Rapid Needs Assessments are increasingly popular as a way of assessing local gambling harm and the evidence on which these are based is improving all the time.

One early piece of work for Manchester and Westminster Councils (opens in new tab) helped to identify vulnerability to gambling harm in combination with geo spatial mapping. Following this research Leeds City Council developed a more action orientated and public health approach (opens in new tab) to the problem.

Other resources available - Citizens Advice gambling support service in England and Wales

In 2018 GambleAware announced a £1.5m partnership with Citizens Advice designed to help front line staff better understand, prevent and reduce gambling related harms, delivered via 12 hubs across England and Wales.  

Based in each hub, a dedicated gambling support worker offers services throughout the region. Local authorities, employers and health agencies should contact their local hub to get more detail about the free services available to them. These include training for front line staff, support for campaigns and help with screening/assessment questionnaires, for example, improving tenancy staff’s confidence and support to screen clients for gambling harm, or raising awareness among student support services.

More information is available, or via a new gambling advice area (opens in new tab) on the Citizens Advice website.

Centre for Public Scrutiny

The Centre for Public Scrutiny (CfPS) – the national centre of expertise on governance and scrutiny - is calling for local authorities to provide details of scrutiny work related to local strategies and activities to tackle gambling harms.

Expressions of interest are also sought from councils wishing to take part in local inquiry days.  Getting involved means that your council will be supported by the CfPS in looking at the way it addresses the impact of gambling harms on your local community.  It will also be able to call on CfPS expertise and help to identify further ways which scrutiny can improve this work.

The insight and learning will be shared via national learning events and a new publication. For more details or to arrange an initial conversation please email katie.grigg@cfps.org.uk

Want to get involved and find out more?

This spotlight is just a snapshot of the work that is happening across the country. The picture is constantly evolving as we all learn more and a wider range of organisations get involved - local, regional and national. For an up to date picture of what is happening and the resources available contact safergambling@gamblingcommission.gov.uk.

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