NICE Recommends Healthcare Professionals Ask People About Gambling at Health Checks and GP Appointments

The National Institute for Health and Care Excellence (NICE) has recommended that general practitioners (GPs) in the UK to ask patients about their gambling habits during health checks and appointments.

The recommendation is included in the first clinical guideline on gambling-related harms: identification, assessment and management.

“Gambling-related harms” is the term used to describe the negative impacts of gambling on the health and wellbeing of individuals, families, communities and society. These harms affect people’s finances, relationships and health (particularly mental health).

The new guideline advises healthcare professionals and social service workers to ask about gambling in various situations. This includes appointments related to depression, anxiety, self-harm, suicidal thoughts or potential addictions such as alcohol or drug dependence. These groups may be at higher risk of gambling-related harm. NICE recommends identifying these risks as early as possible.

People may also be at increased risk of gambling-related harm for several other reasons, including if they are suffering from post-traumatic stress disorder (PTSD), personality disorder or attention deficit hyperactivity disorder (ADHD). Taking medication that may affect impulse control, experiencing safeguarding issues or violence or a family history of gambling that harms could also increase a person’s level of risk.

People should be encouraged to assess the severity of their gambling-related harms by completing a questionnaire available on the NHS website. This is based on the Problem Gambling Severity Index (PGSI), a standardised measure for at-risk behaviour. A score of 8 or above indicates that they should seek support and treatment from a specialist gambling treatment service, while those with lower scores may also benefit from available support.

Healthcare professionals and social care practitioners must recognise and take action to ensure that stigma, shame and fear of disclosure does not prevent people experiencing gambling-related harms from seeking and accessing support and treatment.

It recommends using a tailored approach to meet the needs of each person, which could include providing them with access to vocation-specific services, such as veterans’ groups, or that take account of their ethnic background and religion. Treatments for gambling-related harms should also be provided in separate locations from services for alcohol or substance dependence.

The guidance recommends healthcare professionals consider involving a partner, family member or other person close to the person experiencing gambling-related harms in their treatment, if that is what they both want.

Gambling related harm has a devastating impact on those who experience it, and the people close to them. The 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.

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.”

Minister for Gambling Baroness Twycross 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.

“We know that clinical treatment is not necessarily right for everyone, but it is important that there is a full spectrum of support as we strengthen 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.”

The Gambling Survey for Great Britain (2023), which collects data from 20,000 respondents each year, reported that 2.5% of the survey population aged 18 years and older living in Great Britain participate in “problem gambling” (defined as a PGSI score of 8 or more), with an additional 12% of the survey population participating in gambling with an elevated risk of harm (PGSI score 1 to 7). Overall, 2.8% of participants who had gambled in the past 12 months reported experiencing at least one severe consequence, such as the breakdown of a relationship. Rates were higher among male participants and were also higher among younger adults (those aged 18 to 34) than older adults (those aged 55 and over).

NHS England has opened 15 gambling clinics across the country since 2019 – seven of which opened in 2024. These clinics are expected to see 3000 people a year. All specialist clinics are fully NHS-commissioned and funded.

As set out in government’s response to the consultation on the structure, distribution and governance of the statutory levy on gambling operators, published in November 2024, the new statutory levy will provide a significant increase in investment for support and treatment services for gambling-related harm.