Agenda item

An overview of the Leicester City Gambling Harms Needs Assessment, outlining the health needs of the local population, the existing support services, and recommendations for further action to address identified needs

Katherine McVicar, Public Health, Leicester City Council submitted a report on the Gambling Harms Needs Assessment. They were joined by Annie Ashton, a Leicester Resident who had been campaigning for stricter gambling regulations following the death of her husband Luke Ashton.

The Chair welcomed Annie and noted the importance and value of having individuals share personal stories with an academic board.

It was noted that:

·       Annie shared that she had lost her husband, Luke, to gambling-related suicide in 2021 in Leicester.

·       The gambling operator had been listed as an interested party and appeared on the death certificate.

·       Following the inquest, gambling had been included in the local suicide prevention strategy a historic step given the complexity of suicide.

·       Annie had since been involved in work relating to gambling harm prevention, including contributions to changes in clinical codes of practice.

·       Katherine thanked Annie for attending and for highlighting the real harms of gambling.

·       An overview of previous work completed around 18 months earlier was presented, this had not previously been shared with the Health and Wellbeing Board.

·       It was noted that 54% of the population had gambled at least once a year, around 40% excluding the lottery.

·       Problem gambling had affected approximately 0.4% of the population, with 0.3% at risk and 7% indirectly affected.

·       When applied to Leicester’s population, this equated to roughly 1,500 cases of gambling harm, 14,000 problem gamblers, and 26,000 indirectly affected individuals.

·       Gambling had been linked to numerous harms including debt, poor mental health, and suicide.

·       Leicester had a higher than average population of young people, people from deprived backgrounds, and ethnic minorities  all factors increasing vulnerability to gambling harm.

·       Gamble Aware data had illustrated the demographics engaging with support services, which had aligned with comparator areas despite small numbers.

·       A map had shown the accessibility of gambling premises, which were more concentrated in the city centre and deprived areas.

·       Leicester had been identified as one of the highest areas for problem gambling but with low levels of support service uptake.

·       Three support services were currently available, including one NHS service accepting referrals across the East Midlands.

Recommendations from the needs assessment included:

­   Developing a local strategy to address gambling harms through collaboration.

­   Improving data collection and screening for those at risk.

­   Increasing training, signposting, and public education especially targeting children and families.

­   Influencing advertising and licensing regulations to protect the public.

­   The work was in its early stages and stakeholders were being engaged.

­   Support from the Health and Wellbeing Board was requested to take the work forward.

It discussions with Members, the following was noted:

·       Members stated that Annie’s contribution had a strong impact and thanked her for attending.

·       Annie highlighted that 44% of people were in a high-risk gambling category and criticised the limited scope of Gamble Aware, noting it was funded by the gambling industry. She cited more recent Gambling Commission analysis suggesting the problem was far greater.

·       Members noted they had attended an online webinar with Leicestershire County Council, Public Health and offered to deliver a similar session for City groups to support affected individuals.

·       Annie’s work was praised and raised concerns about the prevalence of gambling harms in non-white communities. She referenced research from the Shama Women’s Centre, noting that while women may not typically gamble, their families were heavily impacted. It was emphasised the need for more awareness raising in healthcare.

·       Annie referenced NICE guidelines, stressing that GPs and other professionals should ask about gambling and ensure it is recorded in patient notes. She explained that proper coding could lead to appropriate treatment, preventative action, and future funding opportunities.

·       Officers confirmed ongoing collaboration with the Shama Women’s Centre and highlighted work being done with LPT and the ICB. She invited representation from UHL to join this work.

·       Gambling was described as a national crisis, criticising the industry’s narrative that gambling is an individual issue, a strategy that was borrowed from the tobacco industry. It was urged that the local strategy needed to reframe the issue, tackle exposure, and address the manipulative tactics used by the industry.

·       Annie highlighted Brent Council’s six-point plan and praised Sheffield for successfully rejecting a bid for a new gambling centre. She described slot machines as the “crack cocaine” of gambling and urged more councils to act together using Brent’s model.

·       The Director of Public Health confirmed that the Board had received Annie’s letter and wanted it to go through the appropriate political process for full support and further consideration.

·       It was asked why support services were underused despite the clear need. It was acknowledged the complexity of gambling harm and explained that the strategy included a recommendation to gather more local lived experience to understand the barriers to accessing support.

·       Members agreed that the issue was not confined to Leicester, as online access had made gambling a widespread concern. They reiterated that gambling should not be framed as a personal failing but as a public health issue, especially given that 85% of industry profits came from addiction.

·       Concern was raised about the accessibility of gambling and noted that communities who hadn’t previously felt targeted were now being drawn in. Members were committed to taking away the importance of proper coding in GP practices and the need to rely less on industry generated statistics.

·       Annie reiterated the importance of accurate medical coding to ensure the right treatment pathways and noted that gambling harm was often hidden behind other diagnoses like depression or alcoholism.

·       Members described gambling as an addiction that brought misery to families. They supported the development of a strategy and expressed eagerness to help drive it forward.

·       A pragmatic concern from acute care was raised, stating that while clear pathways existed for alcohol and drug dependency, there was little clarity on where to refer patients with gambling issues.

·       UHL needed to reflect on its own coding practices and the kinds of questions being asked, stressing the importance of neighbourhood-level integrated work.

·       Annie shared that during her research, two people had attempted suicide and their care teams did not know where to refer them. She confirmed the existence of the NHS Gambling Clinic for the East Midlands.

·       Annie clarified that if someone disclosed gambling issues to their GP, it needed to be recorded specifically in the medical notes  not hidden under general issues like debt or alcohol so that referrals could be made and information captured for inquests if necessary.

·       Members agreed, saying that proper coding would allow issues to be flagged and that it was essential to support both professionals and patients in making this process meaningful.

AGREED:

1.    It was agreed to send a letter to UHL, LPT and GP practices to highlight the need for consistent coding of gambling harms.

2.    The ICB agreed to take leadership on the issue and use the neighbourhood board structure to feedback progress.

3.    Webinars were to be developed to help healthcare professionals understand NICE guidance on gambling harm, the importance of coding, and available referral pathways.

4.    The issue of referral pathways and coding forward with the East Midlands Chief for further action.

5.    To gather more information from the Shama Women’s Centre report to better understand the community impact and barriers to accessing support.

6.    An update to be brought to the September meeting and Annie to be invited.

7.    The draft strategy to come to the board once ready.