NICE recommends healthcare professionals ask people about gambling at health checks and GP appointments

NICE publishes final guidance on identifying, assessing, and managing gambling-related harms.  

Healthcare professionals should consider asking people about gambling when speaking to them about smoking and alcohol consumption during a health check or GP appointment, new NICE guidance recommends. 

The recommendation is included in NICE's first clinical guideline on gambling-related harms: identification, assessment and management, published today (Tuesday, 28 January). 

‘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) and can impact their families, friends and other people close to them.  

The new guideline recommends healthcare professionals and people working in social services should ask about gambling in a number of situations, such as when people attend appointments about depression, anxiety, or thoughts about self-harm or suicide or in relation to a possible addiction (for example, alcohol or drug dependence) as they may be at increased risk of gambling-related harm and NICE recommends this needs to be identified as early as possible. 

People may also be at increased risk of gambling-related harm for a number of 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 ensurethat 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 takeaccount 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.   

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

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), which collects data from 20,000 respondents each year, reported that 2.5% of the 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 3,000 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. 

NICE is working closely with the Department for Culture, Media & Sport (DCMS), the Department for Health and Social Care (DHSC) and NHS England to support the implementation of the guideline and has published an implementation statement on the guideline. 

Read the full gambling-related harms: identification, assessment and management clinical guideline. 

Notes to editors

An embargoed copy of the final draft guidance for gambling-related harms: identification, assessment and management is attached. NG248 Guideline 20250128.pdf.