GamCare – Supplementary written evidence (GAM0124)

Regarding the information we gather on gambling activities used by those who contact our treatment services:

• We publish data from our helpline and treatment services each year – these are made available on our website and are accessible to all: https://www.gamcare.org.uk/about-us/annual-review-and-statistics/
• The number of callers to the National Gambling Helpline reporting that online gambling is problematic for them has increased from 47% in 2014/15 to 55% in 2018/19.
• The number of treatment clients reporting that online gambling is problematic for them has increased from 43% in 2015/16 to 54% in 2018/19.
• ‘Betting’, ‘Casino Games’ and ‘Slots’ are what individuals tell us are the most problematic activities online.
• ‘Betting shops’ are the most often reported offline gambling facility.

Regarding the outcomes and effectiveness of our treatment interventions:

We use validated outcome measures with every client at every session, not only to assess reduction in gambling harms but improvement in quality of life.

As per our last published data set (2018/19):

According to the Problem Gambling Severity Index (PGSI), clients who were gambling problematically when entering treatment showed an average improvement of 16.1 (significantly reduced risk) upon successfully completing their treatment plans.

According to Clinical Outcomes in Routine Evaluation (CORE-10), clients showed an average improvement of 12.4 upon successfully completing their treatment plans. CORE-10 specifies: ‘The client must improve by 6.0 or more from pre- to post-therapy to be able to say that they have made reliable improvement’.

Regarding our Women’s Programme:

GamCare has been awarded funding from the Tampon Tax team in the Department of Digital, Culture, Media and Sport (DCMS) to run a new nationwide programme to increase awareness of gambling-related harms for women, to increase access to support, and to make sure the interests of vulnerable women and girls are properly represented in the gambling treatment sector.

The project is building a nationwide network of local public sector and third sector organisations that work with women, to spread awareness of the problem gambling and its many impacts, and how it relates to other issues that women may face. We are building up our referral network into gambling treatment for women so that we can encourage more women to receive the right help and support, preferably before issues become catastrophic.

We are also working within the gambling treatment sector to upskill all practitioners about the specific issues that affect vulnerable women. We will build on information and learning for the whole treatment sector to ensure that our response to vulnerable women is sensitive and well informed. We will also work with the gambling industry to ensure that they are able to use this learning to improve their safer play and responsible gambling strategies.

Read more about the programme at https://www.gamcare.org.uk/our-work/our-programmes/womens-programme/

Regarding our education work:

Our experience over the last eight years tells us that giving young people the awareness, knowledge and skills to make safer choices, understand impact of gambling problems and know how to access help is one of the key ways that we can reduce harms in the future.

Likewise, increasing the confidence of the youth-facing workforce to understand, interact and signpost around gambling harms is vital in safeguarding future generations.

Over 16,000 young people received education sessions and over 6,000 youth facing professionals received awareness sessions from our Youth Outreach Programme in the last three years, and the programme will soon be expanding in partnership with YGAM.

Our evaluation of this work so far is available online at https://www.gamcare.org.uk/our-work/our-programmes/youth-outreach-programme/

GamCare Written Statement and clarifications of points raised by Gambling with Lives

On behalf of Ms Anna Hemmings (CEO of GamCare) and GamCare’s Board of Trustees, following their evidence session at: House of Lords Select Committee on the Social and Economic Impact of the Gambling Industry

The note below provides factual clarifications on incorrect or misleading statements made by Ms Ritchie (Gambling with Lives) directly regarding GamCare and its services at the public hearing of House of Lords Select Committee on the Social and Economic Impact of the Gambling Industry on 25th February 2020.

Written Statement

GamCare is the largest provider of support and treatment to those affected by gambling related harms.

With over 20 years’ experience, we are committed to providing safe and effective support and treatment for gamblers as well as their loved ones who are impacted.

Our role is to help those affected and work collaboratively with others to minimise the development of harms in the wider population. To do so, we strive to continually improve our treatment, education initiatives and contribute to ongoing research and learning on this under recognised issue.

We are a non-judgemental organisation that seeks to support rather than to campaign. By focusing on treatment support, we hope to minimise stigma, something we see as one of the biggest barriers to people’s engagement with support services.

The campaigning work that Ms Ritchie and Gambling with Lives do is valuable in raising the profile of gambling problems and addiction. We support them in many of their goals for the field, such as striving to grow the resources allocated to treatment and raising awareness of gambling harms.

Clarifications of points raised by Gambling with Lives

*It should be noted that quotations are taken from live recordings of the 25th February session and not the published transcript of the session. This was not available on drafting of this response.

1. “GamCare has got industry people on the Board.” (Ms Ritchie, Gambling With Lives, 25th February 2020)*

GamCare does not have any representatives from gambling operators on its Board. As is considered good practice, we have Board members with a diversity of experience and backgrounds from NHS commissioning and clinical addiction specialists to experienced business leaders.

One Board member has experience of working with the gambling industry in a legal capacity. We consider this vital expertise in both developing and implementing effective services, as well as navigating the existing governance and funding structures within the sector.

We completed an external board review in 2017/18 and have implemented the recommendations from this.
 

2. “[A lot of concerns about GamCare and GamCare counselling]. I was shocked to come across job adverts which actually said that counsellors were given two days training…generic person-centred training then two days training…I have recently come across ads where there is no clinical qualification at all.” (Ms Ritchie, Gambling With Lives, 25th February 2020)*

There is no specialist nationally recognised training programmes in the UK to work in gambling support or treatment. This is something we have been discussing with academic institutions and are aiming to develop over in the future.

There are a variety of levels of clinical qualification required for different roles at GamCare, specifically between Frontline Services Advisers and Treatment Practitioners.

No role at GamCare can be undertaken with two days training – all roles providing support and treatment receive a full week-long induction to our Model of Care as well as ongoing mandatory training in matters such as safeguarding, confidentiality, information governance and self-care as well as regular and ongoing supervision and practice development.

• Frontline Services Advisers must be educated to diploma or equivalent level in a relevant subject, or with considerable experience in a relevant clinical or helpline setting. They receive a full week of training and undergo 3-4 weeks of further helpline specific training prior to taking calls, which includes shadowing experienced staff and latterly beginning to undertake supervised calls themselves.  All helpline staff receive regular supervision and practice development, as well as continuous professional development. All calls are recorded and these a routinely reviewed for quality assurance purposes. All helpline staff complete additional mandatory training which is refreshed at regular intervals.
• Staff training on the helpline is in line with other frontline crisis management or helpline roles. Our Helpline is externally accredited by The Helplines Association and has been continuously since 2012.

For a comparative example, please note, NHS 111 Health Advisers are required to “be educated to GCSE level and possess a fundamental level of maths, English and IT skills. You'll have experience of working and communicating with members of the public.” (Source: healthcareers.nhs.uk, Link: https://bit.ly/38oa8Ke)

• GamCare treatment practitioners are required to have significant clinical experience with a Professional qualification in health/social/youth and community care. For example, NVQ Level 3 or above, DipSW, Mental Health Nursing, Counselling, Addiction Studies; or Demonstrable experience of working in the field of addiction with a commitment to complete NVQ Level 3 Health and Social Care. GamCare Treatment is accredited by The British Association of Counselling and Psychotherapy (BACP) which assesses standards independently.
• Treatment practitioners receive 4 days of Model of Care training and complete additional mandatory training, which is refreshed at regular intervals. They receive both individual and group supervision and regular practice development.
• The qualifications required for treatment practitioners are in line with the requirements of other community based addiction services.
   
• “GamCare own the only referral point because they run the helpline and because GPs aren’t trained there’s no pathway. [There is a] Conflict of interest, they refer to their own partners…and they don’t refer into the clinics.” (Ms Ritchie, Gambling With Lives, 25th February 2020)*

We have run the UK’s only national helpline for gambling harms since it’s inception and originated the helpline ourselves in 1997. GamCare is the sole operator of the National Gambling Helpline having been commissioned by GambleAware to supply this service.

Our Helpline signposts to a variety of clinical services, including GamCare partners, the NHS and other providers across the National Gambling Treatment Service commissioned by GambleAware.

We currently make facilitated (digital) referrals to our network of 13 partners nationally, and are working closely with the NHS to ensure we can make secure digital referrals to their services as they develop, in the same way as we currently do to our partners. If we are concerned that an individual has complex needs that would be better served by an NHS service, we refer to the NHS accordingly. This has happened on 47 occasions from April 2019 to date.

GPs can refer directly to our treatment service, any of our partners, NHS services or other treatment commissioned by GambleAware. Though we acknowledge that awareness of GPs is likely to be limited which is why we support the Gambling Commissions work with the Hurley Group of GP’s to jointly deliver their gambling support service and to develop GP awareness and training.

4. “[There is] no proper suicide risk assessment. [There] certainly isn’t at the point of triage or at the point of referral.” (Ms Ritchie, Gambling With Lives, 25th February 2020)*

GamCare has appropriate safeguarding policies, processes and staff training in place across our services, which includes potential for suicidality, we take the potential for suicide among our service users very seriously. Last year alone our Advisers on the National Gambling Helpline called Emergency Services over 30 times in direct response to suicide risk.

We monitor a range of safeguarding indicators on a monthly, quarterly and annual basis and regularly review any safeguarding concerns flagged by our teams, including where we are liaising with other agencies to ensure the safety of our service users and their loved ones.

Every member of staff receives annual safeguarding training, and full safeguarding reports are reviewed at our Clinical and Quality Governance Committee as well as by our Senior Management Team. A senior manager is on call every day of the year, 24 hours a day, in order that urgent concerns can be escalated quickly where needed.

We are part of the National Suicide Prevention Alliance and work in partnership with the Samaritans with the aim of reducing the risk of suicide among those harmed by gambling.

30 March 2020