Local authorities should be legally mandated to combat gambling harms, as they already are for drugs and alcohol, a new report argues.

Slipping Through the Cracks, published by the Social Market Foundation (SMF), says frontline services are missing opportunities to catch gambling-related harms.

The report found 2.7% of British adults – around 1.4 million people – score at the level of ‘problem gambling’ on the Problem Gambling Severity Index, while NHS England recorded an almost 130% rise in referrals to gambling clinics over six months in 2024.

Unlike alcohol, drugs and smoking, gambling is not a prescribed public health responsibility for councils and is rarely included in standard screening questionnaires used by GPs and social care.

The report says this creates a ‘postcode lottery’ in which people experiencing gambling harm fall through the cracks, often only receiving help once harm is already severe.

Barriers identified include a knowledge-action gap among staff, siloed services, patchy information sharing and long waiting lists that limit early identification.

Recommendations for tackling problem gambling

The SMF recommends that councils be legally mandated to address gambling-related harm in public health policies and should embed gambling prevention as a local health priority.

NHS England and the Department of Health and Social Care should also ensure adequate, accessible gambling treatment capacity nationwide, with gambling questions included in patient questionnaires, according to the report.

A national gambling database should also be created to monitor treatment pathways across Integrated Care Boards.

Comment

‘This report lifts the lid on gambling harms across Britain – and the sober truth is that while demand for support is surging, our response falls far short,’ said Niamh O Regan, Senior Researcher at the Social Market Foundation.

‘Our interviews with frontline staff give a clear insight into the problems they face: there is a chronic lack of training and resources – compounded by an uneven adoption of preventative measures by local councils. If we are to tackle gambling harms comprehensively, nothing less than a public health approach, embedded into every local authority, is required.’

Professor Durka Dougall, Chief Executive at the Centre for Population Health, added: ‘This important work highlights both the scale of gambling-related harms and the opportunity to do things differently. Too many people are only identified when they reach crisis point.

‘At a time when the NHS and wider public services are placing greater emphasis on prevention and population health, there is a real opportunity to strengthen early identification, provide timely support and improve outcomes for communities across the country.’