Wiltshire Council: A collaborative approach to addressing gambling harms as a public health team

In the Gambling Act 2005, gambling refers to gaming, betting and participating in a lottery. Beyond the activity itself, gambling harms are the adverse impacts that can arise, including financial, cultural, mental and physical health harms.

According to the World Health Organisation (WHO), around 0.5 per cent of the world’s adult population has a gambling disorder. The negative effects of such harms extend beyond the individual to friends, families, communities, and wider society, with around 7 per cent of the UK population in 2020 being affected by another person’s gambling.

The societal burden of such harms is significant. The Office for Health Improvement and Disparities (OHID) estimate the annual UK cost to be £1.05 to £1.77 billion.

Several key publications have demonstrated the breadth and impact of harm, including:

• Select Committee on the Social and Economic Impact of the Gambling Industry - Gambling Harm Time for Action (July 2020)
• OHID and Public Health England published ‘Gambling-related harms evidence review summary’ (January 2023)
• In 2023, the UK government published the ‘High stakes: gambling reform for the digital age’ white paper.
• In January 2025, the National Institute for Health and Care Excellence (NICE) released guidelines on identification, assessment and management of gambling-related harms.

The traditional, individual focused view of gambling harms often misses their wider impact. Research shows that for every person directly affected, around six others also experience adverse effects. This highlights the need for a broader, more inclusive population level response to reducing harm.

A public health approach shifts the focus from personal responsibility to collective action. It addresses root causes, tackles inequalities, and promotes sustainable solutions. By integrating education, early intervention, treatment, and research, this approach not only contributes to the reduction of gambling harms, but also addresses interconnected challenges such as poor mental health, substance use, and suicide.

The Gambling Commission is currently responsible for regulating most gambling activities, with councils in England acting as designated licensing authorities. However, this role does not extend to addressing the broader duty of care around gambling harms.

In 2023, Wiltshire Council commissioned the Institute of Public Care (IPC), Oxford Brookes University to review the local prevalence and impact of gambling harms.

Conducted between December 2023 and June 2024, the mixed methods review explored national policy and legislation, including:

• The Gambling Act 2005
• White Paper: High Stakes Gambling Reform for the Digital Age (2023)
• National Strategy to Reduce Gambling Harms (2019–2022)

Local data was analysed to build a county-wide picture, identifying affected populations, determinants and demographics associated with increased risk.

The review found that around 12,000 adults in Wiltshire may benefit from some form of gambling treatment or support, according to estimates from the Office for Health Improvement and Disparities (OHID). Additionally, it's estimated that 6,000 children live in households with an adult who may require gambling-related support.

Data from GambleAware further suggests that 1.8 per cent of adults in the county are at significant risk of experiencing gambling-related harm. These figures highlight the scale of the issue locally and the pressing need for targeted prevention, support, and treatment services. 

Five core recommendations emerged from the review (which is available here):

• data intelligence: develop further local insights into gambling harm prevalence
• communication: raise awareness and reduce stigma through targeted messaging
• training: equip frontline staff to recognise and respond to gambling harms
• visibility: promote gambling harms as a public health issue
• collaboration: strengthen interagency partnerships.

These recommendations were presented at a local gambling harms event (more information below) and now form the foundation for Wiltshire’s response.

In 2024, the public health team partnered with public protection to map licensed gambling premises against areas of deprivation in the county. This aimed to establish whether there was a relationship between the frequency of such premises and areas of deprivation as per the Index of Multiple Deprivation (IMD). The results showed that although there are few areas of high deprivation in Wiltshire, there were a greater proportion of gambling premises within these areas. 

Following publication of the research and deprivation mapping, Wiltshire Public Health led coordination of the county’s opening conference on gambling-related harms, an opportunity to share the findings. It brought together a wide range of Wiltshire stakeholders including statutory services, voluntary sector organisations, training providers, and lived experience advocates to deepen collective understanding of the scale, nature, and impact of gambling harm within our communities. However, what we currently understand, remains the tip of the iceberg, with stigma and shame often preventing individuals and families from seeking support.

The conference provided a platform for local support services and training providers to share their experiences of working with those affected, highlighting both the challenges and opportunities for early intervention and recovery.

Most powerfully, we heard directly from individuals with lived experience of gambling harm. Their stories, deeply personal and emotive, illustrated the profound effects on mental health, financial stability, and family relationships. This emphasised the urgent need to shift the narrative, to move away from victim-blaming and toward a more compassionate, systemic approach that holds the gambling industry accountable for its role in perpetuating harm.

As part of the event, stakeholders collaboratively identified priorities for action and were invited to express interest in forming a partnership group dedicated to reducing gambling harms.

This conference marked a significant step forward in Wiltshire’s public health response to gambling harm.

Since the formation of the Wiltshire Gambling Harms Working Group, the partnership has taken great strides to set foundations for work in the county. 

The group works to raise awareness, improve access to support, and advocate for policy and environmental changes that protect individuals and communities. Members have co-ordinated a range of initiatives aimed at raising awareness, building capacity, and promoting collaborative action. 

Key milestones include: 

development of targeted resources to support understanding of and access to services working with the licensing team to support their understanding of gambling harms and their role in recognising signs and signposting to appropriate support. This information is being shared with licensed premises.  training opportunities delivered by ARA Recovery4All and YGam

• engagement in forums, including the IPC Knowledge Exchange Programme webinar.

Looking ahead, the partnership will focus on

Expanding training opportunities Further resource development Launching a local communications campaign to reduce stigma and promote support

The group will continue to work collaboratively, acknowledging that this is a complex and evolving agenda, responding to emerging trends to address the risks of harm associated with gambling harms.

Safer Gambling Week is the current national campaign working to address gambling-related harm. While it has gained visibility and traction, it is co-ordinated by the gambling industry. In recognition of the need for a more independent, public health led approach, the Wiltshire Gambling Harms Working Group has collectively agreed to launch its own flagship communications initiative in 2026, designed to raise awareness and understanding of gambling and its harms through a public health lens and ensure messaging is rooted in evidence, lived experience, and community priorities.

To understand the impact of our work, we hope to establish a baseline dataset examining the impact of gambling harms in Wiltshire. It is proposed to include data around support, such as training opportunities, uptake and trends in referrals.

The group is committed to continuing this journey through shared learning, collaboration, and action.

In Wiltshire, our approach to addressing gambling harms has been shaped by developing an understanding of the national context and importantly, the specific needs and realities faced within our local communities.

Through the IPC research and deprivation mapping, we identified clear inequalities in gambling related outcomes, with harms disproportionately affecting young people, men, and individuals living in areas of greater deprivation.

This evidence reinforced our commitment to a public health approach that is broad in scale and grounded in prevention.

We recognise that gambling harms are multi-faceted and often hidden. Stigma remains a significant barrier to open discussion and help-seeking, and the role of the gambling industry in shaping behaviours and perceptions cannot be overlooked. The economic burden of gambling harms on individuals, families, and public services is substantial and demands coordinated action.

Our work has been strengthened by the engagement of committed partners across the system. We have found a shared enthusiasm and dedication to driving meaningful change, and we are encouraged by the momentum building nationally. The current climate presents an opportune moment to push forward with driving change.

We are particularly excited by the development of infrastructure to support prevention, especially in what has historically been an understudied area. The involvement of OHID commissioners in shaping the prevention arm of the national strategy is a promising development, and we welcome opportunities to collaborate and share learning.

We are happy to be contacted by others working in this space and remain committed to contributing to a national movement for change.

• Kelly Fry, Public Health Principal – Building Resilience: [email protected] 
• Katherine Hoskin, Public Health Specialist – Mental Wellbeing and Emotional Resilience: [email protected] 
• Imogen Bambrough Stimson, Speciality Registrar in Public Health