The national healthcare needs assessment (HCNA) report estimates the prevalence of gambling harms in Scotland, maps service provision and demand for services, recognising the limitations of the current evidence. It draws on the views of people living in Scotland who have experienced gambling harms or work in services to support those who do, and compares these findings to evidence from England and Wales. Increased awareness of harms, partnership working, and resources are needed to establish a coherent, integrated system of prevention, treatment and support. It is hoped that the HCNA will inform the future commissioner responsible for the establishment of treatment and support in Scotland being introduced through the gambling levy funds, in the development of services. The HCNA considers the advantages and disadvantages of potential models of care and outlines a bespoke model using the key priorities it has outlined which should be used the development of a future model.