"PATS Problems"

We have recently received inconsistent, precarious advice from Broome Patient Assistance Travel Scheme (PATS) and I'm seeking clarification.

The scenario below highlights a recent case:

After following a process which was advised by a WACHS staff member via email which stated…

“All women will receive PATS support for an escort if the doctor states ‘pregnancy at risk’ on the PATS certificate – this cannot be challenged by a PATS clerk and does not require RD (Registered Doctor's) approval if the doctor has completed the PATS form”, a Bidyadanga patient still had her PATS application for an escort declined.

• The application was reassessed (possibly twice?) with additional information included in two separate letters of support: 1 from her Bidyadanga clinic GP and 1 from the Broome Hospital Service (BHS) obstetrician. This step according to the above email advice shouldn’t be required for the approval process. And despite these support letters the application was again declined. The GP was informed by the PATS clerk that the decision had been made by BHS Regional PATS Coordinator and the Head Obstetrician. Nobody was informed why.

• The Kimberley Aboriginal Medical Service (KAMS) Deputy Medical Director and Bidyadanga Midwife approached the on-call obstetrician to discuss the situation, she was unaware of the declined application and requested information from the Head Obstetrician via email. He responded stating he had not been involved in the decision and it had not been discussed with him. So who did make the decision?

• Both BHS Obstetricians supported this patients application due to her high risk pregnancy and supported the GP and Midwife in their local decision making.

• After The Deputy Medical Director and Midwife approached the Acting Operations Manager at BHS to discuss the decision they were informed the case would be looked at again and somebody would get back to KAMS. Again another step which isn’t required according to WACHS instructions.

• The Midwife was informed the next morning by Regional PATS Coordinator - (The Head Obstetrician) had changed his mind - and the PATS application for an escort was now approved.

• Please note that the same week an almost identical patient and application was approved without these unnecessary steps.

The initial decision, process and timing caused unnecessary stress and concern for the patient, as well as wasted time and effort for several staff members involved in both organisations.

The Bidyadanga Antenatal Team welcome the original WACHS email advice (noted above) and feel that with reassurance that PATS staff will follow the same practise it will be an efficient and adequate approach.