❓ A WA parliamentary question scrutinises the cost, management, necessity, and transparency of the WA Health's Patient Blood Management (PBM) program, with the Minister providing justifications and clarifications.
AnsweredQoN 2437Legislative Assembly
QuestionView source ↗
I refer to WA Health’s pilot blood
management program and ask: (a) why did
the Western Australian PBM contract cost $3.9 million when a much bigger and
more stringent program spread across many countries in the EU cost 300,000
euros ($440,000); (b) the EU program
demands medically qualified professionals run it. Why wasn’t there the same
requirement in Western Australia; (c) why
was the Western Australian PBM tender process restricted, when there was more
than one group capable of implementing this program in WA; (d) why was PBM deemed necessary when Western
Australia already had the lowest transfusion rate in the developed
world; (e) how was the $16 million in
claimed savings on blood products calculated; (f) how much money has the entire program cost, including staffing, new
equipment, pharmaceutical products used as blood transfusion alternatives, and
travel costs of international experts on PBM to Western Australia; (g) will you release a copy of the submission to
the WA Health Department in December 2007 from Farmer, Hofmann and Friedman
entitled Western Australian Patient Blood Management Project 2008–2012:
Analysis, Strategy, Implementation and Financial Projections ; (h) why was the media denied access to attend the
first PBM national conference being held in Perth last weekend (21 June);
and (i) did WA Health provide any funding
towards the PBM national conference, if so, how much?
management program and ask: (a) why did
the Western Australian PBM contract cost $3.9 million when a much bigger and
more stringent program spread across many countries in the EU cost 300,000
euros ($440,000); (b) the EU program
demands medically qualified professionals run it. Why wasn’t there the same
requirement in Western Australia; (c) why
was the Western Australian PBM tender process restricted, when there was more
than one group capable of implementing this program in WA; (d) why was PBM deemed necessary when Western
Australia already had the lowest transfusion rate in the developed
world; (e) how was the $16 million in
claimed savings on blood products calculated; (f) how much money has the entire program cost, including staffing, new
equipment, pharmaceutical products used as blood transfusion alternatives, and
travel costs of international experts on PBM to Western Australia; (g) will you release a copy of the submission to
the WA Health Department in December 2007 from Farmer, Hofmann and Friedman
entitled Western Australian Patient Blood Management Project 2008–2012:
Analysis, Strategy, Implementation and Financial Projections ; (h) why was the media denied access to attend the
first PBM national conference being held in Perth last weekend (21 June);
and (i) did WA Health provide any funding
towards the PBM national conference, if so, how much?
AnswerView source ↗
Answered
12 August 2014
Responded by
Minister for Health
Response time
48 days
(a) Comparisons to the EU program cannot be made without further details of that program. The WA Health contract with Medicine and Economics to implement the program was for $3.6 million. The funding also included educational sessions and workshops for clinicians in WA's public and private hospitals.
(b) The WA program is managed by medical professionals. Across all involved hospitals, the WA program is led by medical (haematology and anaesthetics) staff working with senior nursing colleagues.
(c) In 2008, when the contract was awarded to Medicine and Economics, due diligence by the then Office of the Chief Medical Officer (CMO) did not uncover other contractors with comparable experience.
(d) The supply for blood and blood products is not keeping pace with growing demand. It is crucial to minimise their use to ensure that stocks are available for people who require blood.
"Lower" compared to other areas of the world is a positive finding, yet not necessarily how low it could be according to evidence based practice. An example of transfusion reduction is: in 2006, the local transfusion rate for total hip replacement was 100%. In 2009, when pilot blood management (PBM) started locally, the total hip replacement transfusion rate of a local PBM based hospital program had come down to 50-75%. It is now (at the same program locally) under 10%. The patient outcomes continue to improve and show true benefit to the patient's short term and long term health.
(e) This was calculated by comparing the actual expenditure for red cells and other fresh blood products against the demand trend prior to the implementation of PBM in WA.
(f) The WA PBM program also funded 1.0 full time equivalent (FTE) for a nurse and up to 0.2 medical FTE at each of Sir Charles Gairdner Hospital, Fremantle Hospital and Health Service, King Edward Memorial Hospital, and Royal Perth Hospital. Total funding for staff wages, educational presentations, and assistance to tertiary laboratories in technology from September 2008 to the end of 2013‑14 was $6,772,189.
(g) The report will not be released publicly as it contains Commercial in Confidence and/or commercially sensitive information.
(h) Registration capacity was originally set at 300 delegates, but was extended to 320 due to strong interest in the program. No further registrations were accepted over 320, this included applications from both media and non-media.
(i) The conference was jointly funded by the National Blood Authority and the Department of Health (DOH). The DOH's contribution to this program was $50,000.
(b) The WA program is managed by medical professionals. Across all involved hospitals, the WA program is led by medical (haematology and anaesthetics) staff working with senior nursing colleagues.
(c) In 2008, when the contract was awarded to Medicine and Economics, due diligence by the then Office of the Chief Medical Officer (CMO) did not uncover other contractors with comparable experience.
(d) The supply for blood and blood products is not keeping pace with growing demand. It is crucial to minimise their use to ensure that stocks are available for people who require blood.
"Lower" compared to other areas of the world is a positive finding, yet not necessarily how low it could be according to evidence based practice. An example of transfusion reduction is: in 2006, the local transfusion rate for total hip replacement was 100%. In 2009, when pilot blood management (PBM) started locally, the total hip replacement transfusion rate of a local PBM based hospital program had come down to 50-75%. It is now (at the same program locally) under 10%. The patient outcomes continue to improve and show true benefit to the patient's short term and long term health.
(e) This was calculated by comparing the actual expenditure for red cells and other fresh blood products against the demand trend prior to the implementation of PBM in WA.
(f) The WA PBM program also funded 1.0 full time equivalent (FTE) for a nurse and up to 0.2 medical FTE at each of Sir Charles Gairdner Hospital, Fremantle Hospital and Health Service, King Edward Memorial Hospital, and Royal Perth Hospital. Total funding for staff wages, educational presentations, and assistance to tertiary laboratories in technology from September 2008 to the end of 2013‑14 was $6,772,189.
(g) The report will not be released publicly as it contains Commercial in Confidence and/or commercially sensitive information.
(h) Registration capacity was originally set at 300 delegates, but was extended to 320 due to strong interest in the program. No further registrations were accepted over 320, this included applications from both media and non-media.
(i) The conference was jointly funded by the National Blood Authority and the Department of Health (DOH). The DOH's contribution to this program was $50,000.
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