Ottawa needs more paramedics to meet missing ambulance response standards: report

Ottawa needs to put an extra 36 paramedics on the road over the next couple of years to meet its own targets for how quickly ambulances reach people in cardiac arrest or other life-threatening situations, according to a city staff report.

A wide-ranging review of the Ottawa Paramedic Service over the past several months found that it did not meet the standards set by council for the most critical cases in 2014 or 2015 — exposing the service to lawsuits.

Meanwhile, the number of times paramedics respond to calls keeps increasing every year. 

The County of Renfrew Paramedic Service complained earlier this year that its ambulances were responding to calls in rural Ottawa, leaving its own community short. 

Ottawa city council agreed to hire a dozen more paramedics in March, ending a hiring drought dating back to 2011.

The new paramedics are now hired, bringing the total full-time paramedic positions to 611, of which 429 do primary and advanced care on the road.

Not meeting targets

Even with the new hires, Ottawa needs to budget for another 24 to be hired in the spring of 2017, and a dozen more in 2018, according to a staff report that will be considered at the October 20 meeting of the community and protective services committee.

The report also recommends five more vehicles to respond to emergencies.

The spending is necessary, staff argue, to keep up with having to respond to more calls every year. Not only that, the paramedic service needs to meet the standards set out by council and legislation.

Paramedics have a six minute-target to make it to people with in sudden cardiac arrest. Though paramedics are expected to meet that target in 65 per cent of cases, paramedics only achieved the six-minute mark 63.7 per cent of the time in 2015.

That's a steep fall from 2013, when paramedics met the target 73.5 per cent of the time.

In the other most serious, life-threatening cases, paramedics are expected to meet a target time of eight minutes in 75 per cent of cases. But while Ottawa paramedics achieved that target 83.6 per cent of the time in 2013, it only did so 72.5 per cent of the time in 2015.

Failing to meet standards exposed the city to "the risk of claims alleging failure in meeting the duty of care to persons who have suffered injury or loss," the city's legal department warns in the report. 

"Given the nature of the service provided by paramedics and the potential consequences of failing to meet a duty of care, the value of such claims can be significant."

Ottawa stats lag other cities

Ottawa's paramedics face challenges, according to the report, because the city's geography is so large and its population is both growing and aging.

The review of the paramedic service compared Ottawa to five other municipalities with similar response time targets: Toronto, Peel, Hamilton, Durham and York.

Ottawa had just 3.25 paramedics per 1,000 residents, slightly more than Toronto, but less than the five or so the other communities had.

The service is efficient but has reached the point where it is no longer able to meet performance targets.- City of Ottawa staff report

The average paramedic in those cities responded to 223 calls per year. Ottawa paramedics answered 308 calls each, on average.

"When compared to other Ontario municipalities, the Ottawa Paramedic Service has one of the lowest numbers of paramedics per 1,000 population and the fewest paramedics per call resulting in the highest number of calls serviced per paramedic," staff conclude in their review.

"This clearly demonstrates that the service is efficient but has reached the point where it is no longer able to meet performance targets."

If the request for more paramedics is approved by councillors at the committee meeting on October 20, it moves on to council for a decision on October 26, ahead of the upcoming draft budget to be tabled November 9.