A former Nova Scotia paramedic who sexually assaulted three women who were patients in his care will have to serve more time in prison for his offences.

James Duncan Keats was initially sentenced to four years in prison for raping a 71-year-old woman in her Annapolis Valley home. He was convicted in October 2015.

As a result of publicity surrounding that case, four other women came forward, alleging Keats sexually assaulted them while he was on the job. At trial, a jury convicted Keats of assaulting two of the women but acquitted him on the charges for the other two.

• James Duncan Keats, former paramedic, guilty of 2 sexual assaults

• Former paramedic James Keats takes stand at his sexual assault trial

The judge, Justice Felix Cacchione, sentenced Keats to 30 months in prison for the assaults, but ordered that the sentence run at the same time as his original, four-year sentence rather than separately. Cacchione ruled that since the two sexual assaults occurred before the rape, he had to treat Keats as a first-time offender.

The Crown appealed and today, the Nova Scotia Court of Appeal ruled the trial judge was wrong. Keats's 30-month sentence is now being tacked on to the original four years.

Keats had appealed all three of his convictions. The court rejected his appeals.

• Women accuse former paramedic of sexually assaulting them on the job

• Paramedic James Duncan Keats sexual assault trial begins