Ontario paramedics are warning that the spillover effects from overburdened hospitals could lead to a greater shortage of ambulances in communities across the province, a chronic problem commonly referred to as a code zero.
Multiple waves of respiratory illnesses have led to a surge of young patients requiring hospitalization, creating additional backlogs of paramedics waiting to offload patients at emergency departments.
“This is the worst year we’ve ever had in history,” said Darryl Wilton, the president of the Ontario Paramedics Association (OPA) of the current gridlock in the healthcare system. “It is just absolutely astounding that we’re starting to see this at pediatric hospitals where paramedics are having triage delays, offload delays.”
Recent Ontario Health data, obtained and released by the Ontario Liberal party, shows ambulance offload times in September increased by 52.5 per cent since 2021 and have risen by 76.5 per cent since April 2010.
The increase meant patients were waiting between 75 to 90 minutes in an ambulance waiting to be offloaded and triaged by a hospital nurse. In some communities patients were waiting up to 151 minutes to be offloaded.
Since then, the OPA said, offload wait times continued to increase leading to more concerns about a lack of ambulances available for patients who call 911.
“We’ve seen double, twice the amount of level zero’s in the first six months of 2022, Wilton told Global News. “We know that that those numbers in some regions will climb 12 times higher than they ever have historically.”
Toronto Paramedic Services told Global News when ambulance availability is low, paramedics are “routinely diverted from lower priority calls to higher priority calls” while supervisors and Toronto Fire services will also respond to low priority calls as patients await an ambulance to transport them to hospital.
“In-hospital wait times are the most significant factor impacting ambulance availability in the community,” Toronto paramedic services said in a statement.
Wilton said in some communities delays are lasting anywhere from 45 minutes to several hours for an ambulance to arrive.
“For most paramedic services that hit level zero, they stop counting at zero. So, sometimes there’s 14, 24, 34 calls waiting,” Wilton said.
The Ministry of Health told Global News in a statement that the province is working on “short and long-term strategies” to increase the availability of ambulances and reduce offload times.
“We have invested $23 million in the Dedicated Offload Nursing Program, allowing paramedics to get back into communities faster and expanding 9-1-1 models of care to empower paramedics to provide more appropriate and timely care in the community,” the ministry said in a statement.
Critics, however, are questioning the viability of the dedicated offload nursing program which has received yearly funding from the Ontario government since 2008 yet has done little to blunt the increase in offload wait times.
“The funding is for three months,” said France Gelinas, the NDP’s health critic. “Try to recruit a highly qualified nurse to a very stressful job where she will be working flat out for three months and then doesn’t have a job any more because the funding ends.”
The Ontario Paramedics Association suggested taking a different route — forcing provincially-funded hospitals to pay paramedic salaries if they are forced to wait outside hospitals longer than 15 minutes.
“The next step for the province to do is (for) any paramedic who works at a hospital with a patient (and continues) to be there after 15 minutes, they will be 100 per cent funded by the province,” Wilton said. “Because if you think about it, after 15 minutes, they are now essentially staff of the hospital.”
“If the province could ensure that all of their hospitals, could just meet the 15 minute triage time… that would fix level zero and all communities in Ontario and it would fix it overnight.”