Ottawa plans to hire 120 new paramedics after record 1,806 'Level Zero' events in 2022

The city of Ottawa is looking to hire 120 new paramedics over the next three years, as the service deals with a record number of 'Level Zero' events, paramedics wait longer to transfer patients in hospitals and the service sees "unprecedented increases" in call volumes.

Mayor Mark Sutcliffe is calling on the Ontario government to fund 51 of those 120 new paramedics to address offload delays in emergency rooms, saying the "strain on our paramedic service has reached a critical level."

But the province says Ottawa has already received funding.

"Ottawa recently received a top up in funding to $2.6 million through the Dedicated Offload Nurses Program, which was expanded beyond nurses last year to allow for paramedics, physician assistants and respiratory therapists to assist with patient offload," said Hannah Jensen, a spokesperson for the Minister of Health. "Our understanding from the mayor is that not all available funding was used. This, combined with the $53 million the province has provided Ottawa in funding for their Land Ambulance Services Grant, has increased ambulance availability by over 30,000 hours in 2022-23."

Jensen says the Land Ambulance Services Grant is based on a 50/50 cost-sharing split between the city and the province and if Ottawa wants more funding, it can increase its budget and the province will match it.

"Additionally, we expanded 9-1-1 models of care to empower paramedics to provide more appropriate and timely care in the community, rather than bringing every patient to an emergency department. The Ottawa Hospital, Queensway Carleton Hospital, Hôpital Monfort, and Ottawa Paramedic Service actively participate in both of these programs," Jensen said.

There was a record 1,806 'Level Zero' events in Ottawa in 2022, with no paramedics available to respond to calls for a total of more than 73,000 minutes.

A report for the emergency preparedness and protective services committee outlines a plan for the city of Ottawa to hire 40 new paramedics in 2024, 40 new staff members in 2025 and 40 paramedics in 2026 to help address the ongoing challenges faced by the Ottawa Paramedic Service.  Three additional paramedic employees would be hired in 2024 for psychological support for employee wellness and reduce occupational stress.

Staff say the new investments will "assist the service in meeting response time standards and would increase the hours of operation for the Mental Wellbeing Response Team."

Paramedic response volume has increased from 144,309 calls in 2018 to 149,344 calls in 2021 and 184,113 calls in 2022.

"In only two years, paramedic response volume increased by 39 per cent," staff said. "As such, in 2021 and 2022, the Ottawa Paramedic Service experienced difficulty achieving legislated response time performance standards and Council-approved targets."

In 2022, paramedics responded to life-threatening calls within the 8-minute target only 61.8 per cent of the time, down from 78 per cent in 2018.  The Council approved target is responding to life-threatening calls within 8 minutes and urgent calls within 10 minutes 75 per cent of the time.

When it comes to sudden cardiac arrest calls, paramedics met the target response time of 6 minutes, only 48 per cent of the time.

"This can be attributed to a significant increase in response volume, unprecedented service impacts associated with COVID-19 and excessive offload delay at Ottawa hospitals," staff say.

1,806 Level Zero incidents in 2022

The report shows there were 1,806 Level Zero occurrences in 2022, when there were no ambulances available to transport a patient to the hospital.

That's a 151 per cent increase from the 719 Level Zero incidents in 2021. Staff say there were 571 Level Zero incidents in 2021.

"The increase in Level Zero events is consistent with a significant increase in response volume and the unprecedented amount of time paramedics spent in hospital offload delay over the past two years," staff say.

Ottawa Paramedics spent 93,686 hours in off-load delays in emergency rooms last year, up from 57,8181 hours in offload delay in 2022.

Staff say while the root causes of offload delays are "related to broader issues within the healthcare system such as patient volumes, the availability of beds" and are outside the control of the city of Ottawa to resolve, "offload delay is a risk to health and public safety and impedes the Ottawa Paramedic Service's ability to meet legislative requirements."

123 new paramedics over three years

The emergency preparedness and protective services committee will vote June 15 on the plan to hire 123 new paramedics and staff members over the next three years.

Under the plan, staff recommend council approve the addition of 23 permanent paramedics and two new emergency response vehicles in the 2024, 2025 and 2026 budgets. The cost of 23 new paramedics would be approximately $2 million a year. An additional three paramedic employees would be hired next year to support employee wellness and reduce occupational stress injuries. 

To address the offload delays in Ottawa hospitals, councillors would direct Mayor Sutcliffe to request the Ontario government to fund an additional 17 new paramedics a year over three years. The new paramedics would "help mitigate frontline staff hours lost in area hospitals beyond 30 minutes."

"The strain on our paramedic services has reached a critical level. Ottawa has been sounding the alarm for some time - we must reduce hospital offload times and allow our paramedics to return to the community to serve patients rather than remain stuck in hospital waiting rooms," Sutcliffe said on Twitter.

"Local taxpayers' dollars should not be spent to fix the healthcare system which is the province’s responsibility. That is why I have asked the Province of Ontario for 100 per cent base funding for 51 additional paramedics over three years specifically to help in hospitals with delays."

A lot of work has been done to mitigate these delays, but the current situation is far from sustainable. We need to take further steps to reduce offload delays and support our dedicated paramedics who serve us every day in difficult circumstances.

— Mark Sutcliffe (@_MarkSutcliffe) June 6, 2023

The city of Ottawa has hired 14 new paramedics a year for the past seven years.

Last August, former Mayor Jim Watson sent a letter to the Ontario government requesting funding for 42 new paramedics to help address offload delays in hospitals.