Ontario regions face ambulance pressures; province won't release offload delay data

Several Ontario municipalities say their paramedic services are under immense pressure, with worrying stretches of times during which no ambulances are available to respond to calls — but the province doesn't track the problem.

The government does have data on the hours paramedics spend waiting in emergency rooms to transfer patients to the care of a hospital, which are often a key factor in ambulance availability, but won't disclose it.

Some emergency officials and community leaders say more needs to be done to help paramedic services, but the lack of publicly available provincial information makes it hard to assess the scope of the problem.

"We just want to be able to have a baseline to say, 'Oh, things have improved since 2020, since 2018,' and being able to quantify the data so that when we do go to the province, or to our employers, we want to be able to go with solutions," said Niko Georgiadis, chair of the CUPE Ambulance Committee of Ontario.

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Ambulance dispatch centres are mostly operated by the province, so they should be keeping track of how often there are no ambulances available — situations known as code zero or code black — said Georgiadis.

A spokesperson for Health Minister Sylvia Jones said the province doesn't track that because municipalities are responsible for ambulance deployment strategies.

Ontario generates monthly reports based on data from ambulance dispatch centres, including time paramedics spend waiting in ERs to transfer patients — known as offload delays — by hospital. But requests for the figures, including a specific request for the most recent report went unacknowledged.

Jones has implemented and expanded various programs to address ambulance availability issues, from increasing funding for nurses to monitor ambulance patients so paramedics can get back on the road, to allowing paramedics to take patients somewhere other than an ER.

"Our government's four-part strategy to tackle ambulance offload time issues is focused on: returning ambulances to communities faster, providing timely and appropriate care in the community, facilitating non-ambulance transportation for stable patients, and increasing health care worker capacity," spokesperson Hannah Jensen wrote in a statement.

But several communities say offload delays and the lack of ambulance availability skyrocketed from 2021 to 2022. Some say it's looking a bit better for 2023, but more needs to be done.

Essex-Windsor EMS Chief Bruce Krauter has been combing through his own region's data, and found that from January to May, code blacks and code reds -- when there were either no ambulances or one or two -- tended to happen between 3 p.m. and 11 p.m.

He ties that to the lack of availability of urgent care clinics and primary care during those hours, and has asked Jones to fund those services for extended hours.

"If we get some better urgent care, primary care, those code reds and blacks should come down," he said.