Mayor asks province to fund 42 paramedic jobs to stave off 'level zero' incidents

Mayor Jim Watson is asking the province to fund 42 new paramedics jobs in the city to help avoid "level zero" situations, where no ambulances are available to respond to emergencies. 

In a letter to Premier Doug Ford sent Thursday, Watson said delays experienced while dropping patients off at hospitals endanger public safety as they affect paramedics' ability to get back behind the wheel quickly. 

Requesting $5 million in base funding, the mayor wrote the paramedics would be stationed at four Ottawa-area hospitals to care for up to four "lower acuity patients"  while they wait in the emergency department. 

"This would enable paramedics to return an ambulance back into service," Watson wrote. 

"The province and municipalities pay for paramedics to be assisting residents needing urgent medical attention...They do not pay, nor do they want, paramedics to perform hallway medicine in hospital emergency rooms."

Ottawa had 801 level zero instances by the end of June — as many as the service had for all of 2021, according to updated figures from the city.

Pierre Poirier, Ottawa's paramedic chief, had previously told CBC News there were more than 750 instances by the end of July. He said revised numbers showed the service actually had 1050 by the end of that month.

So far this year the city has experienced over 1,125 level incidents, Watson wrote in his letter — numbers backed up by the Ottawa Paramedic Service. The service is also experiencing a 20 per cent increase in number of calls since April. 

Plan expands on existing pilot project

Poirier said the new paramedics would expand existing emergency department paramedic pilot programs at the Montfort, Queensway Carleton and Ottawa Hospital's General campus to operate 24 hours a day, seven days a week.

"Essentially if we could have one paramedic taking care of four patients, that actually relieves eight paramedics into the community. It's four ambulances," Poirier said.

Watson's letter said the province needs to send a clear message to hospitals that such delays aren't acceptable, adding the leadership of local hospitals knows urgent action is needed.

Ottawa has struggled with level zero events for more than five years, but Watson said he stands by council's decision to hire only 14 additional paramedics a year in the last two years.

He said the pandemic has contributed to a "logjam" in emergency departments that require's provincial attention.

"We can't allow this to go on. We need the provincial government's help. Health care is a provincial responsibility," he said.

Watson said existing dedicated offload nurses often get pulled into other part of emergency departments and stationing a paramedic there could help prevent that.

A south Ottawa woman with a fractured hip had to wait six hours before being taken by Cornwall paramedics to a hospital late last month. 

The city is not alone in experiencing these days, and the fact that neighbouring municipalities are experiencing similar issues compounds the problem, Watson said.

Paramedics lost 49,000 hours in offload delays

Attached to Watson's letter was one from the paramedic service addressed to the mayor, dated Aug. 10.  

The service wrote that paramedics spent 49,000 hours stuck in these delays in 2021, and that many were far off the 30-minute target used as a benchmark. 

"In some cases, Ottawa has had 11 hours of continuous level zero and low acuity patients waiting more than seven hours before being transported to the hospital," the letter reads.

"Our residents expect that an ambulance will be available in their time of need, " the service said in its letter.

In a statement, the Ministry of Health said it provides funding for 50 percent of land ambulance operations for large municipalities like Ottawa and it announced last week it's increasing province-wide funding by a total of $764 million dollars.

The ministry also said it is increasing funding for the dedicated offload nurses program and recently allowed those funds to be used toward hiring non-nurse staff, in recognition of the nurse shortage.

In addition to funding, it's looking at supporting "treat-and-refer" patient models which would allow paramedics to reduce unnecessary emergency department through care in the community.