Should London's ambulance dispatch be run by city hall?

Lack of staff and old technology continue to be concerns at London’s ambulance communications centre as Middlesex-London Paramedic Services prepares to meet with the province’s health minister next Tuesday.

Out of the 22 dispatch centres owned by the Ministry of Health and Long-term Care, the London centre is one of 11 centres operated by the ministry. Paramedic officials hope the dispatch centre can switch to being operated by city hall instead.

Chief Neal Roberts gave an update about the land ambulance dispatch to Middlesex County council on Tuesday. The council announced their support for the transfer of provincial operations to municipal control and confirmed a delegation will meet with Health Minister Christine Elliott to discuss ongoing concerns.

“We always appreciate county council support,” Roberts said. “We have had their support since 2011 when the issue was first raised.”

Roberts said reduced staff at dispatch has been an ongoing issue during the past couple years. He said it not only affects London, but a lack of staff also affects other ministry-operated centres, such as Windsor and Cambridge.

Roberts said technology at the dispatch centre has been lagging since 2005.

“It’s very backward,” he said.

On the August long weekend, the Ontario Public Service Employees Union ambulance division reported that the London ambulance communications centre was under-staffed by 50 per cent, phone lines were down and back-up phones, including flip phones, were being used for incoming and outgoing calls.

“It creates additional stress,” Roberts said. “It doesn’t allow for efficient and effective processing of calls.”

Roberts said he is looking forward to briefing the health minister about these ongoing issues.

“We certainly want to make sure she is aware of the ongoing issues in London,” he said. “At the end of the day, the public is concerned about getting an ambulance and paramedics in the quickest amount of time and most cost-effective way.”

It’s hard to say whether transfer of the dispatch centre from ministry operation to municipal operation will be approved, but Roberts said he is optimistic.

“Some of the better operated systems are operated by municipalities,” he said. “We will put our best case forward.”

The paramedic service also had recent success getting access to real-time dispatch data through software called the central integration platform.

“We were not getting any dispatch data in real time,” he said. “All of that data, like call details and times, was not coming to our service in real time.”

The platform allows paramedics to access some, but not all, of the data created with each call received by dispatch. Robert’s report to county council said he is optimistic the software will improve insight into its daily operations.

Last year’s annual Middlesex-London Paramedic Service report also was presented to county council on Tuesday. The report said there was an 8.4 per cent increase in the number of calls in 2017 from 2016. In comparison, the increase from 2015 to 2016 was six per cent.

Roberts said they have added temporary vehicles as calls increased.

“Certainly demand was high and we needed to address it,” he said.

During a 24-hour shift, there typically are 43 ambulances with 86 paramedics on shift. Roberts said they have added two additional 12-hour vehicles until Sept. 30, 2018.

The length of time due to offload delays — the time ambulances are at hospitals waiting to transition a patient to hospital care — increased 44 per cent in 2017 from 2016. In total, the equivalent of 445 24-hour ambulance days were lost while waiting for patient transfers in 2017.

Provincial guidelines start the clock for offload delay 30 minutes after the arrival of an ambulance to a hospital and it ends once the patient is transferred onto a hospital stretcher.

“Paramedics are pre-hospital care, not in-hospital care,” Roberts said. “It’s impacting hospitals and it’s impacting us.”

Roberts said there is a productive, ongoing dialogue between paramedics and senior hospital management and they are seeing progress in offload delays.

The annual report states about 89 per cent of incidents attended by emergency services occurred within the city of London.

Last year, emergency response time across Middlesex-London was less than 10 minutes 90 per cent of the time.

Middlesex-London Paramedic Service By the Numbers 2017:

  • 58,200 potential patient carrying calls, an increase of 8.4 per cent over 2016 and an increase of about 31 per cent from 2008
  • 38,822 life threatening calls, an increase of 9.9 per cent over 2016
  • 444.8 24-hour ambulance days lost to offload delays
  • 263 paramedics
  • 230 average calls a day
  • 89 per cent of calls attended by Middlesex-London EMS were within the city of London
  • 78 second chute time, the average time for a crew to mobilize on a life threatening call
  • 29 reportable ambulance collisions, five with a patient on board
  • 1.4 million kilometres driven by service vehicles, equal to driving 37 times around the Earth
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