County Of Essex Declares Emergency Due To EMS Delays

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The County of Essex has declared a local emergency in response to persistent ambulance offload delays that are causing situations when there are no ambulances or only a limited number of ambulances available to respond to emergency calls.

County of Essex Warden Gary McNamara activated the declaration at 8:45am Monday.

County officials say the frequency and duration of offload delays has risen sharply since 2020, creating situations where multiple ambulances are forced to idle for hours at a time outside hospital emergency rooms waiting for patients to be admitted. They say sometimes those delays last longer than 12 hours.

“Essex-Windsor EMS has worked with our local hospital partners to reduce offload delays but the problem persists, putting patients at risk and negatively affecting the morale of paramedics,” said Warden Gary McNamara. “We are activating this local state of emergency so we can do everything we can to keep our paramedics on the road responding to emergency calls instead of sitting outside of congested hospitals.”

Last Wednesday, Essex-Windsor EMS moved into code red status (two ambulances available) and then quickly into a code black (no ambulances are available) for a period of about three hours. Locally, 26 ambulances were rostered but all 26 were experiencing offload delays outside hospitals.

County officials say neighbouring ambulance services have been able to rely on each other for support when one region had higher than normal call volumes. But last Wednesday, services across southwestern Ontario were all experiencing intense pressures at the same time. Over one period of time, officials say there were zero to seven ambulances available to cover the region from London to the Detroit River between lakes Erie and Huron.

“Our paramedics and our hospital partners are doing everything they can to respond to this crisis but the causes are complex and related to longstanding systemic issues including hospital capacity, patient flow and a lack of available local primary care providers,” said Essex-Windsor EMS Chief Bruce Krauter. “Essex Windsor EMS transports account for about 35 per cent of emergency room visits compared to a provincial average between 10 and 15 per cent. This is unsustainable.”

Krauter and County of Essex officials recently met with Ministry of Health officials to advance solutions to address the provincewide crisis. Those suggestions included:

• Recognize offload delays as a public health risk.
• Create incentives for hospitals to meet 30-minute offload targets and enforce consequences for those that fail to meet the targets.
• Require hospitals to triage patients brought in by paramedics as a first priority – every time.
• Implement Fit-to-Sit programs: Allow low acuity patients brought in by ambulance to go to the waiting room so paramedics can get back on the road.
• Require hospitals to take a whole-hospital approach and develop escalation plans mobilizing all levels of the hospital to deal with emergency department surges and offload delays.
• Create standardized measurements and reporting between hospitals and paramedics to ensure consistent and accurate data collection to inform decisions.