Province transformed ambulance system, record number of people supported
The Province has transformed ambulance services with close collaboration with the BC Emergency Health Services (BCEHS) and CUPE 873/Ambulance Paramedics of BC (APBC), benefiting a record number of people.
“Since 2017, our government has made significant and long overdue changes to B.C.’s ambulance services in response to the pressures from population growth, COVID-19 pandemic, toxic-drug crisis and climate events, including heat, floods and wildfires,” said Adrian Dix, Minister of Health. “I am grateful for the support of BCEHS and CUPE 873/Ambulance Paramedics of BC during these difficult times. The extraordinary progress we’ve made together to retain and recruit more paramedics and the investment we’ve made to add more ambulances have benefited people across the province, particularly those in rural and remote communities.”
To improve ambulance services for patients in B.C., the Province, BCEHS and CUPE 873/APBC came together to strengthen the workforce, while ensuring they have the support needed, adding more ambulances, improving response times and better supporting rural and remote communities.
“BCEHS has provided emergency care for 50 years and we’re making sure they can provide world-leading patient care for the next half-century,” said Jason Jackson, president, Ambulance Paramedics of BC. “We’re committed to working collaboratively as a union to put the needs of our patients, communities and members first. We will continue to make strides on improving gaps in care and helping those who need to access care, wherever they might live, by fostering and inspiring supportive workplaces and addressing health-care inequities faced by Indigenous people.”
As of March 2024, there are 5,040 CUPE 873 staff working in BCEHS, 1,104 more than in March 2017. Of these paramedics, 62% now have regular permanent positions, a 51% increase compared to 2017-18. In 2023-24, there were 375 dispatch staff working across BCEHS’s three dispatch centres, a 42% increase since 2017-18. This has contributed to more hours of services each day. Between April 2022 and March 2023, BCEHS has added 1,325 in-service hours per day across the province, a 19% increase.
“Nearly a half century of providing patient care across the province is a significant accomplishment, one that BCEHS has achieved by always looking ahead, always anticipating and always adapting,” said Leanne Heppell, chief ambulance officer, BCEHS. “Today, BCEHS serves 5.6 million people through ground and air transport, and covers over one million square kilometres, and that’s why we continue to focus on new and innovative ways to build on this success and advance our effectiveness in the health-care system even more.”
As the population continues to grow and age, paramedics, dispatchers and call takers have responded to more people than ever before, each day answering more than 1,900 911 calls and responding to more than 1,600 events. In rural and remote communities, people identified as having the most life-threatening conditions waited nearly 20% less time to get an ambulance, from eight minutes and 53 seconds wait time in 2017 to seven minutes and 14 seconds in 2023.
In 2023-24, 658 ambulances and 273 non-transport support vehicles supported paramedics responding to patients, a 26% one-year increase and an 88% increase since 2017-18. Five additional dedicated air ambulances have been added since 2017-18, an increase of 50%, bringing the total to 15.
In addition, scope-of-practice changes in 2022 allowed BCEHS to expand the skills of its paramedics. BCEHS has new models of care that link the nearly two-thirds of calls that are not life-threatening with appropriate services. Between Jan. 1, 2022, and April 2024, more than 9,000 patients who were assessed by secondary triage did not require an ambulance. Link and referral units support also helped more than 14,000 patients avoid a trip to the emergency department.
The Province, together with BCEHS and CUPE 873/APBC, also phased out the existing schedule-on-call model and introduced new models in April 2024. This means that the communities have their unique needs met, paramedics are better supported, and patients have access to faster, more equitable care. This is supported by transitioning many part-time positions to full-time positions, with 271 full-time positions added to support the new models.
“We’re investing in ambulance services, so people get the urgent, life-saving care they need, when and where they need it,” said Jennifer Rice, Parliamentary Secretary for Rural Health. “Wherever a health emergency takes place, in our biggest cities or in our rural and remote communities, every second counts. We will continue to build out ambulance services to reduce response times and help BCEHS deliver timely, quality care everywhere in B.C.”
Paramedics, dispatchers and call takers also have access to more mental-health supports. BCEHS hired 175 additional clinicians to the network of trauma-informed and occupationally competent counsellors, who provide psychological care, bringing the total to approximately 338. The Critical Incident Stress Management Program, which provides access to mental-health services for front-line staff and their families, has increased by 121% since it started in 2018. In total, 4,148 connections with the program were made in 2023-24.
Since 2017, the Province has been making investments and changes to service delivery to support a stronger ambulance service. This work began with a stand-alone bargaining association for paramedics with focus on critical areas, such as response times, rural and remote staffing, and innovative ways of treating patients with non-emergency injuries and illnesses. The Ambulance Paramedics and Ambulance Dispatchers Bargaining Association was established on Jan. 18, 2018. Since then, two collective agreements have been reached between the Ambulance Paramedics and Ambulance Dispatchers Bargaining Association and the Health Employers’ Association of BC.
To further improve ambulance services in the province, BCEHS is adding 55 new ambulances and 15 paramedic response units across metro and urban areas, where modelling shows the demand is greatest and where they are needed most to maintain response times. The ambulances will be ordered now and delivered in approximately 12-18 months.
Since 2017, spending in emergency health services increased by more than $475 million, reaching close to $1 billion in 2023-24. This increased spending has been enabled through targeted provincial investments in increased BCEHS staffing, training and mental-health supports, as well as investments to improve equitable access to ambulance services in B.C.
“As we approach the 50th anniversary of B.C.’s provincial ambulance service, it’s more important than ever to recognize the unwavering dedication of our call takers, dispatchers and paramedics, as well as the BCEHS, CUPE 873/APBC for championing ambulance services in the province. Together, we will continue to deliver our joint work in every community across the province,” said Dix.