“Aging tsunami” drives paramedic plans for the future
Consultants Todd MacDonald and John Prno gave council a first look at their 10-year master plan for the Kawartha Lakes paramedic service. Their proposed solutions are driven by demographics, and if adopted will see a considerable re-shaping of how and where the service does business from 2022-2031.
MacDonald and Prno suggested that over the next 10 years there will be “steady long-term population growth in Kawartha Lakes” and that the bulk of the growth is going to be in the population cohort above the age of 65.
“This cohort produces more business for ambulances than all the other groups put together,” MacDonald said. “This ‘aging tsunami’ is already happening in Kawartha Lakes and will only get worse. It will create increasing amounts of work for paramedics. Children and old people take more time per call than any other group and we saw in 2019 the more old people, the more ambulance calls, the more time spent per call.”
In Lindsay alone, the consultants are predicting a population increase of 12,500 new inhabitants, and “these will not be kids. They will be retirees and Lindsay will be importing this ‘aging tsunami’ which will up EMS demand.”
With a significant bump in the aging population caused by people leaving the GTA en masse in a phenomenon called “flight from density” MacDonald predicts that over the next ten years paramedics in this area will see a 41 per cent increase in their total number of calls. In 2022, the service is expecting to answer 13,000 calls. By 2031, local paramedics are expected to be dealing with almost 19,000 calls per year.
“The in-service time for each call will also increase to a little more than an hour a call (because of the age of the patient) which will generate 57,000 additional hours of paramedics’ time needed to cope with this new case load,” MacDonald said.
MacDonald also told council that the data points towards “more calls coming during a mid-day peak causing a reduction in the availability of ambulances and longer wait times.”
If all ambulances are busy, the service is in what MacDonald calls “code black” where response time drops from eight minutes to as many as 18-21 minutes. MacDonald calls those response times “not good, especially if the call is truly serious.”
“We need to flatten that midday curve,” MacDonald told council. “Community paramedics doing preventative community interventions and a 911 option that provides education to callers rather than simply dispatching an ambulance will need to be looked at.”
John Prno, a retired paramedic chief, drilled down on paramedic station locations and what can be done to improve service and cut response time. “The service currently has trucks in Pontypool, Lindsay, Bobcaygeon, Fenelon Falls and Coboconk,” Prno said. “The poorest levels of service are in the south of the city and the far north.”
Prno compiled data on every ambulance call the service answered and determined, based on wait times, that Bobcaygeon and Fenelon Falls bases are in good locations to service their local needs.
“The Coboconk and Pontypool locations are only posts with the ambulances beginning their shifts somewhere else,” Prno told council. “The truck in Pontypool often gets dragged back to Lindsay because of call volume, creating poor service in the south when needed.”
The data presented by the consultants clearly shows that based strictly on call volume, Lindsay and Omemee generate the most EMS demand. A closer look at calls coming from inside Lindsay also tells the consultants that the new paramedic station needs to be constructed on the west side of the Scugog River once the service abandons their current facilities on St. David Street.
That same data compares five different sites for the new Lindsay location and show clearly that a location on Angeline Street North would allow for an average travel time of two minutes and 27 seconds for Lindsay based ambulances.
“The Angeline Street North location was by far the best model,” Prno said. “The areas of growth in the city are in the northwest around Wilson Fields and Jennings Creek. Those two locations alone will generate another 1,000 calls a year all by themselves.”
Based on the data analyzed and presented to council, Prno and MacDonald went over their recommendations with council. These include:
- A common deployment strategy with the Peterborough paramedic service.
- Re-deployment of the truck in Pontypool to the former fire station in Oakwood. The Oakwood station would be serviced by five twelve-hour shifts a week. Manvers Township would be covered from that point on by the Peterborough paramedic station in Millbrook. Cost $185,000.
- A new 21,500 square foot paramedic complex to be built in Lindsay on Angeline Street North. Cost $8.4 million.
- Additional staffing at the new Lindsay facility the equivalent of an additional 84 hours a week of paramedic strength. Cost $628,000.
- Replacement of the Fenelon Falls base. Cost $1.6 million.
- Upgrade the Coboconk base. Cost $160,000.
- New base in Omemee. Cost TBA.
When given the opportunity to ask questions, councillors wanted to talk about many aspects of the consultants’ report.
Councillor Tracy Richardson was concerned about what kind of coverage Pontypool would receive in this new plan, and was assured that the Millbrook paramedic station would “provide much more regular coverage” for the community than the station that is located right in Pontypool.
Councillor Emmett Yeo, who represents a huge swath of the north of the city, told the consultants that he is very concerned about the poor EMS coverage his constituents are receiving.
“We need more posts in the north of the city,” Yeo said. “There should be additional posts in Dalrymple and Kirkfield. We need to look seriously at a cross-border sharing agreement with Orillia. I can’t support this as it stands.”
The two consultants suggested that improving service in the north of the city is going to be tough “because of isolation, the lack of concentrated population areas and lakes getting in the way of roads. We hope the community paramedic program will prevent many of these 911 calls from occurring.”
Yeo continued questioning the consultants, wondering why volunteer fire personnel are no longer allowed to respond to health related calls. “They are told not to go anymore. Let volunteer firemen do what they are trained to do,” Yeo argued.
The consultants shared with Yeo that data tells them “that there are not a lot of health-related emergencies that fire personnel can help at.”
Councillor Pat Dunn was very supportive of the style and content of the consultants’ presentation, telling council that on issues of health and safety he is “an open wallet.”
Councillor Ron Ashmore wondered why money is being considered for new paramedic posts when instead ambulances could be strategically rotated around the city to safe parking areas and fire stations that already exist.
“We try to avoid that kind of ‘street corner posting’ anymore. It is tough on the crews to sit in a truck for a 12 hour shift. We want to use the data to place ambulances where the calls are coming from,” MacDonald replied.
Ashmore continued his questioning, wondering what efficiencies have been achieved in the ongoing Lindsay-Peterborough shared service agreement.
Paramedic chief Randy Mellow, who is shared between Peterborough and Kawartha Lakes, said, “We are looking for efficient ways for the services to work together. There are quick wins we have already discovered in technology and purchasing.”
Councillor Kathleen Seymour-Fagan wanted to know the impact of off-loading patients at Ross Memorial on ambulance availability, and whether a bottle neck was being created at the hospital.
“The delay is not significant yet,” MacDonald said. “When the tsunami arrives it could be a real problem.”
Finally, Seymour-Fagan wanted to know how closely the consultants have been working with the fire department, who are also working on a long-range plan.
“We have talked,” MacDonald said. “The fire department suggested the paramedics taking over the abandoned station in Oakwood.”
The final copy of the report with recommendations will be brought back to council later in 2021 for discussion and approval.