CALGARY -- Calgary city council voted Monday to ask the provincial health minister to scrap aa plan to consolidate Calgary’s EMS dispatch into a province-wide dispatch system
Alberta Health minister Tyler Shandro says the change will streamline EMS dispatch, saving the province millions of dollars, while not affecting patient care.
Several city councillors and Mayor Nenshi dispute the merits of the move.
“I don't understand where these supposed cost savings will come from," said Nenshi. "And certainly no one has ever made the case that this will decrease response times or improve patient outcomes - so I'm left really with the question of why are we even having this conversation?”
Alberta Health Services (AHS) announced in August that the final four municipally-run, contracted satellite dispatch sites in Calgary, Lethbridge, Wood Buffalo and Red Deer would be transitioned to one of three existing AHS dispatch centres.
Nenshi, alongside the mayors of the other cities affected met with Health Minister Tyler Shandro last week to voice their concerns over the potential for lengthier response times that could cost lives.
The group says it was blindsided by the announcement and feels local dispatchers can send help and accurate information more quickly than those picking up the phone elsewhere in Alberta.
“If they could answer the question, why, if they could prove this would be better, for patience, or if they could prove that it would actually save money, I'll stand down," said Nenshi “But they've not been able to prove those things. So if they move forward with this without proving those basic questions, it says a lot about their lack of faith in evidence-based decision-making.”
AHS has been running a dispatch system for the rest of the province since 2009, which the Ministry of Health says has run more efficiently.
In a letter to the City of Calgary, Shandro said "There will be no delays in emergency response and Albertans who request EMS will notice no change."
Documents supplied by the health ministry shows that the province pays the City of Calgary close to $6M per year for ambulance dispatch.
"The saving is not the driver of the decision," explained Steve Buick, Ministry of Health press secretary. "We’re making this change because it’s how the system is intended to work and how it does work in 60 per cent of the province. But it’s fair to point out that the city does not want to lose $6M in revenue."
Buick also pointed to Edmonton, which has marginally faster ambulance dispatch times than Calgary.
Committed
Minister Shandro met with the mayors of the affected cities last week. He says he is committed to reviewing the information they brought to the table about EMS dispatch.
“If the evidence shows that response times would somehow be adversely affected then I'm going to be against it.” said Shandro “But that's quite frankly not not the evidence I've seen right now from AHS, but I have committed to these measures that I will look at that information that they provided last week.”
Multiple emergency services
One of Calgary’s main concerns is that the change will adversely affect calls requiring multiple emergency services.
911 officials worry that once the initial call is transferred out of their call centre to the offsite EMS provincial centre, firefighters and police must wait for it to be transferred back before dispatching other emergency services.
Presently in approximately. 70 per cent of emergency medical calls firefighters are first to arrive on scene and begin administering medical assistance.
"I strongly support the current integrated response model," said Calgary Fire Chief Steve Dongworth. "For medical events, we know seconds matter. In the case of heart attacks, each minute a patient waits for CPR reduces the chance of survival by up to 10 per cent."
The director of Calgary Community Standards, which operates the 911 call centre is more blunt. Richard Hinse said Calgarians enjoy one of the best emergency response systems in North America and that change is unnecessary.
“I think Calgarians have already had the gold standard for 15 years in this model, based on 911. It's not broken. Why would you fix it?” asked Hinse “If we break the model in Calgary, fire does not get into opportunity to go as quick as possible and Calgary police will not understands what's happening. The citizens of Calgary have to have all three services working together, out in the community to get that ambulance there as quickly as possible and get it back to the hospital. That's public safety versus healthcare.”
Foothills County also calls for changes to EMS system
The Foothills Regional Emergency Services Commission (FRESC) is supporting the City of Calgary and was scheduled to present data to administration at Monday’s special meeting in support of returning local ambulance dispatch centres.
Foothills County has been waging a public campaign for the past three years to reverse the province’s decision.
Officials within the rural area note that they follow the National Fire Protection Standard for all of their calls, including 911 ambulance dispatch.
That standard states that "Processing times for emergency calls requiring medical dispatch questions and pre-arrival medical instructions is 90 seconds, 90 per cent of the time."
However, FRESC data from 2017 shows that of all AHS dispatch notifications to Foothills 911:
● 95 per cent are not being completed within 90 seconds.
● 84 per cent are 60 seconds over the 90 second recommended response time.
● 53 per cent are double (180 seconds or three minutes) over the 90 second recommended response time.
While Shandro said Tuesday he still was open to scrapping the EMS consolidation idea, in a letter following his meeting with he mayors of Red Deer, Fort MacMurray, Lethbridge and Calgary he wrote:
“I think consolidating ambulance dispatch into AHS makes sense," he said. "It will make the system work better and save money that we’ll reinvest right back into ground ambulance services.
"Most importantly," he added, "the evidence I’ve seen shows it won’t change response times or cause delays for ambulances or other first responders.”
Shandro went on to say when EMS was integrated into ANS the dispatch system was left fragmented “Ten years later, finding ways to run our healthcare system more efficiently while improving patient care is more critical than ever, and we cannot ignore an opportunity to do so.”
