B.C. family doctor shortage impacting 911 service and ambulance waits
Delays for 911 emergency service in B.C. have been growing for months, with officials at E-Comm 911 – the province’s dispatch service – insisting the paramedic shortage is to blame. Now, CTV News Vancouver has learned E-Comm’s own staffing issues are also affecting response times.
CTV News has obtained a third-party analysis of E-Comm 911’s operations, which supports urgent warnings from the call-takers’ union that the not-for-profit company is understaffed and underfunded for the services it provides.
“There's a staffing crisis and funding crisis at E-Comm, there's a staffing crisis at (BC Emergency Health Services), and both organizations are experiencing the crunch,” said Donald Grant, president of the Emergency Communications Professionals of B.C. “We're experiencing constant callouts, people are working extreme amounts of overtime and they're going without breaks. There simply aren't enough of us to take the calls."
When someone in British Columbia calls 911, the call is answered by a call-taker at E-Comm 911, who transfers them based on their needs: police, fire or ambulance. It’s well-documented that there are shortages of paramedic call-takers – who also provide medical guidance if required – as well as the ambulance paramedics they dispatch.
There are no delays transferring to the dozens of municipal fire departments E-Comm supports, but the company also provides emergency and non-emergency call-taking and police dispatch for 33 police agencies throughout the province, including Vancouver police and Richmond RCMP. E-Comm acknowledges the policing supports, in particular the non-emergency services they’re contracted to provide, are understaffed with long waits.
“For 911, assuming normal call process, forecasted volumes and the typical time it takes to hand off a call, we are properly staffed and funded at the 911 level,” insisted E-Comm 911 president and CEO Oliver Gruter-Andrew. “Where we’ve seen problems recently is that the time takes to hand off to the BC Ambulance Service has taken longer than expected and planned. Because of that, we are staying on the line for longer and that depletes our resources able to answer the next 911 call.”
e described the paramedic shortages as a threat to public safety, since they have ripple effects throughout the first responder system. But, when CTV News pointed out that E-Comm was backing up its own 911 response with its understaffed policing supports, Gruter-Andrew claimed that was not the case and that the initial call-taking sector was staffed appropriately.
"(Staff) are crying before their shifts, they're crying after their shifts, they know there's this extreme burden to work additional overtime,” said Grant, noting a regular shift is already 12 hours long. “It just simply couldn't be further from the truth that we are adequately staffed."
THIRD-PARTY ANALYSIS FINDS CRITICAL STAFFING SHORTAGE
Professional services company PricewaterhouseCoopers reviewed E-Comm’s staffing and structure, producing a final report for the company and stakeholders on April 9, 2021.
“E-Comm is significantly understaffed,” reads the report. “It could take three-plus years to ramp up to required call-taker FTE (full-time equivalent positions), by which time target FTE could be significantly reduced from current state requirements by introducing operational efficiencies.”
Gruter-Andrew said the analysis was done based on the policing support side of the business, which he acknowledged is short-staffed, but said is also underfunded because there have been many more calls and more complicated police reports coming in to call-takers in recent years. Municipalities that contract E-Comm to handle those services haven’t increased their funding in step with those complexities, he added.
PricewaterhouseCoopers, however, wrote that “although funding is available, ability to recruit and retain is challenged, resulting in significantly understaffed dispatch,” with overtime costs of more than $2 million in 2020 – the equivalent of about 22 full-time dispatchers.
“E-Comm currently has 34 existing call-taker vacancies and an additional 40 vacancies for police dispatchers,” acknowledged the company. “In total, the PwC report recommends E-Comm hire an additional 91 call-takers and 7 dispatchers, in addition to filling current vacancies.”
It’s important to note, 911 call volumes have continued to increase since the final report was presented to E-Comm in April, with New Year’s Eve-level volumes through the summer.
THE TOLL ON CALL-TAKERS
Under the E-Comm model, the person who answers 911 calls in B.C is not medically trained or able to support someone in an emergency: their purpose is to help them figure out what help is required and send them to the appropriate first responder agency.
But with backlogs from the non-emergency police side and emergency health services, those call-takers often find themselves waiting for several minutes with people pleading for help they aren’t qualified to provide.
“People don't get into this job to sit there and listen to people in distress,” said 911 call-taker Carrie James. “When you're sitting on the phone for 10, 15, even 20 minutes waiting to transfer someone through to the ambulance service and unable to provide any type of support whatosever other than to say, 'I'm still on the phone with you', when you can't give them advice, you can't reassure them an ambulance is coming – it's very difficult. It's very demoralizing."
Gruter-Andrew called the situation horrible, saying: “Our entire organization is deeply concerned about that, because we're not trained for it.”
E-Comm receives some two million calls per year, 700,000 of which are non-emergency calls. Sixty-five per cent are for police, 30 per cent for ambulance and five per cent for fire.
James told CTV News the stress and pressure often begin before even showing up at work, since management routinely asks people to work overtime on top of their 12-hour shift and pays them to reduce break time to 45 minutes for the entire shift.
"It's gotten to the point where instead of it being occasional or periodic where people are being overrun or overworked, it's very consistent,” said James. "I know so many people that are actively looking for work."
This is the first installment in a CTV News series investigating the pre-hospital emergency system in British Columbia.