​“Since 2017, our government has supported BCEHS’s work to significantly improve paramedic staffing and strengthen and transform ambulance service throughout the province,” said Adrian Dix, Minister of Health. “The April 1, 2024, conversion of 60 ambulance stations across the province to more effective service delivery models that respond to each of these 60 communities’ unique needs provides more equitable access to care for people living in rural and remote communities, and better compensation and work environments for paramedics, particularly those who already live and work in these communities and provide emergency medical care to neighbours and community members. I commend the continued collaboration by BCEHS and CUPE 873 to make things better for paramedics who provide valuable, essential healthcare service to people in B.C.”  

All 16 communities in the Island Health region transitioned from the “scheduled on-call” (SOC) model to one of three new models that will support available, staffed ambulances, and will continue to move BC Emergency Health Services (BCEHS) towards a predominantly regularized workforce. 

Three communities including Gabriola Island, Gold River and Quadra Island were upgraded to 24/7 full-time “alpha” ambulance stations on April 1, 2024. Under this model, each station has 8 full-time positions, with paramedics in the station 24 hours a day. Compared to the previous model, this means that there will be paramedics in the station on duty three times more than with the SOC model that had paramedics at the station 8 hours a day, and 16 hours on call.

Twelve communities including Alert Bay, Cortes Island, Denman Island, Galiano Island, Mayne Island, Pender Island, Port Renfrew, Port Alice, Sayward, Sointula, Tahsis, and Ucluelet upgraded to a new “mix shift” staffing model on April 1, 2024. The mix shift model has staff on duty in the station twice as often as they do with the SOC model, with 16 hours in station on duty and 8 hours on call (pager) at night. 

The community of Zeballos is also benefiting from a new full-time paramedic unit chief position, to provide support to on-call paramedic staffing.  The on-call “kilo” model in these stations offers more flexible staffing options to maximize local recruitment. It also leverages the latest collective agreement with paramedics, which increased the on-call rate from $2 per hour to $12 per hour.

“In our many discussions with community leaders in these rural and remote communities we heard how critically important paramedic services are to them,” said Leanne Heppell, BCEHS’ Chief Ambulance Officer. “These improved paramedic staffing models and the increase in full-time and regular part-time positions together with the changes we are making to enhance community paramedicine services are an exciting investment in the health and well-being of our patients in rural and remote British Columbia.” 

The plan to convert staffing models in 60 communities in rural and remote B.C., including 16 in the Island Health region, was outlined in a joint announcement from BCEHS, the Ambulance Paramedics of British Columbia (APBC/CUPE Local 873) and the Ministry of Health on November 9, 2023. Further changes in December 2023 resulted in additional positions in two communities, Rossland and Sointula. 

BCEHS and APBC (CUPE Local 873) worked together closely with the 60 communities to determine the best staffing model for each and to bring forward recommendations to the Ministry of Health. This work included engagement with staff, the communities, First Nations leaders and health authorities. BCEHS will continue working closely with partners to address future needs of communities and make changes as needed.

“The April 1 conversions are an important change in how we provide paramedic services in these 60 communities,” said Ambulance Paramedics of BC president, Jason Jackson. “Patient care is the most important thing to us, and this new approach helps us better recruit and retain paramedics to work in these smaller communities, improve how we respond to 911 calls, and most importantly, help paramedics provide better care to our patients.” 

“Enhanced ambulance services for our communities are welcome news, and this investment will bolster emergency response times so more people in rural and remote areas get the timely care they need, when and where they need it,” said Jennifer Rice, Parliamentary Secretary for Rural Health. 

“People need timely, urgent care when they are faced with an emergency, and with this expansion of ambulance services, people can count on better access to the services they need,” said Michele Babchuk, MLA for North Island. 

“This investment in ambulance care will give people living in rural and remote areas the peace of mind of knowing that they can access vital services when they need them,” said Josie Osborne, MLA for Mid-Island Pacific Rim. 

"When a health emergency strikes, every minute matters. By expanding ambulance services in Port Renfrew, we are improving access to care to support people and their loved ones when they need it most," said Ravi Parmar, MLA for Langford-Juan de Fuca.

The changes are being welcomed by many community leaders.

“Having advocated for the improved resources that come with the SOC change, I am glad to see them being put into place,” said Area A Director for the Regional District of Mount Waddington Michelle Pottage. “I am looking forward to the next steps and improved paramedic resources for Sointula and the North Island.”

Together with the staffing model conversions, changes have been made to Community Paramedic positions to better fit community needs. At least 55 stand-alone Community Paramedic positions (55.2 full-time equivalent positions) will focus on delivering community-based care and outreach services. Unlike the previous scheduled on-call model, these roles are no longer automatically integrated into the 911 emergency response. They will however respond to potentially life-threatening 911 calls if they are the nearest available unit, along with regular ambulance resources providing support.

While the conversions are complete as of April 1, 2024, the job competition and recruitment process for the new positions is ongoing. Many of the new shifts are currently being filled by existing staff working backfill to fill the new roles.

The transformation to the new models represents one of the single largest recruitments of primary care paramedics in BCEHS history. To help recruiting efforts, BCEHS has created a dedicated BCEHS talent acquisition team with 32 permanent staff as well as temporary support staff. BCEHS has also created a proactive recruitment team with five Indigenous recruiters, focused on bringing more Indigenous paramedics into BCEHS. 

The conversion to the new models builds on significant provincial investments to better support ambulance paramedics and dispatchers and improve services for people throughout B.C. 

Creating opportunities for people to join the health-care workforce in B.C. is part of government’s Health Human Resources Strategy, which was announced on Sept. 29, 2022. The strategy supports patients by ensuring they get the health services they need and are cared for by a healthy workforce. It focuses on 70 key actions to recruit, train and retain health-care workers, while redesigning the health-care system to foster workplace satisfaction and innovation.

Two backgrounders follow.

BC Emergency Health Services (BCEHS) is responsible for the delivery and governance of pre-hospital emergency medical care and inter-facility patient transfer services through the BC Ambulance Service and BC Patient Transfer Services. For more information, please visit www.bcehs.ca or follow us on Twitter @BC_EHS.