At the end of this month, paramedics serving the City of Brantford and County of Brant will have been without a contract for a full year.

But their problems with being overworked and under-resourced have been going on for much longer.

In 2015, the director of ambulance services asked council for help. Brant County council decided to take more time to examine the issue, hiring an outside contractor to look at the problems.

That report came back in August of 2016 and echoed what the director had said, making a number of recommendations to combat what it called “significant” patient risk.

You can read the full report here, but these are some key findings:

Busiest time of day for paramedics: Midday

In 2012, they were busiest at 11 a.m. (average of 3.6 calls per day), compared to one call per day at 4 a.m.

In 2015, they were busiest at 1 p.m. (average of four calls per day), compared to 1.3 at 5 a.m.

No help left

Between 2012 and 2015, paramedics were in a “zero available unit” situation an average of 1,192 times a year.

When that happens, the average wait for an ambulances doubles to 17 minutes.

Cross-border lifesaving

In 2015, other jurisdictions responded to help out Brant County paramedics 1,218 times.

Brant County helped those neighbours out in return less than half as often – 452 times.

Stuck at the hospital

Ambulances are getting held up waiting to “offload” their patients at Brantford General Hospital. In 2014, the average offload wait time was one hour and 31 minutes. That increased to one hour and 38 minutes in 2015. Last year, the number jumped again to two hours, three minutes and 45 seconds, according to the county's director of ambulance services

Keeping up with the Joneses: How Brantford and Brant County compare to peer municipalities

The report compares Brant to a few similar municipalities: Elgin, Haldimand, Norfolk, Peterborough and Guelph-Wellington.

In 2015, the number of times all of Brantford’s ambulances were busy, with no trucks left for new calls, far surpassed its peers: 1,175 times, compared to 135 times in Haldimand and only 67 in Wellington-Guelph.

In 2014, those peers spent an average of $10.7 million on their paramedics, with an average cost per capita of $109.50. Brant spent $9.3 million, with a per capita cost of $72.11.

Here we grow again

With a rising population and an aging population, the number of calls is projected to more than quadruple between now and 2041.

Each year, the report projects an increase of about 6% -- going from 11,445 emergency calls in 2011, to 66,110 in 2041.

Jeff Graham, the OPSEU unit steward, called these numbers conservative. He says calls have increased by 20% over the past three years.

So what can be done?

The report makes a number of recommendations – the main ones are below. The chair of the county’s ambulance committee says all of them have been approved by Brantford and Brant County councils, but they take time to roll out. Will Bouma expects the changes to be in place by this summer. The union boss says he’s taking that with a grain of salt.

By this past fall, the report called for a shift in trucks: removing one ambulance from the night shift, and moving it to the busier day shift. Bouma says they needed to buy a new ambulance to do that, and couldn’t do it in the middle of a budget year.

Extra shift: The report called for one additional 12 hour shift during the day, at a cost of an extra $0.5M every two years.

Changes in oversight: Changes to the supervisor model will cost an extra $0.5M, to be implemented in 2018.