Response Time Standards

Version 1.0

Comes into force November 7, 2025

Ministry of Health

Emergency Health Regulatory and Accountability Branch

To all users of this publication:

The information contained in the Standards has been carefully compiled and is believed to be accurate at date of publication.

For further information on the Response Time Standards for Ontario Ambulance Services, please contact:

ParamedicStandards@ontario.ca, or

Emergency Health Regulatory and Accountability Branch
Ministry of Health
5700 Yonge Street, 6^th Floor
Toronto, ON M2M 4K5

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Preamble

The Response Time Standards are incorporated by reference in Ontario Regulation 257/00 as made under the Ambulance Act. Standards set the requisites for paramedic practice.

Every upper-tier municipality, every delivery agent responsible under the Ambulance Act for ensuring the proper provision of land ambulance services and every land ambulance communication service shall comply with the requirements respecting response times that are set out in the Response Time Standards.

The Response Time Standards describe the requirements for response time targets, performance plans, performance measures and reporting.

The Response Time Standards is a Living Standard published by the ministry and available to the public. As a Living Standard document, any updates to the Response Time Standards will undergo the Living Standards process.

Definitions

“Act” means the Ambulance Act, R.S.O. 1990.

“Ambulance service” means, subject to subsection (2), a service that is held out to the public as available for the conveyance of persons by ambulance.

“Communication service” means a communication service referred to in clause 4 (1) (a) of the Act.

“Delivery agent” means a person or organization designated as a delivery agent under subsection 6.7 (1) of the Act and includes a delivery agent under section 6.10 of the Act.

“Director” means the person appointed under section 17.2 of the Act as the Director and, where more than one person has been appointed, means the person who is the Director for the purposes of the provision in which the term appears.

“Emergency medical attendant” means a person employed by or a volunteer in an ambulance service who meets the qualifications for an emergency medical attendant as set out in the regulations, but does not include a paramedic or a physician, nurse or other health care provider who attends on a call for an ambulance.

“Notice” means notice given to a land ambulance crew by a land ambulance communication service of a request.

“Paramedic” means a person employed by or a volunteer in an ambulance service who meets the qualifications for an emergency medical attendant as set out in the regulations, and who is authorized to perform one or more controlled medical acts under the authority of a base hospital medical director, but does not include a physician, nurse or other health care provider who attends on a call for an ambulance.

“Patient” means a person who,

1. receives first aid, emergency or other medical care from an emergency medical attendant or paramedic, or
2. is transported in an ambulance by an emergency medical attendant or paramedic.

“Request” means a request made to a land ambulance communication service for ambulance services that are determined to be emergency services by the communication service at the time of the request.

“Upper-tier municipality” has the same meaning as in the Municipal Act, 2001.

Upper-tier municipality or gelivery agent

In this section, “response time” means the time measured from the time a notice is received to the earlier of the following:

1. The arrival on-scene of a person equipped to provide any type of defibrillation to sudden cardiac arrest patients.
2. The arrival on-scene of the ambulance crew.

A. Requirements

1. No later than October 1 in each year after 2011, every upper-tier municipality and every delivery agent responsible under the Act for ensuring the proper provision of land ambulance services shall establish, for land ambulance service operators selected by the upper-tier municipality or delivery agent in accordance with the Act, a performance plan for the next calendar year respecting response times.
2. Each upper-tier municipality or delivery agent to which subsection A.1 applies shall ensure that the plan established under that subsection sets response time targets for responses to notices respecting patients categorized as Canadian Triage Acuity Scale (“CTAS”) 1, 2, 3, 4 and 5, and that such targets are set for each land ambulance service operator selected by the upper-tier municipality or delivery agent in accordance with the Act.
3. An upper-tier municipality or delivery agent to which subsection A.1 applies shall ensure that throughout the year the plan established is continuously maintained, enforced and evaluated and, where necessary, updated, whether in whole or in part.
4. An upper-tier municipality or delivery agent to which subsection A.1 applies shall provide the Director with a copy of the plan established under that subsection no later than October 31 in each year, and a copy of any plan updated, whether in whole or in part, under subsection A.3 no later than one month after the plan has been updated.
5. An upper-tier municipality or delivery agent to which subsection A.1 applies shall report to the Director, as required from time to time by the Director and on forms or in a manner provided or determined by the Director, on any matter relating to,
   1. the nature and scope of the plan established under that subsection or updated under subsection A.3; and
   2. the establishment, maintenance, enforcement, evaluation and updating of the plan.
6. Without limiting the generality of subsection A.5, no later than March 31 in each year after 2013, an upper-tier municipality or delivery agent to which subsection A.1 applies shall report to the Director on the following matter for the preceding calendar year:
   1. The percentage of times that a person equipped to provide any type of defibrillation has arrived on-scene to provide defibrillation to sudden cardiac arrest patients within six minutes of the time notice is received.
   2. The percentage of times that an ambulance crew has arrived on-scene to provide ambulance services to sudden cardiac arrest patients or other patients categorized as CTAS 1 within eight minutes of the time notice is received.
   3. The percentage of times that an ambulance crew has arrived on-scene to provide ambulance services to patients categorized as CTAS 2, 3, 4 and 5 within the response time targets set by the upper-tier municipality or delivery agent under its plan established under subsection A.1.
7. Without limiting the generality of subsection A.5, an upper-tier municipality or delivery agent to which subsection A.1 applies shall report to the Director on the performance of each land ambulance service operator selected by the uppertier municipality or delivery agent in respect of the targets set for that operator under subsection A.2.

Land ambulance communication service

In this section, “response time” means the time measured from the time a request is received to the time a notice is given respecting that request.

B. Requirements

1. No later than October 1 in each year after 2011, every land ambulance communication service shall establish a response time performance plan for the next calendar year that sets out the percentage of times that the communication service will give notice within two minutes of the time a request is received respecting sudden cardiac arrest patients or other patients categorized as CTAS 1.
2. A land ambulance communication service to which subsection B.1 applies shall ensure that throughout the year the plan under that subsection is continuously maintained, enforced and evaluated and, where necessary, updated, whether in whole or in part.
3. A land ambulance communication service to which subsection B.1 applies shall provide the Director with a copy of the plan established under that subsection no later than October 31 in each year, and a copy of any plan updated, whether in whole or in part, under Section B.2 no later than one month after the plan has been updated.
4. A land ambulance communication service to which subsection B.1 applies shall report to the Director, as required from time to time by the Director and on forms or in a manner provided or determined by the Director, on any matter relating to,
   1. the nature and scope of every plan established under that subsection or updated under subsection B.2; and
   2. the establishment, maintenance, enforcement, evaluation and updating of the plan.
5. Without limiting the generality of subsection B.4, no later than March 31 in each year after 2013, a land ambulance communication service to which subsection B.1 applies shall report to the Director the percentage of times in the preceding calendar year that the communication service gave notice within two minutes of the time a request was received respecting sudden cardiac arrest patients or other patients categorized as CTAS 1.