Any member of the public – including a patient, parent, stakeholder or agency member – can file a complaint with the emergency health services provider directly or the Ministry of Health.
Examples of emergency health service providers include:

  • Central Ambulance Communication Centres/Ambulance Communication Services (Dispatch)
  • land ambulance service operators/paramedic services
  • air ambulance and certified air ambulance providers
  • base hospital programs

The Ministry of Health’s Emergency Health Services Division conducts investigations to determine if there were any contraventions of the Ambulance Act, its regulations or standards. Investigations can take place in response to a complaint. They can also start because of other concerns. However, the division does not conduct investigations into matters covered under any other provincial or federal legislation. The division also does not conduct investigations to determine the cause of injury or death, or the actions of other allied agencies (for example, fire, police, or hospital staff).

How to file a complaint with the Ministry of Health

The Ministry of Health’s Emergency Health Services Division has the authority to investigate complaints through the Ambulance Act. The division is committed to investigating complaints about pre-hospital care responsively and reliably through a rigorous complaints management and investigations process.

In your complaint, please tell us as much as possible, including:

  • a description of what happened
  • when and where it happened (including the date and approximate time)
  • who was involved

This will make it easier for the ambulance service provider or ministry to investigate your complaint. Also, if you require any accommodations under the Accessibility for Ontarians with Disabilities Act, 2005 (AODA), please let us know in your complaint submission.

Complaints can be submitted anonymously or with contact information included. Contact information helps the investigator follow up on complaints and collect additional information for investigations. Anonymous complaints, however, could limit the division’s ability to investigate.

Complaints can be sent directly by email to: inspections_investigations@ontario.ca or the complaint form can be submitted.

Alternatively, you can mail the complaint information to:

Investigation Services
Emergency Health Regulatory and Accountability Branch
North American Centre, 6th floor
5700 Yonge Street
Toronto ON M2M 4K5

What to expect after filing a complaint with the Ministry of Health

If you have included contact information with your complaint, you can expect the following.

Intake and processing

Once you have filed a complaint, the division will acknowledge receipt and complete the complaint intake process by:

  • contacting you to review the complaint and explain the process (this typically takes place within 5 business days of receiving your complaint)

Investigator assigned

If your complaint is actionable under the Ambulance Act, an investigator from the Emergency Health Services Division will be assigned to your complaint.

  • An investigator is typically assigned to your complaint within 1 to 2 business days.
  • Typically, within 2 business days of an investigator being assigned, they will contact you directly by phone or email to introduce themselves and provide their contact information. They can also answer questions about the investigation process.
  • If your complaint is about matters outside of the Ambulance Act, we may make recommendations to you on how to redirect your complaint to the appropriate oversight body.


An investigation will be conducted in accordance with the Ministry of Health’s investigation process, which typically results in an investigation report and may include additional outcomes.

Report back to complainant

Once an investigation is complete, you will receive a close-out letter, which will include the concerns raised and identify any contraventions of the Ambulance Act, its regulations or standards.

  • If you would like to obtain the investigation report, you must request it from the ministry’s Access and Privacy Office to ensure compliance with privacy legislation.

Appeals process

If you are dissatisfied with the investigation outcome, you may submit a request to appeal by email to: inspections_investigations@ontario.ca.

You may also file a complaint with the Ontario Ombudsman.

Investigation process

To carry out an investigation, investigators gather evidence in several ways, including:

  • gathering and reviewing documentation
  • taking statements and conducting interviews
  • recording observations
  • conducting searches
  • making material, document, and equipment seizures

Investigation timing

The amount of time required to investigate a complaint varies from case to case, based on a variety of factors.

You are welcome to contact your assigned investigator or Investigation Services for status updates at any time.

Please note that the Ministry of Health cannot comment beyond the status of the investigation until an investigation is complete.

Investigation results

Outcomes from an investigation could include:

  • a collaborative approach with the service – The Ministry of Health will work with the respective services to address the identified contraventions of the act and may also make recommendations to the respective services of acceptable outcomes. The respective services will then provide their action plan to the ministry and confirm its completion to demonstrate their compliance.
  • a rewrite order – The Ministry of Health will require that a paramedic rewrite the Advanced Emergency Medical Care Assistant (AEMCA) exam where there are consistent concerns of incapacity through an established process. The AEMCA is a paramedic qualification requirement to work within Ontario.
  • a provincial charge – The Ministry of Health reserves the ability to lay a provincial charge for offences respecting the Ambulance Act.
  • no further action (NFA) – The Ministry of Health will take no action in instances where the pre-hospital care was performed in accordance with the legislation, its regulations and standards.

Investigation reports

Investigations include an official report of the findings, which will be made available to any entitled parties involved in the incident.

If the complainant is not the patient, every effort will be made to contact the patient – unless doing so will cause them emotional harm.

The investigation report will outline the evidence collected and reviewed, and it will identify if there were any contraventions.

How to request an investigation report

Because investigation reports contain personal health information of the patients involved, complainants must request the full report from the Ministry of Health’s Access and Privacy Office.

The office will require documentation to determine the information it can release with the report. Documentation could include information relating to the executor of will, substitute decision maker, power of attorney, next of kin, or other requirements.

To request investigation reports, contact the Access and Privacy Office.

Responding to the Ontario Ombudsman

On May 20, 2021, the Ontario Ombudsman made 53 recommendations to revamp the Ministry of Health’s oversight of land and air ambulance services.

The ministry is developing and implementing a plan that is responsive to the report, with input from our valued sector partners and providers.

This includes recruiting additional investigation and air ambulance oversight unit staff. It also involves improving protocols and processes and investing in modern IT systems to ensure the investigative process is more transparent and accountable.

Contact Us

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