Middlesex-London Paramedic Service (MLPS) is a public service, certified to operate land ambulance services under the authority of the Ambulance Act and the Ministry of Health. As a public service, we are also accountable to the public, to Middlesex County Council, and to the Middlesex-London Paramedic Service Authority Board for the quality of the service we provide.
To achieve and enforce the highest standards possible, the Professional Practice, Clinical Excellence, and System Oversight department provides the organization with operational and system support. This includes conducting clinical audits, investigations, professional credentialing, quality assurance, quality improvement, data analysis, and system reporting. Additionally, the Professional Practice, Clinical Excellence, and System Oversight division is responsible for liaising with the Ministry of Health, the Base Hospital Program, and other regulatory bodies.
“I wanted to pass along our thanks to the paramedics that picked up, assisted my mom with a cardiac emergency, and again last night, taking her to UH. They showed extraordinary care, and saved her life, with their skill and compassion. Big thank you from our family”
Regulatory Compliance and Investigations
The Professional Practice, Clinical Excellence, and System Oversight department is responsible for responding to and investigating internal, public, and institutional complaints, and for recommending changes to procedures that will eliminate future problems and result in improved standards of care and service.
As such, the division works closely with the Ministry of Health and Long-Term Care, specifically the Investigations, Certification and Regulatory Compliance Group (ICRCG), the Provincial Coroner’s Office, local and municipal Police Services, Special Investigations Unit (SIU), the Ministry of Labour and other external investigative bodies.
The MOH monitors the investigations conducted by ambulance operators indirectly through the Incident Reporting Standards contained in Part III of the Ambulance Service Documentation Standards. In addition, the MOHLTC may also choose to refer the complaint to the service operator for investigation as it may not have the resources to investigate all complaints received.
Quality Assurance, Metrics & System Auditing
Quality Assurance is a component of the division and is tasked with confirming clinical excellence and system analysis to maintain comprehensive quality management concerning various Acts, legislative requirements, and best practices. Paramedics are required to complete accurate and comprehensive documentation for each call for service. Quality assurance personnel independently review these documents to ensure compliance with policies, protocols, treatment, and adherence to provincial documentation standards.
In addition to clinical auditing, quality assurance activities include comprehensive system analysis providing data through standardized metric reports and risk-specific analysis. These activities also include identifying trends, performing field audits, ongoing policy auditing, and completing recommendations for system improvement.
Health, Safety and Environment
The Department also oversees the occupational health and safety program and the internal responsibility system. This includes ensuring that MLPS complies with relevant clinical and occupational health and safety regulations. This includes conducting risk assessments and implementing measures to mitigate risks. Additionally, all accidents or incidents are investigated to determine their causes and prevent future occurrences.
Ministry of Health Certification and Standards
The Department gathers, and stores ambulance call reports, as mandated by the Ontario Ministry of Health and Long-Term Care, overseeing credentialing of paramedic and support staff in line with the Ambulance Act and MLPS policies. Additionally, the Department completes MOH performance reporting, liaises with the Southwest Ontario Regional Base Hospital Program (SWORBHP) to maintain paramedic certification, and reports incidents to the Ministry of Health – Emergency Health Service Field Office, as required under the Ambulance Act.
Ambulance Service Review
The Ambulance Act states that no person shall operate an Ambulance Service unless the person holds a certificate issued by the certifying authority, the MOHLTC, Emergency Health Services Branch. The Act further stipulates that a person shall be issued a certificate by the certifying authority only if the person has successfully completed the certification process prescribed by the Regulations.
The purpose of the Service Review is to ensure Ambulance Services are operated in a manner consistent with the Land Ambulance Certification Standards and in compliance with the legislation. Services are required to complete the prescribed Ambulance Service Review certification process once every three years to maintain their certification to operate the Service.
Contact Information
To contact the Professional Practice, Clinical Excellence and System Oversight department, please email QualityImprovement@mlems.ca
To report a service complaint or concern about the conduct, or competence of Middlesex-London Paramedic Service staff member(s). You must:
- submit the complaint or concern in writing to @email
- be involved in the incident
- identify yourself (cannot be anonymous)
- name
- address
- telephone number
- Location of the ambulance call or incident
- Approximate time of service
- Relevant details of the incident
Once an investigation is complete you will be informed of the completion status of the investigation.
If you are not satisfied
If you are not satisfied with how your issue was handled you may:
- Let the individual handling your issue or complaint know that you are not satisfied and they will review the matter further, or
- Contact the Commander, Professional Practice, Clinical Excellence and System Oversight, to discuss the matter at (519) 679-5466 x1104 during normal business hours, or
- Contact the Emergency Health Services Branch, Ministry of Health and Long Term Care, by phone at 1 (800) 461-6431 (toll-free in Ontario only) or in writing to
5700 Yonge Street, 6th Floor
Toronto, ON M2M 4K5
Attention: Complaint
If we determine that your issue is not within the jurisdiction of Middlesex-London Paramedic Service, your concern will be forwarded to the appropriate authority, whenever possible. You will be notified to whom your issue was redirected.