Hato Hone St John declares major incident after record calls

Hato Hone St John has activated a major incident response after record demand for its ambulance service, following the busiest single day in its history.

The service received 2,562 calls to 111 for ambulance assistance on Saturday, well above its usual daily total of about 1,900. The surge placed heavy pressure on emergency call handlers and frontline crews.

The peak capped a week of unusually high demand. It was the third time in the same week the daily call record had been broken, after 2,404 calls on Monday and 2,454 on Thursday.

By Sunday afternoon, Hato Hone St John had received 15,268 ambulance calls for the week and was close to surpassing the previous weekly record of 15,289. That mark had been set the week before, after overtaking the earlier record of 14,984 set in late August last year.

Doug Gallagher, Director of Ambulance Operations at Hato Hone St John, said the figures stood out even against other periods of heavy strain on the health system.

"All three days were busier than any recorded during the COVID-19 pandemic or on traditionally high-volume dates such as New Year's Eve. At the peak, emergency call handlers were answering a call every 20 seconds," Gallagher said.

The declaration triggers a national incident structure and the activation of an Emergency Operations Centre. The centre brings together operational, clinical and support teams to track ambulance availability, monitor risks and coordinate decisions across the country.

It also supports closer coordination with Health New Zealand and hospital partners as the service manages pressure across the wider health system. The major incident setting will be reviewed regularly against demand, ambulance availability and broader conditions.

Weekend pressure

Gallagher said the pattern of calls was unusual because Saturdays do not normally bring the heaviest ambulance workload. The expected easing in pressure over the weekend had not occurred, and the service was preparing for further strain because Mondays are typically its busiest day.

"Saturday is not normally our busiest day, so this level of demand is highly unusual," Gallagher said.

"Our emergency ambulance staff are continuing to respond effectively, but the workload is not showing the signs of easing that we would normally expect over a weekend.

"With demand remaining high and Mondays typically bringing the greatest workload, we are preparing for further pressure."

He said activating the response was intended to help the organisation maintain safe care during an exceptional period.

"This is an early and precautionary decision to help us continue providing safe and effective care during an unprecedented period of demand," Gallagher said.

"We want to reassure people that emergency ambulance help remains available, and we are continuing to respond to those who need us."

Patient triage

Patient safety remains the first priority, and staff continue to prioritise life-threatening and time-critical cases. People with less urgent conditions may face longer waits during periods of exceptional demand.

Callers whose condition worsens after first contacting 111 should call again with an update. In some cases, where clinicians judge it safe and appropriate, people who contact emergency services may receive clinical advice over the phone or be directed to another health care service instead of having an ambulance sent.

Ambulance staff may also treat some patients at home, refer them to another provider, or help them obtain care outside an emergency department. Gallagher said those decisions were made on clinical grounds.

"Our first priority is patient safety. Ambulance staff continue to prioritise people with life-threatening and time-critical conditions," Gallagher said.

"People should call 111 immediately when someone is seriously ill or injured or there is an immediate threat to life."

On the use of alternative care pathways during the surge, he said: "These are clinically led decisions based on the individual patient's condition and needs. They are about providing the right care, at the right time and in the right place."

Hato Hone St John urged people with non-emergency health concerns to seek advice early and check what services were available locally, including GPs, pharmacists, urgent care providers and Healthline. The organisation provides emergency ambulance services to about 90% of New Zealand's population across 97% of the country.