More patients are being taken to emergency departments by ambulance in Rotorua.
Lakes District Health Board figures show 5114 patients were delivered to its emergency department by road ambulance in 2015 and 133 by air ambulance. The previous year, 5083 patients presented by road ambulance and 121 by air ambulance.
St John assistant director of field operations, Derek Liefting, said demand for St John services was increasing.
In the 2014/15 year, there were 17,020 more 111 emergency calls for an ambulance than the previous year nationwide.
"I'm really proud that, although demand continues to increase, we are responding to patients with life-threatening conditions more quickly than ever before," he said.
St John's "clinical hub" initiative meant people who didn't need to go to hospital were assessed by a registered nurse and not transported unnecessarily but received more appropriate care.
A patient-centred approach to ambulance resources had also been successful, said Mr Liefting.
It could use use historic data to predict where jobs were likely to be on a given day and aim to have ambulances in the right places.
If there was a major incident in one area, St John would dispatch resources to the scene then consider the areas left uncovered and move other resources there, he said.
St John was also focusing more on a "right care and right destination" approach, he said.
Its "spinal cord destination policy" meant patients in areas such as Rotorua would be transported directly to Middlemore Hospital in Auckland for certain spinal injuries.
That resulted in improved outcomes for patients and healthcare savings due to shorter stays in hospital, said Mr Liefting.
Nationwide, St John attended 366,375 emergency incidents last financial year, according to its annual report, up more than 1000 on the previous year.
St John also attended 78,770 other incidents, most of which were inter-hospital transfers.
New Zealanders supported St John's work with $31.7 million in donations last financial year, according to the report.
Mr Liefting said St John relied on the generosity of New Zealand communities for donations that supported frontline work and community services. Volunteers were also important in rural or remote areas and St John was always looking for volunteers, he said.