Demand for ambulance services in the Bay of Plenty is climbing, particularly for people suffering heart problems, strokes or abdominal pains.
New data from St John shows the number of callouts in the Lakes District related to abdominal pains rose from 405 to 536 while callouts for strokes increased from 252 to 312.
Meanwhile, in the Western Bay of Plenty, St John went to help someone suffering from heart problems 444 times, an increase of 64 on the 380 callouts in 2019.
The top five reasons an ambulance was called across the region were referrals by GPs, falls, breathing problems, chest pain and people unconscious or passing out.
In December 2020, St John responded to 3,222 emergency incidents in the Western Bay of Plenty and Lakes Districts, up 8 per cent on last year.
St John acting district operations manager said it was the busiest December on record.
This was made of up 1936 incidents in the Western Bay of Plenty and 1386 incidents in the Lakes area.
The overall number of callouts decreased in the Western Bay of Plenty by 10 and in the Lakes District by 26. The Covid-19 lockdown may have played a part, St John ambulance operations deputy chief executive Dan Ohs said.
"Despite the slight decrease in the number of ambulance callouts in April, the total number of 111 calls received during 2020 was similar to 2019.
"While the reduced movement of New Zealanders during lockdown saw a decrease in
trauma-related accidents, the ambulance service was just as busy."
Ambulance officers were dealing with an ever-increasing number of patients with complex health issues - this, in addition to increasing traffic congestion and lower speed limits, meant the total time spent on each callout continued to increase.
Once New Zealand moved out of lockdown and people were able to socialise freely
again, alcohol-related incidents increased.
New Zealanders also began to feel the impact of job losses. In addition to the general social, financial and mental strain associated with Covid-19, this led to an increase in mental health call-outs, he said.
St John was working hard to improve equality in health services for all New Zealanders, and 2020 saw an improvement in response times to Māori in rural and remote areas, Ohs said.
"We are also supporting Māori to improve their health outcomes. Last year we referred three times more Māori patients to stop-smoking pathways."
St John is now in its final year of a four-year programme to fully crew all ambulances.
"It is particularly pleasing to see this project come to completion as it provides rural New Zealand with the same crewing levels as urban areas," added Ohs.
"Double crewing improves safety for ambulance officers and means all our patients can
receive expert clinical care while being transported to hospital."
While St John always aimed to get to people with life-threatening conditions as soon as possible, Ohs said meeting response time targets remained challenging and he was always looking at innovative ways to respond.
"We continue to work hard to take the pressure off hospital emergency departments.
In 2020 we introduced a specialised paramedic role to respond to people in their
home, provide treatment and refer patients to more appropriate health care."
Mount Medical general practitioner Tony Farrell was surprised to learn GP referrals were the leading cause for ambulance callouts.
"I don't know why GPs would be the main instigators but maybe people are presenting with their illnesses to GP and they are getting duly referred," he said.
"We'll call an ambulance when we think the patient needs to be transferred to hospital and there is a possibility that they can't drive or they might destabilise on the way."
Situations could range from cardiovascular problems to requiring pain relief, Farrell said.
A Bay of Plenty police spokesman said both St John and the police worked closely together every day, attending a wide range of incidents.
"Our two organisations share a common mission to support and care for our communities.
"There is a strong camaraderie between first responders and our officers often get to know their local St John counterparts well."
He said the police valued the service St John provided and would continue to support them, "as they do us".
A Lakes District Health Board spokeswoman described the ambulance service as an "integral part of the health system".
Bay of Plenty District Health Board acting planning and funding general manager Mike Agnew agreed.
"The Bay of Plenty DHB and PHO (primary health care) have worked with St John on developing and improving models of ambulatory care.
"St John are important partners in the "whole of system" approach to the care provision we aspire to in the Bay of Plenty."