The sick and injured are being forced to wait for help in the back of an ambulance at several emergency departments at the country's biggest hospitals as demand skyrockets.
The waits are affecting patients who require medical assistance upon arrival at Auckland City, Middlemore and Christchurch hospitals.
The Herald understands some patients had to wait up to two hours, while St John has confirmed the "average" wait time was between 30 and 45 minutes on Monday night.
The pressure on emergency departments had been felt all year and had St John concerned that it was only likely to increase as winter approaches.
"St John Ambulance was in extremely high demand all day in Auckland and Christchurch on Monday, with demand surging for staff on the night shift, 6pm–6am," St John general manager ambulance operations Stu Cockburn said.
"St John personnel work closely with hospital staff to limit the extent of these surges on demand during peak periods and to optimise the process of transferring the care of patients."
Last year St John had introduced new roles for Extended Care Paramedics; experienced staff who could support patients with urgent, unscheduled primary healthcare needs in their own home; often saving the need for an ambulance or hospital admission.
However, the patient would be sent to hospital if deemed serious enough, or referred to their GP.
During the Covid-19 last year, St John trained 20 ECPs to work in Auckland, Christchurch, Horowhenua and South Taranaki.
Cockburn said the pressure on not only their own staff and resources was usually at its peak in winter.
That was now happening on a more regular basis, particularly Mondays.
"This is extremely concerning in terms of what may yet occur this winter.
"We are working with our District Health Board and health colleagues to develop plans to better manage these periods of excessive demand on a system that is currently under pressure."
St John had seen a 3 per cent increase in patients year-on-year and "busier than ever" and that wasn't expected to ease off any time soon.
Counties Manukau DHB has been feeling the pressure for some time and over Easter trialled free urgent care at 16 Auckland GP clinics to help ease the pressure on Middlemore.
While a spokesperson confirmed that was a temporary measure it would be "reviewed".
"Middlemore Hospital has been working to manage the increased demand, which has been challenging with the high number of presentations."
The situation had eased by today
compared to earlier in the week.
"Staff were deployed to support the increased demand, and we implemented our escalation plans and worked with the region to manage this."