An influx of synthetic cannabis-related callouts in September contributed to a 33 per cent year-on-year increase for Lakes Territory St John Ambulance staff.

The annual increase of callouts was 9.8 per cent (about 1000 more jobs), above the 8 per cent national average.

Lakes Territory manager Steve Lynch said the incidents were cyclic in nature due to sporting seasons and tourist numbers during summer.

"Right now we are seeing a slight drop off as summer approaches and winter sports have wound up," Lynch said. "Come December/January there will be another increase as summer sport is in full swing and there is an increase in population because of the holidays."

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Lynch said the extra callouts did put extra pressure on staff, however the Lakes Territory had been lucky to be one of the first areas to have double-crewed ambulances rolled out.

"Obviously it's a much better system when there are two people crewing an ambulance."

Throughout the Central East region, including Rotorua, Taupo, Turangi, Mt Maunganui, Tauranga, Opotiki, Whakatane, Gisborne and Ruatoria, there were 43,939 incidents attended in the calendar year to date, up from 43,139 in the same period the year before.

Nationwide New Zealanders called 111 for an ambulance more than 500,000 times a year, more than 10,000 than the year before.

St John assistant director of operations, Clinical Control Services, Adrian Haigh, said staff in all centres worked collaboratively together and operated a virtual system whereby 111 calls can be answered in any of the country's three call centres.

"Calls that originate in St John jurisdiction areas go first to Auckland or Christchurch and will be rerouted to Wellington if these centres can't answer within a set time. The same applies in reverse."