St John records busiest day on record, ‘no immediate evidence' EDs affected

There was "no immediate evidence" that emergency departments have been impacted, Te Whatu Ora says, after St John received more than 2500 calls on Saturday – its busiest single day on record.

Hato Hone St John today activated its major incident response after receiving 2562 calls through 111 on Saturday – a 34% increase from its usual 1900 calls.

St John director of ambulance operations Doug Gallagher said Saturday was "not normally our busiest day, so this level of demand is highly unusual".

It was the third time the daily record had been broken this week, Gallagher said, with 2404 calls received on Monday and 2454 calls on Thursday.

"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 ambulance service received 15,268 calls this week as of 2pm on Sunday.

It was on track to exceed the previous weekly record of 15,289 calls, set last week between July 27 and August 2. That week had broken the previous record of 14,984 calls, set between August 25 and 31 last year.

Demand was expected to remain high on Monday – traditionally the busiest day for ambulance workload.

The major incident arrangements would be reviewed regularly against current demand, ambulance availability and wider health system conditions.

Outside St John’s ambulance hub in Auckland’s Mt Wellington this afternoon, Gallagher told reporters the major incident response was declared to "get ahead of the game" as winter ills set in.

"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," he said.

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

It had been a "relatively mild winter" when St John began seeing a "sudden spike in demand" for their services roughly a week to a week and a half ago amid the cold snap.

Gallagher reassured members of the public that the response times to St John's sickest patients remained "within safe limits".

However, he acknowledged some patients without "time-critical conditions" had experienced hours-long wait times.

"Patients with conditions such as broken bones, patients who have fallen and not in life-threatening pain have sometimes had to wait for quite a long period of time," he said.

"During that time, though, those incidents are being managed and are being monitored."

Ambulance personnel may also assess and treat suitable patients at home, refer them to another provider or help them access care somewhere other than an emergency department, he said.

"Our message to the public is clear – only call 111 if you have a genuine health emergency such as chest pain, trouble breathing or you’re not able to wake a person up. [It’s] really important that the public have confidence in us and continue to call 111."

People were also urged to be patient and respectful towards St John staff.

"They're working under these very exceptional circumstances."

Hato Hone St John had declared a major incident and activated its Emergency Operations Centre to strengthen national coordination and ensure all reasonable steps were being taken to maintain a safe response, Gallagher said.

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

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

Activating the major incident response gives St John a clear national structure for coordinating decisions and resources at pace, he said. The Emergency Operations Centre would bring operational, clinical and support teams together to maintain a detailed national view of demand and ambulance availability, monitor risk and take further action as conditions change.

It also supported closer coordination with Health New Zealand and hospital partners.

Gallagher said St John’s first priority was patient safety.

"Ambulance staff continue to prioritise people with life-threatening and time-critical conditions," he said.

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

Hato Hone St John encouraged people with non-emergency health concerns to seek advice early and check which services were available locally.

Options may include a GP, Health New Zealand’s online GP care service, a pharmacist, an urgent-care provider or Healthline on 0800 611 116.

People were advised to check availability, opening hours and waiting times before travelling and should not delay calling 111 in an emergency.

St John was working closely with Health NZ and other health sector partners to manage demand, maintain patient safety and support patient flow.

In a statement, a Te Whatu Ora Health NZ spokesperson said there was "no immediate evidence" that emergency departments or ward capacity had been impacted by the higher than usual ambulance demand.

"Our Emergency Departments are also busy as usual at this time of year, but there is no immediate evidence that ED or ward capacity has been impacted by higher than usual ambulance demand, including at Middlemore."

Health NZ director community and primary care funding Martin Hefford told 1News in a statement the ambulance system was "responding appropriately to the increased recent demand they are seeing".

"Health NZ supports Hato Hone St John’s decision to activate the major incident response to ensure they have the structures in place to manage current high demand. Activating the major incident response gives Hato Hone St John a clear national structure for coordinating decisions and resources at pace.

"It also supports closer coordination with Health New Zealand."

Hefford said ED numbers across Health NZ hospitals had "increased slightly" to 0.4% from July compared to the same time last year.

"While there are districts experiencing higher increases in demand the overall picture remains well within our planning expectations and is not unexpected."

The recent cold weather and winter illnesses were likely drivers behind St John's higher call volume.

"Emergency Departments are busy, as is usual at this time of year. We have winter plans in place to respond to these demands," Hefford said.

"Health NZ are working closely with St John to support patient flow through hospitals and other services and to ensure people receive the right care, at the right time.

"Anyone requiring emergency care should continue to call 111 or come to ED as usual."

People were encouraged to "take simple steps to stay well" this winter, including staying up to date with immunisations and seeking medical advice early if they become unwell.