Ambulance workload reaches new highs

Emergency ambulance demand continued to climb in 2025, reaching the highest level on record, with Hato Hone St John responding to more than half a million incidents.  

New national ambulance data shows there were 706,194 emergency 111 calls for an ambulance last year, an increase of nearly 30 percent over five years, while the emergency ambulance service logged 551,399 incidents, up 17 percent since 2020. 

“Demand on our emergency ambulance service has never been higher,” says Dan Ohs, Hato Hone St John Deputy Chief Executive – Ambulance Operations. 

“Despite significant changes to how we operate, the volume and complexity of cases continue to grow year on year.” 

The pressure was most acute over winter, with August recording the highest monthly call volume ever, at 63,888 emergency calls. Mr Ohs says this reflects wider system pressures, an ageing population and rising acuity. 

Leading reasons for calling an ambulance remained consistent, including referrals from health practitioners, breathing problems, chest pain, falls and loss of consciousness. Several largely preventable incident types increased sharply, with drowning and diving incidents up 32 percent to 582, animal bites and attacks rising almost 19 percent to 1,212, and falls increasing eight percent to 52,559 incidents. 

Falls are now one of the single largest drivers of ambulance demand and disproportionately affect older New Zealanders. Nearly half of all ambulance responses involved people aged 65 and over, underscoring the growing impact of falls-related harm on both emergency services and hospitals. 

“Falls are not just accidents, they are a major and growing health issue,” says Mr Ohs. 

“Many falls are preventable, and when they do occur, early intervention can reduce long-term injury, loss of independence and pressure on hospitals.” 

Cardiac and respiratory arrest incidents also continued to rise, increasing five percent to 5,750 in 2025. Survival outcomes are highly time-critical, making rapid response, bystander CPR and access to defibrillation essential. 

“Improving cardiac arrest survival is one of our most urgent priorities,” says Mr Ohs. 

“Our data reinforces the importance of early intervention, community CPR training, public access defibrillators, and seamless coordination from first call to hospital care.” 

Higher-acuity cases continued to dominate ambulance demand, with patients assessed as having serious but not immediately life-threatening conditions accounting for 43 percent of incidents, and life-threatening cases making up a further 35 percent. About 10 percent involved patients whose conditions did not appear serious, and at the highest rate last quarter, 7.4 percent of incidents were safely resolved through clinical advice over the phone.   

“Our clinicians are increasingly helping people avoid unnecessary trips to emergency departments,” says Mr Ohs.  

“Enabling patients to be safely cared for at home or in their community keeps ambulances and hospital resources available for those who need them most.” 

Auckland recorded the highest number of ambulance responses, followed by Canterbury, Waikato and Bay of Plenty, reflecting population growth and urban density. 

Hato Hone St John also saw a rise in the number of Māori patients which had increased by 14 percent and accounted for 21 percent of all ambulance responses. Given Māori make up around 17 percent of the national population, the data indicates Māori are using ambulance services at a higher rate per capita.  

“This is a good thing from our perspective, we know tāngata Māori can feel hesitant to access healthcare, and it’s great to see they are accessing our services when they need them.” 

In response, Hato Hone St John is strengthening engagement with iwi Māori, improving culturally appropriate models of care, and using data to better target services where inequities are greatest. 

“With demand continuing to rise, prevention, equity and system efficiency are no longer optional, they are essential,” says Mr Ohs. 

These trends underpin Hato Hone St John’s new ten-year Ambulance Service Strategy, which together focus on prevention alongside emergency response, improving outcomes for high-risk groups, and ensuring patients receive the right care, in the right place, at the right time. 

Breakdown of emergency ambulance incidents by chief complaint (2024–2025) 

The data below reflects emergency ambulance service incidents, not individual patients. Total patient numbers are therefore higher.