St John continues to be there for New Zealanders, and in 2020 responded to nearly half a million medical emergencies with ambulance communications centres answering nearly 97% of the more than 550,000 emergency 111 calls within 15 seconds.
COVID-19 changed 2020 for everyone, including the emergency ambulance service, and while reduced movement of New Zealanders during lockdown saw a decrease in trauma-related accidents, the ambulance service was just as busy. Due to the extra precautions necessary to keep both ambulance officers and patients safe, the duration of call outs increased.
St John ambulance officers are dealing with more and more patients with complex health issues and this, in addition to increasing traffic congestion and lower speed limits, means the total length of time each call out takes continues to get longer as we move into 2021.
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. As we moved down alert levels, the pre-COVID trend of increasing call numbers returned and in December 2020 St John had its busiest December yet, responding to over 1,100 incidents per day. This escalation continues into 2021.
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 and this, in addition to the general social, financial and mental strain associated with COVID-19, led to an increase in mental health call outs.
Dan Ohs, St John Ambulance Operations Deputy Chief Executive, says St John works hard to improve equity in health service for all New Zealanders, and 2020 saw an improvement in response times to Maori in rural and remote areas.
“We are also supporting Maori to improve their health outcomes and last year we referred three times more Maori patients to stop smoking pathways.”
2021 will see the completion of St John’s four-year project to double crew all transporting ambulances, and in 2020 nearly 99% of transporting ambulances were fully crewed. 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. Double crewing improves safety for ambulance officers and means all our patients can receive expert clinical care while being transported to hospital.
Ohs says that while St John always aims to get to people with life threatening conditions as soon as possible, meeting response time targets remains challenging and St John is always looking at new and innovative ways to respond to these challenges faced by the wider health system.
“We continue to work hard to take the pressure off hospital emergency departments, and in 2020 introduced a specialised paramedic role to respond to people in their home, provide treatment, and refer patients to more appropriate health care.”
“In addition, skilled clinicians can provide advice to people over the phone when an ambulance may not be the most appropriate response.”
Thanks to these initiatives, St John was able to provide alternative care to nearly 20% of patients, avoiding unnecessary hospital presentations.
St John will continue to seek out ways to address the continuing challenges and improve health outcomes for all New Zealanders in accordance with the recommendations of the Health and Disability System Review (2020).
Breakdown of 2020 incidents by chief complaint
(based on calls received, not number of patients and therefore actual patient numbers are higher).
|
REASON FOR CALL
|
2019
|
% of total
|
2020
|
% of total
|
|
Referral from a GP
|
82,661
|
18.0%
|
77,144
|
17.0%
|
|
Falls and traumatic back injury
|
42,383
|
9.2%
|
41,979
|
9.2%
|
|
Chest pain
|
38,998
|
8.5%
|
39,366
|
8.7%
|
|
Breathing problem
|
41,034
|
8.9%
|
36,079
|
7.9%
|
|
Sick person (not specified)
|
35,615
|
7.8%
|
33,070
|
7.3%
|
|
Unconscious/passing out
|
35,251
|
7.7%
|
32,971
|
7.3%
|
|
Abdominal pain
|
17,888
|
3.9%
|
20,271
|
4.5%
|
|
Traumatic injuries
|
17,213
|
3.7%
|
18.181
|
4.0%
|
|
Unknown problem – 3rd party collapse
|
18,833
|
4.1%
|
16,897
|
3.7%
|
|
Traffic crash
|
18,011
|
3.9%
|
16,108
|
3.5%
|
|
Haemorrhage/laceration
|
14,167
|
3.1%
|
14,375
|
3.2%
|
|
Convulsion/fitting
|
14,521
|
3.2%
|
13,478
|
3.0%
|
|
Stroke (CVA)
|
10,599
|
2.3%
|
12,206
|
2.7%
|
|
Overdose/ingestion/poisoning
|
8.765
|
1.9%
|
9,283
|
2.0%
|
|
Assault/rape
|
8,886
|
1.9%
|
9,163
|
2.0%
|
|
Heart problems
|
7,475
|
1.6%
|
8,562
|
1.9%
|
|
Psychiatric/suicide attempt
|
8,229
|
1.8%
|
8,443
|
1.9%
|
|
Unknown
|
6,719
|
1.5%
|
6,244
|
1.4%
|
|
Backpain – non traumatic
|
5,932
|
1.3%
|
5,843
|
1.9%
|
|
Cardiac/respiratory arrest
|
5,248
|
1.1%
|
4,791
|
1.1%
|
|
Headache
|
3,938
|
1.3%
|
5,843
|
1.3%
|
|
Allergies/rash
|
3,426
|
0.7%
|
3,835
|
0.8%
|
|
Diabetic problem
|
3,858
|
0.8%
|
3,664
|
0.8%
|
|
Extended care paramedic
|
|
|
3,069
|
0.7%
|
|
Pregnancy/childbirth/miscarriage
|
2,847
|
0.6%
|
2,889
|
0.6%
|
|
Choking
|
1,784
|
0.4%
|
1,996
|
0.4%
|
|
Burns/explosion
|
1,070
|
0.2%
|
1,169
|
0.3%
|
|
Stab/gunshot wound
|
891
|
0.2%
|
997
|
0.2%
|
|
Animal bites/attacks
|
759
|
0.2%
|
821
|
0.2%
|
|
Carbon monoxide/inhalation/hazmat
|
643
|
0.1%
|
606
|
0.1%
|
|
Eye problems/injuries
|
538
|
0.1%
|
523
|
0.1%
|
|
Drowning/diving accident
|
412
|
0.1%
|
356
|
0.1%
|
|
Industrial/machinery accident
|
205
|
0.0%
|
194
|
0.0%
|
|
Heat/cold exposure
|
210
|
0.0%
|
194
|
0.0%
|
|
Electrocution
|
94
|
0.0%
|
114
|
0.0%
|