Code red: Ambulances missing targets for time-critical emergencies
Saturday, 2 May 2026
Patients with potentially life-threatening health emergencies are waiting too long for ambulances, with more than one in 10 urban Wellington patients left waiting more than 20 minutes.
An ambulance union says while an ageing population is stretching paramedic services, genuine emergencies are also being delayed by Kiwis increasingly calling 111 for non-urgent problems, in the hope of jumping the queue in an overloaded health system.
Ambulance callouts are given a colour category based on their urgency.
While ambulances nationwide meet time targets for the most urgent “purple” calls ‒ suspected heart attack or stopping breathing ‒ they take too long to reach “red” incidents, which are also time-critical or immediately life-threatening.
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For red emergencies, ambulances should respond to 50% of urban callouts within eight minutes, and 50% of rural callouts within 12 minutes.
In the 12 months to March, ambulances nationwide fell short on both, at 46% for urban patients and 45% for rural.
But Wellington Free Ambulance patients waited much longer, with just 40% of urban red callouts reached in the 8-minute target.
The service also failed to meet the second time target, with 88% of callouts attended within 20 minutes ‒ well short of the 95% goal. In late 2025, as many as one in four Wellington Free red patients (26%) waited more than 20 minutes.
Wellington Free Ambulance failed to explain what was going wrong, or what it was doing to reduce red callout waits.
“We have not been able to achieve these targets for some years, but we are pleased to report that there has been steady progress towards meeting them,” general manager of operations Eric Tibbott said in a statement. (Data shows while performance has improved in recent months, from 2025 lows, it remains similar to a year ago.)
NZ Ambulance Association chairman Mark Quin ‒ a paramedic for 25 years ‒ said the delays were more complicated than just a shortage of staff or ambulances.
In the last 15 years, he’d seen a “generational change” in attitudes, with more Kiwis calling an ambulance for non-emergencies because they didn’t want to wait for a GP appointment, or thought arriving by ambulance would jump the queue at the emergency department.
“We’ve moved from emergency services to almost a primary care responder.”
Combined with a risk-averse phone triage system categorising calls as red that ended up being non-life-threatening, that meant genuine emergencies were delayed by non-urgent jobs, Quin said.
“The ones that really are red jobs are lost amongst these other jobs. It’s not unusual to be going to five red jobs, and only one was truly a red … And sometimes it does have consequences. We’ve had chest pains that, when we’ve actually got to them, they’ve turned into cardiac arrest.”
Hato Hone St John, which covers 90% of Kiwis, agreed an increasing number of patients were calling ambulances for non-life-threatening problems.
Where possible, those problems were dealt with over the phone. St John also acknowledged that some red-coded calls turned out to be less urgent, as it was impossible to tell over the phone if conditions such as chest pain in the elderly were life-threatening.
While it had been unable to achieve red call targets “for some years”, extra resources and system changes had resulted in “steady improvement” over the past three years, St John said.
Health NZ and ACC, which contract ambulance services, said growing and ageing populations and increasing health complexity were increasing demand on ambulance services and emergency departments.
However, ambulance response times had improved significantly since the 2022 contract helped fund an extra 300 frontline and comms centre staff. The four-year contract, which is up for renewal, includes a requirement for action plans where services fail to meet the red 95% urban and rural target response times.
Initiatives such as telehealth and giving paramedics direct access to doctors were helping reduce the number of non-emergency callouts ambulances were attending, Health NZ said.
Australasian College for Emergency Medicine New Zealand chair, Michael Connelly, said patients seeking emergency care for non-life-threatening conditions often resulted from difficulty getting care in the community, including cost and long waits to see a GP.
A “whole-of-system” response, including better access to community services and mental health support, was needed to fix the problem, Connelly said.
“We are seeing more healthcare alternatives becoming available for patients with non-life-threatening conditions, including urgent care clinics, after-hours services, and telehealth. We encourage people to explore these options when they are not experiencing a potentially life-threatening emergency.”