St John Ambulance declared a “major incident” last night after it faced delays transferring patients to Waikato Hospital, forcing it to set up a makeshift patient-offloading area.

St John’s general manager of ambulance operations Debra Larson said any delay was not ideal for patients: “The safest outcome is for all patients to be transferred into the care of hospital staff as soon as possible”.

She said the major incident was declared about 10.30pm so special arrangements could be made to enable the emergency ambulance service to “continue the delivery of all services”.

Te Whatu Ora Waikato interim lead of hospital and specialist services Michelle Sutherland said the delays were caused by “very high demand” on Monday.

The hospital had a 103 per cent occupancy rate during the day, Sutherland said, and 143 people had turned up tot the emergency department at 6pm alone.

“[This] is one of the busiest periods we have experienced,” she said, and community urgent care providers also faced high demand yesterday.

Clinical teams worked with St John Ambulance and its local and national managers “to improve patient flow”, she said.

“We were able to deploy additional senior and junior doctors to assist. Overnight we deployed additional nurses to continue supporting the ED.

 “This meant that ambulances could urgently offload any transported patients into the ED if they had two or more priority community response calls in the central Hamilton area however, this capability was not required.”

Sutherland said Te Whatu Ora Waikato was trying to reduce the high levels of demand on EDs.

She said an ambulance waiting area was set up so paramedics could safely offload patients to be managed by a nurse and could take the “highest priority patients” to the emergency department faster.

“Every effort was made to prioritise transferring the patients in most urgent need into ED while ensuring those waiting in ambulances continued to receive appropriate care and observation,” Larson said.

“As a result [of the major incident declaration], we are confident there was no significant impact on our overall ability to meet demand in the community last night.”

She said St John Ambulance worked with hospital staff to best transfer patients.

Te Whatu Ora Waikato, responsible for Waikato Hospital, has been approached for comment.

Waikato Hospital staff issued the hospital with a provisional improvement notice this month, Newshub reported, claiming the ED was “critically unsafe”.