People have been urged to think before dialling 999 - after it was revealed the North East Ambulance Service (NEAS) answered almost 7,000 calls on Boxing Day.
The service has reported an increase in pressure, with calls to 999 and 111 yesterday having increased by a third compared to last year.
NEAS answered more than 6,800 calls, compared to 5,100 on Boxing Day 2016.
Meanwhile, over the four days from Saturday, December 23 to Boxing Day, there was a 49% increase in calls, from 16,400 last year to more than 24,500.
Douglas McDougall, strategic head of operations at NEAS, said: “We are experiencing severe pressures in responding to emergency calls because of a significant increase in calls.
“Please help us reach those patients who need us most by using 999 wisely.
"Your call could potentially delay our response to someone else who might need us more.
“Please think before you pick up the phone; do you really need to go to hospital and if you do, is there anyone else who can take you?
"Turning up to hospital in an ambulance does not mean you will be seen any quicker.”
NEAS say that one of the reasons for the increase in calls to 111 since Friday has been from patients wanting a repeat prescription over the weekend.
Mr McDougall added: “I want to add my thanks to all the staff in the ambulance service who have been working over the festive season.
"It’s been incredibly demanding for them and they have worked tirelessly – many beyond their break or finish periods – to care for their patients.”
People have been reminded that they should only dial 999 for medical emergencies, including chest pain, breathing difficulties, unconsciousness, severe loss of blood, severe burns, choking, fitting, drowning and severe allergic reactions.
If it's not an emergency, the public are asked to seek help from their GP, pharmacist or local walk-in centre, and those unsure of where to go can call 111.
The operational status of NEAS is under pressure at level three of four, under the national resource escalation action plan.
The framework is designed to maintain an effective and safe operational and clinical response for patients.
While it attempts to operate a normal service, NEAS says that its response standards to potentially life-threatening calls has deteriorated, as a result of additional pressures across the wider NHS network.
For example, delays in ambulance turnaround times at hospitals saw four-and-a-half days’ of ambulance capacity lost on Boxing Day alone, according to NEAS.
More information about the services available, as well as links to health advice, is also available at urgentoremergency.co.uk