Eleven people have been taken to hospital after a "traffic-related incident" in the Gisborne region on Friday evening.
A major response by St John took place and included three helicopters.
St John said thirteen vehicles were sent to the scene on Wharekopae Road, Pātūtahi at 5.15pm on Friday.
"Five ambulances, two rapid response units, two operations managers, three helicopters, and our major incident support team responded to the scene.
Five people are in a serious condition, three are in a moderate condition and three in a minor condition, St John said.
They were taken to Gisborne Hospital.
Police said the road was closed.
"Motorists are advised to avoid the area and expect delays."
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