Ambulance response times across central Victoria have not met target since reporting began six years ago.
And in the last quarter, one municipality recorded the second-slowest response time in the state.
Ambulance Victoria aims to respond to 85 per cent of Code 1 events - patients in need of urgent care - within 15 minutes statewide, and 90 per cent within this time in centres with populations above 7500.
But the agency's performance data shows no municipality in central Victoria met these targets last quarter, and has not done so since reporting began in 2013-14 - nor has the state overall.
Ambulance Victoria's Loddon Mallee regional director Michael Georgiou acknowledged the target had never been met, but said there had been improvements.
Since 2014, he said, the proportion of Code 1 incidents attended to within 15 minutes had improved since 2014 by 12.7 per cent in Greater Bendigo, 7.9 per cent in Campaspe, 9 per cent in Buloke, 7.2 per cent in Central Goldfields, 3.4 per cent in Loddon, 12 per cent in Macedon Ranges, and 3.8 per cent in Mount Alexander.
But Mr Georgiou said that while there was some work to do, the workload for Ambulance Victoria had grown at a faster rate than the population, due to heart and respiratory conditions.
Across Victoria the number of Code 1 cases rose by 12 per cent on the same time last year, and in Bendigo they grew by 10.8 per cent.
Meanwhile, Mr Georgiou said, the decrease in responses within 15 minutes was just 0.5 per cent.
Of all the local government areas last quarter, paramedics in the City of Greater Bendigo attended the greatest proportion of Code 1 incidents within 15 minutes, at 79.8 per cent.
The highest proportion Bendigo has achieved since 2013 is 81.8 per cent, earlier this year.
However, the average response time for Code 1 incidents fell from 11 minutes 57 seconds in the previous quarter to 11 minutes 51 seconds.
The data suggests residents of more rural and remote areas experience greater waiting times.
In Loddon Shire only 34.6 per cent of such incidents saw a response to Code 1 incidents within 15 minutes last quarter.
There the average response time was 20 minutes 46 seconds, down from 21 minutes 49 seconds in the previous quarter.
Buloke's average response time was just one second shy of 23 minutes - the second-longest behind 23 minutes and 46 seconds in Towong, in north-east Victoria.
In Central Goldfields Shire, the percentage of incidents attended by paramedics within 15 minutes fell from 68.9 per cent in the previous quarter to 65 percent.
The average response time grew from 13 minutes 41 seconds to 14 minutes 51 seconds.
Mr Georgiou said Ambulance Victoria was addressing the longer wait times with such initiatives as the paramedic community support co-ordinators, four of whom began working in the Loddon Mallee last year.
He said their role focused on improving health outcomes and preventing the need for acute care by working with other services and the most vulnerable in the community.
Ambulance Victoria is also looking at introducing between two and four Heart Safe communities in the region.
Mr Georgiou said this initiative would include CPR training for community members and the provision of defibrillators.
The app GoodSam - which alerts CPR-trained individuals when their assistance was needed nearby - was another strategy, he said.
Last quarter Macedon Ranges Shire also saw the average wait time increase.
But in Mount Alexander Shire, while the proportion of incidents attended on time fell between quarters, so too did the average wait time.
Statewide, 83.3 per cent of Code 1 incidents were responded to within 15 minutes, the lowest proportion since at least the same time last year.
Meanwhile, the average response time to Code 1 incidents was 11 minutes 19 seconds.