Watch Jacquie Bird's report.
South Western Ambulance Service says it's "desperate" to avoid the critical incident it faced last winter.
With winter pressures looming, the service says extra paramedics and call handlers are being trained to stop it from becoming overwhelmed.
It comes as NHS England figures show ambulance response times in the region for some of the most serious conditions are almost three times slower than the national average.
Staff often have to treat patients within ambulances because the wards are too busy. This also means that the vehicle isn’t available for emergency call-outs.
In October, two of the region's hospital trusts were already operating at the highest level of alert, warning patients that emergency departments were extremely busy.
Last month, two of Cornwall's coroners sent a prevention of future deaths report to the Health Secretary calling for action.
It highlighted four cases where ambulance delays of up to 13 hours were a factor in patient deaths.
Wayne Darch, the deputy chief executive of South Western Ambulance Service offered his "personal condolences" to the families of the four patients in the report.
He also thanked the coroner for "raising the challenges and the issues we're facing across the health system in the south west."
Mr Darch said: "As winter approaches, temperatures drop and we see an increase in respiratory illness in particular. We see that translated into higher demand for the ambulance service.
He added: "We've reflected on last year and we've learnt a number of lessons, and we've responded to those lessons.
"This year, we're putting additional ambulances on the road- so we've increased our resourcing from 37,000 hours in 2020 to 52,000 hours as we go into this winter.
"We've also increased the number of emergency call handlers to answer the 999 calls."
Mr Darch also explained they have now employed an ambulance service leader working with crews to ensure patients are handed over more quickly.