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Emergency department presentations have hit a record high in Hunter New England, heaping more pressure on the crippled public hospital system.
The district recorded 113,365 presentations in the January to March quarter, the highest since modern records began in 2010.
The figure represented a 6 per cent rise on the same quarter last year, the latest Bureau of Health Information [BHI] data shows.
AMA NSW president Kathryn Austin warned that the BHI's statewide data showed there was "a catastrophe waiting to happen" in the public health system.
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Dr Austin said the system was "straining under the weight of increased demand and complexity at a time when budgets are being slashed".
She said the figures showed the record demand was "not matched by record investment".
"Patients can expect worsening figures in subsequent quarters and that means increasingly poor interactions with a desperately underfunded health service.
"The 2023 NSW budget allocated only a 0.87 per cent increase to the state's health system, which after health inflation is an effective cut."
She said doctors and other health workers were "being pushed to the limit and the system is largely being held together by the goodwill of the health workforce".
NSW Nurses and Midwives' Association general secretary Shaye Candish said staff were "dealing with complex clinical care and increased workloads as patient numbers surged".
"These figures show EDs across the state are being pushed well beyond their limits and this is having a severe impact on the staff and patients," Ms Candish said.
At a press conference on Tuesday, NSW Health Minister Ryan Park urged people who don't need to be in emergency departments to "please look for those other avenues that we have in place".
Mr Park urged people to call Healthdirect, a state service that diverts people away from emergency departments to GPs, virtual or urgent care services, pharmacies or self care.
He said he was "looking at every single lever I can pull ... to try and improve efficiency through our hospitals".
Emergency presentations at John Hunter Hospital were 21,505 in the quarter, a 1.6 per cent rise on the same period last year.
Presentations at the district's other hospitals were 13,917 at Maitland (up 8.7 per cent), 10,508 at Calvary Mater (up 5.4 per cent), 7521 at Belmont (up 3.4 per cent), 4135 at Cessnock (up 1.2 per cent) and 718 at Kurri (up 2 per cent).
Only 55.4 per cent of patients were discharged from Hunter New England emergency departments within the recommended four hours.
Ms Candish said this figure reflected "the sheer volume of patients presenting to public hospitals, coupled with the issue of bed block" and chronic understaffing.
Ambulance responses in Newcastle also hit a record high of 11,415 in the quarter, a 9.2 per cent rise compared to the same time last year.
The BHI data also showed that 6496 elective surgeries were performed in the Hunter New England district in the quarter, a 6.7 per cent fall compared to the same period last year.
The district hit a high of 8418 surgeries in April-June 2021.
There were 1731 elective surgeries performed in the quarter at John Hunter, down by 2.4 per cent compared to the same period last year.
Surgeries at other hospitals in the district numbered 1054 at Belmont (up 0.6 per cent), 413 at Maitland (down 21.9 per cent), 297 at Calvary Mater (down 6.6 per cent), 171 at Cessnock (down 5 per cent) and 702 at Kurri (down 18.6 per cent).