One in 10 patients are waiting nearly 11 hours in NSW hospital emergency departments as unprecedented numbers of patients turn up in urgent need of treatment.
A record number of triage level one and two presentations - people with the most pressing clinical needs - were logged in the state's hospitals in the final quarter of 2023, according to the Bureau of Health Information.
Almost 60 per cent of patients spent less than four hours in emergency departments, a slight improvement on the preceding quarter and the same period in 2022.
But one in 10 patients spent longer than 10 hours and 30 minutes in emergency, well above pre-pandemic levels.
Australian Medical Association NSW president Michael Bonning said the figures should be a wake-up call for the state government.
He called for the next NSW budget to include a substantial increase in funding for the health system.
"Our drastically overburdened health workforce cannot continue to perform under the current conditions," he said on Wednesday.
"Without an urgent injection of health dollars, it is patients who will suffer as they wait longer in the emergency department and are forced to endure longer stays in hospital."
Health Minister Ryan Park acknowledged the system was under pressure with record numbers of people in severe category one or two - those with conditions classified as immediately life-threatening and that of an emergency - presenting to emergency departments.
"There are concerns that people are waiting a longer period of time before they're going to get that regular checkup with their GP ... and by the time they come to our emergency departments they're very, very severely unwell," he told reporters.
Mr Park acknowledged a moderate decline in category four cases, with category five remaining stable.
"We're starting to see people who don't need to be going to emergency departments using alternative pathways for care," he said.
"We cannot have a situation where emergency departments are used as medical centres."
The health minister said health care couldn't be delivered under just one level of government and said NSW had to lean heavily into areas traditionally funded by the commonwealth.
"The reality is I've had to lean into that and invest about $124 million to roll out about 25 Urgent Care Services because if I sit idle, our emergency departments will not cope," he said.
Of the 195,269 people treated and admitted in the last recorded quarter, 25.4 per cent spent less than four hours in an emergency department, according to the latest figures.
There was also a continued improvement in the time patients waited to start treatment, despite the record-high presentations.
Two in three patients started their treatment on time and almost 80 per cent of patients who arrived by ambulance had their care transferred to emergency department staff within 30 minutes.
An emergency department task force has been set up to cut wait times and improve care, while more than 1000 temporary nursing roles have been made permanent.
An extra 1200 nurses and midwives are also being recruited to lift staffing levels in the state's hospitals.
