The South Coast Register reported earlier this week, the hospital was again in bed block last Sunday (November 3), with up to 25 patients in the emergency department waiting room and seven ambulances and staff trying to offload patients.

Shoalhaven Hospital general manager Craig Hamer said the Emergency Department experienced high presentations on the weekend.

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"Staff worked closely with NSW Ambulance to ensure patients received the care they needed as quickly as possible," he said.

"Emergency departments do occasionally have spikes in demand and we have systems in place to manage the increase in presentations."

He said those systems include the use of the rapid assessment area of the emergency department, which enables a more timely transfer from ambulance to hospital care.

That unit has five beds, including beds in the plaster and procedures rooms, as well as three treatment chairs.

"Staff are allocated to this unit according to the demand and this unit was in use on the weekend to assist with the increased volume of patients," Mr Hamer said.

However, there was no mention of possible changes to staffing procedures or possible closure of the unit after 10.30pm.

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The overcensus unit, a 24-hour a day ward that caters for lower acuity patients who are stable and are waiting to move into the wards or to go home, was also closed over the weekend.

"The overcensus unit is attached to the ED and is used in times of peak demand, such as during winter," Mr Hamer said.

"The unit has been undergoing planned maintenance that will allow more patients to be treated more quickly.

"The maintenance was not completed before the weekend, so additional surgical beds were opened to help meet the higher demand.

"The work has now been completed."

Mr Hamer said ambulances parked in the ambulance bay "does not mean they are delayed".

"In the most recent Bureau of Health Information Healthcare Quarterly Report, April to June 2019, ambulance patients were offloaded into the emergency department at Shoalhaven Hospital on average within 14 minutes," he said.

But that report also revealed Shoalhaven's 14 minutes, was still two minutes longer than the state average.

The BHI report also showed Shoalhaven ED patients have some of the worst wait times for treatment for imminently life-threatening conditions.

The hospital also had the second lowest per cent of patients who started treatments within clinically recommended time frames for triage categories 2 and 3.

With only 37 per cent and 45 per cent of patients, respectively, being treated within the recommended time compared to the state average in the mid 60 per cent range.

For 10 per cent of patients with the longest times in triage category 2, those are patients who need to have treatment within 10 minutes - having an "imminently life-threatening condition", had to wait 52 minutes or more. This was the second highest waiting time in NSW.

For average time spent in the ED, Shoalhaven Hospital had the 6th highest wait times in the state. With patients spending an average of three hours and 34 minutes in the ED compared to the state average of two hours and 53 minutes. Over 42 per cent of patients spend more than four hours in the ED.

"The hospital is always looking to improve its patient flow and improve the experience and care delivered to its patients," Mr Hamer said.

He said to help meet the increasing demand the NSW Government was investing $434 million for the upgrade of Shoalhaven Hospital, which would not only ease the pressure on the emergency department but enhance clinical care across the hospital network.

"While emergency departments can and do treat everyone, the most seriously unwell patients will always been seen first," Mr Hamer said.

"To reduce unnecessary burdens on busy emergency departments, people are reminded that where their symptoms are not serious or life-threatening, they should see their local GP or medical centre."