The contentious issue of bed block at Shoalhaven District Hospital has again been raised, with NSW Ambulance Paramedics concerned at the amount of time they have to wait to transfer patients.
Paramedics claim they often wait up to two hours to transfer patient care to the hospital, simply because there is not enough beds.
One paramedic told the South Coast Register the hospital was already "busier now than what it was last winter".
"We haven't even reached winter yet which is traditionally the busier time," said the paramedic, who wished to remain anonymous.
"We are having a number of ambulances tied up at the hospital waiting for patients to either be offloaded or provided with a bed.
"We have cars waiting well over an hour, sometimes more than two.
"This has been going on for around a month.
"With paramedics tied up with patients still on our beds and unable to be moved to a bed in ED because there are none, we are effectively unavailable to respond to other cases."
He said it's known similar incidents are also occurring at Wollongong Hospital.
The paramedic said the issue was getting worse.
"It's Wollongong as well, there are just no beds to move people around to."
"There has also been instances at Shoalhaven where adults are being put in the paediatric wards.
"We just seem to be getting a lot more sick people and with GPs charging people for services and the lack of a full-time 24-hour service, people are using the ambulance and hospitals as a GP service.
"It's putting more pressure on us and more pressure on the hospital ED and its staff.
"It is an issue for the hospital staff who are also under the pump. They are feeling our frustration as well and are trying their best but they're not being supported by their management."
ISLHD Acting Executive Director Clinical Operations Craig Hamer said the district acknowledged the increase in activity that Shoalhaven Hospital is experiencing and thanked staff for their hard work in providing high quality care to patients during this busy time.
"ISLHD is preparing for the increase in patient demand that typically coincides with the winter period," he said.
"Along with the increase in demand, the patients coming to the ED are increasingly presenting with more complex conditions that require higher levels of care."
He said during the last week, there were 799 people who came to the Shoalhaven District Hospital Emergency Department, of which 179 arrived by ambulance.
"Around 54 per cent of patients requiring treatment in the ED were in the most urgent categories, and 147 people required admission," he said.
"The NSW Government has invested $434 million for an upgrade of Shoalhaven Hospital which will not only ease the pressure on the ED but enhance clinical care across the hospital network and meet the needs of the growing Shoalhaven population.
"This upgrade will build on the $1.8 million expansion of the ED that has enabled faster treatment of patients with redesigned triage and inquiries areas, and a larger space.
"While there has been a rise in presentation and admission numbers, Shoalhaven Hospital has been performing well."
He said the latest Bureau of Health Information (BHI) statistics which reported on October to December 2018, showed the hospital performed 92.7 per cent of 315 semi-urgent elective surgeries on time, an improvement of 13.5 percentage points compared to the October to December 2017 period.
"Across the district nearly all of the 839 urgent surgeries, or 99.6 per cent, were completed on time, and 90.5 per cent of the 982 semi-urgent surgeries were completed on time - an improvement of 1.9 percentage points compared with 2017,"he said.
But the Australian Government's Australian Institute of Health and Welfare My Hospital website reports shows a different story when it comes to ED treatment times.
In 2017-18, 40,342 patients were treated at the Shoalhaven ED.
Sixty-six per cent of patients were treated within four hours, where the peer group average was 69 per cent.
The time until most patients departed the ED (90 per cent) was 9 hours 20 minutes compared to the median time on two hours 54 minutes or seven hours 50 minutes in the peer group average.
The time spent in ED (patients treated or admitted to same hospital - 90 per cent) was 18 hours two minutes average compared to the peer group average of 13 hours 48 minutes.
Time spent in the ED (patients discharged - 90 per cent) was six hours 24 minutes compared to the peer group average five hours six minutes.