Blocked access and overcrowding has left NSW hospital emergency departments under "incredible pressure", with some patients waiting up to 36 hours to be admitted, a parliamentary inquiry has been told.
Pressures on hospital EDs "have been on an increasing trajectory for decades" but are now a "permanent state of being", Australasian College for Emergency Medicine president Clare Skinner told the upper house inquiry on Wednesday.
Emergency medicine experts are being quizzed at the probe - called by Labor earlier this year - about bottlenecks at public hospitals as they remain under pandemic stress.
Dr Skinner said there was a crisis in the system, describing COVID-19 as "the straw that broke the camel's back".
Some patients were forced to wait up to 36 hours after presenting to emergency departments to secure a hospital bed, she said.
A patient's chance of death lifted 10 per cent if they waited more than eight hours in an ED, Dr Skinner told the inquiry.
Asked by Greens MP Cate Faehrman if she thought the government recognised the problems, Dr Skinner said: "I do think they are aware that the system is under incredible pressure".
"I can honestly tell you that the kettle feels dry at the moment," she said.
Ms Faehrman also asked about government claims that so-called ambulance ramping - where ambulances get stuck at hospitals unable to offload their patients - was rare.
"It's not rare, it's common," Dr Skinner said.
ED access block was not only harming patient outcomes, but was also affecting healthcare workers, especially senior nurses, she said.
"Access block is the biggest cause of stress, poor morale and burnout in their work," she said, noting that healthcare staff had "had enough".
Scott Beaton, vice-president of the Australian Paramedics Association, said ambulance ramping was worse than a previous low point in the early 2000s.
"I think that it's probably at its worst at the moment, yes," he said.
"It's certainly back with a vengeance across the whole of NSW."
Australian Paramedics Association president Chris Kastelan said the problem had spread from metro to regional parts of the state, with paramedics having to keep patients on stretchers at EDs for "many hours".
He called it a "dire diagnosis" for hospitals and said stories of paramedics doing CPR in hallways and patients short of breath waiting 30 minutes for care then going into cardiac arrest and dying were "significant concerns".
John Bruning, CEO of the Australasian College of Paramedicine, union officials and ED doctors are also set to testify about the crisis.
The Labor opposition announced the inquiry in July, saying it was required to take a comprehensive view of the issues facing the state's hospitals.
It comes after the latest Bureau of Health Information quarterly report revealed patients waited longer in EDs and faced record waiting times for ambulances from January to March.
Two senior specialist emergency doctors set to appear at the inquiry have previously said western Sydney emergency departments are under constant strain from overcrowding.
