John Hunter Hospital has recorded its worst quarterly result for the time that patients spend in the emergency department since modern records began in 2010.
This result coincided with a big spike in patients presenting with conditions rated as "emergency" and "urgent".
Rising pressure on the region's busiest hospital came as the health sector continued to face the fallout from restricted healthcare during the pandemic, staff shortages and demands for better pay and conditions.
The latest Bureau of Health Information [BHI] data also showed that more than 1000 people attended the hospital's emergency department for minor conditions.
The BHI report stated that the percentage of patients leaving John Hunter's emergency department within four hours in the January to March quarter was 38.1 per cent - ranking the hospital 12th out of 13 hospitals in its peer group.
This was the worst result for the hospital in this category since BHI began reporting in 2010.
The median time of patients leaving John Hunter's emergency department was 5 hours and 1 minute. One in 10 patients left after "11 hours and 58 minutes".
Julie Tait, executive general manager of John Hunter Hospital, said "I acknowledge and apologise to patients who have waited in the ED longer than the four-hour period, so we can attend to high priority patients".
Ms Tait said the hospital was "working on maximising patient flow through our hospital".
"The ED [emergency department] sees a phenomenal number of patients. This quarter we again saw an increase in triage 1-3 categories - the most sickest presentations," Ms Tait said.
"These high-level presentations require a significant amount of time and resources. Fundamentally you're providing lifesaving and emergency care."
The data showed 201 people presented for resuscitation (T1), 3980 for an emergency (T2) and 8060 for urgent cases (T3) in the quarter. These categories rose by 23 per cent, 26 per cent and 17 per cent respectively, compared to the same quarter last year.
Ms Tait said an increase in patients in the triage categories 1-3 could be due to "more trauma" and people with chronic conditions having "an acute episode".
"We do see large spikes happen occasionally."
The data showed that 11,450 patients were treated and discharged at John Hunter in the quarter, 6456 were treated and admitted to hospital and 2277 left without - or before - completing treatment.
Furthermore, 1022 people who attended emergency were ranked in the lowest triage category (T5), which meant their condition was "chronic or minor enough" for treatment to be delayed up to two hours from arrival.
Such conditions can involve minor cuts that don't require stitches, a problem with minimal pain or minor symptoms of "existing stable illness".
A further 7910 people presented to emergency with "semi-urgent" conditions ranked in the second-lowest triage category (T4), which can include sprained ankles, migraines and foreign bodies in the eye.
Officials hope the reintroduction of the GP Access After Hours clinic at the Mater, and restored hours at other GP Access clinics in the region, will ease this problem amid difficulties in securing a time to see a GP promptly.
As reported on Wednesday, elective surgeries at John Hunter Hospital rose by 29 per cent in the January to March quarter. However, the number of patients on the "semi-urgent" waiting list for elective surgery at the hospital rose from 532 to 787.
Also at John Hunter Hospital, 578 patients were waiting longer than recommended for surgery at the end of the quarter, a rise of 320 patients from the same period last year and the worst result since reporting began in 2010.
Ms Tait said the hospital was concerned about surgery delays and "we're doing our best to avoid that in the current climate".
"We continue to explore strategies to reduce the surgery wait times, including reviewing our theatre capacity and outpatient waitlists, and working with private hospitals through collaborative care relationships.
"We are working with the NSW government, which has established the surgical care taskforce, to investigate other best practice models. I think that will help us further reduce the surgical waitlist."
The data also showed the percentage of patients transferred from paramedics to emergency department staff within 30 minutes was 71.2 per cent. This fell by 16.2 per cent when compared to the corresponding quarter last year.
The median wait in this category was 16 minutes (a rise of three minutes), while one in 10 patients waited longer than one hour and 14 mins (a rise of 41 minutes).
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