More than 17,000 patients presented to the hospital’s ED from April to June, a 7.2 per cent rise compared to the same quarter last year.

Shellharbour Hospital’s ED also saw an increase with 7659 presentations, up 4.4 per cent; while at Shoalhaven Hospital presentations grew 3.4 per cent to 9714.

It was a busy season for hospitals across NSW according to the Bureau of Health Information (BHI) quarterly report, with Queanbeyan, Blacktown and Campbelltown hospitals among others feeling the heat.

“We have seen an overall increase in the number of people visiting EDs across the state – with a total of 700,000 visits,” BHI acting CEO Hilary Rowell said. “However despite that increased activity, hospitals’ performance remained stable.”

However at Wollongong ED, the increased presentations led to a 5.3 percentage point drop in the number of patients starting treatment on time.

Plus there was a small drop in the percentage of patients leaving the ED within four hours. Just 67 per cent of patients were able to leave within that timeframe, compared to the state average of 74 per cent.

Across the Illawarra Shoalhaven Local Health District, there was a total of 37,836 emergency presentations in the April to June quarter – a 4.3 per cent increase on the three months in 2017.

It was one of 11 local health districts across the state with increased presentations, with the remaining four either stable or experiencing decreased activity.

NSW Nurses and Midwives’ Association general secretary Brett Holmes said the figures showed EDs were “overloaded”, with the year-on-year pressure taking a toll on nurses and midwives.

“We know presentations are rising, yet nurses and midwives are taking on that increased workload,” he said.

“It’s unsustainable to rely on a staffing model that we now know is being manipulated to save costs.”

Mr Holmes said it showed the need for mandated nurse-to-patient ratios in EDs and other wards in city, regional and rural hospitals.

“We need a new reliable shift-by-shift ratios system to provide a clear understanding of how many patients nurses have to care for,” he said.

“Our regional hospitals are experiencing a higher volume of patients, yet they receive less nursing hours per patient than city hospitals.

“It’s not right that a patient’s postcode can determine their level of care.”