At Wollongong Hospital, 45.7 per cent of patients waited for longer than four hours in the ED from October to December 2019, the latest Bureau of Health Information quarterly report reveals. That represented the fifth longest waits in the state.

Shoalhaven Hospital came in seventh, with 43.1 per cent of people waiting longer than the state benchmark; and 38.7 per cent of Shellharbour Hospital patients waited more than four hours - the ninth worst waits in NSW.

Across the Illawarra Shoalhaven Local Health District there were just over 42,000 emergency presentations.

More than 3250 elective surgeries were conducted in district hospitals from October to December last year - 85 per cent of all surgeries were performed within recommended timelines, although 99.9 per cent of urgent surgeries were on time.

By the end of December, 6630 patients remained on the waiting list ready for elective surgery within the ISLHD.

Labor's health spokesman Ryan Park said the figures showed the public health system in the region was already under enormous strain.

"The figures show we have a hospital system on its knees in the Illawarra and Shoalhaven and I am concerned that COVID-19 may be the knockout punch," Mr Park said.

"Those waiting for important surgery is now up to a record 6638 people and 10 per cent of them will wait longer than a year. That is simply unacceptable.

"Our EDs are stretched, with Wollongong recording the 5th worst result in NSW. We urgently need additional funding into our hospitals to help our frontline doctors, nurses and health workers who are already overworked and it will only get worse with this pandemic and flu season both yet to peak."

The Keira MP said a "massive injection of resources" was vital for hospitals across the state to deal with both the outbreak of COVID-19 and the flu season.

"Data released today by the Bureau of Health Information shows that our health system is already in a critical condition," Mr Park said.

"The most recent quarterly data shows worsening performance across almost every metric from ambulance response times and emergency room performance to various elective surgery procedures.

"Emergency department performance across NSW has gotten worse. Currently 1 in 10 patients across the state are spending almost 8 hours (7 hours and 40 minutes) in an emergency department.

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"Ambulance performance has also gotten worse with arrival times lengthening across all categories. Currently 1 in 10 patients waiting for an urgent ambulance call (P2) are now waiting over an hour (62.2 minutes).

"Patients across NSW are also now waiting longer than ever before for elective surgery, with the waiting list numbers at a record 88,000."

"... What's alarming is this data ends in December, before COVID-19 spread to NSW. We're alarmed that if our hospital system was already under such strain then how well are we placed to respond to this pandemic?"

The NSW Nurses and Midwives' Association (NSWNMA) has urged the NSW Government to bring forward its planned 5000 health 'workforce boost', in light of the evolving COVID-19 crisis and increased pressures on emergency departments.

NSWNMA general secretary Brett Holmes said the extra nursing staff were needed now to meet growing demand.

"Nurses and midwives were already facing burn-out and fatigue after a difficult winter, but they pushed on through summer and the devastating bushfire season, only to be confronted with the global health crisis that is COVID-19," he said.

"The government promised 5000 extra nurses and midwives at the last election, with the majority to be allocated in the latter part of their four-year term.

"These numbers out today show the government must urgently bring its planned workforce boost forward."

Mr Holmes said while the NSWNMA appreciated the government's broader public health response towards tackling COVID-19 to date, there had not been enough done to boost frontline nursing staff numbers.

ISLHD executive director clinical operations Margaret Martin said the latest BHI figures showed each of the region's hospitals experienced increased activity during what was an extremely challenging quarter.

"The presentations in EDs across the district as a whole remained stable with 42,005 attendances in the quarter, a 0.3 per cent decrease - 113 attendances less than in the same quarter in the previous year,'' she said.

"The unprecedented fires impacted significantly on our communities, including directly on ISLHD staff. As a district, we are extremely proud of the efforts of our staff who went above and beyond to care for patients in this time of great need."

Ms Martin said the BHI report also showed that close to 86 per cent of all ISLHD elective surgery procedures were completed on time and nearly all of urgent procedures were completed on time.

"Wollongong Hospital completed 13.9 per cent more elective surgeries for the quarter - 1767 procedures and completed 23.6 per cent more non-urgent surgeries than in the same quarter in the previous year - 450 procedures," she said.

The district had a number of initiatives underway to improve the delivery and timeliness of ED care, Ms Martin added, including continued work on implementing changes to support improved patient access and flow throughout the hospital.

This included ongoing recruitment of additional ED senior staff specialists to enable increased early senior assessment of patients.