The Mercury has detailed the rollercoaster ride - pre-COVID, during the height of the global crisis and post-pandemic.

Recently our coverage has focused on the state of the health system - from the economics of bulk-billing on GPs to bed-block at at Wollongong Hospital and beyond.

We have spoken with patients, ancillary staff, nurses, midwives and doctors who wanted to detail their experiences. Now Illawarra Shoalhaven Local Health District chief executive Margot Mains has written to us.

"Recently, the community will have seen reports of the pressures on Wollongong Hospital, particularly its emergency department.

These challenges are multi-faceted and there are no simple solutions. As Chief Executive of our Local Health District, I am keen to provide the community with some additional insights.

Firstly, despite the challenges, the thing that has remained constant is the resilience, determination and sheer dedication of our staff in caring for the community.

Our teams continue to deliver the best patient care to our community and are leaving no stone unturned to improve access to timely care.

A major contributing factor to the current situation is that the region has lost more than 200 residential aged care beds in recent years. Presently, the District has almost 100 of its hospital beds occupied by aged care patients who no longer need hospital treatment, but cannot be discharged because there are no vacant aged care facility beds.

Residential aged care facilities are a federal government responsibility and we continue to work closely with it to develop solutions.

Another factor placing pressure on our EDs is the difficulty in accessing General Practitioner (GP) appointments.

Our GPs are a very important part of the health system, and while the responsibility for GPs also rests with the Commonwealth, we continue to work closely with the GP network to improve this situation.

Let me assure the community, anyone presenting to emergency will always be given priority according to the seriousness of their condition, which can sometimes mean people with less urgent conditions have a longer wait.

Our dedicated staff work tirelessly on improving patient flow during these most challenging times and suggestions to the contrary are untrue and unhelpful to both the community and to staff.

In addition to the challenges already mentioned, COVID and influenza continues to impact staff availability and replacing skilled clinicians at short notice is extremely difficult, as it is for many other workplaces.

We are working closely with private hospitals to provide additional clinical staff, bed capacity and fast-track elective surgery, which has been further bolstered state-wide by an extra $408 million in the recent NSW Budget.

I continue to urge the community to use alternative options to the ED for minor illnesses. These options include medical centres, the Urgent Care Centre at Bulli Hospital, pharmacies or calling HealthDirect on 1800 022 222; a 24-hour telephone health advice line staffed by registered nurses.

There is also support available via the NSW Health Flu and COVID-19 Care at Home Support Line on 1800 960 933.

Finally, and most importantly, please do not hesitate to call an ambulance or come to the emergency department if you are experiencing an emergency.

The ED is open 24 hours a day, seven days a week for 365 days year.

Thank you sincerely for your patience and support as we continue to do our very best to provide high-quality health care to the people of the Illawarra and Shoalhaven."

Margot Mains,

Illawarra Shoalhaven Local Health District Chief Executive