The Mid North Coast Local Health District (MNCLHD) has not been spared from the impacts and challenges of the COVID-19 health pandemic with local emergency department pressures reflective of statewide trends.

The latest figures in the Bureau of Health Information Healthcare Quarterly report are not unexpected given the significant pressures associated with preparing for and responding to COVID-19.

The report comes as the state's hospital system braces for the impact of the worsening coronavirus crisis, predicted to peak in October, with health staff warning the system could be overloaded.

The second quarter of 2021 was one of the busiest NSW Health has ever recorded. The surge came as the system recovered from the first wave of of the health pandemic in 2020.

There were 806,728 emergency department visits across NSW between April and June, the highest since reporting began in 2010.

The report also revealed that the enormous elective surgery waitlist declined dramatically and a record 19,113 babies were born in NSW public hospitals.

NSW Health deputy secretary Wayne Jones said the figures were not unexpected, and showed the system bouncing back from the impacts of the first COVID-19 wave and the national halt of elective surgery in 2020.

Emergency Department (ED) attendances at Mid North Coast hospitals surged in the April to June 2021 quarter compared to the same time last year.

There was a 31.7 per cent increase in ED attendances to 36,553 in the April to June 2021 quarter, compared with 27,757 for the same period last year.

At the Coffs Harbour Health campus, there was a 34 per cent increase in ED attendances as compared to the same period last year (11,369 compared to 8,486) and a 25.5 per cent increase in Kempsey District Hospital (7,576 compared to 6,039).

Port Macquarie Base Hospital recorded a total of 12,489 ED attendances between April and June 2021, which was 35.2 per cent, or 3,253, up on the same quarter last year.

The proportion of patients leaving the ED within the recommended four hours was down by six percentage points at 70.8 per cent (compared to 76.8 per cent in the same quarter last year).

Mid North Coast Local Health District (MNCLHD) chief executive Stewart Dowrick said public hospitals across the state have faced unprecedented challenges and have had to adapt their service delivery in response to the COVID-19 pandemic.

"Through these difficult times, our staff have worked exceptionally hard to ensure we continue to provide a safe environment with quality and timely care for our patients," Mr Dowrick said.

Mr Dowrick said elective surgery performed across the health district continued to bounce back to pre-COVID levels and beyond after being significantly impacted by the national suspension from late March 2020.

"Between April and June 2021, we performed 3,437 procedures at our public hospitals with 77.4 per cent of all surgery completed on time," he said.

"Coffs Harbour Health Campus performed 100 per cent of urgent elective surgery procedures on time, while Port Macquarie Base Hospital performed 99.6 per cent on time.

"We recognise that COVID-19 has impacted our patients' access to elective surgery and we have been working to fast-track all procedures that were delayed."

Mr Dowrick said the figures reaffirm the consistent messaging of NSW Health throughout the pandemic that the best way for everyone to protect their health, the health of their loved ones, and to reduce the pressure on the health system and its dedicated workforce is to get vaccinated.

He said there are more than 200 healthcare workers assigned to testing and vaccination across the Mid North Coast Health footprint.

"We are working with the state and national program recommendations to be really agile and ready for anything," Mr Dowrick said.

"Health services will change forever after this and our health services need to be working differently in the future because COVID has changed the landscape for us.

"COVID will be part of the community and we can expect that people will be presenting to hospital or their GP with it.

"We would like as many people vaccinated as possible.

"For those with any doubts about that, I would encourage them to see their medical practitioner.

"Five to six billion people have been vaccinated around the world with these vaccines, they are very safe, effective and well-researched."

Between mid-2012 and mid-2021, MNCLHD increased its workforce by an additional 1,128 full-time equivalent staff - an increase of 41.3 per cent including 137 more doctors, 538 more nurses and midwives and 85 more allied health staff.

Health Services Union NSW secretary Gerard Hayes said the data shows more staff are desperately needed, even without outbreaks.

"Yet now we confront the furious heat of the worst health crisis this state has faced," he said in a statement.

"Even after that passes, the pent-up demand of people returning to pubs, restaurants and sporting fixtures mean there will be no let up for our paramedics and hospital workers over the summer.

"It simply won't do to rely on the goodwill of permanently fatigued, overstretched workforce."

NSW Nurses and Midwives' Association secretary Brett Holmes said the data shows the quality of health care was already being compromised.

Opposition health spokesman Ryan Park backed their calls for more staff, saying the report showed health system was already "on its knees" before the outbreak.

Recruitment of extra paramedics in particular, is gallingly slow.

"When you call triple-O and you ask for ambulance and it's an emergency, you cannot wait half an hour to access that," Mr Park told national reporters on September 15.

"At the moment, that's what's happening in some parts of southwest and western Sydney."

In the 2021-22 Budget, the NSW government announced $1.1 billion to continue the state's response to the COVID-19 pandemic, including:

This takes the total commitment to the health system to manage the impacts of the COVID-19 pandemic to more than $4 billion since March 2020.