The service treats more people with severe injuries than any of its Sydney-based counterparts, 39 per cent coming from rural areas.

Staff say the hospital is struggling to keep up with that level of demand and is frequently being bypassed, severely impacting patients who are transferred to Sydney.

The delay in treatment leads to poorer outcomes and longer recovery times, as well as using more resources and inconveniencing families.

"Our patients have prolonged scene times and prolonged transfer times", John Hunter Hospital staff say. "Due to a lack of adequate intensive care unit capacity John Hunter Hospital frequently cannot fulfil its regional role

"We know that our rural and remote patients have long delays until they reach definitive care compared to their metropolitan counterparts, more than 3.5 hours, compared to 86 minutes."

There have been 700 submissions to the NSW Parliamentary Inquiry, "Health outcomes and access to health and hospital in rural, regional and remote NSW'.

A "critical" lack of staff and specialists, missed diagnoses, long wait times and a lack of accessible services in Hunter New England are some of the other concerns patients and healthcare staff have raised. Submissions have now closed and hearings have begun.

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A spokesman for Hunter New England Health said it was a parliamentary process, and an opportunity for people to present their concerns. While management was across the regionally-relevant content they would not be responding to individual submissions. However, senior staff were 'pencilled in' to attend hearings being held in Gunnedah and Taree later in the year.

John Hunter Hospital is also the busiest in the state, and the second busiest nationally for treating elderly hip fractures, staff say. Where possible, rural and remote patients are treated at local hospitals but a lack of resources means that more complex patients are transferred to the John.

"For those patients transferred into us their access to operating theatres is severely impacted, on average adding more than 48 hours to their wait times."

Patients and their families are then forced to travel long distances to attend follow-up appointments and while telehealth has helped, accounting for between 10-15 per cent of outpatient appointments, the burden on patients and treating teams continued to be "large and less than ideal", the submission says.

"Despite our best efforts there are still significant delays to definitive care for our rural and remote patients and this impacts negatively on their outcomes that are well published in peer reviewed journals."

Hunter New England Health chief executive Michael Di Rienzo has said he is unable to comment on individual submissions. "If there is something specific in nature we need to look at immediately, then I would welcome that being brought to our attention."

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