At the same time, burgeoning numbers of COVID-19 cases in the region are having a significant and drawn-out impact on staffing levels.

Health professionals say they fear the upcoming closure and scaling back of the Hunter's GP Access After Hours service will increase the number of ED presentations, making conditions even worse.

NSW Nurses and Midwives Association (NSW NMA) John Hunter branch steward Keely Parkes said the waiting times and conditions were "obviously unsafe" for patients and their families.

Waiting times were 'huge', Ms Parkes said, some days blowing out to eight hours to see a doctor, and up to three hours to see a nurse after being triaged.

"We are incredibly concerned about the close of the GP Access clinic at the Mater and reduced operating hours," Ms Parkes said.

"As a team we are already seeing a large number of presentations with large waiting times. We use GP Access really well in our department to refer patients. And I know the community uses it, especially because of the bulk billing medical service. We believe we will start seeing more patients and those waiting times will blow out even more."

The NSW Nurses and Midwives Association is calling for mandated ratios of one nurse to three patients for emergency departments and one nurse to four patients in other wards.

A rally against the closure and scaling back of GP Access After Hours is taking place online on Wednesday. Federal Newcastle MP Sharon Claydon said time is running out for the GP Access After Service at the Calvary Mater Hospital which is due to close on Christmas Eve.

Operating hours at the four remaining clinics at the John Hunter, Belmont, and Maitland hospitals, as well as the Toronto Polyclinic will be significantly reduced.

The state and federal governments have pointed the finger at one another as to whose responsibility it is to fund the service

Hunter New England Local Health District chief executive Mr Michael Di Rienzo said the District has supported GP Access After Hours services since their inception in 2005, by initially providing annual funding and in-kind contributions, such as facilities and equipment for the clinics.

But with increasing demand for higher acuity services, he needed to focus on delivering core tertiary and specialist services, including emergency medical care.

"With an ageing community and a growing population, the District must ensure it continues to deliver the tertiary and specialist services the community needs," Mr Di Rienzo says.

NSW Health Minister's office said it was a matter for the Federal Minister for Health and Aged Care Greg Hunt. Ms Claydon said Mr Hunt has refused to continue funding the after hours service to keep it running as it is, and he has refused to rule out further cuts.

"The Minister for Health has a review sitting on his desk, which, if implemented, would totally gut our GP Access After Hours Service - effectively wiping out any hope retaining an after-hours service as we know it," Ms Claydon said.

Dr Milton Sales, of Brunker Road General Practice, who will work his last shift at the GP Access service at John Hunter Hospital on Christmas eve said he was disappointed.

"It's very sad," Dr Sales said. "The inevitable outcome is going to be increased burden on our overstretched EDs which are some of the busiest in the Australia."

The funding divide between the state and federal governments was part of the problem, he said. "It's a primary care service in a tertiary care setting. Tertiary care funding is being tightened all the time."

Concerns among emergency staff include excessive overtime and unsafe staffing inside John Hunter Hospitals Ed prompting grave concerns for patient safety as the busy summer holiday period begins..

An open letter signed by 500 ED clinicians and supporting services was submitted to Mr Di Rienzo in July.

NSW NMA John Hunter and John Hunter Children's Hospital Branch delegate and ED nurse, Kieran Patterson, said after responding tirelessly to the pandemic to keep the community safe, ED nurses were still being stretched beyond their limits and were fed up.

"We've had nurses working shifts of up to 18 hours in the ED, while others have been required to work significant overtime to cover regular sick leave and rostering shortfalls," Ms Patterson said.

"In one case, a registered nurse worked eleven days straight, including 12-hour shifts. The amount of overtime and unsafe staffing has prompted many senior staff to find other employment. Our clinicians are some of the hardest working in the state, but we are burnt out and tired."

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