Waiting times at Katoomba Hospital's emergency department have increased in the December quarter compared to the same period the previous year.
Bureau of Health Information data for the October-December period, released on March 1, showed that 5140 people presented to Katoomba's ED, compared with 4,604 for the same period in 2021 (an increase of 536 patients).
But less than two-thirds of patients were treated on time, compared with 85 per cent at the same time the previous year.
This put Blue Mountains at the very bottom of its peer group, district group 2, which includes hospitals in towns such as Lithgow, Cessnock, Mudgee, Cowra and Forbes.
The on-time starting of treatment across the 20 hospitals in district 2 was 77.2 per cent - hospitals like Forbes (88.7 per cent) and Inverell (88.1) compared to Katoomba's bottom of the heap 60 per cent.
Nepean Blue Mountains Local Health District, Chief Executive Kay Hyman said the figures can be explained by an increasing number of complex cases.
Ms Hyman said the Katoomba hospital "has seen an increasing number of very unwell patients presenting over the past 12 months with 1,019 triage category 2 patients - the highest since BHI began reporting, and 1,459 triage category 3 patients - slightly less than the October to December 2019 quarter, during the 2019 bushfire season."
Only a year ago, Blue Mountains Hospital was keeping pace with Lithgow where 85.2 per cent of patients were treated on time. In the latest data Lithgow had dropped to 75.4 - a drop of 11 per cent - but not the dramatic 25.2 per cent Blue Mountains has experienced. (Lithgow Hospital also had an increase in patients presenting with 25 per cent or 647 more patients presenting to emergency in the latest period).
There were 1347 patients arriving by ambulance at Blue Mountains (an increase of 14.7 per cent, or 173 arrivals, up from 1174 patients) in the latest period.
Ambulance ramping (where paramedics queue to wait for an ED bed) remains a minimal issue at Katoomba, with 89 per cent of patients transferred from ambulances into the ED within 30 minutes - but those figures have worsened by 5.3 percentage points on the October-December 2021 reporting period when 94.3 per cent of patients were transferred within 30 minutes.
There were 195 elective surgeries performed in the December quarter, a drop of 13.7 per cent or 31 surgeries less on the same quarter from the previous year period.
And there are 58 more patients on a waiting list for elective surgery in the latest data - 235 patients in total - compared to the same time the previous year. The biggest wait is for gallbladder removals (35 waiting for surgery), abdominal hysterectomies (30 waiting) and varicose vein stripping and ligation (30 waiting).
Ms Hyman said "all patients are seen and triaged on arrival at the ED and, as always, the most seriously unwell patients are treated first. During busy times, those with less urgent conditions will experience longer wait times when there are large numbers of seriously unwell patients being prioritised for emergency care".
Ms Hyman thanked her "dedicated teams".