Mid North Coast Local Health District (MNCLHD) acting chief executive Kathleen Ryan said there had been an increase in emergency department activity.

Compared to the same period last year, emergency department presentations increased by 1683, or 5.3 per cent, to 33,557 presentations. This included 666 more patients arriving to EDs by ambulance, an 11 per cent increase.

"Despite the increased activity in our emergency departments, we have also seen improvement in the proportion of our patients who start treatment on time, with 78.4 per cent starting treatment on time this quarter compared to 75.2 per cent in the same quarter last year," she said.

The larger hospitals at Port Macquarie and Coffs Harbour have performed well, with an increase in the proportion of ED patients starting treatment on time at Port Macquarie Base Hospital (6.6 percentage point increase compared to 2018) and at Coffs Harbour Health Campus (3.7 percentage point increase compared to 2018).

Both sites have also seen a higher proportion of patients leaving the ED within four hours of presentation (75.3 per cent, improved by 4.3 percentage points, and 68.9 per cent, improved by nearly one percentage point, respectively).

Ms Ryan said the BHI Healthcare Quarterly also reports on elective surgery performance across the district and the MNCLHD continues to make very effective use of Network operations between its larger base hospitals and smaller district facilities.

"Our smaller hospitals at Kempsey and Macksville have continued to support our clinical networks by completing 100 per cent of their elective surgery procedures on time," Ms Ryan said.

Between June 2012 and June 2018 MNCLHD has increased its workforce by an additional 686 full time equivalent staff - an increase of more than 25 per cent including 88 more doctors and 306 more nurses.

The 2018-19 budget for MNCLHD is more than $634 million, an increase of nearly $28 million on the 2017-18 annualised budget.