Mr Marshall said staff in Armidale are overworked and at breaking point, because they are acting as an unofficial emergency department for the likes of Glen Innes, Inverell and Tenterfield, and he has taken aim at Hunter New England Health (HNEH), claiming it has refused to listen to genuine ideas about how to improve coverage in the area.

"Just under a month ago the union took a reasonable, and workable, five-point plan to alleviate staffing issues at Armidale Hospital ED to HNEH senior management, only to have the request completely rejected," Mr Marshall said.

"Because of Hunter New England Health's continued refusal to pay for additional staff in outlying hospitals - although it's never once asked for more funding to do so - a culture has developed which sees patients transferred to Armidale, often unnecessarily, for treatments."

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But HNEH said the situation is not as bad as Mr Marshall has made out and it is working to fix the problems.

"Armidale Hospital's emergency department (ED) has at no stage been on the brink of collapse," executive director of rural and regional services Susan Heyman said.

"We monitor activity and staffing levels in the hospital on an ongoing basis, including the ED, and can assure the community that they can continue to receive safe and appropriate care at Armidale Hospital.

"Every effort is being made to resolve the concerns of the Armidale Branch of the NSW Nurses and Midwives Association and we will continue to proactively engage with the branch in the best interest of our patients and community."

HNEH maintains Armidale hospital has received strong investment in recent times too, with more than $30 million spent in the past five years, which excludes the hospital's regular operating budget.

A spokesperson said staffing issues are being faced by all local health districts across the country, but there was still a 15.4 per cent increase in the workforce between mid-2012 and mid-2021.

Meanwhile, Mr Marshall has also hit out at HNEH claims that data does not support putting additional staff in Armidale, calling that a "barefaced lie".

He's accused the organisation of being too Newcastle-centric, and has urged managers to make decisions based off of real-life experiences, as opposed to just using the data.

"It's time that Hunter New England and NSW Health stop viewing the current regional health crisis through rose-coloured glasses and start listening to the experiences of the workforce and hearing their needs," Mr Marshall said.

"The situation at Armidale hospital is dire, and unless steps towards change are enacted immediately, we will be faced with an exodus from the workforce.

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"While I, and the union, acknowledge steps are being taken to proactively recruit staff long term, there appears to be insufficient planning to alleviate the real pressures which exist right now.

"We don't have years to solve this crisis, it'll be far too late by then."

In order to relieve the strain on Armidale Hospital, HNEH has urged all patients to present to their local ED unit where they will either receive the care they require, or be treated by a nurse until further help arrives.

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