Auckland City Hospital is struggling to cope with a huge increase in demand which has seen almost 200 people coming through the emergency department every day.

And it is not a phenomenon isolated to Auckland, according to a medical union.

Auckland District Health Board chief executive Ailsa Claire yesterday sent a memo to all staff acknowledging it had been busier than usual for this time of year and thanking staff.

Presentations in Auckland City Hospital's emergency department topped 200 four days in a row last week - in an usual week there would be no more than two days where staff treated that many people.

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Director of adult medical services Barry Snow said the emergency department had seen a 7 per cent growth on last year while the inpatient unit was up 3 per cent.

The hospital was averaging about 199 people through the emergency department each day but at this time last year it was about 187, he said.

"We are as busy as we've ever been," he said. "We've never treated so many people."

Snow said capacity had been in the high 90s and had hit 100 per cent a couple of times recently.

"We normally run the place pretty full but it's much more common to be in the mid to low 90s - 100 per cent is very unusual."

On top of that, there had been an increase in the severity of the illnesses being treated.

Part of the reason for the increase in patients came down to population growth but modern medicine also played a part, Snow said.

"We're definitely seeing sicker people. We're seeing older people as well. Part of this is the miracle of modern medicine. They are surviving their illnesses now."

But while people may survive illnesses they wouldn't have in the past, they were often left with chronic illnesses which saw them coming back to hospital.

The district health board had begun to implement measures usually reserved for the busy winter months, Snow said.

To manage the increase the hospital was treating people with minor injuries in armchairs rather than filling up a bed, standardising care for certain conditions, putting more staff on, and focusing on supporting people in their homes.

"The bad news is that at times it feels like we're as busy as we can cope with, which is quite hard for our staff," Snow said.

To take pressure off hospitals he asked people to see their family doctor before coming in to the hospital unless it was a life-threatening issue, to seek treatment earlier rather than wait until they are so sick they need hospital care, to fill their prescriptions and take the medication, to be more sensible about how much alcohol they drank, and to get the flu vaccine.

The executive director of the Association of Salaried Medical Specialists, Ian Powell, said he was hearing of increased demand in hospitals around the country.

He believed a lot of it came down to prolonged poverty in the community and the ageing population.

Powell was concerned about the increased pressure it put on already stretched medical staff.

"Our concern is that we already have an absurdly high level of burnout among hospital specialists."

Last year about 50 per cent of those surveyed said they were burned out, he said.

Powell said the Government and district health boards needed to create more positions and hire more trained medical staff to manage the workload in hospitals.

What you can do:

• Get the flu vaccine
• Visit your GP before the hospital
• Get treatment early
• Get your prescriptions filled
• Be sensible about your alcohol intake