One of the heads of the Nurses Union says New Zealand's public health system is short 4000 nurses heading into winter.
The system has been stretched to breaking point during the Omicron outbreak and the Ministry of Health is warning the worst may be yet to come.
On Friday, the Director General of Health, Ashley Bloomfield, said the country could see Covid-19 hospitalisations alone hit 1000 during a predicted peak in the colder months.
Union Kaiwhakahaere Kerri Nuku said due to the Omicron outbreak the public health system has not been able to prepare for an influx of patients over winter.
"This winter surge is huge and from what my colleagues have told me, which seems a bit contradictory to me, is that they don't see that there's anything being done on winter preparedness or planning because they're still coping with the Covid overflow."
Hospitals are already packed and higher staff absences over winter pose a huge challenge.
She said rosters are being adjusted to help but it won't be enough.
With staff having to take more sick leave over winter there will be few resources to help fill the gaps, she said.
With a global shortage of nursing staff the country needs to do more to attract nurses here.
"Four thousand nurse vacancies throughout the country is a significant time that it's going to take to recover those and given that there's an international shortage of nurses we are competing on an international stage here."
Nuku said even though work conditions are often no better in Australia, New Zealand nurses are moving across the Tasman for better pay.
Meanwhile, she also believes the high cost of taking a course is a barrier stopping trained nurses from working in healthcare in New Zealand.
Nurses who gained their qualification overseas or who have been out of practice need to take a competence assessment programme - which costs hundreds of dollars to complete.
Nuku said if the government took away the fees for the course, it could help reduce acute staff shortages.
She said the government needs to admit the public health sector is in a staffing crisis.
New phase at CDHB
Canterbury District Health Board will introduce new roles and a dedicated staff redeployment centre, when it moves into a new phase of Covid-19 management this week.
From Tuesday, a new management system will take over from its Emergency Coordination Centre.
Spokesperson Tracey Maisey said it's important the DHB starts to treat the virus like business as usual.
Maisey said all the changes are internal and patients won't notice any differences to the quality of care they're currently receiving.
She said the new specialised roles will deal with Covid-19 so the rest of the staff can go back to managing their regular workloads.