The Southern Highland News understands Highlands-based ambulance officers are increasingly concerned about their ability to meet needs.

At times there is only one ambulance available in the area, the News has been told, Bowral intensive care paramedics were sent "nearly every shift" to work in Sydney, and there was no ambulance officer on call after 11am each day.

Asked about the staffing numbers, a NSW Ambulance spokesman said deployment rosters were regularly reviewed to ensure all residents in the Highlands would have access to emergency care if needed.

“In March 2015 the number of paramedics working out of Bowral Ambulance Station was increased by an extra five full time staff,” he said.

“Across the Illawarra/Southern Highlands, paramedics are mobile for most of the day attending to patients in their homes and in the community and transporting them to the appropriate hospitals as required.”

The spokesman said the Bowral Ambulance Station roster currently consisted of two day shifts, one afternoon shift and one night shift, with two additional on-call paramedics each night, seven days a week.

There are also two Community First Responder (CFR) units supporting the area, one in Bundanoon and one in Canyonleigh.

Concerns have also been raised about the issue of staggered shifts which will begin at Bowral from February 28. 

Staggered shifts create overlaps for start and finish times as well as meal breaks.

The News was told none of the ambulance officers at Bowral wanted staggered shifts “as it’s a fatigue issue”.

Staggered shifts will also be rolled out in metropolitan Sydney, the Illawarra and the Central Coast.

The Ambulance NSW spokesman said these changes had been made in consultation with paramedics and unions.

“These reforms are designed to ensure that as far as possible paramedic crews are rostered at the same time as our patients need them,” he said.

“This initiative represents an expansion of an already existing staggered rosters arrangement and addresses concerns raised by paramedics and unions in a number of forums about meal breaks and not finishing shifts on time.

“NSW Ambulance will continue to work collaboratively with paramedics and their union representatives to address any issues that may arise during the implementation process.”