Frontline workers at Auckland District Health Board are complaining of under-staffing, exhaustion and unpaid overtime.
The Herald on Sunday has obtained a Safe Staffing Healthy Workplace report, which includes nine recommendations for change.
Of the DHB's 10,000-plus staff, 685 took part in an online survey in July and August. About 70 staff also gave face-to-face interviews.
Almost half said the message they hear from the DHB is patient safety and quality of care must be balanced with achieving volumes, targets and budgets.