Contingency arrangements have been put in place as Middlemore Hospital is hit with a record demand for care across the hospital's services.
Dr Vanessa Thornton, acting chief medical officer for Counties Manukau Health, said the DHB had taken steps, including providing extra staff and additional beds in wards, but could not anticipate the sudden spike in demand.
"Last week we saw record numbers of patients coming into our emergency department, many with underlying medical conditions, including respiratory related illnesses which we often see in winter," Thornton said.
"Last Monday was a record number of patients for our emergency department and it did require us to call on extra staff to make themselves available to work across the hospital."
The department cared for over 350 patients on most days last week, with a record 393 seen on Monday, June 26.