Murrumbidgee Local Health District chief executive Jill Ludford said the organisation needed to focus more on recruiting, retaining and up-skilling nurses to help them "cope" with working in emergency departments without on-site doctors.

She said communities were "feeling the pain" of medical workforce shortages and acknowledged that health bureaucrats in Wagga had to "do things differently" to improve the way they deliver services.

Ms Ludford made the comments in her speech to the annual Local Health Advisory Committee forum on Tuesday, where she unveiled a draft copy of the MLHD's vision for the next five years to healthcare advocates from across the region.

There are 33 hospitals in the MLHD, where most of the smaller sites are staffed by visiting medical officers who also work as private general practitioners in the local community.

This model has been shaken by the maldistribution of doctors in rural Australia, which has seen hospitals having to depend on nurses and virtual doctors providing advice over the phone or via video-link in some emergency situations.

Ms Ludford said the MLHD needed to "have much more acknowledgement of nurses and allied health professionals" in order to support them to work in emergency departments with no GPs.

Staff wellbeing and engagement are expected to form a key part of the MLHD's strategic plan for 2021 to 2026, which commits the health district to "working with our communities and holding an unwavering focus on safety and improvement".

Ms Ludford said the coronavirus pandemic had led to a "critical workforce shortage" because it prevented the MLHD from bringing in locum doctors and international nurses to fill roster gaps.

In its draft plan, the MLHD outlines its aim to be a "preferred employer" that can attract and retain a diverse and skilled workforce.

Speaking on Tuesday, Ms Ludford said the health district would look to equip more of its registered nurses with technical skills, such as suturing wounds, to be able to provide high level emergency care in the absence of doctors.

She also said the MLHD wanted to encourage more "locally led reform" of health services across its district. "They can be hard conversations to have. Sometimes the community might think they need things that are not aligned with the data," she said.

She said the "crux" of the strategic plan was the district's move away from buildings and hospital beds to focus on more "holistic" patient wellbeing.

She said the MLHD board would use a separate document containing specific metrics with which to measure the success of the "ambitious" strategic vision. "We're not going to hide anything. Our accountability is on the line," she said.

She has since clarified that she was referring to the internal key performance indicators described in the MLHD's service agreement with NSW Health.

She said the plan would be monitored regularly and results reported quarterly to the MLHD board and available publicly in the MLHD's annual Safety and Quality Account.

The MLHD plans to release the endorsed plan next month before the new financial year.