The professional body for emergency doctors says Rotorua Hospital has until January to employ more senior clinicians to keep its licence to train specialists.

In a letter leaked to RNZ, Te Whatu Ora Lakes senior manager Alan Wilson told senior ED doctors they would have to cover both Rotorua and Taupō due to workforce shortages.

He warns Rotorua ED is at risk of losing accreditation as a teaching department unless it has 24-hour cover using doctors with a specific credential from the Australasian College of Emergency Medicine.

However, the College - which oversees training and education for specialists - says it's "concerned by misleading statements in the letter" and clarifies that Rotorua is not in immediate danger of losing its accreditation.

Currently, Rotorua ED has emergency medicine specialists rostered for 14 hours per 24-hour period on weekdays and 10 hours per 24-hour period on weekends.

However, in order to maintain its training accreditation, it needs to have emergency medicine specialists rostered for a minimum of 14 hours per 24-hour period, seven days a week.

Emergency medicine specialists must also be rostered on-call overnight, when there is a trainee on the night shift, and 50 per cent of each trainee's shifts must be supervised.

"To maintain its tier two accreditation, Rotorua ED must actively demonstrate that it is working to engage sufficient emergency medicine specialists to meet requirements and meet all tier two requirements by January 2025," the spokesperson says.

Workforce shortages across the country were adding to "already significant pressures".

"This is being exacerbated by cuts to funding that are preventing some emergency departments from filling vacancies."

In a message to all staff on Wednesday, Health New Zealand chief executive Margie Apa confirmed all clinical recruitment was on hold.

Once budgets are confirmed, recruitment will be able to proceed as long as roles are "within budget or replacing existing roles".

The Resident Doctors Association, which represents junior doctors, says Te Whatu Ora Lakes needs support urgently to boost the number of doctors on staff, not just in the emergency department but across the hospital.

Its head, Dr Deborah Powell, says if Rotorua ED lost its accreditation, it could have a disastrous knock-on effect for the whole hospital.

"Accreditation is critical to training - you lose workforce and you lose all the good things that come from having a training programme in place, one of the obvious ones being, if you train in a region, you tend to stay in a region.

"So your ability to recruit and retain senior doctors is far less, it gets worse and worse, it really does go downhill quite quickly if you lose accreditation."

One senior doctor at Rotorua ED says they are only managing to cover the shifts they do now by going without annual leave and education leave.

"The letter [from Alan Wilson] also implied that our annual leave and education leave were contributing factors to staffing issues and that leave would now be more regulated.

"The reality is that we did not have enough staff to cover our annual leave and education leave (that we are entitled to) before Alan WIlson's directive to also cover Taupō's roster.

"We already have limits on leave and our colleagues work tirelessly to ensure our shifts are covered and there is equitable access to leave."

-RNZ.