A major pay rise for NSW nurses is possible without hurting the state budget by using billions of dollars in untapped federal funds, a union says.
Inaccurate and inefficient hospital reporting has blocked access to $3 billion in commonwealth funding over the past five years, according to analysis by Deloitte and released by the NSW Nurses and Midwives' Association on Monday.
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Union boss, Shaye Candish, said the missing billions were down to a long-running failure to capture accurate patient data.
"Information that's collated when we care for patients is reported through our hospital system and, at times, it generates commonwealth funding through some of the arrangements that the Commonwealth and the state governments have to one another," she told ABC radio.
"We don't have appropriate systems (in NSW) to really reflect the care that's already been provided and the consequence of that is that NSW has missed out on over $3 billion of commonwealth funding in the last five years."
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The "technical inefficiency" was reflecting a rosier picture of patient health than was the reality, Ms Candish said.
Savings of $1.2 billion per year could be achieved by NSW Health if treatments and patient data were processed accurately, on top of other measures to reduce waste, the report found.
"The NSW treasurer can afford both higher wages and more nursing and midwifery positions, by removing systemic inefficiencies in the healthcare system," Ms Candish said.
NSW Health Minister Ryan Park said his office would review the findings of the report and noted wage negotiations were still in their early stages.
"Last year we abolished the wages cap and delivered the largest pay rise for nurses and midwives in over a decade," a ministerial spokesperson told AAP.
"We are also in ongoing discussion with the Commonwealth about health funding arrangements."
All NSW public sector workers, including nurses, have been offered a 10.5 per cent pay rise over three years at an expected cost of $3.6 billion.
But the nurses and midwives' association has called for a one-year increase of 15 per cent, an amount Premier Chris Minns has described as "more than we can afford right now".
Last Tuesday's state budget included a string of forecast deficits and a rising interest bill to service growing debts before factoring in pay rises above the existing offer.
The union's assistant general secretary, Michael Whaites, said if systemic reforms could be identified to offset costs, then workers would progress above the baseline 10.5 per cent.
Ms Candish said NSW nurses and midwives were "working on a 2011 wage in 2024".
"The government put a challenge to us to go and find saving. We've done it - now the ball's in the government's court," she said.
Nurses in Victoria are set to consider a 28.4 per cent wage rise over four years on Wednesday, while Queensland nurses got a boost in a three-year deal struck in December.