NSW Premier Gladys Berejiklian announced a $1 billion investment into ambulance services in June last year, including 750 new paramedics and staff over a four-year period.

While 200 paramedics joined the ranks during 2018/19, none of them started work at a station in central or western NSW, the Australian Paramedics Association (APA) says.

Union executive officer Scott Beaton, who works in the region, said he had seen first-hand how staff levels affect response times.

"It's increasing paramedics' fatigue levels and, as it progresses up the chain, it impacts hospitals," he said. "We've needed extra [paramedics] out here for some time."

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Bathurst paramedics experienced a 7.0 per cent jump in call-outs from 2005 in January to February 2018 to 2146 in the same period this year.

Dubbo region paramedics, meanwhile, had a 19.4pc increase in call-outs over the same period, while call-outs in Orange jumped by 10.8pc.

The increase in responses led to a longer median time for an ambulance to reach the emergency case in all regions except Bathurst, which had a slight decrease.

Mr Beaton said the NSW Government's promise of 750 new staff across four years was too long and called for new paramedics now.

"As soon as you get on this side of the sandstone curtain we're just forgotten," he said.

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Mr Beaton said a scheduled SWEP (State Wide Enhancement Program) meeting to plan for staff in western NSW should have been held last November, but he said it was cancelled and never rebooked.

APA president Chris Kastelan said paramedics were doing their best to cope with the workload, but were frustrated by the slow rollout of recruits.

NSW Ambulance was contacted, but was unable to provide a response to the APA concerns before deadline.