A hospital in a Blue Mountains town threatened by a large bush fire is being evacuated ahead of a predicted worsening of conditions.
The Rural Fire Service (RFS), Nepean Blue Mountains Local Health District and Ambulance NSW are assisting in the evacuation of 24 patients and 17 staff from the Springwood hospital.
"At present Springwood Hospital is not under direct threat from the fire, today's evacuation is pre-emptive," Nepean local health district incident controller Clair Ramsden said.
Patients will be taken to the Nepean Hospital and are expected to stay there until at least Wednesday.
An emergency warning has been issued for Blue Mountains' residents after a bushfire at Springwood flared up.
There is thick smoke in the area and fire activity has intensified near Muru Avenue and St Columba's High, the Rural Fire Service (RFS) says.
Firefighters and helicopters are battling the out-of-control 2152 hectare fire.
"Be alert to burning embers. Put out any spot fires which start where you are," the RFS advises.
An emergency telephone alert is being sent to residents.
Several roads in the area are closed.
It's unclear when they will reopen and the RFS is urging people to avoid all bushfire zones.
More than 190 properties have been destroyed and 109 damaged around Springwood and Winmalee.
About 95 per cent of the fire ground has been assessed and authorities warn the number of damaged or destroyed properties may rise.
An evacuation centre has been opened at the Springwood Sports Club.
The RFS has also issued an emergency warning for a large fire at Lithgow.The 32472 hectare bush and scrub fire is being controlled but properties at Bell, Dargan, Berambing and Bilpin are under threat.