A teenage girl is in a serious condition in a Newcastle hospital after falling from her horse near Warialda.
The accident happened about 9am on Sunday on a property near the town.
Emergency services were told the 15-year-old was riding a horse when she fell and suffered serious head and back injuries.
Paramedics then rushed the girl to Warialda hospital, where the chopper landed.
The helicopter's critical care medical team, which includes a doctor and paramedic, then assessed the girl.
She was stabilised and prepared for the flight.
The teenager was then flown to John Hunter Hospital in Newcastle in a serious but stable condition.
It was one of two missions from the North West to Newcastle on Sunday morning after a 21-year-old man was seriously injured in a crash near Gunnedah.
Sign up for our newsletter to stay up to date.