HEALTH Secretary Shona Robison has ordered an independent review after a whistleblower raised concerns that long A&E waiting times were being under-reported in NHS Lothian.
Ms Robison ordered the health board to carry out a full investigation following concerns focused on St John's Hospital in Livingston in October.
The interim findings of that investigation confirmed what have been described as "areas of concern".
They suggested staff in the emergency department felt pressured to achieve the four-hour access standard and the number of patients waiting longer than four hours had been understated in performance reports.
Early findings from the internal review showed staff in St John's Hospital have been applying locally-produced guidelines on how to record patients who breach the four-hour access standard which do not comply with national guidance.
It meant some patients who may have been recorded as breaching the waiting-time performance target were not included in departmental performance reports.
Ms Robison has now asked the Scottish Academy of Medical Royal Colleges to carry out an independent inquiry led by Prof Derek Bell.
The health secretary said: "These are serious allegations and the early findings are clearly a cause for concern.
"That is why I have asked Prof Bell to lead an independent review of these allegations.
"We are working very closely with the board to ensure that lessons are learned from the investigation and recommendations made are fully implemented as soon as possible and shared across NHS Scotland."
NHS Lothian has promised to fully cooperate with the independent inquiry.
Deputy chief executive Jim Crombie said: "We actively encourage our staff in NHS Lothian to highlight issues relating to patient safety and we take any allegations of misconduct or wrongdoing very seriously.
"We have a robust whistleblowing policy in place to ensure that all our staff are supported and feel able to raise any concerns and I am encouraged that staff are able to discuss them.
"As soon as we received these concerns, an internal audit team was appointed, headed by a senior non-executive director to oversee the investigation and get to the bottom of the concerns."
Five years ago, then health secretary Nicola Sturgeon ordered an independent review after telling MSPs she is "shocked and extremely angry" at a report into manipulation of waiting times by NHS Lothian.
It found NHS Lothian was marking patients as unavailable to artificially reduce the number in breach of the statutory waiting times guarantees.
The board offered treatment in England at short notice and recorded them as unavailable if they did not travel.
NHS Lothian then apologised "unreservedly" for the "unacceptable" practices.
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