According to new figures released by Public Health Scotland, some 8,857 people waited more than half a day in A&E last month, accounting for 7.2% of all attendances.
That's up from 6,644 in December and marks a new record.
The previous highest level was in December 2022, when 8,821 people waited at least half a day.
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The Scottish Goverment's target is for 95% of patients to be admitted, transferred or discharged within four hours.
However, the latest figures reveal that a total of 43,240 people waited longer than this at the start of the year. It is the second highest number of people waiting record.
Again, the only time the figure has been higher was in December of 2022, when 49,283 people waited more than four hours.
Scottish Lib Dem leader Alex Cole-Hamilton said the NHS was in "crisis".
He said: “Thousands of people waiting over 12 hours at A&E month after month should be something staff and patients never have to suffer through but, under this SNP Government, it’s practically the norm.
“The new Health Secretary needs to act now to pull our NHS out of crisis. Staff and patients cannot afford yet another year of stagnation and no recovery.”
Scottish Tory health spokesman Dr Sandesh Gulhane agreed that the lengthy waiting times had now become the “unacceptable norm”.
“We know these excess waits lead to tragic, needless loss of life,” he said.
“They are the direct result of the dire workforce planning of successive SNP health secretaries, as well as Humza Yousaf’s flimsy recovery plan.
“Despite the best efforts of my frontline colleagues, Scotland’s emergency wards simply can’t cope with the demands placed on them."
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Scottish Labour deputy leader Dame Jackie Baillie said Health Secretary Neil Gray “has been put in charge of an NHS fighting for its life”.
“This chaos is not just the handiwork of Michael Matheson or Humza Yousaf before him – it is the culmination of 17 years of SNP incompetence,” she said.
“Patients are being left stranded for hours on end because overstretched A&Es simply cannot cope.”
She added: “Neil Gray has a huge challenge ahead to tackle this crisis and bring our NHS back from the brink, but it is essential that he does so.”
A spokesperson for the Scottish Government said: “We know that long delays remain too high and we continue to work with boards to reduce these instances, which are not unique to Scotland.
“A&E performance is impacted by pressures from across the wider health and social care system which is why our unscheduled care collaborative programme is taking a whole system approach as we work with health boards to deliver sustained improvement.
“Hospital bed occupancy continues to be a major factor impacting on performance.
“To address this, the delayed discharge and hospital occupancy action plan is being implemented at pace, delivering actions we know work to ensure patients receive the right care in the right setting.”
There was some good news in the most recent weekly figures, which showed the proportion of patients seen and subsequently admitted, transferred or discharged within four hours rising to 64.1% in the week up to February 25 from 62.8% the previous week.
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