The Health Secretary has ordered an independent review after a whistleblower claimed long A&E waiting times at a hospital were being under-reported.

Shona Robison told NHS Lothian to carry out a full investigation after she was contacted about St John’s Hospital in Livingston last month.

The whistleblower 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 at St John’s 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.

‘These are serious allegations and the early findings are clearly a cause for concern.’

Shona Robison

After the interim findings confirmed areas of concern, Ms Robison asked the Scottish Academy of Medical Royal Colleges, chaired by Professor Derek Bell, to undertake an external review to investigate the full circumstances.

She said: “These are serious allegations and the early findings are clearly a cause for concern.

“That is why I have asked Professor 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.”

The review will report back to Ms Robison early in the new year.

The initial draft report noted no evidence of bullying or harassment was found during interviews with staff and that busy staff had produced their own reference guides for inputting information into the data recording system.

But the report stressed the guidance sheets were only “created with the best intentions of clarifying arrangements”.

Jim Crombie, deputy chief executive of NHS Lothian, said: “NHS Lothian is committed to the values of openness and transparency, and we have placed them at the heart of our organisation.

“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.”

Mr Crombie said an internal audit team, headed by a senior non-executive director, was appointed as soon as the concerns were raised.

He added: “We will co-operate with and support the work being carried out by the external review team.”

Scottish Labour’s health spokesman Anas Sarwar said: “These are deeply troubling findings that will concern patients across NHS Lothian and beyond.

“It is absolutely right that they are independently investigated.”