A record number of patients spent more than four hours in Scotland’s A&E departments in August as new figures underline growing pressure on the NHS ahead of winter.
Public Health Scotland figures show 50,747 patients were in A&E for more than four hours before being admitted, transferred or discharged during the month.
It is the highest number recorded and exceeds the previous peak of 49,538 in December 2022.
Only 66.7% of A&E attendances were completed within four hours in August, well below the Scottish Government target of 95%.
A total of 17,717 patients, or 11.9%, spent at least eight hours in A&E during August, up from 10.1% in July.
Another 7,071 patients spent 12 hours or more in emergency departments, accounting for 4.8% of attendances compared with 3.8% a month earlier.
Public Health Scotland said compliance with the four-hour standard has remained below 80% since summer 2021.
There are signs that pressure has continued to increase since the August figures were recorded.
During the week ending 27 September, only 60.3% of patients attending Scotland’s major A&E departments were admitted, transferred or discharged within four hours.
Of 29,248 attendances that week, 11,616 lasted longer than four hours.
Almost 4,800 patients spent eight hours or more in A&E, while 1,993 – 6.8% of all attendances – were there for at least 12 hours.
It was the poorest weekly four-hour performance recorded since early April.
The latest figures come as Scotland prepares for the annual increase in pressure on hospitals during the winter months.
Health Secretary Angela Constance is expected to set out further winter planning measures to MSPs this week.
She said the Scottish Government remained committed to improving A&E performance and tackling long delays, adding that the “status quo cannot continue”.
The government published a national plan in August aimed at improving the movement of patients through hospitals, with delayed discharge and difficulties moving patients into community care among the wider issues affecting capacity.
The latest figures are likely to increase pressure on ministers to demonstrate that those measures can improve performance before winter demand peaks.
Scottish Conservative health spokesman Miles Briggs described the figures as an “extraordinary failure”, highlighting that the record had been reached during August rather than the middle of winter.
The Scottish Government’s four-hour emergency access standard requires 95% of A&E patients to be admitted, discharged or transferred within four hours of arriving.
Public Health Scotland formally monitors performance using monthly figures covering Scotland’s type 1 emergency departments and type 3 minor injury and community casualty departments.
With performance deteriorating further during September, the NHS in Scotland will enter the winter already under sustained pressure.