According to NHS Lothian, reporting guidelines were breached at the Royal Infirmary, the Royal Hospital for Sick Children and the Western General’s Acute Receiving and Assessment Unit (ARAU).
The revelations, published by the health board after an internal review, come just weeks after a whistleblower raised similar concerns about St John’s Hospital in Livingston.
Staff at the hospital were found to have set up their own recording system, which meant emergency department patients waiting longer than four hours were not being properly logged.
The news prompted health secretary Shona Robison to call for an independent review, which has now got under way and is expected to report back in the new year.
In the meantime NHS Lothian has said it will remodel its reporting practices for emergency waiting times. Officials said they had “already created a robust Standard Operating Procedure (SOP), instructed comprehensive staff training around it and begun development work to better support staff”.
The report states that the number of discharges initially recorded as exceeding the four-hour target but then altered to being within it almost doubled from 5.7 per cent in October 2015 to 10.5 per cent in September 2017.
It advises improved staff training, greater monitoring and stricter governance, and states those measures could have prevented some of the practices earlier.
Jim Crombie, NHS Lothian’s deputy chief executive, said: “The report has made a number of recommendations and the board members will discuss them in greater detail. We have already put several of them into place, including the creation of a Standard Operating Procedure and created staff training.
“We also have to do work with our teams across NHS Lothian to help them feel supported and that will feature as a key strand in our development plans.
“As soon as we received these initial concerns, an internal audit team was appointed, headed by a senior non-executive director to oversee the investigation. We now have the results and the recommendations from that report and we will develop a plan to ensure effective action is taken.” Health secretary Shona Robison said she remained “very concerned” but that it was important to await the outcome of the Academy of Medical Royal Colleges review to fully understand the situation.
Labour health spokesman Anas Sarwar said: “It is extremely disappointing to see NHS Lothian’s emergency department waiting times may in actual fact be much worse than initially published. The truth is waiting times are far too long in the Scottish NHS, with targets being missed on a weekly basis.”