Bed-blocking threatens to plunge NHS Fife into a fresh crisis as health workers struggle to send A&E patients back into the community.
More than 150 emergency department patients at Victoria Hospital had to wait more than four hours for treatment in a week because of problems in discharging patients, as well as rising admissions.
Fife has the worst A&E waiting times figures in the country for the week ending January 3.
And it saw the proportion of those failing to be seen within the four-hour target rise 10 percentage points in just seven days.
There were 158 patients in Fife who did not get seen within the target time that week.
That amounted to 13.1% of all those arriving at the emergency department. The national figure was 5.3% with NHS Tayside at 1.7%.
Fourteen patients in Fife waited more than eight hours in A&E.
Bosses at the Kirkcaldy hospital have found it difficult to put patients back into the community because of capacity issues in the community system.
An NHS Fife spokesman said they are seeing more people arriving at Victoria Hospital’s emergency department.
He added: “This increased attendance, in addition to a rise in hospital admissions and a drop in the number of patients we are able to discharge into the community, has led to a number of patients waiting longer than four hours for the completion of their treatment.”
Bed-blocking has been a long-running problem in Fife, but the council and health board say they have made significant progress in the past year despite rising demand.
Sandy Riddell, director of health and social care at the council, said: “Although there continues to be significant demand for services and there was a short period immediately following the festive break when the number of patients in delay increased, the position as of today (Tuesday) is that the number has reduced to 84 with further patients due to be discharged to a more appropriate care setting over the next few days.”
Jim Hume, the Liberal Democrats’ health spokesman, said: “Despite promises from the SNP government, these revelations show that there is still a great deal of work to be done.”
Labour MSP Claire Baker said the figures were a “cause for concern”.
Health Secretary Shona Robison said: “Recent years show us that the first few weeks of the year are always when A&E performance is under most pressure.
“However, we have record investment and increased staffing in place to help meet demand through this winter period.”