Accident and emergency waiting time targets are endangering patient safety and care, a leading group of doctors has warned.

The College of Emergency Medicine claimed the four-hour target was putting NHS staff under “incredible pressure”, saying that circumstances meant it could not always be met.

While supporting the scheme in principle, the college said quality should always take priority over waiting times, especially when lives were at stake. On average four to five consultants are assigned to accident and emergency units which receive between 60,000 and 80,000 patients a year - a “woefully inadequate” ratio, he said.

College of Emergency Medicine chairman Dr John Heyworth claimed the desire to meet the mark at any cost was dangerous and had gone too far.

He said: “We’ve had nurses reduced to tears. We’ve had very senior consultants in emergency medicine threatened with a disciplinary process. This is an outrageous misuse of the standard.

“It’s not what the clinicians are in the emergency departments for. But it’s representative of the immense pressure being put on chief executives and all managers downwards from there to comply with the target.”

Responding, a Department of Health spokesman said: “Patient safety and good quality care should always take priority over administrative targets where a doctor believes that is necessary. Ministers have repeatedly said that to managers and doctors.”

Figures released by the Department of Health have shown that at the beginning of 2003 almost a quarter of patients spent more than four hours in A&E.

Department of Health statistics for 2008-09 have shown 98.1 per cent of patients in England spent less than four hours in A&E from arrival to admission, transfer or discharge.