Health chiefs have been put on red alert after failing to meet a string of waiting time targets.
Almost half of the key lists at NHS Ayrshire and Arran are being flagged up for causing major concern.
Medical director Bob Masterton outlined the figures at the latest meeting of the Ayrshire and Arran board.
Of the 31 performance targets, a total of 13 are on red alert. Another is on amber and 17 are rated as green for OK.
The numbers have become a worrying trend for the health board, with nearly 50 per cent of targets in the red zone during 2012.
A main area for concern is Clinic Outcome Recording, which is a key strand of the new patient management system.
And Professor Masterton drew special attention to the failings in this area at the meeting last Wednesday.
Only 78 per cent of return or outpatient appointments are being given a recorded code in the new system by clinicians. The national target is 90 per cent.
And Prof Masterton admitted to the board meeting: “Quite frankly, our performance is far from what we’d want to see.”
But he denied to board members at the meeting that the poor numbers are a direct result of doctors “refusing to record on the outcomes of patients’ appointments”.
Chief executive John Burns said he was “disappointed” not to be on target with the national levels.
But he added: “All of our clinicians accept the importance of documenting clinic outcomes for each patient and are supportive of doing so.”
Mr Burns also stressed that a lot of hard work was underway to address the problems. He said: “We were disappointed by the performance reported to the NHS board in October and apologise to any patient who has had to wait longer than they should have had.
“At the same time, however, I continue to be impressed by the efforts and commitment of hardworking staff on the front line to respond to these challenging targets.
“I want to highlight that, as a board, we are consistently achieving the 18 week referral to treatment target.
“We do also recognise the importance of the stages of treatment targets and are determined to achieve these.
“Our operational teams are working hard on all elements.”
Mr Burns added: “I want to reassure the people of Ayrshire and Arran that we are committed to achieving the waiting time targets and to deliver high-quality, safe and effective care.”