Significant changes are required to ensure the financial sustainability of Scotland’s health service, according to a report from Audit Scotland.

The report said the Scottish Government “needs to develop a clear national strategy for health and social care to address the pressures on services.”

It said that “growing demand, operational challenges and increasing costs” have added to the financial pressures the NHS in Scotland was already facing.

“Its longer-term affordability is at risk without reform,” said the report.

“Activity in hospitals and other secondary care settings has increased in the last year, but it remains below pre-pandemic levels and is being outpaced by demand.

“This pressure is creating operational challenges throughout the whole system and impacting staff, patient experience and patient safety.

“There are a range of strategies, plans and policies in place for the future delivery of healthcare, but no overall vision.

“The absence of a shared national vision, and a clear strategy to deliver it, makes it more difficult for NHS boards to plan for change.”

Stephen Boyle, Auditor General for Scotland, said: “Without change, there is a risk Scotland’s NHS will take up an ever-growing chunk of the Scottish budget.

“And that means less money for other vital public services.

“To deliver effective reform the Scottish Government needs to lead on the development of a clear national strategy for health and social care.

“It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS.

“And it should put patients at the centre of future services.”