GOVERNANCE must improve at NHS Scotland to deliver the “reforms” needed to allow it to “remain affordable and sustainable,” Audit Scotland has warned.

In its latest report, the public finance watchdog found weaknesses in the Scottish government’s scrutiny of the service, weaknesses exacerbated by increasingly complex planning and governance structures across the country’s 22 boards.

While Audit Scotland noted the Scottish government’s new planning framework had been well received, they warned it would be challenging to put into practice and would need further strengthening to enable further NHS reform.

Auditor general for Scotland Stephen Boyle said: “The delivery of NHS services must be reformed for Scotland’s health service to remain affordable and sustainable.

“NHS Scotland’s governance arrangements are key to delivering that reform, but they need to be strengthened.

“The planning of healthcare in Scotland is becoming more complex and the Scottish government needs to ensure lines of accountability and decision-making are clear.”

Scottish Labour health spokeswoman Jackie Baillie, who has pledged to cut the number of health boards, said: “Scotland’s NHS is at breaking point and patients and staff across Scotland are suffering the consequences of the SNP’s failure.

“The status quo won’t cut it, but the SNP’s overcrowded and bureaucratic structures are standing in the way of modernisation and hindering accountability.”

Pointing to NHS Scotland’s recently published Operation Improvement Plan, SNP Health and Social Care Secretary Neil Gray, however, said that the report “supports the approach we have already set out for protecting, strengthening and renewing our NHS.”

“In order to ensure this modernisation and renewal of our services is supported, good governance will be key and the Scottish government will work closely with NHS boards to ensure we deliver on our ambitions,” he said.