Targets for NHS employment under Scotland's Covid recovery plan are "unlikely to be met," according to Audit Scotland.
The watchdog for government spending urged ministers to be "transparent" regarding hospital backlogs and give health boards attainable goals.
And it demanded more assistance for patients who were snarled up in lengthy wait times.
Although opposition MSPs called Health Secretary Humza Yousaf's record "shambolic," he predicted that it would take years for the NHS to fully recover.
The Scottish government's plan was created to alter the way services are provided and lessen the patient backlog caused by the pandemic, which caused some health boards to postpone non-urgent procedures.
It included 800 new general practitioners as one of its ambitious hiring goals for 2027.
That objective, according to Audit Scotland, was "not on track" and endangered the recovery of primary hospital care.
In addition, the GP workforce only grew by 113 between 2017 and 2022, according to its report.
It claimed that plans to hire 1,000 more mental health workers were "at risk" because of cuts of £65 million to primary care and £35 million to mental health services.
The government's NHS recovery plan, according to Scotland's Auditor General Stephen Boyle, lacked "detailed actions" that would allow advancement to be precisely gauged.
According to him, "robust modeling" was used to analyze demand and capacity.
In the 18 months since the plan's publication, according to Mr. Boyle, the treatment backlog has only gotten worse.
He stated that "NHS staff are still under tremendous pressure, and the Scottish government is faced with difficult decisions.".
"Money is tight, but recovery investments are necessary. That requires ministers to give priority to NHS goals that can actually be achieved. Additionally, they must be more open about their development. ".
Additionally, the Auditor General urged ministers to explain to the public in plain terms how the pressures on the NHS will affect the level of service they can receive, including the waiting times that have skyrocketed over the winter.
According to the annual report on the state of Scotland's health system, operations are currently 25 percent below pre-pandemic levels, the care backlog is growing, and more people are being added to waiting lists than are being taken off of them.
Additionally, it was discovered that health boards need to save more than £620 million to break even in 2022–23.
Only three hospitals—NHS Forth Valley, NHS Shetland, and NHS Western Isles—are anticipated to achieve financial balance in the upcoming fiscal year.
It also emphasized the National Treatment Centres (NTC) network's delays, which were supposed to result in a delay of 40,000 additional procedures by the end of 2026.
These objectives are less likely to be met now, according to Audit Scotland. .
The NTC in Livingston was initially expected to cost £70.9m, but current estimates indicate the new facility will cost £184m, according to BBC Scotland.
The three NTCs in NHS Fife, NHS Forth Valley, and NHS Highland that were scheduled to open last year are now anticipated to do so this year, according to the Audit Scotland report.
However, it was noted that some wouldn't likely open until late 2027 or early 2028.
Humza Yousaf commented on the report, saying it reiterated the "challenges and successes" of the Covid recovery.
"We have never concealed the scope of the task, and recovery will not take weeks or months—it will take years," he continued.
"That recovery, outlined in our £1 billion plan, is supported by record investment and has produced real success, including the Covid-19 vaccination drive and a notable decrease in the number of two-year outpatient waits," said the spokesperson.
"We are determined to build on this, and we will update you on our progress each year in the most detailed way we can. " .
The Health Secretary, Humza Yousaf, was condemned by opposition politicians for running for the SNP leadership.
The report's harsh criticism of the government's Covid recovery plan by Audit Scotland stands out. .
Despite being tasked with clearing the backlog, health boards were not consulted when it was first published in 2021.
According to the report, it does not appear to be possible to stick to commitments to increase planned operations by more than 10% over pre-Covid levels. .
Hospitals continue to have to reject routine care in order to concentrate on urgent cases, and a number of National Treatment Centres, a crucial component of expanding capacity, are behind schedule.
The government needs to start being upfront with patients about how long they will have to wait, according to the Auditor General. .
According to the watchdog, the main issue with the recovery plan is the dearth of reliable data and modeling on demand and capacity.
Because of this, it is challenging to determine whether or not something is working and where more focused efforts are required.
Of course, Scotland is not alone in feeling these pressures; people all over the world are experiencing them.
It is not simple to create a health service that is fit for the future. .
However, Stephen Boyle asserts that in addition to a growing number of frontline medical personnel, the government also needs to engage the populace in a direct discussion about the limitations of the NHS.
The "scathing report," according to Scottish Conservative health spokesman Dr. Sandesh Gulhane, revealed the scope of the challenge facing the service under Mr. Yousaf.
"His flimsy NHS recovery plan is inadequate, and there is trademark SNP lack of transparency about his strategy," the doctor concluded.
"That is leaving my burnt-out front-line colleagues and the suffering patients in the dark about what, if any, progress is being made in clearing the enormous treatment backlogs. ".
Jackie Baillie, a spokesperson for Labour Health, stated that the report "highlighted astronomical wait times and numerous missed targets.".
"This report lays bare the dysfunctional state of our NHS and the comprehensive need to support the valiant frontline staff working day and night to keep it afloat," she continued.
"Thousands of Scots who lost loved ones while Mr. Yousaf oversaw the NHS will be offended that he is now looking for a promotion rather than resigning from his current position. ".
"Today's report makes for a damning verdict of the failing NHS recovery plan and Humza Yousaf's tenure as health secretary," said Alex Cole-Hamilton, leader of the Scottish Liberal Democrats.
"Record wait times are increasing, and every aspect of the healthcare system is struggling. Now, we have learned that the staff needed to relieve the pressure won't show up. ".
The assessment of the staffing "crisis" in the NHS was well received by the Royal College of Nursing (RCN).
Colin Poolman, director of the RCN, stated: "We need fair pay that truly reflects the safety-critical role that nursing staff play, effective workforce planning that is based on population need, and implementation of Scotland's safe staffing legislation. ".
He also demanded that the government's new Nursing Taskforce make implementing a retention program to stop the "exodus of nursing staff" from the field a top priority.