NHS Grampian’s diversion of some ambulances away from Aberdeen Royal Infirmary (ARI) is a “major warning light” for the health service, a union says.

BMA Scotland said doctors were “extremely concerned” after a critical incident was declared by the board on Thursday over very high demand on its services.

Patients requiring immediate life saving care will still be dealt with at ARI, but other patients will be taken to other hospitals where clinically appropriate.

Health Secretary Neil Gray said the Scottish government was working urgently to help mitigate pressures on the hospital.

Some elective procedures and appointments have been postponed, except for cancer treatment and diagnostic tests.

Dr Iain Kennedy, chair of BMA Scotland, said the timing of the incident was alarming.

He said: “There is a bed based problem in Aberdeen, there’s simply a shortage of beds in Aberdeen Royal Infirmary.

“The fact that this critical incident has been declared in November is extremely concerning.

“We’ve probably got a very cold winter ahead with inevitable seasonal virus outbreaks.”

Dr Kennedy said doctors in Grampian feel they are not being heard by NHS chiefs or the Scottish government.

He added: “What they’re telling me is that there needs to be far more investment in the community in General Practice, so that the doctors and the wider team there can help prevent patients needing to go to hospital In the first place.

“It’s right up there as a major warning light of the ongoing crisis in the NHS in Scotland.”

The Scottish Ambulance Service (SAS) said it was “working collaboratively” with NHS Grampian to manage the current pressures.

Patients have been diverted from ARI for care in Dundee and Elgin.

The heath board said people with the greatest clinical need would be prioritised for admission to ARI and it was aiming to get back to “business as usual” as soon as possible.

NHS Grampian has faced severe pressure in recent years, with staffing problems and multi-million pound overspends.

There have also been serious issues with ambulances forced to queue outside ARI.

Last month, the health board announced plans to reduce the number of ambulances waiting outside the hospital.

The scheme allows ambulance staff to take some patients directly into the initial assessment unit to avoid lengthy queues at the hospital entrance.

The Unison union has opposed the change, saying it would add to the pressure faced by hospital staff.

The Scottish government said it was “working urgently” with NHS Grampian to help mitigate pressures at ARI and provide support.

Health Secretary Neil Gray said “patient safety is paramount”.

He added: “This type of sustained pressure that services are facing is not unique to Scotland, similar challenges are being felt across the UK.

“While Scotland continues to have the best performing core A&E departments in the UK, performance is not of the standard we all expect.”

The health secretary said investment continued to be made in NHS 24 call handlers and the SAS workforce – with 1,388 more staff recruited since 2020.