The move follows concerns about the board's financial position, plans, leadership and governance, and the impact these may have on the delivery of local services.

The Scottish Government will oversee the development and delivery of NHS Grampian's Improvement Plan to address concerns in spending.

Health secretary Neil Gray said: ‘Staff in NHS Grampian continue to work tirelessly to deliver the high-quality care we expect. However, there are continuing concerns about financial management and associated operational pressures.

‘Escalation to Stage 4 will bring enhanced scrutiny and support from the Scottish Government and we will work with Grampian to ensure sustained improvement. This will include a whole system diagnostic to be carried out by an external consultancy to help inform a tailored package of support.

‘I am confident that, through these actions, we will soon have a clear plan to stabilise the system and set the right conditions for the necessary, longer-term transformational work – with the key aim being to ensure the sustainable delivery of high-quality healthcare services for the benefit of local people.'