Services may have to be cut back at hospitals in Lanarkshire due to a serious shortage of nursing staff, according to a letter obtained by BBC Scotland.

The problem is being blamed on the number of nurses who have been lost to the new NHS 24 helpline and regional cancer centres.

The revelations come a week after another Scottish health trust voiced concerns over the impact of the number of staff joining the helpline.

NHS 24 has been launched in Grampian

The letter was sent from Paul Wilson, the director of nursing at Lanarkshire Acute Hospitals NHS Trust, to the organisation's management team.

He said the trust was losing lower grade nurses in accident and emergency and other critical care areas.

They were leaving for higher graded positions at NHS 24 and expanding regional cancer centres.

Mr Wilson said that the sudden expansion in the health service has left too many employers chasing too few nurses.

The situation is worst at Monklands General Hospital in Airdrie, where there has been an 82% turnover of nurses in the space of 12 months.

We are aware of the need to improve co-ordination of the NHS Scotland workforce

Scottish Executive

Replacement staff are not skilled in techniques like chemotherapy.

Mr Wilson also warned that managers may have to consider cutting services.

His letter claims that better planning is needed by the Scottish Executive, and that more nurses should be recruited to the workforce before other areas of the NHS are expanded.

A spokesperson for the Scottish Executive said nurse recruitment and retention was a top priority.

The action already taken includes the promise of at least one year's employment for all newly qualified nurses.

"We are also equally aware of the need to improve co-ordination of the NHS Scotland workforce, including the nursing workforce," said the spokesperson.

Reduce pressure

"That is why we plan to organise workforce development functions around a regional structure, supported at national level."

A report on the future size and shape of the workforce is due to be issued on Thursday.

"The report will not only acknowledge the need to act promptly but also the need for the executive, NHS Boards and other partners to act together in setting up practical and sensible arrangements," added the executive.

The aim of NHS 24 is to reduce pressure on GP out-of-hours services and hospital accident and emergency departments.

Nurses are being recruited for the west of Scotland

The helpline is already operating Grampian, where 85 nurses and about 40 other staff offer round-the-clock advice.

Recruitment is under way for a new call centre to cover patients in the west of Scotland.

Last week the medical committee at North Glasgow University Hospitals NHS Trust raised concerns following the loss of 75 nurses.

However, the Royal College of Nursing doubted that all the nurses leaving the trust were going to work for the telephone service.

NHS 24 argued that it was actually helping bring back nurses who had left the profession.