Operations may be postponed this winter, despite a rise in NHS staff

NHS Scotland's chief executive said A&E admissions could also be diverted if there was a rise in patients with the winter vomiting virus or seasonal flu.

Kevin Woods admitted a global shortage of flu vaccines meant only a third had been delivered by the end of October.

However, he said plans were in place to deal with increased demand.

It was also revealed that the telephone service NHS24 is expected to take more than 12,000 calls a day at peak winter periods, at a rate of a call every two seconds.

There are bound to be issues and pressures put on some parts of our system Kevin Woods

The figures were disclosed by Mr Woods and deputy chief medical officer Professor Peter Donnelly as they set out the NHS's plans for the winter.

About 1.3 million flu vaccines have been ordered this winter, 200,000 more than ever before.

However, Professor Donnelly said only 32.6% of vaccines had been delivered by the end of October, with NHS Tayside, Lothian and Grampian experiencing particular delays.

But he insisted GPs had been made aware of potential delays as early as June and had planned accordingly.

By the end of this month 84% of the supply will have been delivered to pharmacies and shared out to GP practices within 24 hours, he claimed.

Extra beds

Mr Woods said: "There are bound to be issues and pressures put on some parts of our system, but we believe that we have anticipated that and have planned for it appropriately."

This winter the NHS 24 will have a total of 761 front line staff, 28 more than last year.

At a local level, NHS Lothian has plans for an additional 80 staff and can provide 61 extra beds if needed.

NHS Forth Valley has plans for about 50 extra staff and will bring an additional 13 spaces in nursing homes to relieve pressure on hospital beds.