NHS Highland is pressing ahead with plans to overhaul its out of hours care amid concerns about GP shortages and spending on locum staff.

The health board approved a proposal to cut the number of centres providing out of hours cover from 22 to 17 over the next two years at a meeting on Tuesday.

Patients could be forced to travel more than 40 miles further for treatment as a result of the decision, which will affect Tongue, Armadale, Lochaline, Applecross and Glenelg.

NHS Highland said its workforce is sustained by "extensive use of locum cover" costing an average of £12.5m annually - with £2.5m spent on out of hours locums alone in 2015.

In a report, senior staff warned that a lack of GPs has put the trust in a "grave" position which could lead to "unplanned service failure" in the next year.

They said the Inner Moray Firth area had been especially badly hit by shortages and noted that contingency plans were necessary most weeks to keep the service running.

Their report concluded: "The current model of providing care in the out of hours period is not sustainable both from a staffing and cost perspective.

"The need for change in now pressing and the proposed new model is believed to be more resilient and makes better use of the available resource."

NHS Highland chairman David Alston added: "The board's decision to approve this direction of travel allows us the team to work with each community on alternative arrangements. There needs to be confidence that these are in place and working.

"I felt the meeting was a positive step in the right direction to greater collaboration and shared ownership of the problem.

"I was pleased to meet and speak with public members from Glenelg at the meeting. My impression was that they appreciated the chance to make their views known and that they felt their concerns had been raised.

"We have to work together on this and I am confident we will come up with something safe, sustainable and local people have confidence in."