A damning report into NHS finances does not take account of the Scottish Government's spending plans, Nicola Sturgeon said.

The Audit Scotland report found NHS Scotland is not financially sustainable and health boards across the country were struggling to break even.

With increasing pressure on NHS services, and rising numbers of people on waiting lists, auditor general Caroline Gardner said "decisive action" was now needed from ministers to secure the future of the "vital and valued service".

At First Minister's Questions on Thursday, Ms Sturgeon described the document as "rightly blunt", but she said it did not take into account the government's new financial plans.

She said health spending had increased year-on-year, with a new financial plan recently announced by health secretary Jeane Freeman.

"We have plans in place both for the investment the health service needs and for the reform the health service needs," the First Minister said.

"The medium-term financial plan is not taken account of in the Audit Scotland report.

"Of course that plan sets out a proposal to see the health budget increase by £3.3bn over the period until 2023. That would be annual growth of 2.9% in real terms.

"As the Audit Scotland report says the Fraser of Allander Institute predicts the health resource budget is likely to have to increase by around 2% per year to stand still.

"So we are providing resources over and above that, and I think that significantly changes the comment about financial sustainability."

Labour leader Richard Leonard said the report was a "damning indictment" of the Scottish Government's "mismanagement" of the health service.

Mr Leonard said boards had faced £1.1bn of cuts since Ms Sturgeon took office, with the latest Audit Scotland findings demonstrating "an abject failure" by ministers.

"This week's Audit Scotland report exposes the mismanagement of the NHS under the SNP, with too many staff under too much pressure, too many patients waiting far too long and too many health boards having to make swingeing cuts," he said.

"The SNP has been in office for 11 years and the Auditor General has concluded that the NHS in Scotland is not financially sustainable - that represents nothing less than an abject failure of government."

The Scottish Government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.

Health boards made "unprecedented" savings of £449.1m, but many relied heavily on one-off savings for this, while three boards - NHS Ayrshire and Arran, NHS Highland and NHS Tayside - needed £50.7m of loan funding from the government to break even.

This was "significantly more" than in previous years, with Audit Scotland adding four boards have predicted they will need a combined total of £70.9m in the current financial year.

The report said the NHS is managing to maintain the overall quality of care, but it is coming under "increasing pressure", adding Brexit would create "additional challenges" for the health service.