Two health boards facing shortfall of around £45m
NHS Ayrshire and Arran and NHS Highland are expected to face significant financial challenges.
Two NHS boards are facing a shortfall of around £45m.
Audit Scotland has found NHS Ayrshire and Arran and NHS Highland are expected to face significant financial challenges in the years ahead.
Ayrshire and Arran is predicted to have a shortfall of £22.4m this year.
NHS Highland is expecting a funding gap of between £19m and £23m in 2018/19.
But the Auditor General has expressed serious concerns about the boards' ability to deliver the savings.
Auditor General Caroline Gardner said: "Both NHS boards face significant financial challenges, and I have serious reservations about their ability to make the changes that are needed to achieve financial balance in future."
The report found: "NHS Ayrshire and Arran has received £23m of brokerage from the Scottish Government in 2017/18 to help it achieve financial balance.
"A repayment plan is yet to be agreed and brokerage repayment costs are not yet included in the planned savings figures set out in this report.
"The board anticipates that it will require a further £22.4m of brokerage in 2018/19."
In relation to NHS Highland, the report added: "To achieve financial balance in 2018/19, the board needs to deliver £52m in savings.
"As at August 2018, the board had plans to achieve savings of £30m, which leaves NHS Highland to meet this gap and the board was forecasting a requirement of brokerage of £19m to £22m.
"The board faces an extremely challenging position in 2018/19 and beyond.
"It will be increasingly difficult to achieve financial balance in the medium term.
"The board has historically found it difficult to achieve savings on a recurring basis while identifying new service models and maintaining the required workforce to deliver services."
NHS Ayrshire and Arran chief executive John Burns said: "Financial sustainability has been an increasing challenge over recent years.
"This has been due to increasing unscheduled care demand, which has required extra hospital beds to be opened, as well as cost pressures, including new drugs and agency medical costs to sustain services.
"However, 2017/2018 was the first year that we received financial brokerage.
"In recent years we have needed to achieve higher levels of cash releasing efficiency savings.
"These savings have been difficult to achieve and 40 per cent of the £24.8 million savings made in 2017/18 were non-recurring."
An NHS Highland spokeswoman said the board is continuing to alleviate the pressures.
She said: "NHS Highland's financial challenges have been widely reported and we continue to work closely with the Scottish Government as we develop plans to return to financial balance."