Jillian Evans, head of health intelligence at NHS Grampian, said the service was facing a “really exceptional situation” with people waiting for care and staff absences.
She said the backlog would take years to deal with, echoing health secretary Humza Yousaf’s warning over how long it would be before the NHS was fully remobilised following the pandemic.
Ms Evans also told how Covid, and dealing with the pressures it has created, could result in some “pretty major adjustments to the way we provide health care”.
Health boards across the country are continuing to deal with the impact of the pandemic on patient care.
Earlier this week, NHS Lanarkshire announced it was having to cancel some planned surgeries, with the health board’s director of acute services Judith Park saying “the pressures on our hospitals are as severe as at any time in the whole pandemic”.
The Scottish Government has given £12 million of additional funding to accident and emergency departments to help them cope, as the latest weekly figures showed almost a fifth (19.9 per cent) of patients had to wait more than four hours to be dealt with.
Ms Evans said demands for care before the pandemic meant the NHS had always operated as a “really tight ship, often with very little headroom in terms of our physical capacity and our workforce as well”.
But she said this situation had been “seriously magnified because of the pandemic”.
Speaking on BBC Radio Scotland’s Good Morning Scotland programme on Thursday, she said: “So many services were put on hold or paused for a time being while we focused on Covid care and on protective and critical services. That has resulted in a significant backlog of people waiting for surgery, predominantly, but other things too.
“That situation will get worse before it gets better because it takes a long time to clear that.
“I’ve been around long enough to see the NHS with very, very long waiting times and very long waiting lists, and this does feel like a really exceptional situation. It’s not surprising given what we have been through.
“It is going to take years, and I think it is much better to be honest with people about the challenges ahead, and we have got challenges ahead and dealing with that backlog will be something we will need to deal with across Scotland and it will involve lots of different parties and different sectors to help with that.”
The NHS could face a “very difficult, challenging time for the next few years”, she warned, but she also said this could result in “opportunities presenting themselves for change in the way we provide healthcare in the future”.
Ms Evans said many health boards are consulting with people about what is important to them in terms of health care.
Changes could see more virtual consultations, as well greater use of robotic surgeries along with ongoing efforts to treat people closer to home, she suggested.