A report from Audit Scotland said Mr Yousaf’s strategy lacked “detailed actions” to allow progress to be accurately measured, and called for greater transparency from the Government.

The recovery includes ambitious recruitment targets, including hiring 800 new GPs by 2027, but the report said that aim was “not on track” and posed a “risk” to the recovery of primary care.

The watchdog’s report said Scotland’s GP workforce increased by just 113 between 2017 and 2022, while noting targets to recruit 1,000 additional mental health staff were “at risk” due to cuts of £65 million from primary care and £35m from mental health services.

Health Secretary Humza Yousaf speaks to the media outside the Scottish Parliament. Andrew Milligan/PA Wire

The report – published just three days after Mr Yousaf formally launched his bid to succeed Nicola Sturgeon as first minister – highlights concerns as the care backlog continues to increase. The document states more people have been added to waiting lists than are being removed, while operations sit at 25 per cent below pre-pandemic levels.

Stephen Boyle, Auditor General for Scotland, said: "NHS staff remain under severe pressure and the Scottish Government is facing tough choices.

“Money is tight, but investment is needed in recovery. That means ministers have to prioritise which NHS aims can realistically be delivered. And they need to be more transparent about the progress they're making.

"The Scottish Government has set out the big challenges facing the NHS. But it also needs to clearly explain to the public what those challenges mean for the level of service they can expect, including waiting times."

Simon Barker, deputy chair of the British Medical Association’s (BMA) Scottish council, said the Government must act “with a sense of urgency.”

He said: “The report paints a bleak picture – one the BMA and others have been warning of for some time. The financial sustainability of the NHS in Scotland is ‘concerning’ – it has been since pre-Covid and things do not look to be getting any better with a predicted funding gap of £221.8m across our health boards by the end of the year.

“Demand is outstripping capacity and the NHS simply cannot deliver what it is asked to under its current limitations. So there must be action if we want to ensure it is put on a sustainable footing for generations to come and stays true to the fundamental value of remaining free at the point of delivery.”

The Royal College of Physicians of Edinburgh (RCPE) said the report meant “serious consideration” must be given to whether the Government continues with its plans for a National Care Service (NCS).

“While the college supports the NCS in principle, it is vital that the care sector is appropriately resourced and staffed to meet current and future demands,” a spokesperson for RCPE said.

However, Mr Yousaf has said he would be open to overhauling his plan to create the NCS if he wins the race to become Scotland’s next first minister, telling Holyrood Magazine: “I’m willing to work with those who oppose the current plan to see if the there are some areas where we could compromise.”

Director of the Royal College of Nursing (RCN) Scotland, Colin Poolman, whose union has been locked in a pay dispute with the Scottish Government, said “the report is clear that tackling the workforce crisis is key for NHS recovery”.

“We completely agree that there also needs to be an open and honest discussion about the ongoing level of investment, and new ways of working, that will be required to meet the growing demands on Scotland’s health and care services,” he said.

Scottish Conservative shadow health secretary, Dr Sandesh Gulhane MSP, described the report as “scathing”. He said it “fully exposes Humza Yousaf’s monumental failures in charge of Scotland’s NHS”.

“Audit Scotland's forensic analysis highlights the ever-increasing scale of the crisis in our health service on his watch,” Dr Gulhane said. “Not only is his flimsy NHS recovery plan inadequate, but there is a trademark SNP lack of transparency about his strategy.

“That is leaving suffering patients and my burnt-out colleagues on the frontline in the dark about what progress – if any – is being made on reducing the huge treatment backlogs.”

Scottish Labour health spokesperson Jackie Baillie said the report “lays bare the shambolic state of our NHS”.

“Not only does this report detail astronomical wait times and multiple missed targets, it also challenges the SNP’s NHS Recovery Plan as the bureaucratic, top-down muddle that we already knew it to be,” she said.

“It is shocking that the worst health secretary since devolution, who has presided over nothing, but chaos since he took on the role, is now being encouraged to fail upwards by a party that is out of ideas and out of time.”

Meanwhile, Scottish Liberal Democrat leader Alex Cole-Hamilton said the report “makes for a damning verdict of the failing NHS recovery plan and Humza Yousaf’s time as health secretary”.

Responding to the report, Mr Yousaf said it “reaffirms both the challenges and successes of the continued recovery of our NHS from a global pandemic”, which he described as “the biggest shock in its history”.

“That recovery, outlined in our £1bn plan, is backed by record investment and has delivered real success, including the Covid-19 vaccination drive and a significant reduction in the number of two-year outpatient waits,” he said.

“We have offered the largest pay package in the history of NHS Scotland to Agenda for Change staff, provided wellbeing support and invested £11m to further domestic and international recruitment.

“NHS investment and workforce numbers are at historically high levels and I am pleased the report highlights the trend in health spending in Scotland is one of growth, despite the UK Government withdrawing funding for Covid-19 related costs. We have allocated more than £19bn of funding for health and social care in 2023/24, which meets our investment target for three years.”

Mr Yousas said “the Scottish Government will consider the report recommendations as we continue to build our recovery from Covid-19”.

SNP leadership contest: Humza Yousaf's leadership credentials dealt blow by NHS report

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