Senior doctors at NHS Grampian have claimed management is ignoring concerns about the lack of staff in accident and emergency departments.
The medics say staff shortages mean the A&Es in Aberdeen and Elgin have no senior registrars on shift to make key decisions for the majority of weekend night shifts.
In a statement, NHS Grampian said it was aware of the problem and was in the process of expanding the workforce.
The senior doctors told this morning’s BBC Radio Scotland’s Good Morning Scotland they were speaking out because they feel they cannot deliver a safe level of care.
Speaking to the BBC, an NHS Grampian spokeswoman thanked staff and said it recognises the pressure on A&E departments.
They said a national shortage of doctors at the appropriate level of training.
A number of senior doctors spoke anonymously about conditions in Elgin and Aberdeen Royal Infirmary (ARI) emergency departments.
They say they have been raising concerns since 2021, both with NHS Grampian and the Scottish Government.
NHS Grampian staffing concerns
In July this year, they say they submitted a formal whistleblowing complaint about the situation.
One doctor told the BBC today: “The staff are in an impossible situation.
“We are witnessing ongoing harm with unacceptable delays to the assessment and treatment of patients.
“There have been avoidable deaths and at other times there are too long delays getting to patients who may be suffering from a serious condition like stroke or sepsis.”
The whistleblowers also revealed that last March, a senior clinician wrote to NHS Grampian to warn of the “incredibly stressful and difficult” conditions at ARI’s emergency department.
The letter warned of the dangers of multiple ambulances with patients waiting outside the hospital.
They also claimed that a high number of patients with chest pains or headaches were waiting for long periods of time to be seen.
The letter said medics did not want a repeat of a 2014 staffing crisis in the health board.
The doctor claimed he had worked six weekends in a row to fill in the gaps.
Staff in the emergency departments also sent a joint letter to NHS Grampian in January this year, the radio show heard.
This warned they were “unlikely to be able to perform their statutory duty in a major incident”, with bed blocking a significant safety concern.
Doctors estimated that between December 30 last year and January 3 this year, a total of 260 A&E patients were delayed in excess of eight hours in Grampian’s emergency departments.
They estimate these long waits equate to at least three excess deaths in that five-day period.
Five weeks after the joint letter was submitted to bosses, a major incident was declared at Aberdeen Royal Infirmary on February 22 as a result of the pressures.
A spokesman for NHS Grampian said: “We recognise that the emergency departments in NHS Grampian are under tremendous pressure – as is the case across Scotland.
“We do know that waiting times are longer than we would wish – this impacts on patient experience and leads to a delay in admission or discharge.”
He continued: “Our consultant workforce has expanded but is not yet at full capacity. Our nursing and advanced health practitioner staff numbers have also increased and are fully recruited.
“The key recent pressure area has been the recruitment of doctors in training who are entering higher specialist training.
“These are nationally recruited and the levels across Scotland have been particularly low this year leading to a significant shortfall. This group of doctors is particularly important in the provision of night cover which is supported by a resident on-call consultant.”
Adding: “We have been working with colleagues across the system to reduce this shortfall and again would like to thank staff both within the emergency departments as well as across the hospital who have gone above and beyond to help.”