The biggest hospital in the Highlands has been placed in 'code black' status due to rising Covid patient admissions and high numbers of staff isolating.
NHS Highland said Raigmore hospital had reached capacity and warned that emergency patients would face long waits with all non-urgent elective surgery and most outpatient appointments cancelled.
The health board said it had experienced 'unprecedented demand' across all health and social care services. The impact of rising Covid cases has been more severe because the hospital is carrying out more surgery than in previous waves of the virus and it is a peak time for annual leave.
The board said efforts are focussed on ensuring patients can be treated "appropriately and compassionately". It is working with other health boards and patients may be transferred to other hospitals in some cases. Cancer and urgent cases will continue and where possible, orthopaedic and day case work.
READ MORE: What does code black for hospitals mean?
Code black means a hospital is at capacity with no available beds for new admissions from A&E. It is declared by the hospital's general bed manager, who then relays this to the local ambulance service and updates local healthcare services such as GPs and district nursing teams.
Fourteen areas in the highlands are now experiencing a rate of more than 400 Covid cases per 100,000 people, mainly in Inverness. The seven day positivity rate is 262.9 and the area is seeing around 100 cases a day.
In June alone the region saw 1300 cases, around a fifth of the total number it has seen since the start of the pandemic.
NHS Highland said: "The number of COVID-19 cases across our area has increased significantly.
"This is impacting on NHS Highland as some of these cases are now being admitted into our hospitals.
"We are also seeing the impact on a large number of our staff, across a number of settings, who are having to self-isolate leading to gaps and pressures in our service.
"In addition to this we are also at the beginning of the summer school holidays and planned annual leave.
"The impact of this at Raigmore Hospital, in particular, has been significant over the past few days.
"We have reached capacity in the hospital, we have long waits in our Emergency Department and we know people requiring urgent care will still need to come in for treatment. As a result, the hospital is currently at code black status.
The health board said the impact on services is also being experienced across community teams in Highland and Argyll and Bute.
"Urgent work is taking place to ensure we can treat our patients appropriately and compassionately.
"Medical, Surgical and Clinical Support teams are meeting regularly to agree the actions that must be taken and discuss what more can be done to reduce the pressure on services within the hospital.
"All non-urgent elective surgery has been cancelled.
"Cancer and urgent cases will continue and we will also, where possible, carry on with orthopaedic and day case work.
READ MORE: Covid Scotland: Kate Forbes claims signs cases are stabilising
"Not only will this help with the bed pressures but it will also reduce the pressure on those working in theatres at the moment."
Dr Boyd Peters, Medical Director for NHS Highland said: “We are doing all we can to safeguard services but we have had to make the difficult decision to cancel non-urgent work which I know many will find upsetting and frustrating. We are very sorry that we have had to do this.
“COVID is on the increase again but what is different this time is that we are seeing more medical and surgical activity at the same time.
"We also have a high number of staff having to self-isolate.
“If you are accessing services please be advised that your wait may be longer than expected."
Dr Peters added: “I know this has been a challenging time for all of us and many just want to get back to normal but COVID is still having an impact on what we do.
"Please can I ask that you all continue to follow FACTS guidance - wear a face mask, avoid crowded spaces, clean your hands regularly, stay 2 metres distance from others, self-isolate if you develop symptoms, and book a test to help us limit the impact that COVID can have.”
Public Health Minister Maree Todd said:“We are acutely aware of the pressure within NHS Highland and the Board have provided assurances that those of most clinical urgency, including vital cancer treatment will continue during this challenging period.
“While the increase in NHS staff absences over recent weeks is significantly lower than previous phases of the pandemic, this reflects the overall increase in infection rates across the population - and it is a reminder that each of us needs to continue doing all we can to slow the spread of the virus."
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