NHS Lanarkshire has moved back into 'Code Black' status as staff and bed shortages put services under severe strain.
The health board said it is currently beyond critical occupancy levels across all three of its acute hospital sites, and that it had taken the decision to escalate its risk level back to black - the highest risk status.
Judith Park, director of acute services for NHS Lanarkshire, said the health board has postponed "a small number" of electives procedures as a result, adding that these will be "rearranged as soon as possible".
Heather Knox, chief executive at NHS Lanarkshire, said: “We are facing relentless pressures, bed shortages and staff shortages due to annual leave, sickness absence and self-isolation.
"University Hospitals Hairmyres, Monklands and Wishaw are all at maximum capacity."
NHS Scotland follows a traffic light system: green when health services are functioning after a major impact; amber when services are moderately affected but functioning following intervention and red when significant intervention is required.
Level black is in place only when a board is experiencing an immediate, tangible impact to its services.
NHS Lanarkshire was previously in 'Code Black' from October 2021 until early May this year, before switching down to 'red'.
The Code Black in October resulted in a raft of elective procedures being put on hold, including some cancer surgeries.
Ms Knox added: “The safety of our patients and staff is our top priority and we are working through short and medium term actions to increase staffing and also improve the flow of patients in and out of hospital.
“The current situation puts us back to the highest level of risk for NHS Lanarkshire.
"The impact of the current pressures is being felt right across the health and social care system, including GP practices which remain extremely busy.
“We recognise that our staff are doing everything they can and showing the highest levels of professionalism, commitment and resilience.
"We hope that the current actions being taken will help ease the pressures on our staff and services."
Visiting arrangements are under review, but currently unchanged.
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Ms Knox said Lanarkshire's A&E departments "remain extremely busy with long waiting times to be seen".
"Patients are also waiting in A&E for admission to beds," she added.
"We strongly advise people that, if your condition isn’t life-threatening, please do not attend our A&Es - call NHS 24 on 111 to access the right care. Only go to A&E, or call 999, if it’s an emergency."
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