A LEADING public health expert said the NHS should adopt a 2020-style emergency footing this winter and consider scaling down "back office" functions.
Dr Graham Foster, the chair of Scottish Directors of Public Health, told MSPs that some of the pressures facing the health service currently might be alleviated in the short-term if staff were freed up from meetings to spend more time on the frontline.
Giving evidence to Holyrood's Covid Recovery Committee, Dr Foster said: "I do think there is learning to be had from the pandemic - particularly from the first year, when we shut down a lot of our back office functions, we had a lot less meetings, a lot less boards, and much less governance, and we devoted our entire effort to the front door.
"During that time, we were a lot more efficient. So there is a question to be asked about whether there is learning from that and whether we could be more efficient in the NHS if we spent less time in front of computers and at committee meetings and more time with our patients.
"I think there's an avenue to be explored there."
Dr Foster, who is also the director of public health at NHS Forth Valley, said Scotland had "been in the habit" of running the health service "at 95-98 per cent with all of our beds full all of the time", contrary to guidance which recommends that safe occupancy levels are around 85%.
He added: "We tend not to have mothballed wards that we can bring on to deal with extra peaks, and at the moment it feels like we're running at about 120% so we're dealing with more patients that we've got hospital beds to put them in.
"That's the reality and that's really quite challenging.".
He said extra money in the short-term "probably wouldn't help because we can't get any more staff and build any more buildings in the time we need to get through this winter".
It comes after figures earlier this week showed that more than 4,400 patients had spent over 12 hours in A&E departments during July - a record high - with the number of beds being lost to delayed discharge over the same period also higher than ever in a signal of the severe pressure on hospital beds.
More than 35,000 people on waiting lists for inpatient and day case procedures at the end of June had been waiting over a year for their operation, with around 10,000 having been waiting over two years - a figure that was just 98 in March 2020, before the pandemic.
The committee, which was hosting its first evidence session since parliament returned from the summer recess, also heard evidence from Carolyn Low, director of finance for NHS National Services Scotland.
Ms Low said "real choices" will have to be made on what to prioritise.
She said: "The money we've had in the past to respond to Covid, it felt like we were resourced properly to do what we had to do.
"But the reality is that that spending resource has stopped and we now need to get back to a position that is more sustainable, and we have wider pressures around inflation that we have to deal with.
"There are real choices that need to be made within health, around prioritisation, and what we have to spend our money on.
"But clearly our choices are limited when were facing a scenario that we have real pressures in our hospitals and we have to tackle that."
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MSPs also heard that Covid testing has been scaled back so dramatically that one of Scotland's major regional labs - capable of processing thousands per day - is doing none at all now.
Mary Morgan, chief executive of NSS said capacity could be rapidly scaled up if necessary, but added: "What we are doing, pending what happens after this winter, is maintaining those laboratories in a state of readiness.
"There's servicing and maintenance costs for equipment, so they are there, they meet regulatory requirements, but just now they're not fully staffed.
"I visited one a couple of weeks ago and there was no activity going through it at all."
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