Hospital scheduled care is "simply short of what we expect" Health Secretary Shona Robison conceded, as new figures showed performance against key NHS waiting times targets falling.
Official figures disclosed 84.7% of patients were treated within 18 weeks of week being referred, below the Scottish Government's target of 90% and the worst performance for more than five years, according to the Tories.
There were six NHS areas where the 18-week referral to treatment (RTT) standard was achieved, with nine health boards failing to meet the target.
Tory health spokesman Donald Cameron said it was "appalling that performance in this area is the worst it's been in five-and-a-half years".
He added: "This is yet another grim report revealing how the NHS is being allowed to decline on the SNP's watch."
The Scottish Government has now launched a plan that aims to ensure outpatients are seen more quickly and in a more local setting.
The strategy has been developed in response to the rise of people who are being referred to consultants for care and aims to free up 400,000 hospital outpatient appointments by 2020.
Of all new outpatients waiting for an appointment, NHS figures showed that on September 30 2016 78.7% had been waiting 12 weeks or less - down from 85.6% at the end of June.
In the NHS Highland area, the latest figures showed 57.4% waiting 12 weeks or less for an outpatient appointment.
Separate figures showed that at the end of September 2016 there were 65,367 patients waiting for one of the eight key diagnostic tests and investigations - a rise of 16.8% from the same point in 2015.
The Scottish Government has set the target of having patients wait no longer than six weeks for the tests, including MRI scans and CT scans.
The figures revealed an "increasing trend of patients waiting longer than the six weeks standard for most of 2016", with the proportion having tests within that time going from a high of 94.7% at the end of February to 90.1% at the end of September.
At the end of July, the rate dropped below 90% for the first time in almost a year, when it fell to 89.6%, before rising to 90.5% at the end of August.
Labour health spokesman Anas Sarwar said: "These damning figures show the consequences of the SNP's mismanagement of the NHS.
"Declining performance in key areas means patients are waiting longer for treatment. That just isn't good enough."
Ms Robison said the new outpatient strategy would "ensure people get seen by the most appropriate health professional, often closer to home and ending many repeated, unnecessary trips to hospital".
The NHS deals with 4.5 million outpatients appointments a year, with about 1.5 million of these being new appointments while three million are return appointments either for follow-up care or a routine check-up.
The strategy proposes that some patients, particularly those who are waiting for a routine check-up or test results, would be seen closer to home by a team of community health professionals with close links to hospital departments.
Ms Robison said: "I am clear that this is not about giving more work to GPs or community nurses.
"Underpinning this plan is an aim for our community and hospital professionals to work more closely together, reducing unnecessary waste in the system and getting people seen by the right professional first time around."
She added: "There are real challenges that our outpatient services are facing right now.
"The performance of our hospitals in scheduled care is simply short of what we expect and that is why we've put in an extra £10 million this month to deliver an extra 40,000 outpatient appointments."
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