Public spending watchdog Audit Scotland highlighted evidence of the growing pressure on hospitals in their latest analysis of NHS finances.
Trouble meeting waiting times targets, rising vacancies for doctors and nurses and more use of bank and agency staff are among the issues they noted.
Commenting on the report Matt McLaughlin, Unison Scotland regional organiser for health, said: "This should be a wake up call for the Scottish Government that the NHS can't keep doing more with less. The Scottish Government need to realise that if they are going to set targets and standards then they need to provide the budget to pay for it."
The Herald is running a campaign calling for a review to ensure the right resources are in the right place at the right time to meet the needs of the growing elderly population.
Scottish Labour health spokesman Neil Findlay said: "Audit Scotland have reinforced the need for an immediate review of the NHS so we can come up with a long-term plan that will support hard-pressed staff and ensure patients are properly cared for.
"We know that in real terms the training budget for nurses has being cut by 7.5%, yet hospitals are struggling to cope with the cuts to nursing staff and have to rely on agency or bank staff. This is not sustainable, there needs to be investment in nursing to cope with the demands of an ageing population going forward."
The British Medical Association in Scotland has also highlighted growing pressure on staff this year and called for action from ministers.
Dr Brian Keighley, chairman of the BMA in Scotland, said yesterday: "NHS boards are facing huge financial pressures at a time when demand for health care services is increasing. NHS managers have the unenviable task of managing shrinking budgets whilst trying to achieve a range of annual targets, outcomes and performance standards that are set by government. This can leave boards focusing on planning services for the short term; making savings from easy targets such as the workforce. This is not sustainable and the BMA welcomes Audit Scotland's recommendation to introduce structures that encourage longer term planning for NHS boards."
The Scottish Government has taken action to improve emergency care in Scotland after hospitals struggled to cope with the number of admissions required last winter.
It emerged yesterday that 13 additional emergency consultants have been recruited - five short of the 18 planned. Officials said they were committed to improving unscheduled care by investing £50m over a three year period.