Patients living in communities in rural areas are being urged to use internet-based phone service Skype to contact their doctors over Christmas and the New Year.

The radical move by health board NHS Grampian aims to relieve pressure on hospitals by reducing the need for patients to visit accident and emergency departments over the busy festive period.

GPs and nurses in the north-east could soon be using both Skype and other video communications tools which are available on mobile phones on tablets to advise patients with long-term conditions.

The technology could also be used by patients with minor ailments who are unable to leave their homes because of wintry weather.

Extra appointments will also be made available at some rural GP surgeries over winter to make sure patients can be checked over at community facilities.

The new measures were introduced as part of the Grampian Winter Plan launched by the Scottish health board yesterday.

A report discussed by the board noted that a surge of patients visiting hospital casualty departments last winter presented "significant challenges" to health and social care services in Grampian and across the UK.

Hospital staff were also struggling to meet Treatment Time Guarantee guidelines introduced by the Scottish Government due to increased workloads.

The report said: "There was a general increase in emergency activity overall and in admissions to our hospitals; there were more people delayed in hospital beds and there were episodes of longer waits in the Emergency Department than in the same time frame for previous years.

"This was coupled with an increase in elective admissions from the previous year. Hospitals are challenged to maintain levels of elective activity during the winter period of increased activity to maintain the Treatment Time Guarantee and keep any cancellations of elective activity to a minimum.

"Certain patient cohorts are known to increase over the winter period; for example people with long term respiratory conditions are more likely to experience exacerbations due to lower temperatures.

"These episodes increase the pressure and clinical risks within certain services and specialties such as respiratory, cardiac and critical care wards.

"Surge and capacity planning is required at team level in order to be sufficiently prepared for the winter period."

The report revealed that staff rotas for hospital casualty departments were finalised in October to help cut costs by reducing the need for agency staff.

Efforts will also be made to reduce the number of delayed discharge patients to free up hospital beds over the festive period.

The report added: "In 2013/14, and in 2014/15 Grampian had significant levels of delayed discharge which caused difficulties for the system flow particularly in acute hospitals and it was clear that health and social care needed to work together to address the issue.

"In Aberdeen city a group has been established to address the level of delayed discharges, meeting fortnightly currently and poised to increase the frequency of meetings during winter if required.

"In Aberdeenshire there will be a focused promotion of the use of technology to support self management approaches including Facetime and Skype for patient communication.

"The Home Care Responder Team is in place and developing on an ongoing basis to support rapid review of people at home to avoid deterioration and a need for acute admission."

The Grampian Winter Plan due to be approved at a board meeting before being submitted to the Scottish Government.