Doctors have criticised the findings of a "highly critical" and "deeply disturbing" report about local healthcare providers.
Audit Scotland, which compiled the report, has called for a fundamental review of Community Health Partnerships (CHPs), which are sub-divisions of the NHS providing primary healthcare services along local authority boundaries.
The British Medical Association (BMA) has said GPs have turned their back on CHPs because they have grown into "bureaucratic monoliths", which has "spectacularly failed to bridge the gap between health and social care".
The report found that some national health trends are getting worse despite there being 36 CHPs managing £3.2bn on improving community healthcare.
An example of this is that more older people and those with long-term health problems are being admitted to hospital as emergencies.
Although initially the number of patients being delayed from leaving hospital had declined, it is now increasing.
Dr Dean Marshall (pictured), who chairs the BMA's Scottish GPs' Committee, said: "This is a highly critical report which confirms our experience of the management and performance of these organisations.
"It is deeply disturbing that with responsibility for such a significant sum of NHS funding, around £3bn, and despite the many bureaucrats that work for these organisations, their financial management, strategy and governance is so poor.
"That a CHP cannot say how many staff it has working within its structure, or how much it has spent on administration costs, is beyond belief."