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Health Secretary Shona Robison said winter flu would be a "key factor" for Scotland's health service to deal with over the coming weeks.

Her statement to MSPs came on the day figures showed patients waiting more than four hours in A&E reached record levels during the last week of 2017.

Ms Robison also highlighted that the take-up of flu vaccination among health staff was "lower than we would want."

Official figures show that less than 50% of NHS workers have been immunised.

The health minister said that the current pressures on the service were not "just about flu", but she added that "clearly it will be a key factor over the coming weeks".

Ms Robison told the chamber: "Usually the winter flu season has an eight to 10 week duration, so it is too early to say what the end season picture will be, but we must review the emerging and current data in the right context."

The latest weekly figures show that just 78% of patients across Scotland were either admitted, transferred or discharged within the four-hour target time of 95% - that is the lowest since weekly figures began in February 2015.

Ms Robison said she was "absolutely grateful to the NHS staff for all the hard work they do". However, she added that on the issue of healthcare workers getting the flu vaccination she thought more could be done.

Just over 40% of staff - including those who have contact with patients and those who do not - had had the jab.

Ms Robison said: "While, ultimately, the decision about whether or not to be vaccinated is down to individuals, I'm sure we would all want to take this opportunity to urge all those eligible to get the flu vaccine as soon as possible."

She also warned against "alarmist" commentary on the flu mortality rate in Scotland.

Ms Robison explained: "Four people have passed away in hospital who were admitted with flu-related symptoms. Each one of these deaths is a personal and family tragedy.

"However, all-cause mortality is not the same thing as flu-related deaths. This data reflects deaths due to any cause - accidents, other diseases, old-age. This is not just about flu."

Tory health spokesman Miles Briggs raised concerns about "alarming" reports that the Scottish Ambulance Service was struggling with a lack of call handlers in local call centres as well as crews on the road to cope with current high demand.

Labour's Anas Sarwar said NHS staff were "overworked, undervalued and under-resourced" all year round which was being "amplified" in winter.

And BMA Scotland, which represents the country's doctors, warned that the current situation should not be dismissed as "the inevitable increase in pressure that winter brings".

Its chairman, Peter Bennie, said: "Instead of gratitude, we need a long term, sustainable plan that closes the growing gap between resources - in particular finances - and the demand for services.

"The BMA believe that multiple targets, an ageing population and the funding gap are creating a vicious circle, stretching the system and the workforce beyond their means.

"In winter, that results in the type of rapid deterioration of services that we have seen over recent days. But over the course of the rest of the year it also means the ongoing eroding of standards, care and services. Patients deserve better."