The Scottish government is to increase scrutiny on NHS Grampian over concerns about its finances and governance.
The health board has been escalated to stage four out of five on NHS Scotland's National Performance Framework.
Health Secretary Neil Gray said there were "continuing concerns" about NHS Grampian's financial management.
The health board said it welcomed the additional support and would work to "ensure sustained improvement".
It was announced last month that NHS Grampian would receive a Scottish government loan of more than £67m to tackle an overspend.
The Scottish government said the health board had been escalated to stage four following concerns about the board's "financial position, plans, leadership and governance and the impact these may have on the delivery of local services".
Financial concerns
Gray said NHS Grampian staff were working "tirelessly" but warned of "continuing concerns about financial management and associated operational pressures".
He said ministers would increase scrutiny on the health board and work with it to "ensure sustained improvement".
Gray said: "This will include a whole system diagnostic to be carried out by an external consultancy to help inform a tailored package of support."
He added: "I am confident that, through these actions, we will soon have a clear plan to stabilise the system and set the right conditions for the necessary, longer term transformational work."
He said the key aim was to ensure the "sustainable delivery of high quality healthcare services for the benefit of local people".
An NHS Grampian spokesperson said: "As we continue to work closely with the Scottish government to ensure sustained improvement in our performance, we would like to acknowledge the tireless efforts of our staff and reassure the public that their care remains our priority."
Health boards can move up and down the performance scale, and different levels of government support apply to each stage.
NHS Greater Glasgow and Clyde and NHS Forth Valley were both at stage four in recent years.
