Healthcare staff at HMP and YOI Grampian are "tired, over-stretched and stressed", according to a new report.
The prison facilities - replacing HMP Peterhead and HMP Aberdeen - opened in 2014.
Officials from HM Inspectorate of Prisons for Scotland (HMIPS) visited the facility in Peterhead in November last year.
A report has said recruitment challenges and staff absences "remain a concern" for healthcare staff.
The Aberdeenshire Health and Social Care Partnership (AHSCP) said the team was working "exceptionally hard" and their dedication was a credit.
The Liaison Visit Report 2020 states a "depleted healthcare team" at the prison was a "key concern", despite an ongoing commitment from the AHSCP to find solutions.
Another area of concern was the provision of pharmacy services.
Following an earlier inspection in 2019, it had been recognised that a local pharmacy team should be established at the prison.
Inspectors were later informed a pharmacy workforce plan had been agreed to advertise for key roles.
However, on the most recent visit, inspectors said they were "disappointed" to find that "very little progress" had been made, and without an on-site pharmacy team, nursing staff were having to take on the additional responsibility of delivering a pharmacy service.
The report said it should be a "priority" for the local healthcare partnership to implement the agreed proposal to recruit staff and free up the time of nurses.
'Significant positive changes'
An inspection in 2015 had previously raised healthcare concerns at the prison.
Meanwhile, inspectors highlighted that prisoners were getting appropriate access to fresh air, showers and telephones.
Mark Simpson, AHSCP's partnership manager for North Aberdeenshire, said: "The healthcare team at HMP Grampian work exceptionally hard, dealing with some very complex cases and their dedication and commitment is a credit to their profession.
"Due to the highly specialised nature of the job it has been hard to recruit more staff to join the team. But we continue to explore every avenue and look at new and creative solutions to support the team already in place and attract more healthcare professionals to join them.
"We have come a long way and working with the team at the prison have made significant positive changes both for the staff and for those we care for."