There is a growing demand for information on forest health due to fears that climate change may cause new kinds of damage that have not previously been encountered. In many cases, forest damage monitoring is conducted exclusively within sparse large-scale grids of sample plots and it is doubtful whether these are capable of providing relevant information to support mitigation programmes or other actions required to reduce economic losses due to damage outbreaks. In this study, we used simulated sampling to assess the precision of estimators related to forest state and changes in the damage sustained by trees within an area corresponding to the Swedish region Götaland, assuming a sampling design corresponding to that used in the Swedish National Forest Inventory (NFI) under different damage scenarios. Large and uniformly distributed damage outbreaks were well captured by an NFI-type inventory, but scattered damage outbreaks produced estimates with poor precision. As a consequence, we propose that there might be a need to revise current forest damage monitoring programmes to make them more useful for monitoring the kinds of damage that are likely to arise as a consequence of climate change.