What the A&E scrutiny panel said

Plans to close the A&E department at Monklands were controversial

Health boards in Lanarkshire and Ayrshire did not make a "convincing case for significant changes to emergency services", a report has said.

The independent scrutiny panel was led by Dr Andrew Walker.

It was brought in by the Scottish Government after May's elections to assess the health boards' proposals.

Its two reports were strongly critical of the proposals to remove consultant-led A&E services from Ayr and Monklands hospitals.

In the assessment, health bosses were accused of selective quotations in making their case for change.

NHS Lanarkshire was said to have used out-of-date evidence.

READ THE REPORTS Report on proposals for NHS Lanarkshire A&E [29KB] Report on proposals for NHS Ayrshire A&E [29KB] Most computers will open this document automatically, but you may need Adobe Reader Download the reader here

While concentrating services at one or two hospitals might benefit a few patients, most would gain little and access for patients may be worse, it said.

Dr Walker, senior lecturer in health economics at Glasgow University, said the burden of proof should have been with the health board.

In the case of Lanarkshire, the health board quoted several documents to support its case - but failed to include quotes from these and other documents which gave a differing view.

Some of the claims made by the board - such as the likely effect of newly-appointed and inexperienced consultants having to work in small teams - were "highly contentious".

'Selective quotation'

Health board claims that doctors would be reluctant to work in Lanarkshire because of on-call rotas and other issues were called into question by doctors' own views.

And the health board relied heavily on studies from America - and also on studies that were almost 10 years old.

In another section, the report said: "Data from practice 15-20 years ago in other countries is now being used to justify reorganising cases in NHS hospitals in Scotland with effects that could potentially last for decades."

In the case of Ayrshire, the independent report again complained of selective quotation.

It is the panel's view that this figure was presented without being underpinned by a sound evidence base Independent scrutiny panel report

Studies that questioned the safety of ambulance response times and distances tended to be "overlooked or criticised" while studies suggesting that longer ambulance journeys were safe were quoted without comment.

In some cases, references were either misquoted or quoted out of context, and evidence was taken from other countries with no heed being paid to the different conditions there.

Claims were made that could not be supported by research evidence, particularly on the safety of transferring sick patients between hospitals, and other claims were made with no evidence offered in support.

The case for a single emergency surgery centre for Ayrshire based on a Royal College of Surgeons report stated that a population of 300,0000 people was needed.

"Having considered this report, it is the panel's view that this figure was presented without being underpinned by a sound evidence base and as such, it does not provide a convincing basis for centralising emergency services," said the panel.

The health board had paid too little heed to local conditions, the report said.

Both NHS Lanarkshire and NHS Ayrshire said they would consider the reports at meetings later in January.