Accident and emergency services at two Scottish hospitals could remain in place after an independent review panel said the case for change was weak.
Plans to downgrade A&E departments at Ayr and Monklands hospitals were announced in 2006.
However, the SNP administration reversed the closures and a scrutiny panel was set up to look at the health boards' revised proposals.
Its interim report has advised against making any major changes to services.
In both cases the panel found there was no strong case for "significant" changes to the present A&E arrangements.
The review body, led by health economist Dr Andrew Walker, said the options that would involve the most change from existing services raised the most questions.
Earlier this year the Health Secretary Nicola Sturgeon overturned plans by NHS Lanarkshire and NHS Ayrshire and Arran, to end consultancy-led A&E services at Monklands and Ayr.
"When a health board proposes substantial change, there is an onus on the board to prove its case"
The two health boards were instructed to produce revised proposals that would be independently scrutinised.
The review panel will now hold a series of public consultations before making its final report.
Dr Walker said: "We want local people to have their say on the proposals.
"We will not be compiling our final reports until we have heard from the public at meetings in Lanarkshire and Ayrshire."
The senior lecturer in health economics at Glasgow University added: "When a health board proposes substantial change, there is an onus on the board to prove its case.
"It needs to provide evidence that the current services is not safe or sustainable, and it needs to show the evidence that what it proposes instead will be better for patients and the public."
Both NHS Lanarkshire and NHS Ayrshire and Arran have produced information packs detailing options for emergency treatment in the future, including scenarios which cut support services at Monklands and Ayr.
More doctors
The panel said some of the research evidence used by the health boards was biased and not necessarily relevant to Scotland.
Both boards cited problems recruiting senior staff as a reason for change.
However, the panel's report said: "In 2006 there were 76 consultants in A&E medicine in Scotland but over the next five years a further 102 A&E doctors will complete their training."
Health campaigner Julie McAnulty, 36, from Coatbridge, stood as an independent candidate at the Holyrood elections in May as a protest at plans to downgrade Monklands hospital.
She said: "This interim report by the health scrutiny panel is very welcome indeed and appears to confirm what we've been saying all along.
"The health board's case for cutting services at Monklands just doesn't add up.
She added: "It's absolutely wrong to downgrade a hospital in a deprived area like this."
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