Growing concerns about NHS staffing could lead to service change plans neglecting accessibility and safety, the Independent Reconfiguration Panel has warned.

The body this week published a report, Learning from Reviews, of lessons and advice drawn from its five years' work.

Chair Peter Barrett said: "Sometimes people develop proposals behind closed doors that focus on the staffing priorities rather than patients."

Concerns about the European working time directive, which will reduce doctors' maximum working week from 56 hours to 48 hours from August, could add to pressure to reconfigure around staff, he said.

The royal colleges of surgeons and anaesthetists last week warned that many trusts were not prepared to properly staff services under the new limit.

In September, the panel rejected proposals by East Sussex Downs and Weald primary care trust and Hastings and Rother PCT to move consultant-led maternity, special care baby services and inpatient gynaecology services from Eastbourne District General Hospital to the Conquest Hospital in Hastings. Reasons for the planned move to a single site included meeting the directive.

To read Learning from Reviews, go to www.irpanel.org.uk