An accident and emergency department is threatened with closure after a critical report from the Royal College of Surgeons.

The college is considering removing up to six junior posts from the Withington Hospital, Manchester, which would leave the A&E department without

surgical cover.

The report criticised the lack of consultant cover for junior doctors, particularly in vascular and breast surgery, and said the viability of the A&E department was 'in major doubt'. It recommended moving all general surgery to Wythenshawe Hospital, South Manchester.

Both hospitals are run by South Manchester University Hospitals trust which is building a new unit at the Wythenshawe to replace Withington's A&E department in 2001.

But the report has forced the trust and Manchester health authority to seek alternative A&E provision until the unit is built.

Manchester health authority spokesman Ian Rhodes admitted they 'should have seen it coming,' because surgical staff have been experiencing 'extreme difficulty' working across split sites.

He added: 'The report was not a surprise, but the fact that they wanted the changes so quickly came as a shock.'

'Our prime concern is the assurances we gave during consultation with the community that we wouldn't transfer services without additional facilities in place. We are still in discussion with the trust and the CHC and hope to come up with a solution.'

Negotiations for A&E services to be provided from Central Manchester Healthcare trust until the new unit opens in the year 2001 are continuing.

Trust chief executive Jane Herbert said: 'We need to review arrangements for our surgical and accident and emergency services at Withington Hospital to ensure that patient care remains safe.'

The college is waiting to see if juniors' training is improved before withdrawing accreditation.