Concerns have been raised about out-of-hours staffing levels for children requiring heart surgery at Yorkhill Hospital.
A new report said improvements had been made in the paediatric cardiac services that are provided at Glasgow's Royal Hospital for Sick Children.
But Healthcare Improvement Scotland (HIS) said that while staffing issues were being addressed, concerns remained about the out-of-hours cover for cardiac surgery.
NHS Greater Glasgow and Clyde has been called on to demonstrate it has robust strategies in place to mitigate the risks from not having a consultant cardiac surgeon in the hospital outside of regular hours.
The same report also recommended the Scottish Government considers combining the children's heart service with the service for adults born with heart problems, possibly at the new South Glasgow Hospitals Campus – currently under construction.
Health Secretary Alex Neil said he would ask for work to be done to "assess the implications of combining paediatric and adult cardiac national services so we can fully consider this option".
Yorkhill Hospital is home to the only specialist children's cardiac surgery unit in Scotland.
Three consultant paediatric cardiac surgeons provide emergency cover through an on-call system.
The report said having a consultant cardiac surgeon present in the hospital out-of-hours was unachievable with three surgeons.
Kevin Hill, director of women and children's services for NHS Greater Glasgow and Clyde, said: "We continue to work with staff and patients and their families to further develop protocols to meet patients' needs and will now develop an improvement plan in collaboration with National Services Division to address the further recommendations made by HIS."
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