PILOT fatigue, high workloads and a lack of recent flying practice may have contributed to an air ambulance crashing into the sea on an emergency flight, an official accident report says today.

The pilot, Captain Guy Henderson, 40, and paramedic John McCreanor, 34, died when their Glasgow-based Islander aircraft plunged into the sea in poor weather at night off the Mull of Kintyre.

They were flying to Campbeltown to take Craig McKillop, 10, who was suffering from suspected appendicitis, to Glasgow for treatment.

Poor weather at Campbeltown airport on the night of March 14-15 last year forced the pilot to make an approach using instruments, an Air Accidents Investigation Branch (AAIB) report said.

It said he was receiving information from a flight service information officer in accordance with procedures, because there was no radar or air traffic control at the airport.

The AAIB said Mr Henderson had indicated that he was starting an approach to the airport. The report went on: "Nothing more was seen or heard from the aircraft, and further attempts at radio contact were unsuccessful."

Emergency services were alerted and searchers eventually found aircraft wreckage on the seabed about eight miles from the airport.

The body of Mr McCreanor, from Paisley, was found soon afterwards, but Mr Henderson's body was not found until late December 2005.

Mr McCreanor lived with partner Karen Pickett and their daughters, Skye and Cheryl, and son, David. Mr Henderson lived in Broxburn, West Lothian, with his fiancee, Lorne Blyth, and their 14-month-old son, Calum.

The AAIB report said the pilot allowed the aircraft to descend below the minimum altitude for its position on the approach procedure, and this descent probably continued unchecked until the aircraft flew into the sea. It said a combination of fatigue, workload and lack of recent flying practice probably contributed to the pilot's reduced performance.

The report said Mr Henderson had not flown for the previous 32 days. The AAIB said Mr McCreanor was probably knocked unconscious when his head hit the pilot's seat in front due to the lack of an upper torso restraint in the aircraft and that the presence of a second pilot "may have prevented the accident".

The report recommended aviation authorities should look at fitting upper torso restraints and at the possibility of having a second pilot on air ambulance flights.

Mr Henderson's fiancee called for Douglas Alexander, the Transport Minister, to implement the recommendations from the AAIB report.

In a statement, issued by her solicitors, she said: "Had a second pilot been on the aircraft or had the aircraft been equipped with a radio altimeter or other low-height warning device, the accident may not have happened."