A protest is planned today over plans to shake up hospital services in South Tyneside.
The Save South Tyneside Hospital Campaign Group will be at the launch of a consultation process which could see a range of services moved from South Tyneside Hospital to Sunderland Royal Hospital.
Among the proposals are plans to move in-hospital stroke services to Sunderland along with some maternity and children and young people services.
Roger Nettleship, chairman of the protest group says the plans will mean South Tyneside District Hospital will, effectively, be downgraded.
Hospital bosses say the plans - which are to be the subject of a three-month consultation are aimed at providing improved services.
There are three options for stroke services and two each for maternity and paediatrics in the document - which is entitled The Path to Excellence.
Mr Nettleship said: "The plans will mean services to a downgrading of services.
"This is an area where over 5,000 children are living in poverty according to the official criteria.
"This will not be a path to excellence but a path to worse health outcomes to an area where it is one of the poorest areas in the North East.
"This is top down cut backs to our hospital services driven by massive financial cuts to our hospital.
"We condemn that the review process has been carried out without the full involvement of clinicians who provide these services in both South Tyneside and Sunderland."
Dr Shaz Wahid, medical director for South Tyneside NHS Foundation Trust, says it is an important time, with consultation offering the chance to make big improvements to hospital services and patient care.
Dr Wahid continued: “We want to explain the current challenges we have around how these services are being delivered at the moment, and present options on the different ways our clinical teams think we could solve some of the problems we have.
“We need to be clear that we simply cannot continue as we are and this means some services will be delivered differently in the future.
“We will share the information we’ve used to come up with our proposals, for example, the best practice clinical evidence from the Royal Colleges, feedback from patient experiences and engagement, to name but a few.”