A legal challenge over an overhaul of stroke, maternity and paediatric services in Sunderland and South Tyneside has been dismissed.
The Save South Tyneside Hospital campaign group argued that NHS bosses had carried out a flawed consultation.
They argued the public had not been provided with enough information.
But this was rejected by the High Court, which found in favour of the Clinical Commissioning Groups (CCGs) for Sunderland and South Tyneside.
Health bosses approved the proposals - part of the Path to Excellence reforms - in February, saying they were needed to maintain patient safety.
They included moving acute stroke care from South Tyneside Hospital to Sunderland Royal Hospital, and a shake-up of maternity care with a consultant-led unit in Sunderland and a midwife-led unit in South Tyneside.
During the hearing at the High Court sitting in Leeds, lawyers acting for the campaigners claimed the consultation process was "fundamentally unfair" and "unlawful", the Local Democracy Reporting Service.
The move was presented as a "fair accompli", with the so-called "do-nothing" option removed from consideration.
Lawyers for the CGCs said the prospect of retaining the services on South Tyneside was not considered a viable option, and information was presented to the public about why things could not stay as they were.
This position was accepted by His Honour Judge Mark Raeside QC, who said: "My conclusion is this is not a case where it can be properly said information was not available to the public and the claims are rejected."