Campaigners fighting an overhaul of stroke, maternity and paediatric services have been given a legal lifeline.
The Save South Tyneside Hospital Campaign Group believes NHS bosses carried out a flawed consultation.
The High Court dismissed a judicial review in December, but the group has won permission to appeal that outcome.
Health chiefs say the shake-up was necessary to provide "safer and sustainable" services.
It has seen stroke care centralised at Sunderland Royal Hospital, as well as changes to maternity care with a consultant-led unit in Sunderland and a new midwife-led unit in South Tyneside.
At the High Court in Leeds last year, campaigners claimed the consultation process had been "fundamentally unfair" and "unlawful".
'Disaster for area'
That was rejected by His Honour Judge Mark Raeside QC, though, who found in favour of the clinical commissioning groups for Sunderland and South Tyneside.
Campaign spokesman Roger Nettleship said: "We have always felt that the move would be a disaster for the area and it was hugely disappointing to see the judicial review conclude in the manner that it did.
"Getting permission to appeal is very welcome and we hope it is another opportunity to highlight just what these changes would mean for our area."
Health bosses maintain the plans, part of the Path to Excellence reforms, were necessary to maintain patient safety and will also benefit staffing, recruitment and costs.
Matt Brown, director at South Tyneside Clinical Commissioning Group, said: "It's important that people realise this appeal is not about the decisions we made to change services, it's about how the judge came to his conclusions during the judicial review".
A hearing at the Court of Appeal is expected to take place in November.
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