'There will always be a hospital in South Tyneside and a hospital in Sunderland', NHS chiefs have promised the public.
Health bosses for Sunderland and South Tyneside are preparing plans for an overhaul of care in the city and the borough.
Speaking at a meeting of the East Shields and Whitburn Community Area Forum (CAF) they tried to soothe concerns proposals could put the region's hospitals at risk.
"There will always be a hospital in South Tyneside and a hospital in Sunderland, " said Patrick Garner, programme manager for the Path to Excellence scheme.
"We are not closing those hospitals, we're trying to invest in both sites and will continue to do that.
"Staff are telling us things aren't sustainable [as they are], that there's no such thing as Winter Pressures anymore, that they're busy all the time and we need to look at doing things differently."
The Clinical Commissioning Groups (CCGs) for Sunderland and South Tyneside are in the middle of a programme of public engagement ahead of a full consultation on proposed changes.
These fall under phase two of the Path to Excellence scheme and are expected to cover:
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Emergency care and acute medicine
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Emergency surgery and planned operations
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Planned care and outpatient services - such as tests and scans
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Clinical support services - such as physiotherapy and occupational therapy
Phase one of the Path to Excellence, which covered stroke, pediatric and maternity care, was challenged in the courts last year from the Save South Tyneside Hospital campaign group.
But Mr Garner said proposals, which are still being worked on, could see more patients sent to South Tyneside Hospital for 'routine surgical work', such as knee replacements.
Health bosses have insisted 'no change' is not a viable option, particularly in the face of mounting workforce and recruitment problems.
Mr Garner added: "This is not just a local problem or a regional or a national problem - it's an international problem, in terms of the availability of health care workers.
"We have local estimates that say we will be 1,500 people short to staff our services by 2025.
"We have big problems around the workforce, not as big as with Phase One in pediatrics and gynecology, but if we don't do something now we could have a situation where services are not sustainable."
