Campaigners braved freezing overnight temperatures while carrying out 24-hour vigils at two hospitals in West Sussex threatened with losing services.
Hundreds of people joined the protests at Worthing Hospital and the Princess Royal in Haywards Heath, with the "hard core" staying through the night.
"We had a fire going and candles lit," said spokesman Jonathan Ash-Edwards at the Princess Royal vigil.
Twelve-hour vigils were also held in Eastbourne and Hastings in East Sussex.
Abolition or amalgamation
The protest campaigns have been prompted by a major restructuring of NHS services taking place in Surrey and Sussex.
The South East Coast Strategic Health Authority (SHA) has been told to shave £100m from its annual budget.
Its Fit for the Future programme proposes the abolition or amalgamation of units such as accident and emergency and maternity services on fewer sites.
It has sparked a huge public outcry and the SHA has delayed publishing firm proposals and a formal consultation until next year.
Consultant obstetrician at Eastbourne District General Hospital, Vincent Ardent, who dressed up as Father Christmas to join the vigil, said he feared the changes.
"There is actually a 30-minute standard that says that emergency services should be available within 30 minutes of some adverse event," he said.
"It takes far more than that to travel to Hastings or Brighton."
In Haywards Heath, hundreds of people signed postcards to NHS bosses John Wilderspin and Candy Morris protesting at the changes.
Charles Hendry, Conservative MP for Wealden, said people would be more prepared to accept the proposals if they were clinically driven by doctors and consultants.
"But it is not - it is financially driven," he said.
Earlier this week, Prime Minister Tony Blair defended NHS changes, saying scaling down local A&E departments and creating specialist centres would save lives.
South Coast SHA has said it wants to bring more care closer to people's homes and, at the same time, ensure the local NHS lives within its means.
"We appreciate that the continuing uncertainty for staff and patients is unsettling but feel that it is most important to have the right proposals for a healthy health service," it said.
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