Groups representing rural health interests have called for an independent assessment of how Derry and surrounding areas are affected by proposed changes to the hospital system.
Mike Nesbitt, who served as Health Minister in 2024, outlined a plan to reorganise healthcare delivery across Northern Ireland with patients expected to travel greater distances for specialist treatment.
The Department of Health has been approached regarding the matter but has not yet provided a public response.
Campaigners argue that current arrangements leave some communities without adequate acute care and warn that lives are being lost as a result.
SoS Causeway Hospital group, Save Our Services Daisy Hill and the Down Community Health committee were among those who signed an open letter demanding action.
These organisations have been campaigning for several years against the closure of acute services in their localities.
The proposed network would maintain four categories: area hospitals, general hospitals, local hospitals and regional centres.
Area hospitals are currently Northern Ireland's largest facilities, providing emergency and planned treatment alongside 24-hour departments, paediatrics, obstetrics and critical care teams.
General hospitals would focus on unscheduled care but serve more isolated geographical locations and would compete with area hospitals for resources.
Local hospitals offer a broad mix of community services including diagnostic and mental health support, though they must justify their continued operation based on population needs and cost-effectiveness.
Regional centres are intended to handle conditions such as breast cancer, strokes and cataracts.
The groups are specifically requesting independent rural-needs and equality assessments alongside the formation of a cross-departmental ministerial working group on rural health access.
They contend that without such measures, rural lives will continue to be treated as an afterthought in national planning decisions.