HINCHINGBROOKE Hospital could be the first hospital in the country to be controlled by a third party after a management buy-out or a private sector take-over both emerged this week as possible futures for the debt-burdened facility. And in a separate anno

HINCHINGBROOKE Hospital could be the first hospital in the country to be controlled by a third party after a management buy-out or a private sector take-over both emerged this week as possible futures for the debt-burdened facility.

And in a separate announcement by the East of England Strategic Health Authority on Monday it emerged that other acute hospitals in the east are likely to borrow extensively from the ideas in the Hinchingbrooke rescue plan.

The SHA has revealed that the emerging option for Hinchingbrooke, which was saved from down-grading last year, is for management of the hospital to be put out to tender as an operating franchise, with bids acceptable from both the public and private sectors.

That means a proposal by Interhealth Canada and Anglia Health Solutions - which includes Huntingdonshire GPs and consultants as well as Michael Lynch, who chaired Huntingdonshire Primary Care Trust for most of its life - is still a possibility.

And other private sector organisations are known to be interested.

The original assumption that the Hinchingbrooke board would be replaced in April 2009 by some other NHS organisation, such as Addenbrooke's or Peterborough and Stamford Hospitals trusts, is also not ruled out.

The SHA is known to favour letting the franchise to a locally-owned organisation, which makes the possibility of a management buy-out - or even a management-employee buy-out - a likely runner, if the current managers want to bid.

Bidders could set up not-for-dividend companies to bid, but not-for-profit vehicles look unlikely as long as the need remains to deal with nearly £40million of historic debt, mostly generated by a Government scheme that penalised efficient hospitals such as Hinchingbrooke.

But it is not yet clear what mechanism will be put in place for formulating the basis of bids and comparing them when they are received.

What is absolutely clear already, however, is that a new management team could not possibly be in place by next April.

If confirmed as the SHA's chosen way forward and if the Department of Health backs it, Hinchingbrooke will be the first hospital in the country to go down this road.

Before any tenders can be sought, health service managers will have to identify exactly what people will be bidding for. They will not get ownership of the assets - such as medical equipment and employee and supplier contracts - but all those things will have to be identified in a "data room" that will be confidentially available to bidders.

Even before that stage, they will have had to succeed in pre-qualifying as competent to run the hospital if successful in the tendering process.

Also unclear is how franchising the operation will save the £1million a year identified from abolishing the Hinchingbrooke trust board.

Mark Millar, Hinchingbrooke chief executive, told The Hunts Post: "Putting the operating franchise out to tender is an emerging proposal that will require support from the SHA and Department of Health. If it becomes a proposal, the trust would need to consider whether and, if so, how it would formulate any bid.

"But it will certainly not happen by March next year."

A spokesman for the SHA said yesterday: "Our emerging preferred solution is for a franchise arrangement, whereby assets, land and staff will all remain within the NHS. No decision has been made. We have options on the table, but until the people of Huntingdon have their say in a final consultation no decision or suggestion is cast in stone.

"If the independent sector can prove that it can deliver that best, then that is the answer. If another NHS organisation proves it is best placed to deliver, then so be it. The best deal for patients and the NHS will be what drives recommendations for a final partner."

The SHA also announced this week that the future of all accident and emergency and maternity departments in the region was secure. And its new vision for the area's health services, Towards the best, together, adopts many of the measures identified in late 2006 and early 2007 to save Hinchingbrooke and transfer about a quarter of its activity into community health services.