Circle healthcare has become the first private company to take control of an NHS hospital.
The employee-owned operation beat out Serco Health to be chosen as the preferred partner to run the Hinchingbrooke Healthcare NHS Trust franchise in Huntingdonshire.
Writing in November's COVER, Richard Walsh explained the arrangements that the winning franchisee would have to work under.
It will not be able to make big decisions which may affect the long-term viability of Hinchingbrooke hospital, like the sale of land, without Trust specific approval.
And it will be governed by the same rules as any NHS provider and not be given guarantees of future revenue by the NHS.
Circle already runs NHS day-surgery hospitals in Nottingham and Burton, employing over 1,000 seconded NHS staff and treating more than 130,000 patients each year.
Dr Stephen Dunn, director of strategy at NHS East of England, explained that debts had been a major driving force behind the decision to offer the franchise.
"Hinchingbrooke has major debts and might have had to close, or receive a large subsidy paid for by the taxpayer," he said.
"Thanks to this process this is not the case. This is not privatisation. Staff and assets will be protected, and the taxpayer will not be forced into bailing out Hinchingbrooke.
"This could be a model for hospitals that face similar challenges," he added.
The NHS East of England's board has recommended that Circle's appointment be for a 10 year franchise term, and said that within the period the company is planning to repay all Hinchingbrooke's historic debt of £38.8m.
It added that no subsidy will be required.
Commenting, Ali Parsa, managing partner of Circle, said: "Our co-operative model offers a Big Society solution for Hinchingbrooke - liberating doctors and nurses to deliver the best services for the patients they know best.
"This is a great opportunity for a social enterprise and local clinicians to come together to lead the next chapter in the long and successful history of the NHS."
Circle will take over the operation of the hospital from 1 June, subject to approvals from the Department of Health and other regulators.
After this approvals process more details about its proposals for the hospital will be made public.
