Circle-style deal for London specialist?

These are difficult times if you are a little non-foundation trust and Stanmore’s Royal National Orthopaedic Hospital deserves credit for being open about its future options.

With a dilapidated estate and a £0.9m deficit last year the hospital has admitted it needs to merge or, more interestingly, form some kind of partnership with a private sector healthcare provider. London management circles believe the latter is more likely and anticipate something interesting could take shape in deepest North West London.

The hospital last week announced it was entering into a two year contract with Spire, which has a hospital in nearby Bushey, to expand its private provision. This does not mean it has gone for option two, but it points in that direction.

Although RNOH has excellent patient outcomes and an enviable reputation, its infrastructure is poor.

The trust is doggedly pursuing a private finance initiative rebuild but an idea is being floated that a private operator will fund the building of the hospital. This could house both the NHS and the lucrative private work of the RNOH’s clinicians, who do not want for offers from outside the health service. The scheme would see the doctors owning equity in the building.

This would create something not dis-similar to the Circle system, where the clinicians own a 49 per cent stake in the company and do their private work with the company.

Ali Parsa’s outfit is in action further round the M25 with a bid to take on Epsom Hospital with the Royal Surrey.

That option is up against a rival bid from Ashford and St Peter’s Foundation Trust but in Stanmore what other choices are there? Nearby trusts are not rushing to grab RNOH. But NHS London does seem to be in a giving mood; it seemed happy with Barts’ £93.5m cash injection.