The NHS’s only privately run hospital, Hinchingbrooke Health Care Trust, could lose core services such as its accident and emergency department despite earlier assurances that franchising the hospital would protect it from such a move.

HSJ has been told independently by two senior local sources that the possibility of turning the trust into an elective hub and downgrading its A&E is being actively discussed by senior NHS leaders in the area.

The discussions are part of a wider programme to reconfigure services across Cambridgeshire and Peterborough, one of England’s most challenged health economies which faces a £250m deficit by 2018-19.  

One figure familiar with the talks said the district general hospital could be used as an elective care hub and potentially provide other community services.

A&E patients could either go to Peterborough City Hospital or Cambridge University Hospitals Foundation Trust’s Addenbrooke site, the source said.

Cambridgeshire and Peterborough Clinical Commissioning Group stressed decisions on potential reconfiguration options would not be made until July 2015 after which they would face public consultation. But it would not rule out the hospital being downgraded.

Asked by HSJ to respond to suggestions the trust could potentially be downgraded, a Circle spokesman said the company was “open minded about what form of future services will give them the care they need” because the current system was “unsustainable and only system wide action will make a difference”.

He added: “Circle will play a full part in the discussions led by the CCG. Patients are the priority, and we’re open minded about what form of future services will give them the care they need.

“Hinchingbrooke’s improvement since 2012 means it is well placed to play a central role in the local health economy.”

Commissioners and the trust’s chief executive Hisham Abdel-Rahman - who was appointed by Circle -  have previously said the franchise deal had “saved” the trust’s A&E from being shut.    

Steve Dunn, then director of policy and strategy at NHS Midlands and East, the strategic health authority which oversaw the deal, wrote in February 2012 in a piece for The Guardian: “Under the agreement, Circle will commit to delivering the same range of services currently provided at the hospital, including accident and emergency, and maternity services.

“Over the franchise term it will have to respond to the NHS’s evolving needs.”

Dr Abdel-Rahman wrote in a letter to local newspaper Hunts Post in January 2013: “It’s well known that the 10 year contract with Circle has saved Hinchingbrooke from being downgraded or closed.

Andy Vowles, chief strategy officer at Cambridgeshire and Peterborough CCG, said no options or plans had been formulated, and the process of drafting plans to reconfigure services was only just beginning.

He said: “The next stage of that work is to model and test different scenarios right across the system. What if services were to be reconfigured? It’s not just a secondary care question. What could change would shift.

“We are not considering plans to downgrade Hinchingbrooke. That is not to say that that scenario could never materialise as part of the work but we are not at that stage yet.”