Hinchingbrooke Hospital will now almost certainly be taken over by a private company after the only NHS organisation bidding for the franchise to run it dropped out.
Cambridge University Hospitals said the onerous bidding process to win the franchise to run the £92m a year hospital would have been a distraction from its core functions.
That leaves five private sector bidders going forward to the next stage of the bidding process, which is being run by East of England strategic health authority.
They are: Care UK, Circle Health, Interhealth Canada, Ramsay Health Care and Serco Health.
The five organisations have been involved in formal contract dialogue with the SHA. Their proposals are expected to set out how they plan to make the 369-bed general hospital a going concern and reduce its £39m accumulated deficit.
The SHA has said it may be prepared to consider paying a subsidy to the successful bidder, but only if the competitive bidding processes reveals that it is necessary.