The chief executive and senior management team of a three-star trust have taken over the running of no-star Dartford and Gravesham trust in what is effectively the first test of the franchising scheme.
Dartford and Gravesham trust has appointed Sue Jennings, chief executive of Basildon and Thurrock General Hospitals trust and the former head of the National Patient Access Team, as interim chief executive for six months.
Ms Jennings and five executive directors will take on the work while remaining in post at Basildon.
The move, involving an entire top team, appears to be a de facto introduction of the franchising scheme announced by health secretary Alan Milburn for failing trusts.
It marks a significant step forward from last month, when Stephen Morris, chief executive of Frimley Park Hospitals trust, was seconded to run nostar Ashford and St Peter's trust as well.
The terms of the Dartford arrangement - made within a fortnight of the departure of former chief executive Anne-Marie Dean - are unclear.
Department of Health guidance on franchising arrangements says that where a chief executive is running two trusts 'it is likely that the salary will increase by about 50 per cent'.
And when the star-rating system was launched, Mr Milburn said the chief executives could receive two salaries and that three-star trusts would get extra resources if they took over and improved persistently failing trusts.
But asked what remuneration she would receive for her new role, Ms Jennings told HSJ: 'I do not know yet.'
There would be 'no financial benefit' to Basildon and Thurrock trust, she added.
'Whenever you go to another trust, you can learn a lot. That is the benefit our trust will get. It will not get any money.'
But there would be funding to bring in more managers at Basildon, she said. 'What we will get is some money to be able to strengthen the management team.'
Ms Jennings said that although detailed arrangements had yet to be negotiated with South East region, she had taken on the new role because 'it seemed an exciting thing to do'. She believed she had been the only person approached for the job, she said.
A South East region spokesperson said the region had acted as 'a broker' for the deal, but that financial arrangements were a matter for Dartford and Gravesham trust.
Basildon and Thurrock's own accident and emergency department was criticised by the Commission for Health Improvement two weeks before the star-ratings were announced in September for 'longstanding delays' in access to treatment, and CHI described the medical assessment units as being 'a major area of concern requiring urgent management intervention'.
But trust chair David Hooper said: 'We are determined that this additional work will not have any detrimental effect on the services this trust provides.'
A CHI spokesperson said that if the Basildon team members felt they had the capacity to meet their own action plan and turn around the Dartford trust, 'good luck to them'.
Acting NHS Confederation chief executive Nigel Edwards called for the new management arrangements to be evaluated so that other trusts could learn from the experience.
He added: 'There does seem to be a desperation to show There is such a thing as franchising.'
After her first day at Dartford this week, Ms Jennings said her new colleagues were 'an enthusiastic bunch, very welcoming'. She had told them: 'This is not a takeover, We are there to help provide a resource to guide and to listen.'
Dartford chair Sarah Dunnett said: 'I am delighted that Sue Jennings has agreed to join us. She has proved herself to be one of the best managers in the country.'