Chesterfield Royal Hospital NHS Foundation Trust is exploring the possibility of transferring around 800 staff to an independent company, the Derbyshire Times has learned.
Bosses are consulting with workers in estates and facilities, IT, procurement and finance on the idea of setting up a subsidiary company which would be wholly-owned by the trust.
The Derbyshire Times understands many hospital employees are concerned by the plans – which the trust says could help to protect jobs and prevent outsourcing to the private sector.
Lee Outhwaite, director of finance at the trust, said: "We'd own 100 per cent of the company and we'd use it to safeguard essential support services, transforming how they operate and reinvesting any company surpluses straight back into the NHS.
"We know that any announcement that has the potential to affect people creates worries and anxieties. That’s why we’re openly sharing information with staff at the very start of the process and we’ll do so throughout our 'fact-finding' mission.
"We've by no means made a decision and there's a long way to go before we know if it's the right thing for us to do.
"We're talking to staff now to make sure they can contribute their thoughts, ideas and suggestions to a business case that the board of directors will consider in the summer and, importantly, to make sure they know how their terms and conditions of NHS service - including pension, pay and annual leave - along with other aspects of employment would be protected."
A member of staff at Chesterfield Royal Hospital, who did not want to be identified, told the Derbyshire Times: "There are a lot of people who work here who are now worried about their future at the hospital."
He said there could be an 'uproar' from staff and the public in response to the plans.
'A form of backdoor privatisation'
A spokesman for Chesterfield Royal Hospital NHS Foundation Trust said: "Wholly-owned subsidiaries are not new, but were endorsed through legal legislation by the Labour government in 2006.
"They are increasing in number across the NHS as hospitals look to keep services in-house, at the same time as transforming how they work in a tough financial climate, where millions of pounds need to be saved.
"Staff transferring to NHS subsidiaries are protected by national TUPE agreements, so they keep their national terms and conditions, including pay, pension and annual leave."
The union UNISON believes wholly-owned susidiaries are 'a form of backdoor privatisation' with 'potentially damaging ramifications for the NHS'.
The UNISON website states: "UNISON is working closely with branches that are affected by plans to set up wholly-owned subsidiary companies, with targeted resources deployed to assist local campaigning.
"We are raising the issue at Westminster with political parties and MPs to get politicians involved in campaigns.
"UNISON is lobbying the national NHS bodies to clamp down on this behaviour by trusts."