The first private company to run an NHS hospital trust is pulling out because it is "no longer sustainable" because of cuts and pressure on its casualty department.
Circle Holdings, which runs Hinchingbrooke healthcare trust in Cambridgeshire, pointed to "significant changes in the operational landscape for NHS hospitals" since the contract was procured in 2009.
It has had to inject almost £5m to prop up the trust - and reaching this level would trigger an option to cancel the deal.
The company said it was "highly likely" it would have to pump in more cash as conditions had "significantly worsened in recent weeks".
Circle blamed unprecedented rises in people visiting A&E and a lack of care places for patients awaiting discharge.
And bosses have claimed funding has been cut by 10.1% this financial year.
They are also facing an imminent report from the Care Quality Commission (CQC) which is expected to be "unbalanced".
Circle began operating the trust in February 2012 but in August warned of "uncertainty over Hinchingbrooke's profitability over the next year".
In a statement on Friday the company said: "Circle today announces that it has determined that its franchise to operate Hinchingbrooke Health Care NHS Trust is no longer sustainable under current terms and that it has entered into discussions with the NHS Trust Development Authority (TDA) with the view to ensuring an orderly withdrawal from the current contract."
Circle said it had invested in the quality of care and in staff and facilities while saving the taxpayer £23m in its first two years.
Low mortality rates, "excellent" patient feedback and waiting time targets have all been met, the company said.
Chief executive Steve Melton said: "Like most hospitals, over the past year Hinchingbrooke saw unprecedented A&E attendances and not enough care places for healthy patients awaiting discharge.
"At the same time, our funding has been cut. We also believe that inconsistent and conflicting regulatory regimes compound the challenge for acute hospitals in this environment.
"This combination of factors means we have now reluctantly concluded that, in its existing form, Circle's involvement in Hinchingbrooke is unsustainable."
A Department of Health spokesman said: "We're disappointed Circle has made this decision.
"There will now be a managed transfer of the running of the trust and patient care will not be affected."
Downing Street added that just 6% of NHS services were provided by the private sector - up only marginally from 5% under Labour.
But shadow health secretary Andy Burnham said: "It was the decision of the coalition in November 2011 to appoint Circle and they must take responsibility for this mess.
"The Government were explicitly warned two years ago about the risky business model Circle were operating, but failed to take any action."
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