Chances are its a private invoice (from a private company) and not a penalty (from police or Council).
Don't do anything yet. Moneysavingexpert has a dedicated forum for such matters. As its a hspital (assuming NHS) they also have policies they have to follow as regards parking management.
Given the rejection and the appeal route I'd say with certainty is a Parking on Private Land issue.
Be careful of imprecations to ignore. OK in the short term but since the Beavis case in the Supreme Court parking companies have become much more bullish about pursuing these cases in the County Court.
If they do that and the 'summons' is ignored or overlooked there's a CCJ and next thing is bailiffs at your door.
Just be ready for the paperwork and have your ducks in a row as regards lack of signage.
A complaint to the Hospital might help?
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