Buried deep in Matthew Kershaw’s report on South London Healthcare Trust is an interesting figure.

The special administrator estimated the trust could have reduced its medical bill by £20m if it had managed its medical workforce better. The trust had allowed consultants too much leeway in shaping its services and employed too many junior doctors, locums and agency staff. Its income per consultant was the lowest of any comparable trust.

We cannot know if South London would have escaped being the first trust to be subject to the NHS failure regime had it managed its medical workforce more efficiently, but the chances would have been significantly increased.

This week the National Audit Office produced its report on Managing NHS Hospital Consultants. The report identifies “significant room for improvement” in the use of the 2003 consultant contract.

Its key recommendation is that “trusts should ensure consultants are engaged in meeting trusts’ objectives and held to account for their performance”.

Easier said than done, but trust boards now have the example of South London to gird their loins when reviewing the productivity of their own medical workforce.