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Anon 17:00 - A very fair, balanced contribution with an excellent analogy to illustrate the problem with the interpretation of the article in question.

Trusts & commissioners who aren't in financial difficulties have very little need to hire outside expertise/support/capacity. This almost always happens when trusts/commissioners forecast an impending problem or crisis (usually financial, sometimes clinical, often both).

Finally, the article lumps all consultancy in together to give the overall "no improved efficiency" message across 120 trusts. It doesn't bother to explain the differences between trusts where consultancy worked and had a positive impact and those where it didn't.