Using consultants with specialist skills and knowledge can be hugely effective when NHS organisations accurately define their needs and requirements. Unclear and broad service specifications and unreasonable time frames for responses to tender unsurprisingly delivers restricted choice and poor services.

The right firm of consultants can provide shared learning and  good practice from working across many different organisations and areas (something the NHS is notoriously poor at and even reluctant to do) and insights from other sectors (is the NHS way always right?). They also can actively share their knowledge and networks and actually facilitate the collaboration and joint working between organisations that Sir David outlines. And let's not forget the much needed capacity, bandwidth and focus that management in an overstretched and challenging NHS simply don't have.  

Working collaboratively and in partnership with consultants might also be an answer....