The report McKinsey provided on how to deliver efficiency savings in the national health service was commissioned by officials in February 2009. Neither the Prime Minister or Ministers were informed of the commission or sighted on the advice. Ministers were informed following initial media inquires in September 2009. Ministers rejected the main proposals in the report. The information has been commissioned for internal NHS management consideration and is not intended for publication. It is therefore not appropriate for a copy of the report to be placed in the Library.