Economic challenges mean future reform of the NHS is likely to happen slowly, with large projects put on the back burner for the immediate future, a report has claimed.

A study by the Economist Intelligence Unit said that while the country’s healthcare sector was in better condition than during the last Conservative government, key recommendations made in the 2002 Wanless review, which included implementing reforms to improve quality and productivity, had not been met.

The EIU investigation, Doing More With Less, suggests cultural rather than structural change is the way forward, and points to the effectiveness of cost-benefit analysis as a way of saving significant amounts of money.

The report, sponsored by private health company BMI Healthcare, warned, however, that a failure of piecemeal reforms could lead to a radical overhaul of the system, possibly including the introduction of obligatory healthcare contributions, as is the case in the Netherlands.

Economist Intelligence Unit senior editor Iain Scott said: “If they are going to work, any reforms ought to rely less on fiddling with institutions and structures, and more on changing the culture of the health service and getting to the root of how to advance the quality of care.”