The four national governments in the United Kingdom need to work far more closely and to coordinate formally over health issues or face growing conflict, a major report says.

Since 1999, devolution has meant ever widening differences in health policy between the four countries, and lack of coordination will damage all four healthcare systems, warns the report by the health policy think tank the Nuffield Trust.

Its report says that extensive overlaps and complexities have arisen since devolution was agreed, leading to “messy intergovernmental relations.” Its findings are drawn from research and extensive interviews carried out over the past seven years.

A basic problem, says the report, is that the current …