The NHS will struggle to control costs as budgets tighten in the years ahead, marking the beginnings of a terminal collapse, warns a report that calls for radical new thinking to create a sustainable future.

It says that the NHS has never experienced a protracted period of static funding in its 60 year history and that the current approach of marshalling limited resources in smarter ways to meet rising demand will not be enough to meet this challenge.

The report is by the Scottish based think tank International Futures Forum (www.internationalfuturesforum), which was set up in 2001 with a grant from BP and works with organisations such …