It has 65% efficiency, I would like something fanless and a lot more efficient.
If you slap together that crap, I doubt you'll get much better efficiency. There is nothing fundamentally outdated in this PSU, UC384x based PSUs are produced till this day.
Over 90% is fairly normal nowadays?
Only if you buy something like 80+ titanium rated ATX PSU. And it's still won't be in a full load range. Not to say it's ridiculous to seek power savings in something like this.
If you want to replace it based on reading this:
https://www.exxoshost.co.uk/atari/last/psu/index.htm, then you should know that autor is an idiot as he estimates efficiency based on BS assumptions.
Looking at a Phihong switchmode of 240V 0.6A input is 144watts input. The maxium output wattage is stated as 39watts. This would yelid a efficiency of about 56%.
And then builds PSU based on toroidal transformer and buck converters with around 75% typical efficiency
. What an upgrade, my ass.