Each NHS trust should have a someone to hold its board to account should it fail to address patient safety issues, recommends Robert Francis QC – author of the Mid Staffs inquiries.

The new so-called Freedom to Speak Guardian should give support and advice to NHS staff who wish to speak out against bad practice.

Francis’ latest report on whistleblowing in the NHS called for the appointment of a national independent officer to provide support for local guardians.

The Freedom to speak Up Review said the officer should be responsible for supporting local guardians as well as identifying failures on patient safety, NHS integrity and injustice against staff.

Francis said the government should seek to improve protection for whistleblowers before, during and after they raise concerns.

Unions, professional bodies and regulators have been asked to offer advice and support, counselling and support for those who have spoken up about bad practice by Sir Francis.

In response to the review, Health Secretary Jeremy Hunt, said the government will aim to pass legislation so NHS whistleblowers are protected against discrimination by prospective employers.

More than 20% of NHS staff experienced harassment, bullying or abuse from NHS staff and managers, in 2012/13, up from 14% in 2010/11 - an increase of more than 50%.

“Failure to speak up can cost lives. I began this review with an open mind about whether there are things getting in the way of NHS staff speaking up. However the evidence received by the Review has confirmed there is a serious issue within the NHS. This issue is not just about whistleblowing – it is fundamentally a patient safety issue,” said Sir Robert who chaired the Freedom to Speak Up review.

“The NHS is blessed with staff who want to do the best for their patients. They want to be able to raise their concerns, free of fear that they may be badly treated when they do so, and confident that effective action will be taken. Unfortunately I heard shocking accounts from distressed NHS staff who did not have this experience when they spoke up.

“Everyone in the NHS needs to support staff so they have the courage to do the right thing when they have concerns about patient safety. We need to get away from a culture of blame, and the fear that it generates, to one which celebrates openness and commitment to safety and improvement. If these things are achieved, the NHS will be a better place to work. Above all, it will be a safer place for patients.”

The current government should have to answer for the alarming rise of fear and bullying in the NHS, said shadow health minister, Jamie Reed.

“This Government has presided over a growing culture of fear and bullying. It goes against everything they have tried to claim – the Government cannot expect staff to speak out when bullying is on the increase.

“Any NHS worker must be able to raise concerns, feel confident they will be listened to and that action will be taken. Crucially, they must know that they will not be mistreated as a result,” he said.

The poor treatment of whistleblowers is a “stain on the NHS” and undermines the efforts of staff in the health service.

Chief executive of the NHS confederation, Rob Webster, said: “We need a set of leaders who will not stand for the ill treatment of genuine whistleblowers or for bullying in the modern NHS.

“Our members across NHS organisations will strongly welcome this report, which recognises that more must be done to support some staff in raising concerns. The NHS treats more than one million people every 36 hours and the vast majority of NHS staff know how to report concerns and most feel safe to do so.”

The review was announced by the Health Secretary, Jeremy Hunt, in June 2014. Sir Francis was asked to chair the review in August 2014.