Responding to the survey findings, NHS chief executive David Nicholson said: 'Part of my job is to support the local NHS to deliver improvements in services for patients using the reforms we've put in place

'Engaging with staff from across the NHS - in a constructive way - is an important element of making sure our reforms are successful.'

He added: 'I want chief executives in the NHS to focus on the big job of leading and driving forward the transformation of services for patients in the direction we've set out, rather than commenting on it. That is where their focus needs to be.'