The report aims to set new standards for reporting procedures

Workers are also reluctant to come forward because of concerns over a blame culture.

However the staff survey, by Quality Improvement Scotland, noted that the health service was better at reporting incidents than other industries.

The report also said the NHS still had room to make improvements.

It came following the largest survey in the Scottish health service on staff attitudes to "incidents", defined as unintended or unexpected events leading to patient or staff harm, as well as near misses.

'Greater improvements'

These included both clinical and non-clinical mishaps resulting in harm to patients or staff.

Almost 4,000 staff replied to the survey, which found that managers felt more comfortable with reporting systems than clinical staff.

Some respondents told of a lack of feedback, under-reporting, a blame culture, difficult or time-consuming reporting systems and the "negative consequences" of admitting a mistake.

"This report shows the NHS is generally performing better than many industries but it also provides a roadmap to practical ways to make every greater improvements," said Jan Warner, of QIS.

"The results of this report will now be used as the benchmark in which to identify an organisational ability to learn from experience."