The damning report into serious failings in the care system was triggered by three key crises in Scottish hospitals.

Although the incidents which prompted the Scottish Academy's investigations themselves took place earlier, reports into all of them were published between December 2013 and 2014.

Inquiries were launched into care at Monklands Hospital run by NHS Lanarkshire earlier in 2013 after it emerged that mortality rates there were higher than expected.

Healthcare Improvement Scotland found no definite reason for the higher death rate.

However the national healthcare improvement body said then it was "concerned about the persistence of practices that represent an unacceptable risk to safe patient care".

These included patients remaining unseen by a senior doctor for up to a fortnight if their consultant was on holiday and specialists who would only see a limited number of patients per day, regardless of need.

Staffing levels were deemed unsafe and leadership condemned as weak.

The inspectors also found problems in the hospital were seen as insoluble, so poor or variable care was allowed to continue.

A second report into the Clostridium Difficile outbreak which killed 34 patients at Vale of Leven Hospital between 2007 and 2008 was only published last November, after a five year inquiry which cost in excess of £10 million.

It found that patients had been let down by serious individual and systemic failures, including an Infection Control Doctor appointed to cover three hospitals including the Vale of Leven who never visited it even at the height of the outbreak.

Nurses did not realise that the outbreak was being worsened by cross-infection within the hospital. Indeed staff at the hospital failed to realise that it was an outbreak at all.

Communication with patients and their relatives was poor - some were sent with soiled and contaminated bedding or nightwear to clean at home, without being given guidance about doing so safely . Problems were partly caused because staff were demotivated amid uncertainty about the hospital's future.

A month after the Vale of Leven report was published, Health Improvement Scotland published another searing report covering problems with management and alleged bullying at Aberdeen Royal Infirmary.

Then Health Secretary Alex Neil had launched an investigation into allegations raised by a senior consultant.

Problems included serious shortages of doctors and nurses, a 'forceful' management style by some senior figures which some described as bullying.

Doctors without emergency medicine training were being used to staff A&E and the general surgery department was described a s dysfunctional.

Although the report said patient outcomes at Aberdeen were broadly similar to those at other Scottish hospitals, the General Medical Council said evidence that patient safety and care could have been compromised at the hospital was "overwhelming".

The latest report from the Scottish Academy is an overview of all the findings and says that the lessons from these and a number of other related reports are similar.

These include communications between frontline staff and managers, 'quality vacuums' where services are threatened with closure or even if it is only a possibility, and complaints being poorly handled.

A key finding is that patient safety failings should not be viewed as unusual or exceptional but should be analysed in relation to each other. "Failings should not be viewed as isolated localised incidents," it says.