In July 2013 as a result of the Keogh Review the Trust was put into special measures by Monitor In October 2013 the Trust was put into the highest risk category by the Care Quality Commission. Karen James was appointed interim Chief Executive in 2013 but was appointed permanently in 2014. She was awarded an OBE in the 2020 New Year's Honours list in recognition for bringing the Trust out of special measures to be rated 'Good' by the CQC in 2017 and 2019.