The head of NHS England backed a doctor whose failures contributed to several deaths to resume her career as a heart surgeon.

Sir Jim Mackey told the family of a patient who died following an operation carried out by Karen Booth that the consultant surgeon should be “supported” to continue working at the Freeman Hospital, in Newcastle, once she had undergone retraining.

The BBC has obtained a recording of a meeting last year with the family of the man who died. In it, he tells them Ms Booth will continue her surgical career.

An NHS investigation found problems in Ms Booth’s cases included clinical errors, carrying out operations she was not skilled or experienced enough to perform, and failing to call for help when she should have.

Sir Jim became head of NHS England in April. Before that he was chief executive of the Newcastle upon Tyne Hospitals NHS Foundation Trust, which runs the Freeman, for 14 months.

Sir Jim declined to answer most of the BBC’s questions but said: “We have taken concerns from all parties extremely seriously and this has been a really complex case in what is a very specialised clinical field, and it had been ongoing for several years.”

In a statement to the BBC, Karen Booth said she continued “to express my condolences to the families who have lost loved ones and who have been affected by the matters raised”. She said she was “cooperating fully” with a review by the doctors’ regulator, the General Medical Council (GMC).

Seven people died following multiple failures by Ms Booth, an internal investigation found, with one patient surviving having experienced avoidable harm.

The BBC has revealed the hospital now plans to allow Ms Booth to resume her surgical career in the cardiac unit after retraining. That is despite strong opposition from many of her surgical colleagues, set out in emails.

Ms Booth, a heart and transplant surgeon, is currently working as a mentor to other surgeons at the hospital.

In January 2024, shortly after being appointed as chief executive of the trust, Sir Jim met the family of Ian Philip, a construction worker from Northumberland, who died in 2021 aged 54, after being operated on by Ms Booth.

The hospital later told his family that the surgeons operating on him had failed to carry out a “bread and butter” procedure known as a graft bypass when they experienced complications, something that the hospital told them would have made his survival “much more likely”.

The BBC obtained a recording of a meeting attended by Mr Philip’s partner Melissa Cockburn and his son Liam.

Sir Jim told them Ms Booth could continue her surgical career because she had not been sanctioned by the GMC or by an internal HR investigation.

“She has to go through a process of being supported, retrained, her practice managed etc over a period of time before she’s allowed to practise fully independently again,” said Sir Jim.

“We, as an employer, have to decide whether that is here or somewhere else.”

The BBC understands the Freeman Hospital has approached at least one other trust to ask whether they would be willing to employ Ms Booth.

Mr Philip’s family told the BBC they were astonished by Sir Jim’s remarks. “It’s bizarre to me that the Freeman would think that it’s appropriate [to bring her back],” said Ian’s son, Liam Philip. “The least they can do is say she’s not coming back.”

Sir Jim became chief executive of the Newcastle upon Tyne Hospital Trust on 1 January 2024. The family said they had hoped his appointment at the trust would help their case.

“[We] went through Christmas with great hope, thinking he’s a new man coming in to sort everything out,” recalled Melissa, Mr Philip’s partner.

But she said she had ultimately found Sir Jim “quite arrogant and more supportive of Ms Booth than our predicament”.

Many of Ms Booth’s surgical colleagues had made it repeatedly clear to the trust’s senior leadership that they did not want her to return to the cardiac unit, believing it a risk to patients.

This was an issue Sir Jim also appeared to recognise. At one point in the meeting, he said that if colleagues were not willing to support a surgeon, “the risk to safety is much heightened.”

In her statement, Ms Booth said she was “grateful to those surgical and wider departmental colleagues who continue to support my reintegration back into full clinical practice”.

The family said their unhappiness with Sir Jim has been exacerbated by the fact the GMC had lifted restrictions on Ms Booth’s practice following an initial investigation.

Asked to explain why a doctor whose failures had contributed to the deaths of multiple patients was allowed to continue practising surgery in the NHS and what this says about the importance it places on public safety, the GMC declined to comment.

It told the BBC: “Patient safety is at the core of everything we do, and we will always take action where there is a risk to the public.” When asked to give examples, it declined.

Patient groups have long complained that the GMC takes too long to take action against medics. It can investigate doctors who are referred to it and decide whether a case is passed to a medical tribunal, which has the power to sanction staff.

Figures show that since 2020, of the 1,120 cases the GMC has passed to a medical tribunal, just 13 were to do with a doctor’s performance. Asked to explain why the figures are so low, the GMC declined to comment.

In a statement to the BBC, Sir Jim said that after joining the Newcastle upon Tyne Hospitals Trust, he had met families affected by Ms Booth’s failures “to discuss and listen to their concerns and reiterate how sorry we are for their loss and the unimaginable hurt caused”.

Mr Mackey continued: “Following the formal referral made to the General Medical Council in 2022, the investigation into this surgeon’s practice is still ongoing – I recognise this is frustrating for everyone, and I have asked them what they can do to expedite this to reach a conclusion as soon as possible.”

Ms Booth said that due to the GMC review, “it would not be appropriate for me to comment publicly on specific matters at this time”.

An investigation by the Freeman Hospital found a number of failures by Ms Booth had contributed to her poor outcomes. As well as surgical errors, she was found to have had poor insight into her own levels of competence, partly through being inexperienced, and that she had failed to seek help from more senior colleagues.

At the time of the complaints, the cardiac unit at the Freeman was in disarray. A Royal College of Surgeons report in 2021 found a problematic working culture, while internal hospital reports criticised poor governance procedures, a reluctance from senior staff to take responsibility and an inadequate multi-disciplinary team (MDT) process – in which clinicians should come together prior to surgery to discuss the best options for patients.

Responding to the BBC, the hospital acknowledged the problems with the unit’s culture, saying it tried to protect patients at all times.

It said it was “currently considering” the next stage of Ms Booth’s phased return, “in line with appropriate standards, review recommendations and external advice”. It did not respond to the BBC’s questions as to whether it was safe for patients for Ms Booth to return to the cardiac unit, given the strong opposition from some of her colleagues.

In a statement, the Newcastle upon Tyne Hospitals NHS Trust said it acts “in the best interests of patients” and seeks “to maintain and protect patient safety at all times, taking account of concerns shared by clinical colleagues”.