A report in 2005 found that his colleagues, and he, had "lost confidence" in his surgical abilities and Mr Pugsley has not performed heart surgery since at consultant level.

The GMC ordered the consultant cardiothoracic surgeon to undergo a performance assessment last year as the suspension had lapsed.

The assessors found his competence in cardiac surgery was "unacceptable" and gave cause for concern in basic surgical skills.

A disciplinary panel sitting in Manchester ruled his fitness to practise was impaired because of his deficient professional performance.

Mr Pugsley was allowed to keep his registration but must abide by a set of conditions for 12 months which will then be further reviewed.

General surgery

In August 2005 a report to the trust from the Royal College of Surgeons and the Society of Cardiothoracic Surgeons noted the loss of confidence in his abilities which caused "increased stress upon you in the theatre environment".

This could have led to further deterioration, the investigators added.

Five months later the GMC ruled he could not carry out elective cardiac surgery unless supervised by another consultant.

In June 2007 Mr Pugsley became a consultant surgeon at the Royal Air Force Medical Services.

When not abroad, he continued to work at Royal Wolverhampton Hospitals in thoracic surgery as a consultant.

The recent GMC assessment also found his performance was "unacceptable" in non-military general surgery for treatment in emergencies.

Mr Pugsley's legal team argued the performance results could not be found to be "seriously deficient" or amount to impairment of his fitness to practise.