Junior doctors stage a second stoppage

78% of junior doctors did not work on both days

Consultants step in to cover emergency care

Dozens of picket lines across England

David Cameron has backed Jeremy Hunt over dispute

3.23pm BST

1.05pm BST

Helen Nightingale, 31, a junior doctor at St Mary’s hospital, tells Alessio Perrone the imposition of a contract by the government is as crucial as to its contents. There hasn’t had a BMA representative for a few months since the last one stepped aside yet the junior doctors have taken part in the strike.

“Regardless of what Hunt said, they haven’t been willing to sit down and discuss at any point. Not just with the BMA, with any junior doctor. The process has been misleading and we feel it’s all been predetermined and imposed on us. It’s disrespectful to us as professionals. A lot of people are disillusioned regardless of the contract because it’s been imposed, they are frustrated and powerless. Also, we are frustrated because the strikes haven’t brought back the expected results, they haven’t made any negotiations happen. Enthusiasm is picking up a bit in this strike, but we haven’t seen the response we wanted.”

12.53pm BST

Damien Gayle has moved on to Lewisham hospital where a packed picket line has massed around a table heaving with cake, which strikers were selling to raise money for a campaign to save the hospital.

Shruti Patel, Lewisham hospital: "The NHS runs on cake and goodwill" #JuniorDoctorsStrike pic.twitter.com/WdoWEi17Ad

“The NHS runs on cake and goodwill,” said Shruti Patel, a trainee paediatric doctor. “This is a good way for the community, for NHS staff and junior doctors to do something positive with the strike, to raise money for a community campaign that has been instrumental in saving this hospital and getting our message out to the public.”

Patel branded as “ridiculous” claims that the government and BMA positions were close: “If the positions were close do you think we would go to all this dramatic effort? Do you think we would manage to get this many junior doctors out if really all that was left was Saturday pay? We feel that the contract is completely unsustainable.

Frantic scenes around the Lewisham hospital #JuniorDoctorsStrike cake sale pic.twitter.com/DaTdbsRbSk

12.27pm BST

Peter Latham, an NHS-trained doctor in Australia, says he is unsure of returning to the UK.

“I’m saddened and upset for my former colleagues who are having to go against their deepest morals and walk away from patient care to ensure the long-term safety of an open access and safe NHS.”

When asked whether he would return to the NHS, he admitted that, at first, his intention was to leave to experience life in another country and then come back. Now, he’s not so sure.

“I have always pictured my career in the NHS,” he said. “I believe in what it traditionally stood for and I believe it is the best model of healthcare. Now I have no idea what I’m going back to. I fear doctors will flee from such a poorly led system and leave those in it stranded. Then it will be left open for private takeover. I don’t want to work in a dangerously understaffed NHS or a privately-run one. That leaves my options limited. I can’t see a resolution under Jeremy Hunt.”

12.22pm BST

Junior doctors have been telling Damien Gayle that suggestions that the BMA and government are actually quite close are off the mark.

Claims that the BMA and government positions were actually quite close were government spin, said Benjamin Robinson, a psychiatry registrar at Maudsley, just over the road from Kings College Hospital.

“The reason they are saying that is they want to say that this is based on reasons that are selfish,” he said. “What the government really doesn’t understand is that the contracts are going to disrupt our relationships with patients, because the new contracts have rotas - times when we work - which mean that you won’t as a patient get to see the same doctor on anything like a regular basis. We won’t be able to form the relationships that especially in mental health you have got to have with a doctor.

12.02pm BST

Many will be wondering at how the impasse over the new contract for junior doctors will be broken. Damien Gayle has been asking the “what next” question of strikers at King’s College hospital in south London.

Striking junior doctors were collecting ideas for a debate on how they can take their fight forward, with little sign that the government is prepared to back down.

Maryann Noronha, who works in emergency medicine at Kings, said she and her colleagues had until now been focused on these two days of all out strike action.

Maryann Noronha, Kings College: "we are trying to have a debate about where we go from here." #JuniorDoctorsStrike pic.twitter.com/Di05ktFZNt

11.40am BST

A junior doctor currently on a break from medicine in the US has contacted the Guardian’s Sarah Johnson about the strike. Namrata Turaga who worked only three as a junior doctor is studying for an MBA degree at Harvard Business school and has been keeping track of events as they unfold. She has been following developments with increasing frustration.

She said: “I needed a break from a system that I felt was not adequately providing the vital clinical training I need to be the best doctor I can be and from a world where I had no choice but to agree to a work schedule that included only 12 day shifts in six months – the rest were evening or night shifts.”

She has been watching colleagues and friends in the UK become “increasingly frustrated with their concerns being ignored or belittled” and was inspired to take classes on negotiations and complex deal making. She wrote a simulation based on the current junior doctors’ contract dispute, the result of which was students with a non-medical background reaching a deal by trading and compromising on issues.

11.30am BST

Damien Gayle has more on the money striking doctors have collected for a food bank.

Striking junior doctors at Kings College hospital have collected £300 and a pile on non-perishable food to donate to a local food bank.

Lucy Carter, an acute medicine doctor, said: “In the run up to the strike we had a food bank drive on the wards and among the junior doctors to bring in foods or cash donations, and yesterday during the industrial action we had another collection. We are taking it to Southwark food bank because we are all quite aware that this hospital serves some of the most underprivileged boroughs in London - Southwark and Lambeth - and it’s time we did something positive with industrial action. Lots of people on the street have come by to bring us tea or coffee and we are not the people who need it the most.”

11.26am BST

Hannah Orrell, a trainee surgeon at Kings who had just come off a night shift, tells Damien Gayle that Jeremy Hunt’s new contract would spell the death knell for the health service.

The implications of the contract for me are quite far reaching. I’m hoping that I will be in the NHS for 30 to 40 years and, from what we can see on the NHS frontline, services are already overstretched as it is. When the new contract is imposed it means that five days worth of services will be stretched to seven days, with the same number of staff. We think that not only will this be unfair for us but it will be unsafe for patients.

Orrell said that when she arrived at work at 5pm last night, she found that her department had been well covered.

Hannah Orrell, trainee surgeon at Kings: "we are already overstretched" #JuniorDoctorsStrike pic.twitter.com/enDn5CTcPg

11.02am BST

Will it take a change of health secretary to break the deadlock and finally settle the junior doctors’ dispute?

Bill Morgan - who was a special adviser to Andrew Lansley, Jeremy Hunt’s predecessor - thinks it might.

“The situation is at a complete stalemate. Jeremy Hunt has the support of Number 10 and the juniors have the support of their consultants. The public have been pretty steadfast in their support of juniors, but that’s been the same since the start – public opinion is neither rallying to their cause nor draining away. In short, neither the BMA nor the government is weak enough to lose.

“Unless and until something happens to decisively shift the balance the strikes are going to continue. It’s impossible to predict how this might play out. On the one hand, juniors might lose the support of their consultants if a local hospital declares an emergency during strike action and the juniors don’t come in off the picket line.

10.57am BST

Steven Morris has interviewed a couple of the older junior doctors - doctors below consultant level - on the picket line at the RUH in Bath.

James Leggett, 38, re-trained after a career as an academic, dong research in neuroscience and is now an F1 doctor (between medical school and specialist training) currently doing general surgery at the RUH in Bath.

“I’ve always voted, I’ve always read party manifestos but I’ve never felt at the sharp end of a government campaign like this. I think the government has backed itself into a corner. They’ve made promises they can’t fulfil but rather than backing down are intent on pushing through. They need to have a bit less ego and a bit more honesty as well as more compassion for patients and doctors. I think they’d get a lot of credit if they backed down and apologised. I don’t regret re-training. I love medicine. But it’s hard to deal with the day-to-day pummelling were getting. We’re being berated and belittled.”

Junior doctor James Leggett on the picket line at the RUH in Bath. pic.twitter.com/spRjyUVqGx

Rebecca Fallaize, 36, has spent longer than most as a junior doctor because she has had two children over the last five years. She believes the “weird structure” of the shift system the government wants to impose will harm patient safety. Fallaize is a specialist bowel cancer surgeon.

“It’s continuity of care that improves patient safety. The fragmented nature of the proposed contract means that the continuity will be lost. It’s important to see your patient regularly. If you don’t see the patient every day, it’s hard to get that continuity, to build that rapport and have that understanding of how the patient is doing.”

Junior doctor Rebecca Fallaize on the picket line at the RUH in Bath. pic.twitter.com/caKfZSaCZh

10.49am BST

The strikers at King’s College have been raising money for a food bank in the London borough of Southwark.

Kings College Hospital #juniordoctors collected £300 and all this food for #southwark foodbank #juniordoctorsstrike pic.twitter.com/FbgkoBMn93

10.24am BST

Alex Gates, 29, organiser of the picket line at the RUH in Bath, says the striking doctors are as motivated on day two as they were on day one. He thinks the next move should be for more pressure to be placed on hospital bosses to challenge the government.

“If 20 chief executives signed a letter calling for the government to think again, I think that would sort it,” he said.

Junior doctors' strike - junior doctor Alex Gates at the RUH in Bath. https://t.co/aOxwOE3pnj

Junior doctors' strike. Doctor Lucy Rose Jefferson on the picket line in Bath. https://t.co/ZhaQHN4PHP

10.21am BST

Aisha Gani has been talking to Dolin Bhagawati, a registrar at the national hospital for neurology at Queen Square (central London) who has been a doctor for nine years.

He says the specialist hospital he is at has probably 40 junior doctors and about 20 consultants, and at any one time 30 junior doctors.

“The majority were on strike yesterday - we had four junior doctors working and all consultants were working.”

Dolin tells me it's not about the money: As a consultant neurosurgeon he would earn £70k in UK, in U.S. $700,000 pic.twitter.com/IaGk6CaGOl

9.41am BST

It’s not all support for junior doctors, reports Alessio Perrone at St Mary’s in west London. Some passers-by shout their disapproval.

“Get back to work now. People could die!” one person said. Then a runner: “Shame on you!” And again: “Shame on you!”

Junior doctor Ali Yazdi, who works in the geriatrics department, shouted back that their bosses supported them and are covering for them. He says it’s frustrating when this happens.

At St Mary's, runners shouted: "Get to work now!" "Shame on you!". Jr dr Yazdi says many dont stop to talk to them pic.twitter.com/ZVZG30pmdJ

9.36am BST

The numbers of pickets at Royal University hospital in Bath are picking up considerably.

Picket growing at the RUH in Bath - more than 100 now easily. pic.twitter.com/pIVUAoBRPe

9.33am BST

Juniors on the picket line at King’s College say official figures on the number of their colleagues who went to work yesterday are misleading, writes Damien Gayle.

According to the hospital press office, six junior doctors turned up to work in emergency departments across the trust - which also includes Princess Royal University hospital. However, despite being asked to do so by the Guardian, the trust did not indicate how many of these were juniors on staff grade contracts. These doctors are not covered by the strike as they are not on training contracts.

Chris James, a trainee anaesthetist, said he had spoken to consultants in A&E who told him no trainee doctors had gone to work.

9.25am BST

Maddy Wells has just finished night shift in intensive care last night at University College hospital and has joined the picket line. She tells Aisha Gani there are eight junior doctors per shift on an average day and two consultants. No junior doctors worked yesterday from 8-5pm and there were six consultants covering.

“My main reason for striking is despite multiple attempts at negotiation from people in prominent positions with Jeremy Hunt he has failed to listen,” said Wells.

Rosie & Maddy work in intensive care and were on call last night. Usually 8 juniors, yesterday 6 consultants covered pic.twitter.com/MaoQibCbms

9.17am BST

An assortment of signs from St Mary’s in Paddington, were numbers are picking up, writes Alessio Perrone. About 20-25 doctors have joined the picket, but they expect it to get much busier after 9.30am, when most surgeries start.

Some of the best signs at St Mary's Hospital #JuniorDoctorsStrike pic.twitter.com/sVCIqZetpW

9.15am BST

Aisha Gani is at University College hospital in central London, where about two dozen junior doctors are on the picket line on a chilly April morning.

Lina Carmona was on call as urology registrar last night, while she is also doing her PhD in prostrate cancer at UCL. She trained as a doctor in Colombia and came to the UK to work as a registrar. She has been a doctor for eight years and has a small child.

“We’re supposed to be encouraging people, and women to be doing research. My wages doing a PhD is much lower than being registrar. I used to earn £3,000 a month and now I earn £1,600 and paying for my PhD. So who’s going to want to go into research when your salary is frozen.

Lina, a doctor of eight years, is a surgeon, urologist and doing a phd in prostrate cancer. Her salary has halved pic.twitter.com/LHGU1IPiKM

9.07am BST

Striking junior doctors are just setting up their pickets at the entrance to the King’s College hospital compound in Camberwell, south London, writes Damien Gayle.

Progress is slower than yesterday, some of those helping put of banners admitted to being hoarse from last night’s demo march through central London. Yesterday had seen hundreds of striking doctors join the picket at its height in the afternoon.

As many are expected today, but the atmosphere is muted for now. Chris James, a trainee anaesthetist, said that yesterday’s strike had really impressed on them the power of the media, and how much most outlets were happy to back the government’s line.

Passing cars beep in support as Kings #JuniorDoctorsStrike stand up for their rights - to a reggae soundtrack pic.twitter.com/zLpRAMD0GN

8.58am BST

As well as reading your reaction to today’s strikes in the comments, we’d like to hear from those of you who are involved and see your pictures of where you are.

Are you a junior doctor on the picket lines today? Maybe you are there in solidarity, or perhaps you have gone to work as a covering senior medic? If you are not a medical worker but are at one of the hospitals up and down the country that is affected, we’d also like to hear from you.

8.53am BST

My colleague Steven Morris is at the Royal United hospital, a major acute-care hospital in the Weston suburb of Bath.

The picket line at the RUH in Bath - around 20 junior doctors so far. More expected presently. pic.twitter.com/NbltQSxlrm

The goodies table on the picket line at the RUH in Bath pic.twitter.com/QgJga27Baw

8.49am BST

It seems the Department of Health has been reaching out to lobby correspondents, including Sam Coates of the Times, to be its new director of communications. The Spectator has this nugget on its so far fruitless search.

With the junior doctors’ strike now in full swing, it’s fair to say that these aren’t the most harmonious days staff at the Department of Health have ever seen. Perhaps that’s why they are looking for a new director of communications to take charge of the department’s ‘external and internal communication activities across a complex and high profile agenda’.

Alas, so far they don’t appear to have had much luck enticing candidates to the public relations role. Despite enlisting the help of ‘executive search firm’ Veredus, the search is still on and recruiters appear to be spending their time sending unsolicited messages to members of the lobby. Sam Coates, the Times‘s deputy political editor, has shared a message online that he received asking if he would be interested in the role — which carries a starting salary of £120,000. Alas, Coates was left unimpressed after two of his friends were approached about the same role just last week.

8.29am BST

Junior doctors on the picket line at St Mary’s hospital in Paddington, west London.

Picket starts at St Marys Hospital #JuniorDoctorsStrike pic.twitter.com/tZDPScAKKL

8.26am BST

The Labour party leader, Jeremy Corbyn, was out yesterday showing his support for striking junior doctors. David Cameron took the opposite tack saying it was “not right” for junior doctors to withdraw emergency care.

Today is the second day of the #juniordoctors' strike. Yesterday I was proud to join their demo #JuniorDoctorsStrikehttps://t.co/XXXbx5fkTH

8.13am BST

Denis Campbell, the Guardian’s health policy editor, writes:

Yesterday the highly-respected NHS blogger and health policy analyst, Roy Lilley, wrote, in effect, “a plague on both your houses” about the BMA and Jeremy Hunt for their tactics during the dispute.

Today Lilley renews his criticism of the doctors’ union - both its leadership and its junior doctors committee headed by Dr Johann Malawana.

8.06am BST

Tim Farron, leader of the Liberal Democrats, last night called on Jeremy Hunt to name an “honest broker” to help bring people back to the table and has put forward its health spokesman, Norman Lamb.

Negotiations are at a standstill, with no end in sight. Something must be done before there is serious risk to the public... Our health spokesperson and former care minister, Norman Lamb would be an ideal honest broker, with experience in the department, credibility among health professionals and a record of delivering improvements in services. If the government and the BMA are willing to bring a third, independent, party to the table, Norman is prepared to work with both sides to find a way out of this dispute.

7.52am BST

It’s day two of the first all-out strike in NHS history. Junior doctors – all those below the level of consultant - will again stay away from hospitals from 8am and 5pm. On the first day, four out of five junior doctors walked out as David Cameron criticised their withdrawal of emergency care.

At some hospitals, almost 90% of junior doctors refused to work in an escalation of their campaign against the new contract that the health secretary Jeremy Hunt intends to impose on them.

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