I flip flopped on my position on the contract vote, and I make no apology for it. It was a difficult decision, in a completely crazy political and NHS environment, and I never spoke to anyone who had a completely clear idea on it. 
68% of doctors voted, and 58% voted no. Given the margin we just left Europe on, this is pretty emphatic. 
So what happens next?
As he always said he would, Johann Malawana, current junior doctor committee chief has stepped down. I always supported Johann, and he has been an incredible leader in unprecedentedly difficult times. I wish he’d stayed on to be honest, but respect his decision and we should be eternally thankful for his service. 
As I’d suggested before, we now need to decide what we want, what we are willing to do to get it, and how we want to go about it.
The strategies now open to us depend on what government’s response will be.
If renegotiation is offered;
1. complete restart on negotiations. With a civil service in Brexit disarray, and no actual leadership in government right now, this may be more viable, or less, than it was a week ago. We simply don’t know. Whatever the circumstances a new contract must have; 
              -Safe staffing and working conditions 

              -no discrimination 

              -fair remuneration

              -whistleblowing protection

2. Further negotiation on the current contract. This might be difficult- there were many reasons and red lines for different doctors- simply tacking on and rejigging this contract might still fail to convince the junior doctor body that already voted this offer down.
3. Or do we push for individual negotiations for different specialties and colleges? A more tailored approach that might address the one-size fits all difficultly of such a complex contract.

4. Or do we simply campaign for no more negotiations- a moratorium on any further discussions for at least a year. Let the politics cool down, let politicians leave the issue alone and the newspapers to wander away. Then, when safe to, we can pick it up again- with time for a better plan regarding an option above. 

The government may impose. 
If they do – then what?
42% of doctors accepted this contract- if you voted yes are you willing to now take part in industrial action with those who voted No?

I might suggest that doing anything other than staying united in support would be foolish. If the government impose, they are more than likely going to change the contract as they did in the original imposed version. Clauses such as ‘we can change anything at any time’ and ‘you can only work for us’ might reappear. Any supplements and premia may disappear, the safety mechanism may also disappear. The contract we may end up striking against may be very different to what we have now.
And if it isn’t? Will it attract the same support for industrial action as before? 
Well we will have to see. Imposition may be illegal, regardless of the terms, and Justice for Health and The BMA both have legal challenges to play out in the courts. 
At the end of the day we all simply want our lives back, we don’t want a payrise, we don’t want special conditions or further perks; we are simply asking that government leaves us alone, and let’s us go back to the jobs we love; looking after patients.
So let’s just put this toxic issue to one side, continue current contracts everywhere, and spend the time restoring goodwill and trust so we can safeguard patients and doctors for the future of the NHS.
Whatever happens we must stay united.

The world is crazy enough right now. Lets hope a bit of sanity can prevail. 
Juniordoctorblog.com