Unions representing junior doctors are furious at a suggestion by NHS chief medical director Professor Sir Bruce Keogh that they could be ordered to break their strike beginning Tuesday (12 January) if there was a danger of hospitals becoming overstretched. The British Medical Association (BMA) said Sir Bruce's letter, sent to every NHS Trust medical director last Thursday (7 January), had caused "concern and anger" to doctors.

Junior doctors are preparing to provide emergency care only for 24 hours starting from 8am, leaving consultants and nursing staff to cover their absence. However if a Trust declares an emergency, doctors are legally obliged to return to work. Now there are fears some Trusts may declare "code black" alerts to force doctors back to work.

In the letter published by the Daily Telegraph, Sir Bruce suggested medical directors "walk the floor" to monitor the situation on the ground and if conditions become dangerous, to call doctors back in. However the letter triggered a furious response from the BMA head Dr Mark Porter, who wrote to Sir Bruce: "Your letter to medical directors has been interpreted by many doctors as a further attempt to thwart lawful industrial action in favour of which junior doctors voted almost unanimously."

Some of those doctors hoping to strike have complained on social media that they have been pressurised to work in order to provide emergency care. Doctor Adam Julius wrote: "My hospital just called a meeting with all its [Junior Doctors]. They are declaring a code black emergency and threatening juniors who don't attend work tomorrow with referral to the GMC."

Despite Prime Minister David Cameron's plea for the doctors to call off their strike, up to 38,000 junior doctors could take part in industrial action. In a blow to health secretary Jeremy Hunt, an IPSOS Mori poll found that two thirds of the public support the doctors.

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