It is looking likely that government will impose a new working contract for junior doctors after being advised by its lead negotiator Sir David Dalton that there is no realistic prospect of a deal.

An eleventh-hour offer by Health Secretary Jeremy Hunt, which made some concession on the key sticking point of unsocial pay, was rejected by the British Medical Association as doctors joined picket lines across England in a second round of industrial action.

The government’s latest proposal reportedly offered extra pay for doctors working at least one in four Saturdays, and included higher fines for trusts over-working doctors, according to the BBC

But speaking to PharmaTimes, a BMA spokesperson said the union has offered the government a ‘cost-neutral’ alternative, which would see part of the proposed increase in junior doctors’ basic pay re-distributed to an increase in unsocial hours pay.

Talks over the new contract have been underway for four years, but Sir Dalton told the BBC that negotiations "have reached the end of the road".

“Drawn out industrial action over contracts and pay would mean further disruption to patients who are relying on NHS care, with thousands more operations cancelled and check-ups delayed,” noted NHS England chief executive Simon Stevens, commenting on the situation.

It’s “incredibly disappointing” that Sir Dalton has reported that there is “no realistic prospect of a negotiated agreement”, he said. “Under these highly regrettable and entirely avoidable circumstances, hospitals are rightly calling for an end to the uncertainty, and the implementation of the compromise package the Dalton team are recommending.”

But there is growing concern that imposition of a contract will fuel continued industrial action by junior doctors that couple end up crippling the NHS. And almost 90 percent of junior doctors said they would consider resigning from the NHS if the government does so, according to a poll of more than 1,000 medics seen exclusively by The Independent, highlighting the strength of opposition to the proposals.