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The second junior doctors' strike in the long-running dispute in England is not yet over, but already attention is turning to what happens next. Talks at conciliation service Acas have broken down, perhaps irreparably. It means the nuclear option - imposition - is now a real possibility. Over the past week ministers and their officials have been putting real thought into how and when they should make their move. There are some suggestions it could come as early as this week. Why now? Quite simply, they've been told the time has come. Senior NHS officials have advised them that the health service needs to start making plans if a new contract is to be brought in this summer as planned. That's because hospitals would need to carry out a detailed review of rotas and staffing before contract offers are made in May, in time for the August start date. But once that has been done, the contract could be imposed quickly. Within six months about 80% of junior doctors would be on a new contract - this is because as trainees, most of them quickly rotate through jobs. That's the theory anyway. But imposition is fraught with difficulties - and ministers know this. If they do impose the contract there will be a collective holding of breath in the corridors of power as they wait to see what junior doctors do next. That's because the anger and determination of the profession to resist these changes has time and again taken ministers by surprise.

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