Junior doctors have joined the picket line for the second day running - in a complete walk-out over the government's new contract.

But health chiefs say emergency care for patients will not be affected by today's industrial action taken by junior doctors.

Junior doctors have withdrawn emergency care in the long running contract dispute.

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Previously, junior A&E doctors working on strike days did not join their colleagues on the picket lines but in an escalation of the row between medics and the government, emergency rooms will now be affected.

Yet Kent's health bosses say they have plans in place to cope.

The trust running Medway Maritime Hospital, in Gillingham, says the strike will mean about 800 outpatient appointments and about 30 non-emergency operations have had to be rescheduled.

VIDEO: Junior doctors tell us why the strike is so important.

Margaret Dalziel, director of clinical operations at Medway NHS Foundation Trust, said: “We respect the right of our junior doctors to take part.

“Our top priority, as always, is to ensure patients continue to receive safe and compassionate treatment during this period.

“We immediately set about putting in place contingency plans with our commissioners and local partners to ensure the safe provision of services.

“Given the unique and unprecedented nature of these strikes, a number of our medical consultants and senior nursing staff will be deployed to the wards and emergency department during the industrial action.

“We’re very fortunate to have this level of experience and expertise at our disposal to help deliver safe care to patients.

“It is important to remind patients in less urgent need of care they might experience longer waiting times.

“If patients have a minor injury or illness and they’re not sure where to go for treatment, they should call NHS111 for advice or their local GP.”

More than 2,500 consultants, GPs and senior doctors have signed a letter to Prime Minister David Cameron and Health Secretary Jeremy Hunt in support of their junior colleagues, offering assurances patients will be kept safe.

The action comes amid a row over new terms and conditions that resulted in Mr Hunt threatening to impose the new contract on trainee medics as part of his vision for a seven-day NHS.

A spokesman for Darent Valley Hospital Trust said no operations have been cancelled, although 60 outpatient appointments have had to be rescheduled.

He added: "We have closely reviewed the staffing levels in the areas where junior doctors have indicated that they wish to join the industrial action and we have reorganised our clinical cover accordingly.

"Consultant and senior grade doctors will be working with matrons and nursing staff to continue to provide hospital services to patients during the strike action.

"Patients should attend their appointments at the date and time specified unless they have been informed otherwise."

The trust also urged people to avoid using A&E unless it was a real emergency, a message echoed by the ambulance service.

A South East Coast Ambulance Service NHS Foundation Trust (SECAmb) spokesperson said: “SECAmb is asking the public to, as always, think carefully about calling 999 during this week’s planned period of industrial action by junior doctors.

"It is difficult to say how substantial the impact will be on our service but we have robust plans in place and will be monitoring the situation closely to ensure that we minimise the impact on patients.

“We will be looking to make best use of our clinicians in our control centres to advise patients, working with our healthcare partners in the community to delay, where appropriate, the transfer of patients to hospital and where possible seek alternative pathways such as minor injuries units as and when necessary.”

Maidstone and Tunbridge Wells Hospitals Trust has cancelled 109 procedures over the two days, but says consultants and other senior staff will keep emergency services running as normal.

Angela Gallagher, the trust’s Chief Operating Officer, said: “We will monitor events very closely during the period to ensure that we have the appropriate cover provided in all areas and we are very grateful for the support and collaborative working from all groups of staff in preparation for this day.”

Nicola Davis, 32, has been a junior doctor since 2009 and works in the oncology ward at Maidstone Hospital.

She said: “It’s a really difficult decision for us to make, to take this industrial action, and one we feel we’ve been forced into. But we have to fight for the future of the NHS and this contract is incredibly dangerous for patients’ safety.

“Doctors are not against having a seven-day NHS, we have one already, but if the government wants a true seven-day NHS, and they want more doctors at the weekend, that unfortunately requires more of us. We don’t have enough doctors, certainly in this hospital and all across the country.

"You’re going to need more doctors and more resources. This isn’t just about doctors, you also need more nurses, more porters, more laboratory staff, everyone across the board. That requires more resources and more money and none of that has been planned for or thought through.”

Asked why doctors resorted to an all-out strike this time, she added: “We’ve been trying so hard to get the government to listen to us and we have given them the option to lift the imposition. We’re desperate to get back to our jobs, we don’t want to be here today.”

Ella Daniels, 23, has been a junior doctor at Tunbridge Wells Hospital for eight months during which time she has watched “morale dwindle” around her.

While striking yesterday she said: “The government is not working with us to find the best solution for the patients. When people feel they’re not being listened to, or that their opinions don’t count, or something’s being forced upon them, they begin to resent their jobs and that makes it unsafe for patients.

“There’s already a seven-day week. I work a lot of weekends, my colleagues work a lot of weekends. Jeremy Hunt wants to create a seven-day elective service, which isn’t feasible because he’s not planning on increasing the number of doctors, just overworking the ones he already has.

“I’d say about 50% of my colleagues are considering walking away. I know a lot of people who are going to Australia or New Zealand, places where conditions are a lot better for doctors. It’s sad the most driven doctors, who want the best for their patients, are seeing they can’t provide that here in the UK."

East Kent Hospitals Trust has had to cancel 1,500 outpatient appointments and 81 planned surgeries.

Matthew Kershaw, Chief Executive, said: “As well as increasing senior doctor presence on strike days, we are taking measures to ensure we have the capacity to see and treat patients who require urgent or immediate care.

“We are taking every precaution to make sure that patients are kept safe and well-cared for over the strike period. It has been necessary to reschedule non-urgent appointments and planned operations.

"We are very sorry for the inconvenience this will cause and those affected will be contacted in advance.”

Dr Navin Kumta, Chair of NHS Ashford Clinical Commissioning Group, said: "It is unavoidable that some services will be affected including postponement of some routine operations and non-urgent outpatient appointments.

“The NHS is open for business but we ask the public to use it wisely in this very challenging time as some services may change and some may be busier than usual so contact services early if you need to book appointments during this time.”

Green Party MEP for the south east Keith Taylor said: “ Jeremy Hunt must surely want to avert strike action so that all doctors can be on hand to do what they do best.

“The government is playing with fire with its bullying.”