A vote of no confidence in the leadership of two separate NHS trusts has reinforced the fears of doctors who believe that a confrontational style of management is invading the health service.

In Plymouth this week junior doctors endorsed their earlier vote of no confidence in the management of Plymouth Hospitals NHS Trust after the sacking of Pat Cooksley, a sister in the neurological ward, for gross professional misconduct. The charge was made after the sister had rewritten a patient's drug chart in the absence of a doctor. The hospital to which the patient went next noticed this omission and sent back an untoward incident slip. Pat Cooksley was suspended, an investigation was held, and she was then dismissed and had …