Never can an acronym have been more appropriate.

Consultants at Great Ormond Street Hospital (GOSH) have given their chief executive a letter of no confidence.

Acording to the Sunday Telegraph's report, around half of the trust's consultant body have signed a letter of no confidence in the CE Dr Jane Collins, which was facilitated by the BMA.

One of the signatories is consultant Dr Kim Holt.

You will probably remember Dr Holt. You will probably remember that the independent investigation commissioned by NHS London into Dr Kim Holt's conduct over the issue of consultant workload, which was highlighted by the intensely distressing Baby Peter case, found that Dr Holt had acted properly in raising her concerns and should be able to return to work.

That report is six months old.

Dr Holt is still suspended.

GOSH has had previous issues with secrecy.

This is a mess. There is a very evident clash of cultures on display here.

It is time for someone strategic to do something.