The hospital’s future is in doubt following DHA's decision not to sanction a financial package to repair the Casualty department. The hospital is only offered an authorised high interest loan, that doesn’t cover all the costs of the everything that needs to be done. The hospital's budget for the year ahead has also been cut so that the Royal will need to dip into the Middleditch trust fund to keep the hospital open. Jean ends up announcing that the only way forward is to consider a a complete closure of Casualty. Ralph ends up taking some secret action to rectify the situation but also ends up bringing up some difficult issues in his past. Carol and Ralph finally end up getting together.
There is a near crash on the road which involves a woman called Dolly and her daughter Alison and a rich aristocratic heir and his girlfriend. Ellis and Ormerod are called out to attend the scene of the accident. The car with Dolly and Alison in it ends up crashing into the lake to avoid the other car. With the car sinking Jack attempts to get them out. The other couple are taken to the hospital to be checked out where a water tank comes crashing through the ceiling and traps Tom the male driver. Suffering with a a ruptured spleen, Ormerod and Rose manage to free him and get him to theatre for surgery.
A patient with cancer dies unexpectedly after a visit from Dr Ormerod, and the grieving family point the finger at him. Dr Omerod is arrested on suspicion of murder – how will he prove his innocence? Dr Ralph Ellis holds a clinic at the local prison and is concerned about the mental health of one of his patients. When a full scale riot breaks out, Ralph’s trapped. Will he escape unscathed?
Mr Middleditch has come in to St Aidan's hospital, accompanied by his wife, for a routine operation. Noticing that Mrs Middleditch looks unwell, the hospital decides to give her a blood transfusion. Distracted by the attentions of a rich divorced playboy, who has promised to marry her, Susie Dixon administers the wrong blood, which later results in serious consequences for both her and the patient.