The train on which Marian was travelling crashes, trapping her in the wreckage. Although she cannot escape, she's free to move around the carriage to help those injured, assisted by fellow passenger Dr Nick Burnett - who turns out to be the Royal's new locum. Back at the hospital, a shortage of staff puts the casualty department under pressure when the crash victims begin to arrive.

Carnegie disapproves when Nick admits several homeless people from Elsinby to the hospital. Gordon is reluctant to let Jill take on heavy duties. However his plans fall apart when she is called to attend to road along the coast when a female victim of a car accident goes into labor. Meanwhile, Matron is stunned when she sees who is the new student nurse, and patient who enjoys gossip discloses where Ken is.

An accident at the harbor leaves a fisherman concerned for the future of his family when Burnett is forced to amputate his hand. Weatherill treats a woman admitted with pneumonia who is deeply concerned about her father's presence around her daughter. Ken bids a final farewell to The Royal, but Lizzie's resolve flounders at the last minute.

Eric Fogle is appointed as new head porter, putting Alun's nose out of joint. The hospital receives a letter of resignation from Dr Banner in Australia and has to appoint a partner to the practice - Weatherill believes she knows just the person, but Dr Ormerod favors Dr Burnett. Elsewhere, when Lucy Bayliss is involved in a horse-riding accident an X-ray reveals a more long-term problem.

Maria Dannini suffers injury when her ice-cream parlour is vandalised, but further revelations lead to a more serious medical situation. Sister Brigid faces a dilemma when her pregnant sister Moira arrives wanting advice on an abortion. Elsewhere, a cunning Susie has a plan to get rid of Eric, and Burnett decides to stay at The Royal.

The hospital staff are pushed to their limits when an amusement arcade collapses. In the search for survivors, a child is found with a suspected blood-clotting disorder and the team must find his mother to obtain his medical history. Stella enters the wreckage to free a girl who is trapped under a fruit machine, but when she becomes blocked in, Frankie tries to save her - and declares his feelings in the process. After another collapse both Frankie and Stella become trapped. The staff work fast to try and free them.

As the hospital staff come to terms with the loss of Stella and Frankie, everyone’s surprised when an attractive surfer, who crashes into Dr Burnett’s car, turns out to be the new ambulance driver, Bobby.

Alun is getting ready for a gig in town with his new band and deafens everyone while he practices in the porter’s office. Marian reasons that they should all go and watch the gig as Stella loved a good night out and wouldn’t want to see her friends sitting in every night. However, when Dr Burnett explains he can’t go as he’s on call, Marian is soon charmed by Bobby, who agrees to be her date to the gig. Will Marian turn to Bobby for a good time?

Dr Burnett is called out to a run down farm house where 15-year-old Simon, who has speech and learning difficulties, is running a high fever. The farm is in a bad state and the family seem to be struggling to cope. They’re horrified when Burnett reveals he needs to get Simon to hospital ASAP in order to rule out meningitis. Will they get to the bottom of Simon’s illness?

Mr. Middleditch's 70th Birthday celebrations are interrupted by a bus crash.

With Susie and Carnegie's relationship becoming the focus of talk in the hospital, Matron reaches the end of her patience and decides to suspend Susie when she's late for work. Mr Rose faces a personal test when a golfing friend of his has to into the operating theatre, Nick copes struggles with a dilemna and Gordon and Bobby are called to a farming accident where a man is trapped by a combine harvester.

Nick races against time to save two schoolgirls who have been poisoned by carbon monoxide, Susie has to use quick thinking when Matron falls ill during their picnic on the cliff front and has to go into hospital, giving Susie an opportunity to prove herself. In the meantime, a man is training to become a priest, which causes a family problem which Jill needs to sort out.

Sister Brigid helps to make a bright future for her sister Moira and her baby. However when things take a shocking twist Gordon and Jill have to make a heartrending decision. Susie does her best to be the perfect nurse and ends her relationship with Carnegie. However he proposes to her. Meanwhile Bobby has to deal with the violent stepfather of a local thug, taking matters into his own hands.

Dr. Ormerod and Dr. Weatherill accompany Brigid back to Ireland for Moira's funeral, and uncover shocking family secrets in the process. Meanwhile, a new locum is thrown in at the deep end at the Royal.

Dr Ellis confronts local prejudice when he discovers one of his patients has contracted a rare disease abroad. Jack and Alun begin a crackpot scheme to raise chickens, Brigid makes a decision about baby Aisling's future, while Jean becomes more frustrated with Lizzie's incompetence.

Weatherill treats a schoolgirl whose crush on a teacher has spiralled out of control, while Ormerod and Ellis launch a daring cliff rescue when a family picnic goes awry. Jack and Alun use an old map to hunt for buried treasure underneath the hospital, and an old friend of Matron is taken ill.

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.

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?

A new student nurse arrives at the Royal. Lizzie falls for a motorcycle stunt rider who is convinced he’s destined to live fast, die young. But Dr Ormerod comes up with a different diagnosis.

A secret from Jean’s past resurfaces when the wife of a former lover arrives at the Royal and accuses Jean of being up to her old tricks. When things take a shocking turn Jean is forced to reconsider her future as well as her past.

A family outing causes trouble for the Ormerods and Lizzie attempts to improve her vocabulary.

A girls’ trip out on board a pirate radio ship ends badly when they are embroiled in a siege. And Drs Ormerod and Weatherill are mystified when a girl guide leader recovers miraculously from a stroke.

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.

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.

A can of worms is opened when Gordon attends to a local family's problems, and when violence spills onto the Royal's wards he gets caught up in the crossfire. Meanwhile, baby Aisling's adoption is final. However, Sister Brigid is confused by her feelings.