By Helen Daly

Published: Friday, 09 December 2022 at 12:00 am


Long-running BBC drama Casualty will never shy away from a challenge, and its latest episode, set to air tomorrow (10th December) is no exception.

Following on from their award-winning special about the COVID-19 outbreak, this special episode is set to explore the pressures currently placed on paramedics within the NHS – in particular, how in demand they are and how this impacts on patients.

What’s more, the frantic episode is improvised, too, meaning it genuinely will feel very real and fly-on-the-wall to viewers.

RadioTimes.com recently caught up with Casualty boss Jon Sen to find out exactly why he wanted to build on the experimentation the long-running drama has already done, and what the future holds for it.

“Casualty’s got a long history of telling stories that are true to the NHS, that really talks to the experience of NHS workers, doctors, medics, but also people who are patients on there,” Sen explained.

“We were talking to a lot of doctors, nurses, paramedics and practitioners within the community (as we do) and realised that actually, this year more than anything for them, the defining visual of hospitals had become this set of queueing ambulances which seemed to start in several central hospitals, but was becoming more prevalent.”

Sen continued: “We felt this needs to be a really intense, naturalistic treatment of a paramedic’s life and we wanted to get as close to that as possible. So we talked about how to do that both camera-wise, production-wise, and then style of performance.

“We realised that actually, in terms of style of performance, the way we could achieve greatest naturalism was to allow the actors to improvise along set lines that we’d set up very particularly for scene breakdowns.”

Was he worried about how to portray the scenes without being overtly political? “We have to be careful because we are the BBC and it prides itself in its impartiality. And it’s important as well that we portray the truth of what’s going on. Our jumping off point is always fact-based research.”

Sen added that he was “proud” of presenting a fact-based episode, adding: “This is the authentic reality of what paramedics are facing.

“We don’t point the finger of blame at anybody – there is obviously a discussion around lack of social provision meaning there’s no beds, which means it knocks on to ambulances – we can talk about the conflicting arguments about the causes, but the truth of it is paramedics on the front line are suffering mental and immense challenges.

“We want to be authentic and are a reflection of their experience, rather than find ourselves taking a political stance.”

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Stevie (Elinor Lawless) and Matthew (Osi Okerafor) in Casualty
BBC

The exec went on to describe the initial process as “terrifying” as it was quite far from what Casualty had done before, but with those nerves came excitement at the prospect of making something very unique – and luckily, the cast were entirely trusting and on board.

“Michael Stevenson [who plays Iain], rang me up after shooting on the first day and he was buzzing with adrenaline,” Sen commented. In particular, during one harrowing mental health patient scene, the actors found the improvised process liberating as the normal cast were kept away from the guest actors to keep spontaneity.

“The improvisation allowed the actors to really feel around the scene. They’re listening. They’re responding. And they’re judging what the other actors in the room are doing. It gives a sense of real-life quality to the scenes… there’s tension in the scenes that we don’t normally get when we do it in a more traditional manner,” the executive producer commented.

As for the actual storyline of the episode, it’s intense, chilling, and the stakes grow with every minute that passes. It’s relentless and doesn’t leave a moment for reflection until the episode closes.

Sen, who regularly speaks to medical professionals, explained how he got a feeling on what type of stories to include from having those conversations.

“We don’t use cases they bring to us for a while host of reasons, but it’s really useful to talk to real-life paramedics because you get the sense of their experience and their pressure. You get the sense of the type of patients who are recurring the whole time in their daily work and the personal toll it takes on them, so you build the story around that.

When the #Casualty paramedics met the professionals… 🚑

We invited real life paramedics to the #Casualty studios to watch this special episode before anyone else 💚
#Casualty the improvised special.
Saturday 8:10pm on @BBCOne 📺
Catch up on @BBCiPlayer if you miss it! ⚽ pic.twitter.com/yXuSLm5Tqn

— BBC Casualty (@BBCCasualty) December 8, 2022