Episode 22 is the 1070th episode of Casualty and the 22nd episode of the 32nd series. It was preceded by Episode 21 and followed by Episode 23. The episode was directed by Fiona Walton and written by Michelle Lipton. The episode marked the first appearance of F1 Bea Kinsella, portrayed by Michelle Fox.
The hospital's new chief operating officer Avis Baxter arrives at the ED to find it in chaos after a red alert is declared. With the hospital already full, lines of ambulances filled with deteriorating patients only worsen the crisis. Despite this, Ethan decides that hiring locums and nurses is unnecessary, which results in a case of necrotising fasciitis being missed. Alicia, determined to save her patient, is forced to break the rules to get him into resus. However, when help comes too late and he is put on life support, she starts to become disillusioned with the NHS and vents her frustration on an anonymous blog.
Elsewhere, new junior doctor Bea Kinsella joins the department. She catches up with Rash, an old friend from medical school, and decides to offload all of her 'uninteresting' patients onto him. Later, a terminally ill patient's relative overhears her make a callous remark about his condition, prompting them to lodge a complaint against her. Fearing that she will lose her job, she is relieved when it is dropped, and Ethan decides to take over as her clinical supervisor.
Meanwhile, Charlie and Duffy prepare to celebrate their one-year anniversary as a married couple at an extravagant restaurant. However, after a particularly distressing case, Charlie decides to drop their plans and settles for a quiet evening at home.