Episode 7 is the 1099th episode of Casualty and the seventh episode of the 33rd series. It was preceded by Episode 6 and followed by Episode 8. The episode was directed by Alex Jacob and written by Jon Sen.
After spending the morning dealing with time-wasters, Iain and Ruby answer a call about an RTC involving a pregnant mother named Siobhan. At the scene, another woman named Lia tries to help her deliver her baby as she goes into labour, but Ruby tells her to back off when it appears as though she has caused an injury. However, on the way to the ED, Ruby allows her to help her perform CPR on the baby. In resus, it becomes apparent that the infant has broken ribs and a pneumothorax, leaving Ruby feeling guilty. Although the baby is stabilised, she still continues to doubt her own abilities.
In cubicles, Ruby learns that Lia knew that Siobhan was carrying her husband's child and tells her that she felt obligated to help keep the child safe to keep the memory of her deceased son Elijah alive. Iain apologises to Ruby for his treatment of her and tells her that they need to trust each other if they're planning on working together. After Lia visits Siobhan and her baby on NICU, Ruby takes her home, and she chooses to let Elijah go.
Following her doctor's appointment, Duffy finds Bill in the department after his daughter Rachael is taken into resus. He begins to argue with Rachael once he finds out that she has alcoholic hepatitis, and Duffy tries to deescalate the situation. However, Bill unintentionally pushes her and triggers a panic attack. Outside, she tells him that she has just been diagnosed with clinical depression. When Rachael begins to deteriorate, Duffy encourages Bill to be there for her. Later, Charlie asks her why she was late to work in the morning, and she tells him that she was receiving a jab.
Meanwhile, Alicia gives Ruby one of her rooms, and she dreads having to tell Gem that a woman named Jamila has offered her double the rent for the other room. However, she soon learns that she is the new consultant anaesthetist and begins to have second thoughts when she observes her blunt attitude towards staff. With Ethan's encouragement, she tells Jamila that she cannot have the room and gives it to Gem.
Elsewhere, Louise prepares for her interview for the band 6 post. Afterwards, although she is delighted to hear that she has unofficially got the job, she becomes irritated with Charlie when he tells her that she was the only applicant.