"It Starts With the Shoes" is the 1029th episode of Casualty and the 25th episode of the 31st series. It was preceded by "Slipping Under" and followed by "The Good Samaritan". The episode was directed by Jo Johnson and written by Kim Millar.
David prepares to hand Ollie over to his aunt, who will be taking him back to live with Rosa in Spain. Ollie is devastated when David breaks the news to him, and they enjoy one last day in the emergency department together, avoiding Jacob in the ED.
Meanwhile, an elderly woman falls from a balcony upon hearing commotion outside. Once back at the ED, a young woman who was in the garden accuses her husband of being a pervert for touching himself in the bushes. However, it transpires that he has a prostate problem which results in him urinating frequently.
Gemma short-changes a customer, and soon recruits Ollie to help her with the maths side of things. Ollie is soon to reveal why he's really there to Iain, and he starts to have doubts about Gem's education. He later realises how bad her maths really is in the ambulance station, when she fails to read the correct number of syringes.
Elsewhere in the ED, a woman and her mother have been admitted, and Elle and David are equally confused as to why the mother's condition is getting worse. Eventually David stands up to Elle, and it later transpires that the daughter has been making her mother take medication in an attempt to make her better.
Dylan and Louise prepare to present their idea of a booze bus to the board, but when the presentation Dylan's prepared fails to capture them, Louise takes them down to the corridors to see the effects of drinking on the ED themselves.
David shares an emotional goodbye to Ollie, and reveals to Robyn he's going to come off his lithium completely after feeling proper emotions for the first time a while. When he gets home, he flushes his medication down the toilet.