Casualty spoilers for the Christmas special episode follow.
Casualty is back with its first episode in over three months, and its first Christmas episode in five years – but it might not be the return you expect. The end of the last series asked more questions than it answered, but these storylines are put to one side for now in favour of a standalone festive episode with a format-breaking twist.
As well as creating drama and entertainment, Casualty has always had a responsibility to tell important stories about the NHS and the current healthcare system, as a fictional version of a very real institution. The latest episode, titled ‘All I Want for Christmas’, is another example of how seriously the show takes this responsibility, using their latest festive offering to pay tribute to the miracle of blood.
The episode begins with Stevie taking the time to donate blood herself, and then you see the entire process of the blood being processed and transported to the hospital. But on Christmas Day, blood supplies are low and Siobhan urges the team to donate if they can.
Related: Best streaming services
Throughout the day, Stevie and the team treat patients who are in need of blood for various reasons. But the special episode also weaves in interviews from real people who have been directly impacted by UK blood donation, making the stories being told feel even more poignant.
A key example of this is Leah, a young girl admitted to the ED who Stevie suspects might have meningitis. But when her results come back, Stevie realises that Leah likely has leukaemia and struggles to deliver the bad news on Christmas Day of all days. Former Coronation Street and Hollyoaks star Lucy-Jo Hudson gives a devastating performance as Leah’s mum Adele, who is forced to come to terms with the severity of her daughter’s condition.
Leah’s story is told alongside the real-life story of Rachel, a university student who was diagnosed with leukaemia while studying to become a doctor. While Rachel tragically died, her father James reflected that Rachel had roughly 150 blood transfusions during her illness that extended her life and gave her more precious time.
Related: Casualty star provides Dylan and Sophia relationship update
But Casualty also respects that for some, blood is a much more complex issue. The team treat Dominic, a man who was involved in a huge motorway pile-up but refuses to have a blood transfusion that could save his life. He later justified his decision and explained that his late sister was one of the victims of the infected blood scandal.
During the 1970s and 1980s, more than 30,000 people in the UK were given contaminated blood products – including interviewee Andrew, who was infected with HIV and hepatitis C by the age of five. He spoke about how he had to learn to trust the blood supply again, and as did Dominic, who was eventually persuaded to get the transfusion.
The most dramatic scenes in the episode are when Iain offers to drive to collect the blood that will save Dominic’s life. His vehicle crashes in the treacherous conditions, but he makes it out and gets the blood to the hospital just in time. There are people who make these journeys every day, such as volunteer courier Terry, who shared his own experiences.
But Casualty makes clear that donating blood is just as heroic an act, with Stevie receiving a text at the end of the episode thanking her for her donation. Plus, in a moving final twist, it was revealed that the blood she donated the previous day was given to none other than her patient Leah.
“Blood is one of the most important things we can treat people with,” says senior donor carer Ang at the start of the episode. “This whole service is reliant on the kindness of strangers, and we need people to do that day in and day out all year, especially round about Christmas.”
There is a very real chance that this special will have a tangible impact, in terms of people looking into blood donation who might not have considered it before, and Casualty should be praised for giving a platform to such a pressing topic.
The opening moments of the special are soundtracked by ‘Fairytale of New York’, and actor Elinor Lawless told Digital Spy that the use of this song feels fitting for the episode, which is “complex and complicated and heartbreaking, but still beautiful”. This seems like a fair assessment: it’s undoubtedly a difficult watch, but it’s also impossible not to feel hopeful and inspired as the credits roll.
There are some lovely character moments in the episode, such as Ngozi getting emotional at seeing snow for the first time, and Stevie and Dylan’s awkward yet moving secret santa exchange. But this is also a Christmas special that can be watched by those who are completely new to Casualty, or haven’t seen it in years, as it represents all that is good and important about the show at the moment.
Plus, next week the new boxset of episodes begins, with plenty of drama ahead in the coming months – so this festive treat is the perfect way to reacquaint yourself with the ED.
Casualty airs on Saturday nights on BBC One and now streams first on BBC iPlayer, where episodes are released at 6am on the day of transmission.
Read more Casualty spoilers on our dedicated homepage
To find out more about blood donation, visit blood.co.uk or the NHS Blood and Transplant website.