Severe weather conditions place the casualty department under even more pressure than usual. Dr Julian and his sidekick Sister Benita treat a pensioner with a broken ankle and a former miner with a chronic lung condition. Meanwhile, Dr Jane treats four-year-old Teddy after a sledging accident.

Staffing problems hit the department as several nurses call in sick. The remaining team are forced to juggle extra patients to make sure every emergency is dealt with. The pressure takes its toll on Sister Benita, and she is herself admitted to a bay for treatment.

The team are facing one of the busiest days in Barnsley Casualty's history, and the pressure mounts on staff members as patients await beds to become available, so self-named Emergency Clown Sister Jane helps to give the younger nurses a moral boost during this difficult period. Meanwhile, consultant doctor Jane treats 10-year-old Oliver, who suffers from a rare condition called Angelman Syndrome.

A two-year-old is rushed to hospital, struggling to breathe, and consultant and part-time stand-up comic Dr Rob Jones is forced to put his comedy skills to good use keeping the distressed child relaxed. Other patients include a miner who has suffered a suspected heart attack and a 98-year-old in need of a CT scan.