Courtesy of BBC

The hit medical programme Casualty (BBC, 1986-) helped revive the public's interest in home-grown hospital-based drama, at a time when UK doctors and nurses were fading from the TV schedules. And although Casualty is not a far cry from the first medical series to quicken the nation's pulse, Emergency - Ward 10 (ITV, 1957-67), its mix of episodic plots with longer, character-based stories means that it works just as well as a stand-alone drama as it does as an ongoing medical soap.

Set in the Accident and Emergency (A&E) department of the fictional Holby City Hospital, the programme was devised as a more authentic take on the US series St. Elsewhere and from the outset Casualty shied away from sentimentality and unrealistic success rates for treatments and cures.

A study published by the British Medical Journal illustrates the point. It revealed that a quarter of patients in Casualty who suffered a cardiac arrest survived after being resuscitated - a similar proportion to real life - while in American medical soaps like ER an over-optimistic three-quarters of patients pulled through.

Former Casualty producer Johnathan Young says that the programme's medical consultants ensure scripts are accurate. "We know very well that the audience wants to see our characters as doctors and nurses, and we also believe very strongly that it is the realism of it which makes the show sustainable," said Young. "If we didn't make it real, it would become melodrama very quickly."

The medical emergency at the heart of each episode is generally resolved, but the show's approach to its subplots is more open-ended, with the treatment of patients in the secondary dramas at times left undetermined. This reluctance to wrap up loose ends helps heighten Casualty's realism although, as with any long-running series, there is the risk that novel elements can become formulaic over time.

The show's primetime ratings success led to an equally popular spin-off, Holby City (BBC, 1999-), set in the hospital's fraught surgical ward. The two shows occasionally share characters but even without this migration their common stylistic heritage is clearly visible.

Anthony Clark

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