Season 4

A fatal motorway coach crash results in a hectic shift for the team. Danny Barton's first day goes from bad to worse when he inadvertently informs a patient's relatives of their son's death, despite him having been discharged several hours earlier, and then ends up being held at gunpoint by the father of a young boy who was murdered after becoming caught up in a turf war. Jack's capability is called into question when he ignores hospital procedure and performs a brain operation on a dying patient.

Christine is interviewed for the position of clinical director in Robert's absence. Jack discovers that one of his former pupils, James De Costa, is being primed for a new registrar's job in the hospital. Terry deals with two brothers who are injured whilst participating in an illegal fight club. Saskia treats a young woman complaining of abdominal pain, who later reveals that she has taken more than forty pills in an attempt to take her own life. Jack is forced to perform an emergency operation on a pregnant patient.

Robert is surprised to learn about Christine's promotion, but is forced to put his emotions on the back burner to deal with a double stabbing. Christine deals with a difficult patient who has misinformed her partner about her ability to conceive. James tries to perform a tricky procedure on a patient with a dislocated elbow, but Ruth goes above his head and contacts Jack. A tense situation arises when Robert is unable to locate blood supplies for his patients. A relative of a deceased patient vows to take revenge on Terry.

An elderly patient admitted with a broken arm makes a live television interview claiming that he was assaulted by a group of black youths. His claims spark racial tension in the black communities of Manchester, sparking a series of incidents which lead to a riot, and Terry and Jay being caught up in the centre of the action. Jay is later admitted after starting a brawl, but unexpectedly comes face to face with a man he attacked. Sam is approached by the leader of a local gang, who claims to be holding her brother captive.

Christine and Ruth come head-to-head over the treatment of a patient involved in a road traffic accident. Poppy's first day as a qualified nurse practitioner goes from bad to worse when she faces a barrage of abuse from a young boy's father. Christine informs the team that Robert has been suspended until the investigation into his outburst is concluded. The gang holding Sam's brother starts to put pressure on her, and she makes a shocking discovery about James. Terry struggles to come to terms with Jay's death.

Jack is angered when James takes credit for one of his operations on television. Danny deals with a difficult elderly patient whose daughter suffers from William's Syndrome. Jeffrey tries to push Robert into resigning. Jack is forced to perform an operation on a paraplegic patient without the use of a general anaesthetic, and later makes a shock proposal to Christine. James confronts Sam when he discovers that she has been stealing from the drugs trial. Robert and Sunita face up to their feelings for one another.

Danny and Judy try to prevent the relatives of a young boy who died of cardiac arrest, finding out that he died in a brothel after having sex with another man. Robert tries to save the life of a base jumper whose parachute failed to open. Sam faces her worst nightmare when a young girl who had been following an overdose is found to have taken Plavitron. Ruth is furious when she discovers that Tessa has been unfaithful to her. Robert tells Christine that he intends to leave to take up a professorship in Edinburgh.

As it is Robert's last day, the rest of the team plans a surprise party for him. However, before he can take a sabbatical, he is forced to put all his efforts into saving a young boy who has been trapped inside a cold store. Sam informs James that her brother appears to have been part of the scam. Christine is disgusted to discover that Drummond plans to split A&E, making James head of a new minors department. In the heat of the moment, she agrees to marry Jack, but soon realizes that she cannot be without Robert.