This episode featured the guest appearance of Holby City character Jac Naylor, portrayed by Rosie Marcel. It also marked the return of Gem Dean, portrayed by Rebecca Ryan as a recurring character after her last appearance on the show in April 2017.
Pressure begins to mount on Ethan after the 'Rage in Resus' blog gains national attention, and the hospital comes under scrutiny. He decides to open a new Clinical Decisions Unit to help curb the department's capacity issues, but it soon starts to fill with patients from a care home experiencing cardiac problems. When a new blog post is published that exposes the weaknesses of the new unit, the trust demands him to find out who is responsible for the blog.
Later, Ethan begins to question his judgement, but Alicia reassures him. Outside, Alicia suggests spending the evening together, and the two share a kiss.
Meanwhile, Gem starts her first shift as a porter but struggles to make a good impression on her boss Jacob when she misses a patient transfer. However, Gem uses her instincts to find a vulnerable patient and helps to save their life. Iain congratulates her for her good work, but Gem tells him that she wants to move out.