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This article covers a real-world subject which should not be taken as part of the Holby universe.

Well, I've seen lots of things change. Probably the most significant is the community we serve. It's fractured — if you'll forgive the medical pun. I don't know, does community even exist anymore? I know I'm an old socialist, but when Thatcher was in power, at least we had a common cause. An enemy to fight. But since then, things didn't get better. Society keeps crumbling. I don't know what it is. Poverty? Attitude? But it continues, and the violence escalates. It does, and we deal with the consequences right here. The blood and the guts.
Charlie Fairhead comments on the state of contemporary society.

"Farmead Menace - Part One" is the 639th episode of Casualty and the first episode of series 23. It was directed by Keith Boak and written by Mark Catley.


A documentary crew consisting of interviewer Nicola Westland and cameraman Alistair Murrell interview the staff of Holby City Hospital's emergency department for an upcoming television show. Paramedics Jeff and Dixon offer the filmmakers the chance of observing them on a shift; Nicola and Alistair claim that they had already agreed to tag along with Curtis and Snezana; they quickly change their minds when Alistair reckons that Jeff fancies Nicola. Porter Big Mac approaches them about an interview, but, feeling that Big Mac's job is not sensational enough, they lie about running out of tape.

On the Farmead housing estate, schoolgirl Sammy Malone is cornered by two other girls and savagely beaten. However, she manages to escape and runs back to her house. In her room, she packs a firework into a backpack and leaves.

Charlie, carpooling with Noel, Ruth and Toby, waits for Tess outside her house. After Tess makes a comment about Charlie's car, the others tell her to "chill out", but she sternly reminds them about the seriousness of their jobs.

In paeds resus, while treating a young girl named Amy, Adam asks Alice for advice with convincing "Amanda" to leave her adulterous husband "Sean" for "Captain Handsome", but Alice claims to not be "the expert" on relationships; this is seemingly confirmed through an awkward encounter with Curtis. However, she tells Adam that Jessica would want stability and suggests that he "grow up a bit".

After Big Mac is turned down for an interview again, he vents his frustration to Noel who claims that the documentary makers only want "action heroes". Alistair overhears and offers Mac the opportunity for a brief one. Meanwhile, Adam tells Nicola that he is too busy to "throw some more pearls of wisdom [her] way", but she insteads asking him out for breakfast; Adam immediately turns her down.

Charlie approaches Adam and tells him that Zoe is in a meeting with the hospital's director of critical care and that her demotion is "definite". Adam sympathises with Zoe and claims that she did a good job as clinical lead. However, during the meeting, Henry Williams brands Zoe's actions during the Kris Kemp debacle as "duplicitous", "manipulative" and "libellous". Charlie reminds Adam that the clinical lead post is now open and argues that it would be beneficial to the department if that post was given to an existing member of staff, but Charlie jibes that it would mean "a bit more responsibility".

At the end of the meeting, Zoe thanks Henry for not reporting her to the GMC. Henry assures her that her demotion does not reflect on her abilities as a doctor; she just made bad decisions in her personal life that impacted the professional. As Zoe leaves, Henry asks if she is single and opines that having a family sharpens one's decision-making skills and prevents "recklessness". Zoe agrees to bear that fact in mind.

As Alistair prepares to interview Big Mac in the restroom, Big Mac explains that it is important to give the ancillary staff a voice as they are most often sidelined in favour of the doctors. However, when the camera rolls, Big Mac is lost for words.

In an interview, Ruth explains that 70% to 80% of the ED's traffic comes from the Farmead estate. Toby states that the estate suffers from rampant substance abuse, domestic violence, vandalism and knife crime, but Ruth remarks that the estate's close vicinity to the hospital is a major factor in the disproportionate number of admissions. Toby calls Farmead "a ticking time-bomb" and mentions that Ruth was brought up on the estate which makes her uncomfortable; Toby repeatedly apologises.

On Farmead, Vic Cheadle visits the increasingly paranoid Joe Geraghty in his flat and finds that he has been creating an electrified door that would shock the youths who have been breaking in. Vic delivers the medication Joe had requested and tells Joe that he cannot be a "prisoner to fear", but Joe suggests that Vic has been watching "too much Jeremy Kyle" and insists that he does not need help. Vic tells Joe that he will not stop trying to get him out of the flat, but Joe claims that he cannot help everyone and proclaims his complacence. However, when Joe realises that Vic has bought the wrong drugs, he tries calling for him, but Vic does not hear.

Sammy lights the firework.

Upstairs, Vic visits Michael Treaver, an autistic adult, and his grandmother and carer to deliver their medication. They overhear Tammy and her friends shouting insults at Sammy from a nearby flat. Sammy ignores them and opens her bag at the bottom of the staircase. Despite Vic's pleas, Sammy ignites the firework and lets it off in the building. The sound of the explosion causes Mrs Treaver to fall over, and a shell explodes in Joe's flat when he opens his door, setting some of his possessions alight. While avoiding the explosion, Tammy breaks her arm and vows to kill Sammy when she sees her. Vic calls for an ambulance.

The documentary crew join Jeff and Dixie on the road. Nicola asks if there is a rivalry between the paramedic crews, and Jeff jokingly asserts that Curtis and Snezana are not in the same league as them. When Nicola explains that Curtis and Snezana changed their minds about having her and Alistar accompany them, Jeff claims that they backed down in submission. Jeff and Dixie declare themselves "The A-Team" and drive to the Farmead apartment block while singing the TV show's theme tune.

Curtis tries to calm Michael who keeps pulling him away from his grandmother whenever she screams in pain and get him to help him and Snezana move her onto a stretcher, but Michael cannot help himself. The neck of Mrs Treaver's femur is fractured, and she needs more morphine and a femoral nerve block; Curtis and Snezana are forced to call in a doctor.

Adam is the doctor chosen to treat Mrs Treaver. Alice asks about his decision to not apply for clinical lead, but Adam suggests that Charlie keep his business to himself so he can "get on with the superhero work". Alice posits that "Amanda" might prefer a clinical lead to a superhero, but Adam is unwavering.

In a voiceover, Kelsey opines that the nurses are forced to carry out all of the unglamorous tasks in the ED and deal with the often extreme emotions of the patients, whereas the doctors spend little time with the patients and get all of the praise. Charlie highlights the nurses' lower wages, levels of training, and worse working conditions. While he acknowledges that the doctors do a "fantastic" job and have their own troubles, he argues that the NHS "lives or dies" on the strength of its nursing staff, so "you can't keep pissing them off". Charlie immediately apologises for swearing.

While Kelsey complains about nursing staff, such as Jessica, not coming into work because of childcare issues, Tess tries to talk on the phone and tells her to "stop talking"; she is ultimately hung up on. Tess insists that they will manage. Charlie suggests bringing in an agency nurse until Jessica arrives, but Tess tells him not to worry. He tries to discuss the conversation they had in the car, but Tess agrees that she needs to take life less seriously and declares that nothing will bother her today. However, upon opening a cubicle curtain, she is greeted by Sammy who has a burnt hand.

Jeff and Dixie finally arrive at the block of flats after getting stuck in traffic on the opposite side of Holby. Curtis inform the pair of Tammy's condition, but Nicola wants him to repeat the summary for the camera. After Curtis explains the situation with Mrs Treaver, Jeff and Dixie instruct Curtis and Snezana to deal with Mrs Treaver, but Nicola suggests that Jeff and Dixie go to the flat for the sake of obtaining better footage. Adam makes a dramatic entrance and accompanies Jeff and Dixie to the flat.

Outside the ED, Kelsey asks Zoe to administer more fluids to a girl with terminal cancer who is waiting to undergo a laparotomy, but Zoe is more concerned about finishing off her cigarette. Kelsey asks Zoe if she cares about the girl, and Zoe says no.

On their way to Mrs Treaver's flat, Jeff and Dixie points out that they are the ones of the front line who have to "pick up the pieces", but Adam jokes that "this is Holby, not Baghdad"; Jeff says he would rather be in Baghdad.

In his flat, Joe frantically tries to soak his burns in water, but he notices smoke drifting into the bathroom. Joe is horrified to discover that his flat is on fire.

Tess tries to clean Sammy's hand to prevent it from getting infected, but Sammy resists treatment. Sammy eventually acquiesces, but she coldly tells Tess that her breath stinks.

Kelsey introduces Zoe to Amy Butler — the young girl with terminal cancer. Zoe criticises Kelsey for not asking Ruth or Toby for permission to insert a nasal tube, but Kelsey claims that she assumed Zoe would be good with children. Amy tells Zoe that she does not mind people recoiling at the sight of her when they know about her condition, but Zoe claims that she did not look at her because she is "full of [her] own troubles". However, Zoe smiles when Amy claims that her mother believes that everyone should meet her because she puts their problems "into perspective".

Sammy tells Tess that she is gifted at "pushing people's buttons" and remarks that Tess is not talking as much so she does not "breathe [her] old lady coffin breath" over her. When Sammy asks if Tess has been drinking coffee or "shit", she pulls her hand back in pain and accuses Tess of deliberately hurting her. When Tess walks away in frustration, Sammy quietly leaves the department.

The gas canisters explode.

As the team prepare to move Mrs Treaver, they hear Joe calling for help but decide to leave checking the rest of the building to someone else. They ignore Michael's complaints about his feet feeling hot, but Jeff feels the floor and tells Dixie to request the fire brigade. While Joe takes cover in his shower, one of the gas canisters in his flat ignites. The team move out of the Treavers' flat, but Michael stays behind to collect his valuables. Suddenly, the gas canisters explode, blowing Michael away and sending a fireball surging through the building.

In an interview, Adam asserts that a "trained monkey" could do a nurse's job, but he struggles to describe the paramedics and asks what is lower than a trained monkey.

Michael screams for help as his lower body dangles over the edge of the hole in the ceiling of Joe's burning flat. Jeff and Adam manage to pull him up and rush towards the door, but Adam hears Joe's cries and insists on returning to the Treavers' flat.

In another interview, Jeff and Dixie describe the doctors as "rich", "snobby" and "jolly hockey sticks", and assert that "daddy put them through medical school to save the less fortunate". Jeff calls them "ponces", but Dixie tells him that he cannot say that.

After soaking a towel in water, Adam wears it and jumps into Joe's flat.

After Tess denies deliberately hurting Sammy, Charlie urges her to tell him what she is stressed about so she can go back to being "Tess the Wonder Nurse". She explains that Sam got engaged without telling her, but Charlie is not bothered and insists that she needs to get on with her job regardless. Tess objects to Charlie dismissing her concerns as "trivial" and tells him to get out of her office; Charlie recommends that she go on her break and asserts that the department will manage without her.

Adam manages to free Joe from his flat and climbs back into the Treavers' flat. He leads the party out of the flat and declares that he has "a flame to rekindle".

When Jessica rushes into work, Zoe tries to hide from her. Noel tells Jessica that she is needed in resus and informs her that Adam is on a shout. Noel is confused by Zoe's behaviour until she reminds him that she had an affair with Jessica's husband. Tess asks Noel if he has seen Sammy; he tells her that Sammy has left and stolen his pen.

"Down! Down! Down!"

Adam tries to lead the group down the stairs with a fire extinguisher, but it quickly runs out, forcing them to move upstairs. Outside, the fire service arrives, but their path to the building is obstructed by the apartment block's residents' cars. The party continues to move up the building, but Adam sees a massive fireball surging towards them and orders the group to go back down. They are forced to return to the Treavers' flat.

Zoe finds Amy's cubicle empty and fears the worst, but she is relieved when she returns from her ultrasound and offers to help clean up her "accident". Kelsey is surprised by Zoe's newfound kindness towards Amy, prompting Zoe to explain that she has "perspexitive".

Dixie warns control that she and the group are in "big trouble", but the firefighters do not know which room they are in. When Adam states that they need to move towards the window before the air becomes unbreathable, Michael manages to find a route along the side of the hole and makes it to the window. Dixie asks him what they are going to do about Mrs Treaver; Adam claims to have an idea.

Jessica tries to apologise to Tess for arriving late; Tess tells her that they will discuss it later. Charlie confirms that Sammy has left the department and continues to urge Tess to have a break. Tess refuses, but she quickly changes her mind when she discovers that Sammy has vandalised her office and drawn a swastika on the blinds.

Adam and Jeff begin slowly carrying Mrs Treaver over the hole. The two continue to crack jokes until Jeff remarks that the floor is moving and loses his footing. Jeff manages to stand up again, and the two make it to the window; Jeff jokingly calls Adam's plan "floorless". Adam tries to shatter the glass with a chair, but the group are instructed to get out of the way by the fire service who break through the window with a hose.

Outside, a hysterical Joe demands to be returned to his flat and begs Vic to help him, but Vic is busy trying to help everyone. Adam tries to reassure Joe, but Joe tells him that he hates him for rescuing him. Jeff thanks Adam for his help and tells him that he is a good man to have in a crisis. Adam returns the compliment and jokingly asks if the two will kiss now; Jeff claps back with "no tongues". In Dixie and Jeff's ambulance, Mrs Treaver arrests.

Tess tracks down Sammy's house on the Farmead estate and is greeted by her mother Cathy. Tess introduces herself and informs Cathy of Sammy's actions. Cathy and Sammy's brother Callum deny Tess' allegations, claiming that Sammy has a tag on her leg. Tess acquiesces, but Callum insists that Tess check Sammy's room and forces her into the house. Cathy leads Tess to Sammy's room, but they find that Sammy has removed her tag and run away. Shaken by the experience, Tess leaves and pleads to God.

When Adam returns to the ED with an ungrateful Joe, he announces to Charlie that he will apply for clinical lead. Adam finds Jessica and asks her about her break; she says that it was "necessary". She asks Adam if he is okay when he starts coughing due to smoke inhalation; he suavely claims to be "waiting for the dust to settle" and tells Jessica that he loves her and wants to be with her. However, she walks away when he continues coughing, and Alice tries to help him.

In the ambulance, Mrs Treaver goes into asystole.

While Charlie explains in a voiceover that it is sometimes dangerous to become too emotionally involved with your patients as you often don't know who you are dealing with, Tess spots Sammy on the estate and pursues her onto a demolition site. However, Tess loses her footing and is impaled on a metal rod.

Charlie explains that different departments have different methods of coping and "rising above the chaos": doctors use emotional detachment, whereas paramedics will make light of the situation. However, Charlie argues that the nurses have to be more pragmatic and "give as much as [they] can" while still maintaining a distance; they need to realise that they are making a difference.

Jeff and Dixie celebrate when they manage to revive Mrs Treaver and sing the theme tune of The A-Team as they prepare to transport her to the ED.

Sammy leaves Tess to die.

On the demolition site, Tess begs Sammy to call for an ambulance and allows her to use her phone. However, Sammy instead records a video of Tess, calling it "pure gold" before leaving her to die. After running away, Sammy is conflicted between leaving Tess and helping her, but she instead hides when she sees her brother Ryan.

While Jeff explains to the documentary crew that they managed to escape a seemingly "impossible" situation because he and Dixie are "The A-Team", Sammy tries to run away from Ryan. However, after Jeff and Dixie high-five, the ambulance collides with Sammy. As Charlie, in a voiceover, states that, when the "whatsit hits the fan", the doctors, nurses and paramedics forget their differences and all pull together as one unit, Dixie is horrified by the sight of Sammy's mangled body and is unable to treat her.

Charlie claims that, when it gets tough, the team pull out all the stops. "Stick around; you'll see. You just watch us. You just watch."


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