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Nathan Spencer is a businessman and the former corporate director of Holby City Hospital. He began working at the hospital in December 2005 and was fired in September 2007 for incompetence.


Early life

Prior to working in the ED, he was the finance director of a chain of restaurants. (CAS: "Enough's Enough")

Introduction to the emergency department

In December 2005, the Holby City Hospital board appointed Nathan as the emergency department's corporate director. Tasked with making the department more efficient, he immediately had several monitors installed to maximise the number of patients meeting the four-hour rule. The ED's medical staff took issue with the monitors as half of the department's cubicles had been closed off due to problems with the air ducts, and there was a shortage of beds in orthopaedics. Nathan instructed the staff to minimise the number of breaches, but consultant Harry Harper argued that Nathan was not qualified to make clinical decisions and defied his orders. Later, Harry told Nathan that his monitoring system was putting his staff under undue stress and asserted that the ED did not operate in the same way as one of Nathan's old restaurants, but Nathan told Harry that "things [were] going to change" and warned him that he would lose the position of clinical director if he continued to resist. (CAS: "Enough's Enough")

The following day, a disabled man named David Anderson presented the ED with a cheque for £20,000 that he had raised by dancing; Harry wanted to use the money to pay for a portable defibrillator, but Nathan insisted that it needed to be used to offset the overspend on the department's equipment budget. After hearing that the money had been seized by hospital management, David confronted Nathan at a Christmas party, and Nathan assured him that the money would be put towards the defibrillator if the department wanted it. (CAS: "Do They Know It's Christmas?")

As a result of Nathan's managerial influence, Harry was forced to acquiesce in Nathan's decisions, generating a backlash from his staff. On 31 December, staff nurse Ellen Zitek pretended to defend Nathan in order to provoke Harry into rebuking him. When a patient's condition deteriorated due to a head injury, Nathan accused registrar Maggie Coldwell of incompetence, prompting Harry to angrily defend her clinical decisions. (CAS: "Out of Your Depth") On 7 January 2006, Nathan warned Harry about the department's blood expenditure; Harry suggested that the cost of the blood units could have been fairly distributed across all the departments using them, but Nathan claimed that it was not possible. (CAS: "Poisoned Love")

On 21 January, Nathan brought in a freelance journalist named Peter Camden to write an article on the running of the ED. However, he quickly discovered that his mother Peggy had been admitted and asked Harry to take charge of her treatment. Harry managed to treat and discharge Peggy within the four-hour rule, but it later transpired that he had reviewed the wrong X-ray, leaving Peggy at risk of further injury and Nathan furious. (CAS: "The Things We Do for Love") The following week, Nathan was aggrieved when the newspaper article focused on a quote from Maggie harshly criticising Nathan's attitude to patient care. He later brought Peggy back into the ED after she experienced another fall; associate specialist Selena Donovan examined her and found that Peggy had an irregular heartbeat. Nathan thanked Selena for her help and asked her out for dinner to show his gratitude; Selena wanted to go out for dinner with Harry, but, after learning that Harry was in a relationship with Ellen, she accepted Nathan's invitation. (CAS: "It's a Man Thing") By the following week, Nathan and Selena had bonded and arranged to have dinner again. However, despite openly flirting in the department, Nathan confronted Harry about his professional conduct, citing his antagonism towards management and "sloppy" work. When Nathan suggested that Harry had used Ellen for sex, Harry took umbrage. (CAS: "Trust in Me")

On 11 February, Nathan informed Maggie of a sponsor's decision to withdraw a donation towards a portable ultrasound scanner as a result of her remarks. (CAS: "Out of the Past") However, he later apologised after finding out that the journalist obtained Maggie's statement from disgraced nurse Bruno Jenkins and offered to do whatever she wanted as recompense. Later, she asked Nathan if an immunisation clinic for patients vulnerable to contracting hepatitis B; Nathan was concerned about the impact of an influx of "junkies" in the ED, but he eventually yielded. (CAS: "The Lost Boys")

Selena and Angel's deaths

Nine days after Angel's birth, she suffered a brain haemorrhage which affected her breathing centre. On 14 September, she was deemed fit enough to be taken off the ventilator, but she struggled to commit to the new effort she had to make. The next day, Angel went into asystole, and paediatrician Andy Fishman decided to put her back onto the ventilator. Later that day, Nathan was informed that Angel had been diagnosed with an E. coli infection, and her kidneys were shutting down. Charlie and Andy warned him that Angel was beyond the point of recovery, but he refused to believe that his daughter was dying and demanded her to be kept ventilated. However, after Andy suggested that they take her off the ventilator and allow him to hold her during her final moments, Nathan began to accept her impending mortality and agreed. In a private room, Nathan cradled Angel until she passed away. Less than an hour after Angel's death, Nathan returned to the ED and started berating the other members of staff for failing to run the department "smoothly", suggesting that, following the bombing the previous week, they would have "learnt [their] lesson"; this outburst resulted in Guppy's public resignation. After Nathan left, Charlie informed the team of Angel's death. (CAS: "Meltdown")


Behind the scenes

Ben Price portrayed Nathan Spencer on Casualty from 2005 until 2007.

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