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Ruby Spark (born December/January) is a former paramedic who worked for the Holby Ambulance Service from July 2018 to April 2020.

Upon joining the service, her insistence on following the rules to the letter irritated her colleagues and led to her making mistakes. Following the death of fellow paramedic Sam Nicholls, she was happy to offer her support to Iain Dean, even when it wasn't appreciated.


Joining the ambulance service

In July 2018, Ruby started her first shift. She successfully revived a drug addict who had overdosed, but he immediately punched her in the face upon regaining consciousness. After she was treated at the ED, she, Iain and Sam visited the home of an elderly woman named Daisy with end-stage cardiac failure. When her colleagues started helping her with her domestic chores, Ruby irritated them by suggesting that she was a time-waster. Later, she treated a man who had fell onto his garage roof and suggested calling the fire brigade. Although Iain disagreed, he later apologised to her when it looked as though the man had sustained a spinal injury.

Afterwards, they were sent back to Daisy's house, and Ruby attempted to resuscitate her after finding her unresponsive. Despite Iain and Sam telling her that Daisy had signed a DNR, citing the job's guidelines, she demanded to see the form herself. Once she was given the form, she stopped performing CPR, but Daisy was soon back in sinus rhythm. At the ED, she was heartbroken to learn that Daisy had suffered brain damage. Later, after she heard that the man she treated on the garage roof may have been paralysed, Ruby was forced to disclose his condition to his wife in order to coax her into the hospital. However, when it transpired that his immobility was temporary, Eddie McAllister decided to take the blame for Ruby. Back in resus, she sat with Daisy as she passed away. At the ambulance station, Ruby recounted her day to Jan, and she tendered her resignation. Jan tore it up, bluntly reminded her of the reality of her job and assured her that her colleagues wouldn't hold what happened against her. After she was dismissed, she decided to get back on the road with Iain and Sam. (CAS: Episode 1089)

The following day, Ruby tried to work on her awkward demeanour during her shift with Sam, but Sam deemed her as a liability when she continued to make mistakes. However, after Ruby went the extra mile for a young homeless patient, her opinion of her began to change. (CAS: Episode 1090)

Sam's death

Later that month, Ruby disagreed with Iain when he concluded that suicidal frequent flyer Mia Bellis was not at any immediate risk of harming herself. They then attended a call at Alicia's house after Eddie had pushed her through a glass door. On their way to the hospital, Iain crashed the ambulance to avoid hitting Mia who had jumped from a footbridge. Ruby and Alicia were left trapped in the back of the ambulance, and Ruby was forced to treat Alicia's injuries with limited equipment and no analgesia. Later, at the ED, Ruby lost her nerve and broke down. (CAS: Episode 1093)

Following Sam's death, Iain and Ruby were told to write statements for an internal investigation. She considered telling the truth about their treatment of Mia, but Iain lambasted her, insisting that it was Mia's fault. Later, Iain decided to revise his statement and took full responsibility. After he was suspended, Ruby and Jan helped him wash Sam's blood from the ambulance. (CAS: Episode 1094) In September, she expressed her delight at the news that, following a tribunal, Iain was allowed to keep his job and told him that she looked forward to them being a team again. However, he rebuked her and insisted that they were not a team. (CAS: Episode 1096) Later that month, Jan forced Iain to work with Ruby. Later, after Alasdair "Base" Newman stole a drug bag, Iain asked her not to report it missing, prompting her to ask him if he had a drugs problem and if it affected his judgement while treating Mia. Iain admonished her for making such a suggestion and told her not to talk to him. (CAS: Episode 1098)

At the end of the month, after answering Alicia's advertisement for a spare room in her house, she was given the room. On the road, Iain continued to give her the cold shoulder as they dealt with numerous time-wasters. At the scene of a car crash involving a pregnant woman named Siobhan, Ruby told a woman named Lia to back off when it appeared as though she caused an injury while delivering her baby. On the way to the ED, Lia helped Ruby perform CPR on the baby. In resus, Ruby felt guilty when she learned that the infant sustained broken ribs and a pneumothorax due to her chest compressions. Although the baby was soon stabilised, she continued to question her own abilities. In cubicles, she learned that Lia knew that Siobhan was bearing her husband's child and was trying to protect the child to preserve the memory of her deceased son Elijah. On the paediatric ward, Iain apologised to Ruby for his treatment of her and told her that they needed to trust each other if they planned on working together. After Lia visited Siobhan and the baby on NICU, Ruby took her home. (CAS: Episode 1099)

In October, Ruby and Iain tried to resuscitate a man who had overdosed on heroin. Despite Ruby telling him that it was pointless, Iain continued to perform CPR, but he eventually gave up. At the ambulance station, Ruby witnessed him smashing an ambulance window out of frustration, and she treated his wrist after he cut it on the glass. After she covered for him, she encouraged him to be honest about what he was going through, but they were interrupted by a runaway car that was being controlled by a young child. Ruby was amazed by Iain when he managed to stop the car with the responsive vehicle. In her office, Jan reprimanded them for damaging two vehicles, but Ruby defended Iain's actions and criticised her lack of compassion. At the end of their shift, Ruby urged Iain to speak to someone about his feelings. (CAS: Episode 1100) In November, Ruby picked up a receipt that Iain had dropped and discovered that he had been shopping at 3 am. At work, Iain froze at the wheel, and Ruby had to snap him back to reality. Later that day, she asked him if he was alright, and he told her that he needed to keep working to overcome his grief. (CAS: Episode 1104)

In December, Ruby was impressed by Iain's approach to dealing with an elderly man who called an ambulance for his dog. Later, Iain asked Ruby if she wanted to go to the pub. That evening, at The Hope & Anchor, they drank together, and Ruby told Iain that she admired him. He kissed her, but she told him that wasn't what she meant and left in embarrassment. (CAS: Episode 1107) The next day, after Iain called in sick, Ruby suspected that he was trying to avoid her. That afternoon, she went to his house to give him cold and flu tablets, but she then changed her mind. (CAS: Episode 1108) In January 2019, Ruby and Iain agreed to forget about the kiss. (CAS: Episode 1111)

The following week, Iain had arranged for Marty to observe him and Ruby, and they forced him to come with them when he tried to drop out. On the road, they reprimanded him for his disrespectful attitude towards patients, and, when Marty told them that he had other commitments, an exasperated Iain left Marty by the side of the road. At the ED, Ruby disagreed with Iain's attitude towards Louise when he complained to her about Marty's behaviour. (CAS: Episode 1112)

Ruby surrendering as she was held at gunpoint. (CAS: Episode 1113)

Near the end of January, Ruby and Iain treated a man named Mark who had ensnared his leg in barbed wire. When a pair of bailiffs came to repossess the property, Mark removed the wire himself and ran to his house. Ruby, Iain, Mark's pregnant wife Tilly and the bailiffs followed him inside, and they were horrified when he returned with a loaded gun. Iain tried to get Mark to drop the weapon, but he fired several warning shots, and a stray bullet hit one of the bailiffs. Ruby pressed the emergency button on her radio; Mark noticed and pointed the gun at her. As she begged him not to shoot her, Iain confidently asserted that Mark had run out of bullets, but Mark was sceptical. Iain dared him to pull the trigger, but Mark caved and gave him the gun. Ruby called for backup and treated the dying bailiff, while Iain inspected the gun and found one remaining bullet in its magazine.

At the ED, Iain told his colleagues that he knew Mark's gun could only fire eight shots, but Ruby was adamant that he only fired seven. Still in shock from the ordeal, she was taken to a cubicle and treated. Later, Iain visited her, and she told him that she found her job too difficult. He encouraged her to persevere and gave her a hug. That evening, Gem informed Ruby that Alicia was going to sell her house. She and Marty invited her to attend Charlie's birthday celebrations, but she decided to go and look for a new home instead. (CAS: Episode 1113)

In March, Ruby and Iain treated a young girl named Emma who had been hit by a car, and she asked Ruby to stay with her. After she was taken to the ED, Ruby was visibly shaken. Later, she was devastated when the team pronounced Emma dead. On the road, Ruby started to break down at the wheel. Once they had pulled over, Iain assured her that she handled the situation with bravery and compassion, and he told her that he was proud of her. Being the only available recourse, Ruby and Iain arrived at a nightclub after its ceiling had collapsed. Inside, they found a man named Stephen who was trapped under a concrete beam. His friend Ben tried to move the beam himself, but he only exacerbated his friend's injuries. Once they took Stephen to resus, Ruby reprimanded Ben for his stupidity whilst Iain watched gleefully; she told Iain that it was great to see him back to his old self. In cubicles, they struggled to keep a straight face when frequent flyer Luke was readmitted to the ED after he had unintentionally consumed magic mushrooms and believed that Dylan was going to embalm him. As they left the department, they found Emma's grieving parents, and Ruby insisted on speaking to them. At the ambulance station, Ruby suggested going to The Hope & Anchor, but Iain declined the offer, claiming that he had "life admin" that he needed to sort out. (CAS: Episode 1117)

Ruby trying to call the hospital after she found Iain's empty medicine bottles. (CAS: Episode 1118)

The next day, Ruby noticed that Iain had left his entire uniform in his locker and taken all of his photographs down. Jan dismissed her concerns, prompting Ruby to take matters into her own hands. When she arrived at his house, he didn't answer her shouts, so she decided to go in through the backdoor. She found a fake rock with a combination lock, and, once she managed to crack the code and retrieve the key, she barged through the door. She was shocked to find all of his belongings and foodstuffs in bags and boxes for donation. Ruby soon found Iain unresponsive in his living room, and she took him to the ED herself. Iain was taken into resus, and Ruby told Connie that she believed that he had deliberately taken an overdose. However, lacking physical evidence, Connie decided to treat his symptoms as those of a myocardial infarction. Convinced that she was right, Ruby rushed back to Iain's house. Although she found nothing on his property, she decided to check his neighbour's bin, and she found three empty medicine bottles. Ruby quickly drove back to the ED and presented the bottles to Connie just before she attempted to thrombolyse him. Despite Gem's objections, Connie accepted the bottles as suitable evidence and started treating Iain's case as an overdose. Later, at the ambulance station, Jan informed Ruby that Iain was stable. Despite telling her that she saved his life, Ruby broke down in Jan's arms. (CAS: Episode 1118) Later that day, Ruby visited Iain on ITU. (HC: "Powerless")


Later that week, Ruby and Jan met young carer Dani Mallison whose mother Tracy, who had motor neurone disease, had fallen over. At the ED, it transpired that Tracy had aspiration pneumonia, and Dani was warned that her mother didn't have much time left. That afternoon, Tracy passed away, and Ruby promised Dani that she would help her in the aftermath, but Jan warned her about getting involved. When Ruby suggested that, by Jan's logic, it was not their job to help Iain, Jan asserted that, as his boss, she was responsible for what he did. Nonetheless, Ruby offered to take Dani home and gave her her phone number. (CAS: Episode 1119) Near the end of March, Gem informed Ruby and Jan that Iain would be able to go home soon, and she thanked Ruby for saving his life. (CAS: Episode 1121)

In April, Dani turned up at the ED after Ruby had agreed to show her who to perform first-aid. Outside, as Ruby went to get a drink, Dani secretly installed tracking software onto her phone. Later that day, Ruby was surprised when Dani returned sporting her hairstyle. (CAS: Episode 1122) The following day, after she had turned up at the scene of an accident, Ruby asked Dani to leave when she appeared at the ambulance station. (CAS: Episode 1123)

On 11 May, Iain returned to work, and Ruby became concerned when he ignored Gem's text messages. At the ED, after Gem stopped to ask him if he had received her messages, Ruby assured him that she was only looking out for him, but he remarked that everybody "tiptoeing around [him]" was making him "lose the will to live", disturbing her. After Jan took away his radio and told him that he was finished for the day, Ruby insisted that she had to tell her where he was, and Iain sarcastically thanked her. Later, when he decided to treat a boy without any supervision, Ruby told Iain that they needed to work as a team, prompting him to accuse her of "telling tales" to Jan. Frustrated, she walked away, and Jan scolded him for being inconsiderate of her feelings. On his way out of the ambulance station, Iain and Ruby cordially said "goodnight" to each other. (CAS: Episode 1126)

The following week, Dani appeared at the ambulance station, and Ruby told her that she was not allowed to be there. However, she empathised with her when Dani claimed that it would have been her mother's birthday. This troubled Ruby, and, later that day, Iain asked her what was wrong. Before she could explain, Dani called her, and Ruby asked her what she was. Once Jan had left, Ruby secretly took Dani on a tour of the station. In the locker room, whilst Ruby's back was turned, Dani stole her stethoscope. She inquired about her Capricorn magnet and discussed her and Tracy's tenacity as Scorpios, but Ruby pointed out that she claimed that it was her mother's birthday. Dani tried to pass her lie off as a joke, but Ruby ordered her to leave. (CAS: Episode 1127)

On 25 May, Ruby could not find her stethoscope. After spotting Dani on a shout, Ruby confronted her when she turned up at the ambulance station and ordered her to return her property, but she denied taking it. Ruby told her to stay away from her. Dani insisted that she just wanted to be friends with her, but she claimed that "friends [didn't] behave like [that]". Once Dani left, Ruby gave Iain an envelope containing a list of phone numbers that he could call if he needed someone to talk to, including her, but he reacted badly to her gesture, labelling it as a "list of babysitters". (CAS: Episode 1128)

On 8 June, Dani appeared at the scene of an accident and attempted to perform a tracheotomy on an elderly woman, but Ruby and Iain arrived before she could make an incision. After they handed the patient over to the team in resus, Ruby opened up to Iain about the situation with Dani, and he encouraged her to admit her mistakes to Jan. Upon hearing the news, Jan was irate and decided to call the police. Ruby asked her what would happen to her professionally, but she had not decided yet. Having been advised not to talk to Dani at all, when Dani tried to call her, Ruby ignored her call.

Ruby persuades Dani to unlock her car and receive treatment. (CAS: Episode 1130)

Later that day, Jan informed Ruby and Iain that Dani had been involved in a car crash and that she was refusing to speak to anyone other than Ruby. At the scene of the accident, after an unsuccessful attempt at coaxing Dani out of her car, Iain allowed Ruby to speak to her. Dani blamed her for the accident, claiming that it would not have happened if she had answered her calls, but, when Ruby asked her what her true motive was, she admitted that she did not know what to do without her mother. Ruby acknowledged that her wanting to help others was admirable, but she reminded her that she was not a qualified paramedic and suggested that Tracy would have wanted her to open the door. Dani eventually agreed to receive treatment. In cubicles, Ruby informed Dani that she had been reported to the police, and, despite offering to find her professional help, Ruby maintained that they could not be friends and ordered her to back off from her.

At the ambulance station, Iain returned her stethoscope and questioned her decision to not confide in him, and she explained that she did not feel as though he was capable of dealing with his own problems, let alone her's. He asked her if they were okay, and she insisted that they would be, but they needed to "talk about things properly". That evening, Ruby attended a paramedic support group at the Coach and Horses, and, despite claiming that he was not attending, she was delighted when Iain made an unexpected entrance. After she discussed her experience with Dani, he took up her offer of a drink. (CAS: Episode 1130)

On 6 July, Iain became concerned when Frankie Harper - a young girl he helped during his stint as a call handler - went missing, but Ruby reminded him that she was not his responsibility. Regardless, despite her objections, he found her home address on the hospital database and went there to investigate further. He later found Frankie unresponsive at the disused Toucan Towers play area and called Ruby for backup. She soon arrived with additional equipment and blankets, and they successfully helped Frankie regain consciousness.

At the ED, Iain confronted Frankie's abusive father Lee about his treatment towards her and Storm when he disparaged Kailey's adequacy as a mother. Ruby was forced to pull Iain away from him after he pinned himself against the wall for suggesting that he had a perverse ulterior motive. Iain decided to go off-shift, and Ruby informed Jan about the incident. She feared that he would not come back, but Jan maintained that they had to trust him. He later returned to the ambulance station, where he told Ruby that he needed her support plan and thanked her for sticking by him. (CAS: Episode 1134) On 13 July, Ruby asked Iain to attend a paramedic support meeting with her that evening, but he turned her down. However, after he witnessed a prisoner hanging in their prison cell, he changed his mind and joined in by opening up about how the experience affected him. (CAS: Episode 1135)

Issues with Lev's past

Following Iain's departure from the ambulance service in September, (CAS: Episode 1143) Lev Malinovsky was hired as his replacement. (CAS: Episode 1144) In November, when Ruby was sexually harassed by a drunken patient, Lev physically restrained them and deterred him by revealing a Nevidimyye tattoo. Lev explained that Nevidimyye was a violent organised crime that he used to be a member of and insisted that he had changed, but Ruby was mortified by the group's acts of terrorism and demanded to receive a new partner. By the end of the shift, Ruby's opinion of Lev began to change when she observed his kind treatment of a young boy and had her decision reversed, but she maintained that she and Lev could not be friends. (CAS: Episode 1151)

Caring for Harmony

On 21 December, Ruby was delighted when her sister Violette appeared at the ambulance station carrying an unborn baby, but the two quickly fell out when Ruby suggested that Violette was attempting to scrounge money from her. Later that day, Ruby found Violette in labour outside a rehabilitation clinic and was forced to deliver the baby — a girl who is named Harmony — in the back of an ambulance. After noticing abnormal symptoms in Harmony, Ruby deduced that Violette was in heroin withdrawal. Violette insisted that she was clean, but Ruby refused to believe her and asserted that Harmony would be better off without her; feeling responsible for her daughter's illness, Violette ran away. When tests showed that Harmony was suffering from sepsis, Ruby regretted her harsh treatment of her sister and promised Harmony that she would find her mother. (CAS: Episode 1154)


  • Ruby is an innate mnemonist, meaning that she can remember and recall large quantities of information. (CAS: Episode 1089)
  • She swims four times a week, runs three times a week and practises jujutsu every other weekend. (CAS: Episode 1098)
  • She owns a Nissan Micra. (CAS: Episode 1118)
  • Her stethoscope was given to her by her grandfather as a present after she graduated from university. (CAS: Episode 1128)
  • Her phone number is 07700 900274. (CAS: Episode 1134)
  • Ruby is allergic to cats. (CAS: Episode 1144)

Behind the scenes

Maddy Hill portrayed Ruby in Casualty from July 2018 to April 2020.