Casualty spoilers follow.

This year, Casualty is airing its first Christmas episode since 2019,

and the BBC medical drama is taking the opportunity to do something different with its comeback festive offering.

The standalone episode, titled ‘All I Want for Christmas’, is all about the

miracle of blood, and is set on Christmas Day in the ED when there is an emergency blood shortage. As the team continues to treat patients, Iain puts his own life on the line to save the day.

What sets this Christmas special apart is, similar to the episode which marked the 75th anniversary of the NHS last year, Casualty has put the spotlight on real voices once again.

There are testimonies from people who have been directly impacted by UK blood donation, as well as key workers who run the country’s blood service. Every story being told on screen has a real-life parallel, which adds another poignant layer to the episode.

Ahead of this festive treat, which will air on Saturday, December 21, Digital Spy got to catch up with cast members Elinor Lawless (Stevie Nash), Michael Stevenson (Iain Dean), Melanie Hill (Siobhan McKenzie), Charles Venn (Jacob Masters) and Barney Walsh (Cam Mickelthwaite).

The actors spoke about celebrating Christmas in the ED, dramatic action sequences and the message behind this special episode – as well as what their characters might wish for this festive season…

What was it like to get into the festive spirit in the ED?

Elinor: It felt like a real honour. You grow up with these Christmas specials, so to be part of one, and to know that you’re going to be part of a household’s Christmas is really exciting. They brought a huge snow machine onto set, and once they brought that out, it just felt like we were ready to play, which was great.

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Michael: Because it’s a Christmas special, we’ve gone all out on the production values. So, the amount of snow that they brought in was just brilliant. And it automatically made you feel cold! Whether it was a mild night or not, the fact that you were stood in snow meant you automatically felt cold.

Casualty has become known for its format-breaking episodes – what did it mean to have real-life stories behind every aspect of this special?

Elinor: When we were sent the episode, that was the first time we got to hear those stories. It’s very humbling to realise the real fine line, in this particular show, between the drama played out on screen and the drama played out in everybody’s everyday lives. To hear the stories of people we’ve never met and how their lives have been changed for the better because of strangers… I think the message is definitely one of hope.

Elinor, Stevie doesn’t seem like a big fan of Christmas. Why do you think this is?

Elinor: I think actually, she’s a secret Christmas fan. Christmas was a time for her where she felt part of something. And I think as she’s gotten older and as she’s distanced herself from family, I think she misses that feeling. Stevie clings to an idealised version of Christmas. And I think she works on Christmas Day and buries herself in her work because it’s too painful to face the fact that it’s not like that anymore.

Melanie, what was it like to play clinical lead Siobhan, who is at the helm of the ED during a busy time of year like Christmas?

Melanie: I think she thrives on all that, because obviously her private life isn’t going very well at the minute. All her life, she’s very much been a workaholic, so I think she’s right where she needs to be. Obviously, the episode starts with a massive catastrophic event that happens and [the team] are up against it. But it’s Siobhan’s job to keep everyone going and just be the calm, central focus for the whole unit, looking after everybody and making sure everything’s going to plan.

The paramedics respond to a serious pile-up during the episode. What was it like to film those dramatic scenes?

Charles: Filming those scenes was such fun. We had two days to shoot it in Newport, and when we saw that set for the first time, we were blown away by how detailed and authentic it looked. It was a major incident with cars piled up, so they recreated this tunnel, with smoke and fog.

Steve Hughes, our wonderful director, said to me, ‘This is like your Indiana Jones moment!’. We’re following the accident through Jacob’s eyes, and he walks through the smoke not knowing what is on the other side. Everyone brought their A game, including our supporting artists and guest actors. We were all locked in, as we knew the enormity of what we were shooting and the message the episode was conveying.

Iain later puts his own life on the line on Christmas Day in dramatic scenes when his vehicle overturns…

Michael: As we know, Iain’s been in a few scrapes here and there over the years. Often a lot of the stuff he gets himself into could be avoided, but this one is out of the goodness of his own heart. The team is crucially trying to get blood into a patient who needs it desperately, and the ED has run out. There is no way of getting the blood into the ED, so Iain steps up and plays his part. So it’s nice for him to get into a scrape where it’s for a good reason.

Was it fun to film an episode where a lot of the cast are working so closely together?

Barney: I love it when we’re all working together, and everyone is in the studio. I don’t get many scenes with Michael, for example, and we have a scene together in this episode, which was nice. It’s great when we all get a chance to come together, especially on an episode like a Christmas special, when we get to highlight important talking points around the NHS and around health at this time of year.

What did you learn while filming this special episode?

Melanie: It was a reminder to be kind at Christmas, and the fact that we should think about our NHS during the festive season. They’ve given up time with their family to look after the nation, and I think sometimes we overlook that, we’re so taken up with Christmas itself and our families. But we should really think about what’s going on in these EDs.

Barney: One thing that absolutely blew my mind when making this episode was how quickly a store of blood can be depleted. At the beginning of the episode, Cam brings down the blood and he puts it in the fridge – and the very next afternoon, there is none left. I was speaking to our medical advisors on set about that, and it absolutely is the case that blood can go that quickly in hospitals.

What can viewers expect from Casualty’s Christmas episode this year?

Elinor: There’s a real grit and brutality to this episode. I know that our producers really wanted to get the clearance to use ‘Fairytale of New York’ as the soundtrack for the whole episode. That song is messy and ugly, and it’s beautiful and celebratory – and I think that’s what this episode is striving for. It’s complex and complicated and heartbreaking, but it’s still beautiful.

Charles: It’s a Christmas special with pathos, that bridges the gap between drama and reality, and has a strong message that applies to everyone globally. There are tears, laughter, warmth and tension, with a sprinkle of community and family. It’s going to be a great episode; the audience are in for a treat. Get your popcorn, or should I say your ham hock!

What do you think your characters would wish for over the festive season?

Michael: Extra gravy! [laughs] This year in particular is Iain’s first opportunity to be part of a family and be around kids, and the extra special element to Christmas that brings. Iain’s often spent Christmas on his own, so this year particularly, he would be looking forward to sitting down and telling all the Christmas cracker jokes. That would definitely be one of Iain’s fortes, I imagine Iain probably makes his own jokes up for Christmas crackers!

Melanie: I think Siobhan would wish that she could turn back the clock, basically. Because she’s not really paid much attention to her husband, and it’s all gone very wrong. So I think she would wish to go back in time, but obviously that’s not going to happen.

Barney: After what he’s been through and the journey he’s had, I think Cam’s just grateful. It’s a time of reflection for him, and he’s just grateful to have friends around him, and to have the support of people like Siobhan. There is a world where I’d like to say maybe Cam wishes for a girlfriend, but I don’t think that’s the case! I think he’s learning what it means to be a man in his own right first.

Casualty‘s Christmas special airs on Saturday, December 21 at 9:20pm on BBC One and BBC iPlayer, and the next series will begin a week later. The show now streams first on BBC iPlayer, where episodes are released at 6am on the day of transmission.

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