The first season of Casualty attracted a lot of political controversy and government condemnation because it "dared" to be critical of hospital conditions and the chronic under-funding of the National Health Service. Also the Royal College of Nursing did not like the way that some of the nurses were portrayed. Despite these initial concerns, a second season of episodes was made, partly because the scripts had already been paid for, though initially it was thought that no more would be made after that. Now, twenty years later, Casualty has become a national institution and is the longest-running BBC drama programme and the second-longest-running medical drama in the world behind America's General Hospital (1963).
Until production of Casualty moved from Bristol to Cardiff in 2011, a common filming location for high-speed car accidents was the "Road to Nowhere" in Yate, just north of Bristol. This is a short length of dual-carriageway road between Rodford Way and Badminton Road, part of a planned bypass around Yate, which was started in the 1970s but was never completed. Consequently it is unused by traffic and is therefore safe for dangerous stunts, but looks like a proper road.
Before the first series was shown, it was described as being a "northern Hospital", often thought of as possibly being similar to St. James' in Leeds, but never of course confirmed. Only really from the second series onwards did references to it being in Bristol start appearing in the media. However when a new producer, Peter Norris, was brought in for Season 4, he decided to play down the association between Holby and Bristol, and so Duffy's West Country accent disappeared and fewer recognizable Bristol locations were used. Despite this, some links to Bristol have remained, even after filming moved to Cardiff in 2011: in Casualty: Death and Doughnuts (2012) a patient's phone number was shown as starting 0117, the code for Bristol, though a fictitious district code 456 was used.
At the time of Casualty's conception, the BBC had two ideas for a hospital drama - a 'cottage hospital' idea, which was seen as the safe option, or an A&E department ('Front Line' - as Casualty was originally titled), an off-the-wall idea which posed more problems for the team. "I went for Casualty," said Jonathan Powell, BBC Head of Drama, about his decision, "because there was a feeling of life and passion and, well, I was anxious for new young people to create something. I put them [creators Jeremy Brock and Paul Unwin] with a very experienced producer, Geraint Morris, and hoped for the best."
Georgia Taylor was not considered for a BAFTA nomination for her portrayal of mentally unstable Dr. Ruth Winters and especially for her outstanding performance in episode Casualty: Place of Safety (2011) (#25.23).
Paul Unwin said in an interview with Radio Times that their pitch for Casualty 'read like a manifesto', with the first sentence being: "In 1948, a dream was born - a National Health Service. In 1985, the dream is in tatters."
The idea for Casualty came together when co-creators Jeremy Brock and Paul Unwin were both hospitalized for different reasons. During their time at the hospital, the pair were 'deeply concerned by what they saw'. Brock and Unwin pitched a document and sent it to the BBC in 1985.
Before Jeremy Brock and Paul Unwin scripted the first series, they took a visit to a hospital based in Bristol. There, they met Pete Salt, a charge nurse. Salt was appointed the series medical adviser, advising the team of Casualty on what was and wasn't medically possible or accurate.