Marian is returning to the Royal by rail when the train crashes and, whilst she is trapped in the carriage, she is able to move about and assist the wounded. Dr. Nick Burnett, the new locum for the hospital, is also on the train and they work together, though when the injured are brought to the Royal, staff shortages put staff under a strain.
Sister Brigid is giving out food to the homeless of the town when Nick suggests that they should be given treatment in the hospital's private suite which is rarely used, an idea which brings him up against Adam. Jill is called out to a car accident where a young couple, the Fishers, have swerved to avoid a dog. The wife, Teresa, is heavily pregnant and goes into labour with Jill delivering the baby in the car. Gordon feels she should not be exerting herself .
Penny Darnby is admitted suffering from pneumonia and is worried that her father should not be left alone with her young daughter. Nick has to amputate the hand of a fisherman, who is concerned about his future livelihood, and, at the Hopkirks' leaving party, Lizzie decides to stay in Elsinby after all and bids her father goodbye.
Alun is disappointed that he has been passed over as Ken's replacement and Eric Fogle has been appointed as the new head porter. Mike sends word that he will not be returning to the Royal and Gordon puts Nick forward as a permanent partner. Lucy Bayliss falls off her horse and the X-ray suggests a more long-term problem. Lizzie throws a party to celebrate staying on.
Moira Kilgannon, Brigid's sister, arrives from Ireland and shocks the nun by revealing that she is pregnant and is seeking an abortion. After the Danninis' ice cream parlour is vandalised, matriarch Maria comes to the Royal where a more serious diagnosis is made. Susie attempts to get rid of officious Eric but Nick decides to stay on in a permanent post.
An amusement arcade in the town collapses, trapping youngsters in the wreckage. One is a boy with a rare blood disorder whose mother must be found. Stella and Frankie work to free a young girl trapped beneath a fruit machine during which time Frankie tells Stella that he loves her. Unfortunately their future is cut short as there is an explosion, which kills them both.
Jack Bell, a new head porter to replace the departing Eric, arrives and ends up as a patient. Bobby comes to replace Frankie as the new ambulance driver and takes Gordon to attend elderly Hester Hindmarsh who lives in a remote and decaying farm-house and is tormented by local youngsters as an eccentric. Susie passes her exams, Nick faces up to his feelings for Marian and Alun's band plays its first gig - in a club which catches fire.
Jack is thrown in at the deep end when the hospital's boiler breaks down and he has to find a new one in a hurry. Nick is called to a dilapidated and unhygienic farm-house where young Simon Watts has a fever and high temperature. His pregnant mother takes on the same symptoms and needs to be rushed to the hospital, where Gordon and Mr. Rose are trying to persuade eccentric explorer Sir James Fawcett that he is in no fit state to travel to Mexico.
Having previously bet Lizzie that she could get Adam to date her, Susie dines out on her success but Matron is less than pleased when she is late for work again and decides to suspend her from duty. Mr. Rose faces complications when he has to operate on a golfing buddy and Gordon has to treat a man trapped beneath a combine harvester.
Nick has to attend to two little girls who have been overcome by carbon monoxide fumes and Jill gets involved with the family of a man training to be a priest. The real hero of the hour is Susie, who well and truly redeems herself with her aunt when they are having a cliff-top picnic and Matron collapses. Susie's actions save the day.
Despite being advised against it by Nick, Bobby takes the law into his own hands with a local thug and ends up getting stabbed. Moira dies and the Ormerods consider adopting her child Aisling. Susie decides to put her nursing career above her private life and breaks off her engagement to Adam - who then proposes to her.