Casualty boss Jon Sen on improvised special: 'This is the reality of what paramedics face'

What's more, the frantic episode is improvised, too, meaning it genuinely will feel very real and fly-on-the-wall to viewers.

RadioTimes.com recently caught up with Casualty boss Jon Sen to find out exactly why he wanted to build on the experimentation the long-running drama has already done, and what the future holds for it.

"Casualty's got a long history of telling stories that are true to the NHS, that really talks to the experience of NHS workers, doctors, medics, but also people who are patients on there," Sen explained.

"We were talking to a lot of doctors, nurses, paramedics and practitioners within the community (as we do) and realised that actually, this year more than anything for them, the defining visual of hospitals had become this set of queueing ambulances which seemed to start in several central hospitals, but was becoming more prevalent."

Sen continued: "We felt this needs to be a really intense, naturalistic treatment of a paramedic's life and we wanted to get as close to that as possible. So we talked about how to do that both camera-wise, production-wise, and then style of performance.

"We realised that actually, in terms of style of performance, the way we could achieve greatest naturalism was to allow the actors to improvise along set lines that we'd set up very particularly for scene breakdowns."

Was he worried about how to portray the scenes without being overtly political? "We have to be careful because we are the BBC and it prides itself in its impartiality. And it's important as well that we portray the truth of what's going on. Our jumping off point is always fact-based research."

Sen added that he was "proud" of presenting a fact-based episode, adding: "This is the authentic reality of what paramedics are facing.

"We don't point the finger of blame at anybody - there is obviously a discussion around lack of social provision meaning there's no beds, which means it knocks on to ambulances - we can talk about the conflicting arguments about the causes, but the truth of it is paramedics on the front line are suffering mental and immense challenges.

"We want to be authentic and are a reflection of their experience, rather than find ourselves taking a political stance."

The exec went on to describe the initial process as "terrifying" as it was quite far from what Casualty had done before, but with those nerves came excitement at the prospect of making something very unique - and luckily, the cast were entirely trusting and on board.

"Michael Stevenson [who plays Iain], rang me up after shooting on the first day and he was buzzing with adrenaline," Sen commented. In particular, during one harrowing mental health patient scene, the actors found the improvised process liberating as the normal cast were kept away from the guest actors to keep spontaneity.

"The improvisation allowed the actors to really feel around the scene. They're listening. They're responding. And they're judging what the other actors in the room are doing. It gives a sense of real-life quality to the scenes... there's tension in the scenes that we don't normally get when we do it in a more traditional manner," the executive producer commented.

As for the actual storyline of the episode, it's intense, chilling, and the stakes grow with every minute that passes. It's relentless and doesn't leave a moment for reflection until the episode closes.

Sen, who regularly speaks to medical professionals, explained how he got a feeling on what type of stories to include from having those conversations.

"We don't use cases they bring to us for a while host of reasons, but it's really useful to talk to real-life paramedics because you get the sense of their experience and their pressure. You get the sense of the type of patients who are recurring the whole time in their daily work and the personal toll it takes on them, so you build the story around that.

"We had an amazing cast of both regular and guests who really ran with the challenge of improvising and brought a real sense of nuance or character detail. It was a real joy to watch it come to life on screen."

What's clear is that Sen has caught the innovation bug, and does have plans to keep pushing the boundaries of continuing drama. One thing that's been mentioned already is Sen's desire to push Casualty into miniseries, which will focus on one major storyline, along with a few other minor narrative points. Not all cast will have starring roles in each miniseries.

"I wanted to create these jumping off points that we advertise to the lapsed audience, as well as the regular viewers," he explained. "You can arrive here [in this special episode] and you won't need to know anything other than it's a hospital drama to enjoy.

"I think it's responding to a change in viewing habits... I think people want that boxsettable narrative in their drama and then if they join halfway through and are interested, we can go back and start at the beginning.

"We're going to start marking them up as different miniseries within the Casualty umbrella. At the moment, it's a soft launch."

One thing's for clear, Casualty is stronger than ever at the moment, and Sen is only just getting started.

Additional reporting by Lewis Knight.

Read more:

• 8 EastEnders spoilers: Will Janine Butcher's lies be exposed ahead of her wedding?
• 7 Coronation Street spoilers: Damon makes his mark and Griff's plot continues
• 7 Emmerdale spoilers: Christening chaos as Charity and Amy start feud

If you’re looking for more to watch, check out our TV guide or Streaming Guide, or visit our Soaps hub.

The latest issue of Radio Times magazine is on sale now – subscribe now. For more from the biggest stars in TV, listen to the Radio Times View From My Sofa podcast.