Inside Holby ED: A Behind-the-Scenes Look at BBC’s ‘Casualty’ as It Approaches Its Monumental 40th Anniversary

As it enters its landmark 40th year, Casualty stands not only as a titan of British television, but as the longest-running primetime medical drama in the world. With its emotional storylines, groundbreaking social commentary, and an ever-evolving ensemble of compelling characters, the series has become a cornerstone of BBC One’s Saturday night schedule. But what lies behind the curtain of the fictional Holby City Emergency Department? Daily Express reporter Fran Winston was granted exclusive access to the hallowed set at BBC’s Roath Lock Studios in Wales—and what she discovered was nothing short of cinematic reverence.

From the moment she stepped inside, Winston was struck by the sheer authenticity of the environment. “It genuinely feels like stepping into a real-life NHS hospital,” she wrote, describing the meticulous design that goes far beyond what the cameras usually capture. Every corridor, resus room, and waiting area has been lovingly recreated with precision, giving actors the rare advantage of performing in a fully immersive, 360-degree world. The set is not just a backdrop—it’s a living, breathing character in its own right.

Unlike the conventional three-walled TV sets viewers may be accustomed to, the Casualty set is a fully enclosed space. The iconic reception area, with its flickering monitors and bustling foot traffic, mirrors the chaos and urgency of real emergency departments. It’s a testament to the production team’s commitment to authenticity, a commitment that has earned the show generations of loyal fans since its debut in 1986.

Yet it’s not just the realism that leaves a lasting impression—it’s the soul of the set. Winston was deeply moved by the personal touches that adorn Holby ED, paying tribute to characters and cast members whose stories left an indelible mark on audiences. Nowhere is this more evident than in the staff room, a space that has witnessed countless moments of camaraderie, heartbreak, and revelation. In one quiet corner, a notice board overflows with photographs of beloved former characters—many of whom met tragic or heroic ends.

These images form a powerful visual memory wall: Robin Miller, the idealistic nurse played by Amanda Henderson; heroic paramedic Jeff Collier (Matt Bardock); the resilient Dixie Dixon (Jane Hazlegrove); warm-hearted Duffy (Catherine Shipton); the ever-reliable Noel Garcia (Tony Marshall); and of course, Charlie Fairhead—portrayed by Derek Thompson—whose departure last year marked the end of an era after nearly four decades on screen. These snapshots, filled with joy, laughter, and behind-the-scenes camaraderie, serve not only as a tribute to the characters but to the legacy of those who brought them to life.

During the tour, Casualty producer Sarah Beardsall pointed out that many of these heartfelt corners are seldom caught on camera. Yet for eagle-eyed fans, the memorial board in the staff room can just be glimpsed tucked away in the far-left corner. It’s a detail that reflects the show’s unwavering dedication to honoring its past while charging into the future.

And it’s not just confined to the staff room. Across the set, these nods to the show’s rich history continue. In the ambulance bay, a fridge freezer is adorned with photos, transforming a utilitarian object into a sentimental homage. Along the walkway to the newer call centre set, another collage of images greets the cast and crew each day—a subtle, constant reminder of the human stories Casualty has told.

Among the many unexpected delights? A copy of the Daily Express nestled in a wall-mounted magazine rack in the fictional staff room, adding another layer of lived-in realism. It’s these elements, small though they may be, that breathe life into Holby ED and bridge the gap between fiction and reality.

The emotional weight of Winston’s visit was palpable. As a long-time fan of the series, the experience was more than just a behind-the-scenes glimpse—it was a personal pilgrimage. “I didn’t anticipate the emotional impact,” she admitted. And perhaps that’s what continues to set Casualty apart. For all its dramatic plotlines and high-stakes emergencies, it’s the human connection—the raw, vulnerable, endlessly complex tapestry of its characters—that continues to resonate.

As the series approaches its 40th anniversary, it does so with its legacy firmly intact and its heart still beating strong. In an age of rapid-fire streaming content and fleeting attention spans, Casualty endures. It has not only adapted with the times—tackling everything from mental health and institutional racism to NHS funding crises and domestic abuse—it has also retained its emotional core.

For fans new and old, the show remains a weekly appointment: a space where the lines between drama and reality blur, where fictional lives mirror real-world struggles, triumphs, and tragedies. The tributes throughout the set are a reminder that the stories may be scripted, but the emotions they evoke are very real.

With the next chapter just around the corner, anticipation is building. What new characters will walk the halls of Holby ED? What new challenges will confront the staff? What stories will be told—and which hearts will be broken?

One thing is certain: Casualty isn’t just television. It’s tradition. It’s a tribute. And above all, it’s a testament to the enduring power of storytelling.

Casualty airs Saturdays at 9:25pm on BBC One.