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From forgotten loves to forbidden flings - Casualty's 9 best romances

From Ethan and Alicia to Tess and Fletch, who's been snogging round the back of the bedpans?

Published: Saturday, 4th April 2020 at 9:00 am

The Emergency Department is a busy and stressful place to be, so you can't blame Casualty's doctors and nurses for seeking a bit of distraction in their colleagues. Over the years we've seen it all: secret trysts in the staff room, kisses in the cubicles and usually a near-death experience at some point, just so the couple can declare their love in front of the whole team.


But which Casualty couples got our hearts racing and our pulses soaring? Read on for our shortlist...

9. Holly and Patrick

Casualty Holly and Patrick

These two needed their heads knocking together! They had previously been a couple at medical school and were thrown back into each other's lives when they arrived at Holby ED. Despite generally disliking people, especially those he had to work with, Patrick always had a soft spot for Holly and kept an eye out for her. They never got the happy ending we wanted, as Holly left to go travelling after her stalker ordeal, but their chemistry kept us hooked. Patrick eventually got together with ED doctor Lara Stone but died in a car crash before they could marry.

8. Fin and Comfort

Casualty Fin and Comfort

Romance isn't restricted to the ED - they're getting it on over at the ambulance station too! Paramedics Fin and Comfort had a rocky road to romance. She was married, they had an affair and when she finally left her husband to be with him, Fin revealed he had a secret daughter. When will they ever learn not to keep secrets?! All's well that ends well though - after a few more stumbles and near-misses, the pair finally got back together and got married in an emotional ceremony. Fin did eventually get murdered though, so happiness was short-lived, sad face.

7. Tom and Sam

Casualty Tom and Sam

This was all a bit awkward. Back when Sam was a consultant rather than a paramedic, she found herself doing shifts alongside her estranged husband Dylan and the man she was falling in love with, Tom. It was the ultimate in Casualty love triangles, and Dylan struggled to come to terms with Sam moving on, but eventually they divorced and she married Tom. Although when Sam returned to Holby four years later she was single again... The best bit about this couple? Actors Oliver Coleman and Charlotte Salt tied the knot in real life and have stayed together. They have a two-year old son.

6. Tess and Fletch

Casualty Tess and Fletch

In the words of Misteeq, this was so-so-scandalous! Cheeky chappy Fletch was everyone's mate, and supposedly a family man - a married dad of three who always had a smile on his face. Nobody expected him to cheat on his wife, least of all with lovely, responsible, older colleague Tess. The pair's friendship turned into an intense, secret affair that neither of them could resist until Tess realised she was pregnant. Spooked by Fletch's wife Natalie turning up at work, and sobering up to the reality of the situation, Tess terminated the pregnancy and ended the relationship, leaving a devastated Fletch in tatters. We shouldn't have been willing them to stay together, but we couldn't help it.

5. Ethan and Alicia

Casualty Ethan and Alicia

These two were clearly made for each other - why couldn't they see it?! Their love was never in doubt but too many silly things got in the way - pride, embarrassment, miscommunication. And remember that time when Ethan didn't make it obvious enough that he wanted to be with Alicia so she dated his brother, Cal, even though she and Ethan were both pining for each other? So frustrating! They had brief, stolen periods of happiness, but ultimately it wasn't to be - Alicia decided she needed to be single for a while and concentrate on her career, leaving Ethan behind. Sob.

4. Lily and Iain


This really shouldn't have worked. Iain's previous relationship with Rita failed because he couldn't commit, meanwhile Lily had a five year plan stuck on the door of her locker. Iain was a fun-loving guy who would get the first round in, Lily's version of fun was staying late at work to get some extra surgical experience. But somehow they just clicked - she kept him on his toes and he was a smitten puppy dog around her. It's just a shame it had to end - Lily was offered a research position in Hong Kong and she just couldn't turn it down, not even for love.

3. Zoe and Max

Casualty Zoe and Max

After dating the Clinical Lead, Nick Jordan, and then rising to the same position herself, Zoe was shocked to find herself falling for the twinkly-eyed porter, Max, especially as there was a notable age difference between them. Max was head over heels for Zoe, and their chemistry was off the charts, but she was embarrassed of their relationship and never quite felt comfortable. It was only after she cheated on him on her hen night (we still blame Robyn for forcing her to go out) that Zoe realised how much she loved Max. After a lot of to-ing and fro-ing, and Zoe leaving to work in America for a while, she eventually came back and the pair got their happy ending on an aeroplane, flying off to new adventures together.

2. Ruth and Jay

Casualty Ruth and Jay

Nurse Jay had the patience of a saint - even though he and Dr Ruth were quite clearly destined to be together, she came up with no end of reasons why they shouldn't be. To be fair she was battling her own demons, including mental illness, taking the morning after pill behind Jay's back and marrying a gay man who left her shortly afterwards. Nothing would diminish Jay's love though, and he and Ruth became one of the few Casualty couples to get a happy ending. The loved-up couple drove off into the sunset together in a camper van to prepare for the birth of their unborn baby after Ruth became pregnant again. Aww.

1. Charlie and Duffy

Casualty Duffy and Charlie

Who else could top this list? Despite Duffy's sad death after a devastating battle with dementia, these two will always be ultimate Casualty couple. They were friends for years: even though the chemistry between them was obvious they were never single at the same time. When Duffy returned to the ED in 2015, the writers finally decided to put us out of our misery, and gave us the moment we all wanted, as the pair got hitched. After a couple of blissful years as the mum and dad of the department tragedy struck, but their love will live on forever.

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