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It's a busy start to the shift, as the North West Ambulance Service answer one new 999 call every 16 seconds. Senior paramedic Aiden is dispatched with an ambulance and advanced paramedic to a category two patient who has fallen 20 feet from a tree with an open wrist fracture. As Aiden treats the patient, another job comes in for a two-year-old who has fallen from a balcony. The decision is made to divert the advanced paramedic, leaving Aiden as the most senior clinician on scene.

In Salford, crewmates Aaron and Emily are seven minutes away from a patient who has absconded from hospital and is suffering from a mental health crisis. The patient’s circumstances are uncertain at first, but after some investigative work, the crew decide to transport the patient to hospital for further treatment. Meanwhile, just a mile away, crewmates Jodie and Tom are attending to a male patient who has been vomiting blood and is in need of urgent medical attention at Salford Royal.

Ninety-seven crews are already busy attending to patients across Greater Manchester when control are alerted that Aaron and Emily’s previous patient has absconded from hospital and is in danger. Paramedic Aaron steps back in to offer the patient some words of encouragement as she continues to refuse treatment. After just one year in the service, the job leads Aaron to reflect on his role as a paramedic: ‘I think in life, we all need someone to talk to. As an ambulance service, we’re in a very privileged position in that, when people are at their worst, we’re there to go in and speak to them, when they most need it.’

Four hours into the shift, and an emergency call is received for a patient who didn’t know she was pregnant and is unexpectedly giving birth in McDonalds. The crew on scene request back-up to help care for mum and baby. Crewmates Jodie and Tom are immediately dispatched. The baby enters the world in the restaurant’s staff room before being rushed to the nearest hospital for checks.

Moments after dropping off their tiny charge, Jodie and Tom are dispatched again, this time to a category one emergency for a patient who is not conscious and not breathing. A warning is placed on the job, as the patient is known to have a history of weapons and the crew are urged to approach with caution. On arrival, they make the decision, given the severity of the reported symptoms, to set aside personal risk and enter the premises. They find the patient conscious and breathing and increasingly aggressive. After hastily retreating and awaiting assistance from the police, the crew are eventually able to get him onto the back of the ambulance and take him to hospital for treatment.

In Manchester city centre, senior paramedic Aiden attends to a homeless patient with an open leg wound. Despite the severity of his injury and the recommendations of Aiden, the patient refuses further treatment at hospital. Aiden is unable to arrange for a GP to come out as the patient is homeless, and after exhausting all options, he is left with no choice but to leave the patient on the streets of Manchester in accordance with his wishes.

It's one hour into the Monday day shift. Crewmates Aaron and Emily are dispatched to a 92-year-old suspected stroke patient. They find the patient struggling to mobilise and recommend a trip to hospital for tests. On arrival, the crew must join the queue of seven ambulances and endure a long wait to hand over their patient.

This episode demonstrates the ambulance service going above and beyond the call of duty, working compassionately to support vulnerable patients in a time of crisis and desperate need, where other services may have failed them.