It's Christmas day. Charlie tells Duffy it's hard not spending it with Louis, but says he'll make it up to him on his day off. It's also Holly's birthday; she tells Amy she'll be celebrating with the girls after the shift. Patrick apologises to Holly for making a fool of her in front of a patient the other day, and asks her out for a drink; she refuses, saying she's going out with her boyfriend to celebrate her birthday. She later tells him he's too clinically minded, and ignores the emotional side of patients. She says he could at least be civil to his colleagues at Christmas. He asks her if she can help him change. Holly says she's spoken for - if he wants to change, he should do it for him. Amy asks Holly in front of Patrick if she's ready for her night with the girls.
Josh and Penny bring in Chris Robertson. He has locked himself in a bunker, convinced that the world will end at the millennium, and hasn't been taking his medication. The staff have to tell him that it's the middle of January to keep him calm.
Noel is driving along with his girlfriend Ruth. She makes him stop, saying he's drunk. He tries to prove he isn't by climbing up and standing on a wall, but falls off. Tina is passing on her way to work and goes to help. Noel is taken to A&E. He has a fracture in his spine. Ruth wants to know if he'll be able to fly to New York in two days, as they have given up everything to take up jobs out there; she is annoyed that the doctors cannot give a straight answer. However, she makes some phone calls and returns with the news that the company will wait for Noel to recover; she'll go to New York and he'll join her there when he's fit.
The actors playing the dwarves in a pantomime turn up in A&E one by one. Holly thinks it's food poisoning as they all had a meal together the night before, until Janice (Snow White presumably) turns up to see them: she ate with them but isn't feeling ill. Holly wonders if it's a virus, as they share a dressing room, and Johnny, one of the dwarves, asks if they can catch a virus from a plant - Alf keeps a plant in the dressing room to the others' annoyance. Charlie suggests that the tingling hands they all have could be caused by arsenic from rat poison (they know that Alf's father was a rat catcher), which Alf may be using as fertiliser for the plant. He turns out to be right.
Max dresses up as Santa for the children's ward, with Adam and Chloe as elves, before being called back down to A&E. He has not spoken to Tina in the last few days; he says he was trying to think things through. He asks her if she wants to join him at home later for Christmas dinner; she says she'll think about it. Max goes to change out of his Santa trousers and braces; he is waiting for the lift, which has been getting stuck all day, and Tina joins him. As they go up the lift stops. Max asks Tina if she's decided about coming round yet; she says she needs to know how serious he is. They kiss, and Tina pulls down Max's braces…
Adam, Sean and some others have been waiting for the lift. Eventually it starts moving and arrives. Max and Tina emerge, straightening their clothes. Sean asks why they didn't press the alarm if they were stuck in there. They say it wasn't working but Sean tests it as he gets in the lift and it rings out.
Thomas Stephens brings in his wife Annie. She has motor neurone disease and he cares for her all by himself. He has brought her in as she has pneumonia and is having difficulty breathing. Holly wants to admit her; Thomas is unsure about this. It's obvious that they love each other. Annie asks Thomas to let her die with some dignity; it seems they have discussed this before. Thomas says he doesn't want to live without her but she says if he loves her he'll do it. He agrees; he is about to put a pillow over her face when she opens her eyes and says she'll spend the day with him at home. He thanks her; they get ready to leave. Holly tries to persuade them to stay, saying Annie needs care and attention. Annie says Thomas will give her more care and attention than she would get in hospital. Holly realises she's right and lets them go.
Martin and Darleen Devern are at home with their children. Martin has made them presents as he can't afford to buy them. The doorbell rings; it is Martin's brother Steve. Darleen doesn't want to let him in as he is a junkie; last time he left his needles around. Martin says he can't throw him out at Christmas and invites him in. Steve wants money to pay off his dealers; Martin can't give it to him but says he can stay until he's managed to get the money together. Martin, Darleen and the kids go to church, leaving Steve there. He goes through the flat searching for money, then starts ransacking the house. He knocks over the cooker, and the gas pipe is disconnected from the back. He leaves with a sackful of their possessions. The Deverns return to find their neighbour Colin there; he tells Martin he heard a noise and came round but couldn't stop Steve. Darleen smells gas and is calling the kids to get them out when Colin lights a match and the whole place blows. Colin is killed. Martin and Darleen's sons Leo and Manson are injured. They are taken to A&E where they are stabilised in resusc.
Some kids are out near a scrap yard. They watch as a car is piled on top of the rest and another car speeds off. They go to take a closer look and realise that there is someone in the boot of the top car. They call an ambulance. Josh goes up with the fire brigade on a platform; they need to make the pile of cars stable before they can do anything. Suddenly the pile topples over and the top car falls to the ground. The guy is taken to A&E; with him in the boot was a sack and Duffy realises the names on it are the names of Martin and Darleen's kids. She speaks to Martin about this and they realise that the guy in the boot is Martin's brother Steve. He was left there when his drug dealers caught up with him. Martin goes to see him; Steve says it wouldn't have happened if Martin had given him the money. Martin tells him he has no money. He leaves and goes to see Darleen. He tells her that he thought that being good and believing in God would keep them safe, but he would have been better off cheating the dole. He says the kids want electronic toys, not the things he makes. He says they'd be better off without him and leaves. As he is sitting outside the hospital, Chloe, on her way home, sees him. She says he can't walk out on them - she's seen him with his kids and knows he couldn't do it.
Amy organises a whip-round for the Deverns, and phones their church and asks them to do the same. She also phones a local hotel and manages to get them a free room for the week. The A&E staff go up to Darwin ward, where the kids are, at the end of the shift to give Darleen the money and the news. She is very grateful. The church choir turn up, and so does Martin, who hugs Darleen. Everyone joins in singing, "O Come All Ye Faithful".