Sam joined Holby A&E at the beginning of series 11. He is a good nurse, but he once had a problem with a patient who refused to be treated by him on finding out that he was gay.
Sam was living with boyfriend Paul during series 12, and although they had problems when Paul lost his job, they got through them. However, Sam was shocked to discover that Paul had been sleeping with a woman, and was heartbroken when he and Paul split up. The end of the series saw him moving into a new house that he was going to share with Sunny Sunderland and Tina Seabrook.
In series 13 Adam confided in Sam that he was HIV positive and was gay. At first Sam didn't want to know until he found out more; they became good friends.
Sam started a relationship with agency nurse Lee. Lee discovered Adam's secret. When Sam found out that Lee had been stealing drugs from the department he was going to go straight to Charlie but Lee threatened to tell everyone about Adam. Sam told him to get out and not to come back; Lee left but Sam was crying.
In the last episode of the series Sam tried to come to Adam's aid when he was attacked by an angry relative. The relative pushed Sam away and he fell straight over the railings to the floor below. The series ended with him lying on the floor, his head surrounded by blood...
Series 14 opened with the team trying to save Sam's life. Though he was badly injured they managed to do so. When he was recovering, Adam went to see him, to ask his advice on returning to nursing. They seemed to be pretty close, but this was the relationship that never happened. Sam went to stay with his friend and ex-teacher Simon in Cornwall for a while; after not being able to get through on the phone, Sunny went down with Tina to look for him. Despite their pleas, Sam told them he wasn't going to go back to Holby, but Simon advised him to go and see what it was like, so he got on the coach with Tina and Sunny. On the way the coach was involved in an accident; Sam had to perform an emergency chrycho-thyroidotomy with makeshift equipment to save a life. When he got back to Holby he cleared out his locker, saying that what had happened had proved to himself that he wasn't quitting through fear. He said he wanted to move on, to do something different, maybe on a one-to-one basis with people. He left, and as Tina said, saving that patient's life wasn't a bad swansong.