Filmed in spring 2024, we join crewmates Ellis and Jade in north east London, who alongside call handler Sumaiya, are amongst the frontline staff beginning a night shift which will deliver care to the nine million people across the capital. Despite the unrelenting pressures on the service and a national cost of living crisis, we see how they go above and beyond during the most testing of times. It's a busy start to the shift, as London Ambulance Service have dispatched 12 resources to a fire at Forest Gate Police Station, leaving 57 patients waiting for an ambulance in north east London alone. Five miles west of the fire, crewmates Ellis and Jade are sent to a 58-year-old female with chest pain, who has already waited over an hour for an ambulance. On arrival, the crew recognise the patient as a regular caller with an extensive cardiac history but find she is struggling with more than her health, as she can't afford to feed herself. As the Budget for spring 2024 is announced, staff reflect on how it could impact them and the patients they serve. However, they have little time to pause and consider the bigger picture, as call handler Sumaiya takes a call from a concerned mother whose son is having a mental health crisis and is heard being violent towards her. Sumaiya provides support over the phone while simultaneously arranging for help to be sent. Working out of Whipps Cross station are crewmates Jasmine and Kayla. They are eight minutes away from a 77-year-old female patient who has fallen out of bed. On scene, they meet the patient's son and main carer. He informs the crew his mum was recently in hospital for five weeks, and it becomes clear the decline in her health is beginning to take a serious emotional toll on him too. Forest Gate Police Station is still smouldering, but fortunately with no patients suffering major injuries, London Ambulance Service are finally able to stand down from scene, easing the pressure on the service. A new emergency call is received for a 54-year-old female suffering with chest pain. Crewmates Ellis and Jade are dispatched, and on arrival they learn the patient struggles with alcohol dependency. Ellis shares his personal journey of supporting his mother through years of addiction and gives advice to the patient, hoping he can set her on the road to recovery. The conversation leads Ellis to reflect: "I always try to instil faith when I go to patients that it is possible for anybody to turn their life around." In control, a call is received from the London Fire Brigade, reporting a domestic house fire. Multiple specialist resources are dispatched to what is assessed as a category one emergency — the most life-threatening — including advanced paramedic Nikki. As crews race to the scene, information is received that suggests the incident could be an arson attack and that the patient is gravely ill. There are 104 patients waiting for an ambulance across London as call handler Sumaiya takes another high priority call for a patient not breathing. After guiding the caller through CPR, she takes a moment to reflect on the challenges she's personally faced in her life: 'I never really understood what being ill was, but life can change in the blink of an eye. At the age of 19, my brother was diagnosed with Crohn's disease, and I'm his main carer... it does get difficult, especially when your family relies on you financially. Some weeks, I'm doing over 30 hours overtime just to survive.' In Hackney, Ellis and Jade are overjoyed to come across an 86-year-old female with shortness of breath who brings laughter to each moment, introducing the crew to her main companion in life, a cat named Puss Puss. Filmed in spring 2024, this episode serves as a stark reminder of the real challenges faced by not just the most vulnerable people in our capital city but also the paramedics and staff who serve them. Faced with mental illness, social care and elderly fallers, we witness the paramedics drawing on their own experiences to put patients at ease, even when they're unable to solve the bigger problems.