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Cas Character

Patrick Spiller

Played by Ian Kelsey


S14 E15 – S16 E28

Job Title

Medical Registrar

First Words

(car beeps him) Same to you!


Staff aren’t too pleased to see Medical Registrar Patrick Spiller when he arrives in S14 E15 – arrogant and cocky, although an excellent doctor – he knows it. He gets on with the medical side, but is not interested in the emotional side of caring for patients. A cyclist is brought in on his first shift following a hit and run – Sean remembers Patrick as the other driver, and is not impressed. There is also tension between himself and SHO Holly, as they used to date eachother – Patrick does ask her out for a drink on her birthday though in S14 E17, but she turns him down, and in S14 E19 Duffy also has a go at him for his poor attitude towards people. In S14 E20, Patrick, who believes everything has an explanation, is thrown when a man regains his sight after being blind for over 50 years. In S14 E21, Patrick treats a man who has a severe rectal bleed. There is a mix up with the blood, but the error is spotted in time – Patrick however fails to take any of the blame. In S14 E23, a young girl is brought in with a fish hook stuck in her hand – but she is scared by Patrick’s attitude, leaving Holly to calm her down. In S14 E25, Barney’s old friend Ewan come to him after being stabbed, but doesn’t want the police involved. When his condition worsens, Barney runs to A&E and begs Patrick to help, together they go back to the flat and treat him. Eventually Ewan is rushed to the hospital and taken to theatre. In S14 E26 a glamour artiste brings in her dog who has been bitten by a snake. Max injects the dog with anti venom, much to Patrick’s disapproval. Later the woman is bitten by the snake, but the last anti venom was used on the dog. Luckily another hospital sends one over. Out of character Patrick takes the dog home to look after!

His softer side also shows at the beginning of Series 15, when he lets homeless Spencer have his spare room. But the team still pull Patrick up on his moody attitude in S15 E2. In S15 E3, we see Patrick still has feelings towards Holly, when he acts jealously over he date with a journalist. In S15 E6, Charlie and Patrick help to deliver Leona’s baby. She calls her ‘Charlie Patricia’ (which she later changes). After Josh persuaded him in a previous episode, in S15 E8, Patrick joins him and Fin out on the road. Their first call is to a young woman who has fallen down stairs and put her arm through a glass door, during an argument. They also treat a tramp who has collapsed. Josh decides to take him to hospital, despite Patrick’s protests that he is merely drunk. Their next case is to an RTA, an old man is trapped in his car. The rescue operation takes some time, Patrick stays with him and talks to him, but sadly he dies, even Patrick shows some emotion. In S15 E13, Holly organises a Well Teddy Clinic for a group of local school children, one of the girls clings to Patrick. Patrick however is interested in the teacher and asks her out, only to find she’s choosing a wedding ring next week. In the snowy Christmas episode, Holly invites Patrick to have dinner with her and her friends, before their shift, he is his usual ‘happy’ self! As they travel back to A&E, Patrick’s car breaks down, and he also twists his ankle. Stranded, they head for a barn for shelter for the night, and cuddle together for warmth. Patrick reveals the reason why he hates Christmas – because his mother died at Christmas when he was just ten. In S15 E21, Patrick is helping Holly move house, when he is caught up with Spencer and held hostage, by a man whose pregnant daughter is dating one of Spencer’s old friends. They are held on a boat, where Holly rings him up on his mobile – he tries in code to explain where he is. Finally, they manage to escape. In S15 E24, a female medical student is shadowing Patrick, so he shows her his charms. Holly looks on unimpressed. When he gets round to asking her out, he’s in for a shock – she also dates women! Holly is becoming increasingly concerned over her mysterious stalker – when in S15 E26, she discovers things being moved in her flat – Patrick offers his support. In S15 E28, he gives her a lift home and they discover the stalker has been in her house and tidied up. Next episode as he goes to take her home after shift again, he finds his tyres have been slashed – Tom takes her home instead, and we realise he is the stalker. In S15 E32, Patrick gets off on the wrong foot with a retired Consultant, who Dan is hoping will donate some money to the department. The pair clash over a patient diagnosis, but eventually Patrick realises that he needs the Consultant’s skills and they successfully work on the patient together. In S15 E34, after Holly’s stalker ordeal, Patrick and Holly talk about their relationship, but they walk away from eachother not realising how the other feels. In S15 E35, Patrick acts jealously when an old colleague of Holly’s turns up. Tom also turns up and kidnaps Holly – when the team discover she is missing, they search for her. They find her unconscious in a disused part of the hospital – Patrick gives her mouth to mouth, and Holly comes round and the pair cuddle.

In Series 16, Holly has left, Patrick receives a postcard from her off on her travels. He is now dating a married policewoman, Rachel. In S16 E1, he is also celebrating his exam success, and is now hoping to become a Consultant. In S16 E3, Patrick’s eyes start wandering when new SHO Lara shows up – she is feisty and strong character. He asks her for a drink after shift but is forced to cancel, when Rachel wishes to see him. In S16 E5, Patrick attends an interview for a Consultancy post, but is turned down on his lack of personal skills. He is annoyed with Max for giving him a bad reference. This episode Patrick however, uses his personal skills to good use when he persuades a baby sitter to bring back the ill child to A&E. In S16 E6, a fuming Patrick sees Max about his lack of support for him – Max tells him he is a good doctor technically but must develop people skills to match. In S16 E7, Lara persuades Patrick to come to Halloween party with her. She then discovers from Dillon that he is dating someone, and stands him up. They call a truce next episode. In S16 E10, Patrick discovers Max has been giving Amanda’s son methadone from the drugs department. Next episode he reports him to Jan, angering Charlie who was hoping to deal with the matter himself. Max is suspended. In S16 E14, Patrick has been spending time with Rachel, while her husband has been away. She gives him a watch as a Christmas present and he looks uncomfortable when she tells him she loves him. Next episode, Rachel tells him she wants to be with him and plans to tell her husband the truth. Patrick refuses to discuss it and heads to work. She asks him if he loves her and is forced to take his silence as the answer. As she tearfully drives home, she spots a mugging in progress. As she chases after them, they attack her. Meanwhile, Patrick declares his love for her on her mobile phone. Rachel is brought into A&E, they also discover she is pregnant. Patrick and the team try to save her but she dies – Patrick is devastated but tries to carry on as normal. Rachel’s husband, Greg, turns up and Patrick tells him the news. He is shocked but confused to learn that the baby she is carrying can’t be his as he has been overseas for five months. Greg walks in on Patrick in CRASH kissing Rachel’s hand, and realises the truth. In S16 E16, he fights with him in CRASH, before being thrown out of A&E. Patrick retreats to a country cottage with Lara, however Greg has followed him there. While Lara is in the bath, Patrick goes to get fire wood – and is attacked again by Greg and left for dead. Next episode, Patrick is missing – Lara and the police search for him in the woods – and eventually find him unconscious by the lake. Lara resuscitates him, but stays in the cottage with her boyfriend Craig, while Nikki and Comfort take Patrick in. The staff are shocked to discover their next patient – Max passing by A&E, rushes into A&E wanting to help but an annoyed Philippa demands him to leave. Later on, after a discussion with Dillon about relationships, Lara splits up with her boyfriend Craig and stays by Patrick’s bed side. Patrick’s eyes flicker open and tells Lara in his usual sarcastic tone that she’s lucky to be in her position. In S16 E19, Patrick returns after his own hospital drama, and treats a transsexual patient, Teri, whose recent sex change operation has become seriously infected. Teri refuses a life saving operation as it will ruin the functions her previous operation gave her. Patrick talks with her, about Rachel and his ordeal, and finally persuades Teri to have the operation. He also invited Lara to dinner. In S16 E21, Lara teases Patrick about her meeting an old med school friend Peta, who was her ‘soul mate’ – Patrick acts jealous until he realises Peta is female! Outside A&E Lara and Patrick kiss. In S16 E22, Lara is back from a course in Dublin and ends up flirting with Patrick all shift – her and Patrick play fight and cuddle in the staffroom – about to kiss, Max calls Lara away. In S16 E23, Patrick celebrates his Consultancy post in London, by booking an expensive restaurant for the evening. Patrick is annoyed when Lara stands him up and as he is about to leave, notices a bra on his windscreen with a note saying ‘Why don’t you see if you can find the other half’. Patrick goes behind the hotel to find an indoor swimming pool – with the knickers on the door handle. He meets Lara inside for dinner, and they find they both had the same idea – with a hotel door key. Next episode, Lara is tired after spending the night at the hotel with Patrick – rumours of their relationship has already spread.In S16 E26, Lara and Patrick’s strong personalities clash, when he wishes her to come to London with him. In S16 E27, Patrick is annoyed when Lara crashes into his beloved sports car – she tries to make it up to him with kisses. After shift, Patrick takes her to a jewellers and proposes to her. In S16 E28, Patrick, about to view a property in London, tries to persuade Lara to join him down there. She refuses to leave her job in Holby for him. Patrick is then involved in a motorway accident. When the call is sent to Holby, Lara, who is unable to get through to Patrick on his mobile, begins to get concerned, and persuades Max to let her and Anna go out in a swift response car. As Lara and Anna arrive, Josh discovers Patrick’s crashed car. Patrick, meanwhile, is trapped in a minibus while trying to save children. When the team discover the crashes minibus, Lara rushes in to see Patrick. She tells him she loves him, although eager to stay she is told to leave. As the minibus is getting increasingly unsafe, Patrick – the last trapped – tells the fire crew to leave if it gets too dangerous. As the team pull out, Lara looks on and fears the worst – however they manage to pull Patrick out just in time before the minibus explodes. Lara throws herself at Patrick in joy. Patrick, who dismisses being checked over, heads straight to dinner with Lara. They both realise the importance of eachother, and although Lara agrees to go to London with him – Patrick tells him he’s going to stay in Holby. Patrick decides to try his proposal of marriage for the third time on bended knee – without hesitation Lara accepts. Patrick admits to feeling dizzy with emotion. Lara goes to the toilets to compose herself, however when she returns, she finds Patrick slumped on the table and he falls to the floor. She desperately starts CPR and screams hysterically for an ambulance. Patrick is rushed into Resus, where Max takes over his care and is concerned he has suffered an inter-cranial bleed from the RTA. A shocked Lara stands in Reception, holding her engagement ring as the team desperately try and save Patrick’s life. Next episode, Lara feels unable to attend Patrick’s funeral and buries herself in work. At Patrick’s wake, Lara realises she must take time off to grieve. She also introduces herself to Patrick’s father, before Spencer takes her to see his grave at the crematorium, where she says her tearful goodbyes.

Memorable Moments

  • S15 E8 – Patrick spends a shift with Josh and Fin, and learns a lot more about the job of a paramedic.
  • S15 E16 – Holly and Patrick are stranded in a barn at Christmas.
  • S16 E15 – Patrick tearfully says goodbye to his girlfriend Rachel who has died.
  • S16 E28 – After proposing to Lara, Patrick collapses and dies after the RTA incident.


Gallery : Patrick Spiller


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