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The shift starts with a call in progress for a patient who has been found walking into the Thames. Ambulance crew Sarah and David are immediately dispatched. They arrive to find the elderly patient being comforted by passers-by who have pulled them from the water. It becomes clear that the person has mental health issues, and there are growing concerns that they are at risk of secondary drowning.

Sarah, who is new to the role of paramedic, feels frustrated by the growing amount of mental health calls and the limited help they can provide.

Eight hours into the shift, and the service has taken over 2,000 emergency calls. Sarah and Keith are dispatched to a 999 call from a mum calling for her son who has recently left a detox programme. When they arrive on scene, they find the patient at home with their parents, who are struggling to get the support that they need. For Keith, the patient represents the realities of the ambulance service and the restrictions for all they can do in their role.

It鈥檚 the start of the night shift, and Sarah, David, Keith and Rosie are back on duty for the next 12 hours.

Sarah and David are immediately dispatched to a patient who is self-harming. They arrive to help them talk about what is happening at the moment and find alternative ways to provide comfort.

It鈥檚 two hours into the shift, and control have received 515 emergency calls. Sarah and David are dispatched to a category two patient suffering with chest pains. They arrive to find the patient reluctant to go to hospital despite the pleas from their daughter.

As the shift enters the early hours, an emergency call is received for a patient who has fallen off a roof and is now struggling to breathe. Multiple resources are dispatched, including Rosie and Keith. When the teams arrive at the scene, they struggle to locate the patient, whilst others are left waiting for help.

As dawn begins to break, a call from a passer-by concerns a patient found on the streets. Keith and Rosie are sent to help. They find the patient in a confused state and clearly suffering with their mental health. The patient has recently been discharged from hospital but they haven鈥檛 been taking their prescribed medication. The shift leaves Keith to reflect on his role as a paramedic.

This is an episode which shines a light on mental health services and the struggles faced by others as the stories behind the sirens have a deep and lasting impact on the staff and crews of the ambulance service.