"A Grand In The Hand" is the 43rd episode of Casualty and the 3rd episode of the 4th series. It was preceded by "Accidents Happen" and followed by "Day Off". The episode was directed by Sue Butterworth and written by Sam Snape.
The police jump to the wrong conclusion when two cars are involved in a crash, but they can't interview the suspect because he's in a serious condition. His family arrive to break the news that his sister Karen, and the other two pals are dead and he tells Sheila, his other sister, how the accident happened. She finds Virginia Wilson in the observation ward, who admits she's responsible and the police charge her, but Richard Cumming's has to face many months of anguish, due to her act. A hen's brought in by it's owner and Alex discovers it has a cold, so tells the girl what to do and sends her home. Lucy has problems with a man's dislocated shoulder but Charlie comes to the rescue and resets it. Megan is having problems coping and when Charlie catches her at the medicine cabinet, she admits she's hooked on pills, prescribed by her doctor. Valerie overhears the conversation and tells him to report it but what she needs most, is his help.