The ITV medical drama series The Royal was originally a spin-off from Heartbeat, with the twelfth-series Heartbeat episode Out of the Blue serving as an introductory pilot for the show, with the Aidensfield police officers conducting parts of their investigations in The Royal hospital.lthough its storylines regularly involve serious crimes and human tragedy, later series of Heartbeat deal with these themes in a relatively cosy and comfortable manner compared to many modern TV police dramas, and much of the grittiness and social realism of the early series disappeared.
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