Roxanna MacMillan was a consultant neurosurgeon and Neurology Clinical Lead at Holby City Hospital. She first worked at the hospital as a locum in April 2013 and began working there on a permanent basis in October 2017 until her death in September 2018.
Roxanna worked in the hospital until 2013 after her unsuccessful operation on Darwin F1 Tara Lo, which resulted in the latter's death.
Roxanna returned on 24 October 2017 and tries to rebuild her bridges with Tara's husband and cardiothoracic registrar Oliver Valentine. Both Roxanna and Oliver pitch for the funding of their research projects. Roxanna is developing a virtual reality device meant for dementia patients. As Roxanna's husband, professor David Hopkins has dementia, Oliver feels for them and persuades medical director Nina Karnik to give the funding to her project.
Oliver is frustrated to find out that Roxanna cancelled her project but soon finds out it was because David's dementia has already developed too much and the project isn't possible to use on him. David suffers from PVO which Oliver operates on, assisted by AAU CT1 Morven Digby and observed by Roxanna. Oliver gets shot by Fredrik Johanssen while operating and as David develops a cerebral bleed, Morven convinces Roxanna to operate on Oliver who has been shot to the head. As Roxanna is operating, David goes into ventricular fibrillation and resuscitation proves unsuccessful.
3 weeks after the shooting, Roxanna is ready to wake Oliver up from his induced coma, but it is too soon for Oliver and he is kept in coma for more.
Before Roxanna's death, John Gaskell and herself where having some friction over Gaskell's trial. After a discussion, John got Roxanna against a wall and said if she tells anyone about the fault with the trial, there will be consequences. As Roxanna ran away from him, she was hit by Meena Chowdhury's car.
She was rushed into the hospital where Gaskell had to operate on her as he is the only other neurosurgeon. He deliberately gave her locked in syndrome which meant she could only see and hear therefore making her not be able to speak and reveal his problems with the trial. When Meena went to see Roxanna a week later, she started blinking. Essie Di Lucca used an alphabet board so she could spell out what she wanted to say using the method, 'blink once for no and twice for yes.'
John saw Essie doing this, again, knowing that she would reveal the problems, so injected much more medication than needed causing her to overdose and go into cardiac arrest. Henrik Hanssen and Meena ran to her aid but it was too late and she passed away.