Kelsey was cast in the soap following the departure of Julia Parsons (Diane Keen), the practice manager prior to Howard.

Howard was based on a real person since producers had heard of a situation where somebody quit the army to become the practice manager of a doctor's surgery.

Howard's storylines in the programme included suffering from bulimia, his on-off relationship with colleague Emma Reid (Dido Miles) and dealing with the miscarriage of their child together.

Howard first appears when he is introduced by Heston Carter (Owen Brenman) as the new replacement of Julia Parsons (Diane Keen) as the new Practice Manager of The Mill.

Howard divides opinion between the team, as Kevin Tyler (Simon Rivers) begins to like him, however Freya Wilson (Lu Corfield), Zara Carmichael (Elisabeth Dermot-Walsh) and Elaine Cassidy (Janet Dibley) dislike him in contrast to Julia.

Colleague Emma Reid (Dido Miles) discovers Howard's eating disorder and attempts to get him help, but he makes her promise to keep it a secret if he stops.

While planning his funeral, Emma reveals to Niamh Donoghue (Jessica Regan) that he had a daughter, Amelia Sullivan, whom he walked out on so that she could become accustomed to her stepfather.

[2] Kelsey added that Howard is an extreme character and that there was pressure about taking over from Keen's role due to having "big shoes to fill".

[3] Howard is billed as a "confident, divorced ex-army captain", and is said to have a "highly different and strict outlook on working life" in comparison to Julia.

He explained that somebody stopped working for the army and began as a practice manager of a doctor's surgery, and within three months of him taking over the position, five of the staff members quit.

[7] When he began filming for the role, Kelsey sourced an authentic army watch and shoe polishing kit, in order to "feel right with the part".

Executive producer Mike Hobson told Digital Spy he made the role of Howard "his own", and said that the cast and crew were sad for him to be heaving, adding that he was a "magnificent and an integral part of the Doctors family", as well as "a consummate professional and a pleasure to work with both on and off the screen".

[9] When asked what his highlight from his tenure is, he stated that it was the friendships that he formed with cast and crew members, specifically co-stars Miles, Midlane and Chris Walker.

[7] He labelled Doctors the "most fun" set he has worked on in the span of his career, and admitted that while it was a tough decision to leave a joyful role, it was "time to go", adding: "One day I was planning on renting a house in Birmingham for a year, the next I just decided I was done.

[10] In the lead up to the episode's airdate, the Doctors Twitter account tweeted cryptic messages such as "everything changes", "cancel all other appointments" and "consider this a friendly warning, you won't want to miss it.

[6] In scenes aired on 22 October 2015, Howard dies suddenly of a brain aneurysm after he learns that Emma has miscarried, of which both storylines were kept secret until transmission.

[4] Producer Lloyd was asked how and why the scenes were kept a secret from viewers, and he stated that it took "an awful lot of cooperation from actors, directors, writers and the press", but that it was worth it for the "sudden and unexpected" shock.

[11] He then spoke about the decision to kill him off, explaining that there were numerous "different scenarios" in which he could leave, but that his death would "have the most impact and would produce many new stories with a lot of potential".

[12] Lloyd was asked if he had considered writing a happy ending for the pair, to which he answered yes, but admitted that he did not believe Howard and Emma's relationship could survive a miscarriage.

[7] After the announcement of his exit, Kelsey revealed that he pitched a spin-off series centred around Howard to the BBC daytime programming department.