The long-running medical drama Casualty, a fixture on British television for nearly four decades, is about to undergo one of the most dramatic transformations in its history. Since first airing 39 years ago, the series has been set in the fictional city of Holby, within the equally fictional county of Wyvern – a location inspired by its original filming base in Bristol. However, following years of production at the BBC’s Roath Lock Studios in Cardiff since 2011, the show is preparing for a seismic shift. According to a new official BBC document, Casualty’s next production era will see the fictional hospital relocated to Wales, marking a brand-new chapter in the show’s legacy. This will not simply be a cosmetic change but a fundamental relocation of the drama’s heart, requiring new storylines, fresh settings, and a chance to explore the Welsh NHS as a backdrop for gripping television medicine.

The BBC has opened the doors to production companies across the UK, inviting bids to take over Casualty for three seasons, with each season consisting of 24 episodes. At the center of this competitive pitching process is a major challenge: whoever wins the contract will be tasked with reimagining the show in a new fictional Welsh hospital. The BBC has made its expectations clear. In their official tendering document, producers are asked to provide “authentic representation of Wales and reflect the reality of the Welsh NHS.” Far from being a superficial move, this demand means the winning team will need to weave Welsh culture, language, and healthcare realities into the DNA of the program, without alienating the loyal audience that has followed the series for nearly four decades. The instruction reads like both a promise and a test: preserve the essence of Casualty while simultaneously reinventing its world.

To reassure fans, the BBC insists that this transformation will not constitute a radical departure from the show audiences know and love. “This is not about radical change of the show,” the document explains, though it acknowledges that shifting the portrayal to Wales will require careful storytelling to maintain familiarity while introducing a new setting. Producers are being challenged to craft editorial pitches that both honor tradition and embrace innovation, and part of this delicate balancing act will include managing characters. While there will be opportunities to introduce new faces that reflect a diverse modern Britain, the BBC fully expects existing characters – beloved by audiences over many years – to make the move to the new Welsh hospital. This duality creates a dramatic tension of its own: how do writers explain the transition of doctors, nurses, and paramedics from Holby to Wales without losing credibility, while still making space for a fresh cast to flourish?

The timeline for this bold reinvention is already in motion. The BBC plans to announce the new production company in November, with the episodes under the new contract set to air between late 2026 and autumn 2029. Furthermore, the deal includes the possibility of a two-year extension, meaning the winning company could shape the future of Casualty well into the next decade. This is not without precedent. Casualty’s sister show, Holby City, went through a similar pitching process in 2017, though BBC Studios ultimately retained the reins until the program’s closure in 2022. The stakes here, however, feel higher: this isn’t just a change in production, but a complete relocation of the show’s fictional geography. BBC Studios itself is confirmed to be in the running once more, meaning the long-time custodians of the show could continue to lead, but face stiff competition from rival producers eager to put their own stamp on the nation’s longest-running medical drama.

This won’t be the first time a BBC drama has shifted its in-universe location. Fans may recall Waterloo Road, which famously moved from Manchester to Scotland during its original run, with teachers and students uprooted and resettled in a new setting for the final three seasons. That gamble gave Waterloo Road fresh storylines and breathed new life into the show before its eventual hiatus. Now, Casualty is poised to follow a similar path, only on a grander scale, carrying with it the weight of 39 years of storytelling and a fiercely loyal fanbase. Will the move to a new Welsh hospital invigorate the drama and allow it to authentically reflect contemporary Wales, or will it risk alienating audiences too deeply tied to the legacy of Holby? One thing is certain: Casualty, a show that has long thrived on life-or-death drama within its fictional wards, is now facing its own moment of high-stakes reinvention. For viewers and characters alike, the heart of Holby is about to beat in Wales, and television history is watching.