Science Research Evidence: winter modelling 2025 to 2026 - Part 6: emergency department attendances
This paper provides modelled scenarios for influenza and pneumonia, COVID-19 and respiratory syncytial virus (RSV) for the upcoming winter season.
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Top line summary
There were 51,790 Emergency Department (ED) attendances due to respiratory problems in 2024 to 2025 — significantly more than the previous two winters.
The modelling scenarios suggest a peak of 264 to 417 ED attendances per day in Wales over the 2025 to 2026 winter period.
ED attendances
ED attendances are defined in the NHS Wales Data Dictionary as individual visits by patients to an accident and emergency department for treatment provided by the accident and emergency service. For winter modelling, the focus is on attendances related to respiratory issues, which represent approximately 8% of all ED attendances throughout the winter.
Figure 22: 7-day rolling average of daily ED attendances due to respiratory problems, between April 2020 and March 2025.
Description of Figure 22: A line chart for the 7-day rolling average of daily ED occupancy, in Wales.
Source: Digital Health and Care Wales (DHCW).
In the winter of 2024 to 2025, there were 51,790 ED attendances due to respiratory problems — significantly more than the previous two years (48,048 in 2022 to 2023 and 50,506 in 2023 to 2024). Of all ED attendances, 35% resulted in admission in a same or different hospital, 6% were discharged, and 45% required no follow-up [footnote 1]. ED attendances due to respiratory problems peaked at 343 in the first week of January 2025. This is consistent with trends observed in the previous years where ED attendances have typically peaked in the last week of December or the first week of January (with the exception of the pandemic years).
Figure 23: daily ED attendances due to respiratory problems scenarios, winter 2025 to 2026.
Description of Figure 23: A line chart showing projected daily ED attendances for respiratory problems in Wales from September 2025 to April 2026 under three scenarios: (severe, moderate, and low), showing potential variation in demand over time.
Source: Digital Health and Care Wales (DHCW).
To create scenarios for ED attendances, the following statistical techniques were used:
Table 6: names of ED attendance scenarios and the statistical models applied:
| Scenario Name | Technique |
|---|---|
| Low | SARIMA |
| Moderate | ETS |
| Severe | Repeat of (2022 to 2023) data |
The low scenario estimates a peak of 264 ED attendances on 1st January 2026, while moderate and severe scenarios predict a peak of 312 and 417 ED attendances on 30 December 2025.
Footnotes
[1]. The following categories cover the remaining 14%: Self-Discharge, Referred - Other HCP (Healthcare Professional), (Unknown), A and E Follow-Up, Transferred Other LHB, Referred - GP, Died in Department, Referred – Outpatients, DOA (Dead On Arrival).