Holby fictional hospital within the city in which "Casualty" and "Holby City" are set. It is based on the Bristol Royal Infirmary which the original script writers spent time observing in the 1980s in order to garner ideas for "Casualty". Although both shows are set in the same hospital, "Casualty" is primarily filmed in Cardiff, whilst "Holby City" is filmed in Hertfordshire at BBC Elstree Centre. The indoor shots for the first series of "Casualty" were filmed at BBC Television Centre in London. The exterior shots of the hospital used in "Casualty" were formerly filmed at the City of Bristol College;
University Hospital Lewisham on the roof. In 2012, architects AWW worked with the hospital to re-plan five wards and medical facilities whilst maintaining the Emergency Department. The expanded facilities improve efficiency with the addition of a new Children's Emergency Department, Urgent Care Centre and new emergency x-ray facilities. In July 2012, South London Healthcare NHS Trust was put into financial administration. A government report in 2012 recommended that three SLHT hospitals should be taken over by nearby NHS trusts and that the University Hospital Lewisham Accident and Emergency unit should close, with A&E patients instead going to the SLHT-run Queen Elizabeth Hospital in