England play their opening World Cup fixture tonight, and while millions of supporters settle in front of screens across the country, NHS emergency departments are preparing for a pattern that health officials know well: a fall in attendances during the match, and a climb once it ends.

Analysis of emergency department data from Euro 2024 found that attendance dropped by nearly 17,000 below expected levels across England during matches involving the national team. The group-stage opener against Serbia produced the sharpest fall, with attendances running 8.8 per cent below the six-week average for equivalent periods. The quarter-final against Switzerland and the final against Spain also saw significant declines, of 5.9 and 5.7 per cent respectively.

There is a regular pattern to the timing of these dips. The steepest point comes in the hour before kick-off, when departments see roughly 11 per cent fewer attendances than normal. Weekend fixtures produce larger falls than midweek ones, suggesting that when football competes with leisure time, fewer people are willing to interrupt their plans to seek medical care.

What follows the final whistle tells a different story. Across the eight hours after each match, emergency departments recorded hundreds of additional attendances above expected levels. Trauma and musculoskeletal injuries accounted for a significant portion of that rise, up by around 10 per cent compared to the average. These injury types are consistent with falls, physical altercations and the kind of incidents that accompany large gatherings in public spaces. The busiest post-match period was between 1am and 2am, when admissions ran 6.3 per cent above the norm for that hour.

In addition to the post-match surge, what may have been postponed during the game itself is a clinical worry. People who put off seeking care can arrive in a more serious condition than they would have done had they gone earlier. Emma Rowland, NHS England's National Clinical Lead for Urgent and Emergency Care, was direct on this point. "We know that the World Cup is a highlight in any football fan's calendar, but even the most die-hard supporter needs to ensure they put their health first and seek emergency treatment when they need it," she said. She confirmed that services will remain fully operational throughout the tournament, including through extra time and penalty shootouts.

The public health guidance from the NHS is straightforward. Anyone facing a genuine emergency should call 999. For everything else, 111 by phone or online remains the appropriate route. Officials have been careful to avoid suggesting that fans should simply ignore their health for 90 minutes. The concern is with those who delay care for longer, or who seek it only after a night out has produced its own consequences.

The tournament runs for 32 days. If England progress beyond the group stage, the number of fixtures, and the emotional and social intensity surrounding them, will increase. Health services are not expecting tonight's match to produce anything they have not seen before. The data from Euro 2024 exists precisely so that departments can plan around it. What officials cannot fully control is how many people choose to weigh a match against their own medical need, or how many walk out of a fan park at midnight having sustained an injury they ignored for the previous two hours. The pattern is well established. Whether fans change their behaviour in response to it is another question.