Two Point Hospital review

I have no idea what working in a hospital is like, but if you’ve worked in any of the ones I designed in Two Point Hospital, you would be suing me right now. With long queues, cold rooms and tired staff, I was never destined to be a great businessman, but I like to think I learned a lot from my time as medical administrator.

Two Point Hospital is the spiritual successor to Bullfrog’s 1997 simulation Theme Hospital. Being developed by several members of the original team, the game carries over many of the same mechanics and themes as you aim to design and run profitable hospitals that will cure fictional comical illnesses. Along the way, you’ll also be caught up trying to keep the place tidy as well as ensuring the staff and patients are all happy.

You’ll begin each stage by building a reception area and some basic diagnosis and treatment rooms. As the money comes in and the number of patients multiply, more advanced rooms will become available. Altogether, there are 15 hospitals and each one comes with a set of challenges and conditions to fulfil. One might be located in an extremely cold area, so placing radiators is a must, whereas another may be prone to earthquakes, in which case keeping the equipment in top shape is the key to success. Progressing through a stage will allow you to win stars, rewards that will unlock further levels.


Aside from stars and the general cashflow, you will also earn a currency known as kudosh, which can unlock new items to be placed within rooms and hallways. Constructing rooms follows the same general principle as Theme Hospital, in that it snaps to a grid, but it has also been expanded to allow more unconventional shapes and fittings. You can then place down objects like bookshelves, plants, radiators, and fire extinguishers, with each one serving a specific purpose. Adding these also increases the prestige of that particular room which will increase your hospital’s reputation and bring in more patients.

I really liked how well this mechanic was translated into a 3D environment, and I think in general the game is most impressive in the way it has transformed from  the 2D sprite graphics of Theme Hospital to work in three-dimensions. Patients moving down corridors now have to get around each other and form queues, something easily done in an isometric 2D engine but a bit trickier when working with 3D. Technical Director Ben Hymers commented on how modern technology allowed them to enhance the experience in an interview with GameWatcher: “having a modern game engine has done nice things for animation quality, such as interesting machine effects. It’s no longer limited by silly memory constraints, such as changing screens at two orientations because there’s only enough memory for animations to use them at two. “

Just like in Theme Hospital, you have a team of staff that you need to manage. Across your career you’ll hire doctors, nurses, assistants and janitors that each come with their share of contributions to the hospital. Doctors and nurses require the most attention as they will be required to diagnose and cure patients, but the assistants and janitors also play a pivotal role in running the hospital. It did, however, frustrate me at how much micro-managing they require. You’ll be getting constant pop-ups that a staff member wants a raise or training, and will threaten to quit if those needs aren’t satisfied. It eventually begins to feel like you’re babysitting these people and it detracts your eye away from other parts of the hospital. And worse yet, these complaints aren’t easily remedied. I had one staff member complain about being too thirsty, despite me placing down water fountains and vending machines in every corridor. Another moaned about being desperate for the toilet, yet they were on a break and within an astonishingly short distance from the nearby restroom.


Reputation is also an important aspect of playing Two Point Hospital. Having a high cure rate and looking after your patients will increase your reputation and thus bring in more buzz to your hospital. This feature mingles well with the monetary side of the game. If your reputation falls, so do the profits. In my playthrough, I underestimated how valuable money was. At one point, I was sitting on $800,000 after a couple of years of running the hospital. I hired a few more staff, made a couple of upgrades and handed out some promotions. About a year after that, I was plunged into the negatives and my reputation fell quickly. It sounds frustrating but I think this was where the real challenge of Two Point Hospital shines. The sandbox elements of the game provide the fun but the developers really want to keep you engaged at all times not unlike a real hospital environment.

One thing I found really interesting was how Two Point Studios implemented a multiplayer component into the game. Theme Hospital had this system where you would be competing with rival hospitals for higher cure rates and profits, but Two Point Hospital takes the concept further and actually has you competing with other players’ hospitals as well as setting each other challenges. I thought it was really cool that I’d be trying to cure as many patients as possible only to be told someone on my friends list has managed a better feat. It brought out the competitor in me, and ultimately drove me to do better.

Despite the amount of polish, there also seems to be a large share of glitches. I ran into a particularly nasty one where several patients became stuck and would not move even when I tried sending them home. They stayed in place for the many years the hospital was open, complaining about being hungry and bored, and this ultimately drove down my reputation and knocked a severe dent into my progress. There’s also the annoying habit of patients queuing for a GP appointment and then going off to fulfil one of their other needs such as eating or using the restroom, allowing the queues for these rooms to build up and become overwhelming. I know for a fact that if I had a doctor’s appointment at my local GP but decided to use the toilet instead, I’d be ignored and would have to rebook it.


While it isn’t perfect, there is a definite sense of evolution going on with the game. Business management sims come and go but none have really outlasted the times quite like Theme Hospital. I was overjoyed to see how well Two Point Studios had managed to adapt the game for a modern audience and I’m pleased to see it’s a hit with players. It has the perfect understanding of how a hospital simulation should play, achieved through its use of humour and time-sinking emergent gameplay. If anything, it has reinforced my respect for the real-life NHS heroes that work day-in, day-out. It feels like Two Point Hospital came along at the right time, and that’s wonderful.

Tested on PC
Developer Two Point Studios
Publisher SEGA
Price £24.99


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