We're in the final week of Skeleton Appreciation Month, so that means that all your games are getting dressed up for Halloween. The latest to don a pumpkin-headed costume is Two Point Hospital, the extremely British comedy healthcare management sim. Admittedly, it's re-using last year's costume—reprising the Spooky Mode event from 2018— but sweetening the deal by slashing gory chunks out of the price until the 28th.

Spooky Mode gives the game a seasonal makeover, with moodier lighting, swarms of bats added to some maps and a new ailment to cure: fright-headedness, a pumpkin-flavoured version of the admittedly more punny lightheadedness illness. There's also a new Halloween-themed soundtrack and a bunch of revamped (emphasis on vamp) decorative items to spook up your halls, as if hospitals weren't terrifying to be in already.

Two Point Hospital is a minor favourite around here. Doctor Fraser Brown was very impressed with the game at launch, and while I felt that it played it a little safe and too close to the Theme Hospital's design, free updates and paid expansions (adding Bigfoot, aliens and tropical plagues to the mix) have gone a long way to making it feel fresh again. As a fan of terrible puns, I must give credit to Two Point Studios for making the majority of illnesses utterly groan-worthy.

Because Valve wouldn't let them use 666 or 66.6, Two Point Hospital is only 66% discounted on Steam until October 28th, but that's still the cheapest its been. The main game costs £8.49/€11.89/$11.89, and the Healthy Collection (including all three expansions) is £21.15/€28.12/$28.12.

Silly medical management sim Two Point Hospital continues to expand in weird and wonderful ways. Yesterday, its third major chunk of DLC, Close Encounters, landed in stores with an meteoric crash. As the name suggests, it introduces all manner of extraterrestrial weirdness to the already bizarre game, with three high-tech new hospitals to run, new patients to treat from way out of town, and thirty-four new illnesses to cure.

As usual, Two Point Studios' pun game is on point. You'll have to treat aliens and astronauts alike for cases of Science Friction, Aller-Gs and Lack Of Humanity. Eleven of the illnesses have external symptoms for extra sight gag fun, and there's three new curative machines to build to hammer the misshapen patients back into shape.

That's all well and good for existing players, but newcomers have a few extra options too. There's a free weekend running until next Monday for the main game, and they've halved the price on a bundle with the main game and the previous two expansions (mountain and tropical-themed, respectively), which is nice.

It's well worth taking a look, too. Fraser Brown found its brand of Theme Hospital-inspired nonsense to be highly infectious when he reviewed it last year, and between patches, expansions and likely future support (thanks to Sega snapping up the studio) it's only likely to get better.

Two Point Hospital is free to try on Steam until Monday, September 2nd, and half price if it tickles your fancy. The Close Encounters DLC is also on Steam for £6.29/$8.09 after the 10% launch discount.

Two Point Hospital developer Two Point Studios is now a part of Sega, which announced today that it has acquired the studio after working with it as a publisher for more than two years. Sega said the acquisition is the first to come about as a direct result of Sega Europe's Searchlight program, which seeks out and supports "exciting new development talent" and games.

"We’re delighted to welcome Two Point Studios officially in to the Sega family. As a relatively new, British-based developer with a global hit already under their belts, we knew we had to move quickly on this deal because they are an extremely attractive investment proposition with a great deal of talent," Sega Europe president and chief operating officer Gary Dale said. 

That's technically true—Two Point Studios was founded in 2016—but co-founders Mark Webley and Gary Carr have been working together for more than 20 years on games including Theme Hospital, Black and White, and the Fable series. Two Point Hospital, released in 2018, is a spiritual successor to the first game they worked on together, and it's exceptionally good: "A brilliant management game," we said in our 87/100 review, even without the benefit of nostalgia. 

"It’s a landmark step for Two Point Studios and we’re thrilled to be joining the Sega family. We’re looking forward to executing the next phase of our plans as we continue to evolve Two Point County," Webley said. 

"It’s a hugely exciting time to be a part of Two Point and we are here today thanks to the hard work, passion and dedication of our small, but amazingly talented team here in Farnham and the incredible fans that have supported us throughout and guided our continued development of Two Point Hospital." 

Two Point Studios added a new co-op challenge mode to Two Point Hospital in the free Superbug Initiative update, released last month. It's also working on "several exciting unannounced projects" that will be revealed over the coming months.

Hectic hospital sim, Two Point Hospital, is getting the Superbug Initiative, a new co-op feature, as a free update arriving April 30 on Steam. 

You can check out the trailer above to get a look at what it's all about and there's good news if you don't want to wait; you can try it out today by heading over to your copy of Two Point Hospital on Steam, locating the 'Properties' tab, and selecting the beta branch.

The Superbug Initiative lets you play with friends and work together to complete various in-game challenges. You'll be rewarded with 'cutting edge' technology and rare items, which should make your hospital run smoother. More challenges will be added with further updates, following the initial launch of Superbug Initiative.

If you've yet to play Two Point Hospital, which launched last August, it's a building management sim which requires you to design and staff your own hospital and research cures to various illnesses—and hoover up the ghosts of any patients you don't manage to save. If you're curious to know more, you can check out Fraser's review.

Two Point Hospital, normally a bastion of cleanliness, has unfortunately become infested with Half-Life headcrabs. They're not the only things sneaking in from other games, either. Total War: Three Kingdoms, the Endless series and Football Manager 19 have all inspired objects that you can now plonk down inside your hospital. 

You can spruce up your rooms with football pitch rugs, arcade cabinets and some lovely new wall art. The headcrab, meanwhile, latches onto its victims, engulfing their heads. Thankfully, they can be yanked off by trained professionals, leaving the patient free from their nightmarish skull prison. 

Even if you don't own Two Point Hospital, you can still check out the new illness and guest items for yourself, as it's hosting a free weekend on Steam. It will run until 5 pm GMT on Monday. If you fancy keeping it after the weekend, it's be 33 percent off. Other Sega games are on sale, too, discounted by up to 90 percent. 

The new Pebberley Island DLC launches on Monday, as well, tasking hospital administrators with building in a hostile jungle and helping an eccentric explorer discover a spring of immortality. 

Two Point Hospital's new DLC sees you committing medical malpractice on the tropical paradise of Pebberley Island, home of many weird diseases—including one that turns its victim into colourful birds—and opportunities to make a quick buck. It also hides a spring of immortality, and you'll need to sterelise a path to it for Wiggy Silverbottom, a courageous explorer whose only weakness is germs. 

Pebberley Island looks like a perfect spot for a holiday, what with its lovely beaches, interesting ruins and the promise of immortality. Unfortunately, there are also 34 new illnesses to fight, dangerous weather and an overgrown jungle that's apparently sentient. It might not take too kindly to you plonking a hospital down in the middle of it. 

I'm not sure if immortality is really a good thing if you depend on cash from sick people. Eternal life means you get your patients for a lot longer, but if they don't need to worry about dying, do they really need doctors and nurses? Maybe we'll get a chance to destroy the spring. Despite being all about private healthcare, Two Point Hospital isn't normally very cutthroat, but what happens on the island stays on the island.

Pebberley Island is due out on March 18. 

A free update has hit Two Point Hospital that lets hospital administrators finally add some custom touches to their rooms, including rugs, paintings, floors and walls. If you don't have time to make your own stunning wallpapers and awe-inspiring portraits, you can just download them from the Steam Workshop. If you do want to stretch your creative muscles, however, Two Point Studios has put together a quick video to get you started. Check it out above. 

Clicking on a room now will give you the option to look through a list of existing custom elements. To make something yourself, the process is thankfully hassle free. You can just add files from your hard drive in-game, add a cost and, if you fancy, a description, and that's you done. 

Adding custom pictures and rugs is a bit more involved, but still relatively painless. You need to select size and shape options first, but otherwise it's as simple as once again uploading an image and then adding it to the room you want to brighten up. Two Point Studios has provided some recommended image sizes, too. 

I've not visited my hospitals in a wee while, but they probably could do with a makeover. Not surprisingly, I plan to fill them with pictures of my dog. That should cheer up anyone on death's door. 

The interior designer update is out now and, conveniently, Two Point Hospital is 20 percent off for the Lunar New Year Sale. If you're on the fence, check out my Two Point Hospital review. It's a great management romp, even if you've not been pining for a new Theme Hospital. 

Hospital management simulation game Two Point Hospital gets its first DLC expansion today, called Bigfoot. As the trailer above illustrates, it features three new hospitals to sort out and 34 new illnesses to cure. It costs £7/$9.

Alongside those new challenges, you'll get a bunch of winter-themed items to outfit your hospitals with. In the fiction of Two Point Hospital, Bigfoot goes by the inconspicuous name Bartholomew F Yeti, and he's lobbying for better healthcare in his home of Pointy Mountains. The new hospitals include Underlook Hotel, which suggests something of a The Shining vibe—Sega says it's rife with lawsuits. There's another at a run-down research institute, and one more set around an aristocratic's fancy castle. 

New illnesses include Aurora Snorealis (at this time of day, in this part of the country, etc), Bard Flu, and Cold Shoulder, all of which sound better than the actual chest infection I caught last winter. The DLC should be out as you read this.

Here's what Fraser had to say about Two Point back when it was released this summer. "While Two Point Hospital does cover a lot of familiar territory, it doesn’t feel like it’s been rudely dragged out of the ‘90s. If you’ve been offering up stethoscopes to Hippocrates’ ghost for a new Theme Hospital, you’ll find it here; but if you’re not craving that fix of nostalgia, Two Points Studios’ spiritual successor will still keep you up to your elbows in corpses and icky illnesses until the wee hours of the morning."

Two Point Hospital debuts its Sandbox: Freeplay mode at TwitchCon today, which will roll out to all players next week. 

Marked as the "first in a line of planned Sandbox updates for Two Point Hospital", Sandbox: Freeplay lets players rename hospitals and unlock every option—which allows you to "make it rain", so tells the narrator below.

As outlined in the video above's description, Sandbox: Freeplay is unlocked by playing through the main campaign's first three levels. After that, you're free to craft sandbox hospitals in any of the game's 15 levels. 

"Whether you’re a malevolent god or a beneficent sky being, use your unlimited cash and Kudosh to affect everything within your sandbox hospitals," says publisher Sega. "Don’t want any epidemics? Turn ‘em off! Don’t want to see any queues ruining the aesthetic of your perfectly designed Healthcare Empire? BAN THEM! And, to continue our recent customisation theme, you can also rename any of your hospitals to whatever you like."

And on top of all that, Two Point Hospital is also running a limited-time Halloween event. Expect a new disease named Frightheadedness and a "spooooooky" soundtrack, among other things. Check-in and check-out between now and next week. 

There was ectoplasm everywhere. The only janitor was engaged in a battle of wits with a clogged toilet, and he wasn’t winning. Nearby, a queue of sick people relieved themselves in the corridor. Outside the doctor’s office, patients had been waiting for over a year; they too were relieving themselves. I couldn’t afford more staff, and even with my skeleton crew I was hemorrhaging money. I wouldn’t have to worry for too long. My plummeting reputation would ensure that I’d stop getting patients eventually. Two Point Hospital’s Duckworth-upon-Bilge, one of the management game’s trickiest missions, is my white whale. Hopefully you can learn from my mistakes.

Achieving the coveted three-star rating in every one of Two Point Hospital's chaotic missions can be a meaty challenge, but if you just want to muck around, curing fictional illnesses and abusing clowns, you can muddle your way through the game without encountering too many road bumps. Netting your first star in each hospital is the easiest part, and that’s all you need to move onto the next mission. Duckworth-upon-Bilge, a struggling public hospital, is an exception, and if you're looking for specific or general advice, the lessons I learned there should help you improve your administrative chops.

Making money 

Cash flow is Two Point Hospital’s main safety net. Whatever disasters might befall you, a fat bank balance will usually help you make a startling comeback, and you’ll rarely be short of cash. Patients have to pay for their treatments even if you’ve done a terrible job, and the whole time they’re waiting to be seen by the doctors and nurses, they’re spending money in cafes and newsagents.

There are countless ways to inflate your bank balance. If you’ve got your eye on a gold-plated swimming pool, you might want to start filling your hospitals with vending machines full of salty snacks, placing them near your pricey drink vending machines. For an initial cost, marketing campaigns can also make a huge difference, turning your hospital into the place to be if you’ve got Mock Star or Night Fever or whatever weird ailment you want to focus on. As administrator your job is equal parts accumulating wealth and making sure your staff are curing people on death’s door. And throughout the missions, the game reinforces this, giving you more ways to get fat off your patients’ wallets. Duckworth-upon-Bilge sets fire to this safety net. 

Balancing your budget

Patients visiting Duckworth-upon-Bilge don’t have to pay a penny for their treatments, and even the vending machines are free. Every little trick to bleed these people dry ceases to work the moment you take over. So while you start with a healthy bank account, that rapidly shrinks, and beyond taking out costly loans, there’s not much you can do from stopping that. Instead, you’ve got to hit public targets—essentially an extra set of challenges—netting you a cash reward. This is on top of doing the regular challenges and completing the mission goals, as well as trying to make sure your hospital doesn’t burn down.

It’s a functioning hospital right away. Sort of. The basics are all in place for diagnosing patients, and some staff are already working away. It looks quite nice, too. Instead of pokey little boxes, the rooms are spacious and stylish, with props and extra items adding a bit of personality to them and increasing the prestige of the hospital. So much for all that. When you’ve got money to burn, large, well-decorated rooms are a luxury you can afford, but in an underfunded public hospital where you’ll see more puke than cash? Start shrinking them down to a more reasonable size. 

I got too attached too soon, building on the broken foundations instead of actually getting stuck in and fixing the problems. Then I expanded quickly, squeezing a few small rooms into the first building before dumping a big wad of cash on a whole new wing. I burned through my initial budget in a flash, and while the rewards from meeting public targets initially kept me above water, my costs were getting out of control. 

None of this is to say that expansion shouldn’t be a priority. As a general rule, you should always be looking to add new rooms and staff, along with improving existing ones, to raise your hospital’s level. This is even more important in Duckworth-upon-Bilge, as the prerequisites for your first star include reaching level 8 and increasing your reputation, both of which mean more rooms and more treatment methods need to be plonked down.

So while you’re doing a reshuffle and a renovation, maximising the space of your first building, you should also be looking towards the future, to what you can do with all this extra space. You don’t want to be too merciless with the demolition, though. You might look at the staff room and wonder if your doctors, nurses and janitors really need all that leisure time, but another mission prerequisite is keeping morale high, so you can’t ignore your hospital’s attractiveness or ancillary rooms. It’s worth going through the staff list to see what their top complaints are. You don’t need to tackle all of them right away, so you should prioritise the ones that are genuinely unhappy. Spending your meager funds on props might sting, but it’s a lot cheaper than doling out huge raises to staff who are threatening to quit. The key is balance. You should build nice rooms that people want to work in, but they should be compact.

Build a training room first

The first room you should build is the training room. You start with two doctors, but both of them are crap. You’ll also only have room for one of them until you build another GP’s office, or any other room that requires a doctor. For reasons that I confess I’ve entirely forgotten, I put both of them into a general practice training programme at the same time, leaving my hospital entirely absent doctors. It should go without saying: don’t do that. On my second attempt I considered firing one of them, but it’s not worth the brief savings. You’ll need a psychiatrist for both diagnosis and treatment, a second GP and eventually a doctor to run the Resolution Lab. It deals with a new illness sweeping through the area, pixelating unsuspecting people. The jobs start piling up at an alarming rate. 

Find your bottlenecks

Turning away patients is a great way to tank your hospital’s reputation, so there’s a constant pressure to invest in more expensive facilities. You absolutely don’t want to go whole hog, however, slapping down new wards and treatment rooms full of pricey (and not remotely safe) doohickeys. If you’ve built your diagnosis rooms, you’ll be able to see what illnesses are more common, letting you build rooms only to deal with the big ticket ailments. Yes, it’s very sad that Dave Casserole’s head has shrunk, turned green and sunk into his neck, but if he’s the only one, he’ll have to wait.

If you’ve got treatment rooms that aren’t being used very often, you might be tempted to chuck them and get rid of the staff members running them. That could be the ruthless decision that keeps the hospital running for another year. When I noticed a doctor had only seen a handful of patients, curing only one of them, in 10 months, I was ready to give him the boot. So I did. I demolished the room, too. The next week I parted with 30 grand for a new room and another three to recruit a doctor to run the place. The dearth of patients, it turned out, was due to a blockage on the other side of the hospital. 

People were getting sent to the GP for a diagnosis, and that just became their life. Shuffling around hospital corridors, subsisting on snacks from vending machines, learning about the outside world from decade-old magazines—dozens of them were living like this for hundreds of days. So you might actually have a hospital full of people who need that treatment, but who instead find themselves waiting in purgatory, unable to even get a diagnosis. When there’s a blockage like this, GPs are almost always the source. It’s not their fault. Every patient visits the GP’s office, often multiple times, and queues are inevitable.

Even when you build your second GP’s office, the waiting area will keep filling up. You could buy a third, and if you’re in it for the long haul and aiming for a three-star rating, you might need to build a few more, but you really don’t want that drain early on. The list of rooms you’ll need to build and staff is long enough, and any additional doctors you hire will have their hands full. That’s why the training room is such a handy early investment. Get skills like motivation, which increases speed, and all the general practice and diagnosis skills. Once one of your staff has learned these skills from an expensive outside consultant, they can teach everyone else for free. 

The point of all this training is to make sure patients get sent to treatment as swiftly as possible. If a doctor fails to make a successful diagnosis the first time, the patient will need to go to another diagnosis room, where a nurse or a psychiatrist will take over. The patient will then need to return to the GP’s office, where the doctor will then choose the next step, which could be yet another trip to a diagnosis room, or maybe, finally, treatment. A well-trained doctor can sidestep all of that rigmarole, allowing the patient to go straight to treatment, then home. 

Micromanage where needed

Big queues mean there’s a greater chance of patients keeling over and dying. This is why I had that aforementioned ectoplasm problem. Fixing the source by training better staff takes time, but there are also ways to alleviate some of the symptoms. If someone’s health is dangerously low, you can bump them to the top of the queue using their chart. Duckworth-upon-Bilge is also a bit on the chilly side, so some radiators in the waiting areas are a necessity. Most missions have a temperature quirk, so you should get used to bringing up the temperature overlay and placing radiators or air conditioning units where people linger. 

Hit those public targets

While you’re busy fighting with queues, training doctors and pinching pennies, you still be beholden to your government overlords. The public targets are arbitrary tasks like generating 200 research points or unclogging eight toilets, and as your only source of income, you’ll want to do them all as quickly as possible. The 50 grand you get for meeting your targets won’t last for very long, turning Two Point Hospital’s normally easy-going pace (despite all the disasters) into a frantic dash. 

When you need to unclog toilets, fill vending machines, or some other kind of busy work to hit a goal, you don’t need to wait until they require maintenance. As long as they’ve not been filled up or unclogged recently, you should be able to order your janitors to get to work. With all the research goals, you’ll need a room for that, too. Keeping a research room running full-time shouldn’t be necessary, though. Since research is persistent, you can do it in earlier missions, letting you use Duckworth-upon-Bilge’s researcher as a surgeon, GP or some other role. Resist the temptation to do that with all of your staff, however. You don’t want your doctors and nurses running all over the hospital, jumping between jobs. Thankfully, you can control their assignments from the staff list.

Like the previous missions, everything from the hygiene levels of your hospital to the mood of your janitor still needs to be managed and juggled, and without cash there’s significantly less room for mistakes. The looming threat of bankruptcy means you’ll have to dig through the game’s menus and figure out how everything links together, creating a hospital that’s efficient, not just functional. It’s micromanagement intensive, but that’s when Two Point Hospital is at its very best, when it’s all about obsessing over nurse schedules and hand-crafting uber-doctors.