Two Point Hospital: Bigfoot & Pebberley Island DLC Review

When we reviewed Two Point Hospital in September last year we came away happy knowing that the spiritual successor to Theme Hospital kept the fun and the spirit of Bullfrog’s original hospital management sim. We’re now almost a year on from its launch and in that time two expansions have been released — Bigfoot in December and, more recently, Pebberley Island in March this year. Both expansions add three new hospitals to manage with a plethora of new illnesses to treat and plenty of new treatment rooms to match.

Starting off with Bigfoot you receive a letter from reclusive celebri-yeti, Bartholomew F. Yeti. Having successfully petitioned for better healthcare in the unloved and secluded Pointy Mountains, it is now your job to bring modern healthcare to the region. Your first port of call is the Underlook Hotel. With barely a few rooms and a fracture clinic in situ, your task is a simple case of modernising and bringing in further diagnoses and treatment rooms. As you work away trying to keep ahead of the ever-increasing amount of patients the hotel this hospital is attached to will assign you targets. Complete them and you’ll get an bonus injection of cash which, if things are getting tight, can be of great relief.

It’s a nice little hook but of the three new hospitals the Bigfoot expansion offers, Swelbard offers the toughest challenge. As one of the most remote locations in the Pointy Mountains it doesn’t really attract the best staff. This forces you to rely heavily on training and, if you want to get even the first star, you need to keep your cure rate above 60%. This is easier said than done and requires you to focus on research alongside training so that you can build the required treatment rooms. This scenario really tests your mettle as it necessitates a delicate balance between training and staff numbers to make sure you don’t get overrun. At the same time, as your staff are completely untrained to begin with, deaths and unsuccessful cures are very high so clawing back the difference can be a tough ask.

Unfortunately, the final new hospital, Roquefort Castle is a bit of let down. The goals for each star just seem obtusely large with one hundred and eighty ghosts needing capturing in this haunted location as part of your one-star requirements. They’re a bit of a slog and suck some of the fun out of planning and building your hospital up. As a trio all three new hospitals are very much more of the same with only Swelbard offering up something of note.

As we put the Pointy Mountains firmly in our rear-view mirror we then moved on to Pebberley Island after receiving a communique from Wiggy Silverbottom. In his quest to discover the secret of eternal life he asks you to help manage the hospitals that are uncovered along the way. Starting off with Pebberley Reef, the new, sunnier climate makes its presence well known since our hospital looks more like a resort than some manically mismanaged excuse for healthcare. It’s a place one imagines that would be popular with celebrities but then again, one visit would be all it would take for them to realise their mistake.

Our mismanagement aside, there are also some interesting weather events from lightning strikes that cause fires, to raining down frogs and tornadoes. Each can damage equipment and litter your hospital but with plenty of janitors on hand they become less of a worry with the exception of fires. Since they require extinguishers to get rid of them, a janitor uses one and then it is discarded and not replaced — as per the law. Should you forget to replace it, the next time a fire starts nearby you’ll need to place one again for a janitor to use it. Whilst it’s not exactly difficult to do, it’d be nice to have the option to have your janitors replace them with a toggle to turn it off should you be strapped for cash.

Once you’ve managed, or mismanaged your way to one star you can then move on to the first of two interesting twists Pebberley Island brings to the usual Two Point Hospital formula. Generally speaking, most hospitals within Two Point County have a few surrounding plots you can buy to expand your operation. With Pebberley Island’s second hospital, Overgrowth, you need to fulfil challenges in order to claim back the area from the wilderness that has reclaimed it. As you do you’ll need to quickly build into them to meet the increasing demands and it’s not as easy at is seems. Overgrowth was the first time we really struggled to make a profit and had to regularly take out loans to bridge the gap as we tried frantically to complete the challenges.

It’s a mode that forces you to think and plan ahead as a badly laid out hospital really can cause issues since patients have to wander to get to their appointments and, if there aren’t enough GP offices for example, queues start to form delaying diagnosis. The fewer patients you churn through and, hopefully cure, the less money you make and it’s deceptively easy to mess things up quickly whilst managing the Overgrowth level. Should you struggle here then Pebberley Island’s final hospital, Topless Mountain, will seriously challenge your abilities.

Built on the flat plateau that used to be a peak, the hospital at Topless Mountain introduces a new game type that I hope reappears or, even better, could spawn its own mode within Two Point Hospital. Given its remote location, tourists who have gotten sick on the way up tend to come to the hospital all at once in waves. These waves increase in their size and difficulty and each one has cure targets and so on to hit. It’s essentially a horde mode for hospitals and it’s really rather fun. The layout of your hospital needs to be spot on and keeping your staff in the right places is important as the more suited to their role they are they higher the chance of curing your patients.

It’s a fun mode and in a way is a tough but interesting way to stumble on and learn better methods of laying out your hospital. We built ours knowing that we needed to be quick with diagnosis so loaded up the entry to our hospital with two GP offices, our General Diagnosis room, a Cardiology department and they then flowed into our cure rooms which we built on demand. Our only struggle was that our staff wandered when they had no patients to cure, but as things intensify this stopped being a problem. You also need to keep an eye on their motivation and make sure they take breaks at the right time, as staff out of position at the wrong time can really make a wave hard to survive.

Both Bigfoot and Pebberley Island add enough unique illnesses and challenges to test even the most seasoned hospital managers among us, especially the horde mode. Whilst Bigfoot feels like more of the same, Pebberley Island’s Overgrowth and Topless Mountain bring in some new ideas we hope to see adopted in any further expansions. Both expansions are available relatively cheaply, so if you’ve grown tired of the sandbox mode or wish to challenge  yourself on new levels then they’re definitely worth your while. However, if we had to pick just one of the two then ours would be Pebberley Island owing to its three very distinctive levels.