Two Point Hospital Xbox review: Addictive, hilarious, with great controls

Two Point Hospital has already proven itself on PC, winning high praise on Steam and other platforms. The simulation game that takes cues from Theme Hospital of yore is all about healing patients, keeping them happy while managing budgets and the training, hiring, and firing of your personnel.

In a game that was designed firmly for mouse and keyboard, I was curious as to how well it would handle on Xbox One, given that so many simulation games tend to struggle with the transition to gamepads. Turns out that, Two Point Hospital thoroughly nails it, and then some.

An addictive, rewarding, and immersive sim

Two Point Hospital throws you into the deep end of the hospital administrative process, although it does give you a wealth of training and tutorials to help you prepare.

Two Point Hospital has a series of levels with unique modifiers and challenges. Some hospitals will be specifically cold, requiring additional expenditure on heating. Some will be training hospitals, requiring you to train up staff from scratch, researching your own cures, and so on. Each level comes with a star rating of up to three for completionists who produce the most effective and efficient hospitals.

Most levels give you a blank building to play with, with the option fo expanding to additional sites as you grow. The game doesn't have any real-world illnesses. Instead, it focuses on more comedic tones with diseases like "Jest Infection," by which the afflicted think they are clowns and mimes. Curing them involves unique psychiatry buildings and "de-humorifier" facilities, which can also be upgraded and improved with research.

Investing in staff is also massively important, making sure they have rest and relaxation facilities, as well as frequent promotions and pay rises to offset increasing workloads. The game gives you a wealth of data via information panels to help you improve your efficiency and effectiveness, as you improve staff conditions, address heavy demand for specific illnesses, and so on.

On top of the in-game progression systems, there are also career challenges that award "kudosh," a currency that can be used to purchase flavor items like better plants, decorations, and cosmetic facilities for your hospitals. Some of these have a gameplay relevance too. The Sega arcade machine, for example (awesome), can improve your patient's happiness rating. Waiting around to see a doctor can get boring, after all.

Deceptively tough, laugh-out-loud funny

The first two levels were straight forward and easy enough, but the difficulty ramps up fairly quickly. Handling the influx of patients can be daunting, and if you're not keeping on top of your budgets, it's very easy to slip into debt and eventually go bankrupt.

The game's performance is truly impressive on the Xbox One X, running at 4K with hundreds of unique patients on-screen at any one time. Simulation games often start to drag in late-game scenarios as more and more units appear on-screen. Two Point Hospital sidesteps the issue with its efficient engine and, perhaps in part, stylized art, which is as funny as it is vibrant and attractive.

The game also has some surprisingly great writing, with sardonic announcements via the hospital's speaker system, and radio show clips inter-spliced with some genuinely laugh-out-loud commentary. The studio is made up of staff from (sadly closed) British studios Lionhead and Bullfrog, among others, and the Brit-sarcasm permeates throughout the whole game. It's as funny as it might be nostalgic for fans of Lionhead and Fable.

The only criticism I can really leverage at the game is that it can be challenging to track and trace down the exact reasons your hospital is failing, at first glance, at least. Knowing where to make those efficiency tweaks and which strategies to emphasize per level can be a bit confusing, but on the flip side, it's what gives the game a sense of challenge many simulation games all too often simply lack.

One particular area of concern I had about Two Point Hospital going in was the control schemes. Many simulation games struggle to make the transition from PC to console when it comes to gamepad controls. Two Point Hospital nails it, though. It's easy to zoom and pan using the triggers and sticks, and large on-screen control cues let you know what you can do and when, very clearly. It wasn't long before the control schemes slipped straight into my muscle memory, and I stopped referring back to the on-screen prompts entirely.

Should you buy Two Point Hospital?

When we reviewed Two Point Hospital on PC last year, problems with Denuvo DRM on PC and some bugs dragged the score down a bit, but we're approaching two years on from that original launch. Sega and its teams have polished up the Xbox version to a mirror sheen.

On Xbox One, there's very little to fault about the game, particularly since it's also heading to Xbox Game Pass on day one, giving it some seriously incredible value.

It nails its humor, the art style is vibrant and interesting, with tons of hidden character interactions and easter eggs as you watch your patients and staff scurry around. The simulation is deep and rewarding, and the performance on Xbox One is impressive across the board, even in the sim's hectic late-stage play. The gamepad controls are also top-notch.

If you're an Xbox strategy and simulation fan, Two Point Hospital will become your new addiction.