Devlog · 3 October 2026

The City Hospital opens its doors

The second walk-in venue is the City Hospital. Like the Police HQ, it is a single special site that makes the ordinary buildings around it work better, and you can step inside to run it. Unlike the HQ, it has to cope with something you do not control: illness, which rises and falls with the state of your city.

Strengthening the care you already have

The City Hospital unlocks with A skyline of our own and you can build one. It coordinates your existing hospitals and clinics: linked ones send ambulances up to 3 tiles further and share ward capacity, so they can look after more residents. How many facilities it can coordinate grows with its residency programme. Every hospital and clinic shows in its inspector whether it is linked and, if not, why, along with a button to visit the City Hospital.

Twelve teams, six departments

You assign 12 clinical teams across six departments, and as with the Police HQ every choice weighs today against later:

Emergency (A&E) sees accidents, extends ambulance reach and cuts casualties when disaster strikes.
Wards handle admissions and add shared capacity.
Surgery works through the operations list.
Maternity and paediatrics deliver babies and make the city more appealing to families.
Public health contains outbreaks and, over months, builds up prevention that makes illness and outbreaks less likely.
Residency trains new doctors, raising performance, the number of linked facilities and the city's skills.

Patients come from the city

The number of patients arriving each day is driven by what is happening in your city. Emergency cases rise with traffic, industry and crime. Ward admissions rise with air pollution and in winter. Disasters and outbreaks add more on top. If a department cannot keep up, a waiting list builds; leave it too long and patients give up and are turned away, which hurts satisfaction.

This links the hospital to the rest of your decisions. A city that cleans up its air and calms its traffic will find the hospital under less pressure, which is the kind of knock-on effect that makes a city builder interesting.

Outbreaks

Occasionally an outbreak begins. They are rare, more likely in winter, in smog and where prevention is low, and only affect cities of a reasonable size. An outbreak spreads from district to district; public-health teams, prevention and a targeted campaign in one district all slow it down. It ends either contained, if it reached only a couple of districts, or burnt out. Bulldozing the hospital will not make it go away: an outbreak that has started keeps going, now unchecked.

Walking the wards

Entering the City Hospital replaces the map with a 3D cut-away of the building: wards with beds and monitors, an operating theatre, maternity, a pharmacy, the waiting room with its live A&E board, and the emergency department itself. Staff appear according to how you have allocated the teams, and patients come from the day's flow, so a struggling hospital looks it, with a full waiting room and red alerts during an outbreak. Ambulances go out with their blue lights on, and an air ambulance uses the helipad when A&E is well staffed.

The hospital has its own computer, Ward OS, with apps for departments, patients, the network of linked facilities, reports, and two mini-games:

Triage, a timed shift in which you read each patient's complaint and vital signs, set a priority and send them to the right department.
Containment map, a short puzzle played during an outbreak: vaccinate a few blocks each round to stop the illness spreading through a district.

Sharing the venue kit

The hospital is built on a shared venue kit taken from the Police HQ: the same people, furniture, materials and day cycle. The kit gained medical outfits, wheelchairs and hospital beds along the way, and improvements to it show up in every venue. Inside every venue, the lights now stay steady at all hours while only the world outside follows the clock, which fixes rooms that used to dim at night.

The venues guide explains how the hospital fits alongside the other walk-in buildings.