It feels like we passed the games set in World War 1 phase a couple of years ago, where Valiant Hearts: The Great War, 11-11: Memories Retold and Battlefield 1 took us into the heart of the conflict to somewhat educate on the sheer scale and impact of the conflict. Whilst all were very different in the way they presented themselves and the stories they told, none were solely focused around what could only be a horrific role as a battlefield surgeon. War Hospital is here to give you that perspective and there’s no shying away from the fact that it was brutal, tiring and a battle of attrition to keep soldiers alive. How then can a game instil the feeling of hopelessness, despair and futility that the skilled doctors and nurses faced on a daily basis? Well it can’t, really… but it can deliver a solid strategy game that tasks you with balancing the needs of the hospital, staff and community against the demands of the Front and repelling the invading forces. As with The Great War itself, it’s a constant fight to shore up defences, resources and morale, and that’s assuming something everything actually goes to plan.
Taking on the role of Major Henry Wells, a retired doctor conscripted to run a field hospital on the Western Front in France, your job is to build and manage a unit that will patch up the wounded, minister to the dying, and provide fresh cannon fodder to the lines and the British HQ. Setup in a bombed out French town and using the church as the surgical theatre, Maj. Wells is responsible for ensuring that all the right services are running and everyone in charge of them has what they need. Alongside the local issues, there’s a wider request from HQ to keep the Front fortified and prevent the enemy from taking over this key territory. It’ll be a thankless task and one that demands that you make tough decisions about how much food gets distributed, when people get to rest, and who gets to live or die. There’s never an easy answer in War Hospital, what seems like the logical decision may cost in the long run, especially if out of desperation you stray from a humanitarian response. A lot will be thrown at you, relentlessly at times, and keeping on top of everything is no mean feat.
The core gameplay loop of War Hospital is treating the patients that get delivered to the Casualty Clearing Station (CCS). This is where you assess the needs of each, assign them to a field surgeon and keep them stable until it’s time to operate. When the right surgeon is available they’re transferred to the Operating Ward to be seen to, then, assuming it’s all successful, they’re transferred to the Rehabilitation Centre. Each patient has a different level of complexity and operating time required, as well as risks of complication and failure. Occasionally there will be special cases where you’re requested to prioritise or treat differently, and those come with additional rewards or penalties depending on whether you deal with them in time. When someone makes it to recovery you get the option to choose where they go when they’re healed – back to the front, off to HQ, or discharged from service. With these decisions you’re effectively bolstering defences, adding currency to spend on upgrades, or boosting morale. The latter is massively important as low morale causes the staff to tire easily, increases the chance of operational failure, and ultimately causes a game over if it drops to zero.
With the ever present threat of attack – denoted by icons moving down the timeline at the top of the screen – you have to prepare and use the resources available to give you the best chance of making it through the next onslaught. The enemy are great at attacking the trenches, launching artillery strikes and dowsing the troops with mustard gas, so you’ll need to specialise in trauma and chemical treatments as well as the standard surgeries. Upgrading the War Hospital facilities and recruiting new staff is essential to providing the right level of service, and this is managed through combinations of the many “currency” types in the game. When you dedicate 8 boxes on the lower part of the screen to resources, you know you’re looking at some serious micromanagement of reserves. There are 3 types of medicine needed to treat patients dependent on the injury types; 2 types of HQ currency to buy items, upgrade buildings or recruit people; and 3 types of crafting resources that work into creating everything else that’s going on. The interlinking of them isn’t complex, though there are never enough of any single one, and the constant trade off can get quite frustrating when you’re flat out doing your best and it’s all going to Hell.
Of course, the low availability of anything you need is part and parcel of the simulation, so you need to consider carefully where you spend what you do have. Aside from surgeons you need nurses, medic teams, engineers and scouts… all of which need feeding. Get the right amount of food in production and there are no issues, but don’t have enough and you’ll be dropping to half rations and hitting the morale meter big style. Improving the different treatment centres and staff buildings can help, though mostly that’s around increasing capacities and enabling shift work, which is essential for stopping all your teams dropping down with exhaustion. The level of team management you have to get into is quite impressive, and when it’s running smoothly the challenge is quite enjoyable (which I know is morbid). However, things don’t run smoothly, and that’s down to the buggy nature of some elements. A good way into the game I ran across issues with medic teams not bringing soldiers in the from the trenches, and operated patients “disappearing” from the Rehabilitation Centre. Coupling these with morale dropping at very high percentages every few seconds and effectively War Hospital became unwinnable. As with most strategy games it’s not exactly a short time commitment, so there’s not much of draw to start again straight away to potentially hit the same problems. Despite some really good tutorials on the mechanics, there’s a fair amount needing piecing together as you play, and miss some of the cues and it does get very hard to figure out what the right approach is. Tiny text doesn’t help this either.
War Hospital looks good, sounds great, and delivers a decent experience of deciding where to focus efforts during combat to ensure a functioning medical facility. There’s nothing too unfamiliar for those who like the genre, and that makes it relatively easy to slip into and overlook the elements that aren’t explained in more detail. But, and it’s a big one, the feeling of it glitching and causing you to fail is a massive turn off. It’s one of those situations where if you’d cocked it up and spent all your resources on building an X-Ray machine to work on ballistic shrapnel and everyone inhales toxic gas, you understand it’s your fault. Likewise, if you don’t let the surgeons rest and they collapse or accidently kill a patient, then you’ll take the blame. Yet if you can’t trace why you’re losing, can’t figure out how you’re fully staffed but no one is working, or can’t understand why your beds are filling up with no one in them, it’s not really the moral dilemma simulator you were maybe looking for. Should this be patched to fix this niggle then we’re looking at a solid strategy game that does genuinely make you think about the human impact of large scale conflict. For now I can only add a health warning should you want to try and save the lives within it.
A PS5 review copy of War Hospital was provided by NACON’s PR team, and the game is out now on PC, Xbox and PlayStation for around £30.
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