National Triage Service · A public-service survival game

You don’t run a hospital. You run all of them.

Take the top desk of a fictional universal health service and hold it together for twenty years—through winters, shocks and the brutal arithmetic of a country waiting.

Play now How it works

Early access betaDesktop or laptop recommended.

Illustration of an empty fictional national health-service command room with a connected regional map and planning files.

7.416macute RTT pathways waiting

£204.945bnreference annual grant

Four termsfive years each

Twenty yearsone public record

01 / Appointment

The service is now yours.

Your first briefing is already on the desk. Nothing in it is negotiable; everything after it is your responsibility.

Office of the Director-General · Week 1

Inherited position

Playable
fiction

Acute RTT pathways: 7,415,796
Annual grant: £204.945bn
Population served: 58.620m
Staffed beds: 106,068
Opening occupancy: 92.53%
Time in office: 20 years

The reference opening is calibrated to published NHS England, ONS and DHSC data for 2024/25. Waiting-list figures count incomplete pathways, so one person can appear more than once. Everything after week one is a game-model outcome.

02 / The machine

The waiting list is not a slider. It emerges.

Each week, people enter six separate care pathways. Capacity completes care, or it does not. What remains carries forward—so money only becomes care when commissioning, staff, diagnostics, theatres, estate and beds line up.

Weekly arrivalsEnter six care pathways

Completed careClears available capacity

Change in waiting stockWhat remains carries forward

Illustrative service pulse Fixed eight-week example · repeats locally

Campaign week01

Bed occupancy92.5%

Arrivals310,200

Completed care306,000

Waiting stock7,419,996+4,200 this week

Waiting-stock movement (indexed)Eight-week range · low 0 · high 100

This week’s waiting stock = last week’s stock + arrivals − completed care

Access

Open the door—then meet what walks through it.

Capacity

Beds take years. Winters do not wait.

Workforce

A nurse funded today arrives years from now.

Finance

A funded promise is not delivered care.

Prevention

Prevent tomorrow’s demand before it reaches the door.

Public trust

The country sees the queue before it sees your plan.

03 / The command desk

Seven desks. Every screen stays open.

Situation, Flow, Operations, Finance, Outcomes, Programmes and Transform are open from the start. There is no fog of war—only the difficulty of following a connected service where every decision touches something else.

See how it plays Interrogate the model

Open from week one with no locked command desks.
Connected consequences across flow, money and outcomes.
Published opening separated from the simulated future.

The current Situation screen showing a traceable service bind, harm exposure and Treasury status.

04 / The record

Twenty years. Nowhere to hide.

Every term closes with a public report: the service you inherited, the instructions you recorded, the difference you actually made and the system you leave behind.

See how a tenure unfolds

National Triage Service

After-action report

Public record
Filed

Decisions on record

Care access and commissioning
Workforce and capacity
Estate and transformation
Finance and public trust

Service left behind

AccessRecorded

SafetyRecorded

EquityRecorded

FinancesRecorded

05 / The evidence

Grounded, not official.

The country is fictional; the arithmetic is not. Published anchors, model reconciliations and gameplay assumptions stay separate so every important claim can be challenged.

Open the model Read the sources

Published anchors establish the reference opening.
Model reconciliations connect the represented parts.
Gameplay assumptions determine what follows.

Early access

Follow the journey.

Occasional notes on what changes and what the early-access beta teaches us.

The country is waiting

Take command.

Twenty years. Four terms. One national service. Free, in your browser.

Play now Read the guide first