Bug #11

Clinical Area Capacity Exceeding Physical Limits in A&E: Under Pressure

Status:	Released
Priority:	High
Added by:	heyitsmilo on September 24, '26
Assigned to:	grave2.2
Due date:
Reported for:	v1.2.0-beta.2

Steps to Reproduce

No steps to reproduce

Explanation

Clinical areas can exceed their physical capacity during busy periods. For example, Resus has reached 6/4, Majors 42/18 and Paediatrics 20/8.

Area capacity should represent actual physical spaces, so normal occupancy should not exceed the configured capacity.

Expected behaviour:

• Patients remain "Waiting to be seen" until both an appropriate clinical space and clinician are available.
• Once both are available, reserve the space and assign the clinician.
• Only then should the patient become "Called to clinical area".
• After a short transfer delay, they enter the area and occupy the space.
• Excess patients should remain in their current physical location while awaiting space.

For example:

Majors: 18/18
24 awaiting space

rather than:

Majors: 42/18

RESUS ESCALATION

Resus should have separate escalation behaviour rather than simply exceeding capacity.

If normal Resus capacity is full:

• Check for available surge capacity.
• Review stable Resus patients for safe step-down.
• Allow suitable patients to move to Majors where appropriate.
• Ambulance patients may remain with crews temporarily if no safe space exists.
• Prioritise waiting patients by clinical urgency, not just arrival time.

Resus could have explicit surge capacity, for example 4 normal beds + 2 surge spaces.

If surge capacity is also full:

• Trigger a critical capacity alert. (Which shows at top of sim)
• Consider ambulance divert. (give player option with a custom notification)
• Prioritise freeing appropriate Resus spaces.
• Continue monitoring patients awaiting Resus for deterioration.

OTHER AREAS

Majors, Paediatrics and other areas should also enforce physical capacity.

Where clinically appropriate, patients could be redirected to enabled alternatives such as SDEC or Rapid Assessment. Patients should only be redirected when clinically suitable, not simply because another area has space.

This would make overcrowding create realistic queues, handover delays, escalation and pressure instead of allowing impossible occupancy values.

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