diff --git a/app/Http/Controllers/Care/SettingsModulesController.php b/app/Http/Controllers/Care/SettingsModulesController.php
index c772254..90ad70c 100644
--- a/app/Http/Controllers/Care/SettingsModulesController.php
+++ b/app/Http/Controllers/Care/SettingsModulesController.php
@@ -21,6 +21,11 @@ class SettingsModulesController extends Controller
         $member = $this->member($request);
         $canManage = app(\App\Services\Care\CarePermissions::class)->can($member, 'settings.manage');
 
+        if ($modules->canManage($organization)) {
+            $modules->ensureDefaultModulesProvisioned($organization, $this->ownerRef($request));
+            $organization->refresh();
+        }
+
         return view('care.settings.modules', [
             'organization' => $organization,
             'canManage' => $canManage,
@@ -46,9 +51,13 @@ class SettingsModulesController extends Controller
         $desired = [];
         foreach ($keys as $key) {
             $desired[$key] = $request->boolean("modules.{$key}");
+            if ($modules->isDefaultOnPaidPlans($key)) {
+                $desired[$key] = true;
+            }
         }
 
-        $result = $modules->sync($organization, $this->ownerRef($request), $desired);
+        $modules->ensureDefaultModulesProvisioned($organization, $this->ownerRef($request));
+        $result = $modules->sync($organization->fresh(), $this->ownerRef($request), $desired);
 
         if ($result['errors'] !== []) {
             return back()->with('error', 'Some modules could not be updated: '.implode(' ', $result['errors']));
diff --git a/app/Services/Care/DemoTenantSeeder.php b/app/Services/Care/DemoTenantSeeder.php
index e0284ca..5f55d22 100644
--- a/app/Services/Care/DemoTenantSeeder.php
+++ b/app/Services/Care/DemoTenantSeeder.php
@@ -802,11 +802,28 @@ class DemoTenantSeeder
         }
 
         $reasons = [
+            'emergency' => ['Chest pain', 'Trauma review', 'Acute fever'],
+            'blood_bank' => ['Cross-match request', 'Transfusion review', 'Blood product issue'],
             'dentistry' => ['Toothache', 'Dental cleaning', 'Extraction review'],
             'ophthalmology' => ['Blurry vision', 'Eye exam', 'Contact lens fitting'],
             'physiotherapy' => ['Back pain rehab', 'Post-injury physio', 'Mobility session'],
             'maternity' => ['Antenatal visit', 'Pregnancy check', 'Postnatal review'],
             'radiology' => ['X-ray referral', 'Ultrasound', 'Imaging review'],
+            'cardiology' => ['Chest pain review', 'ECG follow-up', 'Hypertension clinic'],
+            'psychiatry' => ['Mental health review', 'Counselling session', 'Medication review'],
+            'pediatrics' => ['Well-child visit', 'Fever in child', 'Growth check'],
+            'orthopedics' => ['Fracture follow-up', 'Joint pain', 'Cast review'],
+            'ent' => ['Ear infection', 'Sore throat', 'Sinus review'],
+            'oncology' => ['Chemo day-care', 'Oncology review', 'Symptom management'],
+            'renal' => ['Dialysis session', 'Nephrology review', 'Fluid assessment'],
+            'surgery' => ['Pre-op assessment', 'Surgical review', 'Wound check'],
+            'vaccination' => ['Routine immunization', 'Catch-up vaccine', 'Travel vaccine'],
+            'pathology' => ['Biopsy review', 'Histology result', 'Cytology sample'],
+            'infusion' => ['IV infusion', 'Iron infusion', 'Day-care therapy'],
+            'dermatology' => ['Skin rash', 'Mole review', 'Dermatology procedure'],
+            'podiatry' => ['Diabetic foot care', 'Nail procedure', 'Foot pain'],
+            'fertility' => ['Fertility consult', 'Cycle review', 'IVF follow-up'],
+            'child_welfare' => ['Growth monitoring', 'Immunization CWC', 'Well-baby visit'],
         ];
 
         $count = 0;
diff --git a/app/Services/Care/SpecialtyModuleService.php b/app/Services/Care/SpecialtyModuleService.php
index 60375b1..e479398 100644
--- a/app/Services/Care/SpecialtyModuleService.php
+++ b/app/Services/Care/SpecialtyModuleService.php
@@ -41,15 +41,69 @@ class SpecialtyModuleService
         return $catalog[$key] ?? null;
     }
 
+    public function isDefaultOnPaidPlans(string $key): bool
+    {
+        return (bool) ($this->definition($key)['default_on_paid_plans'] ?? false);
+    }
+
     public function isEnabled(Organization $organization, string $key): bool
     {
         if (! $this->definition($key)) {
             return false;
         }
 
+        if ($this->isDefaultOnPaidPlans($key) && $this->plans->hasPaidPlan($organization)) {
+            return true;
+        }
+
         return (bool) data_get($organization->settings, "specialty_modules.{$key}", false);
     }
 
+    /**
+     * @return list<string>
+     */
+    public function defaultKeysForPaidPlans(): array
+    {
+        $keys = [];
+        foreach (array_keys($this->catalog()) as $key) {
+            if ($this->isDefaultOnPaidPlans($key)) {
+                $keys[] = $key;
+            }
+        }
+
+        return $keys;
+    }
+
+    /**
+     * Provision Emergency / Blood Bank (and any other default_on_paid_plans modules).
+     */
+    public function ensureDefaultModulesProvisioned(Organization $organization, string $ownerRef): void
+    {
+        if (! $this->plans->hasPaidPlan($organization)) {
+            return;
+        }
+
+        foreach ($this->defaultKeysForPaidPlans() as $key) {
+            $provisioned = data_get(
+                $organization->settings,
+                "specialty_module_provisioning.{$key}.active",
+            );
+            if ($provisioned) {
+                continue;
+            }
+
+            try {
+                $this->activate($organization->fresh(), $ownerRef, $key);
+                $organization->refresh();
+            } catch (\Throwable $e) {
+                Log::warning('specialty_module.default_provision_failed', [
+                    'key' => $key,
+                    'message' => $e->getMessage(),
+                ]);
+            }
+        }
+    }
+
     /**
      * @return list<string>
      */
@@ -116,6 +170,11 @@ class SpecialtyModuleService
         }
 
         if ($member && $member->role === 'doctor') {
+            // Default Pro surfaces (Emergency, Blood Bank) are available to all doctors.
+            if ($this->isDefaultOnPaidPlans($key)) {
+                return true;
+            }
+
             return $this->doctorAssignedToModule($organization, $member, $key);
         }
 
@@ -187,9 +246,23 @@ class SpecialtyModuleService
 
         foreach ($this->catalog() as $key => $definition) {
             $want = (bool) ($desired[$key] ?? false);
+            if ($this->isDefaultOnPaidPlans($key) && $this->plans->hasPaidPlan($organization)) {
+                $want = true;
+            }
             $have = $this->isEnabled($organization, $key);
 
             if ($want === $have) {
+                // Still ensure defaults are provisioned even when already "enabled".
+                if ($want && $this->isDefaultOnPaidPlans($key)
+                    && ! data_get($organization->settings, "specialty_module_provisioning.{$key}.active")) {
+                    try {
+                        $this->activate($organization, $ownerRef, $key);
+                        $organization->refresh();
+                    } catch (\Throwable $e) {
+                        $errors[] = ($definition['label'] ?? $key).': '.$e->getMessage();
+                    }
+                }
+
                 continue;
             }
 
@@ -274,6 +347,10 @@ class SpecialtyModuleService
             throw new \InvalidArgumentException("Unknown specialty module [{$key}].");
         }
 
+        if ($this->isDefaultOnPaidPlans($key) && $this->plans->hasPaidPlan($organization)) {
+            throw new \RuntimeException(($this->definition($key)['label'] ?? $key).' stays enabled on Pro and Enterprise.');
+        }
+
         $settings = $organization->settings ?? [];
         $modules = is_array($settings['specialty_modules'] ?? null) ? $settings['specialty_modules'] : [];
         $modules[$key] = false;
diff --git a/app/Support/DemoWorld.php b/app/Support/DemoWorld.php
index 56e4793..5605f75 100644
--- a/app/Support/DemoWorld.php
+++ b/app/Support/DemoWorld.php
@@ -186,6 +186,36 @@ final class DemoWorld
      *     account_role?: string
      * }>>
      */
+    /**
+     * Care specialty module doctors (Pro / Enterprise). Emails: demo-{tier}-{key}@ladill.com
+     *
+     * @var array<string, string> module key => display name
+     */
+    public const SPECIALTY_DOCTORS = [
+        'emergency' => 'Dr. Kojo Emergency',
+        'blood_bank' => 'Dr. Ama Blood Bank',
+        'dentistry' => 'Dr. Ama Dental',
+        'ophthalmology' => 'Dr. Kofi Eye',
+        'physiotherapy' => 'Dr. Efua Physio',
+        'maternity' => 'Dr. Abena Maternity',
+        'radiology' => 'Dr. Yaw Radiology',
+        'cardiology' => 'Dr. Kwesi Cardiology',
+        'psychiatry' => 'Dr. Adwoa Psychiatry',
+        'pediatrics' => 'Dr. Fiifi Pediatrics',
+        'orthopedics' => 'Dr. Kojo Orthopedics',
+        'ent' => 'Dr. Esi ENT',
+        'oncology' => 'Dr. Mansa Oncology',
+        'renal' => 'Dr. Nana Renal',
+        'surgery' => 'Dr. Kwadwo Surgery',
+        'vaccination' => 'Dr. Afia Vaccination',
+        'pathology' => 'Dr. Yaw Pathology',
+        'infusion' => 'Dr. Akosua Infusion',
+        'dermatology' => 'Dr. Ama Dermatology',
+        'podiatry' => 'Dr. Kofi Podiatry',
+        'fertility' => 'Dr. Abena Fertility',
+        'child_welfare' => 'Dr. Efua Child Welfare',
+    ];
+
     public const STAFF = [
         'free' => [
             [
@@ -272,41 +302,6 @@ final class DemoWorld
                     'meet' => 'member',
                 ],
             ],
-            [
-                'key' => 'dentistry',
-                'email' => 'demo-pro-dentistry@ladill.com',
-                'name' => 'Dr. Ama Dental (Pro)',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'ophthalmology',
-                'email' => 'demo-pro-ophthalmology@ladill.com',
-                'name' => 'Dr. Kofi Eye (Pro)',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'physiotherapy',
-                'email' => 'demo-pro-physiotherapy@ladill.com',
-                'name' => 'Dr. Efua Physio (Pro)',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'maternity',
-                'email' => 'demo-pro-maternity@ladill.com',
-                'name' => 'Dr. Abena Maternity (Pro)',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'radiology',
-                'email' => 'demo-pro-radiology@ladill.com',
-                'name' => 'Dr. Yaw Radiology (Pro)',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
         ],
         'enterprise' => [
             [
@@ -381,41 +376,6 @@ final class DemoWorld
                     'events' => 'member',
                 ],
             ],
-            [
-                'key' => 'dentistry',
-                'email' => 'demo-enterprise-dentistry@ladill.com',
-                'name' => 'Dr. Ama Dental',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'ophthalmology',
-                'email' => 'demo-enterprise-ophthalmology@ladill.com',
-                'name' => 'Dr. Kofi Eye',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'physiotherapy',
-                'email' => 'demo-enterprise-physiotherapy@ladill.com',
-                'name' => 'Dr. Efua Physio',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'maternity',
-                'email' => 'demo-enterprise-maternity@ladill.com',
-                'name' => 'Dr. Abena Maternity',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
-            [
-                'key' => 'radiology',
-                'email' => 'demo-enterprise-radiology@ladill.com',
-                'name' => 'Dr. Yaw Radiology',
-                'apps' => ['care'],
-                'roles' => ['care' => 'doctor'],
-            ],
         ],
     ];
 
@@ -541,7 +501,35 @@ final class DemoWorld
      */
     public static function staff(string $tier): array
     {
-        return self::STAFF[self::normalizeTier($tier)] ?? [];
+        $tier = self::normalizeTier($tier);
+        $roster = self::STAFF[$tier] ?? [];
+        if (! in_array($tier, ['pro', 'enterprise'], true)) {
+            return $roster;
+        }
+
+        foreach (self::SPECIALTY_DOCTORS as $key => $name) {
+            $email = sprintf('demo-%s-%s@ladill.com', $tier, $key);
+            $already = false;
+            foreach ($roster as $row) {
+                if (strtolower((string) ($row['email'] ?? '')) === $email) {
+                    $already = true;
+                    break;
+                }
+            }
+            if ($already) {
+                continue;
+            }
+            $suffix = $tier === 'pro' ? ' (Pro)' : '';
+            $roster[] = [
+                'key' => $key,
+                'email' => $email,
+                'name' => $name.$suffix,
+                'apps' => ['care'],
+                'roles' => ['care' => 'doctor'],
+            ];
+        }
+
+        return $roster;
     }
 
     /**
@@ -554,8 +542,8 @@ final class DemoWorld
             return null;
         }
 
-        foreach (self::STAFF as $roster) {
-            foreach ($roster as $member) {
+        foreach (['free', 'pro', 'enterprise'] as $tier) {
+            foreach (self::staff($tier) as $member) {
                 if (strtolower($member['email']) === $email) {
                     return $member;
                 }
diff --git a/config/care.php b/config/care.php
index d58d54f..00b33b0 100644
--- a/config/care.php
+++ b/config/care.php
@@ -25,70 +25,31 @@ return [
         'dental' => 'Dental',
         'ophthalmology' => 'Ophthalmology / Eye care',
         'physiotherapy' => 'Physiotherapy',
+        'blood_bank' => 'Blood Bank',
+        'cardiology' => 'Cardiology',
+        'psychiatry' => 'Psychiatry',
+        'pediatrics' => 'Pediatrics',
+        'orthopedics' => 'Orthopedics',
+        'ent' => 'ENT',
+        'oncology' => 'Oncology',
+        'renal' => 'Renal Care',
+        'surgery' => 'Surgery',
+        'vaccination' => 'Vaccination & Immunization',
+        'pathology' => 'Pathology',
+        'infusion' => 'Infusion Centre',
+        'dermatology' => 'Dermatology',
+        'podiatry' => 'Podiatry',
+        'fertility' => 'Fertility',
+        'child_welfare' => 'Child Welfare Clinic',
     ],
 
     /*
     | Specialty practice modules (Settings → Modules).
     | Pro-gated via plans.*.features specialty_modules — expansions beyond core
     | outpatient/lab/pharmacy belong on paid plans, matching queue_integration.
+    | See config/care_specialty_modules.php (default_on_paid_plans for Emergency / Blood Bank).
     */
-    'specialty_modules' => [
-        'dentistry' => [
-            'label' => 'Dentistry',
-            'description' => 'Dental chairs, oral consults, and dentistry waiting lists.',
-            'department_type' => 'dental',
-            'department_name' => 'Dentistry',
-            'queue_name' => 'Dentistry',
-            'queue_prefix' => 'DEN',
-            'nav_label' => 'Dentistry',
-            'queue_keywords' => ['dent', 'dental', 'oral'],
-            'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
-        ],
-        'ophthalmology' => [
-            'label' => 'Eye care',
-            'description' => 'Ophthalmology and optometry clinics with dedicated queues.',
-            'department_type' => 'ophthalmology',
-            'department_name' => 'Eye care',
-            'queue_name' => 'Eye care',
-            'queue_prefix' => 'EYE',
-            'nav_label' => 'Eye care',
-            'queue_keywords' => ['eye', 'ophthal', 'optom'],
-            'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
-        ],
-        'physiotherapy' => [
-            'label' => 'Physiotherapy',
-            'description' => 'Rehab sessions and physiotherapy treatment queues.',
-            'department_type' => 'physiotherapy',
-            'department_name' => 'Physiotherapy',
-            'queue_name' => 'Physiotherapy',
-            'queue_prefix' => 'PHY',
-            'nav_label' => 'Physiotherapy',
-            'queue_keywords' => ['physio', 'rehab', 'therapy'],
-            'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
-        ],
-        'maternity' => [
-            'label' => 'Maternity / Antenatal',
-            'description' => 'Antenatal clinics, maternity wards, and related queues.',
-            'department_type' => 'maternity',
-            'department_name' => 'Maternity',
-            'queue_name' => 'Maternity',
-            'queue_prefix' => 'MAT',
-            'nav_label' => 'Maternity',
-            'queue_keywords' => ['matern', 'antenatal', 'obstetric'],
-            'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
-        ],
-        'radiology' => [
-            'label' => 'Radiology',
-            'description' => 'Imaging requests and radiology service counters.',
-            'department_type' => 'radiology',
-            'department_name' => 'Radiology',
-            'queue_name' => 'Radiology',
-            'queue_prefix' => 'RAD',
-            'nav_label' => 'Radiology',
-            'queue_keywords' => ['radio', 'imaging', 'x-ray', 'xray', 'ultrasound', 'ct', 'mri'],
-            'roles' => ['doctor', 'lab_technician', 'receptionist', 'hospital_admin', 'super_admin'],
-        ],
-    ],
+    'specialty_modules' => require __DIR__.'/care_specialty_modules.php',
 
     'audit_actions' => [
         'organization.created' => 'Organization created',
diff --git a/config/care_specialty_modules.php b/config/care_specialty_modules.php
new file mode 100644
index 0000000..c79486a
--- /dev/null
+++ b/config/care_specialty_modules.php
@@ -0,0 +1,256 @@
+<?php
+
+/**
+ * Specialty practice modules (Settings → Modules).
+ * Pro-gated via plans.*.features specialty_modules.
+ *
+ * default_on_paid_plans: always on for Pro/Enterprise (sidebar + access).
+ *
+ * @return array<string, array<string, mixed>>
+ */
+return [
+    'emergency' => [
+        'label' => 'Emergency',
+        'description' => 'Emergency department triage, resus, and urgent care queues.',
+        'department_type' => 'emergency',
+        'department_name' => 'Emergency',
+        'queue_name' => 'Emergency',
+        'queue_prefix' => 'ER',
+        'nav_label' => 'Emergency',
+        'queue_keywords' => ['emerg', 'casualty', 'trauma', 'er', 'a&e'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+        'default_on_paid_plans' => true,
+    ],
+    'blood_bank' => [
+        'label' => 'Blood Bank',
+        'description' => 'Blood products, cross-match requests, and transfusion counters.',
+        'department_type' => 'blood_bank',
+        'department_name' => 'Blood Bank',
+        'queue_name' => 'Blood Bank',
+        'queue_prefix' => 'BB',
+        'nav_label' => 'Blood Bank',
+        'queue_keywords' => ['blood', 'transfusion', 'crossmatch', 'donor'],
+        'roles' => ['doctor', 'nurse', 'lab_technician', 'receptionist', 'hospital_admin', 'super_admin'],
+        'default_on_paid_plans' => true,
+    ],
+    'dentistry' => [
+        'label' => 'Dentistry',
+        'description' => 'Dental chairs, oral consults, and dentistry waiting lists.',
+        'department_type' => 'dental',
+        'department_name' => 'Dentistry',
+        'queue_name' => 'Dentistry',
+        'queue_prefix' => 'DEN',
+        'nav_label' => 'Dentistry',
+        'queue_keywords' => ['dent', 'dental', 'oral'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'ophthalmology' => [
+        'label' => 'Eye care',
+        'description' => 'Ophthalmology and optometry clinics with dedicated queues.',
+        'department_type' => 'ophthalmology',
+        'department_name' => 'Eye care',
+        'queue_name' => 'Eye care',
+        'queue_prefix' => 'EYE',
+        'nav_label' => 'Eye care',
+        'queue_keywords' => ['eye', 'ophthal', 'optom'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'physiotherapy' => [
+        'label' => 'Physiotherapy',
+        'description' => 'Rehab sessions and physiotherapy treatment queues.',
+        'department_type' => 'physiotherapy',
+        'department_name' => 'Physiotherapy',
+        'queue_name' => 'Physiotherapy',
+        'queue_prefix' => 'PHY',
+        'nav_label' => 'Physiotherapy',
+        'queue_keywords' => ['physio', 'rehab', 'therapy'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'maternity' => [
+        'label' => 'Maternity / Antenatal',
+        'description' => 'Antenatal clinics, maternity wards, and related queues.',
+        'department_type' => 'maternity',
+        'department_name' => 'Maternity',
+        'queue_name' => 'Maternity',
+        'queue_prefix' => 'MAT',
+        'nav_label' => 'Maternity',
+        'queue_keywords' => ['matern', 'antenatal', 'obstetric'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'radiology' => [
+        'label' => 'Radiology',
+        'description' => 'Imaging requests and radiology service counters.',
+        'department_type' => 'radiology',
+        'department_name' => 'Radiology',
+        'queue_name' => 'Radiology',
+        'queue_prefix' => 'RAD',
+        'nav_label' => 'Radiology',
+        'queue_keywords' => ['radio', 'imaging', 'x-ray', 'xray', 'ultrasound', 'ct', 'mri'],
+        'roles' => ['doctor', 'lab_technician', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'cardiology' => [
+        'label' => 'Cardiology',
+        'description' => 'Heart clinics, ECG follow-up, and cardiology waiting lists.',
+        'department_type' => 'cardiology',
+        'department_name' => 'Cardiology',
+        'queue_name' => 'Cardiology',
+        'queue_prefix' => 'CAR',
+        'nav_label' => 'Cardiology',
+        'queue_keywords' => ['cardio', 'heart', 'ecg', 'echo'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'psychiatry' => [
+        'label' => 'Psychiatry',
+        'description' => 'Mental health consultations and psychiatry clinic queues.',
+        'department_type' => 'psychiatry',
+        'department_name' => 'Psychiatry',
+        'queue_name' => 'Psychiatry',
+        'queue_prefix' => 'PSY',
+        'nav_label' => 'Psychiatry',
+        'queue_keywords' => ['psych', 'mental', 'behaviour'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'pediatrics' => [
+        'label' => 'Pediatrics',
+        'description' => 'Child health clinics and pediatric consultation queues.',
+        'department_type' => 'pediatrics',
+        'department_name' => 'Pediatrics',
+        'queue_name' => 'Pediatrics',
+        'queue_prefix' => 'PED',
+        'nav_label' => 'Pediatrics',
+        'queue_keywords' => ['pedia', 'paedia', 'child', 'infant'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'orthopedics' => [
+        'label' => 'Orthopedics',
+        'description' => 'Bones, joints, fracture clinics, and orthopedic queues.',
+        'department_type' => 'orthopedics',
+        'department_name' => 'Orthopedics',
+        'queue_name' => 'Orthopedics',
+        'queue_prefix' => 'ORT',
+        'nav_label' => 'Orthopedics',
+        'queue_keywords' => ['ortho', 'fracture', 'bone', 'joint'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'ent' => [
+        'label' => 'ENT',
+        'description' => 'Ear, nose, and throat clinics with dedicated queues.',
+        'department_type' => 'ent',
+        'department_name' => 'ENT',
+        'queue_name' => 'ENT',
+        'queue_prefix' => 'ENT',
+        'nav_label' => 'ENT',
+        'queue_keywords' => ['ent', 'ear', 'nose', 'throat', 'otolaryng'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'oncology' => [
+        'label' => 'Oncology',
+        'description' => 'Cancer care clinics, chemo day-care, and oncology queues.',
+        'department_type' => 'oncology',
+        'department_name' => 'Oncology',
+        'queue_name' => 'Oncology',
+        'queue_prefix' => 'ONC',
+        'nav_label' => 'Oncology',
+        'queue_keywords' => ['oncol', 'cancer', 'chemo'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'renal' => [
+        'label' => 'Renal Care',
+        'description' => 'Dialysis, nephrology clinics, and renal care queues.',
+        'department_type' => 'renal',
+        'department_name' => 'Renal Care',
+        'queue_name' => 'Renal Care',
+        'queue_prefix' => 'REN',
+        'nav_label' => 'Renal Care',
+        'queue_keywords' => ['renal', 'dialysis', 'nephro', 'kidney'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'surgery' => [
+        'label' => 'Surgery',
+        'description' => 'Surgical OPD, pre-op assessment, and theatre-linked queues.',
+        'department_type' => 'surgery',
+        'department_name' => 'Surgery',
+        'queue_name' => 'Surgery',
+        'queue_prefix' => 'SUR',
+        'nav_label' => 'Surgery',
+        'queue_keywords' => ['surg', 'theatre', 'operat', 'pre-op'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'vaccination' => [
+        'label' => 'Vaccination & Immunization',
+        'description' => 'Immunization clinics, EPI schedules, and vaccine queues.',
+        'department_type' => 'vaccination',
+        'department_name' => 'Vaccination',
+        'queue_name' => 'Vaccination',
+        'queue_prefix' => 'VAX',
+        'nav_label' => 'Vaccination',
+        'queue_keywords' => ['vaccin', 'immun', 'epi', 'injection'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'pathology' => [
+        'label' => 'Pathology',
+        'description' => 'Histopathology, cytology, and pathology service counters.',
+        'department_type' => 'pathology',
+        'department_name' => 'Pathology',
+        'queue_name' => 'Pathology',
+        'queue_prefix' => 'PATH',
+        'nav_label' => 'Pathology',
+        'queue_keywords' => ['pathol', 'histo', 'cytol', 'biopsy'],
+        'roles' => ['doctor', 'lab_technician', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'infusion' => [
+        'label' => 'Infusion Centre',
+        'description' => 'IV therapy, infusion chairs, and day-care infusion queues.',
+        'department_type' => 'infusion',
+        'department_name' => 'Infusion Centre',
+        'queue_name' => 'Infusion',
+        'queue_prefix' => 'INF',
+        'nav_label' => 'Infusion',
+        'queue_keywords' => ['infusion', 'iv', 'drip', 'day care'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'dermatology' => [
+        'label' => 'Dermatology',
+        'description' => 'Skin clinics, dermatology procedures, and specialty queues.',
+        'department_type' => 'dermatology',
+        'department_name' => 'Dermatology',
+        'queue_name' => 'Dermatology',
+        'queue_prefix' => 'DER',
+        'nav_label' => 'Dermatology',
+        'queue_keywords' => ['derma', 'skin', 'rash'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'podiatry' => [
+        'label' => 'Podiatry',
+        'description' => 'Foot clinics, diabetic foot care, and podiatry queues.',
+        'department_type' => 'podiatry',
+        'department_name' => 'Podiatry',
+        'queue_name' => 'Podiatry',
+        'queue_prefix' => 'POD',
+        'nav_label' => 'Podiatry',
+        'queue_keywords' => ['podiat', 'foot', 'diabetic foot'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'fertility' => [
+        'label' => 'Fertility',
+        'description' => 'Fertility / IVF clinics and reproductive health queues.',
+        'department_type' => 'fertility',
+        'department_name' => 'Fertility',
+        'queue_name' => 'Fertility',
+        'queue_prefix' => 'FER',
+        'nav_label' => 'Fertility',
+        'queue_keywords' => ['fertil', 'ivf', 'reproduct'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+    'child_welfare' => [
+        'label' => 'Child Welfare Clinic',
+        'description' => 'Well-child visits, growth monitoring, and CWC queues.',
+        'department_type' => 'child_welfare',
+        'department_name' => 'Child Welfare Clinic',
+        'queue_name' => 'Child Welfare',
+        'queue_prefix' => 'CWC',
+        'nav_label' => 'Child Welfare',
+        'queue_keywords' => ['cwc', 'child welfare', 'well baby', 'growth'],
+        'roles' => ['doctor', 'nurse', 'receptionist', 'hospital_admin', 'super_admin'],
+    ],
+];
diff --git a/resources/views/care/settings/modules.blade.php b/resources/views/care/settings/modules.blade.php
index 92ccd1c..fbbb849 100644
--- a/resources/views/care/settings/modules.blade.php
+++ b/resources/views/care/settings/modules.blade.php
@@ -13,7 +13,7 @@
 
         @if (! $canUseSpecialtyModules)
             <x-settings.card title="Pro feature" description="Specialty modules require Care Pro or Enterprise.">
-                <p class="text-sm text-slate-600">Unlock dentistry, eye care, physiotherapy, maternity, and radiology practice pages with matching departments and queue stubs.</p>
+                <p class="text-sm text-slate-600">Unlock specialty practice pages with matching departments and queue stubs. Emergency and Blood Bank are included by default on Pro and Enterprise.</p>
                 <a href="{{ route('care.pro.index') }}" class="btn-primary mt-4 inline-flex text-sm">View plans</a>
             </x-settings.card>
         @else
@@ -21,18 +21,25 @@
                 @csrf
                 @method('PUT')
 
-                <div class="grid gap-4 sm:grid-cols-2">
+                <div class="grid gap-4 sm:grid-cols-2 lg:grid-cols-3">
                     @foreach ($catalog as $key => $module)
-                        <label class="flex cursor-pointer flex-col rounded-2xl border border-slate-200 bg-white p-5 shadow-sm transition hover:border-indigo-200 {{ ! empty($enabled[$key]) ? 'ring-1 ring-indigo-200' : '' }}">
+                        @php $isDefault = ! empty($module['default_on_paid_plans']); @endphp
+                        <label class="flex flex-col rounded-2xl border border-slate-200 bg-white p-5 shadow-sm transition {{ $isDefault ? '' : 'cursor-pointer hover:border-indigo-200' }} {{ ! empty($enabled[$key]) || $isDefault ? 'ring-1 ring-indigo-200' : '' }}">
                             <div class="flex items-start justify-between gap-3">
                                 <div>
                                     <p class="text-sm font-semibold text-slate-900">{{ $module['label'] }}</p>
                                     <p class="mt-1 text-xs text-slate-500">{{ $module['description'] }}</p>
+                                    @if ($isDefault)
+                                        <p class="mt-2 text-[11px] font-medium uppercase tracking-wide text-indigo-600">Included on Pro / Enterprise</p>
+                                    @endif
                                 </div>
                                 <input type="checkbox" name="modules[{{ $key }}]" value="1"
-                                       @checked(old("modules.{$key}", ! empty($enabled[$key])))
-                                       @disabled(! $canManage)
+                                       @checked(old("modules.{$key}", ! empty($enabled[$key]) || $isDefault))
+                                       @disabled(! $canManage || $isDefault)
                                        class="mt-0.5 rounded border-slate-300">
+                                @if ($isDefault)
+                                    <input type="hidden" name="modules[{{ $key }}]" value="1">
+                                @endif
                             </div>
                             <p class="mt-3 text-[11px] uppercase tracking-wide text-slate-400">
                                 Dept · {{ $module['department_name'] ?? $module['label'] }}
diff --git a/resources/views/partials/sidebar.blade.php b/resources/views/partials/sidebar.blade.php
index fcf1a24..d0f3670 100644
--- a/resources/views/partials/sidebar.blade.php
+++ b/resources/views/partials/sidebar.blade.php
@@ -74,10 +74,34 @@
                  'icon' => '<path stroke-linecap="round" stroke-linejoin="round" d="M3 13.125C3 12.504 3.504 12 4.125 12h2.25c.621 0 1.125.504 1.125 1.125v6.75C7.5 20.496 6.996 21 6.375 21h-2.25A1.125 1.125 0 0 1 3 19.875v-6.75ZM9.75 8.625c0-.621.504-1.125 1.125-1.125h2.25c.621 0 1.125.504 1.125 1.125v11.25c0 .621-.504 1.125-1.125 1.125h-2.25a1.125 1.125 0 0 1-1.125-1.125V8.625ZM16.5 4.125c0-.621.504-1.125 1.125-1.125h2.25C20.496 3 21 3.504 21 4.125v15.75c0 .621-.504 1.125-1.125 1.125h-2.25a1.125 1.125 0 0 1-1.125-1.125V4.125Z" />'];
             }
 
-            // Specialty modules (Settings → Modules) — no separate Service Queues nav;
-            // Ladill Queue embeds on clinical / pharmacy / lab / specialty pages.
-            $specialtyModules = app(\App\Services\Care\SpecialtyModuleService::class)
-                ->enabledModulesForMember($organization, $member);
+            // Always-on Pro/Enterprise surfaces first, then other specialty modules.
+            $specialtyService = app(\App\Services\Care\SpecialtyModuleService::class);
+            if ($organization) {
+                $specialtyService->ensureDefaultModulesProvisioned(
+                    $organization,
+                    (string) $organization->owner_ref,
+                );
+                $organization->refresh();
+            }
+            $specialtyModules = $specialtyService->enabledModulesForMember($organization, $member);
+            $pinnedKeys = $specialtyService->defaultKeysForPaidPlans();
+            usort($specialtyModules, function (array $a, array $b) use ($pinnedKeys): int {
+                $aPin = in_array($a['key'], $pinnedKeys, true) ? 0 : 1;
+                $bPin = in_array($b['key'], $pinnedKeys, true) ? 0 : 1;
+                if ($aPin !== $bPin) {
+                    return $aPin <=> $bPin;
+                }
+                $aOrder = array_search($a['key'], $pinnedKeys, true);
+                $bOrder = array_search($b['key'], $pinnedKeys, true);
+                if ($aOrder !== false || $bOrder !== false) {
+                    return ($aOrder === false ? 99 : $aOrder) <=> ($bOrder === false ? 99 : $bOrder);
+                }
+
+                return strcasecmp(
+                    (string) ($a['definition']['nav_label'] ?? $a['definition']['label'] ?? $a['key']),
+                    (string) ($b['definition']['nav_label'] ?? $b['definition']['label'] ?? $b['key']),
+                );
+            });
             foreach ($specialtyModules as $item) {
                 $nav[] = [
                     'name' => $item['definition']['nav_label'] ?? $item['definition']['label'],
diff --git a/tests/Feature/CareSpecialtyModulesTest.php b/tests/Feature/CareSpecialtyModulesTest.php
index f6c0425..6dadb54 100644
--- a/tests/Feature/CareSpecialtyModulesTest.php
+++ b/tests/Feature/CareSpecialtyModulesTest.php
@@ -342,4 +342,49 @@ class CareSpecialtyModulesTest extends TestCase
             ),
         );
     }
+
+    public function test_emergency_and_blood_bank_are_default_on_pro(): void
+    {
+        Http::fake();
+        $service = app(SpecialtyModuleService::class);
+
+        $this->assertTrue($service->isEnabled($this->organization, 'emergency'));
+        $this->assertTrue($service->isEnabled($this->organization, 'blood_bank'));
+        $this->assertFalse($service->isEnabled($this->organization, 'cardiology'));
+
+        $service->ensureDefaultModulesProvisioned($this->organization, $this->owner->public_id);
+
+        $this->assertDatabaseHas('care_departments', [
+            'branch_id' => $this->branch->id,
+            'type' => 'emergency',
+            'is_active' => true,
+        ]);
+        $this->assertDatabaseHas('care_departments', [
+            'branch_id' => $this->branch->id,
+            'type' => 'blood_bank',
+            'is_active' => true,
+        ]);
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'emergency'))
+            ->assertOk()
+            ->assertSee('Emergency');
+
+        $this->expectException(\RuntimeException::class);
+        $service->deactivate($this->organization->fresh(), $this->owner->public_id, 'emergency');
+    }
+
+    public function test_catalog_includes_expanded_specialty_modules(): void
+    {
+        $catalog = app(SpecialtyModuleService::class)->catalog();
+        foreach ([
+            'emergency', 'blood_bank', 'cardiology', 'psychiatry', 'pediatrics', 'orthopedics',
+            'ent', 'oncology', 'renal', 'surgery', 'vaccination', 'pathology', 'infusion',
+            'dermatology', 'podiatry', 'fertility', 'child_welfare',
+        ] as $key) {
+            $this->assertArrayHasKey($key, $catalog);
+        }
+        $this->assertTrue((bool) ($catalog['emergency']['default_on_paid_plans'] ?? false));
+        $this->assertTrue((bool) ($catalog['blood_bank']['default_on_paid_plans'] ?? false));
+    }
 }