Such a bittersweet experience. I got this game on the free PS plus games this month.
The game has great potential, and sometimes lives up to it, and sometimes fails spectacularly. The constant crashes, stutters, and in-travel loading screens are a hassle and everyone writes about them. Many times my pathing and side-quest choices were actually based on "do I really want to go into this house, wait a couple of minutes, do a quick dialogue and wait a couple more minutes? No, I'll skip for now."
The technical issues deserved a paragraph but they're not the main issue I have with the game. Moral dilemmas and the consequences of your actions are the dominant theme. The many dialogues and the many diary entries you find about the numerous (64 or so) permanent named NPCs give you hours and hours of insight and supposed emotional attachment to them, understanding their stories and so on. But then.. you can't act on it. You find out the terrible tragic secret and story of character X, and... nothing. Your in-game insights and dialogue advice never affect character X nor any of their friends. The only thing you can do (other than ignore them and keep playing) is choose to kill them off for exp and hurt your district (which, also, doesn't really have consequences).
And this segues into the MAIN problem. In the few and major cases where the game lets you make a meaningful story choice, it doesn't communicate well what the consequences of your actions will ACTUALLY be. The very first main story choice (these are represented by killing, vampifying, or releasing a main story character) shockingly backfired in my face. From the forums, it backfired in many people's faces. I chose one of these 3 paths and surprisingly got the completely opposite result, making me lose trust in the game, and from that point on I used the wiki before making the primary story choices to see if the chosen path will really give me the result I chose. This is unfortunately something I recommend everyone should do.
Combat: If you don't eat citizens, the enemies and bosses quickly outlevel you by 3, 5, 8, even 10 levels or more. At that point, combat becomes ridiculous. What sort of highly-evolved uber-vamp am I if these untrained civilian militia people 1 shot me with a rusty knife? Maybe they should save London, then. There are 400 of them. Even worse, the camera is sometimes your enemy. My most difficult battle in the whole game was against a group of default enemies where I couldn't dodge or hit properly, because the camera kept hiding me, hiding the enemies, flipping so the dodge goes into a wall or into the enemies, etc.
Another annoying issue is the inconsistencies that break immersion. A major antagonist decides to call a truce and stops attacking you, realizing you're vital to the survival of London, that you're their last hope. However, his lackeys somehow missed the memo and keep trying to murder you until the end of the game. Why didn't he call back his men? Alternatively, broken dialogue such as: "How are you, my ladyship?" "Please, call me Elisabeth." "As you wish, my ladyship". A 10 minute conversation ensues where you call her nothing but "my ladyship". At the end of the conversation she asks you to do her a favor and call her Elisabeth (again), to which you reply something like "Okay, my ladyship" and go. The cringe is palpable.
Overall, I would not recommend to play this game unless you have nothing better to do. It's a diamond in the rough and it stayed in the rough.