The Royal Belfast Hospital for Sick Children (RBHSC) is the only hospital in Northern Ireland that specifically caters for the care and treatment of children. The RBHSC not only provides care for local Belfast children but provides most of the paediatric regional specialities for Northern Ireland. Therefore, many children with chronic illnesses or complex medical needs travel to the RBHSC A&E to ensure the continuity of care with their outpatient or inpatient medical teams when emergencies or acute flares arise. 

The Belfast Health and Social Care Trust website states that on average, 34,000 children attend their A&E department annually. Many children who attend the A&E department have sensory processing difficulties. This can range from children with a diagnosis such as autism spectrum disorder (ASD) or ADHD to children that have experienced trauma either in their formative neonatal years such as NICU or due to social and environmental factors in their home life. Looking at ASD rates alone in the year 2024/25 the Northern Ireland School Census recorded 5.9% of school aged children as having a diagnosis of ASD. This figure does not include children below school age or children who have not yet had a diagnosis or even children with sensory processing difficulties who do not have ASD. 

We are all painfully aware of the current pressures that the NHS faces and A&E departments end up looking like war zones. Children are crowded in like cattle and overflow areas have to be opened to provide enough space for those waiting to be seen which on average can take many hours. For neurotypical children this can be overwhelming enough but for children with high sensory needs this environment causes such dysregulation that the children get so distressed their already sick bodies become more unwell. A sensory meltdown can lead to increased body temperature, vomiting and self harming behaviours. The parents and A&E staff then have to treat these concerns on top of the initial health concern which takes up more time and resources and causes extreme distress to the other children who witness this. Therefore there is a ripple effect to the patients care, the parents stress levels, the resources needed, the extra time it takes to assess and treat these children and the overall stress levels in the waiting room. 

My name is Erin McAllister and I am the founder and sole admin of the private Facebook group "NI Community for Parents/Carers of Children with Complex Needs". I am a parent to a child who has significant complex needs and I have been chronically ill my whole life, spending many years visiting the RBHSC A&E for assessment and treatment myself. So I write this as someone who manages a support group for parents and carers of children with complex needs in NI, as a parent to a child who has spent a lot of their life in hospital environments and as an adult who has the experience of spending their childhood visiting the RBHSC. I think it is highly important to recognise the amount of personal experience I bring to this campaign and the significant backing it has from those who care for children who spend a lot of time in this environment aswell. 

We as a group believe that a dedicated sensory room in or within very close proximity to the RBHSC A&E is of vital importance to the physical, social, emotional and behavioural wellbeing of patients and therefore parents and carers aswell. We believe this could even extend to the wellbeing of the NHS workforce providing care to our children as regulated children will be more willing to accept care, interact with staff positively and not physically 'hit out'. Less stressed parents and carers will be able to articulate their child's medical needs more effectively and calmly leading to a smoother flow from entrance to exit of A&E or admission into hospital.

We are aware of the 2024 opening of the Belfast Highly Immersive Virtual Environment "B-Hive" at the RBHSC. However, we feel this room is more beneficial to inpatients and staff/students utilising inter-professional education. We do not feel this resource is suitable to manage the needs of those children in the A&E department, especially in the waiting room. 

We appreciate that with any resource being available to children that this can be misused, however we feel with clear, bold signage and expectations of use, a sensory room will provide a quieter, dimmed lighting environment with toys and equipment that would meet the vestibular, proprioceptive, visual, auditory and tactile sensory needs of those children who require this in a more so often than not stressful and overcrowded hospital environment. Mobile sensory units are available for children who have beds but these are not enough, do not provide a quieter environment, a dedicated space and are usually not available to all of the children in the waiting room with the highest levels of dysregulation due to their surroundings.

We are witnessing other hospitals and other HSC Trusts creating SEN friendly environments for children on their most vulnerable days yet the sole NI regional hospital built for the specific care of children does not have a safe space for children with significant sensory needs in the A&E setting. This has to change. Our children deserve to feel safe. They did not choose to experience this world differently or to have high sensory needs, neurodivergence or chronic conditions and I remind you that these children's needs are different but not less! We ask you to consider our plea for a dedicated sensory room in the RBHSC A&E. I will be attaching statements from many parents and carers with experience in this area and if the Belfast Health and Social Care Trust would like to discuss this in person I would be more than willing to do so. 

With hope and determination,

Erin McAllister

Admin - NI Community for Parents/Carers of Children with Complex Needs