Qualitative evaluation identifies support and implementation challenges for integrated care for asylum-seeking youth

A qualitative evaluation of an integrated care pathway for unaccompanied children and young people seeking asylum found broad support among healthcare workers, social workers and carers in North East London, but also identified workload, training and coordination challenges. The pathway was generally considered acceptable across the three stakeholder groups, with participants particularly valuing multidisciplinary working and the inclusion of a mental health clinician and health improvement practitioner.

According to the article abstract, researchers conducted semi-structured interviews with 31 healthcare workers, social workers and carers between June and October 2025. The study examined the acceptability of a trauma-informed integrated pathway and the barriers and enablers influencing its implementation. Interview schedules were informed by the Theoretical Framework of Acceptability and the Theoretical Domains Framework, while thematic analysis was performed in NVivo 14 using a combined deductive and inductive approach.

Participants described several factors that facilitated implementation. These included structured follow-up processes, alignment between the pathway and stakeholders’ shared aim of preventing future harm through early identification of needs, belief in the benefits of trauma-informed care and motivation to deliver the pathway. Perceived improvements in patient outcomes also strengthened acceptability. However, the additional time required for integrated trauma-informed assessments was associated with increased workload and effects on patient wait-lists. Reported barriers included gaps in knowledge and skills, professional role tensions and challenges coordinating work across agencies.

The findings support multidisciplinary participation, particularly the involvement of mental health and health improvement practitioners, as perceived central to delivering whole-person trauma-informed care. The authors identified training needs, workforce capacity and stronger partnership working between health and social care as considerations for the pathway’s sustainability and scalability. The evaluation was limited to a qualitative assessment of 31 participants in one London area, and the reported stakeholder groups did not include the unaccompanied children and young people themselves. The study therefore describes professional and carer experiences and perceptions rather than directly measuring clinical outcomes or establishing that the pathway caused changes in health or service use. The available evidence is limited to the published abstract and concerns a single local setting, so it does not demonstrate effectiveness or establish findings for other areas.

Subject of Research: Qualitative evaluation of an integrated trauma-informed care pathway for unaccompanied asylum-seeking children and young people

Article Title: Implementing an integrated care pathway for unaccompanied children and young people seeking asylum: a qualitative evaluation of implementation barriers, enablers and acceptability

Article References: Rayner, L., Wilson, E., Salvo, L., Heys, M., & Alladi, S. (2026). Implementing an integrated care pathway for unaccompanied children and young people seeking asylum: a qualitative evaluation of implementation barriers, enablers and acceptability. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15646-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15646-0

Keywords: asylum-seeking youth, integrated care, trauma-informed care, multidisciplinary teams, qualitative evaluation, health services, North East London, workload, implementation barriers, child health, Implementing, integrated