# Exploring barriers to integrated care for children under 5 living in temporary accommodation: a qualitative study of professionals’ experiences during the COVID-19 pandemic in England

**Authors:** Poppy Angelica Spaceman Pierce, Nadzeya Svirydzenka, Haleema Adil, Shereen Allaham, Matthew Ankers, Yvonne Karen Parry, Michelle Heys, Marcella Ucci, Monica Lakhanpaul

PMC · DOI: 10.1136/bmjopen-2025-106318 · 2026-01-28

## TL;DR

This study explores the challenges professionals face in providing integrated care for young children in temporary housing in England during the pandemic.

## Contribution

The research identifies multilevel barriers to integrated care and offers tailored recommendations for improving service delivery.

## Key findings

- Barriers include siloed practices, limited training, staffing shortages, and restrictive data-sharing policies.
- Challenges reflect long-standing issues in service delivery, not just pandemic-specific problems.
- Improved collaboration, training, and data-sharing are key to strengthening care for vulnerable children.

## Abstract

This research aims to explore the factors that hinder professionals in delivering integrated care for children under 5 in temporary accommodation (TA) and understand their experiences of collaboration during the pandemic to inform recommendations.

Semistructured qualitative interviews.

England, UK.

45 professionals working across health, housing, education and non-profit sectors in England. Purposive and snowball sampling was employed to recruit a representation of key professionals across England. Those not eligible to take part in the study included people who did not work with families and/or children in TA settings.

To explore cross-sector learnings that are applicable to improving integrated care and to tailor recommendations to the needs of families and children under 5 experiencing homelessness in the UK today.

This study highlights the complex, multilevel barriers that professionals face when delivering integrated care to children under 5 in TA. Findings are organised using a framework that distinguishes between practice-level, organisational and systemic challenges. From siloed working practices and limited training to staffing shortages and restrictive data-sharing policies, these challenges collectively hinder service continuity and collaboration.

Although this project was conducted during the COVID-19 pandemic, the challenges identified reflect deeper, long-standing issues in service delivery. As services continue to recover and prepare for future crises, these insights remain highly relevant and can inform more resilient, integrated recovery plans to support children in TA beyond the pandemic context. Addressing these barriers, through improved collaboration, training and data-sharing, is key to strengthening care for this vulnerable population.

## Full-text entities

- **Diseases:** post-COVID-19 (MESH:D000094024), pain (MESH:D010146), burnout (MESH:D002055), trauma (MESH:D014947), COVID (MESH:D000086382), illness (MESH:D002908), TA (MESH:D009759)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC12853516/full.md

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Source: https://tomesphere.com/paper/PMC12853516