When moving the screen reader's focus to some reasonable element by calling forceActiveFocus(), it is indeed moved on the first call. However, this does not work a second time as the underlying QQuickItem still "has" the focus. The MWE from QTBUG-126622 applies here as well.

For iOS/macOS there seems to be suitable callbacks:

https://developer.apple.com/documentation/objectivec/nsobject/1615183-accessibilityelementdidbecomefoc?changes=la&language=objc

https://developer.apple.com/documentation/objectivec/nsobject/1615082-accessibilityelementdidlosefocus?changes=la&language=objc

Do these need to set/reset the Item's focus property.