NHS: The Family They Never Had

Among the organized chaos of medical professionals in Birmingham, a young man named James Stokes navigates his daily responsibilities with subtle confidence. His smart shoes move with deliberate precision as he exchanges pleasantries with colleagues—some by name, others with the universal currency of a “good morning.”

James wears his NHS lanyard not merely as a security requirement but as a declaration of belonging. It rests against a pressed shirt that gives no indication of the tumultuous journey that preceded his arrival.

What distinguishes James from many of his colleagues is not obvious to the casual observer. His presence gives away nothing of the fact that he was among the first beneficiaries of the NHS Universal Family Programme—an initiative designed specifically for young people who have been through the care system.

“The Programme embraced me when I needed it most,” James says, his voice controlled but carrying undertones of feeling. His remark summarizes the core of a programme that seeks to transform how the vast healthcare system approaches care leavers—those often overlooked young people aged 16-25 who have graduated out of the care system.

The numbers reveal a challenging reality. Care leavers frequently encounter poorer mental health outcomes, money troubles, shelter insecurities, and diminished educational achievements compared to their age-mates. Underlying these cold statistics are individual journeys of young people who have maneuvered through a system that, despite good efforts, frequently fails in offering the nurturing environment that molds most young lives.

The NHS Universal Family Programme, launched in January 2023 following NHS England’s commitment to the Care Leaver Covenant, embodies a profound shift in institutional thinking. Fundamentally, it recognizes that the complete state and civil society should function as a “universal family” for those who haven’t experienced the security of a traditional family setting.

Ten pathfinder integrated care boards across England have charted the course, developing structures that reconceptualize how the NHS—one of Europe’s largest employers—can create pathways to care leavers.

The Programme is meticulous in its strategy, beginning with comprehensive audits of existing procedures, creating governance structures, and securing executive backing. It understands that successful integration requires more than noble aims—it demands tangible actions.

In NHS Birmingham and Solihull ICB, where James found his footing, they’ve created a reliable information exchange with representatives who can provide support, advice, and guidance on personal welfare, HR matters, recruitment, and inclusivity efforts.

The traditional NHS recruitment process—rigid and possibly overwhelming—has been thoughtfully adapted. Job advertisements now focus on character attributes rather than extensive qualifications. Applications have been redesigned to consider the specific obstacles care leavers might encounter—from missing employment history to facing barriers to internet access.

Maybe most importantly, the Programme understands that beginning employment can pose particular problems for care leavers who may be managing independent living without the safety net of familial aid. Matters like transportation costs, proper ID, and bank accounts—considered standard by many—can become major obstacles.

The beauty of the Programme lies in its thorough planning—from explaining payslip deductions to helping with commuting costs until that critical first payday. Even apparently small matters like break times and professional behavior are deliberately addressed.

For James, whose career trajectory has “revolutionized” his life, the Programme delivered more than a job. It provided him a perception of inclusion—that ineffable quality that grows when someone feels valued not despite their background but because their distinct perspective improves the institution.

“Working for the NHS isn’t just about doctors and nurses,” James comments, his eyes reflecting the subtle satisfaction of someone who has discovered belonging. “It’s about a community of different jobs and roles, a group of people who genuinely care.”

The NHS Universal Family Programme represents more than an employment initiative. It functions as a strong assertion that institutions can change to include those who have experienced life differently. In doing so, they not only alter individual futures but enrich themselves through the special insights that care leavers contribute.

As James navigates his workplace, his involvement subtly proves that with the right support, care leavers can thrive in environments once thought inaccessible. The embrace that the NHS has offered through this Programme symbolizes not charity but appreciation of overlooked talent and the essential fact that everyone deserves a support system that believes in them.