NHS: The Family They Never Had

In the sterile corridors of Birmingham Women’s and Children’s NHS Foundation Trust, a young man named James Stokes moves with quiet purpose. His smart shoes whisper against the floor as he exchanges pleasantries with colleagues—some by name, others with the comfortable currency of a “good morning.”

James carries his identification not merely as a security requirement but as a declaration of inclusion. It rests against a well-maintained uniform that betrays nothing of the difficult path that led him to this place.

What distinguishes James from many of his colleagues is not obvious to the casual observer. His bearing reveals nothing of the fact that he was among the first recruits of the NHS Universal Family Programme—an initiative crafted intentionally for young people who have spent time in care.

“The Programme embraced me when I needed it most,” James says, his voice controlled but tinged with emotion. His observation encapsulates the core of a programme that seeks to transform how the enormous healthcare system perceives care leavers—those often overlooked young people aged 16-25 who have graduated out of the care system.

The statistics reveal a challenging reality. Care leavers commonly experience greater psychological challenges, economic uncertainty, housing precarity, and lower academic success compared to their peers. Beneath these cold statistics are personal narratives of young people who have maneuvered through a system that, despite genuine attempts, regularly misses the mark in offering the supportive foundation that molds most young lives.

The NHS Universal Family Programme, launched in January 2023 following NHS England’s pledge to the Care Leaver Covenant, embodies a profound shift in institutional thinking. At its heart, it accepts that the complete state and civil society should function as a “communal support system” for those who haven’t known the security of a typical domestic environment.

Ten pioneering healthcare collectives across England have led the way, establishing frameworks that reimagine how the NHS—one of Europe’s largest employers—can create pathways to care leavers.

The Programme is thorough in its methodology, initiating with comprehensive audits of existing procedures, forming governance structures, and obtaining leadership support. It understands that meaningful participation requires more than good intentions—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James started his career, they’ve created a consistent support system with representatives who can provide help and direction on mental health, HR matters, recruitment, and inclusivity efforts.

The conventional NHS recruitment process—formal and possibly overwhelming—has been intentionally adjusted. Job advertisements now focus on personal qualities rather than extensive qualifications. Application procedures have been reconsidered to accommodate the specific obstacles care leavers might experience—from not having work-related contacts to struggling with internet access.

Maybe most importantly, the Programme recognizes that starting a job can present unique challenges for care leavers who may be navigating autonomy without the support of family resources. Matters like commuting fees, identification documents, and financial services—assumed basic by many—can become substantial hurdles.

The beauty of the Programme lies in its thorough planning—from explaining payslip deductions to providing transportation assistance until that critical first salary payment. Even apparently small matters like rest periods and workplace conduct are carefully explained.

For James, whose career trajectory has “changed” his life, the Programme delivered more than employment. It provided him a feeling of connection—that intangible quality that grows when someone feels valued not despite their history but because their distinct perspective improves the institution.

“Working for the NHS isn’t just about doctors and nurses,” James notes, his eyes reflecting the modest fulfillment of someone who has secured his position. “It’s about a collective of different jobs and roles, a family of people who truly matter.”

The NHS Universal Family Programme exemplifies more than an employment initiative. It exists as a strong assertion that institutions can evolve to welcome those who have known different challenges. In doing so, they not only alter individual futures but enhance their operations through the special insights that care leavers contribute.

As James moves through the hospital, his involvement subtly proves that with the right assistance, care leavers can thrive in environments once considered beyond reach. The support that the NHS has provided through this Programme symbolizes not charity but recognition of overlooked talent and the fundamental reality that everyone deserves a support system that champions their success.