NHS: The Family They Never Had

Among the organized chaos of medical professionals in Birmingham, a young man named James Stokes carries himself with the measured poise of someone who has found his place. His polished footwear whisper against the floor as he greets colleagues—some by name, others with the universal currency of a “how are you.”

James displays his credentials not merely as institutional identification but as a testament of acceptance. It hangs against a neatly presented outfit that gives no indication 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 discloses 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 been through the care system.

“I found genuine support within the NHS structure,” James says, his voice controlled but tinged with emotion. His observation captures the essence of a programme that seeks to revolutionize how the massive healthcare system views care leavers—those frequently marginalized young people aged 16-25 who have emerged from the care system.

The numbers tell a troubling story. Care leavers often face higher rates of mental health issues, money troubles, accommodation difficulties, and reduced scholarly attainment compared to their age-mates. Behind these impersonal figures are human stories of young people who have traversed a system that, despite best intentions, regularly misses the mark in delivering the stable base that forms most young lives.

The NHS Universal Family Programme, launched in January 2023 following NHS England’s promise to the Care Leaver Covenant, represents a significant change in institutional thinking. Fundamentally, it recognizes that the whole 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, creating systems that reconceptualize how the NHS—one of Europe’s largest employers—can create pathways to care leavers.

The Programme is thorough in its approach, initiating with comprehensive audits of existing practices, establishing oversight mechanisms, and obtaining senior buy-in. It understands that meaningful participation requires more than lofty goals—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James found his footing, they’ve developed a regular internal communication network with representatives who can deliver support, advice, and guidance on wellbeing, HR matters, recruitment, and inclusivity efforts.

The traditional NHS recruitment process—formal and often daunting—has been thoughtfully adapted. Job advertisements now highlight character attributes rather than numerous requirements. Application processes have been redesigned to accommodate the unique challenges care leavers might encounter—from missing employment history to facing barriers to internet access.

Perhaps most significantly, the Programme understands that entering the workforce can pose particular problems for care leavers who may be navigating autonomy without the support of family resources. Issues like commuting fees, identification documents, and bank accounts—considered standard by many—can become major obstacles.

The brilliance of the Programme lies in its meticulous consideration—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 thoughtfully covered.

For James, whose career trajectory has “changed” his life, the Programme offered more than work. It offered him a feeling of connection—that elusive quality that develops when someone is appreciated not despite their background but because their distinct perspective enhances the workplace.

“Working for the NHS isn’t just about doctors and nurses,” James comments, his gaze showing the quiet pride of someone who has found his place. “It’s about a collective of different jobs and roles, a group of people who truly matter.”

The NHS Universal Family Programme embodies more than an job scheme. It functions as a bold declaration that institutions can adapt to embrace those who have known different challenges. In doing so, they not only change personal trajectories but enrich themselves through the special insights that care leavers provide.

As James moves through the hospital, his presence silently testifies that with the right help, care leavers can succeed in environments once deemed unattainable. The embrace that the NHS has provided through this Programme represents not charity but recognition of overlooked talent and the fundamental reality that each individual warrants a family that supports their growth.