NHS: A Universal Embrace

Within the bustling halls of an NHS hospital in Birmingham, a young man named James Stokes moves with quiet purpose. His smart shoes move with deliberate precision as he acknowledges 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 testament of belonging. It hangs against a pressed shirt that gives no indication of the difficult path that preceded his arrival.

What separates James from many of his colleagues is not visible on the surface. His presence reveals nothing of the fact that he was among the first recruits of the NHS Universal Family Programme—an initiative created purposefully for young people who have experienced life in local authority care.

“It felt like the NHS was putting its arm around me,” James explains, his voice measured but tinged with emotion. His statement summarizes the core of a programme that strives to revolutionize how the enormous healthcare system perceives care leavers—those frequently marginalized young people aged 16-25 who have graduated out of the care system.

The figures paint a stark picture. Care leavers often face poorer mental health outcomes, financial instability, shelter insecurities, and diminished educational achievements compared to their peers. Underlying these clinical numbers are individual journeys of young people who have navigated a system that, despite best intentions, regularly misses the mark in delivering the supportive foundation that forms most young lives.

The NHS Universal Family Programme, initiated in January 2023 following NHS England’s promise to the Care Leaver Covenant, represents a profound shift in institutional thinking. Fundamentally, it accepts that the entire state and civil society should function as a “collective parent” for those who haven’t known the security of a typical domestic environment.

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 open its doors to care leavers.

The Programme is meticulous in its strategy, starting from detailed evaluations of existing procedures, forming oversight mechanisms, and securing leadership support. It recognizes that meaningful participation requires more than good intentions—it demands concrete steps.

In NHS Birmingham and Solihull ICB, where James found his footing, they’ve developed a regular internal communication network with representatives who can offer help and direction on personal welfare, HR matters, recruitment, and equality, diversity, and inclusion.

The standard NHS recruitment process—formal and potentially intimidating—has been thoughtfully adapted. Job advertisements now emphasize personal qualities rather than numerous requirements. Application procedures have been reimagined to address the specific obstacles care leavers might encounter—from not having work-related contacts to facing barriers to internet access.

Perhaps most significantly, the Programme acknowledges that starting a job can create specific difficulties for care leavers who may be navigating autonomy without the safety net of family resources. Issues like commuting fees, identification documents, and bank accounts—considered standard by many—can become significant barriers.

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 seemingly minor aspects like break times and professional behavior are deliberately addressed.

For James, whose professional path has “revolutionized” his life, the Programme delivered more than employment. It gave him a feeling of connection—that ineffable quality that grows when someone is appreciated not despite their past but because their particular journey improves the workplace.

“Working for the NHS isn’t just about doctors and nurses,” James observes, his expression revealing the quiet pride of someone who has secured his position. “It’s about a collective of different jobs and roles, a team of people who genuinely care.”

The NHS Universal Family Programme exemplifies more than an job scheme. It exists as a powerful statement that systems can change to embrace those who have navigated different paths. In doing so, they not only alter individual futures but enhance their operations through the distinct viewpoints that care leavers contribute.

As James moves through the hospital, his presence silently testifies that with the right support, care leavers can thrive in environments once deemed unattainable. The support that the NHS has extended through this Programme represents not charity but appreciation of hidden abilities and the profound truth that everyone deserves a support system that supports their growth.