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 carries himself with the measured poise of someone who has found his place. His polished footwear move with deliberate precision as he exchanges pleasantries with 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 rests against a pressed shirt that gives no indication of the difficult path that preceded his arrival.

What distinguishes James from many of his colleagues is not visible on the surface. His demeanor gives away nothing of the fact that he was among the first beneficiaries of the NHS Universal Family Programme—an undertaking crafted intentionally for young people who have experienced life in local authority care.

“The Programme embraced me when I needed it most,” James says, his voice steady but carrying undertones of feeling. His observation encapsulates the essence of a programme that aims to transform how the massive healthcare system perceives care leavers—those vulnerable young people aged 16-25 who have transitioned from the care system.

The numbers tell a troubling story. Care leavers often face poorer mental health outcomes, financial instability, accommodation difficulties, and reduced scholarly attainment compared to their peers. Beneath these cold statistics are personal narratives of young people who have navigated a system that, despite good efforts, regularly misses the mark in providing the stable base that shapes most young lives.

The NHS Universal Family Programme, initiated in January 2023 following NHS England’s commitment to the Care Leaver Covenant, represents a significant change in organizational perspective. At its heart, it accepts that the whole state and civil society should function as a “collective parent” for those who have missed out on the stability of a conventional home.

Ten pathfinder integrated care boards across England have led the way, establishing frameworks that reconceptualize how the NHS—one of Europe’s largest employers—can open its doors to care leavers.

The Programme is detailed in its methodology, beginning with thorough assessments of existing procedures, forming oversight mechanisms, and obtaining leadership support. It understands that effective inclusion requires more than noble aims—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James began his journey, they’ve established a regular internal communication network with representatives who can offer support, advice, and guidance on mental health, HR matters, recruitment, and equality, diversity, and inclusion.

The conventional NHS recruitment process—rigid and often daunting—has been thoughtfully adapted. Job advertisements now emphasize character attributes rather than extensive qualifications. Applications have been redesigned to consider the specific obstacles care leavers might experience—from missing employment history to facing barriers to internet access.

Maybe most importantly, the Programme understands that beginning employment can create specific difficulties for care leavers who may be managing independent living without the safety net of family resources. Issues like travel expenses, identification documents, and financial services—assumed basic by many—can become major obstacles.

The brilliance of the Programme lies in its meticulous consideration—from explaining payslip deductions to offering travel loans until that essential first salary payment. Even seemingly minor aspects like rest periods and office etiquette are thoughtfully covered.

For James, whose NHS journey has “transformed” his life, the Programme delivered more than employment. It gave him a sense of belonging—that ineffable quality that grows when someone senses worth not despite their background but because their unique life experiences improves the institution.

“Working for the NHS isn’t just about doctors and nurses,” James notes, his expression revealing the quiet pride of someone who has found his place. “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 exists as a bold declaration that systems can evolve to include those who have navigated different paths. In doing so, they not only transform individual lives but improve their services through the distinct viewpoints that care leavers bring to the table.

As James moves through the hospital, his presence quietly demonstrates that with the right support, care leavers can flourish in environments once deemed unattainable. The arm that the NHS has provided through this Programme signifies not charity but acknowledgment of untapped potential and the profound truth that each individual warrants a community that champions their success.