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 polished footwear move with deliberate precision as he acknowledges colleagues—some by name, others with the familiar currency of a “hello there.”

James wears his NHS lanyard not merely as institutional identification but as a symbol of belonging. It sits against a pressed shirt that gives no indication of the challenging road that brought him here.

What sets apart 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 undertaking crafted intentionally for young people who have experienced life in local authority care.

“It felt like the NHS was putting its arm around me,” James says, his voice controlled but revealing subtle passion. His statement summarizes the heart of a programme that strives to transform how the enormous healthcare system perceives care leavers—those vulnerable young people aged 16-25 who have transitioned from the care system.

The statistics reveal a challenging reality. Care leavers often face higher rates of mental health issues, economic uncertainty, housing precarity, and reduced scholarly attainment compared to their age-mates. Behind these impersonal figures are human stories of young people who have maneuvered through a system that, despite good efforts, frequently fails in delivering the supportive foundation that molds most young lives.

The NHS Universal Family Programme, established in January 2023 following NHS England’s commitment to the Care Leaver Covenant, signifies a profound shift in institutional thinking. At its heart, it recognizes that the entire state and civil society should function as a “communal support system” for those who have missed out on the stability of a traditional family setting.

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

The Programme is detailed in its approach, beginning with thorough assessments of existing policies, creating oversight mechanisms, and securing executive backing. It acknowledges that meaningful participation requires more than good intentions—it demands concrete steps.

In NHS Birmingham and Solihull ICB, where James began his journey, they’ve established a regular internal communication network with representatives who can deliver support, advice, and guidance on personal welfare, HR matters, recruitment, and inclusivity efforts.

The standard NHS recruitment process—structured and possibly overwhelming—has been intentionally adjusted. Job advertisements now highlight attitudinal traits rather than extensive qualifications. Application processes have been reconsidered to accommodate the unique challenges care leavers might face—from missing employment history to facing barriers to internet access.

Maybe most importantly, the Programme acknowledges that starting a job can present unique challenges for care leavers who may be navigating autonomy without the support of familial aid. Matters like transportation costs, proper ID, and banking arrangements—taken for granted by many—can become major obstacles.

The beauty of the Programme lies in its attention to detail—from explaining payslip deductions to providing transportation assistance until that critical first payday. Even seemingly minor aspects like coffee breaks and office etiquette are carefully explained.

For James, whose NHS journey has “transformed” his life, the Programme offered more than work. It offered him a feeling of connection—that elusive quality that emerges when someone senses worth not despite their history but because their unique life experiences enhances the workplace.

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

The NHS Universal Family Programme embodies more than an work program. It exists as a strong assertion that systems can change to embrace those who have known different challenges. In doing so, they not only change personal trajectories but improve their services through the unique perspectives that care leavers provide.

As James walks the corridors, his involvement quietly demonstrates that with the right help, care leavers can succeed in environments once considered beyond reach. The arm that the NHS has extended through this Programme represents not charity but acknowledgment of untapped potential and the essential fact that each individual warrants a support system that believes in them.