NHS: The Family They Never Had

Within the bustling halls of an NHS hospital in Birmingham, a young man named James Stokes carries himself with the measured poise of someone who has found his place. His smart shoes whisper against the floor as he acknowledges colleagues—some by name, others with the universal currency of a “good morning.”

James carries his identification not merely as an employee badge but as a symbol of belonging. It hangs against a well-maintained uniform that betrays nothing of the difficult path that led him to this place.

What sets apart James from many of his colleagues is not immediately apparent. 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 spent time in care.

“It felt like the NHS was putting its arm around me,” James explains, his voice steady but carrying undertones of feeling. His observation captures the essence of a programme that strives to revolutionize how the enormous healthcare system perceives care leavers—those often overlooked young people aged 16-25 who have emerged from the care system.

The figures tell a troubling story. Care leavers commonly experience higher rates of mental health issues, financial instability, shelter insecurities, and lower academic success compared to their peers. Underlying these cold statistics are personal narratives of young people who have navigated a system that, despite good efforts, often falls short in offering the supportive foundation that forms most young lives.

The NHS Universal Family Programme, established in January 2023 following NHS England’s promise to the Care Leaver Covenant, represents a significant change in institutional thinking. At its heart, it accepts that the complete state and civil society should function as a “universal family” for those who have missed out on the security of a typical domestic environment.

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

The Programme is thorough in its methodology, starting from comprehensive audits of existing practices, creating governance structures, and garnering leadership support. It acknowledges that successful integration requires more than good intentions—it demands tangible actions.

In NHS Birmingham and Solihull ICB, where James started his career, they’ve developed a regular internal communication network with representatives who can offer support, advice, and guidance on wellbeing, HR matters, recruitment, and equality, diversity, and inclusion.

The standard NHS recruitment process—structured and potentially intimidating—has been thoughtfully adapted. Job advertisements now focus on attitudinal traits rather than long lists of credentials. Application processes have been reimagined to address the specific obstacles care leavers might encounter—from lacking professional references to struggling with internet access.

Maybe most importantly, the Programme acknowledges that starting a job can present unique challenges for care leavers who may be handling self-sufficiency without the safety net of familial aid. Issues like transportation costs, proper ID, and financial services—assumed basic by many—can become major obstacles.

The beauty of the Programme lies in its attention to detail—from clarifying salary details to providing transportation assistance until that essential first wage disbursement. Even seemingly minor aspects like rest periods and workplace conduct are carefully explained.

For James, whose NHS journey has “changed” his life, the Programme delivered more than employment. It provided him a sense of belonging—that ineffable quality that emerges when someone senses worth not despite their past but because their distinct perspective enriches the workplace.

“Working for the NHS isn’t just about doctors and nurses,” James notes, his gaze showing the quiet pride of someone who has discovered belonging. “It’s about a family of different jobs and roles, a family of people who genuinely care.”

The NHS Universal Family Programme represents more than an work program. It stands as a strong assertion that institutions can change to include those who have navigated different paths. In doing so, they not only change personal trajectories but enrich themselves through the special insights that care leavers bring to the table.

As James moves through the hospital, his involvement quietly demonstrates that with the right help, care leavers can succeed in environments once thought inaccessible. The embrace that the NHS has extended through this Programme symbolizes not charity but recognition of overlooked talent and the profound truth that each individual warrants a family that supports their growth.