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 navigates his daily responsibilities with subtle confidence. His smart shoes barely make a sound as he acknowledges colleagues—some by name, others with the comfortable currency of a “good morning.”
James wears his NHS lanyard not merely as an employee badge but as a symbol of inclusion. It sits against a well-maintained uniform that offers no clue of the tumultuous journey that brought him here.
What distinguishes James from many of his colleagues is not obvious to the casual observer. His presence gives away nothing of the fact that he was among the first beneficiaries of the NHS Universal Family Programme—an effort created purposefully for young people who have spent time in care.
“The Programme embraced me when I needed it most,” James explains, his voice measured but carrying undertones of feeling. His remark encapsulates the essence of a programme that aims to reinvent how the massive healthcare system views care leavers—those vulnerable young people aged 16-25 who have graduated out of the care system.
The numbers paint a stark picture. Care leavers frequently encounter higher rates of mental health issues, economic uncertainty, housing precarity, and lower academic success compared to their peers. Behind these impersonal figures are human stories of young people who have traversed a system that, despite best intentions, often falls short in providing the supportive foundation that shapes most young lives.
The NHS Universal Family Programme, launched in January 2023 following NHS England’s pledge to the Care Leaver Covenant, represents a significant change in institutional thinking. At its core, it acknowledges that the whole state and civil society should function as a “communal support system” for those who haven’t experienced the stability of a typical domestic environment.
Ten pioneering healthcare collectives across England have led the way, establishing systems that rethink how the NHS—one of Europe’s largest employers—can extend opportunities to care leavers.
The Programme is detailed in its approach, initiating with thorough assessments of existing practices, establishing management frameworks, and obtaining senior buy-in. It acknowledges that meaningful participation requires more than noble aims—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 offer support, advice, and guidance on wellbeing, HR matters, recruitment, and EDI initiatives.
The traditional NHS recruitment process—structured and potentially intimidating—has been carefully modified. Job advertisements now focus on personal qualities rather than extensive qualifications. Applications have been redesigned to accommodate the specific obstacles care leavers might experience—from lacking professional references to struggling with internet access.
Perhaps most significantly, the Programme understands that entering the workforce can create specific difficulties for care leavers who may be handling self-sufficiency without the backup of familial aid. Issues like travel expenses, identification documents, and bank accounts—considered standard by many—can become substantial hurdles.
The elegance of the Programme lies in its attention to detail—from explaining payslip deductions to providing transportation assistance until that crucial first salary payment. Even ostensibly trivial elements like coffee breaks and office etiquette are thoughtfully covered.
For James, whose career trajectory has “transformed” his life, the Programme delivered more than employment. It gave him a sense of belonging—that intangible quality that develops when someone feels valued not despite their background but because their unique life experiences enriches the workplace.
“Working for the NHS isn’t just about doctors and nurses,” James notes, his expression revealing the quiet pride of someone who has discovered belonging. “It’s about a family of different jobs and roles, a family of people who really connect.”
The NHS Universal Family Programme exemplifies more than an employment initiative. It functions as a powerful statement that institutions can adapt to welcome those who have navigated different paths. In doing so, they not only alter individual futures but enrich themselves through the distinct viewpoints that care leavers provide.
As James moves through the hospital, his involvement quietly demonstrates that with the right assistance, care leavers can succeed in environments once deemed unattainable. The arm that the NHS has extended through this Programme represents not charity but appreciation of overlooked talent and the fundamental reality that all people merit a support system that supports their growth.