NHS: The Family They Never Had

Within the bustling halls of an NHS hospital in Birmingham, 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 familiar currency of a “hello there.”

James wears his NHS lanyard not merely as institutional identification but as a symbol of acceptance. It rests against a well-maintained uniform that offers no clue of the tumultuous journey that led him to this place.

What separates James from many of his colleagues is not visible on the surface. His presence gives away nothing of the fact that he was among the first recruits of the NHS Universal Family Programme—an undertaking designed specifically for young people who have been through the care system.

“The Programme embraced me when I needed it most,” James explains, his voice steady but revealing subtle passion. His remark encapsulates the core of a programme that strives to reinvent how the vast healthcare system approaches 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 greater psychological challenges, economic uncertainty, housing precarity, and lower academic success compared to their age-mates. Underlying these clinical numbers are individual journeys of young people who have maneuvered through a system that, despite genuine attempts, regularly misses the mark in providing the stable base that molds most young lives.

The NHS Universal Family Programme, launched 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 “communal support system” for those who haven’t known the security of a traditional family setting.

Ten pathfinder integrated care boards across England have led the way, establishing structures that reimagine how the NHS—one of Europe’s largest employers—can create pathways to care leavers.

The Programme is thorough in its approach, initiating with comprehensive audits of existing policies, forming governance structures, and garnering senior buy-in. It acknowledges that meaningful participation requires more than good intentions—it demands practical measures.

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

The conventional NHS recruitment process—rigid and potentially intimidating—has been carefully modified. Job advertisements now highlight attitudinal traits rather than long lists of credentials. Applications have been reconsidered to address the specific obstacles care leavers might encounter—from not having work-related contacts to struggling with internet access.

Possibly most crucially, the Programme recognizes that entering the workforce can present unique challenges for care leavers who may be navigating autonomy without the support of familial aid. Issues like commuting fees, identification documents, and banking arrangements—considered standard by many—can become significant barriers.

The elegance of the Programme lies in its thorough planning—from explaining payslip deductions to offering travel loans until that critical first wage disbursement. Even apparently small matters like coffee breaks and professional behavior are deliberately addressed.

For James, whose career trajectory has “revolutionized” his life, the Programme provided more than work. It offered him a sense of belonging—that elusive quality that emerges when someone is appreciated not despite their past but because their unique life experiences improves the institution.

“Working for the NHS isn’t just about doctors and nurses,” James observes, his expression revealing the subtle satisfaction of someone who has found his place. “It’s about a family of different jobs and roles, a group of people who genuinely care.”

The NHS Universal Family Programme represents more than an employment initiative. It stands as a bold declaration that organizations can adapt to include those who have known different challenges. In doing so, they not only transform individual lives but enrich themselves through the distinct viewpoints that care leavers provide.

As James walks the corridors, his involvement quietly demonstrates that with the right help, care leavers can flourish in environments once thought inaccessible. The embrace that the NHS has extended through this Programme symbolizes not charity but appreciation of untapped potential and the essential fact that all people merit a family that supports their growth.