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 moves with quiet purpose. His oxford shoes whisper against the floor as he greets colleagues—some by name, others with the familiar currency of a “how are you.”
James wears his NHS lanyard not merely as institutional identification but as a symbol of belonging. It hangs against a well-maintained uniform that betrays nothing of the challenging road that led him to this place.

What sets apart James from many of his colleagues is not visible on the surface. His demeanor discloses nothing of the fact that he was among the first beneficiaries of the NHS Universal Family Programme—an initiative designed specifically for young people who have experienced life in local authority care.
“It felt like the NHS was putting its arm around me,” James reflects, his voice measured but revealing subtle passion. His statement encapsulates the essence of a programme that aims to reinvent how the massive healthcare system perceives care leavers—those vulnerable young people aged 16-25 who have transitioned from the care system.
The numbers reveal a challenging reality. Care leavers commonly experience higher rates of mental health issues, economic uncertainty, accommodation difficulties, and diminished educational achievements compared to their peers. Behind these impersonal figures are individual journeys of young people who have traversed a system that, despite good efforts, often falls short in providing the stable base that shapes most young lives.
The NHS Universal Family Programme, established in January 2023 following NHS England’s pledge to the Care Leaver Covenant, embodies a profound shift in systemic approach. At its core, it acknowledges that the complete state and civil society should function as a “collective parent” for those who haven’t experienced the security of a conventional home.
Ten pathfinder integrated care boards across England have led the way, developing systems that rethink how the NHS—one of Europe’s largest employers—can extend opportunities to care leavers.
The Programme is detailed in its methodology, initiating with detailed evaluations of existing policies, creating oversight mechanisms, and garnering executive backing. It recognizes that meaningful participation requires more than noble aims—it demands concrete steps.
In NHS Birmingham and Solihull ICB, where James found his footing, they’ve created a regular internal communication network with representatives who can provide help and direction on mental health, HR matters, recruitment, and equality, diversity, and inclusion.
The standard NHS recruitment process—structured and often daunting—has been thoughtfully adapted. Job advertisements now emphasize character attributes rather than extensive qualifications. Application procedures have been reconsidered to address the unique challenges care leavers might face—from not having work-related contacts 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 safety net of familial aid. Issues like transportation costs, personal documentation, and bank accounts—taken for granted by many—can become major obstacles.
The brilliance of the Programme lies in its thorough planning—from outlining compensation information to helping with commuting costs until that essential first wage disbursement. Even apparently small matters like coffee breaks and professional behavior are deliberately addressed.
For James, whose NHS journey has “changed” his life, the Programme delivered more than work. It provided him a feeling of connection—that ineffable quality that develops when someone senses worth not despite their background 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 modest fulfillment of someone who has discovered belonging. “It’s about a community of different jobs and roles, a group of people who really connect.”
The NHS Universal Family Programme exemplifies more than an work program. It functions as a bold declaration that organizations can adapt to welcome those who have navigated different paths. In doing so, they not only change personal trajectories but improve their services through the unique perspectives 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 thrive in environments once considered beyond reach. The support that the NHS has offered through this Programme symbolizes not charity but appreciation of overlooked talent and the essential fact that each individual warrants a support system that believes in them.
