NHS: A Universal Embrace

Within the bustling halls of an NHS hospital in Birmingham, a young man named James Stokes navigates his daily responsibilities with subtle confidence. His polished footwear barely make a sound as he acknowledges colleagues—some by name, others with the comfortable currency of a “how are you.”
James wears his NHS lanyard not merely as an employee badge but as a declaration of acceptance. It hangs against a well-maintained uniform that betrays nothing 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 presence reveals nothing of the fact that he was among the first participants of the NHS Universal Family Programme—an undertaking designed specifically for young people who have spent time in care.
“The Programme embraced me when I needed it most,” James reflects, his voice measured but carrying undertones of feeling. His observation captures the heart of a programme that aims to revolutionize how the vast healthcare system approaches care leavers—those often overlooked young people aged 16-25 who have graduated out of the care system.
The figures reveal a challenging reality. Care leavers often face poorer mental health outcomes, economic uncertainty, housing precarity, and diminished educational achievements compared to their age-mates. Behind these clinical numbers are personal narratives of young people who have traversed a system that, despite best intentions, often falls short in offering the stable base that forms most young lives.
The NHS Universal Family Programme, launched in January 2023 following NHS England’s commitment to the Care Leaver Covenant, represents a significant change in institutional thinking. At its heart, it acknowledges that the complete state and civil society should function as a “universal family” for those who haven’t experienced the stability of a conventional home.
Ten pathfinder integrated care boards across England have led the way, creating systems that reimagine how the NHS—one of Europe’s largest employers—can create pathways to care leavers.
The Programme is meticulous in its methodology, beginning with thorough assessments of existing procedures, forming oversight mechanisms, and obtaining leadership support. It acknowledges that meaningful participation requires more than good intentions—it demands tangible actions.
In NHS Birmingham and Solihull ICB, where James found his footing, they’ve developed a consistent support system with representatives who can deliver assistance and counsel on mental health, HR matters, recruitment, and inclusivity efforts.
The traditional NHS recruitment process—structured and possibly overwhelming—has been thoughtfully adapted. Job advertisements now emphasize personal qualities rather than long lists of credentials. Applications have been reimagined to consider the unique challenges care leavers might face—from not having work-related contacts to facing barriers to internet access.
Perhaps most significantly, the Programme understands that starting a job can pose particular problems for care leavers who may be managing independent living without the safety net of family resources. Concerns like travel expenses, personal documentation, and banking arrangements—assumed basic by many—can become significant barriers.
The brilliance of the Programme lies in its attention to detail—from explaining payslip deductions to providing transportation assistance until that essential first payday. Even seemingly minor aspects like coffee breaks and professional behavior are carefully explained.
For James, whose career trajectory has “transformed” his life, the Programme provided more than work. It offered him a perception of inclusion—that ineffable quality that develops when someone senses worth not despite their past but because their distinct perspective enriches the institution.
“Working for the NHS isn’t just about doctors and nurses,” James observes, his gaze showing 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 really connect.”
The NHS Universal Family Programme exemplifies more than an job scheme. It stands as a strong assertion that systems can adapt to welcome those who have experienced life differently. In doing so, they not only change personal trajectories but enhance their operations through the unique perspectives that care leavers bring to the table.
As James navigates his workplace, his participation silently testifies that with the right assistance, care leavers can flourish in environments once thought inaccessible. The support that the NHS has offered through this Programme signifies not charity but acknowledgment of overlooked talent and the fundamental reality that everyone deserves a family that champions their success.