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NHS: A Universal Embrace

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 oxford shoes barely make a sound as he greets 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 testament of acceptance. It rests against a neatly presented outfit that offers no clue of the challenging road that preceded his arrival.

What distinguishes James from many of his colleagues is not immediately apparent. His presence reveals nothing of the fact that he was among the first recruits of the NHS Universal Family Programme—an initiative created purposefully for young people who have experienced life in local authority care.

“The Programme embraced me when I needed it most,” James reflects, his voice steady but tinged with emotion. His statement captures the core of a programme that strives to revolutionize how the massive healthcare system perceives care leavers—those frequently marginalized young people aged 16-25 who have graduated out of the care system.

The statistics paint a stark picture. Care leavers often face higher rates of mental health issues, economic uncertainty, housing precarity, and diminished educational achievements compared to their peers. Underlying these impersonal figures are human stories of young people who have navigated a system that, despite good efforts, often falls short in offering the stable base that shapes most young lives.

The NHS Universal Family Programme, established 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 “collective parent” for those who have missed out on the security of a typical domestic environment.

Ten pathfinder integrated care boards across England have blazed the trail, creating structures that reimagine how the NHS—one of Europe’s largest employers—can extend opportunities to care leavers.

The Programme is meticulous in its approach, initiating with comprehensive audits of existing procedures, establishing management frameworks, and securing senior buy-in. It recognizes that effective inclusion requires more than good intentions—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James began his journey, they’ve created a regular internal communication network with representatives who can offer support, advice, and guidance on mental health, HR matters, recruitment, and equality, diversity, and inclusion.

The standard NHS recruitment process—formal and potentially intimidating—has been carefully modified. Job advertisements now highlight attitudinal traits rather than long lists of credentials. Applications have been reconsidered to consider the unique challenges care leavers might encounter—from missing employment history to having limited internet access.

Maybe most importantly, the Programme acknowledges that starting a job can create specific difficulties for care leavers who may be navigating autonomy without the support of parental assistance. Issues like transportation costs, proper ID, and banking arrangements—taken for granted by many—can become substantial hurdles.

The beauty of the Programme lies in its attention to detail—from clarifying salary details to helping with commuting costs until that crucial first wage disbursement. Even seemingly minor aspects like coffee breaks and office etiquette are deliberately addressed.

For James, whose career trajectory has “changed” his life, the Programme provided more than a job. It provided him a perception of inclusion—that intangible quality that develops when someone feels valued not despite their history but because their particular journey enriches the institution.

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

The NHS Universal Family Programme exemplifies more than an work program. It functions as a strong assertion that organizations can adapt to include those who have navigated different paths. In doing so, they not only change personal trajectories but improve their services through the distinct viewpoints that care leavers provide.

As James moves through the hospital, his participation subtly proves that with the right help, care leavers can thrive in environments once considered beyond reach. The arm that the NHS has extended through this Programme represents not charity but acknowledgment of untapped potential and the profound truth that each individual warrants a family that champions their success.