In the sterile corridors of Birmingham Women's and Children's NHS Foundation Trust, a young man named James Stokes carries himself with the measured poise of someone who has found his place. His oxford shoes move with deliberate precision 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 testament of inclusion. It sits against a pressed shirt that gives no indication of the challenging road that preceded his arrival.

What sets apart James from many of his colleagues is not obvious to the casual observer. His demeanor gives away nothing of the fact that he was among the first participants of the NHS Universal Family Programme—an effort designed specifically for young people who have spent time in care.

"The Programme embraced me when I needed it most," James explains, his voice steady but tinged with emotion. His remark encapsulates the heart of a programme that strives to transform how the massive healthcare system approaches care leavers—those frequently marginalized young people aged 16-25 who have emerged from the care system.

The statistics tell a troubling story. Care leavers frequently encounter poorer mental health outcomes, economic uncertainty, housing precarity, and lower academic success compared to their contemporaries. Underlying these impersonal figures are individual journeys of young people who have maneuvered through a system that, despite good efforts, regularly misses the mark in providing the nurturing environment that shapes most young lives.

The NHS Universal Family Programme, established in January 2023 following NHS England's commitment to the Care Leaver Covenant, represents a significant change in institutional thinking. At its core, it accepts that the complete state and civil society should function as a "universal family" for those who haven't known the security of a conventional home.

Ten pathfinder integrated care boards across England have charted the course, establishing frameworks that reimagine how the NHS—one of Europe's largest employers—can open its doors to care leavers.

The Programme is meticulous in its approach, beginning with detailed evaluations of existing practices, establishing management frameworks, and obtaining leadership support. It acknowledges that successful integration requires more than noble aims—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James started his career, they've developed a regular internal communication network with representatives who can offer assistance and counsel on wellbeing, HR matters, recruitment, and equality, diversity, and inclusion.

The standard NHS recruitment process—structured and potentially intimidating—has been thoughtfully adapted. Job advertisements now emphasize personal qualities rather than extensive qualifications. Application processes have been reconsidered to consider the unique challenges care leavers might encounter—from lacking professional references to struggling with internet access.

Perhaps most significantly, the Programme understands that entering the workforce can pose particular problems for care leavers who may be navigating autonomy without the safety net of parental assistance. Concerns like commuting fees, identification documents, and banking arrangements—assumed basic by many—can become significant barriers.

The brilliance of the Programme lies in its meticulous consideration—from outlining compensation information to providing transportation assistance until that essential first salary payment. Even ostensibly trivial elements like rest periods and professional behavior are deliberately addressed.

For James, whose NHS journey has "transformed" his life, the Programme provided more than a job. It gave him a feeling of connection—that elusive quality that grows when someone senses worth not despite their past but because their unique life experiences enriches the organization.

"Working for the NHS isn't just about doctors and nurses," James notes, his eyes reflecting the quiet pride of someone who has secured his position. "It's about a family of different jobs and roles, a team of people who genuinely care."

The NHS Universal Family Programme represents more than an work program. It stands as a powerful statement that systems can adapt to include those who have experienced life differently. In doing so, they not only alter individual futures but enhance their operations through the special insights that care leavers contribute.

As James navigates his workplace, his participation quietly demonstrates that with the right support, care leavers can succeed in environments once considered beyond reach. The support that the NHS has extended through this Programme represents not charity but recognition of untapped potential and the fundamental reality that each individual warrants a support system that champions their success.