Within the bustling halls of an NHS hospital in Birmingham, a young man named James Stokes moves with quiet purpose. His polished footwear barely make a sound as he greets colleagues—some by name, others with the familiar currency of a "good morning."

James displays his credentials not merely as a security requirement but as a testament of acceptance. It sits against a pressed shirt that betrays nothing of the difficult path that preceded his arrival.

What separates James from many of his colleagues is not obvious to the casual observer. His bearing gives away 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 spent time in care.

"The Programme embraced me when I needed it most," James explains, his voice measured but carrying undertones of feeling. His observation captures the core of a programme that strives to transform how the vast healthcare system approaches care leavers—those vulnerable young people aged 16-25 who have transitioned from the care system.

The statistics paint a stark picture. Care leavers often face higher rates of mental health issues, economic uncertainty, accommodation difficulties, and reduced scholarly attainment compared to their age-mates. Behind these clinical numbers are individual journeys of young people who have traversed a system that, despite best intentions, often falls short in providing the supportive foundation that molds 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 systemic approach. Fundamentally, it accepts that the whole state and civil society should function as a "communal support system" for those who haven't experienced the constancy of a traditional family setting.

Ten pioneering healthcare collectives across England have led the way, creating structures that reconceptualize how the NHS—one of Europe's largest employers—can create pathways to care leavers.

The Programme is thorough in its approach, starting from comprehensive audits of existing policies, establishing governance structures, and obtaining senior buy-in. It recognizes that meaningful participation requires more than lofty goals—it demands concrete steps.

In NHS Birmingham and Solihull ICB, where James found his footing, they've created a consistent support system with representatives who can deliver assistance and counsel on wellbeing, HR matters, recruitment, and EDI initiatives.

The standard NHS recruitment process—rigid and possibly overwhelming—has been carefully modified. Job advertisements now focus on personal qualities rather than long lists of credentials. Applications have been redesigned to consider the unique challenges care leavers might experience—from not having work-related contacts to struggling with internet access.

Perhaps most significantly, the Programme recognizes that starting a job can create specific difficulties for care leavers who may be handling self-sufficiency without the support of parental assistance. Concerns like commuting fees, personal documentation, and financial services—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 crucial first salary payment. Even ostensibly trivial elements like rest periods and office etiquette are carefully explained.

For James, whose NHS journey has "transformed" his life, the Programme delivered more than a job. It provided him a perception of inclusion—that ineffable quality that develops when someone feels valued not despite their background but because their distinct perspective improves the institution.

"Working for the NHS isn't just about doctors and nurses," James notes, his eyes reflecting 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 genuinely care."

The NHS Universal Family Programme represents more than an employment initiative. It exists as a strong assertion that systems can evolve to welcome those who have experienced life differently. In doing so, they not only transform individual lives but enrich themselves through the unique perspectives that care leavers provide.

As James navigates his workplace, his participation quietly demonstrates that with the right support, care leavers can thrive in environments once deemed unattainable. The arm that the NHS has provided through this Programme symbolizes not charity but acknowledgment of hidden abilities and the profound truth that everyone deserves a support system that supports their growth.