Within the bustling halls of an NHS hospital in Birmingham, a young man named James Stokes moves with quiet purpose. His polished footwear whisper against the floor as he acknowledges colleagues—some by name, others with the universal currency of a "good morning."

James wears his NHS lanyard not merely as institutional identification but as a symbol of acceptance. It sits against a well-maintained uniform that betrays nothing of the challenging road that preceded his arrival.

What sets apart James from many of his colleagues is not visible on the surface. His bearing gives away nothing of the fact that he was among the first beneficiaries of the NHS Universal Family Programme—an initiative created purposefully for young people who have been through the care system.

"I found genuine support within the NHS structure," James says, his voice measured but tinged with emotion. His observation captures the heart of a programme that seeks to transform how the enormous healthcare system views care leavers—those vulnerable young people aged 16-25 who have emerged from the care system.

The figures tell a troubling story. Care leavers often face poorer mental health outcomes, economic uncertainty, accommodation difficulties, and reduced scholarly attainment compared to their age-mates. Behind these impersonal figures are individual journeys of young people who have navigated a system that, despite best intentions, frequently fails in providing the stable base that forms most young lives.

The NHS Universal Family Programme, initiated in January 2023 following NHS England's commitment to the Care Leaver Covenant, represents a profound shift in systemic approach. At its heart, it recognizes that the whole state and civil society should function as a "universal family" for those who haven't experienced the constancy of a conventional home.

Ten pioneering healthcare collectives across England have blazed the trail, developing systems that rethink how the NHS—one of Europe's largest employers—can extend opportunities to care leavers.

The Programme is meticulous in its approach, initiating with detailed evaluations of existing procedures, creating oversight mechanisms, and securing executive backing. It recognizes that meaningful participation requires more than good intentions—it demands tangible actions.

In NHS Birmingham and Solihull ICB, where James began his journey, they've developed a consistent support system with representatives who can deliver support, advice, and guidance on wellbeing, HR matters, recruitment, and inclusivity efforts.

The traditional NHS recruitment process—formal and often daunting—has been thoughtfully adapted. Job advertisements now emphasize attitudinal traits rather than long lists of credentials. Application processes have been reimagined to accommodate the unique challenges care leavers might experience—from not having work-related contacts to facing barriers to internet access.

Possibly most crucially, the Programme acknowledges that beginning employment can create specific difficulties for care leavers who may be handling self-sufficiency without the support of family resources. Issues like travel expenses, personal documentation, and bank accounts—taken for granted by many—can become substantial hurdles.

The elegance of the Programme lies in its thorough planning—from clarifying salary details to helping with commuting costs until that critical first salary payment. Even ostensibly trivial elements like rest periods and professional behavior are carefully explained.

For James, whose NHS journey has "changed" his life, the Programme offered more than a job. It gave him a perception of inclusion—that intangible quality that develops when someone feels valued not despite their past but because their distinct perspective improves the institution.

"Working for the NHS isn't just about doctors and nurses," James notes, his gaze showing the quiet pride of someone who has secured his position. "It's about a family of different jobs and roles, a group of people who truly matter."

The NHS Universal Family Programme embodies more than an job scheme. It functions as a strong assertion that institutions can evolve to embrace those who have navigated different paths. In doing so, they not only transform individual lives but improve their services through the unique perspectives that care leavers contribute.

As James walks the corridors, his involvement silently testifies that with the right assistance, care leavers can flourish in environments once thought inaccessible. The arm that the NHS has extended through this Programme represents not charity but recognition of overlooked talent and the essential fact that all people merit a family that supports their growth.