Among the organized chaos of medical professionals in Birmingham, a young man named James Stokes navigates his daily responsibilities with subtle confidence. His polished footwear whisper against the floor as he greets colleagues—some by name, others with the familiar currency of a "hello there."

James carries his identification not merely as an employee badge but as a declaration of inclusion. It rests against a neatly presented outfit that betrays nothing of the challenging road that preceded his arrival.

What separates James from many of his colleagues is not obvious to the casual observer. His presence gives away nothing of the fact that he was among the first participants of the NHS Universal Family Programme—an effort created purposefully for young people who have been through the care system.

"It felt like the NHS was putting its arm around me," James reflects, his voice measured but revealing subtle passion. His observation summarizes the heart of a programme that seeks to transform how the vast healthcare system perceives care leavers—those often overlooked young people aged 16-25 who have transitioned from the care system.

The statistics reveal a challenging reality. Care leavers commonly experience greater psychological challenges, economic uncertainty, shelter insecurities, and reduced scholarly attainment compared to their peers. Underlying these impersonal figures are human stories of young people who have traversed a system that, despite best intentions, regularly misses the mark in offering the stable base that molds most young lives.

The NHS Universal Family Programme, established in January 2023 following NHS England's promise to the Care Leaver Covenant, embodies a profound shift in organizational perspective. At its heart, it recognizes that the complete state and civil society should function as a "communal support system" for those who have missed out on the security of a conventional home.

Ten pioneering healthcare collectives across England have charted the course, establishing structures that reimagine how the NHS—one of Europe's largest employers—can create pathways to care leavers.

The Programme is thorough in its strategy, starting from comprehensive audits of existing practices, creating governance structures, and securing leadership support. It recognizes that successful integration requires more than good intentions—it demands practical measures.

In NHS Birmingham and Solihull ICB, where James began his journey, they've established a regular internal communication network with representatives who can provide support, advice, and guidance on personal welfare, HR matters, recruitment, and inclusivity efforts.

The traditional NHS recruitment process—formal and potentially intimidating—has been intentionally adjusted. Job advertisements now focus on character attributes rather than long lists of credentials. Applications have been redesigned to consider the unique challenges care leavers might encounter—from lacking professional references to having limited internet access.

Maybe most importantly, the Programme recognizes that beginning employment can pose particular problems for care leavers who may be managing independent living without the support of familial aid. Concerns like travel expenses, identification documents, and financial services—assumed basic by many—can become major obstacles.

The brilliance of the Programme lies in its attention to detail—from clarifying salary details to offering travel loans until that critical first salary payment. Even ostensibly trivial elements like rest periods and office etiquette are deliberately addressed.

For James, whose professional path has "changed" his life, the Programme provided more than employment. It gave him a perception of inclusion—that intangible quality that develops when someone feels valued not despite their background but because their distinct perspective enriches the institution.

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

The NHS Universal Family Programme embodies more than an work program. It exists as a powerful statement that institutions can evolve to welcome those who have navigated different paths. In doing so, they not only transform individual lives but enrich themselves through the unique perspectives that care leavers bring to the table.

As James moves through the hospital, his involvement subtly proves that with the right assistance, care leavers can succeed in environments once thought inaccessible. The support that the NHS has provided through this Programme signifies not charity but acknowledgment of untapped potential and the essential fact that each individual warrants a support system that supports their growth.