Co-production in social care: What it is and how to do it

Practice example: Nothing about Disabled people without Disabled people

How setting up a Disabled People’s Commission, led by Disabled residents in the London Borough of Hammersmith & Fulham led to eight co-production recommendations for transforming public services.

The Commission was established in 2016 and all of its recommendations for change were accepted in full by the Council’s Cabinet in December 2017. The report was launched in June 2018 and was followed by the setting up of a co-production implementation group that includes Disabled residents, Councillors and senior Council officers to take forward making the recommendations a reality.

The working definition of co-production is:

Local Disabled residents are working together with decision-makers to actively identify, design, and evaluate policy decisions and service delivery that affect our lives and remove the barriers we face.

About this project

Hammersmith & Fulham Council set up the Disabled People’s Commission in 2016, to work with Disabled residents to look at the barriers that stop people being able to take part in day-to-day life and to find ways to overcome them with a commitment to inclusivity and accessibility. This was across all barriers and not just those that arise in social care.

Hammersmith & Fulham Council has a long history of working with Disabled residents on issues that affect their lives that, for example, led to abolishing charging Disabled residents for essential Independent Living ‘home care’ support in 2015. See Tax on disability to be abolished.

Its vision was to put in place a new way of doing things that saw Disabled residents, councillors and officers and other organisations in the borough working together in a way that values and respects the rights of local Disabled people: 'Nothing about Disabled people without disabled people'.

The Commission took a social model of disability approach to its work.

Social model of disability: this is when Disabled people are seen as people with impairments who are ‘Disabled’ by the barriers in society. These barriers discriminate against Disabled people and push us out of society. It is the way society is run and organised that is the problem, not the Disabled person.

Nothing about Disabled people without Disabled people (H&F Council, 2018)

The Commission defines Disabled people as:

all people with physical, cognitive, and sensory barriers, people with learning difficulties; Deaf people, deafened, hard of hearing people, mental health system users, and survivors, neuro-diverse people such as those with autism, dyspraxia, attention deficit disorder (ADHD), Asperger syndrome and dyslexia, people with long-term health conditions and people who self-identify. We mean Disabled people of all ages that experience barriers including Disabled children & young people with special educational needs labels.

The Commission

All commissioners who were appointed self-identified as Disabled people and reflected a wide age range of local residents.

The Commission worked in four stages:

  1. A review of relevant information
  2. Speaking to local people
  3. Public events and hearings
  4. A final report

What has co-production meant to the project?

Working towards co-production is at the heart of everything that has been achieved. Co-production is the mechanism to bring people together, to work together to start to dismantle the barriers.

The Disabled People’s Commission, through its recommendations, has progressed work including:

What has helped in a co-production approach?

Co-production at every stage – from the setting up of the Commission, developing a vision and agreeing on eight recommendations for change, to setting up of a co-production implementation group to take forward the recommendations.

What are the main strengths, differences or outcomes in the approach that has been taken?

The work has been led by Disabled people themselves.

The eight strategic recommendations aim to remove significant barriers for Disabled residents so they are strategic and not piecemeal.

The results will be measured by Disabled people themselves.

Below is a list of the Commission’s co-production recommendations.

What difficulties were there in implementing a co-production approach?

The Co-production implementation group (HFCIG) is at the very beginning of implementing the change, but the will is there and it will need to lead the change by creating a culture that makes it possible. It takes time to develop a Council-wide framework and make it happen.

How has the project worked to engage all sections of the community?

This will take time as co-production activities start to increase. We had a diverse group of Commissioners as the work of the Commission took evidence from a wide range of Disabled residents through a survey, public meetings, International Day of Disabled People event and as more people started to engage in the different opportunities for co- production work.

The Council has not worked like this before and part of its work is building trust and making it part of its everyday work. So more and more residents are part of making their own Borough inclusive and accessible.

What advice would you give to others who might be considering doing a similar thing?

Co-production needs to be done across the board and as scary as it sounds, it needs to be done in a big way.

Disabled resident

Further information

Kevin Caulfield / Tara Flood
Strategic Lead Co- production (Job share)
Public Services Reform Department (PSR)
Chief Executive’s Office
London Borough of Hammersmith & Fulham