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:

A review of relevant information
Speaking to local people
Public events and hearings
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:

implementing the recommendations from the Direct payment review, an independent report by Ruils (an organisation run and controlled by Disabled people) which looked at direct payment support in the Borough
co-producing 'what is good direct payment support' and setting up a new direct payment support service, funded by the Council from January 2020, based at Action on Disability (AOD) a local Disabled People’s Organisation (DPO)
working with residents to review how residents can access Council services
resourcing the Disability Forum Planning Group to make sure that new planning applications create new buildings that are accessible and inclusive for everyone
working with residents to develop the Disabled People’s Housing Strategy (DPHS).

Key example: Co-production with Disabled residents of the redevelopment of Civic Campus project (Hammersmith Town Hall and surrounding area). Open
One of the first successes has been the co-production work on the Hammersmith Civic Campus project, a huge public project, which includes refurbishment of the town hall and the development of new housing and a cinema.

Six Disabled residents (DRT) have worked with council officers from planning, the architects Rogers Stirk Harbour + Partners and Proudlock Associates, which is a Disabled person-led access consultancy, as a team.

This way of working has ensured a high level of inclusive design throughout the process, something both Disabled residents and the architects have described as a pioneering way to work and not the usual way that things are done.
- Co-chair is a Disabled resident and residents are paid for their work.
- Residents were part of the team and not just seen as ‘service users’ - this built respectful working relationships.
- Disabled residents helped identify barriers to working together as a team and to find solutions to remove them.
- Early practical difficulties were resolved, for example, meeting each other’s access needs.
- Everyone took part in a Disability equality training team building workshop learning together.
- The architects say this way of working has saved time and money in the long term.
The planning application was agreed in February 2019 and Disabled residents will continue be part of the team until the work is completed. The work has been shortlisted for a National Planning Awards 2020. See Civic campus update.

Barriers faced by Disabled people in using buildings and open spaces were raised early before plans were submitted rather than left to detailed design at a later stage. This way of working together allowed robust solutions to be found early as well as saving time and money for the developer. This is most unusual and should be adopted in all major development projects.
Jane Wilmot Co-chair Disabled Residents Team

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.

Commitment to being successful from Disabled residents, councillors / Leader of Council and Council officers including the Chief Executive and the Senior Leadership Team.
Appointing a strategic senior officer for co-production under the Chief Executive’s office.
Running accessible meetings in a language everyone can understand and having all documents in Easy Read including the role descriptions for the implementation group and the strategic officer.

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.

Creating a co-production culture Open

Recommendation 1:

The Council brings in a human rights way of working to the way it plans its policy and services. The Council should use the UN Convention on the Rights of Persons with Disabilities (UNCRPD) as the base for change.

Recommendation 2:
Open
The Council brings in a policy which means that the Council must work in co-production with Disabled residents.

Recommendation 3:

The Council plans and puts in place an accessible communication strategy. This should promote co-production in the whole Borough.
Training and development plan Open

Recommendation 4:

The Council works with the Co-production to put together a co-production support strategy. Support should be put in place so that the strategy can be carried out.

This means giving the right skills to Disabled residents, local Disabled People’s Organisations (DPOs), staff and councillors so that they can work together with the council to plan and carry out policies and services.
Service design and commissioning Open
Recommendation 5:

The Council co-produces a framework. This framework should have:
- Information about quality assurance, this is information about how the Council will make sure its services and the way it works are good quality.
- Information about its values and how these are used in the Council’s work. These should be social values, about how people are seen and treated by the Council. It should also have information about its economic values, this means its values around money and how it is spent.
This will give information about the Council’s values and how it will work and behave. It will give information about how all organisations running services which are paid for by the council will do the same.
Resourcing co-production Open

Recommendation 6:

The Council looks at how much money and resources are spent on different ways of involving Disabled residents. For example, co-production, linking in with Disabled people, and consultations with Disabled residents.

Once the Council knows how much it spends on this, a new co-production budget should be put together.
Review and funding of Disabled People's Organisations (DPOs) Open

Recommendation 7:

The Council sees how important Hammersmith & Fulham’s Disabled People’s Organisations and their networks are. The Council sees how important their values and voices are.

The Council must work with Disabled People’s Organisations to decide on a long-term plan for paying for this work - this can be called a funding strategy.

This will make sure that local Disabled residents can access their rights, inclusion and equality and that Disabled residents can lead on co-production.
Independent monitoring and evaluation Open

Recommendation 8:

Carry out monitoring and evaluation of co-production work and of how well the recommendations are put into place. This should be done so that information about how co-production can be used and how this affects people’s lives can be shared outside Hammersmith & Fulham.

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?

Build relationships and work together with residents, councillors and Council officers.
Develop a vision to achieve your goals and that will need to be supported by resources to make it happen.

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

coproduction@lbhf.gov.uk

View more: Co-production practice examples