Tackling Disabling Practices: co-production and change.

Disabled people's lives are often devalued, by comparison with others' (ODI, 2011). For instance, there are scandals in care homes (Flynn, 2012) and in the health service (Heslop et al., 2013; Francis, 2012) and we know that social care is struggling due to financial cuts (Woods et al., 2011). Disabled people have long said that they can provide solutions for themselves (Oliver & Barnes, 2012) and this notion is now embraced by government policy which aims for disabled people to exercise 'choice and control' over their own lives. In all these areas, there are policies that identify the potential problems and lay out by contrast the person-centred goals of government (DH, 2012). The problem is therefore not about a lack of appropriate policy, but the gap between that policy and its enactment in practice. There are many areas in which research has shown what works, but in which we do not yet know how to stimulate and maintain changes in practice. Instead of simply describing the barriers faced by disabled people, we will focus instead on mechanisms of change, aiming to find out what theoretical ideas have practical adequacy. This research aims to focus on how to develop and sustain practices that are on the terms of disabled people themselves. Phase 1: Theories The first key word in our title is 'Co-production', where disabled people's own solutions are in the spotlight. The DRUK (Disability Rights UK) is a partner in this project, and will lead our thinking about co-production. Disabled people are centrally involved across the various strands, and we will collect evidence about the process of co-production from the point of view of all those involved in the study itself. Our second key word is 'change' and we will form a 'Getting Things Changed' group, starting with a series of seminars on: 1) user-driven change; 2) interventionist conversation analysis; 3) social practice theory; 4) theories of 'sense making'. These will kick-start a sustained dialogue across the length of the project. Phase 2: Research based Interventions The central part of the study is organised into five parallel research based interventions, to identify problematic social practices and work out how to tackle them. Each strand delivers action and insight about how to make changes on the terms of a specific grouping of disabled people and within a different layer of social life. All of these are areas in which research has already revealed problems of practice. The five strands focus on 1) how to improve everyday interaction between people using primarily non-verbal means of communication and their support workers, 2) how to change practices in universities, which unintentionally marginalise disabled students; 3) how to shift health care practices by making 'reasonable adjustments', 4) how to develop better interdisciplinary support for parents with learning difficulties, particularly where child protection issues have been raised; 5) how to affect statutory commissioning of social care by listening to disabled people's own solutions. In each of these areas, we will work with disabled people, to help identify improvements and understand how to sustain them. Phase 3: Embedding Change Impact is both an outcome and a focus of the study, running through everything we do. The final phase will bring these activities together in academic outputs, policy impact and in dissemination to a network of disability organisations, as we did in the recent Confidential Inquiry (Heslop et al., 2013). Disability Rights UK and its networks are equally a key to our routes to impact, and we are well placed at NFRC to disseminate via disability events and journals. Following our three sets of project briefings for policy makers, during this final period we will hold events led by each of the five strands, and a public dissemination event at a media centre in Bristol.