Tackling Disabling Practices: Co-production and Change

In this blog Sue Turner discusses a  three year research project by the Norah Fry Research Centre, School of Policy Studies in partnership with Disability Rights UK

The Equalities Act 2010 requires public sector organisations to put reasonable adjustments in place for disabled people, so that they will not be disadvantaged when accessing services. Unfortunately we know that this does not always happen. Why is this and what can be done about it?

Broadly, these are the questions the ‘Tackling Disabling Practices’ project is trying to answer, recognising that top down policies do not always work, and using different theories of change to understand what is happening. The project is big, consisting of five different strands through which questions about what leads to change at a practice level can be asked, and crucially how disabled people are involved in, and are part of making change happen.

Briefly the strands are:

  1. Improving everyday interaction between people with dementia and their support workers; also young people with learning disabilities who are starting to employ PAs.
  2. Changing practices in universities which unintentionally marginalise disabled students and disabled staff
  3. How to shift health care practices by making reasonable adjustments for disabled people using hospital services.
  4. How to develop better interagency support for parents with learning disabilities.
  5. How disabled people can take direct action to develop services and affect commissioning practices.

I am involved in strand three. With regard to this strand it is worth remembering that the NHS Contract includes the requirement for service providers to carry out an annual audit of compliance with providing ‘reasonable adjustments for service users, carers and legal guardians who do not speak, read or write English, or who have communication difficulties (including hearing, oral or learning impairments’ (NHS England 2015, p.14). Work is currently focused on gathering information from an analysis of audit and inspection documents. There will also be a survey of patient experience leads, Healthwatch representatives and disabled people and their families, as well as face-to-face interviews with disabled people. The information gathered will inform two workshops for representatives from NHS hospitals and disabled people including people with learning disabilities who have used these hospitals’ services. The first workshop will focus on identifying strategies and approaches that could be taken to improve the delivery of reasonably adjusted services, and will ‘buddy up’ participants for peer support purposes. The second workshop will build on what people have learnt from implementing these strategies and approaches, and identify learning that could usefully be shared more widely.

So it is early days for this project, but I wanted to share this with you as I am sure that getting reasonable adjustments embedded in day to day practice is something that many of you will be grappling with. If you have found strategies that work, or have audited the provision of reasonable adjustments in your own organisations we would love to hear from you. Please contact Stuart Read (stuart.read@bristol.ac.uk).


Sue Turner, Learning Disability Lead at the NDTi



NHS England (2015) NHS Standard Contract 2015/16 Service Conditions. Available at: http://www.england.nhs.uk/wp-content/uploads2015/03/14-nhs-contrct-serv-conditions.pdf


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