Employee spotlight: Oliver Lake, Transition CEO for PRSB

We sat down with Oliver Lake, PRSB’s new Transition CEO, to ask him a few questions about his experience, what drives him, and a bit about life outside of work.

Oliver Lake portrait shot


What initially drew you to your field, and how has that passion evolved?

My first job at age 16 was in Data Input and IT support at a GP surgery after finishing my GCSEs (my mum was a receptionist there) …and I rapidly learnt about the importance of both having the right tools for the job and how vital training is to use clinical systems properly.  I will always remember the practice manager tearing her hair out because of the inconsistencies in quality between different teams, meaning that reporting was mixture of system-generated data, forms and in some cases referring back to the Lloyd George notes!  Since then, I have always had an interest in technology and data, and I also spent 15 years working in NHS communications and transformation to broaden my horizons.

 

What skill or expertise do you bring to the table at the PRSB?

I hope relevant background and experience in how to make change happen, taking the lesson that if you are over ambitious, persistent and determined you will see far greater improvement than if you hadn’t had such high aspirations in the first place.

 

What’s a recent project or initiative you’ve been involved in that you’re particularly proud of?

There are so many PRSB projects that I am proud of, but I’m going to pick our recent work on Person Characteristics for NHS England where we gathered intelligence on the clinical information requirements related to person characteristics – to help identify data items which are routinely needed when treating patients, but which aren’t generally available within IT systems in use in the NHS.  It was an incredibly thorough piece of work, delving into specifics which are vital to maintain patient safety and also dignity and respect.  Both our team (Sarah Jackson, James Critchlow and Steve Bentley) were amazingly dedicated to the quality of consultation and analysis, but also the NHS England team (Cath Chilcott and colleagues) were a delight to work with.  I really hope the report can be taken forward and we will support this as much as we can.

 

What difference do you think standards can/do make to health and care?

I don’t think that the vitality of standardised high-quality data can be underestimated – even little seemingly inconsequential differences in recording data can have a huge impact on patient outcomes and the ability to use data for population health.  More than that, listening to our patient representatives tell their stories (and I’m sure we can all relate to this) about having to repeat history, tests and personal preferences when they move between providers really incentivises us to solve that problem.

 

What changes do you hope your role/PRSB can make to health and care?

I want PRSB to provide more system leadership so that high quality standardised health and care data enables better and safer care, empowering innovation and building trust in technology-driven health such as AI.

 

If you could make one change to the health and care sector, what would it be?

To invest in implementation and evaluation, rather than just the procurement of a product of solution.

 

What is your favourite thing about your job?

The people – both in the PRSB, but working with our amazing clinical leads, patient representatives and across with our members and partners – I’ve not met anyone who does not want to make things better or is negative about the potential from the analogue to digital shift. What is so enjoyable about working at PRSB is that one minute you can be in the detail of diabetes, then it will be social care, then it’ll be maternity – there is so much learning possible by working across the sector and across the 4 nations.

 

Do you have any hobbies or talents?

In our house, painting is often referred to as my ‘hobby’, although I would much rather be riding my Vespa, or playing darts!  My ’talent’ is playing the piano by ear – you name a song, and I’ll bang it out!

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CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”

Successful teams have the functional skills to lead a task, benefit from diversity, and are led in a way that creates time and space for reflection; the ability to take stock periodically, of the task and of the way in which the team is engaged in delivering it. Your stakeholder analysis [HYPERLINK] should help you assemble the most appropriate team and identify how the team interacts and relates to other stakeholders like sponsors, services users, etc.

The variation in the size, both in terms of population served and numbers of constituent organisations, and of complexity, between Integrated Care Systems, precludes the possibility of any prescriptive guidance on the way in which this team is assembled.

Engeström’s expansive learning cycle of learning actions explains how there are 7 stages of learning actions;