Table 2 Types of NED perlocution observed in board meetings

Type 1 Supportive

 I am impressed with this report and the extent of working with partners. (Site D, PCT).

 Are you happy with the 4 h target? [Board setting criteria for pilot work in the new Minor Injuries Unit] (Site A, PCT).

 How are the problems with the NHS IT system affecting the staff at grass-roots level? (Site E, FT).

 Are you content with the length of time between an incident and the report; is it good enough? (Site F, FT).

Type 2 Lesson-seeking

 How have we managed to reduce both long term and short-term sickness? (Site H, SGT).

 Do we know why our C. Diff rates have improved so much? (Site E, FT)

 The success of the sexual health model is to be applauded; is there a model here that we can also use for immunisation? (Site C, PCT).

Type 3 Diagnostic

 Why are we not achieving targets for out of hours diabetes services; is the target unrealistic? (Site B, PCT).

 Why is COPD not included in the top ten [World Class Commissioning] priorities? (Site D, PCT).

 It says here that we’re running at 148 % capacity: how? (Site G, SGT).

 Why are almost 50 % patients waiting more than 31 days? (Site A, PCT)

 Why are we focusing on hips and knees [in reducing waiting lists]? (Site E, FT).

 Communication [with patients whose appointments were cancelled] is a weak area and needs improving. (Site G, SGT)

Type 4 Option Assessment

 Will the new informatics strategy improve co-ordination of diabetes management? (Site B, PCT).

 What are the complaints about? We’re far more interested in the nature of the complaints; we need more detail on this rather than the process to resolve them. (Trust G, SGT).

 What are the additional costs for pre-op screening of all patients [for MRSA]? (Site H, SGT).

 The risks and staffing are quite different for home and hospital births; are the tariffs [i.e., payments to the hospital] different? (Site E, FT).

Type 5 Seeking Strategy

 How will we know that changes [resulting from a Health Care Commission report on one of the provider trusts] are being sustained? (Site B, PCT)

 Who are we consulting with [about regionalisation of stroke and trauma services]? (Site C, PCT).

 How will we review this [Health Care Commission] rating during the year to ensure we’re not in the same situation again? (Site F, FT).

 How can we take this [problem with inpatient and outpatient waiting times] forward in relation to our Foundation Trust application? (Site H, SGT).

 When will we see improvement in the privacy and dignity performance indicators? (Trust D, PCT).

Type 6 Requesting Fuller Reports

 We can’t see what the targets are and what the current baseline is; this needs different presentation. (Site A, PCT).

 Can you please provide a separate report on orthopaedics each time and add it to the exception reporting. (Site F, FT).