Continuing our series looking at people and organisations in the rail industry, RailStaff asks the question: What do they do?
So far, this series has looked at the work of the Rail Safety and Standards Board (RSSB) and the Office of Rail Regulation (ORR). Both promote safe working practices on the railway, with the RSSB setting standards and the ORR enforcing them. Writes Nigel Wordsworth
However, what happens on the day that things go wrong and there is an accident or, even worse, somebody hurt? No matter whether it is an overturned digger, or a crashed train, someone needs to find out what went wrong, so that lessons can be learned and it doesn’t happen again.
Enter the Rail Accident Investigation Branch (RAIB). Set up in 2005 following Lord Cullen’s public inquiry into the Ladbroke Grove rail accident, the RAIB is one of three transport Accident Investigation Branches, the other two being Marine and Air.
Each Branch is required to be operationally independent of all other organisations, including the Department for Transport (of which they are part) and their respective regulators. The RAIB’s chief inspector, Carolyn Griffiths, reports directly to the Secretary of State for Transport on investigation matters.
The RAIB investigates whenever a serious railway accident occurs, one from which it judges there could be material safety lessons learned. A serious accident is defined as a derailment or collision which results in, or could result in, the death of at least one person, serious injury to five or more people, or extensive damage to rolling stock, the infrastructure or the environment. It also includes other types of accident with an obvious impact on railway safety regulations or the management of safety.
As well as these statutory duties, the RAIB has the discretion to investigate any other accident or incident, which, under slightly different circumstances, may have led to a serious accident. It can also look into any other accident, near miss or trend if it believes an RAIB investigation might lead to recommendations that will materially improve the safety of the railways. Its jurisdiction is the whole of the UK, including Northern Ireland and the channel tunnel in collaboration with its French counterpart, BEATT.
In addition, the RAIB investigates worker accidents that are specific to the operational railway (defined as those associated with the movement of trains which includes on track engineering vehicles). It does not investigate suicides or accidents involving deliberate trespass.
All this is laid down in the Railways (Accident Investigation and Reporting) Regulations 2005. These Regulations specify that mainline passenger, freight, metro, heritage, tramway and cable-hauled railways are all within RAIB’s scope. They also place a duty on the railway industry to notify the RAIB of specific types of incident within prescribed time limits which ensures that RAIB inspectors can respond quickly, where necessary, to attend the accident site.
Training an inspector
Being an accident investigator is a very skilled job. RAIB inspectors are generally recruited from specialisms within the industry, and are then trained in-house to become competent, cross- discipline, professional accident investigators.
The type and scope of the training is so specialised that it had to be developed especially for or by the RAIB. The industry, the European Rail Agency (ERA) and other accident investigation organisations have all expressed interest in learning from and sharing this training, and the RAIB is working to facilitate this where ever possible.
Once notified of an accident, the RAIB will normally lead an investigation unless there is a clear indication that a serious criminal act has caused the accident, in which case the police will normally lead.
If it is felt that there is critical evidence at site, for example perishable evidence or evidence that needs to be recorded or secured, inspectors will be deployed immediately to the site.
In most cases the RAIB conducts a preliminary examination. This is to gather sufficient details and evidence to enable the RAIB to make an informed decision on whether or not to conduct a full investigation. In forming this decision, the RAIB takes into account the actual or potential seriousness of the accident or incident, the potential for recurrence, and whether an investigation by the RAIB would likely meet the aim of improving the safety of the railways.
If the accident or incident does not warrant a full investigation, but the RAIB feels there may still be some learning points for the industry, it will publish a short bulletin.
Although completely and legally independent, the RAIB will involve the industry in its investigation as far as is appropriate and keep all parties informed of progress during the investigation. It will share technical evidence and factual data arising from its tests and examinations with other statutory investigatory bodies. It will not, however, share the identity of witnesses nor their statements so as to enable witnesses to speak with the RAIB openly.
The RAIB’s sole function is the independent investigation of accidents and incidents with the aim of determining the causes, improving safety and preventing similar accidents and incidents in the future. It does not determine liability or apportion blame.
Therefore, after every investigation, a report is published outlining what happened, the cause of the accident, and any recommendations that the RAIB feels justified in making to improve safety in the future.
The RAIB has no role or statutory powers to follow up on the implementation of recommendations, other than if it becomes relevant as part of a subsequent investigation. It is the safety authorities (the ORR, the Department of Regional Development Northern Ireland, and the Intergovernmental Commission for the Channel Tunnel) which must ensure that the industry takes appropriate and timely action in response to the RAIB’s recommendations.
Since going operational in 2005, the RAIB has published 182 investigation reports into accidents or incidents, and 30 bulletins. There are currently 27 investigations in progress and the average time to complete an investigation report is approximately 11 months.
On average, each investigation report includes five recommendations. Of these, where the outcome has been reported, 96% have been accepted and have been, or are being, implemented. Currently, the response to 87 recommendations is being considered by the industry.
The RAIB works from two centres. One has recently moved to Farnborough, on the same site as the Air Accident Investigation Branch, and the other is in Derby. The chief inspector, Carolyn Griffiths, manages a budget of around £5 million a year. Even this amount has come under cost- saving pressure, and is around £1 million less than it was a year or so ago.
Carolyn was, in fact, the first ever employee of the RAIB in 2003. An experienced railway engineer who has worked in the UK, Sweden, Germany and Singapore, she was recruited to establish the organisation from scratch and develop its legislation, its team and all its training, logistics and operational procedures ready for the launch in 2005.
Seven years on
Looking back on the first seven years of operation, Carolyn is proud of the reputation that the RAIB has gained. “We have come a long way in seven years,” she commented. “Starting from nothing, the RAIB is now seen by others as a world leader in rail accident investigation.
“We have had investigators from other European countries come to us for learning and training. We shall shortly be receiving investigators from further afield on our upcoming training courses. We have also assisted other countries’ investigations when they feel that they could benefit from our particular expertise or experience.”
Over the seven years, a wealth of experience has been built up. “As time has gone on, our knowledge increases and we have been able to identify trends in the accidents we investigate,” Carolyn continued. “We have seen causal factors that are connected to common areas of equipment, infrastructure or operations, and this has influenced our ongoing recommendations and the safety discussions we have with the industry.
“Examples are level crossing risk management and safety management and leadership during track renewals and maintenance.” These areas will be discussed in more detail in the RAIB’s Annual Report which will be published later this month.
“In recent years, we have seen a limited number of accidents which our earlier recommendations might, in our opinion, have prevented. In these cases it is vital we investigate why those recommendations were not implemented, so we look at actions taken by the industry and the safety authority in this respect. And we will redouble our own efforts to influence the adoption of any additional related recommendations.
“The RAIB makes recommendations – it can not require organisations to take actions. It is the safety authorities’ responsibility to ensure those to whom we make those recommendations properly consider them and take the appropriate action.”
Carolyn is upbeat. “We have a very good working relationship with the industry and other stakeholders such as the police. People have seen what we have to offer, we have credibility and are taken seriously, and we are now welcomed at accident sites as everyone knows what we have to do and the ability to do it.”
So, although RAIB inspectors are only seen on the railway when things have gone wrong, their resulting recommendations are designed to make everyone safer. No wonder the whole industry is cooperating.