UK NSA Annual Safety Report 2012

Transcription

1 UK NSA Annual Safety Report 2012 September 2013

2 Contents Scope of the report 3 Summary of the report 4 1. Introduction 5 Introduction to the report 5 2. Organisation 7 Introduction to the organisation 7 3. The development of railway safety Important changes in legislation, regulations and administrative provisions The development of safety certification and authorisation Supervision of Railway Undertakings and Infrastructure Manager Reporting on the application of the CSM on risk evaluation and assessment Alternative measures through derogations regarding ECM certification scheme NSA conclusions on the reporting year priorities Northern Ireland Sources of information Annexes 50 Office of Rail Regulation September 2013 Title of document 2

3 Scope of the report Article 18 of the Railway Safety Directive requires National Safety Authorities (NSAs) to publish an annual safety report. This report covers the UK NSA s activities from 1 January to 31 December In the UK, the role of NSA is shared between the Office of Rail Regulation (ORR) and the Department for Regional Development in Northern Ireland (DRDNI). ORR is responsible for England, Scotland and Wales, collectively known as Great Britain (GB), and DRDNI is responsible for Northern Ireland (NI). ORR represents DRDNI in relations with the European Railway Agency (ERA); therefore this report covers the UK as a whole. The Common Safety Indicator (CSI) data has been aggregated at UK level and includes data for the mainline network in Great Britain and Northern Ireland. Chapter K relates specifically to Northern Ireland. As well as the UK NSA, ORR is also the regulatory body and competition authority for the mainline UK railway industry. The scope of this report is the entire UK mainline railway system (including High Speed 1 line between London St Pancras and the Channel Tunnel), and covers both 1435mm (GB) and 1600mm (NI) networks. Mirroring the scope of UK implementation of the Railway Safety Directive, the report does not cover metros, tramways and other light rail systems, or infrastructure that is functionally separate from the rest of the UK network. The report does not cover the Channel Tunnel which has a separate NSA, the Intergovernmental Commission (IGC). The IGC produces a separate annual report to ERA. This report will be made available to the UK Department for Transport (DfT), the Railways Accident Investigation Branch (NIB), the Railway Safety and Standards Board (RSSB), RUs, IMs, ECMs, passenger associations (Passenger Focus and London Travel Watch) NoBos and DeBos. Office of Rail Regulation September 2013 Title of document 3

4 Summary of the report Great Britain continues to have one of the safest railways in Europe in During the year one track worker was killed after being struck by a train while carrying out maintenance work on adjacent line. No passengers were killed in 2012 as a result of railway accidents. There were 42 CSI reportable fatalities on Great Britain s mainline railway network during 2012, a fall from 55 the previous year, and largely consistent with figures going back to 2006 when CSI data started being collected. Northern Ireland also has one of the safest railways in Europe and had no CSI reportable fatalities and no serious injuries in Office of Rail Regulation September 2013 Title of document 4

5 1. Introduction Introduction to the report Article 18 of the Railway Safety Directive states: Each year the safety authority shall publish an annual report concerning its activities in the preceding year and send it to the agency by 30 September at the latest. The report shall contain information on: a) The development of railway safety including an aggregation at member state level of the Common Safety Indicators (CSIs) laid down in annex 1; b) Important changes in legislation and regulation concerning railway safety; c) The development of safety certification and safety authorisation; d) Results of and experience relating to the supervision of infrastructure managers and railway undertakings. This is the seventh annual report from ORR to the European Railway Agency (ERA). The report will be published on the ORR and ERA websites and will contribute to the next ERA biennial report on safety performance in member states which is due to be published in ORR produces an annual report on its overall activities which is available on the ORR website. 1 ORR also produces an annual health and safety report covering our health and safety strategy and our key finding from the previous year. The report and previous versions can be found on the ORR website. 2 This report reflects the ERA template and feedback received from ERA and other NSAs. Certain sections have been abbreviated or combined for editorial purposes. Where we have been unable to provide the required information, an explanation has been given on why this has not been possible. 1 ORR Annual Report and Accounts 2012/13: 2 ORR Health & Safety Report 2013: Office of Rail Regulation September 2013 Title of document 5

6 Railway structure information Railway network In GB in 2012 the railway network consisted of 15,777 km of track, of which 5,262 km is electrified, either 25kV AC overhead, 750V DC third rail or some small sections which are dual voltage 25 kv AC overhead/ 750V DC third rail. A map showing the main routes can be found in annex A. Railway undertakings and infrastructure managers Network Rail is the Infrastructure Manager for GB s mainline railways. Network Rail (High Speed), a subsidiary of Network Rail, is the Infrastructure Manager for HS1(the high-speed line between London and Folkestone) and carries out operation, maintenance and renewal of the asset. Network Rail is a private company limited by guarantee. The vast majority of passenger services on the GB mainline are operated by franchised train operating companies. A small number of open-access operators run services without a franchise on specific routes. Freight services are provided by a small number of freight operating companies. Details of railway undertakings and infrastructure managers that operate in GB can be found in Annex A. As well as the mainline railway ORR is also responsible for regulating health and safety on the UK s six tramway systems (Croydon, Manchester, Sheffield, Blackpool, Nottingham and Birmingham), over 200 heritage railways, London Underground, the Docklands Light Railway, Glasgow subway and the Tyne and Wear Metro. These operations are all outside the remit of this report. Summary: general trend analysis Great Britain s mainline railways continued to have a good safety record. During 2012 the number of CSI reportable fatalities fell from 55 to 42. The majority of fatalities continued to be unauthorised users and the figure fell from 45 to 33 in For the fifth consecutive year there were no CSI reportable passenger fatalities. Office of Rail Regulation September 2013 Title of document 6

7 2. Organisation Introduction to the organisation ORR is the safety and economic regulator of Britain s railways. We are independent of Government and of the rail industry but accountable to the UK parliament and the courts for the achievement of the objectives set out in UK and European Union law. These objectives require us to promote continuous improvement in: The health and safety performance of the railways The value for money the railways offer to users and funders, including meeting the needs of passengers and of freight users, and the wider needs of society and the economy In summary, we promote safety and value on Britain s railways. ORR has six directorates: Railway Safety Railway Planning and Performance Railway Markets and Economics Legal Services Corporate Services External affairs ORR as rail industry regulator Our regulation focuses on business risk, recognising that business risk includes commercial risks and health and safety risks. Health and safety is not an overhead or an optional add-on. It is a fundamental requirement and it is good for business. Health and safety regulation We safeguard the public by challenging the rail industry to improve its health and safety performance and prevent people being killed, injured or made ill as a result of its activities. Office of Rail Regulation September 2013 Title of document 7

8 What we do The rail industry in mainland Britain is made up of many businesses. We oversee those businesses and how they work together to keep the rail system safe. A business will be safe if its people manage risks effectively every day. Our role is to motivate businesses to have excellent health and safety management and to check that they identify and assess risks properly, control them effectively and comply with the law. We recognise that any business which either creates a risk or is partly responsible for a shared risk, must effectively manage that risk. This is irrespective of that business s profitability, availability of resources, or how long any contract they hold has left to run. Although ORR is also the economic regulator, this applies as much to ORR s dealings with Network Rail and HS1 Ltd as with any other companies. As the economic regulator for Network Rail, we decide what it has to deliver (its outputs) and how much this should cost. When we do this, we take safety into account so that the government s priorities are met. These are: a rail industry that maintains a high level of safety controls its costs and delivers both value for money for the taxpayer a good service to its customers We have identified five strategic themes across economic and safety regulation in order to categorise our work. We judge our own performance by how effectively the industry addresses them: Drive for a safer railway: Enforce the law and ensure that the industry delivers continuous improvement in the health and safety of passengers, the workforce and public, by achieving excellence in health and safety culture, management and risk control. Support a better service for customers: Use our powers to hold the industry to account for performance and standards of service across the railway network, for passengers and freight. Promote on-going improvement in the experience of passengers by encouraging the industry to work together, including to provide greater transparency of information. Secure value for money from the railways, for users and funders: Strengthen incentives for the whole industry to work together to drive greater efficiency from the use and maintenance of existing railway capacity, and more cost-effective investment in the network. Promote an increasingly dynamic and commercially sustainable sector: Support sustainable economic growth by promoting innovation and efficient long-term investment across the rail industry through the appropriate development of effective markets and regulatory intervention. Office of Rail Regulation September 2013 Title of document 8

9 Be a high performing regulator: Develop and apply proportionate and risk-based regulation, taking a whole-sector approach. Make more effective use of our resources across safety and economic functions, maximise the value of our regulation while minimising the costs of compliance for the industry. Our core focus We expect businesses to achieve proper control of risks by having an excellent safety management system. We expect leaders in the rail industry to understand their risks and how to measure their performance in controlling these. Our major concern is to secure high standards of protection from train-crash risk without businesses losing sight of other risks that need to be controlled, such as asbestos or falls from a height. We look for evidence of what is being done by businesses to control health and safety risks. We actively seek evidence through our inspections, investigations of incidents and permissions for certain activities. And we strike a balance on the resources we allocate to each. At all times, we act fairly and compare evidence against consistent standards of what businesses should be doing. ORR can use its enforcement powers to require improvement if that is needed. We will not settle for mediocrity or a culture of complacency. We will always ask whether improvement is needed, but we recognise that the law sets minimum standards and that an excellent organisation is one that delivers compliance with the law efficiently and consistently. We encourage excellence, but will not enforce beyond the standard set down in law. A railway system which is designed with safety in mind from the outset is more likely to deliver a railway that can be operated safely and efficiently for years to come. We expect careful thought during the design process to eliminate risks or reduce them where possible. We work with other European regulators to help deliver sensible regulation and a common European approach. This is so that trains can run through the Channel Tunnel to British and European destinations safely, and so that trains built in one country can operate in another. Like our European neighbours, we keep the legal framework for safety on the railway under review and can propose changes if necessary. We do this in line with the principles of better regulation, which underpin all that we do. Organisational flow ORR is a non-ministerial government department with an annual budget of 30 million. We are funded almost entirely through a licence fee and safety levy charged to railway service providers. In 2012 around Office of Rail Regulation September 2013 Title of document 9

10 55% of our costs related to our safety role, and 45% to economic regulation. The annual turnover of the rail industry in Great Britain is around 18 billion. ORR s health and safety activities are funded through a safety levy on the railway industry. The size of the levy paid is proportionate to the turnover of each organisation. ORR is led by a board appointed by the Secretary of State for Transport. Anna Walker is the current chair and begun her appointment on 5 July The Chief Executive is Richard Price, who began his role on 16 May As of 31 December 2012, ORR employed 273 people, down from 280 in December FTE worked in the health and safety directorate. Approximately 200 were employed were based in the London head office and around 70 either home based, or working in one of 5 regional offices in Glasgow, York, Manchester, Birmingham and Bristol. ORR structure chart An organisation chart for ORR at directorate level and a more detailed chart of the railway safety directorate are in Annex B1. A flowchart showing the relationship between ORR, other government departments and railway industry bodies can be found in Annex B2. Office of Rail Regulation September 2013 Title of document 10

11 3. The development of railway safety Initiatives to maintain/ improve safety performance ORR has teams of inspectors allocated to different areas of the railway network: The mainline Infrastructure Manager (Network Rail) and associated suppliers and contractors. Each Network Rail route has a team of inspectors assigned to it. There is also a national team that deals with issues, such as level crossings, that are relevant to all routes. Passenger railway undertakings Freight railway undertakings, metros, trams and heritage railways Transport for London (TfL). This team covers London Underground, the Docklands Light Railway and London Overground A central regulation team covering human factors, occupational health & safety and railway safety policy. The team also provides the UK secretariat to the IGC and CTSA which provide support to the head and members of the UK delegations. We are strategic in how we regulate health and safety on Britain s railways. ORR s strategy for regulation of health and safety risks is published on our website. 3 We do this to deliver a safe railway where the health and safety management is cost effective and performance is amongst the best in the world. ORR s health and safety strategy covers ten key areas: 1. Health and safety management 2. Industry staff competence and human failure 3. Management of change 4. Level crossings 5. Interface system safety 3 ORR s strategy for regulation of health and safety risks: Office of Rail Regulation September 2013 Title of document 11

12 6. Infrastructure asset safety 7. Rolling stock asset management 8. Workforce safety 9. Occupational health 10. Europe 1. Health and safety management A health and safety management system (SMS) is fundamental to the ability of an organisation to meet its legal obligations to identify, eliminate or reduce so far as is reasonably practicable, the risks its activities create. ORR has developed the railway management maturity model (RM3) 4, a tool which describes the components of effective safety management, such as leadership, staff competence, and proper risk management. We use RM3 to assess information gathered from inspections and investigations to develop a comprehensive picture of duty holder health and safety risk management capabilities. We encourage duty holders to use RM3 to test and pinpoint where and how to improve their capability to manage risk. Our inspectors work directly with duty holders as well as holding workshops to show how best to use RM3 and to share good practice. 2. Industry staff competence and human failure Workforce errors and violation can pose serious risks to railways. However, we are satisfied that both railway undertakings and infrastructure managers are taking positive action to sustain and improve staff competence. Human failure is a continuing priority because of the potential for multi-fatality events if a safety critical worker makes a mistake. ORR encourages and supports infrastructure managers, railway undertakings and other duty holders to embed human factors considerations into their management systems and endeavour to error-proof their operations and equipment designed to prevent human failure contributing to accidents. Critical to achieving this is having a validated competence management system that is proportionate to the risk, targeted to the needs of the organisation and relevant to its medium and long-term development. 4 RM3 is available on the ORR website: Office of Rail Regulation September 2013 Title of document 12

13 Our priorities for helping duty holders deal with human failure is to focus on ensuring that their SMS reliably identifies and controls risks from: Unreliable performance and errors; performance and safety failure due to competence, non-compliant behaviours, distraction or ineffective supervision; safety impact from insufficient human resource; and failures due to poor design of equipment, workplaces or the design of safe systems of work. 3. Management of change Change management processes are the means by which organisations ensure that changes to their structure, functions, procedures or processes are implemented such that the expected outcomes are delivered, and those issues that could have an impact on risk, are subject to rigorous self-assessment. ORR s focus on the UK industry management of change is concerned with duty holders having adequate arrangements to deal with changes to their structure, functions, procedures or processes. To do this we engage with duty holders in the early stages of planning and make sure that the principles of safety by design are properly adopted. If necessary, further control measures are identified and put in place before the change is implemented. The degree of effort required to manage the change should be proportionate to the extent and complexity of change. ORR has produced guidance for the industry on using the CSM risk assessment as a change management process Level crossings There are approximately 6,500 level crossings in use on the national mainline rail network in GB. The number of unsafe events occurring at level crossings in GB compares favourably with the record of other countries in Europe. 6 5 ORR guidance on CSM risk assessment: 6 ERA intermediate report on the development or railway safety in the European Union: Register/Documents/SPR%202013%20Final%20for%20web.pdf. See figure 18. Office of Rail Regulation September 2013 Title of document 13

14 ORR has a long-established policy that no new level crossings should be installed unless there are exceptional circumstances. Our approach at existing level crossings is to: Help closures happen, encouraging all risk assessments of crossings to consider closure first Check that people understand the risks and controls Competent people leading risk assessments All parties, such as businesses that use crossings, railway undertakings and users, working together to consider risk and controls; A risk management plan for each crossing Encourage innovation and new technologies In bridging & underpasses In level crossing design and fitment In specific controls at each crossing Encouraging a move away from a one-size-fits-all types of crossing approach. We produce guidance on the management, operation and modification of level crossings. 7 Separately we also produce guidance for members of the public including pedestrians, cyclists, motorists, motor cyclists and horse-riders on how to use level crossings safely Interface system safety Interface system safety risks are those that arise at the interface between parties on the railway, such as between different duty holders or between duty holders and other parties, such as passengers. Analysis shows that interface system safety is the second highest safety risk priority on the railway. For mainline operations, ORR s interface system strategy is focused on the following areas: 7 Level crossings: A guide for managers, designers and operators: 8 Using level crossings safely: Office of Rail Regulation September 2013 Title of document 14

15 Low adhesion Signalling and telecommunications Emergency preparedness Platform train interface Trespass and vandalism including suicides Vehicle incursion (not at level crossings) Passenger slips, trips and falls Station crowding/ control of passenger congestion Where appropriate we validate the key elements of a duty holder s SMS to give us confidence in overall management capability on interface risks. We promote collaborative working between duty holders through industry groups to tackle specific interface risks. 6. Infrastructure asset safety Infrastructure is defined as the fixed assets used for the operation of a transport system. This includes, but is not limited to: Track (including switches and crossings (S&C)); stations; structures, such as bridges, tunnels etc.; signalling equipment; and equipment supplying electricity for operational purposes (e.g. overhead line equipment). The provision and maintenance of infrastructure is a primary element of effective, safe operation of the railway. ORR carries out national inspections on structures management, and follows up local issues through specific inspection activities. We work with infrastructure managers, particularly Network Rail, to improve its approach to structures inspection, scheduling, recording, prioritisation and remedial action. Office of Rail Regulation September 2013 Title of document 15

16 We also work with infrastructure managers to ensure new infrastructure is properly designed and built and its maintenance incorporated into the existing management system. 7. Rolling stock asset management Rolling stock has a direct and indirect contribution to risk on the railways. The integrity of the stock itself is key to reducing direct risk such as brake failure, axle failure or fire resulting in immediate occupant risk and secondary risk from evacuation on live railway. Indirect risks generally relate to the resilience of stock to collision, known as crashworthiness. Recent serious train accidents, in the UK and elsewhere, have highlighted that crashworthiness significantly influences survival rates. ORR, working with industry stakeholders over a period of time have developed a number of protocols relating to the management of rolling stock risk, including regulations, guidance and standards. With the introduction of new technologies, material developments and changes in operating practices there is a steady evolution in protocols and practices. The overall risk contribution from rolling stock is historically low and reducing. The introduction of ECMs should further reduce risks associated with maintenance of private wagons. Our strategy for health and safety regulation of rolling stock is focused on management of change, particularly around the introduction of new technology and equipment to extend the life of existing stock. 8. Workforce safety ORR s corporate vision is zero workforce and industry-caused passenger fatalities, with an everdecreasing overall safety risk. There has been a steady improvement in the safety of workers in recent years. Working on the railway covers a wide range of occupations and activities such as maintenance/ construction workers, shunters and customer-facing roles including station staff and train crew. Staff in different roles can face a variety of hazards, some of which are particular to the rail industry, some of which are not. ORR addresses workforce safety by influencing each part of the sector to establish a vision for workforce safety that will deliver continuous improvement towards the goal of excellence in health and safety risk management. With regard to construction and maintenance we work with Network Rail and its contractors to reduce the amount of work done adjacent to open lines. We also check that there are robust risk controls associated with working at height, worker/traffic segregation and lifting operations. Office of Rail Regulation September 2013 Title of document 16

17 We work with the freight sector and freight wagon suppliers to drive down shunting risks. Across the industry we take action where we find inadequate risk control to reduce the number of slips, trips and falls. 9. Occupational health Occupational or work-related ill health describes those conditions that are caused, or made worse, by work. Occupational health covers many different aspects of workforce well-being. This includes health considerations from: Physical work activities such as musculoskeletal disorders arising from manual handling and exposure to hand arm vibration; Exposure to hazardous substances; and Mental health issues, for example stress. ORR launched its occupational health programme 9 in 2010 with the aim of improving how health is led and managed by organisations in the rail industry. We believe the industry can significantly improve its worker health management performance and secure the economic benefits that arise from better health management. Since the start of our occupational health programme ORR has positively engaged with rail companies, stakeholders and trade groups and has noted that many rail companies are starting to develop proactive management strategies and action plans. Health risk management, particularly the requirements of the Control Of Substances Hazardous to Health Regulations, 2002 (COSHH) have been a particular weakness and we have taken enforcement action on fourteen occasions for failures associated with employers not controlling risks to their employee s health. This illustrates that we are driving companies to shift the balance of their safety management activities to give better consideration to health risk management. ORR encourages greater industry leadership and follow-through from middle managers, the sharing of good practice on health, promoting greater awareness on health issues (including the costs); and encouraging a culture of excellence in health risk management. 9 ORR occupational health programme : Office of Rail Regulation September 2013 Title of document 17

18 10. Europe ORR works closely with the Department for Transport (DfT) to ensure that GB has the right framework of law and meets its European obligations. As European policy becomes more influential, the effectiveness of policies and strategy at the domestic level will be increasingly determined by the success of our engagement within Europe. Our input and influence within the European framework is key to our strategic aims for the industry to achieve excellence in health and safety culture, risk control and in asset management. ORR s strategy for engagement within Europe is to influence the development of the safety regulatory regime; ensure that our legislation, guidance and liaison enables the rail industry to comply with European requirements; ensuring that the right arrangements for enforcement of the requirements are in place; and engaging effectively in the development of harmonisation initiatives Detailed data trend analysis CSI data has now been collected for seven years. The scope of the statistics, the definitions applied and the data on CSIs can be found in Annex A. CSI reportable accidents In 2012 the total number of CSI reportable accidents decreased slightly from 78 to 75, which was the second lowest figure in the seven years CSI data has been collected. Of the six categories of CSI, the number of collisions increased; the number of derailments, level crossings accidents and rolling stock in motion accidents all decreased. There were no CSI reportable fires in rolling stock. A graph and analysis is included below for each of the four CSI categories where an incident was recorded in 2012: Collisions Derailments Level crossing accidents Rolling stock in motion accidents There were three other incidents that were CSI reportable but did not fit into the other five categories: Office of Rail Regulation September 2013 Title of document 18

19 A stoneblower ran into a stationary ballast regulator causing injuries to workforce members and derailment of the stoneblower; The under-slung operator cab on a maintenance train became displaced, causing damage to Blatchbridge Foot Crossing; A Road-Rail Vehicle ran away and collided with buffer stops at Bradford Interchange Station. CSI reportable collisions Number Number of CSI reportable collisions Collisions Year In 2012, the number of CSI reportable collisions increased from 3 to 10. One incident resulted in a fatality when a train collided with two people on motorbikes who were trespassing on the railway, fatally injuring one of them. There was an incident of a train colliding with a car that became uncontrolled and left the road and entered the railway after crashing through a boundary fence. The collision caused serious injuries to one of the four occupants of the road vehicle. A freight train was derailed and fell down an embankment following a collision with a large bolder. The driver was shaken but unhurt. Office of Rail Regulation September 2013 Title of document 19

20 CSI reportable derailments Number of CSI reportable derailments Number Derailments Year In 2012 the number of derailments decreased from 6 to 3, continuing a downward trend since Most derailments resulted from track or environmental (usually weather-related) causes; there were fewer caused by irregular working than in the previous year. CSI reportable level crossing accidents 25 Number of CSI reportable level crossing accidents Number Level crossing accidents Year Office of Rail Regulation September 2013 Title of document 20

21 In 2012 the number of level crossings accidents fell slightly from 11 to 10. Of the ten individual events, six resulted in fatalities, three in serious injuries and one caused a fatality and a serious injury to the two occupants of a motor vehicle. We remain focused on the continued risk posed by level crossings on the railway. We are conscious of the fact that much of the risk is based around user behaviour. We and the industry aim to continue in reducing this risk. We have committed resource to pursuing overall improvements in level crossing safety in a number of different ways including local inspection initiatives, engagement with local Network Rail Risk Coordinators and high-level discussions to determine and agree a national strategy. We have applied pressure to ensure all Network Rail s level crossings have a suitable and sufficient risk assessment. CSI reportable rolling stock in motion accidents Number Number of CSI reportable accidents to persons caused by rolling stock in motion Accidents to persons caused by rolling stock in motion Year In 2012 the number of CSI reportable rolling stock in motion accidents fell from 54 to 49 which is largely consistent with figures for previous years. Of the 33 fatalities of unauthorised railway users, 32 were involved rolling stock in motion. The fall in the number of fatalities involving unauthorised users of the railways is partly reflected by the fall in the number of rolling stock in motion accidents Office of Rail Regulation September 2013 Title of document 21

22 CSI reportable fatalities In 2012 the number of fatalities fell from 55 to 42. The vast majority of CSI reportable fatalities continued to be unauthorised users and the figure was largely consistent with figures for previous years. For the fifth consecutive year there were no CSI reportable passenger fatalities. An infrastructure worker was killed by a moving train while working on the adjacent line. This has been the first fatality of a railway employee caused by the railway since The other CSI reportable fatality was a member of the public who was injured after driving a mobility scooter off a platform and in front of a train as it was slowing to stop at a station. Although not struck by the train, the fall from the platform caused a number of injuries to the victim who later died in hospital of bronchopneumonia. The injuries sustained in the accident were deemed to be a contributing factor. There were seven fatal accidents involving level crossing users. Four involved pedestrian users of crossing, two involved car drivers and one involved a motor scooter rider. Nearly all unauthorised users killed on the railway are trespassers with most incidents occurring away from stations. ORR continues to work with infrastructure managers, railway undertakings and the British Transport Police through Community Safety Partnership Groups (CSPGs) to reduce unauthorised access to the network. There was an improvement in the platform-train interface risk with the number of fatalities falling from four in 2011 (classified other ) to zero in Train dispatch remains a concern despite this improvement as Office of Rail Regulation September 2013 Title of document 22

23 there were several incidents where passengers fell between the train and platform, including after the train had been dispatched properly and was in motion. We are working with industry to reduce platform-train interface (PTI) risk through developing a long-term cross-industry strategy to progressively minimise existing gaps between train and platform. Large but historic platform-train gaps remain a concern, but we are encouraged by examples of improvements made to enhance platform edges. We will continue to press for reasonably practicable improvements, including reviewing options for applying new technologies and processes, and identifying and applying good practice. CSI reportable serious injuries Number of serious injuries Number of CSI reportable serious injuries Employee Passenger Others Level crossing user 3 Unauthorised Year There were 19 CSI reportable serious injuries in This was a significant increase from 2011 (which was a historically low figure), but below average for the six year period One passenger was seriously injured after jumping from a moving train. One track worker was seriously injured after being struck by a train while working alone carrying out assessment of line side vegetation. Four level crossing users were seriously injured in separate incidents; two were pedestrians and two were vehicle users. Office of Rail Regulation September 2013 Title of document 23

24 CSI reportable broken rails and SPADs Number Number of CSI reportable broken rails and SPADs Broken rails 352 SPADs Year There were 164 broken rails in 2012 compared to 127 in The prolonged cold temperatures at the end of 2012 compared to the mild winter of 2011 resulted in a higher number of breaks. The number of broken rails in 2012 relative to 2011 showed less of a change when compared to the number of breaks in 2009 relative to 2010 when winter temperatures were similarly low. Network Rail is continuing to invest resource into reducing the number of broken rails. Recent developments include increased use of non-destructive testing of the rail foot to identify weaknesses that could lead to breaks. Broken rails are concentrated on the Southern and East Coast Mail Line routes where the rails are generally older. There has been a steady decline in the number of SPADs since 2006 from 352 to 220. Historically SPADs have been the cause of some of the most serious accidents on the GB mainline network. Network Rail has worked closely with railway undertaking to reduce the number of SPADs. Measures taken include improved siting of signals and training of drivers on the location of multiple SPAD signals. A focus on improved sanding by RUs has also helped reduce the number of SPADs and the distance travelled. Office of Rail Regulation September 2013 Title of document 24

25 CSI reportable track buckles Number Number of CSI reportable track buckles Track buckles Year A total of 10 track buckles occurred in This is a small improvement on the significant reduction achieved in There were two factors behind this continuous improvement; planned, preventative action and another temperate summer. Automatic train protection In 2012 there were 15,498 route Km of track in Great Britain. Not equipped Warning + stop Discrete Continuous Total Conventional mainline 1236 Km Km 0 Km 382 Km Km of route High Speed Km 108 Km 244 km of railway is fitted with ERTMS. Office of Rail Regulation September 2013 Title of document 25

26 Level crossings In 2012 there were approximately 6447 level crossings on the GB mainline. Level crossing type Number Active with automatic with user-side warning 293 Active with user-side protection 0 Active with automatic user-side protection and warning 450 Active with automatic user-side protection and warning, and railside protection 53 Active with manual user-side warning 0 Active with manual user-side protection 392 Active with manual user-side protection and warning 417 Passive 4842 Total 6447 Results of safety recommendations The Rail Accident Investigation Brach (RAIB) is the UK s National Investigation Body as defined in article 21 of the Railway Safety Directive. RAIB can direct recommendations to any organisation it regards as best placed to implement the required changes, including railway and non-railway organisations. As National Safety Authority, ORR is responsible for ensuring that recommendations are properly implemented. In 2012 RAIB produced 28 reports containing 81 recommendations into incidents on the UK rail network: Office of Rail Regulation September 2013 Title of document 26

27 22 main line 2 tramways (Manchester Metrolink and Midland Metro) 1 London Underground 1 Metro system (Tyne and Wear Metro) 2 heritage railways One new recommendation was made against ORR following a collision between a train and a lorry and trailer at Llanboidy level crossing near Whitland in South Wales on 19 December The recommendation was for ORR to revise its guidance in Railway Safety Publication 7 Level crossings: A guide for managers, designers and operators to provide: guidance on how to assess the misalignment between the centreline of the road over the crossing and the road approaches and how to mitigate its effects; and guidance supplementing the existing requirement for a 3m minimum gap between barrier tip and road edge to ensure consideration of the actual vehicle exit path taking into account the largest vehicle permitted to use the crossing without telephoning the signaller. One existing recommendation against ORR is still in progress. The recommendation is one of two made against ORR following an uncontrolled freight train run-back between Shap and Tebay on the West Coast Main Line in Cumbria on 17 August The first recommendation asked ORR to provide information to industry on the accuracy of mathematical models used to predict fatigue, including the Health & Safety Executive (HSE) Fatigue and Risk Index (FRI). ORR is currently working with the Railway Safety and Standards Board (RSSB) to develop a detailed specification and business case for a research project. The project is likely to take at least a year. The other recommendation from that incident asked ORR to produce guidance for the rail industry on how to reduce the number of shifts that cause fatigue. ORR published the guidance in January recommendations were successfully implemented in RAIB report Collision between a train and a lorry and trailer trailer on Llanboidy automatic half barrier crossing: 11 Managing rail staff fatigue: Office of Rail Regulation September 2013 Title of document 27

28 4. Important changes in legislation, regulations and administrative provisions The Railway Safety Directive has been implemented into national law by the following legislation: a) The Railways and Other Guided Transport Systems (Safety) Regulations 2006 (ROGS) implement chapters II, III (except article 13) and IV of the Railway Safety Directive. b) The Railways (Access to Training Services) Regulations 2006 implement article 13 of chapter III; and c) The Railways (Accident Investigation and Reporting) Regulations 2005 and the subsequent Railways (Accident Investigation and Reporting) (Amendment) Regulations 2005 implement chapter V into UK law. The Railways (Interoperability) Regulations 2006 (RIR06) implemented some aspects of article 16 of the Railway Safety Directive that relates to the authorisation and placing in service of structural subsystems and new and altered rolling stock. In 2011, RIR06 was replaced by Railways (Interoperability) Regulations 2011 as part of implementing changes made by the recast Interoperability Directive (2008/57/EC). Also in 2011, the Railways and Other Guided Transport Systems (Safety) (Amendment) Regulations 2011 (the ROGS Amendment Regulations) implemented changes made to the Railway Safety Directive by Directives 2008/110/EC (which mainly concerned entities in charge of maintenance) and 2009/149/EC (which concerned common safety indicators). Implementation of the recast Interoperability Directive by revoking the Railways (Interoperability) Regulations 2006 (RIR06) took place in January 2012 but was included in the UK NSA report The details of legislative changes that took place in 2012 can be found in Annex D. Office of Rail Regulation September 2013 Title of document 28

29 5. The development of safety certification and authorisation Starting date for issuing Safety Certificates according to Article 10 of the RSD /1/ (if necessary, distinguish between Part A and Part B) The directive 2004/49/EC was transposed into UK as part of the Railway and Other Guided Transport Systems (Safety) Regulations 2006 (ROGS). ROGS came into force in All GB mainline railway undertakings have been required to hold a ROGS safety certificate since Starting date for issuing Safety Authorisations according to Article 11 of the Railway Safety Directive 2004/49/EC All GB infrastructure managers have been required to hold a ROGS safety authorisation since Availability of National Safety Rules (NSR) or other relevant national legislation to railway undertakings and infrastructure managers ORR has published guidance for the GB rail industry on our website. 12 ORR has notified NSRs for the GB mainline and Channel Tunnel to ERA. We will publish them on our website once the European Commission has approved ERA s recommendation. Discussions are taking place between ORR and the GB government (Department for Transport) on the notification of rules for HS1. Numerical data See Annex E for data relating to safety certificates and authorisations. Procedural aspects Safety Certificates Part A Reasons for updating/amending Part A Safety Certificates (e.g. variation in type of service, extent of traffic, size of company, etc.) ORR did not amend any part A Safety Certificates in A guide to ROGS: Office of Rail Regulation September 2013 Title of document 29

30 Main reasons for cases when the issuing time for Part A Certificates (restricted to these mentioned in Annex E and after having received all necessary information) exceeded the 4 months foreseen in Article 12(1) of the RSD /1/ The average issuing time for Part A Safety Certificates was within the four month timescale laid down in article 12(1) of the Railway Safety Directive. To facilitate the authorisation application process ORR provides guidance documents and informal advice to railway undertakings. This helps the applicant submit the correct documentation in the required format, reducing the administrative burdens for both the applicant and ORR Overview of the requests from other NSAs to verify/access information relating the Part A Safety Certificate of a RU that has been certified in your country but applies for a Part B certificate in the other MS During 2012, ORR did not receive any requests from other NSAs to verify or access information relating to the Part A certificate of a railway undertaking that had been certified in the UK, but applied for a Part B certificate in another Member State. Eurostar International were issued with a Part A and B safety certificates by ORR in Eurostar was also issued with part B certificates for the Channel Tunnel, Belgium and France during Summary of issues with the mutual acceptance of the Community-wide valid Part A Safety Certificate Currently there is one railway undertaking (Europorte Channel SAS) operating on the GB mainline network and holding a Part B safety certificate that was awarded by ORR and a Part A certificate that was issued by another NSA. During 2012 ORR did not encounter any major problems with the acceptance of Part A certificates issued in another Member State. NSA charging fee for issuing a Part A Safety Certificate (Yes/No Cost) ORR does not charge a fee for the issue of Part A certificates. Summary of the issues with using the harmonised formats for Part A Safety Certificates, specifically in relation to the categories for type and extent of service ORR encountered no major problems using the harmonised format for Part A certificates during Summary of the common issues/difficulties for the NSA in application procedures for Part A Safety Certificates We find the application procedures for Part A certificates to be straightforward. We encourage railway undertakings to make early contact with ORR as well as to submit applications in advance in order to avoid any unnecessary delays. We feel the process could be improved by including a question on the application form asking the applicant if they also wish to apply for safety authorisation. This is particularly relevant to Office of Rail Regulation September 2013 Title of document 30

31 railway undertakings that operate passenger services and also manage stations as is the case with most franchised passenger operations in the UK. Summary of the issues mentioned by RUs when applying for a Part A Safety Certificate In general, the feedback ORR has received from railway undertakings is that the application process is straightforward. We actively engage with applicants to ensure that they understand what they are required to include in their application for a certificate. The ORR ROGS guidance also provides a step by step description of the application process. Feedback procedure (e.g. questionnaire) that allows RUs to express their opinion on issuing procedures/practices or to file complaints We hold regular liaison meetings with railway undertakings. These provide an opportunity for railway undertakings to raise any problems they may be having, including any issues relating to safety certification. In addition, ORR assessors maintain an issues log, detailing any problems that occur with an application and what actions are necessary to rectify them. The document is shared with the applicant. On some occasions, we will meet with the applicant to outline the content of the issues, especially if there are major issues. We will explain what actions are necessary to rectify the issues; in some cases this can be achieved during the meeting. ORR has an inspector assigned to each franchised route who can provide some assistance to new applicants. Safety Certificates Part B Reasons for updating/amending Part B Safety Certificates (e.g. variation in type of service, extent of traffic, lines to be operated, type of rolling stock, category of staff, etc.) ORR did not amend any Part A Safety Certificates in Main reasons for cases when the issuing time for Part B Safety Certificates (restricted to these mentioned in Annex E and after having received all necessary information) exceeded the 4 months foreseen in Article 12(1) of the RSD /1/ The average issuing time for Part B Safety Certificates was within the four month timescale laid down in article 12(1) of the Railway Safety Directive. To facilitate the authorisation application process ORR provides guidance documents and informal advice to railway undertakings. This helps the applicant submit the correct documentation in the required format, reducing the administrative burdens for both the applicant and ORR. NSA charging fee for issuing a Part B Safety Certificate (Yes/No Cost) Office of Rail Regulation September 2013 Title of document 31

32 ORR does not charge a fee for the issue of Part A Safety Certificates. Summary of the issues with using the harmonised formats for Part B Safety Certificates, specifically in relation to the categories for type and extent of service ORR encountered no major problems using the harmonised format for Part B certificates during Summary of the common issues/difficulties for the NSA in application procedures for Part B Safety Certificates We find the application procedures for Part B certificates to be straightforward. We encourage railway undertakings to make early contact with ORR as well as to submit applications in advance in order to avoid any unnecessary delays. We feel the process could be improved by including a question on the application form asking the applicant if they also wish to apply for safety authorisation. This is particularly relevant to railway undertakings that operate passenger services and also manage stations as is the case with most franchised passenger operations in the UK. Summary of the issues mentioned by RUs when applying for a Part B Safety Certificate In general, the feedback ORR has received from railway undertakings is that the application process is straightforward. We actively engage with applicants to ensure that they understand what they are required to include in their application for a certificate. The ORR ROGS guidance also provides a step by step description of the application process. Feedback procedure (e.g. questionnaire) that allows RUs to express their opinion on issuing procedures/practices or to file complaints We hold regular liaison meetings with railway undertakings. These provide an opportunity for railway undertakings to raise any problems they may be having, including any issues relating to safety certification. In addition, ORR assessors maintain an issues log, detailing any problems that occur with an application and what actions are necessary to rectify them. The document is shared with the applicant. On some occasions, we will meet with the applicant to outline the content of the issues, especially if there are major issues. We will explain what actions are necessary to rectify the issues; in some cases this can be achieved during the meeting. ORR has an inspector assigned to each franchised route who can provide some assistance to new applicants. Safety Authorisations Reasons for updating/amending Safety Authorisations Office of Rail Regulation September 2013 Title of document 32

33 ORR amended one Safety Authorisation in 2012 to reflect the change of name of an infrastructure manager from Network Rail (CTRL) Ltd to Network Rail (High Speed) Ltd. Main reasons for cases when the issuing time for Safety Authorisations (restricted to these mentioned in Annex E and after having received all necessary information) exceeded the 4 months foreseen in Article 12(1) of the RSD /1/ The average issuing time for Safety Authorisations during 2012 was under four months. No application exceeded the timescales set out in ROGS. ORR provides informal advice to infrastructure managers in order to support applications for safety authorisations. This ensures that applicants submit the correct documentation in the required format, reducing the administrative burdens for both the applicant and ORR. Summary of the issues/difficulties in application procedures for Safety Authorisations ORR finds the application process for Safety Authorisations to be relatively straightforward. Summary of the issues mentioned by IMs when applying for a Safety Authorisation In general, the feedback received by from infrastructure managers was that the application process was straightforward. As mentioned earlier in this chapter, both railway undertakings and infrastructure managers have highlighted the lack of a question relating to Safety Authorisations on the safety certificate application form. Some applicants state in their covering letter of a safety certificate application that they also wish to apply for a Safety Authorisation. ORR, infrastructure managers and railway undertakings are all of the opinion that a formal approach to Safety Authorisation applications would better reflect current industry practice. Feedback procedure (e.g. questionnaire) that allows IMs to express their opinion on issuing procedures/practices or to file complaints In 2012, we met regularly with infrastructure managers. This provided an opportunity for them to raise any problems they had been experiencing, including issues relating to Safety Authorisations. NSA charging fee for issuing a Safety Authorisation (Yes/No Cost) ORR does not charge for issuing Safety Authorisations. Office of Rail Regulation September 2013 Title of document 33

34 6. Supervision of Railway Undertakings and Infrastructure Manager Description of the supervision of RUs and IMs In 2012 ORR undertook both statutory and reactive work, as well as proactive inspections and audits of railway undertakings and infrastructure managers in order to test the effectiveness of safety management systems and risk control in priority risk areas. In 2012 ORR inspectors spent just over 55% of their time carrying out frontline inspection activities. Audits and inspections Audits and inspections are carried out by ORR inspectors. Occasionally expert support on specific subjects will be provided by consultants or from the Health & Safety Executive, the enforcing body for labour health and safety. ORR has teams of inspectors that specialise in specific areas including passenger railway undertakings, freight railway undertakings and the mainline UK infrastructure manager. Each railway undertaking has an ORR inspector designated as their account holder who is primarily responsible for its supervision and auditing. ORR has continued auditing the safety management systems of infrastructure mangers and railway undertakings using the Rail Management Maturity Model (RM3). 80% of railway undertakings are making progress towards excellence in health and safety management. ORR employs 82 inspectors out of a headcount for ORR s NSA function of full time equivalents. Description of the coverage of the legal aspects within the annual reports from the RUs and IMs availability of the annual reports before 30 June according to Article 9(4) of the RSD /1/ ORR received 29 RU/ IM annual reports ahead of the 30 June deadline. Office of Rail Regulation September 2013 Title of document 34

35 Summary of the relevant corrective measures/actions (amendment, revocation, suspension, important warning, etc.) related to safety aspects following these audits/inspections In most cases we secure improvements in health and safety for passengers, the workforce and public through evidence-based advice and encouragement to duty holders to improve and adapt their risk management. But occasionally we use our formal powers to ensure compliance with the law or deal with immediate risk. Mostly, we use enforcement notices to stop an activity involving serious risk or to rectify serious gaps in risk control. ORR has a number of enforcement powers relating to health and safety law. These range from providing information and advice to railway undertakings and infrastructure managers to issuing notices requiring remedial action or bringing prosecutions under British health and safety law. Our enforcement policy statement ( sets out how we use these powers. We use the Health & Safety Executive enforcement management model ( to ensure consistency in enforcement decisions. Improvement Notices: Improvement notices require a duty holder to take remedial action to reduce a potential health and safety risk. In 2012 ORR inspectors served 17 improvement notices, 23 less than in Regarding the mainline infrastructure and operations covered in this report, 7 of the notices were issued against Network Rail, 5 against contractors working for Network Rail and one against a passenger RU. Of the remaining four notices, three were issued against heritage railways and one against London Underground. A list of improvement notices issued by ORR during 2012 can be found on our website - Prohibition Notices: Prohibition notices are issued in circumstances where a risk is so serious it requires an activity to stop completely until the risk has been satisfactorily addressed. ORR served 6 prohibition notices in 2012, 7 less than in One prohibition notices was served against Network Rail and 5 against contractors working for them. A list of prohibition notices issued by ORR during 2012 can be found on our website - Prosecutions: ORR can prosecute organisations and individuals for breaches of GB health and safety law. ORR concluded 9 successful prosecutions during Of those associated with activity on the mainline, four were against Network Rail, one against a passenger railway undertaking, one against a freight railway undertaking and one against an individual train driver working. This includes the prosecution of Network Rail for failing to provide and implement suitable and sufficient standards, procedures, guidance, training, tools and resources for the inspection and maintenance of fixed stretcher-bar points which led to a train Office of Rail Regulation September 2013 Title of document 35

36 derailing at Grayrigg in Cumbria, causing the death of one passenger and injuring 86. The incident, which took place on 23 February 2007, was the last incident of a railway passenger being killed on the mainline railway network on the UK network. A list of prosecutions during 2012 can be found on the ORR website - Short summary/description of the complaints from IMs concerning RUs related to conditions in their Part A/Part B Safety Certificate We did not receive any complaints during 2012 from infrastructure managers in relation to part A/ part B safety certificates. In general ORR encourages infrastructure managers and railway undertakings to have regular meetings and other dialogue. Short summary/description of the complaints from RUs concerning IMs related to conditions in their Safety Authorisation We did not receive any complaints during 2012 from railway undertakings in relation to safety authorisations. In general ORR encourages infrastructure managers and railway undertakings to have regular meetings and other dialogue. Office of Rail Regulation September 2013 Title of document 36

37 7. Reporting on the application of the CSM on risk evaluation and assessment NSA experience/ Feedback from stakeholders We have received very limited feedback from industry on the application of the CSM risk assessment. We have received generally positive responses from industry to the CSM process and the ORR guidance to it. Revision of NSRs to take into account the EC regulation on CSM on risk evaluations and assessment Our regulatory approach already requires a risk assessment to be carried out so is affectively aligned with the CSM risk assessment. RSSB is undertaking work to identify key risks and produce guidance. Office of Rail Regulation September 2013 Title of document 37

38 8. Alternative measures through derogations regarding ECM certification scheme In the UK no alternative measures through derogations to the ECM certification scheme were needed. In 2012, ORR issued 3 ECM certificates. By the 31 May 2013 deadline ORR had issued a total of 9 certificates. The issuing of ECM certificates was in line with other ORR certification work with our staff engaging with applicants at an early stage. Applicants also reported that they found our guidance documents were accessible, useful and clear. Office of Rail Regulation September 2013 Title of document 38

39 9. NSA conclusions on the reporting year priorities Infrastructure Manager: Network Rail. As the infrastructure manager for the GB mainline, Network Rail is the major focus of ORR s inspection activity. Level crossings Network Rail is committed to reducing level crossing risk 25% by 2019 and it is currently on-target, as measured by its own model, to deliver this. This improvement has come through strong leadership from senior managers and demonstrates what can be achieved with the right focus. However, we found that this was not consistent across the GB network, and in some areas some level crossing risk assessments were poor and did not identify the best risk controls. We also found that risk assessments were not always being carried out at the right stage of the renewal and enhancement process, which introduced delays and additional costs at the level crossing commissioning stage. Network Rail has recently introduced route-level crossing managers and a national level crossing team, which should improve the quality of the risk assessment process. Maintenance of infrastructure It is important for an infrastructure manager to carry out the right amount of planned maintenance to prevent faults from occurring. Our inspections found that not all the planned maintenance work was delivered, partly because there were not enough people to do the work and partly because Network Rail does not always have the right information to plan its work effectively, including complete asset registers. We found that track inspection and reactive maintenance was being carried out, but using a 'find and fix approach which is not the most reliable way to ensure a safe and resilient track and infrastructure. We encouraged Network Rail to adopt a proactive predict and prevent approach to planned maintenance as it is a better way to control underlying train accident precursor risks. During the year, we saw an increase in the number of track faults including track geometry faults and an increase in the number of rail breaks on some routes, particularly on the London to Edinburgh East Coast mainline and Sussex routes south of London. Track geometry faults do not necessarily present an Office of Rail Regulation September 2013 Title of document 39

40 immediate safety risk, but can be precursors to more serious track faults and are often indicative of insufficient planned maintenance or renewal. Network Rail has acknowledged that some maintenance depots are under-resourced and intends to increase the amount of planned maintenance work this year. We will continue to monitor this issue closely and take action where we find evidence that health and safety risk is not being managed adequately. Earthworks There was a significant increase in the number and severity of earthwork failures in 2012, mostly associated with periods of heavy rainfall. Our inspections and investigation of earthwork incidents found that many slopes were vulnerable to severe weather because they were in a poor condition and had not been properly maintained and therefore pose the potential to cause serious incidents. The quality of the drainage can affect the stability of earthworks. We took enforcement action requiring Network Rail to use operational controls to reduce the likely consequences from a train hitting failed earthworks; for example, by introducing proportionate and riskbased speed restrictions. Network Rail made a commitment to complete its asset register for drainage and carry out an initial examination by 2012; some progress has been made but the work is not complete and therefore, Network Rail cannot demonstrate that its drainage asset is maintained to reduce risks so far as is reasonably practicable. We found some positive initiatives to improve slope drainage in some routes, such as the active use of local water management groups. Structures It is important that structures (such as bridges, tunnels and viaducts) are examined regularly to ensure they are in a safe condition and to prioritise future maintenance requirements. Our inspections found that Network Rail s examination reports for structures generally gave an accurate picture of their physical condition, but in some cases the recommendations made following the examination were too general; they did not contain specific actions or effective arrangements to ensure defects were rectified. We found that Network Rail route asset managers did not have the time or resource to fully evaluate the implications of examination reports, especially from site inspections. Network Rail has a backlog of bridge capability assessments and we considered that the normal planned work programme was inadequate to rectify this. Network Rail has engaged contractors to address the backlog and priority has been given to structures with the highest risks. Although the bridge assessment Office of Rail Regulation September 2013 Title of document 40

41 process was in backlog, we found that generally Route Asset Managers are using a risk-based approach to the high-risk structures they manage, for example by restricting train speed over higher risk bridges. Safety-by-design ORR strongly encourages infrastructure managers to consider safety at a project s design stage to ensure that early and efficient opportunities are taken to control risks so far as is reasonably practicable in later operation and maintenance. We found occasional examples of good practice but in most cases project development failed to take full account of opportunities to reduce later maintenance and operational requirements. We will continue to press Network Rail on this because it provides a big opportunity to efficiently and effectively remove risks from the system. Workforce health and safety Workforce health and safety is another area where Network Rail recognises it can and must improve. Network Rail has developed a workforce safety strategy and takes an active part in the cross-industry track worker safety group. Track workers are still disproportionately more at risk from fatal and major injury risks. Improvements to track worker safety are lagging behind improvements in other areas. In our inspections, we found examples of poor planning and poor systems of work, which meant that track workers are unnecessarily exposed to additional risks. Network Rail is proposing or implementing a number of initiatives to improve track worker safety, including better protection systems for track workers using new technologies and innovation and improved fatigue management. Network Rail has put forward a number of track worker safety initiatives in recent years, some of these have been implemented, but others have failed or not delivered the expected outputs. Therefore, we will continue to monitor the development and implementation of the current proposals and activities to improve worker safety, described in Network Rail s new strategy 13 and we expect Network Rail to measure the effectiveness of any new processes to identify where it can make further improvements. Occupational health During the year, we inspected the risks and controls associated with hand-arm vibration (HAVs), exposure to silica dust when ballast is being handled, exposure to dust and fume when cutting, grinding and welding rail, and the management of asbestos. We found poor on-site control measures, because of poor risk 13 Network Rails Health & Safety Management System: Office of Rail Regulation September 2013 Title of document 41

42 assessments and little evidence of proactive monitoring to check that the planned controls were actually in use. We found a general lack of ownership and accountability for health management, particularly at route-level and a lack of good data to allow Network Rail to prioritise areas for action in the future at national level. Network Rail lags behind other UK industries in its management of occupational health issues. We are encouraging Network Rail to remedy this situation through our economic regulation of the company, and we have made the assumption that improvements in occupational health and wellbeing will generate savings for Network Rail through reduced workforce absence. Railway Undertakings: Train and Freight Operators ORR has teams of inspectors that specialise in passenger railway undertakings and freight railway undertakings. Each railway undertaking has an ORR inspector designated as their account holder who is primarily responsible for their authorisation and supervision. In many cases, we identified good health and safety management arrangements although there are some specific topics where we made recommendations for improvement. Safety performance indicators The rail industry now has a specific guidance document to complement the Health and Safety Executive s (HSE) guidance on setting and monitoring activity and outcome indicators, often referred to as leading and lagging indicators. We are committed to helping the rail industry establish a more balanced suite of safety performance indicators (SPIs) which can help provide assurance of risk control performance, particularly those controls that are safety-critical. The majority of railway undertakings report that most safety-critical incidents are caused by unsafe acts or behaviours by passengers or staff. We believe that a suitable suite of SPIs could help monitor the effectiveness of initiatives taken by railway undertakings to improve these behaviours. Low adhesion A continued focus of our attention in 2012 was low adhesion. All multiple unit vehicles are now fitted with sanding systems and sand depositing rates on some units are 2kg/min, which helped increase adhesion during the leaf-fall season. We made unannounced inspections of sanding maintenance procedures across virtually all train operators in autumn 2012 and we generally found a much improved situation, with more consistently monitored sanding deposit rates, good data recording and general management arrangements. Office of Rail Regulation September 2013 Title of document 42

43 There were some isolated pockets of poor maintenance, for example water contamination of sand in storage, low-levels of sand in on-train equipment and some slackness in maintenance record keeping. Train Protection and Warning System (TPWS) We continued to seek assurances from train operators that potential risk arising from on-board TPWS equipment failures have been addressed properly. We saw improvements in the suitability and sufficiency of specific risk assessments undertaken by passenger railway undertakings, focused on the risks of their own TPWS operations. Following on from the on-going work we did with railway undertakings over recent years on TPWS inservice monitoring and reset and continue weaknesses in TPWS, we have seen that some train operators now have firm plans to upgrade their TPWS equipment and encouraging initiatives to display alarm indications via the existing Train Management Systems. Platform train interface (PTI) Train dispatch remains a concern despite some improvements in There were no train dispatch fatalities in 2012 but there were several incidents where passengers fell between the train and platform, including after the train had been dispatched properly and was in motion. Several of the passengers involved were impaired through alcohol and were fortunate not to sustain fatal injuries. Overall PTI risk fell by 10% in We are working closely with industry to identify and address key contributing factors to PTI risk, such as large platform-train gaps. We will continue to press for reasonably practicable improvements, including reviewing options for applying new technologies and processes, and identifying and applying good practice. Driver management We continue to be concerned about the effects of interrupted concentration and distraction for train drivers. We are pressing railway undertakings to consider what further steps can be taken to help understand why train drivers become distracted as they approach signals. RSSB has recently begun further research on this. In addition, RSSB is considering research into the use of in-cab CCTV monitoring to aid incident investigation. Train driver distraction by the use of a personal mobile phone was a likely contributor to at least one serious collision during the year. We support the enhanced use of remote data recorders on trains, to help managers identify emerging trends in poor behaviour and take action to prevent operational incidents. The industry has improved its management of fatigue and we have seen examples where hours worked by individuals have been restructured to reduce fatigue risks. Office of Rail Regulation September 2013 Title of document 43

44 Emergency planning Generally, we found evidence of a good appreciation and capability of emergency planning issues. We saw good practice in emergency preparedness during the 2012 Olympics where some railway undertakings had to deal with significantly increased passenger numbers. However, weaknesses still exist including some lengthy failed-train recovery times and some examples of inadequate management of large numbers of passengers during service disruption. Rolling stock We continue to be concerned about weaknesses in the management system that can result in components falling from a moving train. We took enforcement action against one RU when train cover panels became detached from a passenger train when it was in-service. This will remain a focus for us in future inspections and contacts with railway undertakings. We found a number of other incidents of poor rolling stock maintenance arrangements which were not sufficient for us to take enforcement action. A persistent level of deficiencies in the supply chain processes is a contributory causal factor in a number of failure incidents. This is an area which the industry continues to find challenging and we will continue to encourage it to find a workable solution. Health strategies Last year we reported that a number of train operators have produced strategies to address occupational health issues and we believe this work is now yielding industry benefits. This year we encouraged an operator owner group to develop their health strategy and produce a health surveillance programme across their business. Freight-specific operations Safety performance in 2012 has remained relatively unchanged compared to previous years. There have been a number of significant freight train derailments; some were related to issues of wagon loading or suspension operation, but many were due to poor track condition. The industry has worked together to reduce derailment risk from suspension systems and is installing technology to detect poorly loaded wagons. We will continue to seek improvement. Most freight train operators have now adopted the RM3 model to assess their safety management systems. Both ORR and the industry have put a significant amount of effort into preparing for the start of the Entities in Charge of Maintenance (ECM) Regulations for freight wagons. Office of Rail Regulation September 2013 Title of document 44

45 10. Northern Ireland Scope of the Report This section of the report covers the railway system in Northern Ireland for the period 1 January 2012 to 31 December There are no metros, trams or other light rail systems in Northern Ireland, nor is there any privately owned railway infrastructure. Translink is the brand name of the integrated public transport operation of Citybus, Northern Ireland Railways (NIR), and Ulsterbus. NIR operates a fully integrated system, acting as both Infrastructure Manager and Railway Undertaking. The Department for Regional Development assists NIR to operate rail services and provides funding to help maintain and develop the rail infrastructure (track, stations, bridges, level crossings) and rolling stock, which includes trains, equipment and associated plant machinery. The Northern Ireland railway network map is shown in Annex A2.. Heritage and tourist railways in Northern Ireland are privately owned and run, for the most part on dedicated track. They do not provide passenger services for the travelling public and are not funded by the Department. They are however a valuable tourist and heritage amenity. All railway operators in Northern Ireland including heritage railways are required to comply with regulations introduced by the Department to further improve railway safety. In some circumstances heritage railways operating on their own tracks and at a line speed that does not exceed 25mph/40km may be exempted from some regulations where the Department is satisfied that the safety of passengers and the general public is not compromised. The Safety Authority for Northern Ireland In Northern Ireland the Safety Authority for the purpose of implementing the Railway Safety Management Regulations (Northern Ireland) 2006, (hereafter known as the Safety Management Regulations ) is the Department for Regional Development, established by article 3(1) of the Departments (Northern Ireland) Order The Department s key responsibilities as Safety Authority are: to ensure that Northern Ireland Railways, the operator of the public railway service in Northern Ireland manages the network efficiently and in a way that meets the needs of its users; Office of Rail Regulation September 2013 Title of document 45

46 to encourage continuous improvement in health and safety performance; to secure compliance with relevant health and safety law, including taking enforcement action as necessary; to develop policy and enhance relevant railway health and safety legislation; and to issue or refuse safety certificates to railway operators in accordance with the Safety Management Regulations. The Safety Authority duties are managed by the Department s Transport Policy, Strategy and Legislation Division, 3rd Floor Clarence Court, Adelaide Street, Belfast BT2 8GB. The Department s role as Safety Authority for Northern Ireland is to: provide the appropriate regulatory framework so that railway safety is generally maintained and, where reasonably practicable, continuously improved; assess each duty holder s application for safety certificates and authorisations, including its cooperation arrangements; assess whether safety is being achieved by inspecting duty holders safety management systems (SMSs) and assessing available safety information and data; and authorise the placing into service of structural subsystems in Northern Ireland on the UK trans- European network; and check that they are operated and maintained in accordance with the essential requirements. authorise the placing into service of structural subsystems in Northern Ireland on the UK trans- European network; and check that they are operated and maintained in accordance with the essential requirements. Development of railway safety in Northern Ireland The Railway Safety Management Regulations (Northern Ireland) 2006 are aimed at harmonising safety standards on the NI Railway Network. These Regulations impose prohibitions and requirements in relation to safety on Northern Ireland railways. Part 2 and regulation 18 of the Regulations implement, in Northern Ireland, Directive 2004/49/EC on safety on the Community's railways and amending Council Directive 95/18/EC on the licensing of transport undertakings and Directive 2001/14/EC on the allocation of infrastructure capacity and the levying of Office of Rail Regulation September 2013 Title of document 46

47 charges for use of infrastructure and safety certification ("the Railway Safety Directive"), except in relation to access to training facilities, placing in service of in use rolling stock and accident and incident investigation. Part 2 of the Regulations contains prohibitions in relation to the operation of trains or vehicles on any railways in Northern Ireland and the management and use of infrastructure unless a person has established and is maintaining a safety management system and in specified cases has a safety certificate in relation to the operation of vehicles or a safety authorisation in relation to the management and use of infrastructure. Part 2 also makes provision in relation to the requirements for a safety management system and the issuing, amendment and revocation of safety certificates and authorisations and for the giving of notices to the Department. Part 3 provides for general duties on any railway operators subject to the duties in Part 2 to carry out risk assessment, co operate with each other and certain other persons and to prepare an annual safety report to the Department. It makes provision in relation to annual reports to the European Railway Agency and for the issuing, keeping and public inspection of documents. Part 4 makes provision in relation to the carrying out of safety critical work on any railways. It imposes obligations on those controlling the carrying out of such work to ensure that it is only carried out by fit and competent persons, that safety critical workers do not carry out work when fatigued, and related co operation requirements. Part 5 makes provision for appeals in relation to decisions relating to safety certificates and authorisations, for transitional provisions in relation to compliance with the provisions of regulations (3)(1) and (2), for the granting of exemptions and for a defence in relation to the safety verification requirements in regulation 4. Common Safety Indicators CSI data was collected for The data is broadly similar to that for 2011 although it has now been compiled in accordance with the latest ERA CSI template. NIR have provided the required data as transport operator in NI. The CSI data has been aggregated at a UK level and includes data for both Great Britain and Northern Ireland. Rail Accident Investigation Branch The Rail Accident Investigation Branch (RAIB) established by the Railways and Transport Safety Act 2003 is established on a UK-wide basis. It had no incidents to consider for full investigation in Northern Ireland in The Department confirmed to RAIB during the year that all outstanding recommendations from previous reports had been accepted and carried out satisfactorily. Office of Rail Regulation September 2013 Title of document 47

48 Procedural issues There were no specific procedural issues raised by NIR during the period covered by this report. This is partly due to the fact that the Department continues to work closely with NIR on all aspects of railway safety on the Northern Irish rail network.the main routes for Northern Ireland Railways to express opinion on issuing procedures, practices or to file complaints continues through the on-going contact between them and the Department. Safety authorisations No updated, amended or part authorisations were issued in This is partly due to the fact that the Department continues to work closely with NIR on the development of their application for authorisation. Supervision of railway undertakings and infrastructure managers In Northern Ireland, the day to day supervision of the health and safety performance of the railway industry is undertaken through the Railway Safety Management Regulations (Northern Ireland) 2006 where the Safety Authority is the Department. General The Department also continues to work closely with its counterpart in the Irish Republic, the Department of Transport, and the two railway operators on the island, NIR and Irish Rail, on all EU issues and mutual railway safety matters as they impact on the shared service between Belfast and Dublin. The Department also works closely with the Department for Transport in Great Britain and with the Office of Rail Regulation on European issues. Conclusions Safety performance on the Northern Irish mainline rail network continued to improve throughout 2011, with European safety data showing that Northern Ireland has one of the safest railways in Europe.Northern Ireland has historically a low level of serious rail incidents. This situation has been maintained during 2012, with no reportable fatalities or serious injuries. The Railway Safety Management Regulations (Northern Ireland) 2006 which came into effect on 30 June 2006 provide an adequate legislative framework for the Department to continue to work with Northern Ireland Railways to ensure smooth implementation of its safety management system. During we continue to push for improved safety, performance and efficiency on the Northern Ireland railway network and will take action on under performance as necessary. Office of Rail Regulation September 2013 Title of document 48

49 11. Sources of information ORR Health and Safety Report 2013: ORR strategy for regulation of health and safety risks: ORR National Rail Trends data portal: ORR Occupational health programme: RSSB Annual Safety Performance Report: Network Rail Annual Return: Office of Rail Regulation September 2013 Title of document 49

50 12. Annexes A. Railway structure information B. Organisation C. CSI data D. Important changes in legislation, regulations and administrative provisions E. The development of safety certification and authorisation numerical data Office of Rail Regulation September 2013 Title of document 50

51 Annex A: railway structure information A1: Map of GB rail network Office of Rail Regulation September 2013 Title of document 51

52 A2: Map of Northern Ireland rail network Office of Rail Regulation September 2013 Title of document 52

53 A3: List of railway undertakings and infrastructure managers Railway undertakings Name Address Website/ Safety Start date Total Track Electrified Total Total ATP Number of Network Authorisation commercial Length/ Gauge Track Double/ Track equipment LC statement link (Number/ Date) activity Length/ Simple Length used Voltages Track HSL Length Network Rail Kings Place, UK October Track Length: 5,262 Km Single 6,447 Infrastructure Ltd 90 York Way, London, N1 9AG orkrail.co.uk/asp x/3645.aspx Expires: 24/05/ ,777 Km Gauge: 1,435 mm (standard gauge) electrified 4,013 Km Double or more 11,764 Km Office of Rail Regulation September 2013 Title of document 53

54 Network Rail Kings Place, UK November Track Length: 108 Km 108km 108Km 0 (High Speed) Ltd 90 York Way, orkrail.co.uk/asp x/3645.aspx Km electrified double track Network Rail (CTRL) changed its name to London, N1 9AG Expires: 01/02/2017 Gauge: 1,435 mm (standard gauge) Network Rail (High Speed on 18 June 2012 Office of Rail Regulation September 2013 Title of document 54

55 Railway Undertakings Name Address Website Safety Certificate A-B 2004/49/EC (Number/ Date) Start date commercial activity Traffic Type (freight, etc.) Number of locomotives Number Of Railcars/ Multiple Unitsets Number of coaches/ wagons Volume of passenger transport (millions) Passenger Km for passenger RUs, train Km for freight RUs Abellio Greater 1 Ely Place A: UK February Franchised ,146.9 Anglia Second Floor London ater_anglia.html B: UK passenger operator EC1N 6RY Exp: 04/02/17 Arriva Trains Wales/ Arriva Trains Wales, A: UK Current Franchised ,154.0 Trenau Arriva Cymru Ltd St Mary s House, 47 Penarth Road, co.uk B: UK franchise began 5 February passenger operator Cardiff, 2004 CF10 5DJ Exp: 29/01/17 Office of Rail Regulation September 2013 Title of document 55

56 C2C Rail Ltd C2C Rail Limited A: UK Current Franchised , Triton Square London NW1 3HG B: UK franchise began 23 May passenger operator Exp. 14/12/ The Chiltern Chiltern Railways A: UK Current Franchised ,132.5 Railway Company Ltd Marylebone Station London NW1 6JJ.uk B: UK franchise began 5 February passenger operator UK Exp. 23/06/ East Coast Mainline East Coast Main Line A: UK Started Franchised ,934.3 Company Ltd Company Limited 4th Floor One Kemble Street B: UK operations 4 December 2009 passenger operator London Exp. 23/09/14 WC2B 4AN Office of Rail Regulation September 2013 Title of document 56

57 East Midlands Trains Ltd East Midlands Trains Ltd Friars Bridge Court s.co.uk A: UK B: UK Current franchise began 11 Franchised passenger operator , Blackfriars Road November London Exp. 10/11/ SE1 8NZ First Capital Connect Ltd First Capital Connect Ltd 50 Eastbourne Terrace Paddington A: UK B: UK Current franchise began 9 February Franchised passenger operator ,637.6 London Exp: 31/03/ W2 6LG First Great Western Ltd First Greater Western Ltd Milford House 1 Milford Street o.uk A: UK B: UK Current franchise began 8 December Franchised passenger operator ,867.8 Swindon Wiltshire Exp 30/09/ SN1 1HL Office of Rail Regulation September 2013 Title of document 57

58 First ScotRail Ltd First Scotrail Limited A: UK Current Franchised , King Street Aberdeen B: UK franchise began 10 passenger operator AB24 5RP Exp. 30/09/13 December 2004 Keolis/ First Transpennine Express Ltd First/Keolis Transpennine Limited 50 Eastbourne Terrace Paddington A: UK B: UK Current franchise began 30 January Franchised passenger operator ,603.9 London Exp: 06/02/ W2 6LG London & London & Birmingham A: UK Current Franchised ,241.2 Birmingham Railway Ltd Railway Limited 3rd Floor Grey Street Newcastle upon Tyne m B: UK Exp. 10/11/17 franchise began 11 November 2007 passenger operator NE1 6EE Office of Rail Regulation September 2013 Title of document 58

59 London & South Eastern Railway Ltd London & South Eastern Railway Limited 3rd Floor ay.co.uk A: UK B: UK Current franchise began 6 December Franchised passenger operator , Grey Street Exp: 30/04/ Newcastle London Overground LOROL A: UK Current Franchised Rail Operations Ltd Great Central House Marylebone Station Melcombe Place B: UK franchise began 9 November passenger operator London Exp. 10/11/ NW1 6JJ Merseyrail Electrics Rail House, A: UK Current Franchised Ltd Lord Nelson Street, Liverpool, B: UK franchise began 17 July 2003 passenger operator L1 1JF Exp. 23/05/18 Office of Rail Regulation September 2013 Title of document 59

60 Northern Rail Ltd Serco House, A: UK Current Franchised , Bartley Wood Business Park, Bartley Way, B: UK franchise began 6 January passenger operator Hook, Exp. 22 June Hampshire RG27 9UY Southern Railway Southern Railway Ltd A: UK Current Franchised ,386.0 Ltd 3rd Floor Grey St, Newcastle Upon Tyne, om B: UK franchise began 19 May 2010 passenger operator Tyne and Wear, Exp. 19/09/14 NE1 6EE Stagecoach South Stagecoach A: UK Current Franchised ,777.5 Western Trains Ltd Southwestern Trains Ltd Friars Bridge Court o.uk B: UK franchise began 20 May passenger operator Blackfriars Road Exp: 24/01/ London SE1 8NZ Office of Rail Regulation September 2013 Title of document 60

61 West Coast Trains West Coast Trains Ltd A: UK Current Franchised ,958.4 Ltd (Virgin Rail Group) The School House, 50 Brook Green, UK B: UK franchise began 10 passenger operator London, W6 7RR Exp. 30/09/13 December 2008 XC Trains Ltd XC Trains Limited A: UK Current Franchised ,254.1 (Cross Country) Admiral Way Doxford International.co.uk B: UK franchise began 6 January passenger operator Business Park Sunderland Exp. 01/11/ SR3 3XP DB Region Tyne DB Regio Tyne & Wear A: UK Current track Open access and Wear Ltd Limited Great Central House o B: UK access contract passenger operator Marylebone Station Melcombe Place London Exp: 31/03/15 began 22 December 1999 NW1 6JJ Office of Rail Regulation September 2013 Title of document 61

62 Eurostar UK Ltd Eurostar (UK) Limited A: UK Current track Open access Times House Bravington Walk B: UK access contract passenger operator London N1 9AW Exp: 18/04/2017 began 14 August 2009 Grand Central Grand Central Railway A: UK Current track Open access Railway Company Ltd Company 2011 Ltd River House o.uk B: UK access contracts passenger operator 17 Museum Street York YO1 7DJ Exp: 30/06/14 began 18 January 2007 (Sunderland services), and 12 February 2010 (West Riding services) Office of Rail Regulation September 2013 Title of document 62

63 Heathrow Express Heathrow Express Ltd A: UK Current track Open access Operating Company Ltd 2 Lancelot Road Wembley com B: UK access contract passenger operator Middlesex HA0 2RJ Exp: 31/03/2017 began 27 May 2005 Hull Trains 4th Floor Europa A: UK Current track Open access Company Ltd House, 184 Ferensway, B: UK access contract began 12 passenger operator Hull, February HU1 3UT. Exp: 31/03/ North Yorkshire Pickering Station A: UK Current track Open access 0.0 Moors Railway Enterprises plc Pickering North Yorkshire YO18 7AJ B: UK Exp: 30/09/13 access contract began 17 January passenger operator 2007 Office of Rail Regulation September 2013 Title of document 63

64 Colas Rail Ltd Dacre House A: UK Current track Freight operator Dacre Street B: UK access London contract SW1H 0DJ Exp: 02/09/12 began 21 December 2006 Devon & Cornwall Stanhope Station A: UK Current track Freight operator Railways Ltd Stanhope Bishop Auckland DL13 2YS om/#/dcr/ B: UK Exp: 26/01/15 access contract began 26 April 2011 Direct Rail Services Direct Rail Services A: UK Current track Freight operator Ltd Herdus House com B: UK access Ingwell Drive contract Westlakes Science and Technology Park Exp: 20/05/2017 began 8 January Moor Row 2010 Cumbria CA24 3HU Office of Rail Regulation September 2013 Title of document 64

65 DB Schenker Rail Lakeside Business A: UK Current track Freight operator (UK) Ltd Park,.uk B: UK access Carolina Way, contract Doncaster, South Yorkshire, Exp: 19/03/2017 began 9 February DN4 5PN 2006 Freightliner Ltd 3rd Floor, A: UK Current track Freight operator The Podium, B: UK access 1 Eversholt Street, contract London NW1 2FL Exp 30/09/13 began 01 April 2009 Freightliner Heavy 3rd Floor, A: UK Current track Freight operator Haul Ltd The Podium, B: UK access 1 Eversholt Street, contract London began 26 NW1 2FL Exp: 30/09/13 September 2007 Office of Rail Regulation September 2013 Title of document 65

66 GB Railfreight Ltd GB Railfreight Ltd A: UK Current track Freight operator Artillery Lane, B: UK access London contract E1 7HA Exp: 06/08/13 began 29 January 2008 Serco Ltd Serco House, A: UK Current track Freight operator N/A 16 Bartley Wood BP Bartley Way Hook B: UK access contract began Hampshire September RG27 9UY Exp: 30/09/ West Coast Railway Off Jesson Way A: UK Current track Freight operator 39 N/A Company Ltd Cragbank.co.uk B: UK access Carnforth contract Lancashire LA5 9UR Exp: 30/09/13 began 7 December 2005 Office of Rail Regulation September 2013 Title of document 66

67 Annex B: Organisational structure B1: ORR organisation chart (at 31 December 2012) Office of Rail Regulation September 2013 Title of document 67

68 B2: ORR Railway Safety Directorate (at 31 December 2012) Director, Railway Safety Deputy Chief Inspector, Network Rail Head of Inspection, Railway Operators Central Regulation Directorate Support Unit Route team: Scotland Train Operating Companies South Human Factors, SMS & Operational Support Permissioning & Divisional Support Route team: LNW Train Operating Companies North Strategy, Planning & System Safety Route team: LNE Transport for London Investigation & Legal Support Route team: Western Tramways/Heritage/ Freight Operating Companies RAIB Relationship & Recommendations Handling Route team: South East Route team: Southern Railway Safety Policy Channel Tunnel & EU Safety Policy NR National Team Office of Rail Regulation September 2013 Title of document 68

69 B3: Organisational flow chart Office of Rail Regulation September 2013 Title of document 69

70 Annex C: CSI data Performance at a glance Passenger fatalities and weighted serious injuries per billion passenger train-km (CST 1.1) FWSI per billion passenger train-km Passenger fatalities and weighted serious injuries per billion passengerkm (CST 1.2) FWSI per billion passenger-km Office of Rail Regulation September 2013 Title of document 70

71 Accidents divided by type 140 Fatalities per accident type Total Others Fires in RS Accidents to persons caused by RS in motion Level crossing accidents Derailments 140 Fatalities per user Total Others Unauthorised persons Level crossing users Employees Office of Rail Regulation September 2013 Title of document 71

72 Fatalities divided by category of person involved Employee fatalities and weighted serious injuries per billion train-km (CST 2) FWSI per billion train-km Level crossing user fatalities and weighted serious injuries per billion train-km (CST 3.1) FWSI per billion train-km Office of Rail Regulation September 2013 Title of document 72

73 6.00 Level crossing user fatalities and weighted serious injuries per billion train-km / Track-km per No of level crossings (CST 3.2) FWSI per exposure Other user fatalities and weighted serious injuries per billion train-km (CST 4) FWSI per billion train-km Office of Rail Regulation September 2013 Title of document 73

74 Unauthorized person fatalities and weighted serious injuries per billion train-km (CST 5) FWSI per billion train-km All person fatalities and weighted serious injuries per billion train-km (CST 6) FWSI per billion train-km Office of Rail Regulation September 2013 Title of document 74

75 Injuries divided by category of people involved Serious injuries per accident type Total Others Fires in RS Accidents to persons caused by RS in motion Level crossing accidents Derailments Serious injuries per user Total Others Unauthorised persons Level crossing users Employees Office of Rail Regulation September 2013 Title of document 75

76 250 Railway accidents Total Others Fires in RS Accidents to persons caused by RS in motion Level crossing accidents Derailments Precursors to accidents 3000 Precursors to accident by type Total broken axles on RS in service broken wheels on RS in service Signals passed at danger Wrong-side signalling failures Track buckles Office of Rail Regulation September 2013 Title of document 76

77 Technical safety of infrastructure and its implementation, management of safety 5% Percentage of tracks equipped with ATP 4% 4% 4% 4% 4% 4% 4% 3% 3% 2% 2% 1% 1% 0% Total tracks with ATP 4% 3% Percentage of train kms on tracks with ATP 3% 3% 3% 3% 3% 3% 2% 2% 1% 1% 0% Total km with ATP Office of Rail Regulation September 2013 Title of document 77

78 16000 Number of level crossings by type Total Passive 1200 Number of train kilometers (millions) Total Freight Office of Rail Regulation September 2013 Title of document 78

79 70000 Number of passenger kilometers (millions) Passenger km Number of line kilometres Line km Office of Rail Regulation September 2013 Title of document 79

80 Number of track kilometres Track km Office of Rail Regulation September 2013 Title of document 80

81 Annex D: Important changes in legislation, regulations and administrative provisions Legal reference or Notif-IT code Date legislation comes into force Reason for introduction (Additionally specify new law or amendment to existing legislation) Description General national railway safety legislation Legislation concerning the national safety authority Legislation concerning notified bodies, assessors, third parties bodies for registration, examination, etc. NONE N/A N/A N/A N/A NONE National rules concerning railway safety Rules concerning national safety targets and methods Rules concerning requirements on SMS and safety certification of RUs Rules concerning requirements on SMS and Safety Authorisation of IMs Rules concerning requirements for wagon N/A N/A N/A N/A NONE NONE NONE Office of Rail Regulation September 2013 Title of document 81

82 keepers Rules concerning entities in charge of maintenance Rules concerning requirements for maintenance workshops National safety rules for RUs* and safety rules for other railway actors N/A N/A N/A N/A NONE N/A N/A N/A N/A Rules concerning requirements for the authorisation of placing in service and maintenance of new and substantially altered rolling stock, including rules for exchange of rolling stock between RUs, registration systems and requirements on testing procedures Common operating rules of the railway network, including rules relating to the signalling and traffic procedures Rules laying down requirements on additional internal operating rules (company rules) that must be N/A N/A N/A N/A N/A N/A N/A N/A Office of Rail Regulation September 2013 Title of document 82

83 established by the IMs and RUs Rules concerning requirements on staff executing safety critical tasks, including selection criteria, medical fitness and vocational training and certification Rules concerning the investigation of the accident and incidents including recommendation Rules concerning requirements for national safety indicators including how to collect and analyse the indicators Rules concerning requirements for authorisation of placing into service infrastructure (tracks, bridges, tunnels, energy, ATC, radio, signalling, interlocking, level crossing, platforms, etc.) N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A NONE Office of Rail Regulation September 2013 Title of document 83

84 Amendments to the Railway Safety Directive Transposed (Y/N) Legal reference Date of entry into force Directive 2008/57/EC Yes Railways (Interoperability) Regulations 2011 [S.I. 2011/3066] 6 January 2012 Directive 2008/110/EC Yes Railways and Other Guided Transport Systems (Safety) (Amendment) Regulations 2011 [S.I. 2011/1860] 26 August 2011 Directive 2009/149/EC Yes Railways and Other Guided Transport Systems (Safety) (Amendment) Regulations 2011 [S.I. 2011/1860] 26 August 2011 Office of Rail Regulation September 2013 Title of document 84

85 Annex E: The development of safety certification and authorisation numerical data E.1 Safety Certificates according to Directive 2004/49/EC A. To ensure the information on ERADIS is current in place, please supply numbers of existing certificates in ERADIS which were valid at the end of the reporting year B. Please ensure that the information provided in this table is in line with the information provided in section G. Supervision of Railway Undertakings and Infrastructure Managers E.1.1. Number of safety certificates Part A issued in the reporting and in previous years and remain valid at the end of year 20xx C. To ensure the information on ERADIS is current in place, please supply numbers of existing certificates in ERADIS which were valid at the end of the reporting year D. Please ensure that the information provided in this table is in line with the information provided in section G. Supervision of Railway Undertakings and Infrastructure Managers E.1.2. Number of safety certificates Part B issued in the reporting and in previous years by your member state and remain valid in the year 20xx Number of certificates Part B, for which the Part A has been issued in your Member-State Number of certificates Part B, for which the part A has been issued in another Member-State Total number of certificates Total number of certificates Number of certificates Part A in ERADIS Number of certificates Part B in ERADIS Please provide input on applications for certificates Part A received in the current reporting year for new certificates or existing certificates which need to be renewed or updated/amended A R P E.1.3. Number of new applications for Safety Certificates Part A submitted by Railway Undertakings in year 20xx New certificates 1 Updated/amended certificates 0 Renewed certificates 8 Office of Rail Regulation September 2013 Title of document 85

86 Please provide input on applications for certificates Part B received in the current reporting year for new certificates or existing certificates which need to be renewed or updated/amended A R P E.1.4. Number of new applications for Safety Certificates Part B submitted by Railway Undertakings in year 20xx Where the Part A has been issued in your Member-State Where the Part A has been issued in another Member-State A = Accepted application, certificate is already issued R = Rejected applications, no certificate was issued P = Case is still pending, no certificate was issued so far New certificates 1 Updated/amended certificates 0 renewed certificates 8 New certificates 0 Updated/amended certificates 0 Renewed certificates 0 To ensure the information on ERADIS is current in place, please supply numbers of certificates in ERADIS revoked at the end of the reporting year E 1.5 Number of certificates Part A revoked in the current reporting year E 1.6 Number of certificates Part B revoked in the current reporting year Total number of revoked certificates in the year 20xx Number of revoked certificates in ERADIS (which were revoked in 20xx) E.1.7. List of countries where RUs applying for a Safety Certificate Part B in your Member- State have obtained their Safety Certificate Part A Name of RU Member-State where Safety Certificate Part A was issued Office of Rail Regulation September 2013 Title of document 86

87 E.2. Safety Authorisations according to Directive 2004/49/EC Please ensure that the information provided in this table is in line with the information provided in section G. Supervision of Railway Undertakings and Infrastructure Managers E.2.1. Number of valid Safety Authorisations issued to Infrastructure Managers in the reporting year and in previous years and remain valid at the end of the year 20xx Total number of safety authorisations 30 Guidance: Please provide input on applications for Safety Authorisations received in the current reporting year for new authorisations or existing authorisations which need to be renewed or updated/amended A R P E.2.2. Number of applications for Safety Authorisations submitted by Infrastructure Managers in year 20xx A = Accepted application, authorisation is already issued R = Rejected applications, no authorisation was issued P = Case is still pending, no authorisation was issued so far New authorisations 0 Updated/amended authorisations 1 Renewed authorisations 4 E 2.3 Number of Safety Authorisations revoked in the current reporting year 0 E.3. Procedural aspects Safety Certificates part A The average time after receiving of the application with the required information and the final delivery of a Safety Certificate Part A in year 2012 for Railway Undertakings New 119 Updated /amended Renewed Office of Rail Regulation September 2013 Title of document 87

88 E.4. Procedural aspects Safety Certificates part B The average time after receiving the application with the required information and the final delivery of a Safety Certificate Part B in year 2012 for RUs Where the part A has been issued in your Member-State Where the part B has been issued in another Member-State New Updated /amended Renewed E.5. Procedural aspects Safety Authorisations The average time after receiving the application with the required information and the final delivery of a Safety Authorisation in year 2012 for IMs New Updated /amended Renewed Office of Rail Regulation September 2013 Title of document 88

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