At 23:24 hrs on 2 December 2018, a track worker narrowly avoided being struck by a train between Horley and Gatwick Airport stations, on the boundary between Surrey and West Sussex. The track worker, a controller of site safety (COSS), was undertaking work related to the electrical isolation of conductor rails and moved out of the path of the train just before it reached him.
The Network Rail isolation planning process meant that BAM Nuttall planners lacked the information needed for them to establish the exact location at which work was to be carried out on the track. The planners lacked the skills and experience needed to understand this and so provided a system of work which provided no protection from train movements at the actual location of the task. The COSS recognised that the planned system of work lacked adequate protection from train movements, but undertook the task without implementing an alternative safe system of work. A second track worker involved in the isolation task did not challenge the COSS about the unsafe method of working. The underlying factor was that Network Rail isolation processes did not provide planners outside Network Rail with sufficient information to always be able to plan safe systems of work.
The RAIB has recommended that Network Rail should improve its isolation planning processes so that safe system of work planners receive the information they need to plan all associated work safely. The RAIB has also recommended that BAM Nuttall should improve its safe system of work planning process to ensure that its planners do not plan work without sufficient information to identify appropriate protection measures.
The RAIB has also identified four learning points relating to working in accordance with appropriate safe systems of work, challenging unsafe work practices, planners seeking additional information when needed to plan safe systems of work and use of train horns.
Published 26 September 2019