We should not forget that the operators should also have had a SMS in place, which could have triggered action. In some instances operators did react, others did not; this variability identifies with some of the problems of SMS’s.
SMS are a good concept which theoretically should improve safety, however not all situations can be identified with proactive work, e.g. audit. Thus, there has to be reliance on knowledge and planning – resulting in procedures, recommendations, which in turn relies on communication and a potential user’s understanding.
In the instances at BRS the knowledge and planning aspects appeared weak across many levels of management – regulators, airport, and operators, and in combination with weaknesses in communication there were many opportunities for error.
The result, like many implementations of SMS, is that the safety system relies on reactive involvement of all parties involved.
This begs the question, how many incidents do you have to have before the hazard is significant? As an example, on a good runway surface, an aircraft could land in very wet conditions and report poor braking, yet the problem could have been with that aircraft alone. Thus for an effective system all aircraft would have to report braking effectiveness, but then this is subjective and depends on aircraft type.
The issue at BRS was that what information was known about poor runway surfaces were not well communicated, not clearly understood, or when obvious appropriate action was slow. The human element – in SMS, like in most operations can be a dominating contribution in incidents.
The background to the UK CAA activity is here:
Factor F01/2009: Serious Incidents to: Boeing 737-81Q,G-XLAC on 29 December 2006, ATR-72-202, G-BWDA on 29 December 2006, EMB-145EU, G-EMBO on 29 December 2006, and Boeing 737-81Q,G-XLAC on 3 January 2007 at Bristol International Airport. | Publicati
For operators who wish to use runways that are ‘slippery when wet’, what additional information do you expect to get from the airport that will help a decision to operate or not – see CAA advice to ask airports.
For crews, if a runway is ‘slippery when wet’, is it treated like a contaminated runway – very wet friction like ice, if so then with any crosswind, landings should not be considered.
But have we learnt this after the fact?