Track worker near miss at Fishguard
RAIB report demonstrates the importance of four actions after a track worker was nearly hit by a train.
At around 09.46 on 4 January 2024, a train travelling at 53 mph had a near miss with a track worker just south of Fishguard. As the train approached, the driver saw the worker on the track, sounded the horn, and applied the emergency brake. The person in charge (PIC) got out of the way, with two seconds to spare.
The track worker was acting as the PIC and controller of site safety (COSS) for a small team of agency staff clearing vegetation for a principal contractor. The incident occurred because the PIC strayed outside the safe area that had been established as part of the planned safe system of work. The line near Fishguard is single, with the track on a tight curve. Vegetation restricts the view for train drivers further.
The work had been planned by the principal contractor, and a safe work pack (SWP) was produced. The PIC was sent the SWP, and verified its contents, three days before the work took place. The team that day was made up of three staff: the PIC/COSS and two vegetation clearance operatives.
Although the SWP said the staff could use ‘various authorised access points within the mileage’ to access each site, there was no specific SWP for each site. There was also no individual consideration of any potential risks.
On the day of the incident, the PIC briefed the team on the planned separated system of work. The team signed the site briefing form to confirm their understanding of the briefing, with one person also signing to confirm that they would undertake the duties of a site warden. The team then opened the gate and walked up the path to find the first strip of vegetation to be cleared. The PIC then asked the site warden to walk along the cess in a position of safety to another strip to be cleared, which was near a bridge. The PIC didn’t know that this strip was actually on the other side of this bridge, beyond the area of limited clearance.
As the warden walked towards the bridge, they moved out of view of the PIC, who had stayed on the access path. At this point the train approached. Hearing it, the PIC moved towards the track to get a view of the warden’s location. The PIC stumbled towards the track while doing this, which led them to stand on the track itself. This is how the incident occurred.
The Rule Book says that a COSS (or PIC in this case) must stay with their group to observe and advise. The PIC wasn’t able to do this because they sent the warden along the cess. The decision also led to the PIC ultimately moving towards and onto an open line when a train was approaching. The SWP did not include any details on the limited clearance at the bridge. Had the PIC visited the site beforehand, they would have seen this for themselves.
COSSs remaining with their group to personally observe and advise them.
COSSs setting up and maintaining safe systems of work in accordance with the relevant provisions of the Rule Book.
COSSs making sure staff, including themselves, remain effectively protected from moving trains.
planners, responsible managers and PICs making sure the planning of work on or near the line accounts for relevant hazards at specific sites of work. (This should be reflected in a safe work pack that is accurate, appropriate and specific to the task being carried out.
infrastructure managers making sure information provided to staff about site specific hazards is up to date and accurate.
