The Rail Accident Investigation Branch (RAIB) has today published its report into an incident where a track worker struck by a train near Chalfont and Latimer station in Buckinghamshire on 15 April 2022.
The incident occurred on the Friday morning at around 09:28. Aa London Underground train in passenger service, travelling at around 25 mph (40 km/h), struck and injured a track worker who was taking part in a patrol planned to take place when trains were running near Chalfont and Latimer station on the Metropolitan line.
The track worker was working as one of a group of three, in the role of second lookout. She had been supplied by a recruitment agency, Morson, for the day's work.
RAIB's investigation has found that the accident happened because the track worker had moved from a place of safety and into the path of the approaching train to get a better view of the track ahead, just as the train was about to pass her. She was walking with her back to the approaching train when she was struck and was not aware of the risk the train posed.
The investigation also found that the track worker was not familiar with the exact location where the accident happened, and that safety briefings provided to her on the day were ineffective in communicating the information she needed in order to work safely. She had been allocated to the job at short notice after a lookout more familiar with the area had become unavailable.
Witness evidence to the enquiry suggested that agency staff feel that if they challenge or complain, they may not be asked back to work, and that there is an imbalance of power between track workers directly employed by London Underground Ltd and those supplied by agencies such as Morson.
RAIB identified two underlying factors. Firstly, London Underground's processes for managing track worker safety did not adequately control the risk to staff working on the line while passenger trains were running. Secondly, elements of the organisational culture at London Underground did not support effective management of track worker safety.
RAIB also pointed out that some designated places of safety on the Metropolitan line are sometimes obstructed, preventing them from being used as places of safety, although this was not relevant to the cause of this particular accident. RAIB also observed that the safety‑critical communications after the accident were effective, and that an accurate understanding of information was reached by all parties involved.
RAIB has made four recommendations, all addressed to London Underground Limited:
- a review of the assessment and control of the risks arising from working on the line during traffic hours.
- a review of the need to work on the track during traffic hours, with the aim of reducing such work.
- improvements to safety assurance processes and safety reporting.
- ensuring that places of safety are fit for purpose.
RAIB has identified two learning points:
- the importance of clear and effective safety briefings
- the importance of effective safety‑critical communication in an emergency situation.
The full report can be read here.
Andrew Hall, Chief Inspector of Rail Accidents said:“Track worker safety continues to be an ongoing theme for the Branch. This accident is an alarming reminder that there is still work to be done to reduce the likelihood of track workers coming into contact with trains on parts of the railway. It cannot be acceptable that any member of staff be working on open lines with insufficient awareness of the direction a train might approach from.“Reductions in the amount of work undertaken on lines open to traffic will lessen the risk to trackworkers; this is as true on London Underground as it is on mainline railways. However, some risk will remain. That is why the universal importance of good planning, clear safety procedures, effective leadership, site discipline and fulsome briefings cannot be overstated.”
