CIRAS has come a long way since its launch back in Scotland in 1996 when it was an experiment amongst one or two train operators. In 2000 it was rolled out across the entire UK Rail Network. The catalyst for this was the tragic event that took place on the 5th October 1999 at Ladbroke Grove. This was the second major accident on the Great Western Main Line in just over two years, the first being the Southall rail crash of September 1997, a few miles west of this accident.
Confidential reporting has been embedded in the rail industry ever since. Today, it continues to have support from senior leaders who welcome its ability to capture those accidents that haven’t yet happened, whilst potentially highlighting undesired safety behaviours within their organisations.
For staff, it provides them with a secure confidential line that they can report to, without fear of being identified. 2016 saw a considerable growth in membership at CIRAS, as we continue to facilitate the resolution of safety concerns in a variety of transport sectors. Chris Langer, Scheme Intelligence Manager at CIRAS, says that most reports made to CIRAS have already been reported internally, it is the response or lack of response that often leads our callers to contact us.
Today CIRAS is changing. The past four years has seen the scheme open its doors to transport operators from all industries. Chris says, “2012 was an important year for CIRAS. Paul Russell, Head of CIRAS, joined us and whilst his background was very much centred around the rail industry, having been a signaller, he had recently worked and lived abroad in countries such as India, Australia and the United Arab Emirates. During this time, not only was he involved in working on multiple transport modes, but he was also experiencing multinational cultures, joined together in the workplace, competing and often clashing.” Chris continues, “He took over CIRAS and knew that it could offer much more. This led to the development of a new strategy, and a very different CIRAS.”
CIRAS is now operating across the UK and when Paul joined it had around 200 member organisations. At the beginning of 2017, its membership stood at an incredible 1800 organisations.
Chris says, “We are still very much on an upward trajectory. In particular, our proven experience in confidential reporting over the last 21 years has enabled us to effectively transition into the bus industry this year, representing a new venture for the CIRAS team.” Transport for London (TfL) are one of the organisations that have stepped up their safety efforts and have recently introduced new safety programmes. Part of this effort was to join CIRAS and this covers not only the rail side of TfL, but also all London buses, river services and other public transport interests.
Chris continues, “The one area we are working very hard on is the exchange of lessons learnt. Or indeed, how we can share our members’ solutions. Our members respond to the concerns raised and often the solutions are well thought out”. One good example of this is on the subject of fatigue. Chris says, “We developed a short video on what essentially is good practice, based on the responses our rail members had provided for several fatigue related reports. Our new members at TfL bus were very interested in this approach and we have worked jointly with them to develop solution exchange workshops on this particular subject. The feedback has been exceptional.”
Chris continues, “Bus operators in London have been keen to see what is possible to learn about their safety culture from the confidential reports we have taken. They are interested in the safety behaviours that drive safety concerns reported to CIRAS. This is healthy and shows a maturity that rail has been benefiting from for well over a decade.” Chris emphasises that a high level of cultural maturity can also pay business dividends, as well as preventing accidents and enhancing safety.
“Confidential reporting can be a difficult product to sell though. Understandably, there is a lot of scepticism and mistrust. Surprisingly, or maybe not, much of this comes from management.” Chris continues, “Often management view it as a form of whistle blowing. It isn’t. It is effectively a system to capture staff safety concerns well before they result in an incident, often causing injury, reputational damage, and time and effort to investigate. We provide another line of defence to their existing safety arrangements.”
On the scepticism CIRAS meets, Chris says, “Our new bus members voiced this just like the rail community did originally. It was a difficult task to get them to understand what confidential reporting was about. With the next generation of rail workers and managers, the task of overcoming that scepticism is just as important so it’s always about raising awareness. It is the same in bus, marine and all the other transport industries we work in.”
“There are, of course, varying degrees of acceptance and implied maturity in organisational safety culture - this will largely depend on the specific organisation we are talking about. But overall, confidential reporting is widely embraced, and respected for its ability to enhance safety and protect against reputational damage. Unaddressed safety concerns will always pose a hazard. Sometimes the only means of addressing such concerns is through a confidential channel. We mustn’t shy away from the challenges involved, despite the inevitable resistance in some quarters”.
“If someone were to ask me to give just one recent example to demonstrate the benefit of CIRAS in 30 seconds, I would cite a fatigue related report. This report may have saved lives. The report uncovered a practice involving rail track workers stepping off a night shift to immediately attend a day’s training, followed by another night shift. This potentially lethal ‘shift-training-shift’ sandwich meant these track workers were awake for more than 30 hours in total. They also had to drive home afterwards.”
Imagine being awake over 30 hours and then attempting to drive. Not to mention the increased risk of using hazardous equipment on the job with impaired grossly cognitive functioning. Your brain simply doesn’t work properly after spending all those hours awake. These track workers were afraid. They were afraid not only of the risk of death or serious injury, but also of speaking out. There was an internal reporting channel (as you would expect), but in this case, it meant nothing because no-one felt able to use it. They had been specifically instructed not to talk to anyone about what was happening. The reporter took that brave step and called CIRAS. The organisation immediately took action and they banned all instances of this practice.
If you take an unaddressed safety issue, create a fearful workforce, then embed it in a local safety culture gone slightly toxic, you have a recipe for potential disaster and loss of life. I would challenge any critic of confidential reporting to explain how that issue could have been picked up internally when there were clear attempts to stifle it.