Formal Inquiry Process

All railway accidents are investigated by the industry to reveal the safety lessons to be learned. Up until 6 January 2007 in the case of major accidents, such as those with passenger fatalities, this took the form of a formal inquiry organised by RSSB and the process is described below.

Each inquiry is undertaken by an independently chaired panel. The overall approach is to embrace the principles for accident investigation endorsed by Lord Cullen in the Part 2 report into Ladbroke Grove.

'The sole objective of the investigation of accidents or incidents should be the prevention of accidents and incidents. It should not be the purpose of such investigation to apportion blame or liability'. Cullen Part 2: Recommendation 62

Immediately following an accident RSSB decides on the level of inquiry. After taking into account the particular circumstances of the accident, RSSB selects a suitable Chairman from a list of respected experienced individuals who have a proven track record of high achievement in relevant railway disciplines, and in leading accident investigations. He leads the investigation into the immediate and underlying causes.

Railway organisations have a duty to cooperate with the inquiry process, which is established by a Railway Group Standard. It is not for the purpose of apportioning blame or liability and is quite separate from any HSE or police investigation. The inquiry is not an on site investigation but a consideration of detailed information gathered from a variety of sources such as:

• site investigation reports
• technical reports
• documents such as standards and procedures
• interviews of individuals by the panel

In order to achieve the highest level of openness on the part of participants and consequently the best review of the accident possible, the inquiry's proceedings are private to the industry. However, observers from involved organisations and unions are permitted to attend. The Rail Passengers Council is also invited to provide an observer for multi-fatality inquiries, so that the travelling public can be assured of the rigour and impartiality of the process.

After completing its consideration of all the information the panel reaches its conclusions and drafts its report making recommendations to industry parties for preventing such occurrences and dealing with lessons learned. The industry parties are then required to consider the recommendations and take appropriate action. RSSB monitors progress in this regard.

On issue of the full report within the industry, a summary is placed on this section of the website.