Development of recommendations for competency of railway doctors Howard Watson Senior Regional Occupational Physician BUPA Wellness York

“It seems strange that the UK, the birthplace of railways, with a railway medical service which is one of the oldest in British industry, dating back to the 1830s, should now be almost the only country in Europe where railway medicine is no longer regarded as a specialist field within occupational medicine requiring special training and experience for its practice. It is hoped it is not too late to reverse this trend.” Dr David Wells June 2004

Background Strategy for Standards Management –conduct of medical assessments Advent of ROGS regulations –competent person ATOC desire for “informed buyers” Questions from Link-up auditor

British Rail Documented induction programme? Medical service career structure Railway-dedicated Easy access to workplace What did I do? –PTS course + exam –footplate rides –signal box visit –traincare depot visit –trackgang visit –one month directly supervised

1995 onwards Purchase of “medicals” Non-prescriptive standards unsupported Loss of experience Difficulty of access to workplace Regulatory powers not exercised –Railway (Safety Critical Work) regulations 1994 approve training courses requirements for responsible doctor registration and approval system

Draft recommendations - Sept 06 OhC Outline training programme 1998 Updated Sufficient to understand system needs and risks Avoid “Catch 22” Allows remote supervision Modern “competency framework” RGS changes - needs revision Dumbed-down?

Items missing Historical overview of railway medicine D&A screening PTS exam Visit track maintenance gang Visit track relaying gang Observe on-track machines in operation Visit specific types of signal box

Items missing Footplate experience during shunting movement Observe driver classroom training Observe psychometric testing Coupling up Observe carriage cleaners at work Visit a kitchen car

Implementation Duty Holders Basic railway medicine course? –18 hours Structure and standards Signalling Infrastructure Passenger operations Freight operations Train maintenance