1. Ageing workforce?

2. “Likely to cause” … …a difference of opinion? Howard Watson

3. Stating the obvious?

4. History 1994 Railtrack Safety & Standards Directorate 2001 Hatfield accident – RSSB formed RSSB controlled by railway stakeholders Many Railway Group Standards Strategy for standards management – Devolve – Concentrate on “interfaces”

5. BR Medical Standards Drivers Train Working Signallers Personal Track Safety

6. Current medical standard Train Movement Code of practice & Guidance Signallers & PTS devolved to Network Rail

7. General health requirement Unchanged No medical condition “likely to cause…” Non-prescriptive Future-proof Allow evolution of guidance Problems – Fragmented OH – Risk averse culture

8. Acceptable risk for the railway? CAA 1% DVLA – Group 1 20% – Group 2 2% RSSB research project T663 – “Managing the risk associated with incapacity in safety critical occupations”

9. T663 Consultations UK data International and intermodal comparisons Event tree analysis

10. Event tree Onset of unavoidable impairment Engaged in safety critical task Engineering controls unable to prevent Hazardous event Fatality/weighted injury Current rate of FWI

11. Assumptions Fatality / weighted injury (FWI) – Tolerated = tolerable? RSSB risk model: 125 types of hazardous event – Not all have human precursor – Probability of FWI estimated Human Error v medial impairment – 2% due to medical impairment

12. Results Driver – 43% Signaller 16% Track worker 15% Crossing keeper 4% PICOP 0.4% Acceptable risk to system safety only

13. Implications for train driving “F1: FIT NORMAL DUTIES” 43% annual risk of incapacity? – 68% chance of an event in 2 years – 94% chance of an event within 5 years? Would a TOC be happy?

14. Train driver: additional considerations for employer Safety of the driver - lone worker Service interruption – Safety of passengers and other staff – Compensation to customers – Reputational damage to TOC Network disruption – Delay penalties – Reputational damage to Rail

15. Inquiry begins into train ordeal Train company GNER has launched an inquiry into how hundreds of passengers became stranded for hours in stifling heat due to a power failure. Some travellers broke carriage windows to escape temperatures of over 37C on its 1555 BST Newcastle to London Kings Cross service on Thursday evening.

16. Acceptable risk to TOC? Likelihood of event in 5 years – “unlikely” (<50%)? – 5% (CAA)? – In between? TOC view? “UK rail” view? – Mutual interest?

17. Australian Standards New draft 2011 Category 1 SCW 5 yr risk >25% – unfit <5% - fit 5-24% risk assessment (split at 10%) “Fit subject to review” UK DVLA 5 year risks: Group I – 66% Group II – 9%

18. Suggestion Fails group I – unfit. Meets group II – fit’ In between = risk assessment OH: risk of relevant impairment; suggested controls Operator: ?safe system of work Fit with limitations

19. ANY CASES?

20. Case Freight Train Driver, 4 months post MI – Well – Inferior infarct – 2 vessels stented – Moderate LV impairment – No ETT – Diabetic type 2 – Probably still smoking

21. Relevant requirements DVLA II – 6/52 post-MI – Exercise test – Repeat 3 yearly Australia – 4/52 post-MI – Exercise test – Repeat 2 yearly

22. Consensus? Fitness category? Further information? Drive meantime? Future management? – Review frequency?

23. Discussion and other cases?