ISSUE 8: THE INDUSTRY SHOULD LEARN FROM EXPERIENCE

The industry and those who work in it should ideally learn from the experience of the industry as a whole, in the UK and where possible around the world. However, the mechanisms to achieve that (appreciating what is being learned, capturing it, testing and peer-reviewing it, making it available in a digestible form, storing the information and making it accessible, incorporating it into education and training) are currently poorly developed in the construction industry. In the most part the industry hears of incidents through the trade press or on the grapevine which inevitably fails to convey fully and accurately the detail or the important lessons to be learned.

This situation compares unfavourably with the aviation industry where there are better systems in operation. The net result for the construction industry is that individuals have little support, beyond the updating of published codes of practice and industry guidance and these documents rarely explain the background to the advice they proffer.

Within organizations, corporate memory resides with individuals, and few organisations (it is believed) have formal post-contract review processes which feed back into future decision- making, although there are understood to be exceptions.

‘

study failures and gain wisdom from them’.

Dr. Allan Mann

In the UK, official reporting of safety failures in the construction industry is though RIDDOR and via. insurance companies. It is known that the levels of RIDDOR reporting are low (about a half of incidents are reported1). Although deaths are probably nearly always reported, many events involving injuries or dangerous occurrences go unreported. It is also not a requirement to report all ‘close call’ events where (by luck) a dangerous situation occurs but an accident or a dangerous occurrence (as narrowly defined) is averted. Reporting is thought to be patchy with high levels of reporting among the major contractors and low levels among smaller firms. HSE has recently strengthened its own system for promulgating safety alerts and notices, now making them available to subscribers via. E-bulletins and other electronic media. However, HSE faces certain constraints with regard to information release when there are potential criminal proceedings in play. This leaves a key role for the industry and its intermediaries to fill in order to get information out as quickly as possible.

Also in the UK, there is a system of informal reporting of matters of concern generally, called CROSS established in 2005 by SCOSS, see Glossary. The on-line survey unfortunately revealed a low level of familiarity with CROSS (despite the average respondent being more likely to be ‘active’ on safety matters).

1

There was concern that learning from experience appeared not to be well-rooted in the industry. There was lack of confidence that:

§ Learning was well-shared, rapidly and widely

§ Lessons were incorporated into education and training processes § Information could be easily accessed.

When there is change in work processes in the UK, the industry appears to be slow to learn, or re-learn, and institutionalise - for example through industry codes and guidance - how to do things safely. Learning from other countries would appear to be useful for everyone and it is possible that more could be done to promote the international sharing of experiences and ideas. If ‘close calls’ were to be reported by RIDDOR or to CROSS, the industry would have a better view of where potential issues are brewing but (by chance) not yet visible. Reporting to

CROSS should be non-threatening; however knowledge of CROSS was found to be inadequate. It is therefore necessary to identify how better reporting under RIDDOR and CROSS could be achieved, such as the promotion of a culture of reporting as per the airline industry (starting during education). Leadership (instilling a professional duty to report) is required.

In the practice areas identified in the study (tower-cranes, tunnelling etc) groups of people were identified who are working together to fill knowledge gaps and (in some instances) to seek agreement on how to respond to events which had arisen. It is beyond the remit of this study to track down and fully understand all the groups which exist. However, certain features of the groups became apparent which are worthy of consideration:

§ Some groups are formed by Institutions or are closely associated with them

§ Many other groups are either funded by vested interests or are voluntary. They operate in a variety of ways, being for example based on membership of an industry

organisation or a local gathering of interested parties.

§ Whilst major contractors share experiences through ‘safety alerts’ the wider industry does not have visibility

§ In some particular risk sectors, there may be more than one group operating

(sometimes at regional level) and there may also be independent sources of knowledge and experience such as in universities and other organizations or in different regions § The HSE is often involved with such groups in an advisory capacity and in assisting in

promulgating good practice guidance

§ The speed at which such groups which provide industry guidance are able to respond to events is variable

§ By the very nature of the UK construction industry, only a proportion of organizations who are active in a particular risk sector will engage with the relevant group; many will not have the time or inclination

§ Disciplines who are not directly involved in a topic area such as ‘tower cranes’ are unlikely to have sight of the workings of the group (in particular designers, who make decisions affecting risks during construction).

These points are made here with a view to seeking improvements in what is already a lively picture of activity.

There is much industry activity which needs to be considered, including: § The activity of Institutions and their sub-groups

§ The work of the various industry bodies and groupings § The work of SCOSS and CROSS

This work should be recognised, celebrated, developed and encouraged.

4.10

_CONCLUSION

Based upon the research reported in Part Two, a number of key issues have been identified which require further consideration. The importance of the risk of catastrophic events has been supported during consultation and it is expected that the industry will be keen to participate. All of the issues identified require concerted action and agreeing the actions to be taken should involve all of the stakeholders; the issues cannot be pigeon-holed; the industry is complex and this means that potential changes need to be seen and discussed in their overall context.

It is possible that during discussion within industry the stakeholder groups will identify further issues which are seen as key to future improvement in safety risk management and

performance.

Risk of catastrophe is a real issue which requires proper consideration by all stakeholders, led by directors and senior staff. There are opportunities for improvement of performance and all stakeholder groups should be involved in agreeing what

PART TWO – Supporting Research