TRAINING IN SAFETY
MANAGEMENT SYSTEMS
ARAB CIVIL AVIATION CONFERENCE
Welcome to Safety
Management
Speakers:
•
CHRISTER PRAHL
•
ATM Safety Expert
•
Electronic Engineer
•
Degree in Communication
•
Degree in Networking
Speakers:
•
MICHAEL NIELS THORSEN
•
ATM Safety Expert
•
Master of Science in Engineering
•
Expert International Cooperation
•
Expert Safety Management Implementation
Round the table
Agenda for today:
Wrap - Up 16.30 – 17.00
The Safety Management System 15.30 – 16.30
Break 15.00 – 15.30
The Safety System 14.00 – 15.00
Lunch 12.30 – 14.00
ICAO presentation on Safety Management System SES Regulations
11.00 – 12.30
Break 10.30 – 11.00
Registration and Welcome 09.00 – 10.30
General “House-Rules”
•
Hand-outs will be given in connection with the lesson;
•
CD will come at the end of the course;
•
Questions during the lessons;
•
Active participation is anticipated;
•
Flexible approach, programme can be changed – also
on request;
•
Turn off cell phone;
•
Please stop the instructors if you don’t understand
them;
Objectives of the workshop
Provide participants the knowledge
of Safety
Management Concept
and ICAO Standards and
Recommended Practices (SARPs) on safety management in
Annexes 6, 11 and 14
and related guidance material
AND TO…
Develop participants knowledge
to certify and oversee
the implementation of key components of an SMS, in
compliance with relevant ICAO SARPs.
ICAO - Safety Management System
•
What is Safety?
•
Zero Accidents?
•
Freedom from danger or risks?
•
Error avoidance?
ICAO - Safety Management System
According to ICAO
Doc 9859:
Safety is the state in which the risk to harm the
persons or property damages is reduced, and
maintained at or below, an acceptable level
through a continuing process of
hazard
ICAO - Safety Management System
A
safety management system (SMS)
is an organised approach to
managing safety, including the necessary organisational structures,
accountabilities, policies and procedures.
(ICAO Doc 9859 - Safety Management Manual)
The objective
of a Safety Management System is to provide a
structured management approach to control safety risks in operations.
Effective
safety management
must take into account the organisation’s
specific structures and processes related to safety of operations.
Safety Management System
Structure and Contents
1: SMS course introduction 2: Basic safety concepts 3: Introduction to safety management 4: Hazards 5: Risks 6: SMS regulation 7: Introduction to SMS
8: SMS planning 9: SMS operation 10: Phased approach
to SMS Implementation
Safety Management Manual
Objectives
Objectives of the Safety Management Manual are to provide States:
• Knowledge of safety management concepts, the ICAO Standards and
Recommended Practices (SARPs) on safety management contained in Annexes 1, 6, 8, 11, 13 and 14, and related guidance material;
• Guidance on how to accept and oversee the implementation of the key components of an SMS in compliance with the relevant ICAO SARPs;
• Guidance on how to develop and implement an SSP in compliance with the relevant ICAO SARPs.
Safety Management Manual
Concept
SMS/SSP Implementation
Generic SMS Requirements
ICAO requirements for implementation of SMS are currently applicable to:
• Air Traffic Service Providers (Annex 11)
• Aerodrome Operators (Annex 14, Volume 1)
• Amendment to Annex 1, 6, 11, 13 and 14 are proposed in order to harmonise and extend provisions relating to safety management.
SES Regulation - Objectives
The second SES package has been put forward by the European
Commission in order to make the European sky safer and more
sustainable by:
•
Introducing a performance framework for European ATM
with quantified
target setting;
•
Creating a
single safety framework to enable
harmonised development of
safety regulations and their effective implementation;
•
Opening the door to
new technologies
enabling the implementation of
new operational concept and increasing safety levels by a factor of ten;
The 1st SES legislative package
The legislative package adopted in 2004 comprises four base regulations, which reinforce safety and foster the restructuring of European airspace and air navigation services. The regulations provide the framework for the creation of additional capacity and for improved efficiency and
interoperability of ATM system in Europe.
• The Framework regulation (EC No 549/2004) - laying down the framework for the creation of the single European sky;
• The Service provision regulation (EC No 550/2004) - laying down common requirements for the provision of air navigation services;
• The Airspace regulation (EC No 551/2004) - on the organisation and use of airspace in the Single European sky;
• The Interoperability regulation (EC No 552/2004) - on the
(EC) No 549/2004 - Framework
The objective of the Framework regulation is to enhance current safety standards and overall efficiency of the general air traffic in Europe, to optimise ATM system capacity and minimise air traffic delays by establishing a harmonised regulatory framework for air traffic
management in Europe.
The Framework regulation establishes harmonised institutional, regulatory and consultation arrangements to enable the creation of the Single European Sky.
In brief these are:
• National Supervisory Authorities (NSA)
• Single Sky Committee
• Military Issues
• Industry Consultation Body
• Implementing Rules
• Performance Review
(EC) No 550/2004 – Provision of Air
Navigation Services in SES
The Service provision regulation establishes common requirements to ensure that air navigation services are provided safely and efficiently, on a continuous and interoperable basis, throughout the European Community. It introduces a
harmonised system of certification and lays down rules for designating service providers.
The stipulations of this regulation apply to the provision of air navigation services to General Air Traffic (GAT) and can be summarised as follows:
• National Supervisory Authorities (NSA)
• Licensing of Controllers
• Common Requirements
• Certification of Air Navigation Service Providers (ANSPs)
• Designation of Air Traffic Service Providers
• Relations between Service Providers
• Transparency of Accounts
(EC) No 551/2004 – Organisation
and use of Airspace in SES
The objective of the Airspace regulation is to put an end to the fragmentation of European Union (EU) airspace and to create an efficient and safe airspace without frontiers. The organisation and management of airspace should be improved by merging all the national flight information regions (FIRs) into a single portion of airspace within which ATS will be provided according to the same rules and procedures.
The Airspace regulation forms part of the first package of legislation on air traffic management designed to create a SES. This objective will make for improved safety, optimum use of
European
airspace, reduced air traffic delays and sustainable air transport growth.
The following is summarising this regulation:
• Establishment of European Upper Flight Information Region (EUIR)
• Reconfiguration of Upper Airspace
• Optimised Route and Sector Design in the Upper Airspace
(EC) No 552/2004 – Interoperability
of the European ATM Network
The aim of the Interoperability regulation is two-fold:
• To achieve interoperability between the different systems, constituents and associated procedures in the European ATM network by establishing a
harmonised system for certification of components and systems;
• To ensure the introduction of new agreed and validated concepts of operations and technology in air traffic management.
The following topics summarise the Interoperability regulation:
• Essential Requirements
• Implementing Rules for Interoperability
• Community Specifications
• EC Declaration of Conformity of Suitability for Use of Components
• Safeguards
The SES Implementation
Implementing the provision of the SES regulations would bring a number of
significant benefits:
• Improved level of safety of air navigation services;
• A more effective and integrated air traffic management architecture;
• Demand driven air navigation service provision;
• Enhanced cross-boarder co-ordination;
Regulations, Directive and
Implementing Rules
•
Regulations
: Mandatory to the letter
•
Directives
: Mandatory with National exemptions
The 1st SES legislative package
The First Report
on the implementation of the Single Sky Legislation
was published in
December 2007
.
It presents:
•
the achievements,
•
identifies new challenges
•
proposes the way forward.
Based on the report findings, the Commission came forward with
proposals for a
2nd Single Sky package
, including extension of EASA
competencies to ATM and adoption of the European ATM Master Plan.
The 2nd SES legislative package
To tackle issues such as traffic increase, financial burden and
environmental awareness, the Commission has come up with 2
ndSES
legislative package aimed to:
•
Create a single safety framework to enable harmonised development
of safety regulations and their effective implementation;
•
Improve the performance
of the ATM system through setting of
targets;
•
Open the door to
new technologies
enabling the implementation of
new operational concept and increasing safety levels by a factor of
ten;
(EC) No 2096/2005 – Common Requirements
for the Provision of Air Navigation Services
The objective of this Regulation is to establish common requirements for the safe and
efficient provision of air navigation services in the European Community and to set uniform and high safety standards for ANSPs.
The common requirements cover the following areas:
• Technical and operational competence and capability • Organisational structure and management
• Safety and quality management • Security
• Human resources • Financial strength
• Liability and insurance cover • Quality of services
• Reporting requirements
(EC) No 2096/2005 – Common Requirements
for the Provision of Air Navigation Services
The Regulation identifies and adopts the mandatory provisions of the following
EUROCONTROL Safety Regulatory Requirements (ESARRs) which are relevant for the certification of air navigation service providers:
• ESARR3 - on the use of safety management systems by air traffic management (ATM) service providers;
• ESARR4 - on risk assessment and mitigation in ATM;
• ESARR5 - on ATM services' personnel, in particular the requirements for engineering and technical personnel undertaking operational safety related tasks.
• The detailed requirements relating to safety of services are contained in Annex II to the Regulation.
(EC) No 2096/2005 – Common Requirements
for the Provision of Air Navigation Services
Subjects summarising (EC) No 2096/2005 are as follows:
• Certification of ANSPs
• Derogations
• Demonstration of Compliance
• Compliance Monitoring
Similarities and Differences between
ICAO and SES
EUROCONTROL Methodology (ESARR) ICAO Methodology St ep 0: Pl anning St ep 1: S ys tem Descript ion St ep 2: Haz ar d I d en tifi cati on St ep 3: Severity Asses sment St ep 4: Likelihood Asses smen t St ep 5: S ys tem Descript ion St ep 6: Ri sk Mitigati on St ep 7: Documenta tion Functional Hazard Assessment (FHA) Preliminary System Safety Assessment (PSSA) System Safety Assessment (SSA) What can go wrong? What can we do about it?
ICAO Safety Regulation
•
ICAO Annex 11 – Paragraph- 2.26 – ATS Safety Management
includes relevant requirements related to ATS
•
Para 2.26.1 requires the States to implements systematic and
appropriate Safety Management Programmes, further detailed in
Para 2.26.4
•
Para 2.26.2, requires States to establish the
acceptable level of
safety and safety objectives
applicable to the provision of ATS
within their airspace and at their aerodromes with acceptable level
of safety further detailed in 2.26.3
ICAO Provisions
•
Para 2.26.5 requires that any significant safety-related change to
the ATC system shall only be implemented after a safety
assessment has demonstrated that an acceptable level of safety will
be maintained.
•
Para 2.26.5 also requires that the responsible authorities shall
provide for post-implementation monitoring to verify that the
defined levels of safety continues to be met
ICAO Provisions
• PANS-ATM doc.4444 includes in Chapter 2 requirements for:
• ATS maintaining acceptable level of safety (section 2.1)
• Implementation of systematic Safety Management Programmes (section 2.1)
• ATS Safety Management Activities (section 2.3)
• Monitoring of Safety Levels (section 2.4)
• Safety Reviews (section 2.5)
• Safety Assessments (section 2.6)
ICAO Provisions
• PANS-ATM Doc 4444 clarifies a significant safety-related change as
(examples):
• A new operating procedure, including departure and arrival procedures, to be applied within an airspace or at an aerodrome;
• A reorganization of the ATS route structure;
• A resectorisation of an airspace;
• Physical changes to the layout of runways and /or taxiways at an aerodrome; and
• Implementation of new communications, surveillance or other safety-significant systems and equipment, including those providing new functionality and or capabilities.
Safety Management Manual
The new Manual on Safety Management for Aerodromes and Air Traffic Services (Doc 9859)
Provides detailed guidance on implementation of the provisions of Annexes 6, 11, 14 and the PANS-ATM
• First Draft was endorsed by 11th Air Navigation Conference (Montreal, Sep/Oct 2003) • Current version in ICAO NET web
• Based on the same approach to safety as recommended by the ATM Operational Concept (Doc 9854)
The Concept of Safety Management
Safety Monitoring Safety Assessment Safety Auditing Safety Promotion Supporting Organisational Requirement Safety Management Safety Culture Safety Policy Philosophy Of Safety Management Maintenance of Improvement of Safety PerformanceLegal and Regulatory Foundation
for Safety Management
Implementation of safety management programs refers to the day
to day keep safety oversight management by the service providers
• States shall establish systemic and suitable ATS safety management programs with defined levels and objectives (PANS-ATM, in force since November 2003)
• The acceptable level of safety shall be established by the States. As
appropriate, the target levels of safety (TLS) will be established through regional air navigation agreements.
• Prior to any significant change to the safety-related ATC system, a safety assessment will be carried out, proving that an acceptable safety level may be obtained
The Safety System
• Global Safety System
• Organizational structure - Staffing, documentation, resources and leadership commitment must be sufficient to support the desired process.
• Planning - Strategic planning and development of appropriate activities must be based on systematic and comprehensive assessment of risks.
• Management personnel standards - Safety must be integrated into line and operating
management responsibilities, and their roles must be clearly defined in written standards of performance.
• Training for operations and emergencies
• Procedures - The organization must develop written procedures for design, operations and maintenance activities to control routine work and probable emergencies.
• Management of change
• Mechanical integrity - The organization must establish systematic and comprehensive means to assess the integrity of process equipment.
• Management of contractors - Safety must be a prominent consideration in the selection of contractors, and appropriate means to monitor the work of contractors must be in place and working.
• Involvement of the work force
• Accident/incident reporting, investigation and follow-up - Monitoring and auditing methods must be in place to monitor the on-going, day-to-day performance of the safety system, as well as to audit thoroughly compliance to all requirements on a periodic basis.
Global Safety System
Documentation:
ICAO EASA EUROCONTROL EC States Ministries CAA Guidelines Regulations Requirements, EU OPS Recommendations Legislation National Legislation NSA Service Providers Manuals Working Procedures Documentation • AD – Technical • Implementing Rules • Guidance Material• Acceptance Means of Compliance • Notices of proposal amendments
•Aviation Law •Airport Law •Regulations •Standards
Global Safety System
Organisation:
•
The world global Safety System consist of all
the existing safety management systems on
all levels in all the areas of aviation like the
service providers, the airspace users, the
maintenance organisations etc.
Global Safety System
Supporting Issues:
•
Auditing
Global Safety System
Security:
•
Improved security of ATM systems and
information
•
Provides assistance and information
•
In Flight Emergency Response
Global Safety System
Security:
Until the events of 11 September 2001, the ICAO model was regarded as adequate and sufficient to ensure the safety of passengers, aircraft and goods. However, in December 2001 the ICAO adopted an Amendment 10 to Annex 17, which set out a number of additional safety and security requirements. These include the following:
1. Aircraft security check
2. Background check
3. Screening
4. Application of Security
5. Security Restricted Areas
6. Objectives
7. International cooperation
8. National Organization and appropriate authority
9. Airport Operations
10. Quality Control Programme
Global Safety System
Security:
Contingency Plan Airport Emergency PlanNational Civil Aviation Security Program
Airport Security Program Operator Security Programs National Training Program Quality Control Program Airport Security Committee Authority
National Aviation Security Committee
Global Safety System
Quality Definitions:
Quality – the totality of features and characteristics of a product or service that bear on its ability to satisfy a given need.
Quality Policy – the overall quality intentions and direction of an organisation as regards quality, as formally expressed by top management.
Quality Management – that aspect of the overall management function that determines and implements the quality policy.
Quality System – the organisational structure, responsibilities, procedures, processes and resources for implementing quality management.
Total Quality Management – a management approach of an organisation centred on quality, based on the participation of all its members and aimed at long term success through customer satisfaction and benefits to the members of the organisation and society.
Quality Assurance – the activities an organisation carries out to provide to external and internal parties confidence that the organisation will consistently meet the requirements for quality.
Global Safety System
Quality:
Airport Quality Process:
•
Evaluation
of user needs and expectations
•
Design and implementation
of service
•
Operation and achievement
of service
•
Measurement
of quality of service
Global Safety System
Quality Definitions:
Airport Quality Elements:
Safety
Security
Efficiency
Service
Capacity
Environment
Health
Global Safety System
Quality:
The implementation of QMS, completed in March 2002, included data and product quality assurance and control processes. These processes drew on the following existing resources:
• day-to-day consistency checking systems for both data and products,
• forecast verification system developed in 2000 which gave for each forecast a score relative to the ICAO desirable accuracy for each of the weather elements.
• The QMS also included on-going review processes for continual
improvement and for the provision of adequate resources to sustain the QMS.
Further, as important components of the QMS, customer needs
assessment and satisfaction survey became an institutionalized part of the system.
Global Safety System
Safety:
•
The world global Safety System consist of all
the existing safety management systems on
all levels in all the areas of aviation like the
service providers, the airspace users, the
maintenance organisations etc.
Global Safety System
Safety Versus Quality and Security:
It is accurate to say that SMS and QMS share many commonalities. They both:
a) have to be planned and managed;
b) depend upon measurement and monitoring;
c) involve every function, process and person in the organization; and d) strive for continuous improvement.
SMS differs from QMS in the following way:
a) SMS focuses on the safety, human and organizational aspects of an organization (i.e. safety satisfaction);
while
b) QMS focuses on the products and services of an organization (i.e. customer satisfaction).
Safety Management System
•
Safety
– The state in which the risk of harm to persons
or property damage is reduced to, and maintained at or
below, an acceptable level through a continuing process
of hazard identification and risk management.
•
Management
– Allocation of resources.
•
System
– Organized set of processes and procedures.
SMS – An organised set of processes and procedures,
based upon a principled allocation of resources, that allows
The Safety Management System
•
What is SMS?
• A system for managing safety as part of the overall
management objective and policy;
•
Why SMS?
• To regulate airport operations and improve safety levels,
especially in areas not covered by applicable ICAO or
applicable national standards and regulations;
•
How?
• Existence of comprehensive technical
Standards/specifications, a safety management policy, their
implementation and maintenance at all times.
The Safety Management System
SMS Tool-box:
•
The scope of SMS encompasses most of the activities
of the organization.
•
SMS must start from senior management, and safety
must be considered at all levels of the organization.
•
SMS aims to make continuous improvement to the
overall level of safety.
The Safety Management System
The components of SMS:
1)
Safety policy and objectives
2)
Safety risk management
3)
Safety assurance
The Safety Management System
SMS at glance:
Safety Effectiveness Efficiency Management Commitment Safety Risk Management Safety Promotion Safety Policy andObjectives
Safety Assurance
The Safety Management System
The Elements of SMS:
Safety policy and objectives
•
Management commitment and responsibility
•
Safety accountabilities of managers
•
Appointment of key safety personnel
•
SMS implementation plan
•
Coordination of emergency response planning
The Safety Management System
The Elements of SMS:
Safety risk management
•
Hazard identification processes
•
Risk assessment and mitigation processes
Safety assurance
•
Safety performance monitoring and measurement
•
The management of change
•
Continuous improvement of the SMS
Safety Promotion:
Safety Risk Management
What is Risk Management?
•
The
identification, analysis
and
elimination
, and/or
mitigation
to an acceptable level of risks that threaten the
capabilities of an organization.
What is the objective of Risk Management?
•
Aims at a balanced allocation of resources to address
all
risks and viable
risk
control and mitigation.
Why is Risk Management important?
•
A key component of safety management systems.
•
Data-driven approach to safety resources allocation, thus
defensible and easier to explain.
Safety Risk Management
Four steps for hazard identification process:
1.
Reporting hazards, events or safety concerns.
2.
Collecting and storing the data.
3.
Analyzing reports.
Safety Risk Management
Risk Assessment and Mitigation Process
Risk Assessment:
Regularly
Commitments
Documentation
Mitigation:
Measures to address the potential hazard or to
reduce the risk probability or severity.
Risk Management System
Risk Management at glance:
Hazard Identification Risk Analysis
Probability Risk Analysis
Severity
Risk Assessment and Tolerability
Risk
Control/Mitigation
Equipment, Procedures, Organisation, etc Analyse the likelihood of the consequence
occurring
Evaluate the seriousness of the consequence if it occurred
Is the risk assessed acceptable and within the organisational safety performance criteria
Yes, Accept the risk
No, take action in order to reduce the risk to an acceptable level
Risk Management System
Risk Mitigation at glance:
Hazard identification and Risk Assessment
Assessment of the defences within the
safety system
Control and
Mitigation of the risks Accepting the mitigationsof the risk(s)
H
H
H
H
Each ConsequenceR
R
R
R
Each Risk Technology Training Regulations Intolerable Region Tolerable Region Acceptable Region • Does it address the risk(s)? •Is it effective? •Is it appropriate? •Is additional mitigationwarranted?
•Do the mitigations
Strategies generate additional risks?
•Etc…
Risk Management Assessment
• There is no such thing as absolute safety – In aviation it is not possible to eliminate all risks.
• Risks can be managed to a level “as low as reasonably practicable” (ALARP)
• Risk mitigation must be balanced against:
• Time
• Cost
• Difficulty of taking measures to reduce or eliminate the risk (i.e. managed).
• Effective risk management seeks to maximize the benefits of accepting a risk
(a reduction in time and cost) while minimizing the risk itself.
• Communicate the rationale for risk decisions to gain acceptance by stakeholders affected by them.
Safety Assurance
Safety Assurance is built upon the following:
•
Safety performance monitoring and measurement
•
The management of change
Safety Assurance
Safety performance monitoring and measurement
The process by which the safety performance of the
organization is verified in comparison to the approved safety
policies and objectives.
•
Safety reporting
•
Safety studies
•
Safety reviews
•
Audits
•
Surveys
•
Internal safety investigations
Safety Assurance
Safety Audits are used to ensure that the structure of the SMS is sound in terms of:
• Levels of staff;
• Compliance with approved procedures and instructions;
• Level of competency and training to:
• Operate equipment and facilities; and • Maintain their levels of performance.
Safety surveys examine particular elements or processes of a specific operation.
• Problem areas or bottlenecks in daily operations.
• Perceptions and opinions of operational personnel.
• Areas of dissent or confusion.
• Check list •Questionnaires
Safety Assurance
Internal safety investigations
include occurrences or events
that are not required to be investigated or reported to State.
•
In-flight turbulence (flight operations)
•
Frequency congestion (ATC)
•
Material failure (maintenance)
Safety Information Sources
• The protection of safety information from inappropriate use is essential to ensure its continued availability in future, since the use of safety information for other than safety-related purposes may reduce the availability of such information, with an undesirable effect on safety.
• During the 35th Assembly of ICAO, it was noted that existing national laws and regulations in many States may not address adequately the protection of safety information from inappropriate use.
• Following the Assembly, ICAO has produced a legal guidance for the protection of information from SDCPS and it is included in Attachment E to Annex 13.
Annex 13
General Principles
• The sole purpose of protecting safety information from inappropriate use is to ensure its continued availability so that proper and timely preventive actions can be taken and aviation safety improved.
• It is not the purpose of protecting safety information to interfere with the proper administration of justice in States.
• National laws and regulations protecting safety information should ensure that a balance is struck between the need for the protection of safety information in order to improve aviation safety, and the need for the proper administration of justice.
• National laws and regulations protecting safety information should prevent its inappropriate use.
• Providing protection to qualified safety information under specified conditions is part of a State’s safety responsibilities.
Principles of Protection
• Safety information should qualify for protection from inappropriate use according to specified conditions that should include, but not necessarily be limited to: the collection of information was for explicit safety purposes and the disclosure of the information would inhibit its continued availability.
• The protection should be specific for each SDCPS, based upon the nature of the safety information it contains.
• A formal procedure should be established to provide protection to qualified safety information, in accordance with specified conditions.
• Safety information should not be used in a way different from the purposes for which it was collected.
• The use of safety information in disciplinary, civil, administrative and criminal proceedings should be carried out only under suitable safeguards provided by national law.
Annex 13
Principles of Exception
• Exceptions to the protection of safety information should only be granted by national laws and regulations when:
• There is evidence that the occurrence was caused by an act considered, in accordance with the law, to be conduct with intent to cause damage, or conduct with knowledge that damage would probably result, equivalent to reckless conduct, gross negligence or wilful misconduct;
• An appropriate authority considers that circumstances reasonably indicate that the occurrence may have been caused by conduct with intent to cause damage, or conduct with knowledge that damage would probably result, equivalent to reckless conduct, gross negligence or wilful
misconduct;
• A review by an appropriate authority determines that the release of the safety information is necessary for the proper administration of justice, and that its release outweighs the adverse domestic and international impact such release may have on the future availability of safety information.
Public Disclosure
• Subject to the principles of protection and exception outlined above, any person seeking disclosure of safety information should justify its release.
• Formal criteria for disclosure of safety information should be established and should include, but not necessarily be limited to, the following:
• Disclosure of the safety information is necessary to correct conditions that compromise safety and/or to change policies and regulations;
• Disclosure of the safety information does not inhibit its future availability in order to improve safety;
• Disclosure of relevant personal information included in the safety information complies with applicable privacy laws;
Annex 13
Responsibility of the Custodian of Safety Information
• Each SDCPS should have a designated custodian. It is the responsibility of the custodian of safety information to apply all possible protection regarding the disclosure of the information, unless:
• The custodian of the safety information has the consent of the originator of the information for disclosure; or
• The custodian of the safety information is satisfied that the release of the safety information is in accordance with the principles of exception.
Protection of Recorded Information
• Considering that ambient workplace recordings required by legislation, such as cockpit voice recorders (CVRs), may be perceived as constituting an invasion of privacy for operational personnel that other professions are not exposed to:
• Subject to the principles of protection and exception above, national laws and regulations should consider ambient workplace recordings required by legislation as privileged protected information, i.e. information deserving enhanced protection; and
• National laws and regulations should provide specific measures of protection to such recordings as to their confidentiality and access by the public. Such specific measures of protection of workplace recordings required by legislation may include the issuance of orders of non-public disclosure.
Change Management Process
Aviation organizations experience permanent change due
to expansion, introduction of new equipment or procedures.
Changes can have the following output
:
•
Introduce new hazards.
•
Impact the appropriateness of risk mitigation.
Change Management Process
Mentioned Changes can be:
External changes
•
Change of regulatory requirements.
•
Security.
•
Reorganization of air traffic control…
Internal changes
•
Management changes
•
New equipment.
Change Management Process
A formal management of change process should:
•
identify changes within the organization which may
affect established processes and services.
•
prior to implementing changes describe the
arrangements to
ensure safety performance
.
Improvement Process
Continuing improvement aims at:
•
Determining the
immediate causes
of below standard
performance and their implications in the operation of
the SMS.
•
Rectifying situations involving below standard
performance identified through safety assurance
activities
Improvement Process
The mentioned improvements are achieved through:
•
Proactive
evaluation of facilities, equipment,
documentation and procedures through audits and
surveys.
•
Proactive
evaluation of the individuals’ performance, to
verify the fulfilment of their safety responsibilities.
•
Reactive
evaluations in order to verify the effectiveness
of the system for control and mitigation of risks, for
example: accidents, incidents and major events
investigations
Safety Promotion
Training and Education
Who?
•
Operational personnel
•
Managers and supervisors
•
Senior managers
•
Accountable executive
Why?
•
To ensure that personnel are trained and competent
to perform the SMS duties.
How much?
•
Appropriate to the individual’s involvement in the
SMS.
Safety Promotion
Training and Education
A building block approach:
•
Operational personnel
• Organization safety policy
• SMS fundamentals and overview
•
Managers and supervisors
• The safety process
• Hazard identification and risk management
• The management of change
•
Senior managers
• Organizational safety standards and national regulations
Safety Promotion
Safety Communication
Safety communication aims to:
•
Ensure that all staff are fully aware of the SMS.
•
Convey safety critical information.
•
Explain why particular actions are taken.
•
Explain why safety procedures are introduced or changed.
Safety Promotion
Safety Communication
The means to communicate may include:
•
Safety policies and procedures
•
News letters
•
Bulletins
•
Website
Safety communication is an essential foundation for the
development and maintenance of a positive culture.
Maintenance
Internal Evaluation Process
•
Management commitment
•
Just culture
Maintenance
Internal Audit Process
An annual audit program should include:
•
Definition of the audits, in terms of;
•
criteria,
•
scope,
•
frequency, and
•
methods;
•
Description of the processes used to select the auditors;
•
The requirement that individuals shall not audit their own work;
•
Documented procedures for assignment of responsibilities, planning
and conduct of audits, reporting results and maintaining records;
Maintenance
External Audit Process
Surveillance and compliance
the authority needs to ensure that international, national and local
standards are complied with prior to issuing any licence or approval and continue to be complied with afterwards;
Areas and degree of risk
the audit should assess how risks are identified and how any necessary changes are made to ensure that all safety standards are met;
Competence
the audited organisation should have adequately trained staff for all safety related positions
Safety management
ensure that the organisation’s SMS is based on sound principles and procedures, and that the organisation is meeting its safety performance targets.
Maintenance
Proactive and Reactive Evaluations
Proactive – before something has happened
•
Taking actions
•
Mitigate
•
Training
Reactive – after something has happened
•
Investigate why it is as it is
Organisation
Cultural Levels of the organisation
The characteristics of a good company safety culture include:
•
Informed
- Managers know what is really going on and workforce is
willing to report their own errors and near misses
•
Wary
- ready for the unexpected
•
Just
- a ‘no blame’ culture, with a clear line between the acceptable
and unacceptable
•
Flexible
- operates according to need
Organisation
The values of an Organisation:
•
The safety management organisation is defining
responsibilities, competence, commitment and communication
of
the involved organisations or persons.
•
The culture is expressed by all parts of the organisation
•
Flight deck
•
Cabin crew
•
Maintenance
•
Ground staff
•
The cabin staff and check-in personnel provide the main indication
of the culture to the paying public
Organisation
Top-down
Managers Flight Crew Engineers (Maintenance) Ground Staff (Luggage Personnel)Managers influencing and motivating all actors to take responsibility for their work and taking into account the safety.
Procedures
Safety Programme
Safety Programme is an integrated set of regulations and activities
aimed at improving safety.
States are responsible for establishing a safety programme,
encompassing the following responsibilities:
•
Safety regulation
•
Safety oversight
•
Accident/incident investigation
•
Mandatory/voluntary reporting systems
•
Safety data analysis and
exchange
•
Safety assurance
State Safety Programme - SSP
State
•States shall establish a State safety programme (SSP), in order to achieve an acceptable level of safety (ALoS) in civil aviation.
•Acceptable level of safety (ALoS) to be achieved shall be established by the State.
Service Providers
• States shall require as part of their State Safety Programme (SSP) that a Service Providers implement Safety Management System acceptable to the State that as minimum:
•identifies safety hazards; •ensures the implementation of remedial action necessary to maintain agreed safety
performance.
•provides for continuing monitoring and regular assessment of
the safety performance; and
•aims at a continuous improvement of the overall performance of the SMS.
Procedures
State’s safety programme
Develop the State’s safety programme around the
following four components:
1.
State’s safety policy and objectives
2.
State’s safety risk management
3.
State’s safety assurance
Procedures
Differences between State and Service Providers
Legal considerations – States
• Establishing acceptable level(s) of safety does not replace legal, regulatory, or other already established requirements, but it must support compliance with them.
• Establishing acceptable level(s) of safety for their safety programme leaves unaffected the obligations of States, and does not relieve States from compliance with SARPs
Operators and service providers
• Establishing acceptable level(s) of safety for their safety management system leaves unaffected the
obligations of operators or services providers and other related parties, and it does not relieve the operator, services providers and other related parties from compliance with SARPs and/or national regulations, as
Procedures
State’s safety programme + Service providers SMS =
Integrated safety system
State Safety Programme Organisation’s Safety Management System (SMS) Organisation’s Production Processes Ove rsight Acceptance Oversight Risk Management Safety Assurance Objective: Public Safety Objective: Manage and control safety risks Objective: Achieve commercial goals and customer saftisfaction
Safety Policy
A typical safety policy document would consist of a policy statement that is further expanded by a number of basic safety management principles to be followed:
• commitment to safety,
• safety priority,
• safety responsibility,
• planning for safety,
• safety management,
• safety standards,
• safety achievement,
Safety Policy - A statement of the organisation’s fundamental approach to achieve acceptable or tolerable safety.
A written document that describes the generic principles upon which the SMS is build and operated upon.
Risk Management
Risk management -
The identification, analysis andelimination (and/or mitigation to an acceptable or tolerable level) of those hazards, as well as the subsequent risks, that threaten the viability of an organisation.
Risk Management consists of the following three elements:
• Hazard identification
• Risk assessment
Risk Management System
Risk Management at glance:
Hazard Identification Risk Analysis
Probability Risk Analysis
Severity
Risk Assessment and Tolerability
Risk
Control/Mitigation
Equipment, Procedures, Organisation, etc Analyse the likelihood of the consequence
occurring
Evaluate the seriousness of the consequence if it occurred
Is the risk assessed acceptable and within the organisational safety performance criteria
Yes, Accept the risk
No, take action in order to reduce the risk to an acceptable level
Safety Assurance
Safety assurance
-
all planned and systematic actions necessary to afford adequate confidence that a product, a service, an organisation or a functional system achieves acceptable or tolerable safetyThe objectives of Safety Assurance is to implement dedicated surveillance and documenting procedures and processes in order to ensure that risk are being properly managed.
According to ICAO State Letter SA include the following activities:
• Safety performance monitoring and measurement
• Management of change
Safety Assurance
Safety Assurance components:
•
Safety Surveys
•
Safety Monitoring
•
Safety Records
Regulators should continuously evaluate the implemented safety
management arrangements and processes by aviation service
providers by means of external regulatory safety auditing and other
safety oversight methodologies.
Safety Promotion
•
Just culture
•
Key Performance Indicators
Thank You for you
attention today
Any Questions?
Agenda for today:
Wrap up Evaluation
Hand over of Diploma 16.30 – 17.00
Joint session/discussions 15.30 – 16.30
Break 15.00 – 15.30
The Safety Components 14.00 – 15.00 Lunch 12.30 – 14.00 WS on Safety Culture 11.00 – 12.30 Break 10.30 – 11.00 Managing Safety 09.00 – 10.30
Managing Safety
Safety Responsibility and accountability
Safety responsibility:
the obligation to carry forward an assigned
safety related task to its successful conclusion. With responsibility
goes authority to direct and take the necessary action to ensure
success.
Safety accountability:
the obligation to demonstrate the task
achievement and take responsibility for the safety performance in
accordance with agreed expectations. Accountability is the
obligation to answer for an action.
Clear and correctly allocated safety accountabilities and responsibilities
are prerequisite for achieving the organisation’s safety objectives
and for implementing an effective safety management and safety
improvement process
Safety Manager (SM)
An individual, responsible for the
development, operation and
continuous improvement of the safety management system
deployed
by an operator/service provider.
He acts as a focal point for safety management issues in the
organisation.
The approach to the assignment of Safety manager’s responsibilities
may differ depending on
the type, size of the organisation
, its
Safety Manager’s
Responsibilities
The appointment of the Safety manager (SM) is an essential step in the establishment of the SMS organisational structure and a prerequisite for an efficient safety planning
process. Irrespectively of any other duties that may be allocated to them, safety managers have the responsibility to:
• Promote safety awareness within the organisation;
• Ensure that safety management has the same or higher priority level throughout organisation as any other management and operational processes;
• Manage all aspects of the organisation’s SMS, including:
• Monitoring the effectiveness of SMS;
• Initiating corrective actions when necessary;
• Providing safety reports on SMS performance on periodic basis;
• Providing safety advice to top management and proposing corrective actions on safety related-issues as needed;
• Ensuring that safety-related documentation and records are available and up-to-date.
Safety Levels and Targets
The term "acceptable risk" describes an event with a probability of occurrence and consequences acceptable to the society, i.e. the society is willing to take or be subjected to the risk that the event might bring.
It is the role of the safety regulatory authorities to translate the society
expectations and perceptions into a qualitative or quantitative target level of safety.
Definition:
The acceptable level of safety expresses the safety goals of an oversight authority, an operator, or a services provider.
From the perspective of the relationship between oversight authorities and operators/services providers, it provides the minimum safety objective(s)
acceptable to the oversight authority to be achieved by the operators/services providers while conducting their core business functions.
Safety Performance Targets
Safety performance targets define the required level of safety performance of a system. A safety performance target comprises one or more safety
performance indicators, together with desired outcomes expressed in terms of those indicators.
Safety Targets can be presented in either:
• Absolute (i.e. less than 1 fatal accident per 1 000 000 operating hours)
Safety Indicators
• Definition on Safety Performance Indicators: A measure (or metric) used to express the level of safety performance achieved in a system.
• Enable the organisation to measure and demonstrate the achievement of the set target levels.
• Safety indicators differ among the various sectors of the aviation industry such as;
• air navigation services provision,
• airline operations and
Safety Levels
The relationship between
acceptable level of safety, safety
performance targets and safety performance indicators, and
safety requirements
is as follows:
•
acceptable level of safety is the overarching concept;
•
safety performance targets are the quantified objectives
pertinent to the acceptable level of safety;
•
safety performance indicators are the measures/metrics used to
determine if the acceptable level of safety has been achieved
Key Performance Indicators
•
Easy judgments
•
Confirmed values
Promotion and Awareness
•
Newsletters – internal
•
Posters
•
Videos
•
Intranet
•
Presentations???
Safety Culture
•
A construct
•
An outcome,
not
a process
•
The introduction of safety management concepts lays the
foundation upon which to build a safety culture
•
•
Safety culture cannot be
Safety culture cannot be
“
“
mandated
mandated
”
”
or
or
“
“
designed
designed
”
”
, it
, it
evolves.
evolves.
•
Safety Culture
How to create a Safety Culture?
•
Depends on where you are starting from - you don’t get to the
end in one step, unfortunately, all the steps have to be traversed
•
Becoming a Safety Culture involves acquiring and then
maintaining a set of skills
•
The two major factors are
information and trust
, so these have
to be developed
•
Be systematic (SMS are a start) and then learn to operate with
the unknown as well
•
Have the program run right from the top
•
Appoint a
senior champion
who is dedicated and willing to stick it
out, even when it gets hard
•
The champion reports direct to the board
•
Recognise that it will be uncomfortable, safety cultures are
different, not just an add-on
Safety Culture
A Way Forward – developing a Safety Culture:
• Agree on ways to analyse incidents to reveal individual and system issues
• Develop reporting systems that are easy to use (compact, open-ended, impersonal)
• Encourage the workforce (air and ground) to realise that all incidents are worth reporting
• Experiment with changes when new information comes in, don’t be afraid to admit failure first time round
• Practice management in wanting to know from near misses before they become accidents
Positive culture
Positive
culture
Flexible culture
People can adapt
organizational processes when facing high temporary operations or certain kinds of
danger, shifting from the conventional hierarchical mode to a flatter mode.
Learning culture
People have the willingness and the competence to draw
conclusions from safety information systems and the
will to implement major reforms.
Informed culture
People are knowledgeable about the human, technical, organizational and environmental factors that determine the safety of the system as a whole.
Reporting culture
People are prepared to report their errors and
experiences
Just culture
People are encouraged (even rewarded) for providing essential safety-related information. However, there is a clear
line that differentiates between acceptable and unacceptable behaviour.
Just Culture
• Get rid of the idea that blame is a useful concept (this is hard to do)
• Define clear lines between the acceptable and the unacceptable
• Have those involved draw up the guidelines, do not impose from above if you want them to be accepted
• Have clear procedures about what to do with other forms of non-compliance
Just Culture
Confidentiality
• People are reluctant to draw attention to errors made by themselves or their colleagues, due to personal embarrassment. They must be confident that their identity, or the identity of any person implicated in the report will not be
disclosed without their permission or unless this is required by law. An
assurance should also be given that any subsequent safety action taken will, as far as possible, ensure the anonymity of the persons involved.
Punitive Action
• A person who breaks the law or breaches a regulation or company procedure through a deliberate act or gross negligence cannot expect immunity from
prosecution. However, if the offence was unpremeditated and unintentional, and would not have come to light except for the report, he/she should be protected from punishment or prosecution.
Loss of Licence
• The circumstances of a report may indicate that the performance of an
individual is below the acceptable level. This may indicate the need for further training, or even cancellation of an individual's licence. Such action must never
Workshop
Safety Culture
Just Culture
Promotion
The Safety Components
Organizational cultural transformation is not for the faint of heart. In fact, many attempts at transforming an organization fail, for a variety of reasons:
• "Playing at it" or "dabbling" with it until it's no longer fun
• Not applying the kind of leadership that would best meet the needs of the situation
• Intervening in the wrong places or at the wrong time
• Not taking this work seriously enough
• Not giving it enough time or attention
• Senior leaders "delegating" this work (rather than committing and investing their own time and energies)
• Knowing what needs to be done but being unwilling to do it...to go all the way
• Not having the people and tools available internally to get the job done
• Inability to engage all the right people in the process
