MAIB publishes the results of 25 incidents in its Safety Digest 2/2019

The second Safety Digest of the year, edition 2/2019, has been published by the Marine Accident Investigation Branch (MAIB). It features the outcome of 25 incidents and accidents in digest format presented in a 71 page pdf which can be downloaded (see below).

Capt Andrew Moll says in his introduction, “As always, I will start my opening comments by thanking Hans Hederström, David Dickens and Keith Colwell for the introductions they have written for the three main sections of this edition of the MAIB’s Safety Digest. We ask guest introduction writers to make insightful comments from their own perspective and to pass on pearls of wisdom. They have not let us down. Do please take time to read their words which are, as ever, very powerful.

Throughout my seagoing career, and especially since joining the MAIB, it has been true to say that ‘every day has been a school day’. There is always something new to learn. I would therefore like to thank Hans for introducing me to his tactful but effective approach to raising concerns when things are not going according to plan. You will read more about his acronym PACE – Probe, Alert, Challenge, Emergency – over the page, but it seems to provide a simple method of escalating expressions of concern, and I will be adding it to my toolkit. Of course, it does require all members of the team to understand the plan beforehand – that shared mental model – so they can spot when things are starting to go awry, and this edition contains a number of examples where this has been the case.

More than half the articles in this edition’s Fishing Section recount stories when the actions of the crew were significant, either in resolving the situation or reducing its consequences. One of my former captains once told me, “it’s not what happens, it’s how you deal with it that matters”. His point was that you cannot always prevent bad things happening, but dealing with them effectively can help prevent a drama from becoming a crisis. The fire-fighting tale (Case 17) and abandonment story (Case 19) provide good examples of when drills and training before the event significantly improved the crew’s ability to deal with an emergency. Is the message about wearing lifejackets when on deck getting through? I hope so. The deckhands in Cases 18 and 20 would probably have perished had they not been wearing lifejackets when they went overboard. While both these cases had a positive outcome, they also help make the point that surviving the initial immersion and remaining on the surface to be rescued is only the first part of the story. A man overboard is not safe until he or she is back on board. Hopefully, you already review and practice your manoverboard recovery procedures but, if you do not, now would be a good time to start.

Some years ago, I was training to become a powerboat instructor. Our teacher told us that it was important to assess the abilities of the students right at the start of the course, and that a good way to do this was during the opening session to invite everyone to introduce themselves and say a bit about their boating experience. Those who were completely new to powerboating would probably say so, but others might claim extensive prior experience. The difficulty was knowing how much value to place on an individual’s self-account. The teacher suggested one simple method for assessing prior experience that was, simply, to quietly invite anyone who might perhaps be overselling themselves to coil up a discarded rope. His theory was that a good seaman would instinctively coil up and secure unused lines. In doing so, they would not just be tidying up. They would be checking the condition of the line as it passed through their hands, ensuring it was kink free, and that it was ready for immediate use when required. His ethos was that professionalism and safety go hand-in-hand. I think he was right.”

Andrew Moll, Chief Inspector of Accidents

Download the 71 page pdf digest: 2019-SD2-MAIBSafetyDigest

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