Accident - G-BXBU

2023-011: It is recommended that the Civil Aviation Authority publish guidance for general aviation pilots on responding to unexpected weather deterioration, highlighting the factors affecting their performance and the benefits of planning before the flight how they will respond.

In addition to the guidance highlighted in the CAA’s initial response to this safety recommendation, the CAA is also developing a new Safety Sense Leaflet (SSL) dedicated to inadvertent entry into Instrument Meteorological Conditions (IMC) when operating under Visual Flight Rules (VFR). The SSL will include guidance on planning to avoid a ‘VFR into IMC’ scenario and what actions to take if a pilot is confronted with deteriorating weather conditions and ends up in IMC when not appropriately qualified.

The SSL has been developed with input from internal and external subject matter experts and is scheduled to be published by March 31st 2024.

The CAA considers the above actions satisfy the intent of the safety recommendation.

Open - Tracked actions

Late 2024

2023-012: It is recommended that the Civil Aviation Authority require air traffic controllers to receive training regarding the human performance characteristics and limitations associated with stress. This should include the verbal cues that may indicate that a pilot is operating under high stress, and mitigation strategies to help controllers deal with such event.

The CAA is working in collaboration with the UK Flight Safety Committee (FSC) to develop a significant update to ‘Aircraft Emergencies: Considerations for air traffic controllers’ (CAP 745). This work includes broadening the scope of the document to include scenarios affecting general aviation activities and flight information service officers alongside air traffic controllers. Our aspiration is for the revised document to be published in Q4 2024, though we are reliant upon the expertise being volunteered by the members of the UK FSC.

The syllabus, which forms Acceptable Means of Compliance (AMC) for Assimilated Regulation (EU) 2015/340 (the ATCO licensing regulation) which provides the learning objectives for trainee ATCOs for the issue and revalidation of unit endorsements, is being reviewed and will include consideration of the intent of this Safety Recommendation. Amendment of AMC will be made in conjunction with the legislation changes being worked on for UK Reg (EU) 2015/340 and in accordance with the CAA Rulemaking Programme/Schedule.

Open - Traced actions

Late 2024

2023-013: It is recommended that the Civil Aviation Authority specify the types of information that air traffic controllers will obtain and record when responding to aircraft in an emergency to ensure that pilots’ needs are met and reported correctly if communicated to other air traffic control units.

The CAA is in the process of modifying the way in which information from a pilot on initial contact, in an emergency situation, can be obtained and recorded. It is our intention to release this in a format that is easily accessible / digestible to not only ATC but also to FIS, AGCS (which is not an air traffic service) and Pilots.

The clarification provided by the AAIB in response to the CAA’s original reply brings in a new dimension (‘This may include information, for example about ground facilities and weather conditions, that are not known to the pilot’) i.e. the presentation of information by ATC to pilots to assist with decision making. Whilst this is outside the scope of the original recommendation, the CAA will give this due consideration.
It should be noted that in the course of an emergency ATS will only deliver information essential for ensuring the best possible outcome.

Open - Tracked actions

Late 2024

2023-014: It is recommended that the Civil Aviation Authority encourage the use of checklists in air traffic management operations when dealing with abnormal and emergency situations.

The CAA will consider how to provide the information described in SR 2023-013 in a format that is easily accessible / digestible.

However, is should be recognised that provision of checklists for an infinite set of circumstances/variables is not practicable in terms of production, or use. It is noted that in the 94 seconds that Exeter ATC were in contact with the pilot there would have been insufficient time to locate and utilise checklists relevant to the specific circumstances presented. Nevertheless, the CAA will include a review of scope and content of existing checklists during its routine oversight of ANSPs.

Open - Tracked actions

Late 2024

2023-015: It is recommended that the Civil Aviation Authority determine the effect the D&D Cell’s executive control has on civil ATCOs and inform civil ATCOs of any differences in their responsibilities whilst executive control is exercised.

The CAA has had multiple discussions with the MAA and the D&D Cell. The anomalies in terminology are now well understood and the relevant military authorities are taking action to amend the terminology used to avoid confusion. The CAA will ensure that this is reflected in the Manual of Air Traffic Services (Part 1) and other relevant material published by the CAA.

Open - Tracked actions

Late 2024