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Output Number
R20070002
Approval Date
Organisation
Civil Aviation Safety Authority
Published Date Time
Recommendation type
Recommendation
Status
Closed - Action Taken
Mode
Aviation
Date released

Safety Issue

CASA did not provide sufficient guidance to its inspectors to
enable them to effectively and consistently evaluate several key
aspects of operator management systems. These aspects included
evaluating organisational structure and staff resources, evaluating
the suitability of key personnel, evaluating organisational change,
and evaluating risk management processes.

Safety Recommendation

The Australian Transport Safety Bureau recommends that the Civil
Aviation Safety Authority undertake further work to address this
safety issue.

Organisation Response
Date Received
Organisation
Civil Aviation Safety Authority
Response Text

We have been addressing a clear requirement to enhance CASA's
'frontline' surveillance workforce capability. The need to assess
the safety related decisions taken by industry management meant we
needed people with management or safety management expertise and
experience to support those with technical experience as a pilot or
engineer. This requirement was enhanced by the increasing use of
safety management systems (SMS) in aviation worldwide and the
impending mandating of SMS for Australian aviation. CASA deployed
its first safety system specialists in mid 2006, a capability that
will have a particular focus on assessing regional airline safety
management capability.

Date Received
Organisation
Civil Aviation Safety Authority
Response Text

CASA has, and continues to provide substantial guidance material
in all aspects of surveillance. Inspectors are highly experienced
and call upon professional judgement in assessing effectiveness of
operators. Inspectors are recruited on the basis of this experience
and professional judgement and are required to carry out their
duties in accordance with surveillance guidance material provided
by CASA.

ATSB Response

The ATSB acknowledges CASA's actions to recruit safety systems
specialists and the importance of professional judgement in
performing regulatory oversight. However, the ATSB still believes
that guidance material provided to CASA inspectors was and is
inadequate.

Date Received
Organisation
Civil Aviation Safety Authority
Response Status
Monitor
Response Text

Whilst CASA acknowledges the thrust of this recommendation, CASA
does not accept the underlying premise that CASA inspectors had
insufficient guidance to fulfil their responsibilities. Furthermore
CASA does not support the categorisation of this recommendation as
a contributing safety factor at paragraph 3.2.4.

CASA currently has a major project underway to improve oversight of
the aviation industry

In 2006, CASA created a new capability to evaluate industry
management systems, employing three Safety Systems Specialists.

These specialists have a different skill set to that of the
existing spectors and auditors employed byCASA. CASA sought and
obtained additional funding from the government and it is envisaged
that a further nine Safety Systems Specialists will be employed by
the end of 2007.

The Safety Systems Specialists will write guidance and
procedures for CASA staff whose responsibilities include evaluating
management systems, to ensure effectiveness and consistency.

ATSB Response

The ATSB defines a safety issue as a safety factor that
(a) can reasonably be regarded as having the potential to adversely
affect the safety of future operations, and (b) is a characteristic
of an organisation or a system, rather than a characteristic of a
specific individual, or characteristic of an operational
environment at a specific point in time. As such, the
classification of the safety issue as a contributing safety
factor is irrelevant in terms of safety action.

The ATSB notes CASA's intention to employ a further nine Safety
System Specialists by the end of 2007 and that these specialists
will write guidance and procedures for CASA staff whose
responsibilities include evaluating management systems, to ensure
effectiveness and consistency. Accordingly, the ATSB has amended
the status of this recommendation to ' Monitor'.

ATSB Response date
Date Received
Organisation
Civil Aviation Safety Authority
Response Text

The Safety System Specialists continue to provide guidance and
development of staff in evaluating management systems. While the
SSS are primarily concerned with the methods and guidance, CASA and
ATOG in particular now has another type of Inspector - the Air
Transport Inspector, and the primary role of these new assets is to
provide the safety management perspective to CASA Surveillance and
audit teams. There are currently 8 Air Transport Inspectors and
these numbers are to be increased shortly. They are spread
throughout the field offices but the resources are not
geographically restrained and work with permissions holders as
required on a risk basis. The ATIs work closely with and are
developed and guided by the SSS.

There is now a Safety Systems Specialist in each Air Transport
Field Office as well as Safety Systems Specialist in the strategy
roles in CASA's Air Transport Operations Group. All Safety Systems
Specialist and Air Transport Inspectors meet on a regular basis for
standardisation and to work together in developing further guidance
material. The Industry Oversight Project is providing tools for
Safety Systems assessment which include specific guidance for each
assessable item, down to the level of word pictures to qualify the
assessment of the system controls in place. The tool is being
developed as an integrated part of the safety performance
verification tools and is closely tied to the Regulatory
development of Part 119 that is taking place concurrently.