Network pre-start briefings are a critical control in place to manage the risk of collisions between rail traffic and workers and machinery, and Queensland Rail had undertaken significant work to improve these processes. However, the design of the first-line assurance activities and the limited conduct of second-line and third-line assurance activities provided only limited assurance that the worksite protection aspects of the briefings were being conducted effectively.
The ATSB is satisfied that the enforceable voluntary undertaking initiatives relevant to the 3 levels of defence assurance model, and the additional proactive safety actions taken by Queensland Rail, have reduced the risk of this safety issue.
On 14 November 2023, Queensland Rail (QR) advised the ATSB that it had identified similar findings in its investigation report. It also advised that, as part of an enforceable voluntary undertaking (EVU) to ONRSR, it had introduced and completed the following initiative:
In addition to the EVU initiative (and other assurance as noted for safety issue RO-2020-003-SI-01), QR has also advised of the following actions related to this safety issue:
