Soon after the first paying passengers boarded Edinburgh's new light rail system in May 2014, its operator had to cope with a spate of "tram surfing", a pursuit which involves thrill seekers hitching precarious lifts by clinging to the outside of moving carriages.
In one case, a surfer had mounted a tram on a downhill section in Edinburgh city centre and slid off, rolling down the road and coming to rest in front of an ambulance. Fortunately, though 74 surfing incidents were reported in 18 months, no one was seriously injured.
Edinburgh Trams had anticipated the risk of hangers-on and its carriages incorporated a design to deter would-be surfers. The plans specified a 6.5 mm gap between the door leaf and car body, which made it difficult to grip on to the outside.
But, as the company's safety and standards manager Michael Powell explains, it was clear this wasn't a sufficient deterrent.
One of the proposed extra measures, a hard-hitting awareness raising media campaign to highlight the potential for life-changing injuries sustained from failed surfing attempts, was rejected by the tram's leadership team after consultation with other light rail operators in the UK and the Republic of Ireland. Edinburgh Trams felt the warnings might encourage copycat surfers rather than deter them.
The solution it adopted was to narrow the door gap even further, to 4 mm, which significantly reduced the possibility of hanging on to the outside. Edinburgh Trams applied the design tweak to all 27 of its trams, each with 12 doors, in a week.
The impact was immediate: the frequency of recorded events fell from one a week to one every four weeks. Footage from closed-circuit TV (CCTV) also showed that the distance surfed significantly reduced.
If you looked like you have not had enough sleep, you would be challenged by the controller about whether you were fit for work
The effective answer to a problem that has bedevilled other light rail systems was one reason why IOSH judges at Edinburgh's Chamber of Commerce Business Awards in February awarded Edinburgh Trams the Excellence in Health and Safety prize.
Edinburgh Trams was set up by the City of Edinburgh Council in 2014 as a limited company to operate the 14 km light rail network on behalf of its Transport for Edinburgh division. Opened on 31 May 2014, the system runs from Edinburgh Airport in the west to York Place in the city centre. A final decision on a proposed extension to Newhaven, 3 km north of the centre, is due next year.
Last year, 5.6 million passengers used Edinburgh Trams and the company's aim is to exceed 6 million journeys in 2017.
Of the 160 employees, around half the staff have safety-critical roles. The network is serviced by 55 tram drivers.
Edinburgh Trams employs ten controllers and six duty managers who are based at the operations control centre at the Gogar depot. There is always at least one manager on duty, whose responsibilities include monitoring tram movements and third parties, such as maintenance workers, operating on or near the lines. Two controllers are also always on duty, one monitoring the working trams on closed-circuit TV, the other overseeing movements into and out of the depot. Edinburgh Trams also employs 54 ticketing service assistants (TSAs), who staff the trams, and six TSA team leaders.
The service operates from 5am till midnight. This year was the first that trams ran through the night on Saturdays during the Edinburgh Festival. The company also ran all night services for the first time at Hogmanay (New Year's Eve) 2016.
The operator is the only UK tram network to allow cyclists to travel on board, a policy that safety and standards manager Michael Powell was instrumental in bringing forward. "Certain restrictions apply of course, but our thorough testing found that we are able to carry bikes safely without any material changes to the rolling stock," he says.
Edinburgh Trams was winner of operator of the year at the Global Light Rail Awards in 2015 and 2017. The service won the "most improved" category in 2016.
When Powell brought his heavy rail industry experience to the company in July 2013, he knew light rail had a different risk profile, but also that it would probably attract tighter scrutiny in the future.
Britain's post-war period was marked by a gradual decline in tramways as cheaper motor buses dominated the roads; a resurgence in light rail, of which Edinburgh's system forms a part, started in the early 1990s with the opening of Manchester's Metrolink in 1992.
Taking heavy rail's more prescriptive approach as a benchmark, Powell drew up Edinburgh Trams' safety management standards and persuaded his superiors on Edinburgh Trams Board to adopt the Office for Rail and Road (ORR) and Health and Safety Laboratory's risk management maturity model (RM3), which is widely used in the rail industry.
The model, which defines excellence in risk management and provides a route map to help organisations improve continuously, is also used by ORR inspectors when they assess dutyholders' risk management systems.
Before joining Edinburgh Trams, Powell's CV included taking the assurance lead for Transport for London's bicycle hire scheme and carrying out audits of safety and security management systems on the Docklands Light Railway in the capital. He also held safety posts with TransPennine Express, GB Rail Freight and First Group's rail division as audit and assurance manager where he standardised procedures throughout the UK.
"The theory was that if everywhere was audited to the same criteria we could be confident that the standard was at a certain level, which is the same as RM3," he says.
"The goal is to be grade five in all areas. That's the gold standard," says Powell. "It's a way of challenging the team to continually improve."
He explains that Edinburgh Trams aims to be first light rail operator to fully implement RM3 and that the model could become a future legal requirement for the sector. Edinburgh started the three-year implementation this year to mirror the roll-out of the company's business plan.
Edinburgh Trams is a relatively small operation among UK light rail operators, employing just 160 people (see box above) on the 14 km network. Powell is its lead OSH professional and oversees the safety and standards operation, one of six key functions, together with engineering, service delivery (operations), customer experience, finance and HR, which has a reporting line to the managing director.
Powell also works closely with six duty managers, who take part in safety incident investigations, which he oversees and authorises.
"Although I manage the process, things will arise that need a risk assessment at the time, which could be at the weekend when I am absent," he explains. He has been organising training for and mentoring the duty managers. As a result, "I'm confident that there are decisions made when I am not here which I would have made myself. I think that demonstrates that the process is working well."
Powell co-ordinated the development of an OSH manual, which outlines all the procedures covering the trams' operation, from alcohol checks on drivers to fitness for work and dealing with acts of violence. The suite of procedures has already been refreshed since May 2014. However, after a management-level RM3 implementation group was set up in early 2017, the documents were reviewed again.
"We've got a system that works but it's just making sure that it reflects what we do in real life, and is compliant with the RM3 requirements," he says.
Tour of duty
Powell and his duty managers undertake regular safety tours and any observations are acted on immediately rather then held over for four-weekly management meetings. Unlike other employers he has worked for in the rail industry, where the number of tours has been mandated, Powell is loath to set targets.
"I've worked at places where the quantity of safety tours or engagement has taken precedence over quality. Here, processes are in place to ensure that those people undertaking safety tours feed any findings to me.
This is channelled to the correct person who takes further action, and the person who raised the issue sees the benefit in the form of a positive improvement. This encourages them to repeat the process."
Trade union Unite has two safety reps stationed at the tram depot, in the west of the city, who work closely with Powell. They hold regular joint safety committee meetings and carry out quarterly joint safety tours.
As part of the RM3 improvement process, Edinburgh Trams has set 12 key performance indicators based on safety performance over the past year. They include tram contact with a road vehicle and "signals passed at stop" -- the tram equivalent of road vehicles going through a red light. A particularly important indicator is emergency brake applications.
"There are three different brakes that apply at the same time and we rely on the drivers reporting those when they happen," Powell says. "The ticketing services assistant [TSA] on board will check nobody is hurt and that's a key reason why they record the incidents. We are very keen on this proactive safety element so, if there are hotspots where they are happening at a particular frequency, we can act on it."
In the first few months of operation, Powell identified a hotspot on North St Andrew Lane, a street popular with the city's licensed black cabs. The taxi drivers were failing to give right of way and shooting out of the side street on to North St Andrew Street, nearly colliding with the trams.
"We engaged with the taxi companies, made some footage of near-misses available to them and ultimately a stop sign and road hump were placed there," he says. "Since then, there has been the occasional one because taxis still use the road [but] it has been a success."
Powell remains vigilant and anticipates a spike in emergency braking each August when tens of thousands of visitors arrive for the Edinburgh Festival. Many are unfamiliar with the city's layout and pedestrians often step into the road without warning to bypass the huge crowds on the pavements. The service's 55 tram drivers receive extra briefings before the festival.
Unlike heavy rail, tramways are open systems so there is no such thing as trespassing. Because pedestrians are free to wander across the tracks, drivers operate on line-of-sight principles.
"That's why the progress through the city centre [where Edinburgh Council has imposed a speed limit of 32 kph] is a lot slower than it is elsewhere," he says. "You have to be able to stop at a safe distance from what you can see in front of you. In wet and icy conditions, drivers will adapt their driving style accordingly to make sure they are comfortable to stop at that distance."
Drivers can increase the tram's speed to 70 kph on the quieter stretches outside the centre but controllers at the depot closely monitor their performance on CCTV.
When a tram hits another vehicle it usually turns out to be the other party's fault but every incident will be investigated. However, if a tram driver is deemed to be wholly or partly responsible, Powell will consider the circumstances and the operator's safety record before pursuing the matter further.
If a driver's actions are found to have contributed to the incident, the company's standard response is to provide further training or, if there are issues at home that may have contributed to distraction at work, it may offer support.
"It's fair to say that there have been occasions where the risk has been deemed too great and the person has sought alternative employment," Powell says.
Fit to drive
Anyone applying to operate one of Edinburgh's trams must take a psychometric test. "If you didn't have the requisite concentration, you wouldn't have made it even to the interview stage," says Powell.
New drivers start with classroom training on the key risks. Towards the end of the first week, trainees can navigate the trams around the depot at up to 10 kph. "It doesn't seem much more than walking pace," says Powell, "but once you're at the controls and you feel the weight of the tram, it feels faster than it is."
After they have been trained to prep the tram and can show they can operate it safely in a controlled environment, the recruits must pass another assessment. Successful candidates then move on to the off-street section of the network, practising in the early hours, which also prepares them for driving in the dark.
Though the driving team includes a few former bus drivers, most are new to light rail. Former train drivers are unlikely to apply because the pay is lower, says Powell, but "even if there was somebody who had driven for Virgin Trains for 20 years, they would still go through the same training programme".
He is reticent to comment on the 2016 Croydon tram crash in south London, when carriages derailed killing seven passengers, or on the Rail Accident Investigation Branch's delayed report into its possible causes. In October, London Assembly member Caroline Pidgeon demanded answers from Transport for London and Tram Operations, which is part of First Group, and runs the Croydon network, over allegations that its shift system could be causing driver fatigue (bit.ly/2yauIih).
"We've never been complacent regarding fatigue -- we've always taken it seriously as it should always be," Powell says. "There are certain defined ratings in terms of the fatigue index and risk indices that need to be adhered to. Our base roster is well within the tolerance of those and we wouldn't accept anything less."
To reduce the likelihood of fatigue Edinburgh Trams has a policy that all drivers must live within an hour's travel to the depot. The company also monitors drivers' fitness with stringent medicals for those in safety-critical roles.
"When you sign on and start your shift, you are declaring yourself fit for work," Powell says. "Even if you've taken a couple of Ibuprofen because your knee [pain] has flared up, you've got to declare that. There is a list of medicines that you are permitted to take and still drive a tram."
Edinburgh Trams insists that drivers must present themselves in person before starting a shift. "Drivers have to come into the depot, ring the bell and sign themselves on," he says. "If you looked like you have not had enough sleep, you would be challenged by the controller about whether you were fit for work."
On the issue of alcohol, Powell says that drivers are told about the company's zero tolerance at their inductions. There are two strands to driver testing; the first is a random test, formerly carried out by an external contractor but now brought in-house. The second is "for cause" testing after an accident. "The reason for that is so that we can discount the driver being under the influence as causation," he says.
Safety in numbers
Powell is not overly concerned about lone worker issues. Each tram has a driver and a TSA. When the TSAs are working off the tram, for example helping tourists with tickets after they have left arrivals at Edinburgh Airport, they always work in pairs. The TSAs are trained to deal with potentially aggressive behaviour and, if need be, can retreat and lock themselves in the back cab. They also carry body-worn cameras.
"That makes it clear the person is being recorded," he says. "There have been instances of unacceptable behaviour where the details have been passed on to the police and it's been followed up."
As part of his drive to instil a positive safety culture, Powell was instrumental in implementing CIRAS, an independent and confidential incident reporting and analysis system at Edinburgh Trams so staff can raise safety or health concerns anonymously. "It's not mandated in light rail but we made the decision to go with that early on because it's a safety net."
Although there was an initial spurt of reports when they introduced it, he says there hasn't been one in the past year.