BEA-TT has published the
final report on the accident to a
TGV▸ test train on 14th November 2015 at Eckwersheim. BEA-TT don't seem to do English summaries of their reports any more, even for those important ones that would justify it.
So far there has only been a short note from BEA-TT, and some longer reports from
SNCF▸ . However, the narrative of the accident has appeared in various leaks to the press, reported above. The final report tells the same story, though in much more detail.
The recommendations look rather anodyne, and in measured language that I find hard to translate exacltly. Most of them produce the response "you mean they really weren't doing that?". Roughly, they are:
Recommendation R1 (SNCF Réseau and EPSF - the rail safety body)
Conclude the review of the documents and regulations that govern proving trials for new high-speed lines, including the UIC in this.
Recommendation R3 (SNCF Mobilités, and any other train operators involved)
To provide drivers for test trains, set up a process to select and suitably train them.
Recommendation R4 (SNCF Mobilités, and any other train operators involved)
Provide tools to support trials teams planning braking. [
For overspeed tests - remember the KVB and equivalent train protection systems were disabled for this.]
Give a clear definition of who does what in conducting the test runs, with respect to driving the train.
Recommendation R5 (Systra, and any other potential trials managers)
Review the reference documents for trials conduct based on what has been learnt from this accident, in particular to ensure:
- that the manager of the trial has suitable qualifations and experience
- that the timetable allows enough time for preparation and debriefing for each run
- that the manager of the trial and the driver manager coordinate their work by direct contact
- that the role of "pilot" is redefined so he is not the communications link between the manager of the trial and the driver manager
- that a realistic division of functions between the manager of the trial and the driver manager is defined
Recommendation R6 (SNCF Mobilités, and any other train operators involved)
Install recorders for any telephone link between the drivers' cab and the trials team, and for sounds within the cab.
How the driving function is shared among the on-board team was important in the accident. It is also very much based on the SNCF way of doing things, and not likely to match anyone else's. The functions and names of the four key actors perhaps need a bit of explaining.
1. The
Chef d'essais bord (my manager of the trial) is in charge on the train. Back at the office, during planing and similar work, he will be part of a team, but during the trial he's in the cab and is The Boss.
2. The
Cadre Transport Traction (my driver manager) directs the driver, based on the agreed "script", and is responsible for safety on board and during planning.
3. The
pilote traction (my "pilot") provides detailed knowledge of the line, its speed restrictions, etc. On board he monitors whether driving actions happen in the right place, and watches for signals. He can also direct the driver.
4. The
conducteur (driver) drives the train, watching the line and the instruments, but not needing to read the script and think about trials issues as well.
5. There is also a
chef de train (train manager) who looks after the doors, and whom to allow into the train and where, as directed by the manager of the trial.