[Peetwo]

Is it just me?

Yesterday the ATSB released their final 'Short Investigation Bulletin' for the year - Aviation Short Investigations Bulletin - Issue 45. At the top of the SIBs page it states:

 "..Released periodically, the Bulletin provides a summary of the less-complex factual investigation reports conducted by the ATSB. The results, based on information supplied by organisations or individuals involved in the occurrence, detail the facts behind the event, as well as any safety actions undertaken. The Bulletin also highlights important Safety Messages for the broader aviation community, drawing on earlier ATSB investigations and research..."

This is Dolan speak (weasel words), for.. "we have limited resources to spend on full blown incident (versus accident) investigations, so if a desktop investigation can be conducted  which will conserve resources then that is what we will do."

However I am not sure if pushing that 'Short Investigation' definition to include a 'serious incident' where a near collision involving a 60 tonne Orion P3-C aircraft and a Schweizer 269C helicopter, over a built up area necessarily justifies a limited, short investigation budget - AO-2015-101.

On sighting the Orion, the pilot of JXO had immediately initiated a climb to avoid a collision, and estimated the Orion passed about 100 ft below. On hearing the controller pass the Orion as traffic to the pilot of JXO, the Orion crew immediately became concerned about the helicopter’s proximity, and looked for it. The co-pilot (non-flying pilot) of the Orion sighted JXO, assessed there was a risk of collision, and called ‘go low, go low, go low’. The captain (flying pilot), also sighted JXO, and increased the rate of descent to pass beneath the helicopter. The Orion crew estimated that JXO passed about 50 ft directly above the Orion, and were concerned it may collide with the Orion’s vertical tail fin. On the radar SDD, at 1514:25, both aircraft appear in the same position at 600 ft (Figure 6).

It is evident, from the safety actions section of the report, that the RAAF are taking this incident very seriously:

Safety action

Whether or not the ATSB identifies safety issues in the course of an investigation, relevant organisations may proactively initiate safety action in order to reduce their safety risk. The ATSB has been advised of the following proactive safety action in response to this occurrence.

Department of Defence
As a result of this occurrence, the Department of Defence advised the ATSB that they are taking a number of safety actions. These include the following:

Compromised separation recovery training

The Department of Defence has released a Standing Instruction that mandates annual compromised separation recovery training for all air traffic controllers.

Controller briefing

All controllers will be briefed on the events and findings of the incident as an element of compromised separation recovery training.

Tower simulation capability

Tower simulation capability is being introduced to enhance compromised separation recovery training.

Additionally, simulation will be used to:

• compensate for low traffic levels and to facilitate controller attainment and retention of skills associated with processing complex traffic scenarios
  
• compensate for low traffic levels and to facilitate controller attainment and retention of skills associated with application of ATC priorities
  
• assess controller proficiency when live traffic levels are below that required to judge controllers’ abilities to process complex traffic scenarios
  
• provide controllers with regular exposure to compromised separation recovery scenarios, to improve decision making and ensure the associated actions become instinctive.
  
  

Airspace procedure briefings

The Edinburgh controllers will provide airspace procedure briefings to pilots who conduct airwork within and around Edinburgh airspace. The Airservices Australia Aeronautical Information Publication (AIP) En Route Supplement Australia (ERSA) entry for Edinburgh will be amended to include a section detailing the requirements for pilots of civil aircraft intending to conduct airwork within, or near, the Edinburgh control zone, to have airspace briefing.

 Hence (I guess) the ATSB quick wrap up of this investigation. However this incident had the potential for a lot more civilian fatalities than the sole occupant of the helo, if the Orion aircraft, minus tailfin, was unable to recover and spun out of control into outer Adelaide suburbia. 

Figure 2: Operating area of JXO, Edinburgh Control Zone and relative tracks


Source: Airservices Australia – annotated by the ATSB  

Maybe it is just me but a visual separation estimate of between 50-100 feet is just way too close for comfort - UFB!

P2 Comment: That said the ATSB Short Investigation team member(s) in collating and writing that report (in less than 4 months), did a sterling job with, 'by definition', very limited resources - Top job!

Update from AAP via the Oz:

Helicopter, plane in 15m near-miss over Adelaide

• AAP
  
• December 23, 2015 10:41AM
  

An RAAF Orion class plane came so close to a helicopter that its crew feared the tail section would hit the chopper.

A military aircraft and a commercial helicopter came within 15 metres of each other over Adelaide in August, with the near miss blamed on communication issues.

A report into the incident says an Air Force Orion passed just below the helicopter after the chopper was given clearance to track towards the RAAF Edinburgh Base tower when a controller mistook the pilot’s request.

Crew on-board the Orion later told investigators they feared the plane’s vertical tailfin would hit the helicopter.

The incident happened on August 31 as the Orion was coming in to land at Edinburgh Airport just after 3pm, following a 10-hour international flight.

About the same time, the pilot of a Schweizer 269C helicopter asked Edinburgh air traffic control for the green light to head towards Clare.

Confusion started when the air traffic controller mistook the pilot’s request to ‘Clare’ for nearby ‘Calvin Grove’ airfield near Virginia, from where the helicopter had taken off.
Instead, the pilot was told to track direct to the control tower to separate it from the Orion and another aircraft completing circuits.

On a number of occasions, the helicopter pilot tried to contact their employer about flying in the direction of the tower using UHF radio.

A circuit aircraft was cleared to land and take off again and told air traffic control the Orion was in sight.

According to the report, the controller examined the tracking of all three aircraft and assessed the helicopter would safely cross in front of the Orion and behind the circuit plane.

The error then went uncorrected because the pilot of the helicopter had selected the wrong radio band.

“The pilot was flustered and expecting an onwards clearance to Clare Valley, (and) consequently had turned right to track northwards to Clare Valley,” the report stated.

According to the report, the two aircraft appeared in the same position on the radar at an altitude of 180m at 3.14pm.

The helicopter pilot reported feeling “a bit rattled” when interviewed by ATSB investigators.

“The pilot was nervous about operating in military controlled airspace and therefore did not question the clearance to track towards the tower,” the report said.

“The pilot had selected Clare Valley on the GPS and was unsure exactly where Calvin Grove was from their current position.”

The Australian Transport Safety Bureau says the incident demonstrates the potential consequences of a loss of communication.
AAP

MTF..P2