Marcus' Model Railway Journey

The accident

Summary of the accident

At 11:50 hrs on Saturday 14 January 2023, a passenger alighting from a train onto platform 1 at Loughborough Central station sustained a serious injury, requiring admission to hospital.

The train involved had just arrived at Loughborough Central station on a return journey from Leicester North station, where the passenger involved had boarded.

The door from which the passenger alighted was the leading door on the train and was adjacent to the platform end ramp rather than the level part of the platform.

Extract from Ordnance Survey map showing location of the accident at Loughborough

Context

Location

The railway through Loughborough Central station can be traced back to the1890s when the then Manchester, Sheffield & Lincolnshire Railway was extended southwards from Sheffield to London.

Loughborough Central station was opened in 1899 and closed as a mainline station in 1969.

Efforts to preserve it began shortly afterwards.

The operation of heritage trains by Great Central Railway (GCR) started in 1974.

The general layout of the station, platforms and tracks has remained largely unchanged since Loughborough Central was closed in 1969.

GCR now operates public passenger trains on the railway which runs from Loughborough Central southwards to a station at Leicester North, a journey of 8 miles (12.87 km).

Intermediate stations are located at Quorn & Woodhouse and Rothley.

Google Earth image showing Loughborough Central station

Layout of the track around Loughborough Central station
The north end of platform 1 at Loughborough Central was in generally good condition with the coping stones at the platform edge made from a coarse dressed stone.

The area intended for use by passengers was level with no identified trip hazards.

The condition of the platform surface and the level of grip it offered are not considered to be factors in this accident.

Organisations involved

GCR is a heritage railway.

GCR owns Loughborough Central station, the associated railway infrastructure and passenger coaches involved in the accident.

The locomotive involved and its tender are owned by the Loughborough Standard Locomotives Group but are maintained by GCR.

GCR staff working on the train and at Loughborough Central station at the time of the accident were all volunteers, although the railway also has paid employees.

GCR freely co-operated with the investigation.

Route of the Great Central Railway

Train involved

The train involved was the 11:05 hrs service from Leicester North station to Loughborough Central station.

It comprised a steam locomotive, number 78019, built by British Railways in 1954 and 6 MkII coaches of different types.

The rear three coaches (on departure from Leicester North) were unavailable for general passenger use as they were being prepared for a dining service later in the day.

A Brake Second Open (BSO (D)) coach was the third coach from the locomotive.

This coach houses a parking brake which is operated by the guard when the train is stationary.

The locomotive was being driven with the tender leading and was on the return leg of a journey which had started out from Loughborough at 10:20 hrs.

GCR recorded 63 passengers on the train during the journey from Leicester North to Loughborough Central.

The passenger coach involved was a Mk1 Tourist Second Open (TSO), number 4857.

It has a central aisle with eight groups of four seats around tables on either side of the aisle.

A pair of toilets are located at one end of the coach.

Access and egress is available by three pairs of external doors, with one pair of doors at each end of the coach and one pair in the middle.

The doors are hinged so they open outwards and incorporate a ‘droplight’ window.

Droplight windows have a simple vertical sliding windowpane which is opened by pulling down a horizontal lip attached to the top edge of the pane.

To open a door, passengers inside the train have to open the droplight and reach outside to operate the external door handle.

There is no internal door handle.

The doors are not locked centrally using a central door locking system and individual doors are not locked by train crew in normal service unless there is an out-of-course incident (such as a fault) or the coach is not in service.

Passengers and staff can move between coaches using interconnecting gangways.

In common with all other coaches on the train, coach 4857 was not fitted with a public address system.

Ex-BR Standard Class 2 2-6-0 78019

Layout of a Mk1 Tourist Second Open (TSO) coach


The locomotive and tender are fitted with steam brakes while the rest of the train uses vacuum operated brakes with the coaches and locomotive being connected via the automatic vacuum train pipe.

The brakes on the whole train are operated by the driver using a single valve in the locomotive cab.

Following an overhaul, the locomotive had recently (November 2022) returned to service.

It was subject to GCR’s maintenance and inspection regime, with its last examination, including the braking system, completed in December 2022.

No defects relevant to the accident were found at that time.

The passenger coaches involved were subject to GCR’s maintenance and inspection regime which required inspections every three months.

A dedicated coach door examination was completed on coach 4857 in December 2022.

This included checks on the general condition of the doors as well as specific checks on the operation of the handles and locks.

No issues requiring attention were recorded and, when the door involved was inspected by RAIB after the accident, no defects were identified.

The coach floor and stepping board at the door involved were in good condition.

The passenger involved

The passenger, Mr Alan Smith, was 76-years old and was visiting GCR with his partner.

The passenger was around 6 feet tall and witness evidence described him as being an agile and independent person, although he was visually impaired as a result of congenital cataracts.

The passenger’s left leg was reported to be around half an inch (13 mm) shorter than the right as a result of a previous operation to replace his left hip joint.

This length difference was managed with an insert in his left shoe and had no known effect on his mobility.

Witness evidence describes the passenger as having good balance and being able to walk quickly with long strides.

The passenger was wearing lace-up shoes with a non-slip sole at the time of the accident.

The passenger was described as an active man who would confidently travel on public transport in all its forms.

This included regularly using mainline trains alone and without assistance.

He used a ‘symbol’ cane if travelling alone, to indicate to others that he was visually impaired and may require additional time and space when moving around.

Like many visually impaired people, he did occasionally also use a cane to find and avoid obstacles (known as a ‘guide cane’ or ‘long cane’) when navigating complex transport hubs.

He was not carrying a cane on the day of the accident.

RAIB has seen no evidence that the passenger was influenced by the presence or actions of other passengers, and he had not consumed alcohol that day.

RAIB found no evidence of factors that might have influenced the passenger’s cognitive function or decision-making.

Staff involved

A driver, a fireman and a cleaner3 were on the footplate of the locomotive.

The driver had been a volunteer at GCR since 1989 and began working on the footplate in 1993, qualifying as a fireman in 1995 and as a driver in 2007.

They had driven locomotive 78019 many times as well as many other types of locomotive.

Outside volunteering at GCR, the driver of the locomotive had a professional background as a railway rolling stock engineer.

GCR assesses driver competency annually, alternating between a practical assessment and Rule Book knowledge test.

The driver was in date for both assessments.

While drivers are responsible for identifying a suitable stopping point for the train and controlling the locomotive to achieve that, they have no specific responsibilities for monitoring passengers getting on or off trains.

The fireman had been a volunteer at GCR since 2012, initially as a cleaner before training as a fireman after 18 months.

Firemen are also required to undertake a practical and Rule Book assessment on alternating years, and the fireman was in date for both.

The role of a fireman is primarily related to the safe management of the locomotive’s boiler.

Staff working in the role of fireman have no responsibility for identifying the correct stopping position of the train or the management of passengers.

The cleaner was an inexperienced volunteer who had been volunteering at GCR for about nine months at the time of the accident.

The role of cleaner is not considered a safety-critical role, so GCR do not require formal assessment ofcompetence.

A guard and a trainee guard were in the BSO (D) coach.

The guard was experienced in the role, having volunteered at GCR for 20 years.

They were accredited to work at GCR in the role of guard, guards’ inspector and duty traffic manager.

As a guards’ inspector, they were responsible for assessing the competence of other guards.

Their annual rules assessment was out of date.

Despite being beyond the 12-month period in which they should have been assessed, there is no evidence to indicate the guard was not aware of, nor complying with, the requirements of their role.

The conduct of the guard is not causal to this accident because they were not in a position to intervene in the accident, nor were they required to be.

The trainee guard was working under the direction of the guard.

Also working on the train was a travelling ticket inspector (TTI) who had no specific safety-related responsibilities on this train.

Six catering staff were also on the train, either working in the buffet coach (number 1962) or preparing the train for the later dining service.

These catering staff had no safety responsibilities and played no part in the accident.

On platform 1 at Loughborough Central station when the train arrived were three other staff, a platform inspector, the station master and the duty traffic manager.

These staff were all located on the southern half of the platform, with the platform inspector walking north alongside the train as it slowed to a halt.

The GCR Rule Book requires staff on the platform to provide a warning to any passengers that they identify as trying to leave trains via doors that are not in the platform.

It also requires platform staff to be in a position to help passengers who seek assistance.

External circumstances

At the time of the accident, it was daylight with good visibility in the area around the platform.

The weather at Loughborough was dull and wet with continuous rain before and during the accident.

There was no significant wind, and a minimum temperature of 6°C was recorded during the day at East Midlands Airport (7 miles(11.3 km) away), meaning there was no ice or frost present.

There was no significant ambient noise at the station although there would have been some background noise from the locomotive as the train was in the platform.

RAIB has concluded that external influences did not affect the accident.

The sequence of events

Events preceding the accident

The train was prepared for service by GCR volunteers, including the driver, fireman, cleaner and a fitter from around 06:00 hrs on the day of the accident.

Train preparation included ‘fitness to run’ inspections.

The fitness to run inspections included a check of the integrity of the locomotive steam brake system, which was successfully undertaken.

The driver then conducted a vacuum brake system leak test.

While creating the vacuum in the system, the driver observed that the needle on the vacuum gauge did not move as smoothly as they expected when increasing the level of vacuum.

Despite this, the locomotive passed the checks and was deemed fit to enter service.

As the locomotive was being moved from the engine shed to platform 1 at Loughborough Central station, the driver performed a running brake test during which the locomotive's brakes performed in line with expectations.

The locomotive was then coupled to the coaches at Loughborough Central station and final checks on the integrity of the train’s brake systems were conducted.

At 10:21 hrs, the train left the station, one minute later than its planned departure.

It arrived at Leicester North station at 10:53 hrs, three minutes later than planned.

The delay was attributed to temporary speed restrictions (TSRs) along the route connected to engineering works at two bridges.

As the train arrived at Leicester North, the driver observed that the brake was slow to release, and they had to apply power to overcome it.

On arrival, the driver satisfied themselves that the braking system was making and maintaining sufficient vacuum and then ran the locomotive around the train for the returnjourney.

During the stop at Leicester North, the passenger involved in the accident boarded the train with his partner.

They entered coach 4857.

This coach was at the northern end of the train.

It was therefore directly behind the locomotive during the return journey to Loughborough.

They entered the trailing end of the coach and walked the length of the coach taking seats at the leading end (nearest to the locomotive).

Once the locomotive had been coupled up for the return journey, the driver examined the locomotive for any signs of overheated brake blocks which would indicate a dragging brake.

The brake blocks showed no signs of overheating.

At 11:15 hrs the train set off on the return journey, 10 minutes later than timetabled.

Another individual, who also boarded the train at Leicester, joined the passenger and his partner at their table and travelled to Loughborough.

This individual is referred to in the remainder of the report as the ‘second passenger’.

On two occasions during the return journey, the driver experienced the brakes being slow to release.

On the first of these, while slowing for a TSR between Quorn and Loughborough, they had to apply power to overcome the additional unwanted braking effort.

The second occasion was on the approach to Loughborough Central station.

This time no additional power was needed to overcome unwanted braking.

Events during the accident

Closed-circuit television (CCTV) at Loughborough Central station shows that the train entered platform 1 at 11:48 hrs, 14 minutes later than timetabled.

The driver of the locomotive was anticipating that the train’s brakes would be slow to release as they had been earlier, so adjusted their driving accordingly.

However, on this occasion the issue with the brakes did not manifest itself, so the train travelled further along the platform than the driver had intended.

When the train came to a stop, the leading edge of the leading door of the first coach (4857) was adjacent to the platform end ramp and beyond the end of the platform by approximately 1.6 metres.

The driver was aware that the train had gone beyond the intended stopping position and that the leading door of coach 4857 was likely to be beyond the platform.

However, they could not safely reposition the train because passengers would have started to alight from the passenger coaches.

The guard and trainee guard were in the BSO (D) coach in accordance with paragraph 4.4 of section H of the Rule Book, as their duties required them to apply the hand brake once the train had stopped.

The TTI, who was not required to be in any specific location at stations, was in another coach.

Although the platform inspector, station master and duty traffic manager were on platform 1 when the train arrived there was no GCR Rule Book require mentor briefing tasking them with being at the platform ends to manage the risk of a train unintentionally stopping with a passenger door situated off the platform.

The platform inspector recognised that the train had stopped further along the platform than it would have normally.

Their assessment was that the leading door of coach 4857 was just beyond the level part of the platform.

However, they saw passengers at the middle door of coach 4857, which was much closer to the platform inspector’s position, and went to that door to assist them.

At that time, the platform inspector had not seen any passengers waiting to board or alight at the leading door of coach 4857.

The passenger and his partner planned to get off the train at Loughborough Central.

Witness evidence indicates that on arrival, the passenger went to the leading end of coach 4857 and opened the door.

The passenger then stepped down onto the platform ramp, placing one foot after the other.

On stepping down from the coach, the passenger lost his footing and crumpled to the ground.

This left him lying on the platform ramp adjacent to the door.

His partner stepped down from the coach around him and went to help him.

Shortly after this, the second passenger also lost their footing exiting from this door.

Witness evidence about where the second passenger landed differs, with one account suggesting that they landed on the first passenger.

The second passenger was not injured and was able to get up unaided.

Events following the accident

GCR staff and visitors, including an off-duty doctor, went to the passenger's assistance and an ambulance was called, which took him to hospital.

In hospital it was identified that the passenger had sustained a spiral fracture to the left femur and he underwent surgery which included replacement of a prosthetic hip joint.

The locomotive remained in service.

The issue with the brakes was formally reported by the driver and shared with a second driver who was rostered to takeover the train later that day.

This second driver also reported the braking issue and a subsequent examination of the locomotive identified the likely defect that had caused the variation in brake performance.

Three days later, having been made aware of the severity of the injury to the passenger, GCR appointed two staff to undertake an internal investigation.

On 22 January, GCR undertook a reconstruction of the position of the train to allow some measurements of the platform-train interface (PTI) to be taken.

Subsequently, GCR reported the accident to the safety authority for railways in Great Britain, the Office of Rail and Road (ORR).

Although this accident should have been notified to RAIB, GCR did not notify RAIB that it had occurred.

RAIB was subsequently informed of the accident by ORR as part of the normal liaison arrangements between the two organisations.

A further reconstruction was undertaken on 30 January at which both ORR and RAIB were present.

Analysis

Identification of the immediate cause

The passenger lost his footing and fell while alighting from the train because he was unable to safely negotiate the step down onto the platform end ramp.

Witness evidence indicates that the passenger, having opened the leading end door of coach 4857, commented to his partner that there was a larger- than- normal vertical distance between the stepping board and the platform.

For this reason, he decided to alight first to help his partner from the train.

The passenger then stepped down deliberately, one foot after the other, but lost his footing and crumpled to the ground.

Shortly after this, the second passenger also stepped down from leading door of coach 4857 and lost their footing.

The north end platform ramp

Formation of the train involved in the accident

Stopping positions of the train involved in the accident

A stepping box and standard stepping height

Reconstruction photos showing standard platform stepping height (left) and the increased stepping heights from the train at its stopped position (right)

Photo of ramp viewed from coach doorway

1st November 2023


TRANSPORT FOR WALES

TfW route closures due to Storm Ciaran​

Passengers are being urged to check for the latest information before travelling as a number of routes will be closed tomorrow (November 2) due to the impact of Storm Ciaran.


Passengers are being urged to check for the latest information before travelling as a number of routes will be closed tomorrow (November 2) due to the impact of Storm Ciaran.

There will be no services on the Heart of Wales line between Swansea and Shrewsbury or the Conwy Valley line between Llandudno and Blaenau Ffestiniog on Thursday 2 November.

On the Cambrian line an amended timetable will be in place with pre-planned bus replacement services between Aberystwyth and Machynlleth and train services between Machynlleth and Shrewsbury running every two hours instead of hourly.

No rail replacement services are available on the Heart of Wales line and passengers are being advised not to travel on this route.

Rail replacement services are in operation on the Conwy Valley line but all passengers should check before travelling as roads will be liable to flooding.

Services on the Heart of Wales and Conwy Valley lines will not reopen until late Friday morning at the earliest, as safety checks will need to be completed before passenger services can resume.

Speed restrictions will also be in place on several routes across the Wales and Borders network as a result of the forecasted extreme winds and rain, meaning journeys may take longer than usual and there may be short-notice alterations or cancellations to services.

Tickets for Thursday 2 November can be used on Friday 3 November and ticket acceptance with other operators may be available, passengers should check tfw.wales for the latest information.

Out and About With Marcus:
Cardiff Queen Street Station

Popped into Cardiff for the day, Cleo and Neo needed to do a few things.

Naturally it turned into a few drinks.

View from platform 4 looking towards Cardiff Central

View from platform 3 to platform 2 looking East

Looking along platform 3 towards Cardiff Central

Class 153 Super Sprinter (153329) arriving platform 4

Class 153 Super Sprinter (153329) departs platform 4

View from platform 3 , Class 231 Flirt arriving platform 2

View from platform 3 looking East

Class 153 Super Sprinter (153329) arriving platform 4

Class 231 Flirt on platform 2

Class 153 Super Sprinter (153922) on platform 5

2nd November 2023


TRANSPORT FOR WALES

Changes to TrawsCymru T2 and T3 services announced​

New timetables for the TrawsCymru T2 and T3 bus services have been announced as part of a series of changes to both services aimed at improving connections across the TrawsCymru network to meet passenger needs.


New timetables for the TrawsCymru T2 and T3 bus services have been announced as part of a series of changes to both services aimed at improving connections across the TrawsCymru network to meet passenger needs.

The new timetables will come into effect from Sunday 5 November, along with revised fares and additional, more frequent bus services on both the T2 and T3 routes.

A full explanation of the changes for both services is available below.

Changes to the T2 service between Bangor and Aberystwyth:

• The T2 service will be integrated with the X28, which is soon be rebranded as the T28 to offer an hourly service between Aberystwyth and Machynlleth.
• Both the T2 and T28 services will connect with the T1 at Aberystwyth in both directions.
• Better value fares will be introduced on the T2 and T28 services, starting from £1.25.
• 1Bws daily and weekly tickets will be valid on both services.
• The T2 service will now serve Criccieth instead of Garndolbenmaen, which will be served by the new T22 services which will be entering service soon.
• Between T2 and T22, an hourly frequency will be offered between Caernarfon and Porthmadog.
• An improved 2 hourly frequency for the T2 on Sundays will give customers more options to travel.

The T2 connects with the T3 (Barmouth to Wrexham) at Dollgellau.

Changes to the T3 service between Barmouth and Wrexham:

• The service will be split into two services – T3 and T3C.
• The T3C will operate Monday to Saturday and will run between Llanuwchllyn, Bala, Llandderfel, Llandrillio, Cynwyd and Corwen.
• Passengers from Llanuwchllyn, Llandderfel, Llandrillio and Cynwyd can connect with the T3 service at Corwen where there will be a five-minute connection in both directions to Wrexham.
• Better value fares will be introduced on the T3 and T3C starting from £1.25.
• Through ticketing will be available allowing seamless travel between the T3 and T3C.

The T10 (Bangor to Corwen) connects into T3 at Corwen for travel to and from Wrexham.

The T8 (Corwen to Chester via Ruthin and Mold) connects into T3 at Corwen for travel to and from Chester.

The T3 connects with T2 at Dolgellau.

2nd November 2023

New Rolling Stock for ETHNON RAIL

Ordered another locomotive to join the ETHNONRAIL fleet.

It's one of my favourite loco's in my favourite livery.

Class 37/0 37116 "Comet" in BR large logo blue

This loco is also special, as it used to be allocated at Cardiff Canton.

And here she is at Canton...........

3rd November 2023


TRANSPORT FOR WALES

Transport for Wales signs Zero Racism Wales pledge​

CEO James Price has signed the Zero Racism Wales pledge on behalf of Transport for Wales.


Transport for Wales is proud to join other Welsh organisations who have already signed the pledge to stand against racism and help create a safe, valued, and inclusive environment here in Wales.

An action plan has been developed by Welsh Government to set out the concrete steps which will address racial, ethnic and religious intolerance that is systemic and institutional, to deliver real change over the next 10 years.

The pledge states the following–

• I commit to promoting zero tolerance to racism in Wales, which means that:
• I will take a stand against racism and promote a more inclusive and equal society for all.
• I will not tolerate racial prejudice, discrimination, harassment, victimisation, abuse, or violence against any individual.
• I will stand in solidarity, come together, and say no to racism, in all its forms.
• I will promote good race relations between people from diverse ethnic backgrounds.
• I will promote equal and fair opportunities for people from diverse ethnic backgrounds.

James Price Chief Executive Officer at Transport for Wales said:

“At Transport for Wales we value diversity and are creating an inclusive transport network that everyone in Wales can be proud of.

We will stand in solidarity against racism and will continue to strive towards a culture that is diverse and inclusive”

We're proudly supporting Welsh Government in establishing a new working group to encourage more women and underrepresented groups to consider a career in transport.

Explore the vacancies that we have available: https://tfw.wales/info-for/job-hunters/our-vacancies

3rd November 2023



NetworkRail:

Passengers urged to plan ahead as Ebbw Vale line upgrade reaches final stage​

Region & Route: Wales & Western: Wales & Borders


Network Rail is reminding passengers to check before they travel as the multi-million-pound upgrade of the Ebbw Vale line moves into its final stage.

Buses will replace trains between Ebbw Vale Town and Cardiff Central from Wednesday 15 November to Sunday 3 December as teams work around the clock to transform the line.

Engineers from Network Rail will carry out 1.2 km of track upgrades at nine different locations between Crosskeys and Crumlin, to complete the creation of a seven-mile loop to enable trains to pass in the future.

Elsewhere on the line, contractors from Siemens will finish setting up and connecting the new signalling system around the Park Junction area.

This will help improve the resilience and reliability of passenger and freight journeys.

The work is all part of the multi-million-pound investment to provide an additional hourly service between Ebbw Vale Town and Newport.

The transformation of the line has been funded by Blaenau Gwent County Borough Council via a loan from the Welsh Government, with the Department for Transport and Network Rail providing a further £17m to deliver signalling upgrades and track renewal.

During the 19-day temporary closure of the line, Transport for Wales will be running a bus service between Ebbw Vale Town and Cardiff Central.

Passengers are urged to plan ahead at /www.journeycheck.com/tfwrail and www.nationalrail.co.uk

Network Rail's route director for Wales and Borders Nick Millington said: “Completing this final phase of work will transform how passengers travel on the Ebbw Vale line and encourage more people to use public transport and support our aim of decarbonisation.

“To keep everyone safe, this work can only be carried out while the line is closed and we are sorry for any inconvenience. I’d like to again thank passengers and our neighbours for continuing to bear with us as we complete these vital improvements.”

TfW’s planning and performance director Colin Lea said: “These works are vital for the timetable enhancements we’ll be bringing in on this route.

“We urge our customers to continue to check before you travel during this period, and as always thank you for your patience whilst we carry out these essential works to upgrade and improve future travel on the Ebbw Vale line.”