Inquiries & Recommendations

Ngā ketuketutanga me ngā tūtohunga

incorporate into existing procedures a requirement that the limits of wrong line running be defined by controlled facing signals. At locations where facing signals are not provided, these limits should be defined by appropriate permanent notice boards.

On 26 February 2025, the Commission recommended to the Director of Civil Aviation at the Civil Aviation Authority of New Zealand that they promote, through the appropriate International Civil Aviation Organization (ICAO) forum, consideration for the requirement and implementation for Vortex Ring State alerting systems to be installed in new helicopters.

Introduce the following directions into the harbour bylaws covering their ports, to emphasise the intent and principles of STCW and SOLAS: • all vessels, whether under pilotage or pilot exempt, shall have an agreed passage plan for transits within harbour limits • the number of crew members on the bridge shall be sufficient to safely carry out the agreed passage plan

On 26 February 2025, the Commission recommended that the Chief Executive of the Ministry of Business, Innovation and Employment and Next Generation Critical Communications collaboratively conduct a review of the emergency 111 system with sector stakeholders, to remove unnecessary delays and improve New Zealand’s emergency response efficiency.

Better search and rescue efficiencies and a safer coastguard operation could be achieved if the design and type of vessels assigned to individual coastguard units are compatible with the conditions they are more likely to operate in and easily integrate with other search and rescue resources available locally and nationally.

Introduce the following directions into the harbour bylaws covering their ports, to emphasise the intent and principles of STCW and SOLAS: • all vessels, whether under pilotage or pilot exempt, shall have an agreed passage plan for transits within harbour limits • the number of crew members on the bridge shall be sufficient to safely carry out the agreed passage plan

Work with lifejacket industry stakeholders to develop guidelines on the information that should be covered in safety briefings on lifejacket use, including doffing, deflation and hazards.

Review the maintenance procedure to ensure as far as practicable that the amplifier/fault protection unit in the nose wheel steering system is replaced before it fails in service.

Require Airways to ensure controllers always confirm that pilots acknowledge receipt of the current ATIS broadcast.

The provision of Area Forecasts and Aerodrome forecasts to general aviation pilots be reinstated.

He consider producing an article for "New Zealand Flight Safety" magazine on the subject of post-maintenance inspection of aircraft for ensuring that tools and equipment have been removed after maintenance.

carry out specific training to ensure key track staff are aware of the vulnerability of sites that have an unknown neutral temperature, and the site deficiencies that justify inclusion of sites in "heat 40" lists. [SR repeated in report 02-104: 3 separate track buckle occurrences on the South Island coal route during the summer of 2001/2002.]