Mid Air Collisions over Ueberlingen

1. Mid Air Collisions over Ueberlingen Weakness in the ANS Safety Chain An Account of the Periode after the Accident until Today

2. PILOT MECH ATCO ATSEP CERTIFIED AVIONICS CERTIFIED AIRFRAME CERTIFIED GROUND INSTALLATION

3. Crucial Safety Elements in ANS Personnel {ATCO, ATSEP} Procedures {Flight Proc, Maintenance Proc} Equipment

4. ANS TEC as Contributing Factors in Accidents and Incidents + Concurrent Work in Progress on several critical Ground Equipment {Landline Branch Exchange, Multiradar Tracker, ...} + TEC Supervisory Unit in the ACC staffed only temporarily -> ATSEP, Ground Equipment and Procedures as Contributing Factors

5. Pre Accident Measures for ATSEP + ATSEP with Safety Critical Tasks are to have an appropriate Personel License + Operationally used Equipment is Safety Critical and therefor certified + The License Holder is aware of its Role, Personal Responsibility and Privileges

6. Pre Accident Measures for ATSEP + President of the Professional Associations is part of the Emergency Org + Chosen ATSEP have followed CISM - Courses and are on Stand-By + CIRP Schemes are in place and work; ATSEP are in the Loop (Agent and Team) + Prepare for Legal Advice + Practise with realistic Exercises

7. Post Accident Measures for ATSEP + Work towards the right priorities in the Emergency Organisation + Employ the correct Words and Acronyms from the very Beginning + Bring in ATSEP CISM-Teams + Plan ahead for replacement (everybody gets tired after 12 h under utmost stress) + Do not address the Press without a Media Concept and proper Training + Launch Press Releases via an Organisation you are affiliated with

8. ATSEP Work Ethics accept responsibility in making engineering decisions consistent with the safety, health and welfare of the public & to disclose promptly factors that might endanger the public

9. After the Accident

10. NLR1 - Study ordered by the CH Minister of Transport: „Aviation safety management in Switzerland“ - SATTA polls all CH ATSEP in with 50 questions - SATTA interviewed among other Key Figures _ 1Nationaal Lucht- en Ruimtevaartlaboratorium

11. Introduction SATTA Questionnaire • Training and Continued Education; Safety; Working Environment; • Responsibility; Human Aspects • Estimated ATSEP in CH ca. 300{CIV, MIL, Airports}

12. PILOT ATCO MECHA ATSEP

13. Report from the German BFU: - final Draft rewritten - concerned parties commented - difficult to keep ATSEP and ANS Ground Equipment inside see also SRC DOC „AIRCRAFT ACCIDENTS / INCIDENTS AND ATM CONTRIBUTION“ Review and Analysis of Historical Data - final Version published and on the internet

14. Exchange of views between BFU CH <-> SATTA: - ATSEP make part of every IFR Accident Investigation Teams

15. CH MoT: • names Safety Advisor and Change Manager to implement • NLR Recommendation • Director of FOCA replaced

16. UVEK • Sicherheitsdelegierter (Luftverkehr) • SAFIR • Umsetzung der Empfehlungen aus dem NLR-Bericht • betr. die skyguide AG • SAFIR-Zielsetzungen 12 a – g • Aufträge der Eigentümer-Vertreter an die Organe der skyguide AG • ……. • Einführen eines Lizenzierungs- (oder mindestens Qualifizierungs-) Systems für das technische Personal bzw. für die technischen Unterhalts-Prozesse (Empfehlung 7-3, ESARR 5) • Internes vertrauliches Vorfall-Rapportierungs-System • ……

17. skyguide initiated: - CISM Training (25 ATCO, 2 ATSEP) - Individual Responsibility Ethical Awareness Program - SIR (instead of CIRP) supported by SATTA - existing Safety Manager supplemented by Risk Manager

18. SATTA initiated: - personal ATSEP License - legal study on the framework for an ATSEP License - Certification of operationally used ground Equipment - Interpreting ESARR’s especially ESRR 5 ver2 - Coordination and Exchange with MoT, CH BFU - Exchange with CH ATCO Organisations - Exchange with IFATSEA Affiliates operating ATSEP License

19. Draft Air Transportation Policy by the CH MoT: „Bericht über die Luftfahrtpolitik der Schweiz 2004“ „Liberalisation in Air Transportation and the erosion in airline fares puts new challenges in front of CAA, namely in regard to safety. The assumption, that companies under market pressure can in their own responsibility hold on to high safety standards or be able to finance them is no longer valid. This change of paradigm leads to the conclusion, that the national state has more often to intervene with a corrective actions“

20. Draft Luftfahrtspolitik by the CH MoT: „Safety is a specific questions of values, comportment and qualification of the actors Law making standardises and reduces the complexity of the systems, but it will not replace the special significance of recruitment and training of the personnel concerned” „In the frame of a segmented air transport industry trough liberalisation, a centralised training is of importance“ „An industry wide licensing system for all safety relevant tasks is mandatory“ „A prosecution free reporting system allows to corect for hidden system flaws and facilitates the exercise of individual responsibility of the personnel concerned.”