The Rail Accident Investigation Branch (RAIB) has published its report into a trolley runaway incident a year ago, making recommendations and highlighting learning points for Network Rail.

On Sunday, 26 May 2024, at around 5 am, a track trolley ran away down a slope at around 20 mph (32 km/h) at North Rode in Cheshire.

The site supervisor and controller of site safety noticed the runaway trolley in time to warn a group of track workers to get off the track, and no-one was hurt.

However, the trolley then collided with equipment in the site where the group had been working. The trolley and the work equipment were damaged.

The RAIB began its investigation last June.

The report into the incident found that the trolley was being used to transport equipment from a railway access point to the work site. It was being used within a ‘possession’ – an area of track under the control of the engineers working on it. The particular section of track has a downhill gradient averaging 1 in 176.

The operator had disabled the ‘failsafe’ function of the braking system on the trolley. Without operational brakes, it began to travel down the track.

The design of the trolley allows the brakes to be ‘defeated’ in this way, and operators may do this because the ergonomics of the trolley brake system made it tiring to use. In this incident, the operator did not know that the gradient could allow the trolley to run away.

The RAIB’s report has identified two underlying factors to the accident.

Firstly, Network Rail’s product acceptance process did not manage the risks associated with this design of trolley.

Secondly, there was a lack of clarity as to leadership roles at the work site, which led to risks not being effectively managed.

The report identified a further, ‘probable’ underlying factor. Network Rail had taken no effrective action to stop operators defeating the trolley’s braking system, despite being aware of the issue.

The RAIB report makes two recommendations to Network Rail and identifies two learning points.

The first recommendation is that Network Rail works with the Rail Safety and Standards Board and the M&EE Networking Group to reduce the likelihood of operators modifying the failsafe brakes on this type of trolley and rendering them ineffective. The RAIB believes that they can identify and implement control measures to prevent trolley misuse, by considering modern ergonomic practices and the product acceptance process.

The second recommendation is that Network Rail improves its implementation of safety learning resulting from accident and incident investigations.

The first learning point reaffirms that it is important for staff to not render this type of trolley’s braking system. The second advises that it is important for controllers of site safety to accompany groups of workers to personally observe and advise them.