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MAIB - Accident Investigation Report 3/2024

Summary
At 1400 on 5 July 2022, the UK registered roll-on/roll-off passenger ferry Alfred grounded on the east coast of Swona Island, Pentland Firth, Scotland. The impact caused injuries to 41 passengers and crew, and damage to Alfred’s port bulbous bow and almost all the vehicles being transported on board. The vessel subsequently refloated on the rising tide and continued to St Margaret’s Hope under its own power later that afternoon; there was no pollution, but the vessel was withdrawn from service for repairs.

Safety issues
• routinely passing too close to land
• fatigue led to loss of awareness at a critical point in the vessel’s passage
• lack of assurance that procedures were being followed

Recommendations
Recommendations (2024/107-109) have been made to the Maritime and Coastguard Agency to: ensure that passage plans are available during inspections/surveys; issue guidance to the UK domestic passenger fleet on the need to secure heavy objects; and, to review the general exemption issued to UK domestic passenger vessels that removes the requirement for them to carry voyage data recorders.
A recommendation (2024/110) has also been made to Pentland Ferries to ensure that it captures passenger details and injuries post-accident

Chief Inspector of Marine Accidents, Andrew Moll OBE, said:
Lots of safety action has been taken as a result of this accident and I am encouraged by the actions taken by Pentland Ferries to address the issues raised in this report. However, this accident offers a wider opportunity for lessons to be learned across the maritime industry.

Alfred’s master routinely operated very close to the coast leaving little margin for error when they found themselves in an unsafe situation. Regardless of the type of vessel you are operating, it is critical that a safe passage plan is made and that it is followed. Always allow sufficient sea room to enable action to be taken in good time if things are not going to plan.

On the afternoon of 5 July 2022, the master almost certainly fell asleep and allowed the ferry to swing towards land. Crew should always be sufficiently well rested when coming on duty.

Finally, this case highlights the importance of management assuring themselves that plans and procedures they have put in place are actually being followed.  If you have management oversight of a vessel or maritime operation, ask yourself; do I know that our crews and front-line staff are following our procedures, and are our plans fit for purpose in a real-life emergency situation?

Source: MAIB    Vessel photo courtesy of the RNLI.

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