NTSB's Landsberg Stresses Need To Overhaul Notams

 - June 2, 2021, 12:03 PM

National Transportation Safety Board vice-chair Bruce Landsberg kicked off the Flight Safety Foundation’s 66th Business Aviation Safety Summit (BASS) on Tuesday stressing a need for the FAA to wrap up its two-decade-long effort to overhaul the notam system, calling the necessary changes a “safety of flight issue."

Speaking during the opening session of BASS, which was held in concert with NBAA, Landsberg also highlighted the need for business aircraft operators to embrace safety management systems (SMS) and flight data monitoring (FDM).

Landsberg questioned why there are so many notams and why they are so cryptic. "The teletype isn’t coming back. It’s been dead for 20 years, yet we still act as if we have to do everything the same way,” he said.

He pointed to the July 2017 incident in which an Air Canada Airbus A320 nearly landed on a taxiway lined with four passenger aircraft at San Francisco International Airport. The crew had missed the notam of a closed runway and lined up incorrectly. Noting “we almost had the big one,” Landsberg said the notam was buried within a stack of notams and was overlooked.

He questioned not only the volume of notams but also a massive amount of acronyms used in them and said, “it’s time we did something different.”

Notams should be accessible in one place and improved in coordination with stakeholders and other groups, including internationally, he said, adding, “I think we can do this.” Landsberg also said he is regularly checking in with the FAA on the issue.

He also noted that his agency recently asked the FAA to consider SMS and FDM requirements for Part 135 and 91 for-hire operations (such as local sightseeing flights). He cited a handful of accidents over the last several years involving Part 135 and 91, such as the October 2019 crash of a B-17 in Windsor Locks, Connecticut, that was on a living-history Part 91 flight and the January 2020 Part 135 crash of an S-76B in Calabasas, California, that killed Kobe Bryant and eight others.

These accidents showed issues involving areas such as maintenance, management, professionalism, and training, he said, adding that in these crashes, “It could be foreseen that some of this could have been done much better.”

Many industry organizations may respond “we’ve never had a problem; we have a perfect safety record,” he noted. But the Safety Board vice-chair said, “The challenge with that is you don’t have crashes until you are having them. Everything is perfect behind you, but it is the next flight that is the most important.”

SMS is designed to take a deeper look into finding unforeseen issues, he said. “The SMS approach is let’s report it, let’s figure out what the problem is, let’s not repeat it, and let’s be a hero.” He acknowledged that changes still need to be made to fully adopt a “just culture” and move away from an enforcement-only approach to one focused on compliance.

Landsberg expressed concern that relatively few Part 135 operators were deemed fully compliant with the FAA’s own SMS program, but he noted that it was unknown how many more were involved with SMS programs outside the FAA. He commended those efforts but said a concern is whether the organizations were practicing and fully implementing those programs.

He further acknowledged concerns of smaller operators and said much of SMS has been focused on processes and terms such as scalability. “One size does not fit all,” he said. “The FAA should be providing guidance and some examples of how they think this should work and keep in mind that it needs to be simple, it doesn’t have to cost a lot of money, and it doesn’t need to have a huge amount of paperwork.”

As for FDM, “We know it works really well in Part 121,” he said. But he also acknowledged that there are cost/safety benefit concerns when looking at all operators and said, “It seems there should be a sweet spot. Do we want to be reactive or do we want to be proactive?”

While one standard of safety doesn’t really apply to all operators, there are things that airlines do that work well, he said. Basic measuring devices will help from oil analysis to engine monitoring, he contended. “If we’re measuring things, it allows us to modify our behavior for optimal outcomes. That’s entirely what flight data monitoring is all about. The devices don’t have to be super complicated. Does it work? Absolutely.”