The Australian Transport Safety Bureau (ATSB) has issued its final report on a lost of separation assurance involving a Robinson R44 helicopter and a Boeing 737-800 at Canberra airport on 2 June 2017.
The incident occurred when a tower controller cleared the helicopter, being flown by a student and an instructor, to take-off parallel to runway 12.
This instruction was in contravention to the flight progress strip used by the tower, which called for a departure in the opposite direction, runway 30. Neither the controller nor student pilot realised that the plan on the flight progress strip was not being followed.
A departure parallel to runway 12 would make the R44 cross runway 35, which was then in use for landings.
As the helicopter, which deviated its take-off slightly to avoid overflying a taxiing 737, approached the intersection of the two runways at 200ft, its crew spotted a Qantas 737 (VH-XZP) touching down on runway 35.
The R44's instructor pilot then informed the aerodrome controller of the proximity event. The controller realised the helicopter had been cleared to depart in the wrong direction.
The ATSB attributed the incident to an incorrect clearance being given to the R44. In addition, runway coordination tasks prevented the controller from realising the mistake.
"This occurrence involved one aircraft being inadvertently cleared to depart along a flight path that crossed an active runway (and the associated go-around flight path) in use by a landing aircraft," says the ATSB.
"Consequently, the ATSB assessed that the departing [R44] encountered a loss of runway separation assurance with the arriving XZP. It was also determined that there was a conflict between [the R44] and the taxiing 737. While the timing of events and the location of the aircraft involved meant no significant manoeuvring was required by [the R44's] crew, the consequences could have been severe had the sequence of events been slightly different."
The ATSB reminds air traffic controllers to use system support tools effectively.
"The use of flight progress strips is intended to enhance the situational awareness of controllers. When fully utilised, these tools are an effective monitoring support tool. Flight progress strips also provide information to assist with the correct execution of the controller’s plan and the early detection of any errors that may occur."