LL E D T E D: Safety Management System Manual

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Safety Management System

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Manual
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INTENTIONALLY BLANK
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Safety Management Section ROA
System Manual Record of Amendments
ROA RECORD OF AMENDMENTS

Issue Date Nature of Amendment
Dec 2010 Initial Issue
Jan 2011 Revision 1
Sep 2011 Revision 2
Dec 2011 Revision 3
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Sep 2012 Revision 4
Dec 2012 Revision 5
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Jun 2013 Revision 6
Aug 2013 Revision 7
Oct 2013 Revision 8
Nov 2014 Revision 9
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Apr 2015
May 2015
Revision 10
Revision 11
Aug 2015 Revision 12
Jan 2016 Revision 13
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April 2017 Revision 14
March 2018 Revision 15
Nov 2018 Issue 2/Revision 0
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May 2019 Issue 2/Revision 1

Jul 2020 Issue 2/Revision 2
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Jan 2021 Issue 2/Revision 3

Jul 2021 Issue 2/Revision 4
Jan 2022 Issue 2/Revision 5
UN
ROA–1 Revision 5 Jan 2022

Safety Management Section ROA
System Manual Record of Amendments
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ROA–2 Revision 0 Nov 2018

Safety Management Section RH
System Manual Revision Highlights
RH REVISION HIGHLIGHTS
Issue/
Paragraph Details
Rev. No.
9 Nov 2014 Sec DIST Section “Distribution List” amended.
Sec ABBR Section “Acronyms and Abbreviations” list
amended.
Sec 1.3 Section “Benefits of SMS” text amended.
Sec 2.1 Section “Policies and Practices” text
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amended.
Sec 2.2 Section “Executive Commitment” text
amended.
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Sec 2.3 Section “Safety Policy Statement” text
amended.
Sec 2.4 Section “Penalty Free Safety Reporting
Policy” amended.
Sec 2.5 Section “Safety Objectives” text amended.
IN OL Sec 2.6
Sec 2.6.1
Section “Safety Accountabilities” re-written.
Section “Corporate Safety Responsibilities”
text amended.
Sec 2.6.2 Section “Accountable Manager” text
amended.
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Sec 2.6.3 Section “Senior Management” text amended.
Sec 2.6.4 Section “Senior Manager Safety“ text
amended.
Sec 2.6.4.1 Section “Safety Manager – Flight Ops“
amended.
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Sec 2.6.4.2 Section “Safety Manager – Airworthiness“

new section added.
Sec 2.6.4.3 Section “Health and Safety Manager“ text
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amended.
Sec 2.6.6 Section “SVP Engineering and Maintenance“
re-written.
Sec 2.6.7 Section “SVP Airport Services“ re-written.
Sec 2.6.8 Section “SVP Flight Operations“ re-written.
Sec 2.6.9 Section “VP Crew Training“ re-written.
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Sec 2.6.10 Section “SVP In-flight Services“ text

amended.
Sec 2.6.11 Section “Manager Cabin Safety and
Standards“ re-written.
Sec 2.6.12 Section “SVP Network Control“ re-written.
Sec 2.6.13 Section “Safety Specialist Flight Ops“ text
amended.
Sec 2.6.13.1 Section “FDM Specialist“ text amended.
Sec 2.6.14 Section “Company Employees“ text and
graphics amended.
Sec 3.1 Section “Recording and Monitoring
Standards” text amended.
Sec 3.2 Section “Formal Safety Review Process” text
amended.
Sec 3.3 Section “Auditing of Asset Purchases and
Contracted Services” text amended.
RH–1 Revision 0 Nov 2018

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Rev. No.
Sec 3.4 Section “Control of Documents” text
amended.
Sec 4 Section “Operational Safety Committees”
amended.
Sec 4.1 Section “Safety and Management Review
Board – (SMRB)” amended.
Sec 4.2 Section “Operations and Control Meeting
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(OCM) – Weekly” amended.
Sec 4.3 Section “Flight Safety Committee (FSC) –
Monthly” text added.
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Sec 4.4 Section “Operations and Control Meeting
(OCM) – Weekly” text amended.
Sec 4.A.1 Appendix “Accountability” text amended.
Sec 4.A.2 Appendix “Meetings” text amended.
Sec 4.A.3 Appendix “Membership” text amended.
IN OL Sec 4.A.4
Sec 4.B.1
Appendix “Terms of Reference” text
amended.
Appendix “Accountability” text amended.
Sec 4.B.2 Appendix “Meetings” text amended.
Sec 4.B.3 Appendix “Membership” text amended.
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Sec 4.B.4 Appendix “Safety Action Group Terms of
Reference” text amended.
Sec 4.C Appendix “Flight Safety Committee (FSC)”
added.
Sec 4.D Appendix “Operations and Control Meeting –
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(OCM – Post Holders Ops Meeting)” added.

Sec 5.1 Section “Safety Reporting System” text
amended.
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Sec 5.2 Section “Code of Practice – Disciplinary” text

amended.
Sec 5.3.1 Section “Operating Reporting System text
amended.
Sec 5.3.1.1 Section “Air Safety Reports” text amended.
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Sec 5.3.1.2 Section “Cabin Safety Reports” text

amended.
Sec 5.3.1.3 Section “Engineering Safety Reports (ESR)”
text amended.
Sec 5.3.1.4 Section “Airports Safety Incident Reports” text
added.
Sec 5.3.1.5 Section “Hard Copy Confidential Reports” text
added.
Sec 5.3.2 Section “Reporting to the Authority” text
amended.
Sec 5.4 Section “Procedure for Processing Air Safety
Reports” text amended.
Sec 5.5 Section “Incident Investigation” text
amended.
Sec 5.6.5 Section “Company Procedures Following an
Accident or Serious Incident” text amended.
Sec 5.6.6 Section “Follow Up Reporting” text amended.

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Rev. No.
Sec 5.7 Section “Investigating Accidents and Serious
Incidents” text amended.
Sec 5.8 Section “Reporting by the Operator to the
Aircraft Manufacturer” text amended.
Sec 5.9 Section “Maintenance Organisations” text
amended.
Sec 5.10 Section “Reporting by the Contracted
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Maintenance Organisation” text amended.
Sec 5.11 Section “Retention of Records” text amneded.
Sec 5.12 Section “Reporting by the Contracted
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Sec 5.13 Section “Safety Trend Analysis” text
amended.
Sec 5.B Appendix “Confidential Safety Report Form
SMS03/2012” added.
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Sec 6.2
Section “Flight Data Monitoring Programme”
text amended.
Section “Flight Data Monitoring Process” text
amended.
Sec 6.3 Section “Flight Data Monitoring Data
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Analysis” text amended.
Sec 6.4 Section “Flight Data Monitoring Procedures”
text amended.
Sec 7 Section “Hazard Identification and Risk
Management” text added.
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Sec 7.1 Section “Introduction” text amended.

Sec 7.2 Section “Hazard Reporting” text amended.
Sec 7.2.2 Section “Predictive Data Capture” text
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amended.
Sec 7.2.3 Section “Reporting by Outstations and
Contracted Agencies” text amended.
Sec 7.4 Section “Risk Assessment” text amended.
Sec 7.5 Section “Process for Risk Assessment” text
amended.
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Sec 7.8 Section “Risk Acceptability” text amended.

Sec 7.9 Section “Tolerability and Response” text
amended.
Sec 7.A Appendix “The Risk Management Process”
text amended.
Sec 8 Section “Emergency Response and Crisis
Management” re-written.
Sec 9 Section “Safety Assurance” re-written.
Sec 9.1 Section “Safety Performance Monitoring and
Measurement” text amended.
Sec 9.1.1 Section “Safety Performance Targets” text
amended.
Sec 9.2 Section “Change Management” text
amended.
Sec 9.2.1 Section “Form SMS03/2010” text amended.
Sec 9.3 Section “Safety Audits” text amended.

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Rev. No.
Sec 9.3.1 Section “Audit Team Qualification and
Trainings” text amended.
Sec 9.3.3 Section “Q-Pulse” text amended.
Sec 9.5 Section “Staff Surveys” text amended.
Sec 9.4.1 Section “Procedure for Planning and
Conducting Line Flying Safety Observations”
text amended.
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Sec 9.6 Section “Quality Control Program (QC)” text
amended.
Sec 9.6.1 Section “Quality Control Program” text
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amended.
Sec 9.6.2 Section “Quality Control Inspectors” text
amended.
Sec 9.6.3 Section “Qualification and Training” text
amended.
IN OL Sec 9.6.4
Sec 9.6.5
Section “Quality Control Inspections” text
amended.
Section “Supplier Evaluation and Monitoring”
text amended.
Sec 9.6.6 Section “Inspection Reports” text amended.
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Sec 9.A.1 Section “Scope of the Safety Audit” text
amended.
Sec 9.A.2 Section “Safety Audit Team” text amended.
Sec 9.A.3 Section “TBD” text amended.
Sec 9.A.4 Section “Audit Schedule” text amended.
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Sec 9.A.5 Section “Audit Reporting” text amended.

Sec 9.A.6 Section “Audit Follow-up” text amended.
Sec 9.A.7 Section “Safety Communication” text
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amended.
Sec 9.C Appendix “Form SMS03/2010” added.
Sec 10 Section “Dissemination of Safety Information”
re-written.
Sec 11 Section “Safety Awareness and Training”
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amended.
Sec 11.1 Section “Introduction” text amended.
Sec 11.2 Section “Safety Training” text amended.
10 Apr 2015 Sec 2.6.15 Section “Senior Manager Security” added.
Sec 5.1 Section “Safety Reporting System” title
updated and text amended in second
paragraph.
Sec 5.1.1 Section “5.1.1” added.
Sec 5.1.2 Section “5.1.2” added.
Sec 5.2 Section “Code of Practice – Disciplinary”
Note: text amended.
Sec 5.3.1 Section “Operating Reporting System”
updated, point “c” text amended and point “d”
added.
amended, last two paragraphs deleted.

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Rev. No.
Sec 6.1 Section “Flight Data Monitoring Programme”
text added to last paragraph.
Sec 6.3 Section “Flight Data Monitoring Data
Analysis” new bullet point added.
Sec 9.1.1 Section “Safety Performance Targets” new
paragraph added.
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title amended, two paragraphs deleted and
text added to final paragraph.
11 May 2015 Sec 5.3.3 Section “Voluntary Occurence Reporting
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System (CAAP 57 – VORSY)” added.
Sec 9.2 Section “Management of Change Process
(MOC)” added.
12 Aug 2015 Sec 2.5 Section Safety Objectives text added.
Sec 4.A.3 Section Membership bullet list added to.
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13 07th Jan 2016
Sec 2.6.4
Sec 2.6.14
Section “Senior Manager Safety” Additional
items to added to bullet list.
Safety graphic replaced with Safety
Organisation Chart
Sec 5.12.6 New Section “Fatigue Reporting Process”,
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added.
Sec 6.1 Section “Flight Data Monitoring Programme”,
Paragraph amendment.
Sec 7.8 Section “Risk Acceptability” text amended.
The Risk Assessment Process graphic text
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amended. Tables Updated.

Sec 7.9 Tolerability and Response table updated.
Sec 7.10 Section “Management Response and Risk
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Reduction“ text amended. The Safety Risk

Management Process graphic replaced with
updated version.
Appendix 7.A The Risk Management Process Tables 2, 3
and 5 updated.
Appendix 7.A The Risk Management Process Table 6
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replaced with updated version.

14 27 Apr 2017 All All ISARP references have been removed.
Reference to ‘VP’ changed to ‘SVP’.
Sec ROA Revision 14 date changed to “Dec 2016”.
Sec ABBR Section “Acronyms and Abbreviations” list
amended.
Sec 0 Section “DIST” replaced by “Section 0,
Administration”.
Sec 0.1 Section “Foreword” text amended.
Sec 2.2 Section “Executive Commitment” graphic
changed.
Sec 2.3 Section “Safety Policy Statement” text
amended.
Sec 2.4 Section “Penalty Free Safety Reporting
Policy” text added.

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Rev. No.
Sec 2.6 Section “Safety Accountabilities” new
paragraphs added and text amended.
Sec 2.6.1 Section “Corporate Safety Responsibilities”
paragraph removed.
Sec 2.6.2 Section “Accountable Manager” text
amended and bullet points added.
Sec 2.6.3 Section “Senior Management” text added and
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amended.
Sec 2.6.4 Section “Senior Manager Safety” text
amended and bullet points added.
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Sec 2.6.4.1 Section “Safety Manager – Flight Ops” bullet
points and text added.
Sec 2.6.4.2 Section “Safety Manager – Airworthiness”
bullet points amended and text added.
Sec 2.6.4.3 New section “Safety Manager Ground
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Operations” added.
Section “Health and Safety Manager”
re-numbered and renamed “Health, Safety
and Environment Specialist”. Text amended
and bullet point added.
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Sec 2.6.5 Section “Key Managers” text amended.
Sec 2.6.6 Section “SVP Engineering and Maintenance”
cross reference re-directed from 1.2.1.5 to
1.2.1.3.
Sec 2.6.7 Section “SVP Airport Services” cross
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reference removed.
Sec 2.6.8 Section “SVP Flight Operations”cross
reference re-directed from 1.2.1.3 to 1.2.1.2.
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Sec 2.6.9 Section “SVP Crew Training” title and

paragraph amended. Cross reference
re-directed from 1.2.1.7 to 1.2.1.4.
Sec 2.6.10 Section “SVP In-flight Services” cross
reference re-directed from 1.3.1 to 1.2.1.9.
Sec 2.6.12 Section “SVP Network Control” text amended
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and bullet points added.

Sec 2.6.13 Section “Safety Specialist Flight Ops” text
removed.
Sec 2.6.13.1 Section “FDM Specialist” content replaced.
Sec 2.6.13.2 New section “FDM Administrator” added.
Sec 2.6.13.3 New section “Health, Safety and Environment
Coordinator” added.
Sec 2.6.14 Section “Company Employees” text
amended. Safety Organisation Chart graphic
updated. Corporate Structure graphic deleted
and text added.
Sec 2.6.15 Section “Subcontracted Provider Safety
Responsibilities” added.
Sec 2.6.16 Section “Corporate Structure” title added.
Sec 2.6.17 Section “Safety Department Organisation
Chart” deleted.

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Rev. No.
Sec 3.2 Section “Formal Safety Review Process” text
amended.
Sec 3.3 Section “Auditing of Asset Purchases and
Contracted Services” replaced by “Safety
Risk Management in Outsourced Service
Providers”.
Sec 3.4 Section “Control of Documents” bullet point
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amended.
Sec 4.2 Section “Safety Action Group (SAG)” text
added.
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Sec 4.A.2 Section “Meetings” text added.
Sec 4.A.3 Section “Membership” bullet points amended.
Sec 4.A.4 Section “Terms of Reference” bullet point
amended.
Sec 4.B.2 Section “Meetings” text added.
IN OL Sec 4.B.3
Sec 4.B.4
Section “Membership” bullet points amended.
Section “Safety Action Group Terms of
Reference” bullet point added and text
amended.
Sec 4.C.3 Section “Membership” bullet point amended.
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Sec 4.D.4 Section “Terms of Reference” bullet point
added and text amended.
Sec 5.1.1 Section “Safety Reporting System”
Paragraph amended.
Sec 5.2 Section “Code of Practice – Disciplinary”
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cross-reference amended in note to SDLPM

Section 10.
Sec 5.3.1 Section “Operating Reporting System” Text
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amended.
Sec 5.3.1.1 Section “Air Safety Reports” text added.
text deleted.
Sec 5.3.1.4 Section “Airport Safety Incident Reports”
replaced with “Ground Safety Reports”.
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Sec 5.3.1.5 Section “Hard Copy Confidential Reports”

content replaced.
Sec 5.3.2 Section “Reporting to the Authority” subtitle
removed. Paragraph deleted.
Sec 5.3.3 Section “Voluntary Occurence Reporting
System (CAAP 57 – VORSY)” new
paragraphs inserted.
Sec 5.4 Section “Procedure for Processing Safety
Reports” title, paragraphs, and bullet point list
amended.
Sec 5.5 Section “Incident Investigation” paragraph
amended.
Sec 5.6.2 Sections "Responsibility for Reporting" and
"Reporting Time" deleted and Bullet point
amended.

Issue/
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Rev. No.
Sec 5.6.3 Section “Company Procedures Company
Procedures Following an Accident or Serious
Incident” section deleted.
Sec 5.6.4 Section “Follow Up Reporting” paragraph
amended.
Sec 5.11 Section “Retention of Records” paragraph
replaced.
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Sec 5.A.3 Section “Aircraft Maintenance and Repair”
bullet point amended.
Sec 5.B “Confidential Safety Report Form” replaced.
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Sec 7.1 Section “Introduction” intro paragraph
replaced.
Sec 7.2 Section “Hazard Identification” section
amended.
Sec 7.2.1 Section “Proactive Data Capture” text
IN OL Sec 7.2.2
amended.
Section “Predictive Data Capture” text
amended.
Sec 7.2.3 Section removed and now replaced with
“Reporting by Outstations and Contracted
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Agencies” and text amended.
Sec 7.7 Figure 1, “The Risk Assessment Process” text
amended. Table 1 “Probability” replaced with
updated version.
Sec 7.8 Figure 1, “The Risk Assessment Process” text
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amended. Table 1 “Probability” replaced with

updated version.
Sec 7.9 Table “Tolerability and Response” replaced.
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Sec 7.10 Section “Management Response and Risk

Reduction” new numbered list added.
Figure 2, “The Safety Risk Management
Process” replaced.
Sec 7.11 Table “Target Dates” text amendments.
Appendix 7.A Section “The Risk Management Process”
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Operation Risk Assessment form replaced.

Tolerability Matrix and Tolerability tables
replaced.
Sec 9.1 New Section “Safety Performance Monitoring
and Measurement” All text replaced.
Sec 9.1.1 New Section “Safety Performance Targets”
all text replaced.
Sec 9.2 Section “Change Management” title changed
to “Management of Change” and paragraphs
amended.
Sec 9.2.1 “Proposal for Change Notification Form”
replaced.
Sec 9.3 Section “Safety Audits” text amended and text
added.
Sec 9.3.1 Section “Audit Team Qualification and
Trainings” text amended.

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Rev. No.
Sec 9.3.1.1 Section “Safety Auditor Qualifications/
Approval” added.
Sec 9.5 Section “Staff Surveys” text amended.
Sec 9.6.1 Section “Quality Control Program” text
amended.
Sec 9.6.2 Section “Quality Control Inspectors”
paragraph added.
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Sec 9.6.5 Section “Supplier Evaluation and Monitoring”
text amended.
Sec 9.A.1 Section “Scope of the Safety Audit” text
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amended.
Sec 9.A.5 Section “Audit Reporting” paragraph deleted.
Sec 9.B “Staff Safety Survey and Questionnaire”
replaced.
Appendix 9.C Appendix “Form SMS03/2010”
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deleted. Appendix “SPIs and SPTs
Submission Process” added.
text amended.
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Sec 11.2 Section “Safety Training” bullet items added
and text amended.
15 29 March Sec 2.4 Section “Penalty Free Safety Reporting
2018 Policy” text and signatures deleted.
Sec 2.6.13.4 Section “Safety Specialist Ground
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Operations” duties and responsibilities

added.
Sec 2.6.17 Section “Safety Department Organisation
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Chart” chart replaced.

Sec 4.A.4 Section “Terms of Reference” bulleted item
text added to incorporate review of ALOSP
through SMRB and SAG.
Sec 4.B.4 Section “Safety Action Group Terms of
Reference” bulleted item text added.
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2/0 15 Nov 2018 Global SMSM Issue 2/Revision 0

SMSM Issue 1 Rev 15 sections were
amended to be aligned with CAR Part X
Sections 1-2.4. No significant Changes to
Policies or Procedures were made. Minor
additions and changes were incorporated for
enhanced clarity and to reflect compliance
with IOSA SARPS.
Global Replace “Safety Audits” with “Safety
Inspections”.
Global Replaced “SMRB” with “SRB”.
Global Replaced “QC” with “QP”.
Global Replaced “QCP” with “QC”.
Sec ROA Current revision details changed to
September, Revision amended to Issue 2/
Revision 0.
TOC-1 Added Section 0 Administration.

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Paragraph Details
Rev. No.
Sec 0.1 Section “Foreword” text amended and
Gateway added.
Sec 0.2.1 Section “Authority to Issue” text amended.
Sec 0.2.2 Section “Amendment Issue” text amended
and section 0.2.2 amended.
Sec ABBR Section “Acronyms and Abbreviations” text
amended and abbreviations added.
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Sec 1 Section “Scope” added and text further
amended.
Sec 1.1.1 Section “History” removed.
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Sec 2.1 Section “Safety Policy and Objectives” text
amended.
Sec 2.1.3.6 – Sections removed.
2.1.3.9
IN OL Sec 2.1.3.11 –
2.1.3.12
Sec 2.1.5
Sections removed.
Section “Safety Accountabilities” text

amended.
Sec 2.1.5.2 Section “Accountable Manager” text
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amended.
Sec 2.1.5.4 Section “Senior Manager Safety” text/section
amended and bullet added.
Sec 2.1.5.6 Section “Safety Department Organisation
Chart” graphic amended.
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Sec 2.1.6 Section “Appointment of Key Safety

Personnel” section amended.
Sec 2.1.6.1 Section “Safety Manager – Flight Ops” text
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amended.
Sec 2.1.6.2 Section “Safety Manager – Airworthiness”
text amended.
Sec 2.1.6.3 Section “Safety Manager Ground Operations”
text amended.
Sec 2.1.6.4 Section “Health, Safety and Environment
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Specialist” text amended and sections moved

up.
Sec 2.1.6.5 Section “Safety Specialist Flight Operations”
title and text amended.
Coordinator” text amended.
Operations” text amended.
Sec 2.1.6.11 Section “Key Managers” text amended.
Sec 2.1.6.13 Section “Operational Safety Committees” text
amended.
Sec 2.1.6.14 Section “Safety Review Board – (SRB)” text
amended.
Sec 2.1.6.14.1 Section “Management Review Board –
(MRB)” title amended.
Sec 2.1.6.15 Section “Safety Action Group (SAG)”
amended.

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Rev. No.
Sec 2.1.3.21.1.1. Section “Accountability” removed.
Sec 2.1.3.21.1.4 Section removed.
Sec 2.1.3.24.1.1 – Sections “Accountability” removed.
2.1.3.24.1.3.
Sec 2.1.6.14.1.1 Section “Meetings” text replaced.
Sec 2.1.6.14.1.2 Section “Terms of Reference” text amended
and SRB amended to MRB.
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Sec 2.1.6.15 Section “Safety Action Group (SAG)” text
amended.
Sec 2.1.6.15.2 Section “Meetings” text replaced.
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Sec 2.1.6.15.3 Section “Membership” text amended.
Sec 2.1.6.15.4 Section “Safety Action Group Terms of
Reference” text amended and bullets
corrected.
IN OL Sec 2.1.6.17
Sec 2.1.6.17.1
Section “Post Holders Operations Meeting”
title amended, text replaced and abbreviation
expanded.
Section “Terms of Reference” text amended.
Sec 2.1.7.1 Section “Emergency Response and Crisis
Management” text replaced.
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Sec 2.1.8.1 Section “Control of Documents” text
amended.
Sec 2.2.1.1 Section “Incident Investigation” text
amended.
Sec 2.2.1.2 Section “Notification of Accidents and Serious
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Incidents” text amended.

Sec 2.2.1.4 Section “Reportable Occurrences” text
replaced.
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Sec 2.2.1.5 Section “Company Procedures Following an

Accident or Serious Incident” text deleted.
Sec 2.2.1.6 Section “Follow Up Reporting” text amended.
Sec 2.2.1.7 Section “Investigating Accidents and Serious
Incident” removed.
Sec 2.2.1.7 Section “Reporting by the Operator to the
UN
Aircraft Manufacturer” text amended.

Sec 2.2.1.9 Section “Reporting by the Contracted
Sec 2.2.2.1.1 Section “Flight Data Monitoring Programme”
text amended.
Sec 2.2.2.1.2 Section “Flight Data Monitoring Process” text
deleted.
Sec 2.2.2.1.3 Section “Flight Data Monitoring Data
Analysis” text amended and bullet added.
Sec 2.2.3 Section “Operational Risk Assessment and
Management” title amended.
Sec 2.2.3.1.1 Section “Introduction” text amended.
Sec 2.2.3.2 Section “Hazard Identification” text amended.
Sec 2.2.3.3 Section “Proactive Data Capture” text
amended.

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Rev. No.
Sec 2.2.3.4 Section “Predictive Data Capture” text
amended.
Sec 2.2.3.10 Section “Risk Acceptability” graphic
amended.
Sec 2.2.3.12 Section “Management Response and Risk
Reduction” text amended.
Sec 2.2.3.14 Section “The Risk Management Process” text
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amended.
Sec 2.2.4.1 Section “Safety Reporting System” text
amended.
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Sec 2.2.4.1.1 Section “2.2.4.1.1” text amended.
Sec 2.2.4.1.2 Section “2.2.4.1.2” text amended.
Sec 2.2.4.2 Section “Code of Practice – Disciplinary” text
amended.
Sec 2.2.4.3 Section “Procedure for Reporting an
IN OL Sec 2.2.4.3.1
Occurrence or Incident” text amended.
Section “Safety Reporting System” title and
text amended.
Sec 2.2.4.3.1.1 Section “Air Safety Reports (ASR)”
abbreviation added.
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Sec 2.2.4.3.1.2 Section “Cabin Safety Reports (CSR)” text
amended and abbreviation added.
Sec 2.2.4.3.1.4 Section “Ground Safety Reports (GSR)” text
amended and abbreviation added.
Sec 2.2.4.3.3 Section “Voluntary Occurence Reporting
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System (CAAP 57 – VORSY)” text deleted.

Sec 2.2.4.3.6 Section “Reportable Incidents to the
Regulator” section amended.
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Sec 2.2.5.1 Section “Safety Risk Management in

Outsourced Service Providers” text amended
and audit amended to inspection.
Sec 2.3.1 Section “Safety Performance Monitoring and
Measurement” text amended.
Sec 2.3.2 Section “Management of Change” text
UN
deleted as repeated in MOC section

Sec 2.3.3 Section “Continuous Improvement” text
amended.
Sec 2.3.3.2.1 Auditor changed to Inspector.
Sec 2.3.4 Section “Line Flying Safety Inspections/
Observations” Observations added to title
and text deleted.
Sec 2.3.4.1 Section “Procedure for Planning and
Conducting Line Flying Safety Inspections”
LFSO changed to inspection, Step one
amended, audit changed to inspection,
changed Audit to Inspection, Auditor changed
to inspector, findings replaced by
observations.
Sec 2.3.3.1 Section “Safety Inspections” Section added.

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Rev. No.
Sec 2.3.3.2 Section “Inspection Team Qualification and
Trainings” text amended, Audit changed to
Inspection and ‘audit’ to ‘inspect’ and ‘auditor’
to '’inspector’. only Quality Assurance
conducts audits.
Sec 2.3.6 Section “Quality Control (QC)” title amended.
Sec 2.3.6.1 Section “Quality Control” title and text
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amended.
Sec 2.3.6.2 Section “Quality Control Inspectors” text
amended, bulletpoints added.
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Sec 2.3.6.3 Section “Qualification and Training” removed.
Sec 2.3.6.4 Section “Supplier Evaluation and Monitoring”
text amended.
Sec 2.3.6.5 Section “Inspection Reports” text amended,
section amended and amended for clarity.
IN OL Sec 2.3.7 – 2.3.7.6 Sections removed.

Sec 2.4.1.2
Sec 3 – 11
Section “Safety Training” text amended.
Sections removed.
2/1 23 May 2019 Sec ROA Current revision details changed to May
2019, Revision amended to Issue 2/Revision
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1.
Sec 2.1.1 Section “Executive Commitment” signature
replaced, text amended.
Sec 2.1.2 Section “Safety Policy Statement” universal
change – change inq COO/Accountable
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Manager.
Sec 2.1.3 Section “Penalty Free Safety Reporting
Policy” signature replaced, text amended.
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2/2 12 July 2020 Global All references to SRB to be replaced by MRB.

Sec ROA Current revision details changed to Jun 2020,
Revision amended to Issue 2/Revision 2.
Sec ABBR Section “Acronyms, Abbreviations and
Definitions” To add definitions to the SMSM.
List updated and sorted alphabetically.
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Sec 2.1.5 Section “Safety Accountabilities” Risk

Assessment Form removed from SMSM.
Sec 2.1.5.2 Section “Accountable Manager” No longer
applies.
Sec 2.1.5.3 Section “Senior Management” Paragraph
reference changed.
Sec 2.1.5.4 Section “Senior Manager Safety” No longer
applicable.
Chart” New Organisational Chart – HSE
removed. Direct Reporting Line of Manager
Business Resilience has changed from Chief
Operating Officer to Senior Manager
Operations Control. SRB changed to MRB.
Specialist” removed.
RH–13 Revision 2 Jul 2020

Issue/
Paragraph Details
Rev. No.
Sec 2.1.6.4 Section “Safety Specialist Operations” Safety
Specialist Operations job description added.
Coordinator” removed.
Sec 2.1.6.13 Section “Management Review Board –
(MRB)” No longer required.
Senior Manager Safety does not act as
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Secretary to the MRB.
Sec 2.1.6.13.1 Section “Management Review Board – MRB”
Not required.
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Sec 2.1.6.13.1 Section “Meetings” Renumbering.
Sec 2.1.6.13.2 Section “Terms of Reference” Renumbering.
Sec 2.1.6.14 Section “Safety Action Group (SAG)” Add a
reference to FRMSAG and CASG.
Remove reference to SDLPM.
IN OL Sec 2.1.6.14.4
Sec 2.1.6.15
Section “Safety Action Group Terms of
Reference” No longer applicable.
Section “Post Holders Meeting” List of
representatives and terms of reference
deleted. Link to MSM added.
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Sec 2.1.6.16 Section “Post Holder's Meeting (PHM) –
Monthly” Post Holder's Meeting (PHM) –
Monthly – deleted.
Sec 2.1.6.17 Section “Post Holders Operations Meeting”
Postholder Operations Meeting Deleted.
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Sec 2.1.7.1 Section “Emergency Response and Crisis

Management” Manager Business Resilience
amended to Business Resilience
Department.
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Change of reporting line.

Sec 2.2.1.1 Section “Incident Investigation” To include
reference to Root Cause Analysis.
Incidents” New Air Accident Investigation
Directive Issued.
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Sec 2.2.1.6 Section “Follow Up Reporting” No longer a

valid process.
Sec 2.2.2.1.3 Section “Flight Data Monitoring Data
Analysis” Section amended to clarify that
action items and corresponding timeline with
ownership are recorded in meeting minutes.
Sec 2.2.3.7 Section “Process for Risk Assessment”
Safety form reference number included –
hyperlink removed as form no longer
contained within SMSM.
Sec 2.2.3.10 Section “Risk Acceptability” Text change
Severity Table Minor – minor ‘injury’ changed
to minor ‘incident’.
To align with Review* risk rating note in the
tolerability table.
RH–14 Revision 2 Jul 2020

Issue/
Paragraph Details
Rev. No.
Sec 2.2.3.11 Section “Tolerability and Response” Text
change Tolerability Table Acceptable –
‘maybe’ signed off changed to ‘must be’
signed off by the appropriate line manager.
Text change Tolerability Table Review –
‘appropriate’ Postholder changed to
‘responsible’ Postholder.
Text change Tolerability Table Review – ‘and
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have the endorsement of the SRB’ removed.
Reduction” Include reference to Risk
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Mitigation Review Form.
Removal of statement ‘on behalf of the SRB’.
Sec 2.2.3.14 Section “The Risk Management Process”
Risk Assessment Form removed from SMSM.
IN OL Sec 2.2.4.3.1.1 Section “Air Safety Reports (ASR)”

Paragraph removed as hard copy ASRs are
no longer available.
CAAP 22 reference change.
Sec 2.2.4.3.1.2 Section “Cabin Safety Reports (CSR)” Text
change – ‘in cabin’ changed to ‘in their area of
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operation’.
Sec 2.2.4.3.2 Section “Reporting to the Authority” Text
change – appendices references CAAP 22
corrected.
List is not included in SMSM.
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Sec 2.3.1 Section “Safety Performance Monitoring and

Measurement” Insert Safety Performance
Management Process.
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Sec 2.3.2 Section “Management of Change” MOC

process revised.
Change Matrix simplified.
Revised MOC Process Flow Chart.
Sec 2.3.2.1 Section “Form FD-SMS-003” Form FD-SMS-
003 removed.
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Sec 2.3.5 Section “Staff Surveys” Form removed from

SMSM.
Sec 2.3.8 Section “Staff Safety Survey and
Questionnaire” Safety Survey and
Questionnaire deleted.
Sec 2.4.1.3 Section “Competency Assessment” Add
competency assessment and status tracking
details for SMS e-learning.
2/3 30 Jan 2021 Global Global change – CAAP references amended
to standalone AMCs.
Sec ABBR Section “Definitions” Changed to reflect
GCAA definition.
Sec 2.1.5.4 Section “Senior Manager Safety” Replaced
Flight Ops, Airworthiness and Training with all
operational areas.
Chart” Senior Manager Operations Control
Box lowered in chart.
RH–15 Revision 3 Jan 2021

Issue/
Paragraph Details
Rev. No.
Sec 2.1.6.5 Section “Safety Specialist Flight Operations”
Changed to align with JD held by HR.
Sec 2.1.6.14 Section “Safety Action Group (SAG)” ESAG
acronym correction and removal of brackets.
Sec 2.1.6.14.4 Section “Safety Action Group Terms of
Reference” Text deleted to remove Review*.
Sec 2.2.1.1 Section “Incident Investigation” Reference to
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structure/template removed.
Sec 2.2.1.6 Section “Reporting by the Operator to the
Aircraft Manufacturer” Added reference to
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CAR M and CAR 145.
Sec 2.2.3.1.1 Section “Introduction” Hazard Register is now
maintained in Q-Pulse.
Sec 2.2.3.2 Section “Hazard Identification” Included
management of hazard register by respective
IN OL Sec 2.2.3.5
area owners.
Added reference to Q-Pulse.
Section “Reporting by Outstations and
Contracted Agencies” Text added.
Sec 2.2.3.10 Section “Risk Acceptability” Table revised to
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remove reference to Review*.
Section “Tolerability and Response”
Tolerability Matrix changed to reflect
numerical risk index scoring system.
Sec 2.2.3.11 Section “Tolerability and Response”
Removed Review* classification.
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Reduction” Chart amended to remove
reference to Review* Risk level as now longer
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in use.
Sec 2.2.3.14 Section “Risk Assessment Review Process”
New paragraph added.
Sec 2.2.4.1.1 Section “2.2.4.1” Paragraph deleted.
Sec 2.2.4.3.1.5 Section “Hard Copy Confidential Reports”
Text amended to include Confidential Report
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form reference.
Sec 2.2.4.3.1.6 Section “Gateway Hazard Report” Gateway
Hazard Report added.
Sec 2.3.2 Section “Management of Change” Revised
MOC process added.
Sec 2.3.3.2 Section “Inspection Team Qualification and
Trainings” Amended to correct terminology –
audit changed to inspection and inspect
changed to audit with reference to technique
training.
Sec 2.3.3.2.1 Section “Safety Inspector Qualifications/
Approval” Added bullet points d and e for
Safety Inspector Qualifications.
Safety Audits were changed to Inspections to
differentiate from Quality Audits.
Sec 2.3.3.3 Section “Audit Process” Section deleted.

Issue/
Paragraph Details
Rev. No.
Sec 2.3.6.1 Section “Quality Control” Removed
references to outsourced.
Sec 2.3.6.2 Section “Quality Control Inspectors” Text
replaced to remove reference to experienced
in the field.
Sec 2.3.6.5 Section “Inspection Reports” Reference to
biannual inspections deleted.
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Sec 2.4.1.3 Section “Competency Assessment” To
include competency assessment of Safety
Personnel.
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Sec 2.4.2 Section “Safety Communication” Paragraph
added.
Sec 2.4.2.1 Section “Dissemination of Safety Information”
Text amended.
Sec 2.2.3.4.1 Section “Safety Trend Analysis” Safety Trend
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2/4 01 Jul 2021 Sec ROA
Analysis Section moved to 2.2.3.4 to reside
under Safety Risk Management/Hazard
Identification.
Current revision details changed to Jul 2021,
Revision amended to Issue 2/Revision 4.
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Sec 2.2.1.1 Section “Scope of Internal Safety
Investigations” Section modified for clarity.
Sec 2.2.2.1.4 Section “Flight Data Monitoring Procedures”
Senior Manager Safety actions regarding
FDM event analysis.
Senior Manager Safety course of actions on
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FDM events analysis not aligned with “Just

Culture” SMS principle.
Sec 2.2.4.2 Section “Code of Practice” Title amended.
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The Safety does not conduct any disciplinary.

Chapter content changed to reflect SMS non-
punitive policy.
2/5 20 Jan 2022 Global Global change from (Inspections) to
(Assessments).
SDLPM is obsolete and replaced with stand-
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alone safety procedures.

Sec 0.1 Section “Foreword” Change of Post Holder
Safety.
Sec 0.2.1 Section “Authority to Issue” Change in Post
Holder Safety.
Sec 0.2.2 Section “Amendment Issue” SDLPM is
obsolete, stand-alone procedures are
published.
Sec 0.3 Section “Distribution List” Due to change in
post holder safety position.
Sec ABBR Section “Acronyms, Abbreviations and
Definitions” SDLPM is obsolete.
Sec 2.1 Section “Safety Policy and Objectives” Text
added to communicate the visible
endorsement of the Safety Policy Statement.

Issue/
Paragraph Details
Rev. No.
Sec 2.1.2 Section “Safety Policy Statement” Corporate
Branding changed the spelling to the UK
spelling.
Sec 2.1.5.2 Section “Accountable Manager” Change of
Post Holder position.
Sec 2.1.5.4 Section “VP Quality & Safety” A new position
(VP Quality & Safety) & Change of Post
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Holder Safety position.
Sec 2.1.5.5 Section “Senior Manager – Safety” Change in
Senior Manager – Safety duties and
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responsibilities due to the new position of VP
Quality & Safety.
Sec 2.1.5.7 Section “Safety Department Org Structure”
To reflect the new position of VP Quality &
Safety Removal of Specialist – Ground
IN OL Operations Safety amendment from FDM

Administrator to Senior Officer – FDM
Reporting line and designation change from
Manager Business Resilence to Manager
Emergency Response and Senior Officer
Emergency Response.
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Sec 2.1.6 Section “Appointment of Key Safety
Personnel” SDLPM is obsolete and replaced
by Stand-alone procedures.
Sec 2.1.6.1 Section “Manager – Flight Operations Safety”
To align with the designation change from HR
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Sec 2.1.6.2 Section “Manager – Airworthiness Safety” To

align with the designation change from HR.
Sec 2.1.6.3 Section “Manager – Ground Operations
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Safety” To align with designation change from

HR.
Sec 2.1.6.4 Section “Specialist – Operations Safety”
Designation change from HR – amended JD
to address an internal finding.
Sec 2.1.6.5 Section “Specialist – Flight Operations
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Safety” To align with the designation change

from HR.
Sec 2.1.6.6 Section “Specialist – FDM Safety” To align
with the designation change from HR.
Sec 2.1.6.7 Section “Senior Officer – FDM” Designation/
Grade Change from FDM Administrator to
Senior Officer – FDM. JD amended to reflect
the change.
Operations” Position no longer exists as per
the amended Safety Department
Organisation Structure.
Sec 2.1.6.8 Section “Specialist Airworthiness Safety”
Reference number section change due to the
deletion of Specialist Ground Operations
Safety to align with designation change from
HR.

Issue/
Paragraph Details
Rev. No.
Sec 2.1.6.9 Section “Manager – Emergency Response”
To reflect the addition of Emergency
Response to the Safety Department.
Sec 2.1.6.10 Section “Senior Officer – Emergency
Response” To reflect the addition of
Emergency Response to the Safety
Department.
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Sec 2.1.6.11 Section “Key Managers” References change
due to the addition of Manager – Emergency
Response & Senior Officer – Emergency
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Response JD.
Sec 2.1.6.14 Section “Management Review Board –
(MRB)” Due to change in wording as per
SDP-04 Safety Assessment Procedure.
Sec 2.1.6.15 Section “Safety Action Group (SAG)” Change
IN OL Sec 2.1.6.15.3
Sec 2.1.7.1
of post holder safety position.
Section “Membership”Change of Post Holder
Safety Position.
Section “Emergency Response and Crisis
Management” Designation change and to
reflect that Emergency Response is now part
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of the Safety Department.
To reflect the designation change.
The Emergency Response team is now part
of the safety department.
To reflect the change in the Manual’s name.
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Sec 2.1.8.1 Section “Control of Documents” To reflect the

change in the manual name.
Sec 2.2.1.1 Section “Scope of Internal Safety
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Investigations” SDLPM is obsolete.

Stand-alone procedures have been issued on
EFOS.
Sec 2.2.1.2 Section “Just Culture” “Just Culture Process
Model” was part of the SDLPM which is an
obsolete document. The “Just Culture
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Process Model” included in the SMSM.

Incidents” AAID02/2020 is superseded by Air
Accident Investigation Regulation AAIIR.
Sec 2.2.2.1.4 Section “Flight Data Monitoring Procedures”
A detailed stand-alone procedure is now
published on EFOS under the Safety Tab.
Sec 2.2.3.5 Section “Reporting by Outstations and
Contracted Agencies” Section amended to
include only practiced procedure.
Sec 2.2.3.14 Section “Risk Assessment Review Process”
Section amended to complete the loop for the
Risk Assessment Process and show the
follow up on mitigation actions.

Issue/
Paragraph Details
Rev. No.
Sec 2.2.4 – 2.2.4.4 Section “Safety Reporting System” To
enhance and clarify the Safety Report
Management procedure and to reflect the
addition of the Voluntary Safety Report
Procedure.
Sec 2.2.4.5 Section “Fatigue Reporting” Word ‘Process’
removed.
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Fatigue Reporting Process replaced with
Fatigue Reporting.
Fatigue Management Flowchart removed as
no longer valid.
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Repetitive and FD-SMS-020 is on EFOS.
Sec 2.3.3.1 Section “Safety Assessments” Stand-alone
procedures are done to further expand on the
Safety Assessment Procedures.
IN OL Sec 2.3.3.2 –
2.3.3.3
Section “Inspection Team Qualification
Trainings” Details are already highlighted in
FD-SMS-023 Safety Department Assessor
Authorization Form.
Sec 2.3.6.1 Section “Quality Control” Sections deleted as
all the information are detailed in SDP-17
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Quality Control Process (stand-alone)
procedure.
Sec 2.4.1.2 Section “Safety Training” Deleted sentences
that are no longer applicable, Senior Manager
Safety does not publish a triennial training
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program.
Sec 2.4.1.3 Section “Competency Assessment” Deleted
parts that no longer reflect the procedure for
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the competency assessment for SMS

Trainers as per SDP-05.
Sec 2.4.1.4 Section “Status Tracking Mandatory e-
Learning” SDLPM is an obsolete document,
replaced by stand-alone procedure.
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Safety Management Section TOC
System Manual Contents
Contents
0 Administration................................................. 0–1
0.1 Foreword .................................................................... 0–1
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0.2 System of Amendment and Revision ...................... 0–1
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0.2.1 Authority to Issue ...................................................................... 0–1
0.2.2 Amendment Issue ..................................................................... 0–2
0.3
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Distribution List ......................................................... 0–2
1 Scope ............................................................... 1–1

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1.1 Introduction to Safety Management Systems......... 1–2
1.2 Benefits of SMS ......................................................... 1–2

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2 SMS Framework .............................................. 2–1

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2.1 Safety Policy and Objectives.................................... 2–1

2.1.1 Executive Commitment ............................................................. 2–1
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2.1.2 Safety Policy Statement ............................................................ 2–2

2.1.3 Penalty Free Safety Reporting Policy ....................................... 2–4
2.1.4 Safety Objectives ...................................................................... 2–4
2.1.5 Safety Accountabilities .............................................................. 2–5
2.1.5.2 Accountable Manager ................................................................................ 2–7
2.1.5.3 Senior Management................................................................................... 2–8
2.1.5.4 VP Quality & Safety ................................................................................... 2–8
2.1.5.5 Senior Manager – Safety ......................................................................... 2–10
2.1.5.6 Corporate Structure ................................................................................. 2–11
2.1.5.7 Safety Department Org Structure ............................................................ 2–11
2.1.6 Appointment of Key Safety Personnel .................................... 2–11
2.1.6.1 Manager – Flight Operations Safety ........................................................ 2–11
2.1.6.2 Manager – Airworthiness Safety .............................................................. 2–13
TOC–1 Revision 5 Jan 2022

2.1.6.3 Manager – Ground Operations Safety...................................................... 2–14

2.1.6.4 Specialist – Operations Safety ................................................................. 2–16
2.1.6.5 Specialist – Flight Operations Safety........................................................ 2–16
2.1.6.6 Specialist – FDM Safety ........................................................................... 2–17
2.1.6.7 Senior Officer – FDM................................................................................ 2–19
2.1.6.8 Specialist Airworthiness Safety ................................................................ 2–19
2.1.6.9 Manager – Emergency Response ............................................................ 2–21
2.1.6.10 Senior Officer – Emergency Response .................................................... 2–22
2.1.6.11 Key Managers .......................................................................................... 2–23
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2.1.6.12 Company Employees ............................................................................... 2–23
2.1.6.13 Operational Safety Committees................................................................ 2–24
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2.1.6.14 Management Review Board – (MRB)....................................................... 2–24
2.1.6.15 Safety Action Group (SAG) ...................................................................... 2–25
2.1.6.16 Post Holders Meeting ............................................................................... 2–27
2.1.7 Coordination of ERP ...............................................................2–27
2.1.7.1
2.1.8
2.1.8.1
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Emergency Response and Crisis Management ....................................... 2–27
SMS Documentation ...............................................................2–28
Control of Documents............................................................................... 2–28
2.1.8.2 Retention of Records................................................................................ 2–28
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2.2 Safety Risk Management ........................................2–29

2.2.1 Accident and Incident Investigation.........................................2–29
2.2.1.1 Scope of Internal Safety Investigations .................................................... 2–29
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2.2.1.2 Just Culture .............................................................................................. 2–29

2.2.1.3 Notification of Accidents and Serious Incidents........................................ 2–31
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2.2.1.4 Definitions................................................................................................. 2–31

2.2.1.5 Reportable Occurrences........................................................................... 2–32
2.2.1.6 Company Procedures Following an Accident or Serious Incident............ 2–32
2.2.1.7 Reporting by the Operator to the Aircraft Manufacturer ........................... 2–32
2.2.1.8 Maintenance Organisations...................................................................... 2–32
2.2.1.9 Reporting by the Contracted Maintenance Organisation.......................... 2–32
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2.2.2 FDM Process...........................................................................2–33

2.2.2.1 Data Collection ......................................................................................... 2–33
2.2.3 Operational Risk Assessment and Management ....................2–36
2.2.3.1 Hazard Identification and Risk Management............................................ 2–36
2.2.3.2 Hazard Identification................................................................................. 2–37
2.2.3.3 Proactive Data Capture ............................................................................ 2–39
2.2.3.4 Predictive Data Capture ........................................................................... 2–39
2.2.3.5 Reporting by Outstations and Contracted Agencies................................. 2–41
2.2.3.6 Risk Assessment ...................................................................................... 2–41
2.2.3.7 Process for Risk Assessment................................................................... 2–42
2.2.3.8 Probability of Adverse Consequences...................................................... 2–43
2.2.3.9 Severity of the Consequences.................................................................. 2–44
2.2.3.10 Risk Acceptability ..................................................................................... 2–44
2.2.3.11 Tolerability and Response ........................................................................ 2–46

2.2.3.12 Management Response and Risk Reduction........................................... 2–47

2.2.3.13 Target Dates ............................................................................................ 2–50
2.2.3.14 Risk Assessment Review Process........................................................... 2–50
2.2.4 Safety Reporting System ........................................................ 2–50
2.2.4.1 Voluntary Safety Report........................................................................... 2–52
2.2.4.2 Hard Copy Voluntary Safety Reports....................................................... 2–52
2.2.4.3 Gateway Hazard Report .......................................................................... 2–52
2.2.4.4 GCAA Voluntary Occurrence Reporting System (AMC-57 –
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VORSY) ................................................................................................... 2–53
2.2.4.5 Fatigue Reporting ................................................................................... 2–53
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2.2.5 Safety Management of Outsourced Service Providers ........... 2–53
2.2.5.1 Safety Risk Management in Outsourced Service Providers .................... 2–53
2.3 Safety Assurance .................................................... 2–55

2.3.1
2.3.1.1
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Safety Performance Monitoring and Measurement ................ 2–55
Safety Objectives ..................................................................................... 2–56
2.3.1.2 Safety Performance Indicators................................................................. 2–57
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2.3.2 Management of Change ......................................................... 2–62
2.3.3 Continuous Improvement ........................................................ 2–66
2.3.3.1 Safety Assessments ................................................................................ 2–66
2.3.4 Line Flying Safety Inspections/Observations .......................... 2–67
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2.3.4.1 Procedure for Planning and Conducting Line Flying Safety

Inspections............................................................................................... 2–67
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2.3.5 Staff Surveys........................................................................... 2–70

2.3.6 Quality Control (QC) ............................................................... 2–70
2.3.6.1 Quality Control ......................................................................................... 2–70
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2.4 Safety Promotion..................................................... 2–70

2.4.1 Training and Education ........................................................... 2–70
2.4.1.1 Introduction .............................................................................................. 2–70
2.4.1.2 Safety Training......................................................................................... 2–71
2.4.1.3 Competency Assessment ........................................................................ 2–74
2.4.1.4 Status Tracking Mandatory e-Learning.................................................... 2–74
2.4.2 Safety Communication ............................................................ 2–74
2.4.2.1 Dissemination of Safety Information ........................................................ 2–74

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IN OL
PR TR
INTENTIONALLY BLANK
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TOC–4 Revision 2 Jul 2020

Safety Management Section 0
System Manual Administration
0 ADMINISTRATION
0.1 FOREWORD
The flydubai Safety Management System Manual (SMSM) is a controlled
document, endorsed by the Accountable Manager, and forms the basis of the
company’s Safety Management System. It is written in the English language
and is issued in accordance with the Regulatory requirements and applicable
standards. The VP Quality & Safety is the owner of this manual, which is
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published and distributed with the approval of the UAE GCAA.
The SMSM must be used in conjunction with and is cross referenced in other
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company manuals, e.g. OM, CAME, MOE, ATO Manual, IFSPM, CSPM, QM,
NCPM, GHM, ERPM and the Management System Manual – MSM. Individual
personnel Safety Responsibilities are explicitly described in the appropriate
Manual.
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The Safety Department local procedures are published on EFOS Library under
the Safety Section.
Additional safety documentation consists of Safety Notices, Safety Memos,

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Safety Forms, Trend reports and Safety Bulletins. This is published on EFOS
Safety Section. Additionally, a safety section is also available on the flydubai
Gateway.
The SMSM is produced and distributed in electronic format. The electronic

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master copy of the SMSM is maintained by the Electronic Document Library

(EDL). The working copy of the SMSM is available to flydubai staff through the
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company’s document management system EFOS (Electronic Flight

Operations System) and Gateway. The SMSM, like any flydubai manual which
is published and used electronically, does not require or contain a List of
Effective Pages (LEP).
The SMSM is not designed to be printed, therefore printed pages from SMSM
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are not controlled documents and must not be retained for operational use.
0.2 SYSTEM OF AMENDMENT AND REVISION

0.2.1 Authority to Issue
The VP Quality & Safety is responsible for preparation and publication of the
flydubai SMSM, including amendments and revisions. Approval, acceptance or
notification to UAE GCAA is required as appropriate.
0–1 Revision 5 Jan 2022

System Manual Administration
0.2.2 Amendment Issue

The Safety Management System Manual and it's associated Safety
Department Procedures, Safety Forms and other related documents, as a
minimum will be reviewed annually, as part of the Safety Department’s internal
quality control, to ensure continuous compliance with regulatory requirements,
company policy and applicable standards.
Additionally, it will be checked for continuing suitability, adequacy and
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effectiveness.
Each time a revision is produced, the affected pages in the manual will be
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assigned the next revision number in sequence and appropriate revision date.
Only explicitly changed content will be marked with a revision bar;

automatically generated content (such as table of contents, Section numbers,
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item numbers in numbered lists, etc.) will not be marked with revision bars,
although the page they are on will be updated with the latest revision
information.
Hand written amendments and revisions are not permitted.

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0.3 DISTRIBUTION LIST
The Safety Management System Manual is distributed as follows:
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Position Format Access

VP Quality & Safety EFOS All
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UAE GCAA EFOS All

Company Employees EFOS All Authorised Personnel
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Safety Management Section ABBR
System Manual Acronyms, Abbreviations
and Definitions
ABBR ACRONYMS, ABBREVIATIONS AND DEFINITIONS

ALARP As Low As Reasonably Practicable
AM Accountable Manager (synonymous with Accountable Executive)
ASR Air Safety Report
ATC Air Traffic Control
ATO Approved Training Organization
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CAME Continuing Airworthiness Management Exposition
CEO Chief Executive Officer
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COO Chief Operating Officer
CRM Crew Resource Management
CSAG Cabin Safety Action Group
CSPM Cabin Safety Procedures Manual
IN OL
CSR
EFOS
Cabin Safety Report
Electronic Flight Operations System
ERP Emergency Response Plan
ESAG Engineering Safety Action Group
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ESR Engineering Safety Report
FDM Flight Data Monitoring
FRMSAG Fatigue Risk Management Safety Action Group
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GCAA General Civilian Aviation Authority

GHM Ground Handling Manual
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GSR Ground Safety Report

GSAG Ground Safety Action Group
IFSPM In-flight Services Procedures Manual
LOSA Line Operations Safety Audit
LFSO Line Flying Safety Observation
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MRB Management Review Board

MOR Mandatory Occurrence Report
MOE Maintenance Organisation Exposition
MSM Management Systems Manual
NCPM Network Control Procedure Manual
NCC Network Control Centre
OM Operations Manuals
PCMCIA Personal Computer Memory Card International Association
QMS Quality Management System
QM Quality Manual
RODGO Reporting of Dangerous Goods Occurrence
ROSI Report of Safety Incident
ABBR–1 Revision 2 Jul 2020

and Definitions
SAG Safety Action Group

SDCPS Safety Data Collection and Processing Systems
SMQA Senior Manager Quality Assurance
SrMS Senior Manager Safety
SMS Safety Management System
SMSM Safety Management System Manual
SOPs Standard Operating Procedures
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VORSY Voluntary Reporting System
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Definitions
Acceptable Level of Safety Performance (ALoSP): The minimum level of
safety performance of civil aviation in a State, as defined in its State safety
programme, or of an organisation, as defined in its Safety Management
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System, expressed in terms of Safety Performance Targets and Safety
Performance Indicators.
Alert Level: An established level or criteria value outside of the normal

operating range or out-of-control region that triggers a warning that an
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adjustment or evaluation is needed.
Consequence: Actual or potential impact of a hazard that can be expressed

qualitatively and/or quantitatively. More than one consequence may evolve
from an event.
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Corrective Action: Action to eliminate the cause of or reduce the effects of a

detected hazard or potentially hazardous situation in order to prevent its
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recurrence.
Defences: Specific mitigating actions, preventive controls or recovery

measures put in place to prevent the realization of a hazard or its escalation
into an undesirable consequence.
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Error: An action or inaction by an operational person that leads to deviations

from organisational or the operational person’s intentions or expectations.
Hazard: A condition or an object with the potential to cause or contribute to an

aircraft incident or accident.
Hazard Analysis: Analysis performed to identify hazards, hazard effects, and

hazard causal factors used to determine system risk.
Hazard Identification: A process to establish a list of hazards relevant to the

activity and the causes/threats that could release them.
ABBR–2 Revision 5 Jan 2022

and Definitions
Human Factors: Principles which apply to aeronautical design, certification,

training, operations and maintenance and which seek safe interface between
the human and other system components by proper consideration to human
performance.
Investigation: A process conducted for the purpose of accident prevention

which includes the gathering and analysis of information, the drawing of
conclusions, including the determination of causes and, when appropriate, the
making of safety recommendations.
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Just Culture: A culture in which front line operators or others are not punished
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for actions, omissions or decisions taken by them that are commensurate with
their experience and training, but where gross negligence, wilful violations and
destructive acts are not tolerated.
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Operational Personnel: Personnel involved in aviation activities who can
report safety information.
Note: Such personnel include, but are not limited to: flight crews; air traffic
controllers; aeronautical station operators; maintenance technicians;
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personnel of aircraft design and manufacturing organisations; cabin
crews; flight dispatchers, apron personnel and ground handling
personnel.
Preventive Action: Pre-emptive action to eliminate or mitigate the potential

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cause or reduce the future consequence of a hazard.

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Risk: The assessed predicted likelihood and severity of the consequence(s) or

outcome(s) of a hazard.
Risk Analysis: Process whereby possible consequences of hazards are

objectively characterized for their severity and probability. The process can be
qualitative and/or quantitative.
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Risk Assessment: The identification, evaluation, and estimation of the level

of risk.
Risk Control: Activities that ensure that safety policies, procedures, and
processes minimize the risk of an aviation accident or incident.
Risk Management: An organisational function that assesses the

organisation’s system design and verifies that the system adequately controls
risk. A formal risk management process describes a system, assesses
hazards, analyses those hazards to evaluate the risk, and establishes controls
to manage those risks.
Risk Mitigation: The process of incorporating defences or preventive controls

to lower the severity and/or likelihood of a hazard’s projected consequence.

and Definitions
Safety: The state in which risks associated with aviation activities, related to,
or in direct support of the operation of aircraft, are reduced and controlled to an
acceptable level.
Safety Assessment: Documentation that contains hazard descriptions, the

related consequences, the assessed likelihood and severity of the safety risks,
and required safety risk controls.
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Safety Assurance: Processes used to ensure risk controls developed under
the risk management process achieves their intended objectives throughout
the life cycle of a system. This process may also reveal hazards not previously
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identified and identify or assess the need for new risk control, as well as the
need to eliminate or modify existing controls. This is one of the four
components of SMS.
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Safety Culture: An enduring set of values, norms, attitudes, and practices
within an organisation concerned with minimizing exposure of the workforce
and the general public to dangerous or hazardous conditions. In a positive
safety culture, a shared concern for, commitment to, and accountability for
safety is promoted.
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Safety Data Collection and Processes Systems (SDCPS): A generic term

used to refer to processing and reporting systems, databases and schemes for
exchange of safety information and recorded information.
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Safety Management System (SMS): A systematic approach to managing

safety, including the necessary organisational structures, accountabilities,
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policies and procedures.
Safety Performance Indicator: A data-based parameter used for monitoring

and assessing safety performance.
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Safety Performance Target: The planned or intended objective for Safety

Performance Indicator(s) over a given period.
Safety Promotion: A combination of safety culture, training, and information

sharing activities that support the implementation and operation of an SMS in
an organisation. This is one of the four components of SMS.
Safety Risk: The predicted probability and severity of the consequences or

outcomes of a hazard.
Safety Risk Management: A process used to assess system design and

verify that the system adequately controls risk. A formal risk management
process describes a system, assesses hazards, analyses those hazards to
evaluate the risk, and establishes controls to manage those risks. This is one
of the four components of SMS.

and Definitions
Severity: The extent of loss or harm associated with consequences of a

hazard.
Training Needs Analysis: The process of identifying skills gaps at the

organisational level, group level, and individual level.
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and Definitions
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Safety Management Section TOC 1
Contents
1 Scope ............................................................... 1–1
1.1 Introduction to Safety Management Systems......... 1–2
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1.2 Benefits of SMS ......................................................... 1–2
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System Manual Scope
1 SCOPE
flydubai is an air operator registered in the United Arab Emirates, operating a
fleet of Boeing 737, engaged in scheduled and charter passenger and cargo
services. In addition to air transport, flydubai provides training services through
the Approved Training Organization.
flydubai has a workforce in excess of 4000 employees including full time

employed flight crew, cabin crew, line maintenance engineers and support
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staff. Ground operations and Base Maintenance is contracted to external
service providers.
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The Safety Department collaborates with all departments to integrate elements
of Environment, Health and Safety across the organization.
This manual establishes the flydubai Safety Management System (SMS) in

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accordance with (as applicable):
• CAR Part X and where appropriate AMC-22, GCAA Mandatory

Reporting Process,
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• ICAO Annex 19 and DOC 9859,
• CAR Part IV Operations Regulation (Sections 1 and 3),
• CAR Part IV Special Purpose Operations (Section A) until such a time,
organisations approved under Section A, have implemented CAR –
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ORA,
• CAR Part V Chapter 3 CAR 145 for UAE based CAR 145 organisations
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holding Class A or B ratings,

• CAR Part V Chapter 5 CAR 21 (Subparts G, F or J) for UAE based
organisations involved in the design and production of complete aircraft,
• CAR Part VIII Air Navigation Regulations,
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• CAR Part IX Aerodrome Regulations, and

• Other CAR M and CAR 145 Approvals,
• IATA Standards and Recommended Practices (ISARPs),
• Best Industry Practices,
• CAR-ORA.
For purpose of flydubai ATO, the Safety Management System is combined with
that of flydubai AOC and incorporates requirements as established within the
CAR-ORA.

System Manual Scope
1.1 INTRODUCTION TO SAFETY MANAGEMENT SYSTEMS

Safety cannot be achieved by simply introducing rules or directives concerning
the procedures to be followed by operational employees; it encompasses most
of the activities of the organisation. For this reason, safety management must
start from senior management, and the effects on safety must be examined at
all levels of the organisation.
Safety Management System is a systematic, explicit and proactive process for
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managing safety that integrates operations and technical systems with
financial and human resource management to achieve safe operations with as
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low as reasonably practicable risk.
It is systematic in that safety management activities are carried out in

accordance with a predetermined plan, and applied in a consistent manner
throughout the organisation. It is proactive by taking an approach that
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emphasises prevention through hazard identification, risk control and
mitigation measures, before events that affect safety occur. It is also explicit in
that all safety management activities are documented, visible and performed
as an essential component of management activities.
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Safety management may also be described as the systematic application of
specific technical and managerial skills to identify and control hazards and
related risks. By identifying, assessing and eliminating or controlling
safety-related hazards and risks, acceptable levels of safety will be achieved.
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1.2 BENEFITS OF SMS

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The primary reason for the introduction of SMS is to improve existing levels of
aviation safety, i.e. a reduction in aviation accidents and incidents, through a
systematic process of hazard and risk management. An effective SMS may
also enable organisations to reap some of the following additional benefits:
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• Minimise direct and indirect costs resulting from accidents and incidents.
• Gain safety recognition from customers and the travelling public.
• Create a positive, reliable and generative organisational culture.
• Reduction in insurance rates.
• Exceed regulatory requirements with simultaneous bottom line and

productivity gains.
• Proof of due diligence in the event of legal or regulatory safety enquires.
• Improved working environment resulting in better productivity and

morale.
• Synergy in the safety related processes and functions within the

organisation.
1–2 Revision 0 Nov 2018

System Manual Scope
The elements of the flydubai safety management system are detailed in this
manual, and are based on guidance from ICAO Doc 9859, ICAO Annex 19,
GCAA CAR Part X, CAR-FAP, CAR-OPS 1 and CAR-FCL, CAR ORA
requirements, CAR-145 and CAR-M along with IATA ISARPS and Industry
Best Practices.
These elements will be introduced in a planned and controlled manner detailed

in the Safety Implementation Plan. Aspects of some of the elements are
already in place, but may be modified in order to be compliant with the
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requirements of the safety management system.
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It is important to recognise that SMS is a top-down system driven by the
Accountable Manager, who is responsible for the implementation and
continuing compliance of the flydubai SMS.
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Contents
2 SMS Framework .............................................. 2–1
2.1 Safety Policy and Objectives.................................... 2–1
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2.1.1 Executive Commitment ............................................................. 2–1
2.1.2 Safety Policy Statement ............................................................ 2–2
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2.1.3 Penalty Free Safety Reporting Policy ....................................... 2–4
2.1.4 Safety Objectives ...................................................................... 2–4
2.1.5 Safety Accountabilities .............................................................. 2–5
2.1.5.2
2.1.5.3
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Accountable Manager ................................................................................ 2–7
Senior Management................................................................................... 2–8
2.1.5.4 VP Quality & Safety ................................................................................... 2–8
2.1.5.5 Senior Manager – Safety ......................................................................... 2–10
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2.1.5.6 Corporate Structure ................................................................................. 2–11
2.1.5.7 Safety Department Org Structure ............................................................ 2–11
2.1.6 Appointment of Key Safety Personnel .................................... 2–11
2.1.6.1 Manager – Flight Operations Safety ........................................................ 2–11
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2.1.6.2 Manager – Airworthiness Safety .............................................................. 2–13

2.1.6.3 Manager – Ground Operations Safety ..................................................... 2–14
2.1.6.4 Specialist – Operations Safety................................................................. 2–16
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2.1.6.5 Specialist – Flight Operations Safety ....................................................... 2–16

2.1.6.6 Specialist – FDM Safety........................................................................... 2–17
2.1.6.7 Senior Officer – FDM ............................................................................... 2–19
2.1.6.8 Specialist Airworthiness Safety................................................................ 2–19
2.1.6.9 Manager – Emergency Response ........................................................... 2–21
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2.1.6.10 Senior Officer – Emergency Response.................................................... 2–22

2.1.6.11 Key Managers.......................................................................................... 2–23
2.1.6.12 Company Employees............................................................................... 2–23
2.1.6.13 Operational Safety Committees ............................................................... 2–24
2.1.6.14 Management Review Board – (MRB) ...................................................... 2–24
2.1.6.15 Safety Action Group (SAG)...................................................................... 2–25
2.1.6.16 Post Holders Meeting............................................................................... 2–27
2.1.7 Coordination of ERP .............................................................. 2–27
2.1.7.1 Emergency Response and Crisis Management....................................... 2–27
2.1.8 SMS Documentation ............................................................... 2–28
2.1.8.1 Control of Documents .............................................................................. 2–28
2.1.8.2 Retention of Records ............................................................................... 2–28
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2.2 Safety Risk Management ........................................2–29

2.2.1 Accident and Incident Investigation.........................................2–29
2.2.1.1 Scope of Internal Safety Investigations .................................................... 2–29
2.2.1.2 Just Culture .............................................................................................. 2–29
2.2.1.3 Notification of Accidents and Serious Incidents........................................ 2–31
2.2.1.4 Definitions................................................................................................. 2–31
2.2.1.5 Reportable Occurrences........................................................................... 2–32
2.2.1.6 Company Procedures Following an Accident or Serious Incident............ 2–32
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2.2.1.7 Reporting by the Operator to the Aircraft Manufacturer ........................... 2–32
2.2.1.8 Maintenance Organisations...................................................................... 2–32
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2.2.1.9 Reporting by the Contracted Maintenance Organisation.......................... 2–32
2.2.2 FDM Process...........................................................................2–33
2.2.2.1 Data Collection ......................................................................................... 2–33
2.2.3 Operational Risk Assessment and Management ....................2–36
2.2.3.1
2.2.3.2
2.2.3.3
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Hazard Identification and Risk Management............................................ 2–36
Hazard Identification................................................................................. 2–37
Proactive Data Capture ............................................................................ 2–39
2.2.3.4 Predictive Data Capture ........................................................................... 2–39
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2.2.3.5 Reporting by Outstations and Contracted Agencies................................. 2–41
2.2.3.6 Risk Assessment ...................................................................................... 2–41
2.2.3.7 Process for Risk Assessment................................................................... 2–42
2.2.3.8 Probability of Adverse Consequences...................................................... 2–43
2.2.3.9 Severity of the Consequences.................................................................. 2–44
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2.2.3.10 Risk Acceptability ..................................................................................... 2–44

2.2.3.11 Tolerability and Response ........................................................................ 2–46
2.2.3.12 Management Response and Risk Reduction ........................................... 2–47
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2.2.3.13 Target Dates............................................................................................. 2–50

2.2.3.14 Risk Assessment Review Process ........................................................... 2–50
2.2.4 Safety Reporting System.........................................................2–50
2.2.4.1 Voluntary Safety Report ........................................................................... 2–52
2.2.4.2 Hard Copy Voluntary Safety Reports ....................................................... 2–52
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2.2.4.3 Gateway Hazard Report ........................................................................... 2–52

2.2.4.4 GCAA Voluntary Occurrence Reporting System (AMC-57 –
VORSY).................................................................................................... 2–53
2.2.4.5 Fatigue Reporting .................................................................................... 2–53
2.2.5 Safety Management of Outsourced Service Providers ...........2–53
2.2.5.1 Safety Risk Management in Outsourced Service Providers..................... 2–53
2.3 Safety Assurance.....................................................2–55

2.3.1 Safety Performance Monitoring and Measurement.................2–55
2.3.1.1 Safety Objectives...................................................................................... 2–56
2.3.1.2 Safety Performance Indicators ................................................................. 2–57
2.3.2 Management of Change..........................................................2–62

2.3.3 Continuous Improvement ........................................................ 2–66

2.3.3.1 Safety Assessments ................................................................................ 2–66
2.3.4 Line Flying Safety Inspections/Observations .......................... 2–67
2.3.4.1 Procedure for Planning and Conducting Line Flying Safety
Inspections............................................................................................... 2–67
2.3.5 Staff Surveys........................................................................... 2–70
2.3.6 Quality Control (QC) ............................................................... 2–70
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2.3.6.1 Quality Control ......................................................................................... 2–70
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2.4 Safety Promotion..................................................... 2–70
2.4.1 Training and Education ........................................................... 2–70
2.4.1.1 Introduction .............................................................................................. 2–70
2.4.1.2
2.4.1.3
2.4.1.4
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Safety Training......................................................................................... 2–71
Competency Assessment ........................................................................ 2–74
Status Tracking Mandatory e-Learning.................................................... 2–74
2.4.2 Safety Communication ............................................................ 2–74
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2.4.2.1 Dissemination of Safety Information ........................................................ 2–74
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System Manual SMS Framework
2 SMS FRAMEWORK
CAR Part X 2
2.1 SAFETY POLICY AND OBJECTIVES

The safety policies of flydubai define the senior management’s intentions in
safety related matters. These policies document the fundamental approach to
be taken towards safety by all employees, contracted organisations,
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companies and agencies.
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The policies are based on the clear and genuine senior executive commitment
that the management of aviation safety is paramount.
These policies are implemented through suitable organisational arrangements

and management systems defined in this SMS manual.
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The following is detailed within this SMS manual:
• Executive Commitment and responsibilities

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• Safety Accountabilities
• Appointment of Key Safety Personnels
• Coordination of Emergency Response Planning
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• SMS Documentation and Records

• Hazard Identification, Risk Assessment and Mitigation
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• Safety Performance Monitoring and Measurement

• Management of Change
• Continuous Improvement of SMS
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• Training and Education

• Safety Communication
The endorsed Safety Policy Statement will be communicated electronically

and displayed within flydubai facilities at various locations.
2.1.1 Executive Commitment

ORG 1.1.3
It is the intent of the Accountable Manager, Senior Executives and Senior

Managers to continuously improve our safety performance.
The Safety Management System Manual (SMSM) provides policy and

guidance on the management of safety within flydubai.

It outlines the standards to be adopted at all locations throughout our network

to ensure that flydubai is a safe operator and complies with all required
legislation, regulation, Company standards and policy.
The Accountable Manager and Senior Managers are responsible for ensuring
that the policies and guidance laid down in this Safety Management System
Manual are reflected in the appropriate manuals and, as required, in
departmental local procedures.
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All flydubai staff shall comply with all policies and processes set out in the
Safety Management System Manual.
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Captain Christopher Grazel
Chief Operating Officer/Accountable Manager (AM)
For and on behalf of flydubai
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2.1.2 Safety Policy Statement
ORG 1.2.3, 1.2.1, 1.2.2, CAR Part X 2.1.1, GM to 2.1.1 (c)
Our mission is to provide a safe and efficient airline service to our customers
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by observing all applicable legal requirements, international standards, and

best practices. flydubai Management will provide all appropriate resources,
enforce safety as a primary responsibility of all managers and ensure that this
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policy is understood, implemented and maintained at all levels.
Our core values include safety, health, responsible consideration of the

environment, and ethical behaviour.
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All levels of management will be clearly committed to our Safety Management

System. The Accountable Manager has the responsibility and the authority to
ensure that all necessary human and financial resources are provided to
enable achievement of the highest Safety Standards and address significant
continuing safety concerns.
Safety is our core business and is a corporate and a personal value. Safety
provides the potential for competitive advantage and strengthens our
business. Commitment to the management of Safety Risks is an integral part
of all our activities. We consider all accidents and incidents preventable. All
levels of flydubai Management and all employees, starting with the Chief
Executive Officer, are accountable for our safety performance.
All employees are encouraged to report Safety issues. To enhance our safety
performance, we are committed to a just and open safety culture. A non-
punitive approach to an employee who discloses an incident or occurrence

involving safety, unless the event involves gross negligence, wilful disregard of
promulgated regulations or procedures or a significant continuing safety
concern.
In order to evaluate and to continually improve our safety performance, we will

establish Safety Performance Indicators and Safety Performance Targets.
Regular safety inspections will be conducted to confirm these performance
targets are being met. The safety inspections will focus on the behavior and
performance of personnel as well as the relevance and effectiveness of
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operating procedures and regulations.
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Every member of the organization will be made fully aware of their safety
responsibilities and they will be held accountable for their own actions.
Furthermore, flydubai personnel who perform operationally critical functions,
are required to be physically and medically fit when reporting for duty.
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Information relating to safety incidents will be openly communicated and we
will share the lessons learned. Each of us will be concerned with the safety of
others within the organization.
Appropriately trained and proficient people are essential to our safety system
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as are resources to identify, monitor and correct potentially unsafe conditions.
We will establish clear standards of acceptable behaviour and provide the
necessary training and resources to effectively operate our Safety
Management System. Employees who exhibit socially, professionally, or
ethically unacceptable behavior will be exempted from the protection offered
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by the flydubai just culture.

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Within flydubai, there will be appropriately open safety communications. The

necessary training will be provided to build and maintain effective safety
leadership skills. The safety of our employees and customers is of strategic
importance to the organization and every improvement we can make to our
safety performance, however small, will help us to continue to grow efficiently
and strengthen our business.
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The Health and Safety Industrial Best Practices together with the UAE Health
and Safety Regulations are strictly followed by flydubai and demonstrate the
corporate recognition of the prime importance of Health and Safety in our
operations. flydubai is committed to continual improvement of safety, not only
for our employees but also for our visitors, contractors and members of the
general public who may be affected by the organization and its operations. This
will be achieved by the identification of hazards and the assessment of risks,
in order to implement appropriate defenses and mitigations. The Safety Policy
will be reviewed as and when needed but in any case, not less than annually,
during the last MRB for the year.

Christopher Grazel
Accountable Manager/Chief Operating Officer
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For and on behalf of flydubai
January 2021
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2.1.3 Penalty Free Safety Reporting Policy
CAR Part X 2.1.1, GM to 2.1.1 (c)
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Non-punitive reporting of incidents, accidents and error is an essential element
of our Safety Management System.
It is, therefore, essential that all information affecting safety is freely available
within flydubai. All personnel can feel confident that they can disclose any such
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information without fear of retribution.
As such, we fully endorse non-punitive incident/accident and error reporting

within flydubai. This will develop and foster a just culture in which we adopt a
team approach to resolve safety issues and prevent recurrences.
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This does not, however, imply that we will tolerate negligence or wilful
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violations of standard operating procedures, policies or regulations.

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Ghaith Al Ghaith Christopher Grazel

Chief Executive Officer Chief Operating Officer/Accountable Manager (AM)
2.1.4 Safety Objectives

ORG 1.5.1, CAR Part X GM to 2.1.1 (b)
The safety objectives of flydubai are broad directions which have been set in
place to facilitate the establishment of specific safety goals or desired targets.
The safety objectives are designed to provide an insight into relevant aspects
of the Company’s safety vision, senior management commitment, realistic
safety milestones and desired outcomes. The safety objectives will be
unambiguous and will be reviewed by the Senior Manager Safety and the MRB
on an annual basis to ensure that they remain relevant to the Company’s
operations.

The flydubai safety objectives are:
• To identify and eliminate as far as is reasonably practicable, hazardous

conditions within our aviation related processes and operations.
• To perform hazard and risk assessment for all our proposed new
equipment acquisitions, facilities, operations and procedures.
• To promulgate an on-going systematic hazard and risk assessment
plan.
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• To provide relevant SMS training and education to all personnel.
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• To provide a safe and healthy work environment for all personnel.
• To minimise accidents and incidents which are attributable to
organisational factors.
• To prevent damage and injury to property and people as a result of our
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operations.
To continually improve the effectiveness of the Safety Management
System through audits and surveys.
• To develop and nurture an open, just and non-punitive culture which is
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trusted by all personnel.
• To actively encourage all personnel to be “safety minded” in all their
activities and participate willingly in the safety system.
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• To achieve all targets set by all Departments, as part of our Safety

Assurance Process and Safety Performance Measurement. These
targets are declared and agreed SPIs and SPTs with the GCAA. Once
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the targets have been met and are no longer considered a threat, they
will become objectives.
In order to avoid continuous changes to the SMSM, the list of objectives from
our SPM Documentation will be considered part of this list.
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2.1.5 Safety Accountabilities

ORG 1.3.1, CAR-OPS 1.037 (b), CAR Part X 2.1.2
2.1.5.1 A primary function of flydubai’s safety management system is the management

of safety in flydubai operations. Each post holder is responsible to liaise with
regulatory authorities, original equipment manufacturers, and other relevant
operational external business partners on safety standards.
Safety Management starts with Senior Management, and the effects on safety
are continuously monitored at all Management Levels and Departments of
flydubai.
Whereas compliance with the Regulations ensures minimum acceptable

safety levels, it is flydubai’s ultimate responsibility to continuously aim to
improve and achieve the highest possible Operational Safety Levels in all

flydubai operations. This is achieved by ensuring Regulatory Compliance and

taking into consideration any Safety Recommendations both internal and
external.
The flydubai Safety Management System is a systematic, explicit and

proactive multi-faceted process for managing safety that integrates operations
and technical systems with financial and human resource management to
achieve safe operations with as low as reasonably practicable risk.
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It is systematic in that safety management activities are carried out in
accordance with a predetermined plan, and applied in a consistent manner
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throughout flydubai. It is proactive by taking an approach that emphasises
prevention through hazard identification, risk control and mitigation measures,
before events that affect safety occur. It is also explicit in that all safety
management activities are documented, visible and performed as an essential
component of management activities.
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It is, therefore, essential that Departmental Heads must adhere to Safety
Management principles with emphasis on Management of Change and
associated Hazard and Risk Identification and proper Management through
appropriate Mitigation. By identifying, assessing and eliminating or controlling
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safety related hazards and risks, superior levels of safety will be achieved.
Post holders and/or department heads will remain committed to the flydubai
safety policy and respect the responsibility of flydubai staff to report any safety
issues without fear of any disciplinary or punitive action (unless, of course,
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such errors result from illegal activity, willful misconduct or other egregious
actions).
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All department heads will ensure compliance with the conditions and
restrictions of the flydubai’s aircraft operating certificate, regulatory
requirements, and the policies and procedures documented in each
department’s operating manual. Further, all operating managers and
subordinate staff have the authority to make decisions that affect the safety
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and security of aircraft operations, if that action is within the professional

purview of that manager.
It is each department head’s responsibility to ensure all employees understand

and adhere to the laws, regulations, and procedures of flydubai.
It must be emphasized, however, that ALL flydubai employees are responsible

and can be held accountable for safety within their area of job scope.
Responsibility for the decision on risk tolerability with respect to safety of

aircraft operations is defined in Risk Management Process form FD-SMS-001.

2.1.5.2 Accountable Manager

ORG 1.1.3, CAR-OPS 1.175 (i), CAR Part X AMC1 to 2.1.2 (a)
The Accountable Manager has overall responsibility and accountability for all
safety issues. He has the corporate authority for ensuring that all operations
and maintenance activities can be resourced in both human and financial
terms and carried out to a standard required by the applicable authority and
any additional requirements of flydubai.
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The Accountable Manager has responsibility and is accountable for ensuring
operations are conducted in accordance with conditions and restrictions of the
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Air Operator Certificate (AOC), and in compliance with regulatory requirements
and company standards.
His Authorities include, but are not limited to:
IN OL a.
b.
Communication and promotion of the safety policy;
Establishment of a just culture which encourages safety reporting;
c. Full authority for human resources issues;
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d. Authority for major financial issues;
e. Direct responsibility for the conduct of the organisation’s affairs;
f. Final authority over operations under certificate; and
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g. Final responsibility for all safety issues;

h. Establishment of the organisation’s safety objectives and safety
targets;
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i. Establishment, implementation and maintenance of the organisation’s

competence to learn from the analysis of data collected through its
safety data collection system;
j. Implementation and maintenance of the safety management system
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(SMS) throughout the organization;

k. Has the authority to ensure the planning and allocation of resources
necessary to manage safety risks to aircraft operations.
The Accountable Manager is ultimately responsible for the efficient and

compliant operation of the flydubai SMS, and will allocate resources necessary
to manage safety and security risks to aircraft operations. The day to day
operation and management of the SMS is devolved to the Senior Manager
Safety, who will report directly to the Accountable Manager on all safety related
matters.
2–7 Revision 2 Jul 2020

Full terms of reference for the Accountable Manager are detailed in the
Management System Manual. In addition, the Accountable Manager is
responsible, in conjunction with and on the advice from the VP Quality &
Safety, for determining the Company safety standards and setting the safety
goals and targets.
As the person ultimately responsible for the flydubai SMS, the Accountable
Manager will perform the duty of Chairman of the biannual MRB as detailed in
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2.1.6.14.
The Accountable Manager delegates the responsibility of the management of
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the flydubai SMS to the VP Quality & Safety and the Safety Department.
2.1.5.3 Senior Management

Senior managers (CEO, Chiefs, SVPs, and VPs) are responsible to the
IN OL
Accountable Manager for the implementation of the Corporate Safety Policy
which is stated in the Safety Policy Statement at 2.1.2.
Implementation of the Corporate Safety Policy will mainly be achieved through

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the normal activities of the MRB which are detailed in 2.1.6.14. Senior Manager
Safety is responsible for providing expert guidance to the senior managers and
the MRB, on matters concerning the safety activities of the Company.
Members of senior management will openly endorse the safety policies and
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non-punitive culture within the Company, and will encourage all Company
employees to participate fully in the safety system and its activities. Company
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employees should be openly encouraged to report any safety occurrences and

all breaches of safety processes and procedures. Senior managers should
ensure that the correct procedures are followed to fully investigate safety
related matters, and provide appropriate feedback to their employees.
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Senior managers should ensure that they are fully acquainted with the
Company safety systems, and will be provided with the appropriate level of
safety training to enable them to fulfil their safety related responsibilities.
2.1.5.4 VP Quality & Safety

ORG 1.1.12, 3.3.2, CAR-OPS 1.175, CAR Part X 2.1.3.1, GM to 2.1.3.1
The VP Quality & Safety is the nominated post holder for safety for all
operational areas. As such, is responsible to the Accountable Manager for the
establishment, implementation and management of the flydubai SMS.
The main objective of the Role is ensuring compliance of all regulatory

standards and elements as established in GCAA CARs and any other
standards as required by flydubai and oversee the policy and direction of the
centrally managed Safety & Quality Management System.

Key Responsibilities:
• Develops and implements a complete and harmonized strategy for

Safety and Quality Management System ensuring that flydubai adheres
to internationally recognized standards and that the airline maintains a
reputation for its safety and quality standards.
• Sets quality controls and policies to ensure that operations are
conducted to flydubai standards and in accordance with applicable
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regulations whilst assuring that safety is never compromised.
• Manages the successful rollout of flydubai’s SMS and implement safety
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campaigns promoting safety standards within the airline that adhere to
international standards and provide periodic reviews to the airline
leadership team in this regard.
• Acts as the focal point for any concerns/queries arising from
IN OL Management and external agencies/entities (GCAA, IATA etc) relating
to the safety management and quality management system and ensure
adherence to Quality & Safety audits and mandatory directives relating
to all operational areas.
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• Develops frameworks, policies & processes related to:
a. Evaluation of Hazard Identifications,
b. Safety/Quality performance management,
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c. SMS/QMS effectiveness,
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d. Safety Performance Indicators (SPIs) and Safety Performance

Targets (SPTs),
e. Risk Assessments & Change Management,
f. Maintenance and dissemination of the Safety Hazard & Risk
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Register,
g. Maintenance and dissemination of the Company Safety
Management System Manual,
h. Maintenance and dissemination of all documentation and
records related to Safety & Quality,
i. Safety Data Collection and Processing Systems (SDCPS) such
as safety reporting, Flight Data Monitoring (FDM) and other
safety data collection methods are established and ensuring
that they are implemented.
• Takes the lead in managing coordination of all incidents and accidents
and continuously facilitate hazard identification and safety risk analysis.
• Puts in place corrective and mitigating actions and continuously
evaluating their effectiveness.

• Monitors Safety/Quality concerns in the aviation industry and their

perceived impact on the organization’s operations aimed at service
delivery.
• Provides advice the Safety Review Board and Management Review
Board on Safety/Quality issues.
2.1.5.5 Senior Manager – Safety

ORG 1.1.12, 3.3.2, CAR-OPS 1.175, CAR Part X 2.1.3.1, GM to 2.1.3.1
D D
The Senior Manager – Safety is responsible to establish, lead and manage the
airline’s Safety Management Systems (SMS) ensuring that all flydubai
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operations according to the Safety regulations set by GCAA and the standards
set by flydubai.
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• Develops appropriate policies and manuals governing Safety protocols
in line with local and international regulations and standards.
• Reviews and makes recommendations on all changes to the SMS
manual.
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• Designs and implements processes/procedures that ensure that all

flydubai operations comply with SMS regulations as set by the GCAA as
well as other applicable regulatory requirements.
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• Acts as the focal point representing flydubai in all matters pertaining to

the SMS.
• Leads and coordinates Safety investigations and define appropriate
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Safety recommendations and mitigation strategies in coordination with

relevant stakeholders as appropriate.
• Actively participates in internal and external audit activities for Safety,
including the processing of audit findings to ensure that set deadlines
are met.
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• Evaluates, disseminates and promotes all Safety related information to

the organization.
• Participates and represents the Airline in any ‘ICAO Annex 13 Air
Accident Investigations’ as required.
• Establishes and implements the Hazard Identification and Risk
Management program.
• Manages all Safety initiatives and related improvement plans.
• Defines and updates the Company’s Safety Data Collection and
Processing Systems (SDCPS).
• Issues periodic and ad-hoc reports related to Safety performance.
• Develops and promotes the Company’s SMS training and awareness
programs.

2.1.5.6 Corporate Structure

For complete Corporate Structure refer to the Management System Manual
(MSM) 1.1.1.
2.1.5.7 Safety Department Org Structure

CAR Part X 2.1.3, AMC2 to 2.1.2 (a)
Figure 1
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Chief Operating Officer
MRB / Accountable
Manager
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Vice President
SAG Quality & Safety PH
Quality and Safety
IN OL Senior Manager Safety
Manager Flight Manager Ground Manager Manager

Operations Safety Operations Safety Airworthiness Safety Emergency Response
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Specialist Flight Specialist FDM Specialist Specialist Senior Officer

Operations Safety Safety Operations Safety Airworthiness Safety Emergency Response
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LEGEND
Senior Officer Reporting Line
FDM
Communication Line
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2.1.6 Appointment of Key Safety Personnel

CAR Part X 2.1.3, AMC2 to 2.1.2 (a)
All Safety Personnel will be trained as per Safety Department Training Record
Matrix in (SDP-01 flydubai Safety Department Training and Training Matrix)
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and/or all prerequisites in JD.
2.1.6.1 Manager – Flight Operations Safety

ORG 1.3.3, 3.3.2
Reports to Senior Manager Safety

• Establish greater awareness and the need for, and the benefits of, a
safety conscious culture in flydubai with a strong emphasis on
prevention, while maintaining thoroughness of investigation and follow
up.
• Assist the Senior Manager Safety with the development of the flydubai
Safety Policy and objectives.
• Develop and maintain Safety Risk Management processes as
applicable to Flight Ops Hazards and Risks.

• Provide Safety Assurance as applies to Flight Ops processes and

procedures.
• Develop strategies for the continued improvement of flight and ground
safety performance in order to reduce costs resulting from incidents/
accidents.
• Authorise, and be responsible for, investigations into any air and ground
accident or incident, in order to determine, as quickly as possible, the
facts of the case and report with recommendations accordingly.
D D
• Monitor safety reports with emphasis on Flight Ops and ensure adverse
trends are tackled appropriately, and in time by the appropriate
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departments.
• Supply the necessary Data for SAG and present Flight Ops Risk
Assessments for approval/mitigation/rejection.
•
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Ensure that regular Safety Assessments and reviews are conducted in
all relevant operational and non-operational areas of flydubai, in Dubai
and throughout the network.
• Promote the effective management of safety arising from incident and
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audit data by developing a safety database, and other tools, as the
Company safety system.
• Communicate appropriate information relating to safety issues, to
management and employees, in order to encourage and develop in
continuing safety culture, at all levels.
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• Promote the development of human factors programmes, as a means of

raising risk awareness, reducing error and enhancing safety.
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• Monitor the safety performance of flydubai aircraft on the ground and in

the air.
• Develop safety programmes for review by the Management Safety
Review Committee, and implement programmes which are approved.
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• Ensure that accidents and incidents are investigated in coordination with

departmental heads, and commenting as necessary on such
investigations.
• Produce, in coordination with departmental heads, reports and
recommendations on each accident or incident involving flydubai
aircraft.
• Carry out analysis and studies of accident/incident trends, to warn
departmental heads of adverse movement.
• Monitor Flight Operations technical procedures and flight training,
including practise drills and procedures, to ensure that there is adequate
and continuing emphasis on Flight Safety.
• Monitor ATO Operations for Safety concerns or issues.
• Represents flydubai in safety matters.

• Observe safety trends in the aviation industry.

• Liaise with national and international flight safety agencies as
necessary.
• Maintain communication with flydubai Flight Crew, through the Chief
Pilot on safety matters, including contribution to the safety section of
Company newsletter.
• Assist Senior Manager Safety in carrying out his responsibilities and to
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carry out any other assignment and mission on his behalf, whenever
required.
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• Deputise Senior Manager Safety as required.
2.1.6.2 Manager – Airworthiness Safety

ORG 1.3.3
IN OL
• Establish greater awareness with the need for, and the benefits of, a
safety conscious culture in flydubai with a strong emphasis on
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prevention, while maintaining thoroughness of investigation and
follow-up.
IF N
• Develop strategies for the continued improvement of flight and ground

safety performance in order to reduce costs resulting from incidents/
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accidents.
• Authorize, and be responsible for, investigations into any air and ground
accident or incident, in order to determine, as quickly as possible, the
facts of the case and report with recommendations accordingly.
• Monitor all safety reports with emphasis on Airworthiness and ensure
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adverse trends are tackled appropriately, and in time by the appropriate

departments.
• Supply the necessary Data for SAG review and present Airworthiness
related Risk Assessments for approval/mitigation/rejection.
• Ensure that regular Safety Assessments and reviews are conducted in
all relevant continuing airworthiness and maintenance areas of flydubai,
in Dubai and throughout the network.
• Communicate appropriate information relating to safety issues, to
continuing safety culture, at all levels.

• Promote the development of human factors programs, as a means of

the air.
• Develop safety programs for review by the Safety Review Board, and
implement programs which are approved.
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investigations.
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aircraft.
• Carry out analysis and studies of accident/incident trends, to warn
IN OL
•
Monitor Engineering and Maintenance technical procedures and
training, including practise drills and procedures as applicable, to ensure
that there is adequate and continuing emphasis on Flight Safety.
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• Represents flydubai in safety matters.
• Ensure Safety promotion within flydubai Airworthiness employees.
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• Liaise with national and international flight and Engineering/

Maintenance safety agencies as necessary.
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• Maintain communication with flydubai Engineers, through the Head of

Engineering on safety matters, including contribution to the safety
section of Engineering newsletter.
• Assist Senior Manager Safety in carrying out his responsibilities and to
carry out any other assignment and mission on his behalf, whenever
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required.
• Deputize Senior Manager Safety as required.
2.1.6.3 Manager – Ground Operations Safety

ORG 1.3.3

• Develop and maintain Safety Risk Management processes as
applicable to Ground Operations Hazards and Risks.
• Provide Safety Assurance as applies to Ground Operations processes
and procedures with special emphasis on Outstation Safety
Assessments in line with GCAA and IATA requirements.

• Ensure Safety promotion within flydubai Ground Operations employees.

• Be responsible for investigations into any air and ground accident or
incident, in order to determine, as quickly as possible, the facts of the
case and report with recommendations accordingly.
• Monitor all safety reports with emphasis on Ground Operations Safety
Reports and ensure adverse trends are tackled appropriately and in time
by the appropriate departments.
D D
• Ensure that regular Safety Assessments and reviews are conducted in
all relevant operational and non-operational areas of flydubai, within
Dubai and throughout the network.
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IN OL
• Communicate appropriate information relating to safety issues to
continuing safety culture at all levels.
• Promote the development of human factors program as a means of
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the air.
• Develop safety programs for review by the Safety Management Review
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Board and implement programs which are approved.

• Supply the necessary Data for Safety Action Group review and present
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Ground Operations Safety Risk Assessments for approval/mitigation/

rejection.
investigations.
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aircraft.
• Carry out analyses and studies of accident/incident trends, to warn
• Monitor Ground Operations related technical procedures and training,
including practice drills and procedures as applicable to ensure that
there is adequate and continuing emphasis on Safety.
• Represents flydubai in safety meetings with the GCAA, DCAA and DAA
as needed.
• Liaise with national and international flight and Ground Operations/
Ground Handling Safety Agencies as necessary.

• Maintain communication with flydubai Ground Operations related

personnel, through the Head of NCC, Airports and Cargo and others as
needed on safety matters, including contribution to the safety TV
Network and Safety Memos.
• Supply the necessary Data for SAG review and present Ground
Operations related Risk Assessments for approval/mitigation/rejection.
• Assist the Manager Safety in carrying out his responsibilities and to carry
D D
out any other assignment and mission on his behalf, whenever required.
• Deputise Manager Safety as required.
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2.1.6.4 Specialist – Operations Safety
• Oversee the Hazard and Risk Register and monitor follow-up on open
Hazards/Risk and recommend revision or introduction of additional
safety controls to the Area Owner as needed.
•
IN OL
Oversee the ROSI/RODGO Register and monitor responses required
for ROSI closure.
• Develop and deliver classroom Safety Training as required.
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• Carry out Safety Investigations as directed by the Senior Manager
Safety.
• Carry out Safety Assessments as directed by the Senior Manager
Safety.
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• Process and monitor, as needed, safety reports CSR/GSR/ASR and

provide feedback recommendations where applicable.
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• Prepare the Weekly Safety KPI Report/Leadership Presentation.

• Provide relevant safety data for SRB/SAG/mini-SAGs and other safety
management meetings when required.
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• Develops safety procedures as directed by the Senior Manager Safety/

Edit and amend Safety Department Manual and Procedures as
required.
• Ensure Safety promotion and awareness within flydubai Operations
employees.
• Perform other duties as assigned by the Senior Manager Safety.
2.1.6.5 Specialist – Flight Operations Safety

• Process Cabin Safety Reports (CSR’s) and Air Safety Reports (ASR’s),
requesting for and following up on assessments where required with
concerned departments. Escalation of serious CSR’s/ASR’s to Safety
Manager Flight Operations.
• Assist Safety Manager Flight Operations in the investigation of incidents
and preparation of reports.

• Assist with preparation of CSR and ASR Safety Performance Indicators

for submission to GCAA.
• Collate data and prepare presentation for quarterly Safety Action Group.
• Monitor all CSR/ASR and ensure adverse trends are addressed
appropriately and in a timely manner by concerned department.
• Deliver SMS awareness training to Cabin Crew as per regulatory
requirements.
D D
• Conduct Safety Assessments as per the approved annual inspection
schedule.
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• Prepare monthly CSR/ASR Bulletin.
• Prepare weekly CSR/ASR statistics for Postholders’ meeting.
IN OL •
•
Monitor external sources for relevant safety information.
Ensure Safety promotion and awareness to flydubai employees.
• Carry out other safety related tasks under the direction of Safety
Manager.
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2.1.6.6 Specialist – FDM Safety

Responsible for Flight Data Monitoring, Trend Analysis/Crew debriefing as
applicable and SPI/SPT Monitoring.
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• Manage, develop and implement the Flight Data Management program,

which includes flight data collection, data processing, and archiving of
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aircraft Operational Data.

• Ensure timely operation of FDM system, ensuring that policies and
procedures are set to evaluate the effectiveness of the system and the
procedures followed internally for data capture and is in line with
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company Safety Management System.

• Conduct investigations based on ASR’s and EFOS deviation reports
analyze, risk assess and classify the hazard or event reported, work
closely with inter departments for the necessary documentation and
follow ups in line with the Safety Management System.
• Reporting safety incident with the regulator GCAA (ROSI) – have the
expertise to identify and classify the Air Safety reports and report
wherever necessary to the GCAA as per AMC-22.
• Flight Data Monitoring and SMS brief to new hire Pilots/Cabin Crew as
necessary.
• Co-author the Local Procedures Manual (LPM) – define processes and
procedures for all FDM functions and incorporate them in the LPM.
• Safety promotion – co-author safety bulletins, safety posters etc.

• To continuously monitor the health of FDM systems. To proactively

recommend optimizations for maximum flight data retrieval performance
and maintain the percentage of data capture to an acceptable level by
continuous monitoring, establish clear guidelines for continuous
availability of Flight Data Monitoring (FDM) services.
• Keep track of flight data capture through the current system available
and to proactively give call out for alternate methods for data download
whenever QAR data is unavailable.
D D
• Generate quarterly trend reports on the basis of the exceedances
configured and use the analytical skills to determine the performance of
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the operations and suggest mitigation strategies to safety manager.
• Monitor flight data to ensure that flight operations are being conducted
in accordance with all applicable flydubai requirements, standards and
procedures. Measure established procedures for safe and efficient
•
IN OL
operational practices and airworthiness; detect deviations and classify
by level of severity.
Analyze the data and continuously look for continuing airworthiness and
maintenance related events and notify maintrol where technical and
airframe limits are exceed and notify engineering for necessary
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inspections to maintain the aircraft airworthy.
• Analyze flight data to identify, filter, and distribute only pertinent
information to management. Apply knowledge of aircraft systems and
aircraft performance so as to provide expert interpretation of data and
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present clear information to internal and external customers.

• Maximize the use of continuously recorded aircraft flight data to benefit
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the company. Analytical ability is required to interpret data and translate

that data into valuable information that is valuable in making operational,
quality and safety decisions.
• Establish liaison with flydubai IT and external service providers and
vendors, Aerobytes and Avionica for maintenance and smooth
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operations of the FDM system.

• Prepare monthly summary for the ASR received – each ASR received
needs to be filtered and necessary information needs be extracted and
published on EFOS monthly for pilots and management.
• Develop and manage a database for Safety Action Group (SAG)
meeting and Management Review Board (MRB) meetings.
• Coordinate with other departments in preparing the data for SAG and
MRB meetings.

2.1.6.7 Senior Officer – FDM

To assist in identification and mitigation of underlying hazards and risks
through the collection, processing, analysis and archival of aircraft operational
data.
• Monitors flight data to identify instances where flight operations are not
in accordance with all applicable flydubai requirements, standards and
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procedures.
• Ensures the smooth operation of the FDM system by coordinating with
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relevant stakeholders if any issues arise.
• Generates timely trend analysis reports and co-authors the FDM safety
newsletters.
IN OL •
•
Analyses flight data to identify, filter, and distribute any gaps or issues
discovered for resolution.
Recommends processes or policies that assist in the optimization of
FDM reporting.
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• Coordinates with internal and external parties to ensure that the FDM
are resolved efficiently and works with them to develop and rollout any
updates.
• Participates in flight replay and brief for flight crew on FDM related
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events and provides guidance and recommendations on any issues

discovered.
• Assists with safety investigations by providing any relevant Flight data in
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a summarized manner.
• Collates safety performance data and prepares a draft for review at the
SRB and SAG meetings.
• Acts as the system administrator for various safety applications
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including the FDM and SMS.
2.1.6.8 Specialist Airworthiness Safety

• Assisting Safety Manager Airworthiness in establishing greater
awareness of the need for, and the benefits of, a Safety conscious
culture in organizations with a strong emphasis on prevention.
• Assisting Safety Manager Airworthiness to ensure the organizations
Safety policy is implemented in its entirety.
• Continually developing strategies for the continued improvement of
Safety performance in order to reduce incidents/accidents.
• Carry out closed loop Airworthiness investigations including ROSI and
Annex 13 investigations into any air and ground accident or incident, in
order to determine, as quickly as possible, while maintaining
thoroughness of investigation the facts of the case and report with

recommendations accordingly. Liaise directly with the GCAA on Safety

related matters and ROSI report conclusions and closure. Producing in
coordination with departmental heads, reports and recommendations on
each accident or incident involving fleet aircraft.
• Present Engineering Safety performance indicator statistic
presentations for Engineering monthly reliability meetings.
• Produce presentation and organize monthly ESAG meetings post
reliability meetings to discuss trends/action plans and recommendations
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to be actioned at the Engineering Maintenance Quality Safety Review
meetings.
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• Ensuring regular Airworthiness Safety audits and reviews are conducted
in all relevant areas of the organization and throughout the network.
• Promoting effective management of safety arising from incident and
•
IN OL
Communicating appropriate information through Safety Manager
Airworthiness relating to safety issues, to management and employees,
in order to encourage and develop continuing safety culture, at all levels.
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• Assist the promoting and development of human factors programs, as a
means of raising risk awareness, reducing error and enhancing safety.
• Developing safety programs for review by the Safety Manager
Airworthiness to present at the Management Safety Review Board, and
IF N
implementing programs which are approved.

• Carrying out analysis and studies of accident/incident trends, to warn
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• Representing the airline in safety matters. Attending seminars and
conferences as and when required by the Safety Manager
Airworthiness/ Head of Safety.
• Observing safety trends in the aviation industry.
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• Liaising with national and international flight and Engineering/

Maintenance safety agencies as necessary and monitoring safety
trends in the aviation industry.
• Assist Safety Manager Airworthiness in carrying out his responsibilities
and to carry out any other assignment and mission on his behalf,
whenever required.
• Deputizing for Safety Manager Airworthiness on Safety Matters in his
absence.

2.1.6.9 Manager – Emergency Response

To establish, lead and manage the airline’s Emergency Response function in
order to protect the operations, safety and security of the airline in the event of
an accident or major incident or unforeseen disruption.
• Establishes and implements Emergency Response strategies that could

have a substantial impact on future business performance.
D D
• Influences, negotiates and manages both internal and external
stakeholder communications and relationships in the event that
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Emergency Response is activated.
• Analyses, designs and implement new processes, methods and
techniques to enhance existing Emergency Response processes.
IN OL •
•
Manages and leads Emergency Response teams, activities and training
throughout all business units.
Oversees the preparation and dissemination of the Emergency
Response manual (technical composition).
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• Acts as the focal point in providing and maintaining interaction and
high-level communication between the Operations Division and other
critical business units in all matters related to the ERP.
• Negotiates and manages external vendor contracts and relations.
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• Interfaces and coordinates with both internal and external auditors to

ensure compliance with regulatory requirements.
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• Provides risk evaluation and assessment by analyzing and identifying

areas of risk affecting Emergency Response activities and compares
estimated risks with criteria established by the airline.
• Assesses training needs and designs, develops and delivers a training
plan for all ER activities companywide, ensuring regular evaluation of
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the training programs.

• Represents the airline at national, regional and international levels at
various Emergency Response task force groups and seminars.
• Evaluates and controls the editorial and presentation of ER information
externally and internally including Safety and Quality meetings, Safety
Review Board meetings, Safety Action Group meetings, periodic safety
and company information bulletins, banners and posters and electronic
newsletters.

2.1.6.10 Senior Officer – Emergency Response

To implement the airline’s Emergency Response function in order to protect
the operations, safety and security of the airline in the event of an accident or
major incident or unforeseen disruption.
• Assists in the development, implementation, coordination, and

administration of the airline’s Emergency Response function.
D D
• Manages, formulates and evaluates the local emergency plans,
procedures, and activities at each outstation.
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• Assists in the design and delivery of Emergency Response training
programmes for all outstations, ensuring each station’s Emergency
Response plan is updated and disseminated where necessary.
IN OL
• Consults with officials of local and area governments, hospitals, and
other institutions in order to determine their needs and capabilities in the
event of a natural disaster or other emergency.
• Manages, develops, and maintains liaisons with relevant entities in
order to facilitate plan development, response effort coordination, and
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exchanges of personnel and equipment at outstations as well as base
station.
• Develops and performs both tabletop and simulation exercises for the
Go Team, Home Team and outstations in coordination with our external
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disaster management provider and analyses exercise audits to develop

post-exercise reports.
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• Prepares the Emergency Response manual (technical composition) and

coordinates with other departments for assembly, printing and
distribution where necessary network wide.
• Coordinates and assists with delivery of ER training courses, as
required, including development and presentation of curriculum, roster
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management, transportation, certification, and management of records.

• Creates, updates, and analyzes Emergency Response databases for
the development of monthly reports
• Proposes alteration of Emergency Response procedures based on
regulatory changes, technological changes, facility changes or
knowledge gained from outcomes of previous emergency situations.

2.1.6.11 Key Managers

ORG 1.1.4
The key managers (Line Managers, Post Holders, Departmental Heads), or

other personnel by special assignment, have the responsibility, authority and
accountability to carry out the daily safety management functions as required
by flydubai safety policy and outlined in this manual, within their areas of
responsibility.
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Key managers are responsible for:
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• Promoting safety within their department as an integral part of the
business.
• Establishing their departmental objectives and requirements to meet the
safety policy.
IN OL • Ensuring that their department is sufficiently resourced to meet the
safety objectives.
• Monitoring adherence to safety standards.
• Reviewing their departmental safety records in order to detect and
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prevent the development of undesirable trends.
• Ensuring all staff in their department are trained to the level required to
give them a full awareness of the management of safety within their area
of responsibility.
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• Ensuring that risks and threats to the safety of the flydubai operation as
reported by members of their particular department, are reported to the
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Safety Department for assessment and mitigation, where necessary,

through the workings of the SAG.
• Ensuring that mitigating measures are implemented in a timely manner
and, through review, are effective.
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2.1.6.12 Company Employees

In flydubai, all employees are required to assume responsibility for the safety
of their own work and actions. They should be fully acquainted with the
requirements of the SMS and of their responsibilities within it. Company
employees will be given training and/or briefing in those aspects of safety
management that are relevant to their work or position.
All Company employees are required to fully cooperate with the Senior
Manager Safety, his nominated representative, or any other member of the
flydubai management team in the investigation of safety related incidents or
accidents.

Company employees will ensure compliance at all times with Company safety
standards, ensuring that these take precedence over commercial or
operational requirements and shall be aware of their accountabilities for the
safety performance of the Company SMS.
Company employees will, at all times, observe, follow and support established
safety policies, practices and procedures prescribed in the various flydubai
manuals and notices.
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A truly effective safety management system relies upon all personnel involved
in an organisation to be aware of the required safety standards and processes,
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and to report any deficiencies or breaches of those standards and processes.
The Company requires all employees to report any safety related incidents or
failures of the safety system to their line manager or, by the use of formal or, if
appropriate, informal or confidential means, to the Safety Department. In order
to fully facilitate an open and free reporting system, the senior management
2.1.6.13
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supports the principle of a non-punitive safety culture.
Operational Safety Committees

ORG 1.5.1, 1.5.2, 3.4.4
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Introduction
There are two distinct groups established to facilitate the functioning and
development of the SMS.
First there is a formal board, the MRB, chaired by the Accountable Manager
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and comprising senior executives and managers, which is convened to monitor

the strategic performance of the SMS.
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Secondly, the Safety Action Group (SAG), comprising line managers, safety
officers, and other nominated personnel, supports the risk assessment
process and undertakes other safety related tasks.
2.1.6.14 Management Review Board – (MRB)

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FLT 1.10.3, DSP 1.10.3, MNT 1.10.3, CAB 1.9.2, GRH 1.9.3, CGO 1.9.3,
CAR Part X GM to AMC to 2.1.3.1 (j)
The MRB is the Company’s highest-level committee and is chaired by the

Accountable Manager with senior executives and other nominated senior
managers in attendance.
The MRB will meet bi-annually to review, among other management systems,
safety performance and achievements of the Company and ensure that any
observations resulting from Safety Assessments and monitoring programmes
are properly addressed.

Further, the MRB shall include assessing opportunities for improvement and
the need for changes to the system, including (but not limited to) organizational
structure, policies, resources, performance monitoring, authorities and
responsibilities, processes and procedures and identification of training needs.
2.1.6.14.1 Meetings
Meetings shall be minuted to document attendees, apologies. Additionally, all
items of discussions, conclusions, recommendations, decisions and actions
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shall be documented and retained, with the Accountable Manager’s Office, for
a period of five years. The minutes of the meeting shall include an owner for
every action and an agreed time line.
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2.1.6.14.2 Terms of Reference
The MRB is established to perform the following functions:
IN OL •
•
Continually improve flydubai SMS
Ensure adequate resources are allocated to achieve and enhance
safety performance beyond that required by the regulatory authority
• Monitor effectiveness of the SMS processes, which support the declared
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corporate priority of safety management as a core business process
• Assess the effectiveness and efficiency of risk mitigation strategies
• Monitor effectiveness of safety supervision for flydubai’ s subcontracted
operations
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• Monitor operational safety performance against company’s safety policy

and objectives
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• Review SPI/SPT and the Hazard Register, with emphasis on hazards

that have not been mitigated to an Acceptable Level of Safety
Performance (ALOSP)
• Give strategic direction to the SAG
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• Identify cause(s) of any substandard performance of the SMS

• Determine implications (if any) of substandard performance of the SMS
• Monitor necessary corrective actions are taken in timely manner
The complete terms of reference is documented within the flydubai

Management Systems Manual.
2.1.6.15 Safety Action Group (SAG)

CAR Part X GM2 to 2.1.3.1
The Safety Action Group (SAG) will be chaired by the VP Quality & Safety, or
his nominated deputy, and is comprised of operational personnel, including
relevant line managers, safety officers and other nominated individuals whose
position has a direct bearing on, or is directly affected by, safety issues.

The group will meet quarterly, or more regularly if dictated by safety

considerations, to support the operation; assessing risks faced by the
Company and suggesting methods of mitigating those risks. They will also
support the systematic review of safety-related standards and procedures
within the Company. The SAG report to, and take strategic directions from the
MRB.
The working of the group will be facilitated, but not directed, by the VP Quality
& Safety and will be used to provide experienced advice on all major aviation
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safety issues.
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As required departmental SAGs i.e. ESAG, GSAG, FRMSAG, CSAG may be
held.
2.1.6.15.1 Accountability
2.1.6.15.2
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The SAG is accountable to the MRB.
Meetings
Meetings will be minuted to record attendees, apologies, items of discussions,
conclusions, recommendations, decisions and actions. The minutes of the
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meeting shall include an owner for every action and an agreed time line.
Records of meeting minutes will be retained with the Safety Department for a
period of 5 years.
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2.1.6.15.3 Membership
The SAG will be chaired by the VP Quality & Safety and the membership will
be drawn from operational managers, safety officers and other personnel
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whose role within the Company has a direct impact on safety, and will include
the following:
• VP Quality & Safety (Chairman).

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• All HODs/Deputies.
2.1.6.15.4 Safety Action Group Terms of Reference

The SAG is established to perform the following functions:
a. Oversee operational safety performance within the functional areas of

the organisation;
b. Coordinate the resolution of mitigation strategies for the identified
consequences of hazards and ensures that satisfactory arrangements
exist for safety data capture and employee feedback;
c. Assess the safety impact related to the introduction of operational
changes or new technologies;
d. Coordinate the implementation of corrective action plans and ensures
that corrective action is taken in a timely manner;

e. Oversee safety promotion activities as necessary to increase

awareness of safety issues among relevant employees, to ensure that
employees are provided appropriate opportunities to participate in
safety management activities.
f. To oversee ‘operational’ safety within the Company.
g. Conduct hazard identification and risk assessments as appropriate
with such involvement of staff as may be necessary to increase safety
awareness.
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h. Conduct hazard identification and risk assessments on all new or
revised aspects of the operation under the Management of Change
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scheme.
i. To recommend means of mitigating perceived risks to an acceptable
level ensuring that remedial action is taken within a set time scale.
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investigations into incidents reported under the flight safety reporting
system and ensure that any actions or recommendations resulting
from such investigations are implemented within a set time scale.
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k. Review the effectiveness of previous safety actions and safety
promotion where applicable.
l. Ensure that shortfalls in human performance which are found to have
contributed to safety events are dealt with in a manner which
preserves the positive safety culture and encourages personnel to
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contribute towards safety.

m. Conduct regular safety reviews to ensure the effectiveness of the
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Safety Policy.
n. Disseminate safety information throughout the Company to increase
an awareness among relevant employees, convening meetings or
briefings as necessary to ensure that opportunities are available for all
employees to participate fully in safety management.
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o. Ensure that suitable safety performance indicators are developed and

regularly reviewed.
2.1.6.16 Post Holders Meeting

The meeting is conducted weekly, chaired by the Chief Operating Officer
(COO) and attended by post holders (or their delegates). For terms of
reference, please refer to the MSM Section 5.
2.1.7 Coordination of ERP

2.1.7.1 Emergency Response and Crisis Management
The corporate emergency response is designed, controlled and managed by
the Emergency Response Team in the Safety Department. The Manager –
Emergency Response reports directly to the VP Quality & Safety. For complete
details, cross refer to the Emergency Response Plan Manual.

2.1.8 SMS Documentation

ORG 2.2.1, 2.2.2, CAR-OPS 1.037 (e), CAR Part X 2.1.5
2.1.8.1 Control of Documents

It is essential for the efficient operation, overview and development of the SMS,
that records are maintained of all measures taken to fulfil the functions of the
system. Such records are required as evidence of the on-going SMS
processes, including hazard identification, risk mitigation and safety
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performance monitoring. Maintenance of SMS documentation is the
responsibility of the Senior Manager Safety, and the records will be kept in
electronic or paper form in the Safety Library.
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The records are retained for a period of at least 5 years. FDM records will be
retained in an easily accessible form for one year before being archived onto
the Company server.
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The following is a list of documents and records that will be kept in the flydubai
Safety Library:
• Safety Management System Manual.

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• Emergency Response Plan Manual.

• Hazard and Risk Register.
• ASRs, CSRs, ESRs, GSRs, Confidential Reports and Hazards Reports.
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• Incident/accident investigation reports.

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• FDM event reports.

• Safety/SMS internal review/assessments reports.
• Reports on SMS/FDM trend analysis.
• Minutes of safety committee meetings.
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• Hazard and risk analysis reports.

• Safety Performance Measurement Records.
• Record of completed/in progress safety assessments.
• Safety promotion records.
• SMS Implementation plan.
2.1.8.2 Retention of Records

All Records are Electronic and are saved on EFOS Server, Aerobytes Local
with back up by FZ IT and US (Avionica) Servers and Safety Drive with a
remote back up by FZ IT.
All Records will be retained for a minimum of 5 years.

2.2 SAFETY RISK MANAGEMENT

2.2.1 Accident and Incident Investigation
ORG 3.3.10
2.2.1.1 Scope of Internal Safety Investigations

The scope of internal safety investigations should extend beyond the scope of
occurrences required to be reported to the competent authority.
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Investigations consist of collecting and analyzing events, determining causal
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and contributing factors, drawing up conclusions, and making safety
recommendations as applicable.
Investigations are carried out in the case of:
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•
Accidents and incidents,
Discovery of new hazards and risks,
• Recurrent safety risks.
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Moreover, the Senior Manager Safety may at any time decide to launch an
investigation procedure on an opportune basis. The safety management value
of the investigation is proportional to the quality of the investigative effort.
Without a structured investigation methodology, it is difficult to collect, integrate
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and analyze all pertinent information, assess risks and produce impartial
output that would help improve safety. As safety investigations are often
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carried out by a single person, the Safety Manager, the flydubai ensures that
investigators possess the necessary skills, experience, and support to carry
out their duties. The investigation reports should be communicated
company-wide and distributed to other parties that are likely to benefit from the
findings. Appropriate de-identification measures shall be applied. Safety
recommendations and suggested corrective actions shall be recorded in a
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database, and their implementation and effectiveness monitored.
Reports of incident investigations will be retained in the Safety Library.
The detailed internal safety investigations procedure/guideline is stipulated in

SDP-02 Safety Investigation Report Procedure.
2.2.1.2 Just Culture

The safety of our customers, employees and the community is of highest
priority at all times.
As a part of this fundamental aim, flydubai will promote just culture within the
company and will encourage all flydubai staff to report all errors, deficiencies
and incidents. Such reports will be investigated, reported on and lead to
improvements within the organization and its Management Systems.

All such investigations and subsequent recommendations will apply the

principles of human factors where appropriate. In this way, the management
systems will be continually assessed for effectiveness and, based on the
assessment process, changes will be made to further enhance the system.
flydubai Management will ensure that all staff and service providers are made
aware of flydubai’s non-punitive based reporting scheme. In essence, this
means that any person(s) who may have any concerns especially in regard to
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safety or quality issues can come forward in confidence and with peace of mind
and report their concern(s) without fear of reprisal. The company does however
reserve the right to take any necessary action where any reports suggest or
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confirm wilful acts of negligence.
Just Culture Process Model

The framework for a just culture ensures a balanced accountability for both
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individuals and the organization. The just culture process model is shown
below:
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It is the responsibility of the Safety Department to supply an Investigation

Report that reflects factual, neutral and independent analysis of a given event.
On completion of the Safety Department Investigation, and for further internal
assessment, the concerned line manager is responsible for reviewing the
investigation results and ensuring that the above Just Culture Process Model
is applied to identify negligence or misconduct.
For each questioned asked, a substantiated answer shall be supplied, e.g.
Q. Was the job understood?

A. Yes, the job was X, and X was performed OR No, the job was X and Y was
performed.
Where an answer has an *, the manager must evaluate if a system failure

occurred and provide corrective and preventative action.
Internal assessment completed by line managers must be recorded and

retained in accordance with their departmental policy. These records will be
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assessed as part of the Safety Assurance process.
2.2.1.3 Notification of Accidents and Serious Incidents
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CAR-OPS 1.420 (c) 1,2,3
The procedure to be followed for the notification and subsequent handling of

accidents and serious incidents will be followed as documented in CAR Part VI
2.2.1.4
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Chapter 3 and Air Accident and Incident Investigation Regulation, AAIIR.
Definitions
An aircraft accident is defined as an occurrence associated with the operation
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of an aircraft, which takes place between the time any person boards the
aircraft with the intention of flight and the time all such persons have
disembarked, in which:
a. A person is fatally or seriously injured as a result of:

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i. Being in the aircraft; or

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ii. Direct contact with any part of the aircraft, including parts
which have become detached from the aircraft; or
iii. Direct exposure to jet blast; except
iv. When the injuries are from natural causes, self-inflicted or
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inflicted by other persons, or when the injuries are to

stowaways hiding outside the areas normally available to the
passengers and crew; or
b. The aircraft sustains damage or structural failure which:
i. Adversely affects the structural strength, performance or flight
characteristics of the aircraft; and
ii. Would normally require major repair or replacement of the
affected component; except
iii. Engine failure or damage, when the damage is limited to the
engine, its cowlings or accessories; or for the damage limited
to propellers, wing tips, antennas, tyres, brakes, fairings, small
dents or puncture holes in the aircraft skin; or
iv. The aircraft is missing or is completely inaccessible.

A serious incident is defined, for the purposes of aviation reporting, as an

incident involving circumstances indicating that an accident nearly occurred.
2.2.1.5 Reportable Occurrences

CAR-OPS 1.420 (d)
The objective of occurrence reporting is to monitor, disseminate and record for

analysis, critical or potentially critical safety occurrences.
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flydubai is required to report aircraft accidents, and any of the instances listed
in AMC-22.
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2.2.1.6 Company Procedures Following an Accident or Serious Incident
2.2.1.7 Reporting by the Operator to the Aircraft Manufacturer
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CAR-OPS 1.420
Under the terms of CAR OPS 1.420, CAR M.202 and CAR 145.60 if an incident
is reported that endangered or could have endangered the safety of the
operation and arose from or related to any failure, malfunction or defect in the
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aircraft, or its equipment then the incident must additionally be reported to the
manufacturer. The SVP Engineering and Maintenance has visibility of ESRs,
and will ensure that any such incidents are reported to the Boeing
representative for the necessary manufacturer’s investigation and action at the
same time as a report is submitted to the Authority.
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2.2.1.8 Maintenance Organisations

Maintenance organisations contracted to flydubai should have their own
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procedures for occurrence reporting, as required by CAR 145. These

procedures are audited and checked for conformity by the Quality Department
as part of the routine audit schedule.
2.2.1.9 Reporting by the Contracted Maintenance Organisation

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flydubai currently contracts out its aircraft Base maintenance to a Maintenance

Repair Organization (MRO) authorised under the terms of CAR 145. The MRO
is required to report to flydubai Authority, the state of registry and the
organisation responsible for the design of the aircraft or component any
condition of the aircraft or component identified by the organisation, that has
resulted or may result in an unsafe condition that represents a serious hazard
to flight safety.
In order to facilitate such reporting, CAR 145 requires these organisations to

establish an internal occurrence reporting system to enable the collection and
evaluation of the reports, including the assessment and extraction of those
occurrences to be reported above. This procedure shall identify adverse
trends, and describe corrective actions taken or to be taken by the organisation
to address deficiencies, including an evaluation of all known relevant
information relating to such occurrences and a method to circulate the
information as necessary.

The contracted MRO must also report to flydubai any such condition affecting
the aircraft or components.
The MRO shall submit such reports as soon as practicable within 72 hours of
the identification the condition to which the report relates.
Reports received shall be investigated by the Safety Department, and results

shared with the Engineering and Maintenance Department and Quality
Assurance Department.
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2.2.2 FDM Process
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2.2.2.1 Data Collection
2.2.2.1.1 Flight Data Monitoring Programme
ORG 3.3.13, 3.7.1, CAR-OPS 1.037 (c)
IN OLFor aeroplanes of a maximum certificated take-off mass in excess of 27000 kg

a flight data analysis programme is established and maintained
(FDM Programme).
The FDM programme allows a detailed analysis of events, occurrences and

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exceedances to be made using data captured directly from the aircraft
systems. This data is regularly downloaded and analysed. Significant events
and exceedances are highlighted as FDM events, and placed into colour coded
categories, depending on the seriousness of the event. The events are coded
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green, yellow and red, with green events being the least serious. Parameters
to determine the seriousness of an event are set by the system designers,
Aerobytes, or by personnel in the Safety Department. These settings will be
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reviewed annually, by the Safety Department, to ensure they reflect the current
aircraft limitations and Company SOPs. A comprehensive list of event
parameters is to be retained in the Safety Department.
Information gathered from the FDM system, relating to specific flights, will
normally be dealt with confidentially. Contact with the crew will normally be
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made by the Senior Manager Safety or his nominated deputy. Only where a
serious exceedance or incidence of gross flying indiscipline has been detected
by the FDM system will identifiable data be made available to senior
management in the training or flight operations departments. Significant issues
will be subject to management review at regular Safety Meetings, MRB, SAG
and PH Meeting as appropriate.

2.2.2.1.2 Flight Data Monitoring Process

Data from flights is recorded in the aircraft on PCMIA cards. These cards are
changed regularly by engineering personnel. Future plans allow for automatic
download into the server via wireless systems directly from the aircraft. Some
aircraft are already fitted with wireless systems.
Occasionally data is missing from the cards or corrupted and not available for
analysis. In this event the nominated Safety Specialist will attempt to discover
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the reason for the missing data, and if is thought to contain information relating
to a significant safety issue, will attempt to recover it by other means. If data is
regularly missing from the cards, he will investigate the reason to ensure the
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failure is not due to a procedural weakness.
The Senior Manager Safety will:
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•
•
Monitor the performance of the FDM system, and ensure that it is
maintained with the most up to date software available from Aerobytes.
Monitor the performance of the system to ensure downloaded data is
available for analysis in a timely manner, usually within three days of a
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flight taking place.
• Ensure the Safety Specialist acting as data analyst is accessing the data
regularly.
• Ensure that the necessary action is taken when an event or occurrence
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is captured by the FDM system and regular reports on detected trends

are produced.
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• Debrief the crews involved in serious breaches of flying discipline to

ensure they are aware of the circumstances of the event and make
recommendations to prevent a recurrence.
2.2.2.1.3 Flight Data Monitoring Data Analysis

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ORG 3.3.1, 3.3.3, CAR-OPS 1.037 (d), CAR Part X GM to AMC1 to 2.2.1,
GM to 2.3.3
Analysis of the FDM data will be undertaken by the Safety Specialist acting as
Data Analyst.
The FDM Data Analyst will:
• Download data from the data cards onto the FDM computer as soon as
possible after their delivery to the Safety Department and ensure that the
wireless system is functioning correctly.
• Verify integrity and validate or invalidate the downloaded Data before
carrying out a flight analysis.
• Regularly check the FDM system for detected events and exceedances.

• Identify and quantify operational risk by highlighting when non-standard,

unusual or unsafe circumstances occur.
• Report any events and exceedances which require crew de-briefing to

the Senior Manager Safety.
• Compile a report on any trends detected by the FDM system for

discussion and assessment by the SAG.
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• Publish a regular FDM newsletter detailing recent trends and regular
events highlighted by the FDM system, together with other FDM
information important and relevant to the operation.
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• Prepare any reports requested by the SAG or authorised senior
management personnel to support flight safety related investigations.
• Advise the engineering department of any exceedances which require

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engineering investigation or rectification.
Ensure that an ASR or ROSI is submitted for those events which require
one.
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• Annually confirm that the parameters set in the FDM system and used
to detect exceedances, conform to the latest aircraft and Company
limitations.
• Significant issues arising from Flight Data Analysis will be subject to
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management review at regular Safety Meetings, MRB, SAG and PH

Meeting as appropriate. Based on discussion and stakeholder
agreement, action items and corresponding timeline with ownership will
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be established in the meeting minutes.
2.2.2.1.4 Flight Data Monitoring Procedures

When an event has been detected and registered on the FDM system, the
following actions will be taken:
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• Events accorded a green or yellow grading by the system will be

investigated by the FDM Data Analyst, and any necessary follow up
action taken.
• The Analyst will ensure that, where required, an ASR is submitted as a

result of an FDM event.
• If the events are accorded a red grading, indicating a serious breach of

procedure or exceedance of limitations, the analyst will advise the
Senior Manager Safety as soon as possible, of the circumstances.
• Records of all events requiring action and the corrective action taken will
be maintained by the Data Analyst and retained in the Safety
Department. Please refer to SDP-07 Flight Data Monitoring (FDM)
Process for detailed information.

2.2.3 Operational Risk Assessment and Management

2.2.3.1 Hazard Identification and Risk Management
ORG 3.1.1, FLT 1.12.1, 1.12.1 (i), DSP 1.12.1, MNT 1.12.1, CAB 1.11.1,
GRH 1.11.1, CGO 1.11.1, CAR-OPS 1.037 (i), CAR Part X 2.2.1, AMC1 to
2.2.1, GM to 2.2.1
2.2.3.1.1 Introduction
flydubai’s hazard identification and risk assessment and mitigation program
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includes processes implemented and integrated throughout the organization
that ensure:
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a. Hazards are identified, analyzed to determine corresponding risks;
b. Operational risks are assessed to determine the requirement for risk
mitigation action(s);
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c. When required, risk mitigation actions are developed and implemented
in operations.
Hazard identification, analysis, and risk assessment are proactive and
reactive tools allowing systematic collection and examination of
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potentially hazardous activities. This process assists flydubai in
establishing effective procedures and practices for our operations.
Analysis of hazardous activities will allow for identification of areas of
relatively higher risk that require monitoring. Once identified, flydubai
can develop action and contingency plans to ensure comprehensive
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solutions to those risk issues.

d. A Master Hazard Register is kept in electronic format on Q-Pulse.
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The essence of a predictive and pro-active SMS is the systematic

management of the safety risks posed to an organisation certified to provide
aviation related services. The safety risks are normally realised by the
consequences of hazards in critical activities related to the provision of
services by the organisation. In this context a hazard can be defined as any
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situation or condition that has the potential to cause adverse consequences or

harm to an organisation. The risks associated with those hazards, or the
realisation of the potential to cause harm cannot always be totally eliminated,
and with the acceptance that a certain degree of risk is inevitable in any
aviation related activity, the aim of the risk management process is to reduce
those risks to a level as low as reasonably practicable (ALARP).
Therefore, risk management can be defined as the identification, analysis and

elimination (and/or mitigation to an acceptable or tolerable level) of those
hazards and subsequent risks that threaten the safety and viability of an
organisation.

Risk management, as part of a SMS, seeks to facilitate the balance between

assessed risks, and viable risk mitigation. It involves a logical process of
objective analysis and comprises three essential elements:
a. Hazard identification.
b. Risk assessment.
c. Risk mitigation.
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2.2.3.2 Hazard Identification
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CAR Part X 2.2.1, AMC1 to 2.2.1, GM to 2.2.1, FLT1.12.1 (ii)
Fundamental to the operation of a predictive SMS is the effective identification

of hazards which may pose a safety risk to the operation. In order for the risk
management process to function correctly, there have to be processes for
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capturing data relevant to the identification of hazards. In flydubai, Company
employees are encouraged to participate in this process by reporting failures
in the safety processes which they observe in their day to day activities.
Data source of hazard identification may be both internal and external to the
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Company.
Internal data source for hazard identification includes:

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• Internal Reporting System, including confidential reporting.

• Flight Data Analysis.
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• Internal Audits.
• Safety surveys
• Feedback from training.
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• Investigation of accident/incident, irregularities and other non-normal

events.
• Normal operations monitoring.
• Management of change.
The internal safety reporting system contains the following elements:
• The collection and evaluation of errors, near misses, and hazards

reported internally.
• Corrective and preventative actions are taken internally to address any
safety issues and hazards.
• Feedback to the Company’s safety training, whilst retaining
confidentiality.

• Provision of feedback to the reporter to ensure his support to the

occurrence reporting system and disseminate the results to other
relevant parties as required.
• A non-punitive approach which encourages safety reporting.
• An investigation process to identify and address contributing factors,
adverse trends, establish root causes and identification of those reports
which requires further investigation.
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flydubai safety reporting system is described with the greater detail in 2.2.4.1.
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External data sources for hazard identification includes, but not limited to:
• GCAA mandatory incident reporting system (ROSI).

• GCAA audits.
•
•
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Information exchange system, safety information gathering.
Industry accident/incident reports.
• EASA publications.
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• ICAO publications.
• IATA publications.
• Industry safety related meetings, workshops, action groups etc.
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Once the data is captured:
• Details are recorded within the hazard register, managed by the

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respective Area Owners and oversight is maintained by the Safety

Department
• Identified hazards are evaluated, prioritized and processed for risk
assessment as assessed by the SAG
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• Sub groups, led by an appropriate manager of the SAG, will be formed

to progress the hazard through risk management process of severity,
likelihood, tolerability and preventive controls
The process of hazard identification will also be undertaken whenever there is

a significant change to the organisation, its staff, procedures or equipment in
the form of change management. The process of the management of change
is dealt with in greater detail in 2.3.2.
A register of hazards will be kept by the Safety Department in Q-Pulse.

2.2.3.3 Proactive Data Capture

ORG 3.1.1, FLT 1.12.3 (ii)
The proactive method of hazard identification actively searches for potential

safety risks through the analysis of flydubai’s activities prior to an occurrence.
The method seeks to actively identify safety risks through the analysis of the
Company’s activities.
flydubai uses the mandatory and voluntary safety reporting systems for use in
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the proactive hazard identification process. Other valuable sources of
information used in the process include information gathered from Safety
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Assessments and surveys.
The analysis of data from the FDM system is also a valuable source of
proactive information, and this is fed into the risk management system by the
FDM data analyst.
2.2.3.4
IN OLPredictive Data Capture
ORG 3.1.1
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The predictive method of hazard identification continuously analyses current
and historical information to forecast potential future occurrences. Predictive
methods are based on the concept that effective safety management is best
accomplished by seeking system failures rather than waiting for them to
develop into a serious incident or accident. Unlike other methods, predictive
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systems do not require a triggering event or failure, but aggressively seek

safety information that may be indicative of a forthcoming failure in the system.
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2.2.3.4.1 Safety Trend Analysis

A predictive SMS relies upon the ability to foresee areas where the safety
barriers are eroded causing a reduction in the required safety standards, and
rebuilds those barriers before the unsafe practices escalate into a safety
incident or accident. The analysis of the information gathered through the
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various sources of safety reporting and hazard identification into meaningful

conclusions, provides a valuable source of information for use in the predictive
system. Analysis is the process of organising facts using specific methods,
tools or techniques and it can be used to:
• Assist in deciding what additional facts are needed;

• Ascertain factors underlying safety deficiencies; and
• Assist in reaching valid conclusions.
A primary function of the Company’s flight safety analysis program is to provide

for the identification of hazards and the analysis of information and data
associated with aircraft operations, to include:
a. Implementation of systematic processes for identifying and analyzing

hazards and potentially hazardous conditions;

b. Production of relevant analytical information and data for use by

operational managers in the prevention of accidents and incidents.
Note: Significant issues arising from the flight safety analysis
program are subject to management review by the MRB and
will be addressed in its regularly scheduled meetings or ad hoc
meetings if timing of response is a critical consideration.
Once the information has been gathered and stored in databases, either within
D D
the Aerobytes FDM system or the EFOS system for safety report management,
that information is assessed and analysed to determine unsafe trends which
require preventative or corrective safety actions.
TE LE
If the systems indicate an increase in a particular activity, or an increasing
number of similar events, processes are started which are aimed at capturing
all similar events within a set timescale. The computer based systems can be
IN OL
directed to capture raw data on events, or to carry out a more sophisticated
process of comparing a number of parameters to detect commonality between
events. Reports created by these systems are in the form of statistical charts
or pictorial representations as graphs. Additionally, safety events are recorded
in a manual database which can be interpreted by members of the Safety
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Department to detect unsafe trends in the operation. The analysis of safety
trends is often iterative and could require a number of cycles to confirm the
presence of unsafe trends. During the process consideration must be given to
all relevant information with the caveat that not all safety information is reliable.
As time constraints may not always allow for the collection of sufficient data to
IF N
allow objectivity, intuitive conclusions may sometimes be reached which are

not consistent with the objectivity required for credible safety analysis.
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The EFOS system, which is used for flight safety reporting, will be used to
categorise flight safety incidents. It is the responsibility of the Safety Specialist
to ensure that the list of event descriptors in EFOS is comprehensive and
relevant to the operation. In addition, a hazard register, detailing specific
hazards which pose a risk to our operation, together with the means employed
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to mitigate those risks, will be maintained by the Safety Department.
By monitoring trends in safety data, predictions may be made about future

events. Emerging trends may be indicative of embryonic hazards. Trend
analysis can be used to trigger “alarms” when performance is about to depart
from acceptable limits.
When an unsafe trend has been identified and confirmed within the Safety
Department, the SAG will be the body responsible for managing the trend and
recommending measures to reverse the breakdown in safety processes. Given
the diverse nature of hazards, and the different perspectives possible in
evaluating any particular unsafe condition, the views of a number of
individuals, including peers and specialists will be sought during the evaluation
process within the SAG. A multidisciplinary team formed to evaluate evidence
of an unsafe condition can also assist in identifying and evaluating the best
course for corrective action.

As part of the normal safety management process, the measures taken to

reverse an unsafe trend will be reviewed after a set time to confirm its
effectiveness. If an event recurs after preventative measures have been
instigated, an appraisal will be conducted by the Safety Department and, if
required, by the SAG, to determine whether these measures are being fully
implemented or whether further corrective action is necessary.
Reports on the hazards detected by this process will be delivered to the MRB
and the SAG during the regular meetings of these groups. Additionally, these
D D
reports will be promulgated on the safety site on the EFOS system. Serious
trends which could have a more immediate detrimental effect on the airline’s
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operation will be notified to staff by other means such as safety or flight crew
notices.
The Trend Report will be released on EFOS quarterly.
2.2.3.5IN OL
Reporting by Outstations and Contracted Agencies
ORG 1.6.6
Hazards detected at outstations and/or contracted agencies used by flydubai

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will be reported to the Safety Department using the normal reporting methods,
i.e. by EFOS Safety Reporting System, EFOS Reports and/or Gateway Hazard
Reporting. In case no EFOS or Gateway Access is available, emailing to
safety@flydubai.com, by Short Message Service or contact by telephone is
acceptable. Where further clarification of the hazard is required to assist in the
IF N
identification and mitigation process, a report will be requested from the

flydubai representative at the concerned outstation. The report will normally be
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requested by the Safety Department through the appropriate manager in the

flydubai Airport Services department.
A pre-appointment assessment process of potential contracted agencies SMS

should normally be carried out. In the case of those agencies involved in the
supply of aircraft engineering or technical services, the scope of the
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assessment will cover the safety systems they have in place and the hazard
reporting systems which are incorporated in their safety systems.
2.2.3.6 Risk Assessment

ORG 3.1.2, FLT 1.12.2, DSP 1.12.2, MNT 1.12.2, CAB 1.11.2, GRH 1.11.2,
CGO 1.11.2, CAR Part X 2.2.2
flydubai’s safety risk assessment and mitigation program specifies processes

to ensure:
a. Hazards are analyzed to determine the corresponding safety risks to

aircraft operations;
b. Safety risks are assessed to determine the requirement for risk
mitigation action(s);

c. When required, risk mitigation actions are developed and implemented

in flight, dispatch, maintenance, cabin, ground handling, and cargo
operations;
d. For internal changes, ensure that safety risk is considered before

changes are implemented;
e. For external changes, evaluate the adequacy of existing risk controls

when such changes will affect the operational environment.
D D
Once a hazard has been identified these safety risks and their potential
consequences must be assessed. Safety risk assessment is the analysis of the
TE LE
safety risks of the consequences of the hazards that have been identified as
threatening the capabilities of the organisation.
Safety risk analysis uses a conventional breakdown of risk into two

IN OL
components – the probability of the occurrence of a damaging event or
condition and the severity of the event or condition, should it occur. Safety risk
decision making and acceptance is specified through use of a risk tolerability
matrix.
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After safety risks have been assessed, elimination or mitigation to ALARP must
take place. This process is known as safety risk mitigation. During this process,
safety risk controls are designed and implemented. These controls may
include additional or changed procedures, new supervisory controls, changes
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to training, additional or modified equipment or any of a number of other

elimination or mitigation alternatives.
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After the safety risk controls have been designed, but normally before they are
put into practice, an assessment must be made of whether the controls
introduce new hazards to the system.
2.2.3.7 Process for Risk Assessment

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CAR Part X AMC to 2.2.2, GM to 2.2.2
A sub-group formed within the SAG will normally conduct the risk assessment
and mitigation process under the direction of the appropriate SAG member.
The sub-group will record the process on the form FD-SMS-001, and the
results will be presented to the SAG on completion. The completed form will be
retained in the Safety Department for future reference if required.
Risk assessment is assumed to be primarily a subjective, qualitative method of

evaluation of the likelihood and severity of damage inherent in the identified
hazard.
Those undertaking the risk assessments will prioritise the severity of the risks
using the risk assessment matrix. They will identify those risks posing the
greatest threat and thus most warranting attention, to allow those tasked with

mitigating the risk to most effectively use the resources available to them. Risk
mitigation measures for serious hazards will be presented to the MRB by the
Senior Manager Safety for their information and approval
A diagram describing the risk assessment process is at Figure 2.
In assessing the risk the SAG will first identify the problem that exists. Whilst
this will not be an easy task, people from different backgrounds and experience
D D
may well perceive the same evidence from different perspectives, it is essential
to define the characteristics of a hazard into a problem for resolution. In
assessing the risks, all potentially valid perspectives must be considered, but
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only the most suitable should be pursued.
2.2.3.8 Probability of Adverse Consequences

Once the risk has been identified, the ability of that risk to cause harm or
IN OL
damage must be assessed.
The following is a list of some of the questions that should be addressed when
carrying out this assessment:
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a. Is there a history of similar occurrences, or is this an isolated case?
b. Is the risk the result of deficiencies in training or supervision?

IF N
c. How many operating personnel are following or are subject to the

procedures in question?
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d. What percentage of the time is the suspect equipment or procedure in

use?
e. To what extent are there organisational, managerial or regulatory

failures or deficiencies that might pose a greater threat to the
organisation?
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Based on these considerations, the likelihood of an event occurring can be

assessed. For example:
• Unlikely to occur. These will include isolated occurrences and risks,

where the exposure rate is low. It should be considered, however, that
even if the possibility of, for instance, concurrent failures, is remote, the
consequences may warrant follow-up action.
• May occur. These events derive from hazards with a reasonable

probability that similar patterns of human performance can be expected
under similar working conditions, or that the same material defects exist
elsewhere in the system.
• Probably will occur. Such occurrences reflect a pattern, or potential

pattern, of material failures that have not yet been rectified.

2.2.3.9 Severity of the Consequences

Having determined the probability of an occurrence, the SAG must next assess
the nature of the adverse consequences if the event does occur. The potential
consequences will determine the degree of urgency attached to the mitigating
action required. In assessing the severity of the consequences, the following
types of question should be considered:
a. How many lives are potentially at risk? This could include employees,
passengers and the general public.
D D
b. What is the likely extent of property or financial damage?
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c. What is the likelihood of environmental damage?
d. What are the likely political implications or media interest.
2.2.3.10 Risk Acceptability

IN OL
Based on the risk assessment, risks can be prioritised relative to other,
unresolved, safety hazards. This is critical in making a rational decision to
allocate limited resources to those hazards posing the greatest risk to an
organisation.
PR TR
Prioritising risks requires a rational basis for ranking one risk against another.
Criteria or standards are required to define which risks are acceptable and
which are unacceptable. By weighing the likelihood of an undesirable outcome
against the potential severity of that outcome, the risk can be categorised
within a risk assessment matrix.
IF N
The risk values to be assigned when assessing risks are shown in the tables
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below which can be applied to the matrix to categorize the risk as acceptable,
review or unacceptable.
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Figure 2 The Risk Assessment Process
Identify the Hazards to Equipment, Property, Personnel or the Organisation Hazard

Identification
Evaluate the seriousness of the consequences of the Hazard occurring. Risk Assessment
Severity
D D
What is the possibility of it happening? Risk Assessment
Probability
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Is the consequent risk(s) acceptable and within the organisation’s safety performance Risk Assessment
criteria? Acceptability
IN OL YES NO
Mitigate as necessary to reduce risk to at

least Review level. The MRB to decide
Accept the risk(s) whether the residual risk is acceptable. The
AM to sign-off as required. The risk must be
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reviewed regularly and additional mitigation
to be taken when possible
Consequences – Qualitative Measures

Consequence is typically evaluated in terms of potential loss, harm or injury. In
IF N
terms of financial loss, both direct and indirect costs should be considered.
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Aviation Definition Meaning

Catastrophic Equipment destroyed. Multiple deaths. 3 or more deaths.
Hazardous A large reduction in safety margins, physical distress or a
workload such that organisations cannot be relied upon to perform
their tasks accurately or completely. Serious injury or death to a
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number of people. Major equipment damage. Up to 2 deaths or 3

or more serious injuries.
Major A significant reduction in safety margins, a reduction in the ability
of organisations to cope with adverse operating conditions as a
result of an increase in workload, or as a result of conditions
impairing their efficiency. Serious incident. Injury to persons.
Serious injury to up to 2 people.
Minor Nuisance. Operating limitations. Use of emergency procedures.
Minor incident.
Negligible Little consequence.

Likelihood – Qualitative Measures

Likelihood can be difficult to assess. Historical data should be reviewed during
the assessment process to avoid subjectivity. Also, when assessing the
likelihood of a potential; threat, it is important to take into account what safety
controls are in existence, and therefore how many levels of protection would
need to fail for the threat to materialise. The more safety controls in place, the
lower the probability of an accident.
D D
Qualitative Definition Meaning
Frequent Likely to occur many times (has occurred frequently).
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Occasional Likely to occur sometimes (has occurred infrequently).
Remote Unlikely, but may possibly occur (has occurred rarely).
Improbable Very unlikely to occur (not known to have occurred).
Extremely improbable Almost inconceivable that the event will occur.
IN OL
Qualitative Risk Analysis Matrix
A qualitative risk analysis matrix should be used proactively during hazard
assessment and re-actively to assess failures in a system highlighted through
incident reporting mechanisms.
PR TR
Table 1 Tolerability Matrix

Tolerability Matrix and Risk Rating Scores
Extremely
Probability Improbable Remote Occasional Frequent
Improbable
IF N
Severity 1 2 3 4 5
Catastrophic 5 Review (5) Review (10) Unacceptable (15) Unacceptable (20) Unacceptable (25)
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Hazardous 4 Acceptable (4) Review (8) Unacceptable (12) Unacceptable (16) Unacceptable (20)
Major 3 Acceptable (3) Review (6) Review (9) Unacceptable (12) Unacceptable (15)
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Minor 2 Acceptable (2) Acceptable (4) Review (6) Review (8) Review (10)
Negligible 1 Acceptable (1) Acceptable (2) Acceptable (3) Acceptable (4) Review (5)
2.2.3.11 Tolerability and Response

The tolerability and response to the risk assessment will always vary. The
variation will be from the way in which the risk is dealt with to no action being
required. The result of this is to eliminate, as far as practical, the likelihood of
the risk event occurring.

Tolerability Descriptors
Definition Meaning
Acceptable The consequence is so unlikely or not severe enough to be of
concern, the risk is acceptable. The Risk Assessment may be signed
off by the Appropriate Line Manager.
Review The consequence and/or probability is of concern, mitigation to as
low as reasonably practicable (ALARP) is necessary. If still in the
review category after mitigation, the risk may be accepted, provided
D D
that the risk is understood and signed off by the Responsible Line
Manager/Post Holder (P/H).
Note: A Post-mitigation Risk Rating Score of 8 and above must be
TE LE
signed off by the Accountable Manager (AM).
Unacceptable The probability and/or severity of the consequence are intolerable.
Cancel/suspend the operation.
IN OL
As a guideline the following actions should be undertaken to manage a risk
assessment:
a. Identify the possible hazards,

b. Complete a risk assessment,
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c. Assess the tolerability; and
d. Manage and Reduce/Avoid the Risk (see Figure 3).
2.2.3.12 Management Response and Risk Reduction

IF N
Safety risk management approaches include:

CO
Avoidance
Consideration should be given to avoiding the activity completely when the
associated safety risks are intolerable or deemed unacceptable in comparison
to the associated benefits.
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Reduction
When risk reduction is required, essential or desirable (in all cases other than
an acceptable risk above), the risk assessment team will identify, taking advice
where necessary, how this may be achieved. Reducing the severity and/or the
probability of recurrence can reduce the level of risk. Solutions can range from
retraining to a memo to crew. These specific actions are called safety
requirements and they provide evidence that the proposed change is safe
enough to be adopted.
The aim of risk reduction is to achieve an acceptable risk as the desirable

result, but a risk considered for review may be tolerable for a short time.

An unacceptable risk will always require action to be taken to reduce it to at

least a review level. A risk requiring review will also require action to mitigate,
but it will be allotted a lower priority than an unacceptable risk. The risk should
be reduced within a set timescale. Tolerable risks may be accepted, but
measures should still be sought to reduce the risk further.
An acceptable risk will not require immediate measures to mitigate, but it

should be kept under review to ensure the risk does not escalate to a higher
D D
category.
In order to reduce the level of risk, risk mitigation actions must be produced.
TE LE
The risk mitigation actions must address the following:
a. Dependent on the level of the associated risk, risk mitigation actions

may be signed off by the Postholder and/or Accountable Manager.
b.
IN OL
The process owner will remain responsible for implementing the risk
mitigation actions. Risk mitigation measures must be reviewed for:
• Effectiveness
PR TR
• Cost/benefit
• Practicality
• Acceptability
IF N
• Enforceability
CO
• Durability
• Residual safety risk
• Unintended consequences
UN
c. Risk mitigation actions will be implemented in accordance with the

approved mitigation action plan.
d. Risk mitigation actions should be completed by the target date as

defined in the approved mitigation action plan.
e. The process owner will evaluate the outcome of the mitigation action
plan and collect required data ensuring that all possibilities for
unintended consequences have been addressed.
f. Risk mitigation actions will be monitored by reviewing the status of the

risk assessment during the quarterly SAG meeting.
g. Status of risk mitigation actions will be reviewed and reported to

Postholder and/or Accountable Manager as required dependent on
risk tolerability. A risk mitigation review may be carried out using Form
FD-SMS-28 as required.

Figure 3 The Safety Risk Management Process
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TE LE
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IN OL ŽĨĨƚŚĞZŝƐŬ͘^ƚĂƌƚͬŽŶƚŝŶƵĞƚŚĞ
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PR TR
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IF N
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2.2.3.13 Target Dates

Dependant on the risk assessment of individual hazards the Target Date for
remedial Action will be based on the level of risk assessed:
• Where the risk is high, then the remedial action will be planned to take
place as soon as practicable and in accordance with the requirements
of the Accountable Manager.
• Where the risk is medium, then remedial action will be required and will
be given a target date that is practical, achievable and acceptable to the
D D
Postholder.
• Where the risk is low no remedial action will be required.
TE LE
2.2.3.14 Risk Assessment Review Process
On receiving notification of approaching review from q-pulse the Safety
Manager overseeing the concerned area will review SDCPS data available
concerning the hazard/risk due for review. They will then connect with the risk
owner to determine if the risk mitigations that have been put in place are still
IN OL
relevant and are effective. The associated hazard will be reviewed for
mitigation as appropriate.
2.2.4 Safety Reporting System

PR TR
The flydubai mandatory occurrence reporting system includes ASRs, CSRs,
GSRs, and ESRs which are to be raised in the event of an occurrence or
incident which, if judged, could adversely affect safety.
For further guidance of these events, Safety has published guidance material
IF N
which is located on EFOS library under the “Safety” tab.
These reports are non-confidential but are dealt with in a controlled manner
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within the concerned departments.
Please refer to SDP-03 Safety Report Management Procedure for a detailed

explanation.
UN

Safety Report Management Flow Chart
Safety Report
Submitted
Acknowledge Safety
D D
Report
TE LE
Mandatory
Report?
Review Safety Report
Classify and Risk
Assess
Yes
IN OL No
Report to GCAA
No
Assessment/
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Investigation
Yes
IF N
Initiate/Assessment
Investigation
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Outcome Notify applicable

No domain for further
satisfactory?
review/action
UN
Yes
Feedback, /Monitor/
Review
Close and log for
statistics

2.2.4.1 Voluntary Safety Report

This report is to be used to highlight possible Safety Concerns that operational
personnel may have that do not fall under the above mandatory reporting
scheme, particularly Human Performance issues. The report can be submitted
as Non-Confidential or Confidential.
A Voluntary Safety Report can be used for, but not limited to the following:
• Identifying potential organizational/systematic induced hazards
D D
• Sharing experience/lessons learnt with the Safety Department for the
purpose of Safety promotion
TE LE
• Recommending any improvement to flydubai’s Safety Management
System (SMS) and correlated procedures/processes
• Any other matter which the reporter may have a believe that reporting it
IN OL
may lead to an improvement to flydubai’s safety standards/SMS.
Please refer to SDP-18 Voluntary Safety Report for a detailed explanation.
2.2.4.2 Hard Copy Voluntary Safety Reports

PR TR
A hard copy Voluntary Safety Report Form is also available to all employees
that do not have access to or do not wish to use EFOS. The forms are available
in a transparent box at AOC and on EFOS under the “Safety” tab. Completed
forms must be inserted into the pre-addressed envelopes and deposited at the
flydubai mail room (AOC/FZ Campus). The Hard Copy Voluntary Safety Report
IF N
will be forwarded to the VP Quality & Safety via the internal mail system.
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The VP Quality & Safety and/or the Senior Manager Safety will file the report
as an electronic Voluntary Safety Report whereby maintaining its
confidentiality status.
The VP Quality & Safety and/or the Senior Manager Safety will decide what, if
any, further action is required. This may include reporting to the regulator,
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advising applicable departments and investigating. These reports can also be

filed anonymously however it must be noted that feedback cannot be provided
to a person who files a report anonymously.
2.2.4.3 Gateway Hazard Report

The Hazard Report available on Gateway is used to cater for employees who
do not have access to EFOS and as an additional vehicle for Safety Reporting.
The Safety Department are notified via email when a Hazard Report is
submitted via Gateway. The Hazard Report is managed and controlled by the
HS & E Specialist.

2.2.4.4 GCAA Voluntary Occurrence Reporting System (AMC-57 – VORSY)

VORSY is a voluntary, non-punitive and confidential reporting system
established by the GCAA in line with ICAO ANNEX 19 & ICAO SMM Document
9859.
All flydubai Personnel are encouraged to utilize VORSY in order to voluntarily

report safety information that may be critical to identify potential hazards. It is
the intent of this program to resolve safety concerns through corrective actions
D D
rather than through punishment or enforcement.
There is no time limitation to submit a report. However, in the interest of safety,
TE LE
time critical information may be reported at the earliest opportunity.
The Voluntary Reporting website page to fill the report can be accessed
through the below address:
IN OL
http://www.gcaa.gov.ae/en/vorsy
2.2.4.5 Fatigue Reporting

CAR-OPS 1.037 (h)
PR TR
Fatigue events must be reported via the relevant area Safety Reports available
on EFOS. Fatigue reports are processed in the same manner as all other
Safety Reports. Hazards identified via Fatigue Reports will be managed by the
Fatigue Risk Management Safety Action Group as per the FRMSAG
IF N
Responsibilities documented in the FRMSAG Terms of Reference.

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2.2.5 Safety Management of Outsourced Service Providers

2.2.5.1 Safety Risk Management in Outsourced Service Providers
Refer to 2.1.5 for detailed responsibilities.
flydubai employs a number of outside agencies under contract to provide

UN
ancillary services in support of its operations. If the outsourced service provider

does not have an SMS in place flydubai will identify and define specific SMS
elements that must be implemented by the provider ensuring the management
of safety in operations. flydubai must also ensure the service providers
personnel are trained to perform duties appropriate to their involvement in the
defined SMS elements.
SMS Elements for implementation by a non SMS compliant Service Provider

should include but are not limited to:
• Hazard Identification.
• Operational Safety Reporting System.
• Accident/Incident Investigation program.
• Training to fulfil the above.

The outsourced services provider having a valid SMS in place will be

monitored to ensure the management of safety in operations conducted for
flydubai.
Unsafe operating practices and procedures conducted by agencies and

organisations under contract, or sub-standard products supplied by those
agencies, can have a dramatic commercial and operational effect on the
Company, particularly in terms of public perception and operating efficiency.
D D
It is important, therefore, that the safety standards required of contracted
organisations are at a level acceptable to flydubai and are clearly defined and
TE LE
understood before the finalisation of any contract.
Area owners are responsible for ensuring necessary safety standards are
considered during the process of appointing contractors to provide services to
IN OL
flydubai.
For contracted Services the following must be observed:
a. A written agreement should exist between flydubai and the contracted

PR TR
organisation clearly defining the safety related services and quality to
be provided.
b. The Contracting Department should ensure that the contracted
organisation has the necessary authorisation or approval if required,
IF N
the resources and competence to undertake the task.

c. Safety Events/concerns by the contracted entity must be
CO
communicated to the Safety Department via EFOS or any other means

available as soon as possible.
All purchasing policies and contracts will include controls to ensure the
maintenance of safety standards. All new products, equipment, materials and
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services will be reviewed by the appropriate department, and assessed as part

of the management of change process conducted by the SAG, to ensure the
safety requirements of flydubai are met and maintained. When procuring
services from outside agencies, due regard must be given the contractor’s
previous safety record. Any safety related failures uncovered by this process
of due diligence should be fully investigated under the direction of the Senior
Manager Safety, to remove any doubt as to the suitability of the agency to
provide a service or product to flydubai. These factors will be given equal
weight with other considerations such as quality and prompt completion.
The Senior Manager Safety will ensure the contractor is made aware of the
flydubai SMS and their responsibilities within it. The ultimate responsibility for
contracted service providers will remain with the contracting department.
Contractors will be audited as a part of the Quality Assurance Department audit
and Safety Department inspection schedule, to verify safety standards are
being maintained.

The contracted Organisation must:
a. Ensure that the necessary authorizations or approvals, as required, for

the service or activity being undertaken are maintained. Any changes
affecting their status is to be communicated to flydubai immediately;
b. Ensure that their employees are aware of, and held accountable for
their safety performance;
c. Ensure that there are clearly defined procedures for the service being
D D
delivered;
d. Ensure that their employees are aware of and adhere to approved
TE LE
policies, procedures including those of flydubai, applicable regulations
and industry best practices;
e. Supporting safety inspections as and when they occur;
IN OL f.
g.
Supporting safety investigations as and when they occur;
Ensure that their products and services are delivered meeting the
quality and safety performance standards required by flydubai;
h. Ensure that the Management and Employees are familiar with the
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ROSI and VORSY System of the GCAA with regards to Mandatory and
Voluntary Safety Reporting.
2.3 SAFETY ASSURANCE

IF N
2.3.1 Safety Performance Monitoring and Measurement

ORG 3.2.1, FLT 1.12.5, DSP 1.12.5, MNT 1.12.5, CAB 1.11.5, GRH 1.11.5,
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CGO 1.11.5, CAR Part X 2.3.1, AMC1-5 to 2.3.1
Safety Performance Management

SDCPS
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Define/refine safety objectives
Define/refine safety performance indicators Safety

Promotion
Safety Monitor and measure safety performance

analysis
Identify actions required
Safety performance can transcend national and international regulatory

requirements to achieve the design criteria of an SMS. It is achieved through
the comparison of quantitative safety performance indicators and safety

performance targets. flydubai’s SMS defines a set of measurable performance

outcomes in order to determine whether it is truly operating in accordance with
design expectations, not merely regulatory requirements, and to identify where
action may be required to bring the performance of the SMS to the level of
design expectations. These measurable performance outcomes permit the
actual performance of activities critical to safety to be assessed against
existing organisational controls so that necessary corrective action is taken
and safety risks can be maintained ALARP.
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Safety performance monitoring is the process by which safety performance
indicators are reviewed in relation to the safety policies and objectives.
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This process includes:
a. Safety reporting;
IN OL
b.
c.
Safety studies;
Safety reviews including trending of data;
d. Safety Inspections;
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e. Surveys;
f. SAG;
g. MRB.
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Safety Inspections are used to ensure that the structure of the SMS is sound
in terms of:
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a. Adequate staff levels;

b. Compliance with approved procedures and instructions; and
c. Level of competency and training to operate equipment and facilities
and maintain their levels of performance.
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2.3.1.1 Safety Objectives

ORG 1.8.1
Safety objectives are brief, high-level statements of safety achievements or

desired outcomes to be accomplished. Safety objectives should therefore be
consistent with the safety policy that sets out the organization’s high-level
safety commitment. They are also useful to communicate safety priorities to
personnel, provide strategic direction for the safety performance management
process and a sound basis for safety related decision-making.
flydubai Safety objectives are:
a. Process-oriented: stated in terms of safe behaviors expected from

operational personnel or the performance of actions implemented by
flydubai to manage safety risk; or

b. Outcome-oriented: encompass actions and trends regarding

containment of accidents or other undesirable events.
Safety objectives should include a mix of both process-oriented and outcome-

oriented objectives to provide coverage and direction for the SPIs and SPTs.
The stated safety objectives and accompanying SPIs and SPTs allow flydubai
to demonstrate whether it is maintaining or improving its safety performance.
2.3.1.2 Safety Performance Indicators
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Safety Performance Indicators must be SMART – Specific, Measurable,
Achievable, Relevant and Timely.
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2.3.1.2.1 Qualitative and Quantitative Indicators
SPIs are used to determine whether or not flydubai safety objectives are likely
to be met; they can be qualitative or quantitative. Quantitative indicators have
a numerical value (count), whereas qualitative indicators are descriptive and
IN OLmeasure by quality.
The selection of qualitative or quantitative indicators requires a thoughtful

process in order to achieve both a good balance and measurable results.
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Quantitative indicators can be expressed as a number or as a rate (e.g. per
100 k flights or sectors) However, just using numbers may create a distorted
impression of the actual safety situation if the level of activity fluctuates. For
this reason, SPIs should be normally reflected in terms of a relative rate to
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measure the performance level regardless of the level of activity. This provides
a normalized measure of performance.
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2.3.1.2.2 Lagging and Leading Indicators

Lagging SPIs measure events that have already occurred. They are also
referred to as “outcome-based SPIs” and are normally the negative outcomes
flydubai aims to avoid. Lagging SPIs are useful for determining long-term
unwanted trends.
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Leading SPIs include processes and inputs implemented to improve or

maintain safety. These are also known as “activity or process SPIs” as they
monitor and measure conditions that have the potential to lead to or contribute
to a specific outcome.
Lagging SPIs are divided into two types:
a. Low probability/high severity: outcomes such as accidents or

serious incidents;

b. High probability/low severity: outcomes that did not resulted in a

serious accident or incident, also referred to as precursor indicators.
They are primarily used to monitor specific safety issues and measure
the effectiveness of existing Safety risk mitigations.
Figure 4 Leading vs Lagging Indicator Concept Phases
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SPIs should be:

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• Related to the safety objective they aim to indicate;

• Selected or developed based on available data and reliable
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measurement;
• Appropriately specific and quantifiable; and
• Realistic, by taking into account the possibilities and constraints of the
organization.
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There should be a clear link between lagging and leading SPIs. Lagging SPIs
should be defined before determining leading SPIs. Defining a precursor SPI
linked to a lagging SPI ensures there is a clear correlation between the two.
See example below.

Figure 5 Examples of Links Between Lagging and Leading Indicators
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2.3.1.2.3 SPI Definition
IN OLThe contents of each SPI should include:
a. A description of what the SPI measures;

b. The purpose of the SPI;
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c. The units of measurement;
d. The person responsible for monitoring/owner of the SPI;
e. The frequency of reporting, collecting, monitoring and analysis of the
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SPI data.
2.3.1.2.4 SPIs and Safety Reporting

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Reporting bias (Under or Over reporting) may distort the intent and accuracy
of the data used for the SPI. Employed judiciously, safety reporting may still
provide valuable data for the management of safety performance.
2.3.1.2.5 Setting Safety Performance Targets

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Safety performance targets (SPTs) define short-term and medium-term safety

performance management desired achievements. The setting of SPTs should
be determined after considering what is realistically achievable and based on
recent performance of the particular SPI, where historical trend data is
available.
2.3.1.2.6 Setting Targets with High-Level Safety Objectives

Targets are established and SPIs will be measured using existing data sources
and additional data to verify emerging trends, which will provide an overview of
flydubai’s safety performance and to establish the likelihood of achieving its
safety objectives.
2.3.1.2.7 Setting Targets with SMART Safety Objectives

An example of the relationship between safety objectives, SPIs and SPTs is
illustrated below. The objective is to reduce the number of runway excursions
by fifty per cent by 2022. “RWY excursions per million movements per year” is

the stated SPI. A safety target which equates to an average reduction of 12.5
per year over the reporting period (four years) is set, with an expected tapering-
off as the target is approached.
a. The SMART safety objective is “50 per cent reduction in RWY

excursions rate by 2022”;
b. The SPI selected is the “number runway excursions per million
movements per year”; and
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c. The safety targets related to this objective represent milestones for
reaching the SMART safety objective and equate to a 12 per cent
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reduction each year until 2022, therefore;
i. SPT 1a is “less than 78 runway excursions per million
movement in 2019”;
IN OL ii.
iii.
SPT 1b is “less than 64 runway excursions per million
movement in 2020”;
SPT 1c is “less than 55 runway excursions per million
movement in 2021”.
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Figure 6 Example SPTs with SMART Safety Objectives
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2.3.1.2.8 Additional Considerations for SPI and SPT Selection

When selecting SPIs and SPTs, the following should also be considered:
a. Workload management. It is better to agree on what is feasible, and

then prioritize the selection of SPIs on this basis. If an SPI is no longer
informing safety performance, or been given a lower priority, consider
discontinuing in favour of a more useful or higher priority indicator.
b. Clarity of SPIs. When selecting an SPI, it should be clear what is being
measured and how often.

2.3.1.2.9 Caveats on Setting SPTs

Some SPIs that are better to monitor for trends rather than use to determine a
target. Safety reporting is an example of when having a target could either
discourage people not to report (if the target is not to exceed a number) or to
report trivial matters to meet a target (if the target is to reach a certain number),
Reporting Bias. Sometimes it may be better to target continuous safety
performance improvement (i.e. to reduce the number of events) rather than
used to define an absolute target.
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2.3.1.2.10 Safety Performance Measurement
Actual safety performance measurement is used to verify the achievement of
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the flydubai stated safety objectives. Accurate data collection is essential in
maintaining good monitoring of the SPI progress on a rolling month-to-month
basis. When the Objective/SPI is set for over a definite time period, carry over
from year to year will also be monitored for Target exceedances.
IN OL
2.3.1.2.11 Use of SPIs and SPTs
In some cases, flydubai will adopt SPIs that have specific associated SPTs.
Alternatively, it may be preferable to focus on achieving a positive trend in the
SPIs, without specific target values.
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SPIs and associated SPTs will be reviewed to determine if they are providing
the information needed to track the progress being made toward the safety
objectives and to ensure that the targets are realistic and achievable.
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It may be necessary to discontinue SPI’s for the following reasons:
• SPIs continually report the same value (such as zero per cent or 100 per
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cent); these SPIs are unlikely to provide meaningful input to senior

management decision-making;
• SPIs that have similar behaviour and as such are considered a
duplication;
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• The SPT for an SPI implemented to measure the effectiveness of a

process or a specific targeted improvement has been met;
• Another safety concern becomes a higher priority to monitor and
measure;
• Safety objectives have changed and as a consequence the SPIs require
updating to remain relevant.
2.3.1.2.12 Update of Safety Objectives

flydubai will review and update our Safety Objectives and SPI’s:
• Routinely, in accordance with the periodic cycle established and agreed

upon by the SAG;
• Based on inputs from safety analyses; and
• In response to major changes in the operation, top risks or environment.

2.3.2 Management of Change

ORG 3.2.2, CAR Part X 2.3.2, AMC to 2.3.2, GM1-2 to 2.3.2, FLT 1.4.2
The Management of Change (MOC) is a formal process that identifies external

and internal changes that may affect established processes and services. It
utilizes the organization’s existing risk management process to ensure that
there is no adverse effect on safety. Change can introduce new hazards that
could impact the appropriateness and effectiveness of any existing risk
D D
mitigation.
Note: The MOC process applies to all departments within flydubai.
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The Post Holder and/or Departmental Head responsible, must proactively
issue a notification of the planned change using the established MOC form
(FD-SMS-003).
IN OL
An MOC may also be carried out reactively, after the change has been
implemented, in the event of insufficient notification.
An adhoc approach is not acceptable in that it may fail to provide for every
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element affected by the change process. An objective of the safety
management system is to assess changes for safety significance and provide
a framework for managing change when introducing or changing:
• Introduction of new aircraft/fleet expansion.

IF N
• Changes in Post Holders/Key Personnel/Safety Significant Personnel.

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• Changes in operating environment.

• Major aircraft modifications.
• Changes relating to Service Providers/Safety significant sub-
contractors.
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• New procedures/internal systems/processes.

• A major organization change is being planned.
• The introduction of new equipment or facilities is being considered.
• Existing equipment is being decommissioned.
• Changes in Quality/Safety/Security requirements.
• There are changes to the regulatory requirements which flydubai
operates under.
• Organizational expansion or reduction.
• Introduction of significant outsourcing of aircraft maintenance.
• Change or modification in communication & IT Systems.
• Identification of emerging risks/economic changes.

• Changes in operating schedules and locations.
Note: The list above is for guidance, and not exhaustive of events requiring
implementation of the Management of Change process.
All such changes must be addressed to ensure safety is not degraded during
or as a consequence of such changes and, wherever practical, safety is
enhanced by changes.
D D
The MOC process has 5 basic phases:
TE LE
a. Initial Assessment
b. Review
c. Verification
IN OL
d.
e.
Acceptance
Implementation.
Both the effect of change and the effect of implementing change are to be
considered.
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a. Initial Assessment
The Responsible Post Holder/Departmental Head must carry out an
initial assessment to determine whether the proposed change is
IF N
significant – i.e. having a notable impact to operations, airworthiness,

processes followed by multiple departments.
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If yes, the Change Notification Form (FD-SMS-003 and Risk

Assessment Form FD-SMS-001 available on EFOS) must be
completed and submitted to Quality and the Safety Department. If
multiple departments are affected, both forms must also be sent to the
relevant Departmental Heads/PH’s.
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Note: Departments may use the Change Impact Matrix Figure 8 to

identify if a change requires risk assessment.
b. Review
QA, the Safety department, and affected departments (if any), must
review the changes to identify further hazards, if any.
Any hazards identified must be logged, and tracked, within the hazard
register and relevant RA’s need to be completed.
Identified hazards (if any) must be risk assessed to establish
mitigations/controls.
c. Verification by QA
The Quality Department will verify Compliance.
Any potential non-compliance will be advised to the Safety
Department.

d. Acceptance
Quality and Safety to sign off acceptance of completed Form FD-SMS-
003.
e. Implementation
The proposed change may now be implemented.
The initiating department is responsible for monitoring the effects of
the implemented change to identify weaknesses and make
D D
amendments (as necessary).
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IN OL
PR TR
IF N
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Figure 7 MOC Process Flow Diagram

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Figure 8 MOC Change Impact Matrix:

CHANGE IMPACT MATRIX
RESPONSIBLE DEPARTMENT ASSESSMENT
Adaptive Change Radical Change
Improvement to(e.g.): Fundamental Departure from(e.g.):
x Current equipment x Current Equipment
x Personnel Structure x Personnel Structure
D D
x Procedures, etc. x Procedures, etc.
See SMSM 2.3.2 Management of Change for more See SMSM 2.3.2 Management of Change for more
TE LE
details details
Responsible department only affected – LOW IMPACT Responsible department only affected – HIGH IMPACT
x Continue as per current approvals x Send MOC to Safety, QA
x MOC recommended (for own record) x Risk Assessment required
IN OL
Multiple departments affected – MEDIUM IMPACT
x Send MOC to Safety, QA and affected

departments
Multiple departments affected – HIGH IMPACT
x Send MOC to Safety, QA and affected

departments
x Risk Assessment(s) may be required x Risk Assessment(s) required

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2.3.3 Continuous Improvement

CAR Part X 2.3.3
IF N
It is important for the continued improvement and growth of the Safety

Management System that its activities are monitored and assessed to ensure
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safety targets and goals are being met, are effective and departments are
fulfilling their obligations to the Safety Management System and identified risks
are being effectively managed. Continuous improvement is measured through
the monitoring of flydubai’s SPI, evaluation and independent audit results.
2.3.3.1 Safety Assessments

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CAR Part X GM to AMC1 to 2.2.1, GM to 2.3.3
Safety Assessments are conducted in cooperation with the Quality Assurance

Department, where the Quality Assurance Department audits safety elements
as identified in the applicable check list during out-station audits, supplier
audits and internal SMS audit of the Safety Department.
Through these assessments the Safety Department ensures that:
a. The structure of the SMS is sound in terms of appropriate levels of

staff, compliance with approved procedures and instructions and a
satisfactory level of competency and training;
b. Effective arrangements exist for promoting safety, monitoring safety
performance processing safety issues; and

c. Adequate arrangements exist to handle foreseeable emergencies.

Ownership of any safety related non-conformances raised from these
audits will remain with the Senior Manager Safety.
d. The effectiveness of existing safety risk controls is reviewed.
Please refer to SDP-04 Safety Assessment Procedure for further
details. Safety Assessors Qualifications and Authorization will be in
accordance with FD-SMS-023 Safety Department Assessor
Authorization Form.
D D
2.3.4 Line Flying Safety Inspections/Observations
TE LE
ORG 3.3.14
The concept of line operational safety auditing was first developed as a means
of monitoring normal line operations. Originally focused on CRM, results of
IN OL
early audits indicated that the actual practice of CRM was completely different
from the one depicted within a typical training department. Most importantly,
the unique insights gathered from the methodological approach of monitoring
normal operations both advanced the concepts of CRM and encouraged new
thinking about crew performance.
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Line flying safety inspections provide a proactive safety data collection
programme providing a diagnostic snapshot of the organisation’s strengths
and weaknesses together with an overall assessment of the flight crew
performance in normal flight operations. Data gathered during the
IF N
observations will be used to support change aimed at improving safety.
The Safety Department will, from time to time, conduct line flying safety
CO
inspections to determine the overall performance level of the flydubai flying

operation. The observations will be conducted over a number of different
Company routes during a pre-notified period. Data collected during the
observations will be collated and analysed in the Safety Department, and the
results issued in the form of a LFSO report. Comprehensive feedback will be
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provided in a timely manner after the observation period.
2.3.4.1 Procedure for Planning and Conducting Line Flying Safety Inspections
The key steps to follow when planning the inspection are detailed in the table
at Figure 9.
When planning an inspection, the Senior Manager Safety will, in addition to

following the key steps detailed in Figure 9, carry out the following actions:
• Issue an inspection programme detailing the dates, routes and crews to

be observed.
• Appoint suitably trained and briefed Inspectors to conduct the
observations.
• Ensure that subject crews are fully briefed on the concept and protocols
of the observations and are in full agreement to being observed.

• Ensure that Network Control is advised of the dates and routes that are
being observed to include the observer on the crew list.
D D
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IN OL
PR TR
IF N
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Figure 9 The Key Steps to Line Flying Safety Inspections
Step 1: 'HFLGHWKHVHFWRUVWR
EHREVHUYHGLQVSHFWHG
Step 2: Gather Information
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Step 3: Scope of observation
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Step 4: Determine number of
sectors to observe
Develop data collection forms
IN OL
Step 5: Schedule LQVSHFWLRQ
dates Select LQVSHFWRUV,
schedule training
and observer training
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Step 6: Conduct observer

training Refine data collection forms as
required
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,163(&7,21 Re-brief observers as required

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Step7: Analyse REVHUYDWLRQV

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Step 8: Provide feedback and

improvements to system
Step 9: Develop enhanced

policies, procedures and safer
operational environment
SAFER OPERATION

2.3.5 Staff Surveys

CAR Part X GM to AMC1 to 2.2.1, GM to 2.3.3
The effectiveness of the SMS from the employee’s perspective will be gauged
by regular staff surveys. The results of the survey will be analysed by the
Safety Department and the resulting score will indicate the level of trust in the
system amongst the Company Employees. Staff surveys will be conducted
either in paper form or on EFOS. The surveys will generally be anonymous,
D D
however, members of staff will have the opportunity of providing their identities
if specific feedback is required.
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Staff surveys are designed to provide an indication of the value and trust the
flydubai staff place in the safety system. They will provide information on areas
that are working up to the design specification and those where improvements
are required. Where specific feedback has been requested this will be provided
IN OL
by a member of the Safety Department. The results of the staff surveys will be
promulgated on the EFOS flight safety site.
Initially surveys will be conducted twice yearly in order to capture the opinions
of new joining staff. When the Company and the SMS have gained some
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maturity, the surveys will become annual events.
The results of these surveys will be evaluated by the Senior Manager Safety
and any concerns and recommendations will be presented to the Accountable
Manager for his consideration. The results will also be presented to the MRB
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and SAG.
2.3.6 Quality Control (QC)

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ORG 3.5.1, CAR Part X GM to AMC1 to 2.2.1, GM to 2.3.3
2.3.6.1 Quality Control

In addition to the oversight provided by the Quality Assurance Department,
flydubai has a Quality Control process that observes and verifies that
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operationally critical processes and procedures are followed and that required
standards are achieved.
Please refer to SDP-17 Quality Control Process for further details.
2.4 SAFETY PROMOTION

2.4.1 Training and Education
ORG 1.6.5, DSP 2.5.1, FLT 2.5.1, MNT 1.12.6, CAB 2.4.1, GRH 2.3.1,
CGO 2.3.1, CAR Part X 2.4.1, AMC to 2.4.1
2.4.1.1 Introduction
For the successful operation of the flydubai Safety Management System it is
essential that all employees understand the principles on which it is based and
their role in it. To achieve this element of the SMS, appropriate training will be

delivered. The Senior Manager Safety will develop a programme of training to

improve upon the competence of managers and staff in relation to aviation
safety to ensure that they are familiar with the principles of safety management
systems and their responsibilities and accountabilities within it.
2.4.1.2 Safety Training

Fundamental to the success of the safety efforts of flydubai is the promotion of
the safety procedures, processes and practices. Comprehensive training will
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be used to ensure that Company personnel are competent to perform their
duties within the SMS. Safety training will be aimed at the level of knowledge
required by personnel to perform their safety management duties, and will be
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as follows:
• The Accountable Manager will be given a general awareness of the

flydubai SMS, including roles and responsibilities, safety policy and
IN OL objectives, safety risk management and safety assurance. The

Accountable Manager will also be fully briefed on the GCAA SMS
regulations and ICAO SMS guidance materials.
• Senior managers will also be briefed on the safety policy, SMS
fundamentals including the safety risk management process, safety
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assurance and promotion, roles and responsibilities and the safety
reporting system. They will additionally be briefed on the safety targets
and acceptable level of safety indicators.
Training syllabus for Senior Management, including Accountable
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Manager:
Objectives:
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– Regulatory requirements ICAO, GCAA, EASA and others.

– Take appropriate role in the implementation of SMS within the
company.
– Promote SMS and Safety Culture within their area of influence.
UN
– Request and interpret appropriate safety-related information.

– Make decisions with appropriate considerations to safety
information and other safety matters.
– Assist the company achieve its vision and aspirations and
improve safety and operational performance.
Subjects covered:
– SMS Benefits for us and the organisation.
– Regulatory requirements (ICAO, GCAA, EASA).
– Learning from other airlines.
– SMS in the company – policy, goals, objectives, safety reporting
process implementation plan, critical steps.

– The role of the top management in implementing and running

SMS.
– Allocation of resources and active promotion of the SMS including
effective interdepartmental safety communication.
– Establishing Safety Performance Targets and alert levels.
– Using SMS processes to make decisions.
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– The management of change in SMS.
– Safety Culture and its importance.
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– Lines of communication for dissemination of safety information.
• Managers and Supervisors will also be trained in the principles of SMS
together with the risk management process, including hazard
IN OL
identification and risk analysis and mitigation to equip them for their
primary role in the SAG. They will also be briefed in the requirements of
change management and safety data analysis.
Subjects:
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– Regulatory requirements ICAO, GCAA, EASA and others.
– What is a safety management system. Policy, goals, objectives,
safety reporting process.
– SMS implementation Plan.
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– Why safety management systems – Benefits of application,

safety, economic, efficiency, etc.
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– Hazard identification process. Risk assessment and mitigation

process.
– Safety Culture basic elements. Improving existing cultures.
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– Management and workforce commitment, responsibilities and

accountabilities.
– Safety committees.
– Recognition of contribution to safety. Awards and other means.
– Communication for dissemination of safety information.
Developing an effective safety presentation.
– SMS audits.
– Safety performance measuring.
– Aviation Safety education and learning strategies.
• The Senior Manager Safety will undergo a formal course in aviation
safety management and be familiar with the GCAA SMS regulations and
ICAO/EASA SMS guidance material.

• Personnel working within the Safety Department, and directly involved

in the SMS will also be given a formal course in aviation safety
management, and are expected to familiarise themselves with the
GCAA regulations and ICAO/EASA guidance material.
• During induction and recurrent training flight crew, cabin crew,
engineering and maintenance staff and other Company employees will
be briefed on the general principles and aims of the SMS, how these are
applied in flydubai, and the part they play in it.
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Subjects covered:
– Organizational safety policies, goals and objectives;
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– Organizational safety roles and responsibilities related to safety;
– Basic safety risk management principles;
– Safety reporting systems;
IN OL – Safety management support
assessment programs);
(including evaluation and
– Lines of communication for dissemination of safety information;

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– Validation process that measures the effectiveness of training;
– Initial indoctrination and, when applicable, recurrent training
requirements;
– Flight Data Monitoring (FDM);
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– Incident Review (As appropriate).

CO
• First officers who are selected for command training will be given a
presentation and discussion on the elements of SMS that are of
particular interest to them as aircraft Commanders. This training will
include the concepts of safety management, organisational accidents,
FDM principles, SMS within flydubai and incident reporting. The training
will be delivered as part of the ground school CRM training.
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General training on the principles of safety management will be carried out

internally using the resources and expertise within the Safety Department with
the nature and scope of that training tailored to the safety-related
responsibilities of the employee’s operational duties. Any specialised safety
management training will be outsourced to specialist safety training
organisations.
Training records for all Company employees who receive safety training will be
monitored by the Safety Department.
The Training Syllabus will include the following topics:
a. Definition of Safety.
b. SMS Structure – Why SMS?

c. Hazard Identification and Risk Assessment.

d. Just Culture.
e. SMS within flydubai.
f. Safety reporting within flydubai.
g. Flight Data Monitoring (FDM).
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2.4.1.3 Competency Assessment
CAR Part X AMC to 2.4.1 (4)
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Competence is assessed on completion of the SMS e-learning by a test
comprising of 20 questions, a pre-defined pass mark must be achieved. All
flydubai staff must complete this course as part of their Mandatory Learning
Plan.
IN OL
Other means of collecting data on the effectiveness of SMS training include but
are not limited to surveys, training feedback forms, classroom training
assessments.
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Safety Department Personnel who are tasked with conducting SMS Training
will be assessed for comptency in accordance with SDP-05 Safety Department
Competency Assessment for SMS Trainers.
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2.4.1.4 Status Tracking Mandatory e-Learning

The Safety Department will follow up on the e-learning completion status as
per departmental procedure, refer to SDP-06 Safety Management System
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Training. If any staff member fails to complete the course within the given time-
frame this will be escalated to their respective line Manager for corrective
action.
2.4.2 Safety Communication

UN
ORG 1.4.2, CAR Part X 2.4.2, GM1 to 2.4.2
As part of the flydubai Safety Communication Policy, an awareness culture is

promoted in which any safety critical information and/or required safety actions
will be communicated across the organization.
2.4.2.1 Dissemination of Safety Information

CAR Part X 2.4.2, GM1 to 2.4.2
It is important in maintaining an open and effective Safety Management

System that safety information is passed on to all employees in a timely and
effective manner. This will ensure all employees are aware of the Safety
Management System to a degree commensurate with their positions, and that
everybody is given the opportunity to participate fully in the gathering of safety
information and ideas.

The Senior Manager Safety and the Safety Managers are responsible for the
gathering and dissemination of safety critical information in a timely manner,
for explaining why particular actions have been taken to improve safety, and
why safety procedures have been changed or additional ones introduced.
Safety critical information will be communicated by mean of notices issued on

EFOS. This will also include conveyance of Health and Safety related
information. These notices may be issued directly by the Safety Department or
be delegated to the relevant Heads of Departments. Responsibility for ensuring
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that the information has been communicated will remain with Senior Manager
Safety. Safety Notices/Memos will normally be issued after consultation with
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the relevant Head of Department and/or the Accountable Manager.
Safety information from internal and external sources, of relevance or interest

to Company employees, will be distributed in the form of Safety Memos or
Bulletins as well as the Safety TV Network deployed in the flydubai premises.
IN OL
This will include output from our Safety Reporting System, Flight Data
Management and Health and Safety for non-operational staff. Safety
Performance Indicators and Targets will also be published.
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IF N
CO
UN

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TE LE
IN OL
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ROA RECORD OF AMENDMENTS

May 2019 Issue 2/Revision 1

Jan 2021 Issue 2/Revision 3

ROA–1 Revision 5 Jan 2022

ROA–2 Revision 0 Nov 2018

Sec 2.6.4.2 Section “Safety Manager – Airworthiness“

Sec 2.6.10 Section “SVP In-flight Services“ text

RH–1 Revision 0 Nov 2018

(OCM – Post Holders Ops Meeting)” added.

Sec 5.2 Section “Code of Practice – Disciplinary” text

Sec 5.3.1.2 Section “Cabin Safety Reports” text

RH–2 Revision 0 Nov 2018

Sec 7.1 Section “Introduction” text amended.

Sec 7.8 Section “Risk Acceptability” text amended.

RH–3 Revision 0 Nov 2018

Sec 9.A.5 Section “Audit Reporting” text amended.

RH–4 Revision 0 Nov 2018

amended. Tables Updated.

Reduction“ text amended. The Safety Risk

replaced with updated version.

RH–5 Revision 0 Nov 2018

Sec 2.6.9 Section “SVP Crew Training” title and

and bullet points added.

RH–6 Revision 0 Nov 2018

cross-reference amended in note to SDLPM

Sec 5.3.1.5 Section “Hard Copy Confidential Reports”

RH–7 Revision 0 Nov 2018

amended. Table 1 “Probability” replaced with

Sec 7.10 Section “Management Response and Risk

Operation Risk Assessment form replaced.

RH–8 Revision 0 Nov 2018

Operations” duties and responsibilities

Chart” chart replaced.

2/0 15 Nov 2018 Global SMSM Issue 2/Revision 0

RH–9 Revision 0 Nov 2018

Section “Safety Accountabilities” text

Sec 2.1.6 Section “Appointment of Key Safety

Specialist” text amended and sections moved

RH–10 Revision 0 Nov 2018

Incidents” text amended.

Sec 2.2.1.5 Section “Company Procedures Following an

Aircraft Manufacturer” text amended.

RH–11 Revision 0 Nov 2018

System (CAAP 57 – VORSY)” text deleted.

Sec 2.2.5.1 Section “Safety Risk Management in

deleted as repeated in MOC section

RH–12 Revision 0 Nov 2018

IN OL Sec 2.3.7 – 2.3.7.6 Sections removed.

2/2 12 July 2020 Global All references to SRB to be replaced by MRB.

Sec 2.1.5 Section “Safety Accountabilities” Risk

RH–13 Revision 2 Jul 2020

Sec 2.1.7.1 Section “Emergency Response and Crisis

Change of reporting line.

Sec 2.2.1.6 Section “Follow Up Reporting” No longer a

RH–14 Revision 2 Jul 2020