Safety Critical Communication Check

• Document No.

• Conducted on

  Date

• Assessor Detail

• Completing the Monitoring Form
  
  This form is designed to be used for monitoring voice communications.
  
  · Space is provided to record the results from monitoring 10 voice communications.
  
  · For MOM’s, Crossing Keepers, Bride Keepers, ECO’s and Controllers – a minimum of 3 voice communications shall be monitored during periods 1 to 6, and a minimum of 3 voice communications shall be monitored during periods 7 to 13.
  
  · A judgement about whether this is sufficient to identify that the standards are being applied consistently across all communications shall need to be made depending on the outcome of the minimum arrangements stated above.
  
  · Additional monitoring may need to be used either to obtain further evidence of consistency or to identify where an individual is deficient and requires development.
  
  · The assessor is required to record all the relevant details of the communication in the form provided and to apply an overall rating to each conversation as stated below:

• Rating Criteria:
  
  Score
  
  A
  Very Good
  Competent
  All of the communications protocols have been followed. The communication content was delivered in a concise, and a clear manner applicable to the parties involved. A clear and positive understanding was reached. Lead Responsibility was taken and the information was delivered in a structured order.
  B
  Good
  Competent
  The majority of the communications protocols have been followed including starting and ending the communication correctly. A clear understanding was reached, ensuring the message was understood through the use of repeat backs.
  C
  Improvement required
  Competent, with minor development
  Some of the communications protocols have been followed, lead responsibility was demonstrated. The likelihood was that a clear understanding was reached.
  D
  Poor
  Not yet Competent
  Some of the communications protocols have been followed, but with significant variations and with a possibility of a misunderstanding occurring.
  E
  Very Poor
  Not yet Competent
  No attempt has been made to follow any of the communications protocols, A very high possibility of a misunderstanding occurring.

• Candidates Name

• Job Title

• Employer

  Select Network Rail TES2000 Other

  • Network Rail
  • TES2000
  • Other

Monitoring details

• High risk activities - compliance

• Post incident investigation

• Additional monitoring - Development action plan

• Other - please specify

Communication Details

• For each communication reviewed please detail the communication reference, parties involved, date/time and the reason for the call, feedback & comments.

• Communication 1

  A

  B

  C

  D

  E

• Communication 2

  A

  B

  C

  D

  E

• Communication 3

  A

  B

  C

  D

  E

• Communication 4

  A

  B

  C

  D

  E

• Communication 5

  A

  B

  C

  D

  E

• Communication 6

  A

  B

  C

  D

  E

• Communication 7

  A

  B

  C

  D

  E

• Communication 8

  A

  B

  C

  D

  E

• Communication 9

  A

  B

  C

  D

  E

• Communication 10

  A

  B

  C

  D

  E

Assessor Decision

• Is the candidate competent?

  Yes

  Yes with minor development

  No

• Assessors signature

  Sign

• Candidates signature

  Sign