Published date: 27 September 2023

The Civil Aviation Authority is making changes to its investigation practices, following an independent review commissioned by the Director of Aviation and Chief Executive of the Civil Aviation Authority Keith Manch. The subsequent report has been published today.  

The report of the review outlines a range of recommendations and ways to improve areas of investigative practice, particularly around complex investigations. The focus is on improving the Authority’s investigative function in order to reflect a consistent, fair and transparent approach across the industry.

The review was commissioned in February as part of the Authority’s continued focus on becoming a values-based, modern regulator, to ensure the investigation and supporting functions work in a cohesive, coherent, and effective manner, meeting their strategic and regulatory obligations and goals.

The Director has accepted the findings and recommendations of the review report and has set out clear expectations within the Authority to implement changes.

Investigations are integral to safety and security outcomes and it’s important that we seek out and act upon opportunities for continuous improvement,” said Manch.

The review was partly informed by a case involving a mid-air collision at Masterton’s Hood Aerodrome in 2019, in which charges laid by the CAA were withdrawn shortly before trial, due to defence expert evidence that focused on an alternative view of the key crash factors.

“While this case wasn’t the focus of the review itself, it has highlighted the role of expert evidence and limitations of our current processes. In the interests of aviation safety we will change our approach to engaging experts as recommended in the report,” said Manch.

A change programme has been established and over the coming months the CAA will work through the specifics of the changes, which will include further examining and making changes to processes, policies and procedures; increasing collaboration and engagement across the Authority in relation to investigation practices; and changes to how experts are engaged in complex or significant cases.

Details of the wider change programme will be communicated with stakeholders in due course and the CAA will engage with industry participants and their representative bodies as the work progresses, to ensure that there is clarity about its operating approach.

“Change can be unsettling and I’m grateful to our people for their willing engagement during the review, and their continued commitment to improving our safety and security outcomes. The expertise they each bring is a critical component to our success as a regulator and the wider aviation industry” said Manch.


Independent review of CAA’s Investigation Function [PDF 1.7 MB]

Director of Civil Aviation‘s Response [PDF 699 KB]

Hood Aerodrome prosecution: CAA withdraws charges - Media release 10 Feb 2023

Please contact the CAA media team for further information

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