Shoreham Air Show Crash – England

On 22 August 2015, a Hawker Hunter T7 aircraft involved in an air show in Shoreham, West Sussex, crashed into the westbound carriageway of the A27 during an aerobatic manoeuvre, killing 11 and causing physical and psychological injuries to a group of people in close proximity to the point of impact. The pilot survived but sustained serious injuries.

During 2015 and 2016 the AAIB published three Special Bulletins on this accident in which they revealed the initial findings of the investigation and made a number of safety recommendations. The Final Accident Report was published on 3 March 2017.

Jim Morris, a former RAF pilot and Head of Aviation at Ashfords LLP, worked at international air shows at RAF Leuchars and RAF Waddington (where he was a flying display coordinator), and has professional experience in performing aerobatic manoeuvres in the Hawk jet military aircraft and other high performance turbo-prop and piston aircraft. From his analysis of the 3 Special Bulletins (and before the Final Accident Report was published), he identified the key points below:

• No problems were found with the aircraft.
• At the apex of the failed manoeuvre, the AAIB indicated that the aircraft was approximately 2600ft above sea level and at a minimum speed of 100 knots. This speed and height at the apex was a concern so the final report needed to clarify the speed and height it should have been travelling at and whether the aircraft could perform the rest of the planned manoeuvre and recover level flight at or above the agreed display minima heights. The AAIB Special Bulletin stated that these minima were 100ft for a fly-past and 500ft for manoeuvres.
• The pilot was very experienced and capable and was fully qualified for the routine he was performing. However, the Special Bulletin identified that only 40 hours of his 14,000 hours experience was on this particular aircraft – the final report needed to clarify whether this was a relevant factor.
• There was no black box as it is a military aircraft – but there were two cockpit cameras that could provide important information that should be included in the Final Report.
• The Flying Display Director did not know the details of the aerobatic sequence in advance of the display.
• The pilot’s display authorisation check was done in a different aircraft type, not the Hawker Hunter.

In special bulletins 2 and 3, the AAIB made 21 safety recommendation covering a number of important safety issues, including an improved risk assessment process, provision of display sequence information to the air show organiser, a display authorisation requirement for each type of aircraft and a process to suspend the display authorisation of a pilot whose competence is in doubt.

When the Final Accident Report was published on 3 March 2017, this was the first time that the AAIB published its analysis of the pilot and how he flew the aerobatic sequence. As Jim expected, the final report concluded that the causal factors were the aircraft entered the manoeuvre too slow, the engine thrust in the climb was too low which caused the apex of the manoeuvre to be too low to complete the manoeuvre.

The other causal factor was that the pilot did not try to abort the manoeuvre, despite the aircraft being too low at the apex.

From a professional military pilot perspective, Jim identified the key points relating to the pilot, which include:

• From his fast jet and aerobatic display flying with the RAF, he was familiar with speed and height safety gates for aerobatic manoeuvres and the recovery (escape) manoeuvres used when a safety gate was not achieved.
• The pilot’s display authorisation checks in 2014 and 2015 were obtained on the Jet Provost and RV-8 aircraft – not the Hunter aircraft.
• From 2013 – 2015 the pilot had only flown 3 display practices and 7 displays in the Hunter aircraft.
• Flight trials by a test pilot in a Hunter aircraft confirmed that during the accident manoeuvre, an escape manoeuvre (rolling the aircraft upright and pulling out of the dive) could be accomplished at airspeeds as low as 80 knots and up to 4 seconds into the descent after passing the apex.
• Recordings from video cameras in the cockpit appeared to show that throughout the flight the pilot was conscious, the aircraft was responding to his control inputs and the engine instruments did not indicate any engine malfunctions.
• The Pilot did not recall the accident flight.
• The aircraft entered the accident manoeuvre at around 185 feet, which was below the minimum height of 500 feet.
• The aircraft entry speed for the manoeuvre was 310 knots, which was below the minimum entry speed of 350 knots. The pilot stated that he would abandon the manoeuvre if the minimum entry speed was not achieved. This was the first safety gate divergence at which the manoeuvre should have been aborted.
• The pilot stated that maximum thrust should have been used for the manoeuvre. Recorded information indicated that engine thrust modulated during the climb. If less than maximum thrust had been detected by the pilot, the manoeuvre could have been abandoned during the climb.
• As the aircraft entered the manoeuvre too slow and with less than maximum thrust it only achieved an apex height of around 2700 feet. The minimum height loss during the downward part of the manoeuvre was 2600 – 2950 feet. The pilot stated that he required a minimum of 3500 feet at the apex and that if he did not achieve this, he would abandon the manoeuvre. This was the second safety gate divergence at which the manoeuvre should have been aborted.
• The airspeed at the apex was 105 knots, which was at the lower end of the airspeed range of 100 – 150 Knots.
• From the apex, the pilot had 4 seconds to escape by rolling the aircraft upright and pulling out of the dive.
• The pilot stated that if the aircraft did not achieve a height of 3500 feet, he would perform an escape manoeuvre by reducing the rate of pitch, increase airspeed, roll the aircraft upright and climb away.
• The AAIB report stated that the pilot had not practiced the escape manoeuvre he described in the Hunter aircraft, but the execution of such a manoeuvre would have been consistent with his background and experience.
• By not abandoning the manoeuvre, there was insufficient height at the apex to complete the manoeuvre before impact with the ground.

This Final Accident Report identifies very concerning aspects in relation to the aerobatic manoeuvre. It confirms that the wrong speeds and heights were used but the pilot did not try to escape the manoeuvre.

Given that he was a very experienced military and display pilot, it is very surprising that he did not escape the manoeuvre. The pilot was aware of escape manoeuvres for other military aircraft but had not practiced and had not been assessed on escape manoeuvres in the Hunter aircraft. This is extremely concerning – if he had practised this in the Hunter, it would have been fresh in his memory and he could have prevented this tragedy.

The AAIB made a further 11 safety recommendations in the final report, including that display pilots be trained and assessed on escape manoeuvres and that an independent review of the governance of flying display activity should be commissioned by the Department for Transport.

The Crown Prosecution Service brought a criminal case against the pilot but, in March 2019, he was acquitted.

Jim Morris continues to represent family members and will be their advocate at the inquest. The inquest should take place towards the end of 2019 or early 2020 and will last around 6-8 weeks.

Following the conclusion of the Inquest, it is hoped that the full chain of events and all evidence that is relevant to this tragedy are identified so that all appropriate measures to improve flight safety in air shows can be implemented.

In terms of the civil law applicable to this tragedy, section 76 (2) of the Civil Aviation Act 1982 imposes strict liability on the owner of the aircraft where damage is caused to anybody or any property on land by an aircraft whilst in flight. This means that damages for the tragic losses and injuries are recoverable from the owner without having to prove negligence or intention.