Emergency response coordination (AMSA)
Date issue released
Issue number
Issue Status
Open – Safety action pending
Transport Function
Shore operations
Issue Owner
Australian Maritime Safety Authority
Mode of Transport
Marine
Safety Issue Description

The Australian Maritime Safety Authority, with direct control of key national emergency response arrangements, did not have the required understanding of its central role in any response, regardless of location. Consequently, its support to, and coordination with, the control agency in relation to emergency towage, salvage and refuge was inadequate, inconsistent with National Plan principles of a single, integrated and comprehensive response and significantly prolonged the emergency.

Issue Status Justification

To be advised

Proactive action
Action number
MO-2022-006-PSA-06
Organisation
Australian Maritime Safety Authority
Action Status
Monitor
Action description

The Australian Maritime Safety Authority (AMSA) advised the ATSB that it generally agreed that there were communication and coordination failures both within and across the agencies responding to the incident. Consequently, it has taken the following safety action:

  • Conducted a review of its emergency response coordination arrangements and initiated a program to give effect to the changes recommended by the review for the future operating model to improve the capacity to manage complex incidents, particularly in the AMSA Response Centre.
  • Since mid-2024, conducted fortnightly tabletop ‘triage and escalation’ exercises to simulate events involving search and rescue, Maritime Assistance Services (MAS) and pollution, with frontline AMSA staff participating to practice decision-making and incident management to build knowledge, expertise and capacity with exercise evaluations to identify lessons. The inclusion of external agencies and organisations in the exercises was being considered.
  • Increased resourcing of its Response Division to improve preparedness and planning arrangements for major incidents with 9 roles created since 2021.
  • Increased staff training with 136 completions of accredited incident management training programs since July 2021, including 101 staff completing Australasian Inter‑service Incident Management System (AIIMS) training, across a range of different courses.
  • Evaluations of MAS incidents following the Portland Bay incident, including:
    • establishing a ‘lessons board’ and ‘actions allocation working group’, which respectively oversee its lessons management process and ensure identified lessons are addressed,
    • prompt and regular assessment of significant MAS incidents by an external service provider or AMSA lessons management staff (with 9 formal lessons reports containing 135 lessons and findings finalised to date),
    • collection and analysis of incident responder observations for minor incidents, where full evaluation processes are not conducted,
    • reviewing its lessons management doctrine for the lessons management program.
ATSB Response

The ATSB notes that AMSA partially agrees with this safety issue and finding and welcomes the safety action it has taken to address this issue. This action and the proposed future operating model for the emergency response coordination arrangements could adequately address the issue when implemented in conjunction with action to address the 3 other safety issues addressed to AMSA. Therefore, the ATSB will monitor the safety issue and action and has issued the following safety recommendation to AMSA.

Safety recommendation
Action number
MO-2022-006-SR-05
Organisation
Australian Maritime Safety Authority
Action Status
Monitor
Action description

The Australian Transport Safety Bureau recommends that the Australian Maritime Safety Authority (AMSA) completes the safety action proposed to address this safety issue in conjunction with action to address the other safety issues addressed to AMSA in this report.

Organisation Response

Date Received
Organisation
Australian Maritime Safety Authority
Response Text

On 13 August 2025, the Australian Maritime Safety Authority (AMSA) advised that it had accepted the ATSB’s recommendation to take safety action to adequately address the safety issue and was committed to its vision of safe and clean seas, saving lives.

Further, AMSA acknowledged that regardless of which agency was nominated as the lead control agency, the National Plan for Maritime Environmental Emergencies (National Plan) embeds the principle of single, integrated response arrangements and provides for shared responsibility and collaborative and cooperative incident response, regardless of the source or location of where an incident occurs. According to AMSA, the range of safety action taken has and will continue to improve:

  • intra and inter agency communication and coordination, both in preparation for and during an incident response
  • understanding of roles and responsibilities during an incident
  • capability to issue directions in a timely manner.

The safety action taken covers the inter-related subjects of incident escalation, incident management, interagency coordination, exercising the National Plan and its review as described below.

The AMSA annual internal escalation exercise program is intended to test and continually refine incident escalation and maritime assistance procedures, and to build whole of agency preparedness and professional development of staff. The 2025-26 program includes:

  • fortnightly response discussion exercises covering recent incidents, upcoming or past exercises, procedures and checklists
  • six scenario-based, 30-minute incident escalation exercises to test incident escalation procedures
  • two longer duration response arrangement exercises that build on a previous exercise that resulted in escalation and consider the appointment of an incident controller and incident management team (IMT), including priority and objective setting
  • monthly incident training activities covering various subjects, including powers of intervention assessment being conducted at least every quarter
  • an annual 1-day exercise, which includes establishing an IMT, full evaluation and involvement of external consultants and partners, where appropriate
  • two education sessions to cover changes to AMSA incident management protocols, systems or plans
  • annual program evaluation. 

Safety action for incident management includes a review of the National Plan, improved capability to issue directions (intervention) and improved procedures. In summary:

  • The 2023-24 review of the National Plan made 11 recommendations to better enable Australian governments and industry to respond to current and future maritime hazards. The National Plan Strategic Coordination Committee (NPSCC), for which AMSA is the Secretariat, is progressing the implementation of those recommendations.
  • The review identified that the provisions of the Protection of the Sea (Powers of Intervention) Act 1981 (POI Act) are restricted to the risk of pollution by oil or other hazardous and noxious substances and may not necessarily address public safety or maritime safety posed by emerging alternative fuel types, particularly fuel releases in gaseous form. While legislative reform is being considered, AMSA has taken action to improve its capability to issue directions under the current POI Act. This includes templates for issuing directions, legal training and guidance for staff, and providing legal representation within IMTs.
  • Incident management procedures have been improved and regularly exercised, including trialling a proactive approach to establishing an IMT in line with the National Plan principle of over-escalation (for example, during significant weather events). The draft trial evaluation report identified improved situational awareness and preparedness. The effectiveness of the trial will determine whether AMSA adopts a proactive approach for establishing an IMT during severe weather events. 

Safety action for interagency coordination includes further steps to improve collaboration and communication with response partners. Monthly meetings are held between AMSA and states, the Northern Territory and the Australian Marine Oil Spill Centre, to discuss implementation and review of the National Plan, exercises, learning and development and recent response activities. The outcomes from these meetings include:

  • further development of strong inter-agency partnerships
  • shared understanding of roles and responsibilities under the National Plan. 

In addition, AMSA facilitates National Plan coordination workshops, the most recent of which (Marine Pollution Controller workshop, June 2025) targeted senior managers responsible for interagency coordination with a focus on coordination across jurisdictional boundaries.

Action has also been proposed to enhance National Plan exercises. In June 2025, the NPSCC agreed that future exercises include more focussed exercising of a maritime casualty, including the use of Maritime Assistance Services (MAS) procedures, issuing of directions (intervention) and coordination with state and Northern Territory authorities. An AMSA proposal outlining the approach to include MAS procedures in future exercises is to be presented for consideration by the NPSCC in November 2025.

Finally, the recommendations from the review of the National Plan noted above include one related to exploring options for a contemporary governance framework, which would also review coordination in transboundary incidents. It is expected that new national arrangements and a supporting governance framework could be in place by the end of 2026.

ATSB Response

The ATSB welcomes AMSA acknowledging the National Plan principle of single, integrated response arrangements regardless of the control agency or the source or the location of the incident.  Understanding its central role in incident response and implementing effective systems to discharge this role is key to AMSA addressing this safety issue.

The ATSB notes that several initiatives are underway to address the issue. Therefore, the ATSB will monitor the issue and seek an update from AMSA in January 2026 on the progress of these initiatives and other related safety action.

ATSB Response date