Why all the fuss about plotting procedures and checking Flight Management System programming over and over again when flying oceanic? If you download the FMS waypoints from the same people who filed the flight plan, what can go wrong? What indeed.

First, let's tackle the actual reason why. No matter where you fly, human error can creep into FMS programming (even when it is downloaded), flight plan transmission to ATC, and a failure of either of these things with any of the other aircraft you share the sky with. When you fly domestically, however, you normally have someone watching you on radar and in most parts of the world, a computer is watching for conflicts in real time. You don't have that when flying oceanic. So that's the why.

Second, let's talk about the likelihood of something going wrong when oceanic. You've been doing this for years and can't remember the last time you had a problem. Maybe you've never had a problem. But you've heard that general aviation has 10 percent of the traffic and 90 percent of the GNE's. That just isn't true. I've talked to oceanic controllers who say most of the problems come from military flights and from several third world countries. Of those that remain, the number of problems from the airlines and general aviation are about the same, despite the fact there are so many more airliners. The difference, I think, is that the system gets most of its funding from the airlines and they are willing to overlook their transgressions more easily.

We aren't here to point fingers, only to illustrate that GNEs do occur and that we need to be careful.

What follows comes from the references shown below. Where I think it helpful, I've added my own comments in blue.


GNE Defined

[ICAO NAT Doc 007, ¶8.1.6] Obviously, there are several combinations of airborne sensors, receivers, computers with navigation data bases and displays which are capable of producing like accuracies, and which with inputs to automatic flight control systems provide track guidance. However, regardless of how sophisticated or mature a system is, it is still essential that stringent navigation and cross checking procedures are maintained if Gross Navigation Errors (GNEs) are to be avoided. A GNE within NAT Airspace is defined as a deviation from cleared track of 25 NM or more. Some of these errors are detected by means of long range radars as aircraft leave oceanic airspace. Other such errors may also be identified through the scrutiny of routine position reports from aircraft.

[Flight Service Bureau] The NAT Central Monitoring Agency (CMA) now defines a Gross Navigation Error as 10nm instead of 25nm.


Causes

Common Causes

[ICAO NAT Doc 007, ¶15.3.1] The most common causes of GNEs, in approximate order of frequency, have been as follows:

  1. having already inserted the filed flight plan route coordinates into the navigation computers, the crew have been recleared by ATC, or have asked for and obtained a reclearance, but have then omitted to reprogram the navigation system(s), amend the Master Document or update the plotting chart accordingly.

  2. a mistake of one degree of latitude has been made in inserting a forward waypoint. There seems to be a greater tendency for this error to be made when a track, after passing through the same latitude at several waypoints (e.g. 57°N 50°W, 57°N 40°W, 57°N 30°W) then changes by one degree of latitude (e.g. 56°N 20°W). Other circumstances which can lead to this mistake being made include receiving a reclearance in flight.

  3. the autopilot has been inadvertently left in the heading or decoupled mode after avoiding weather, or left in the VOR position after leaving the last domestic airspace VOR. In some cases, the mistake has arisen during distraction caused by SELCAL or by some flight deck warning indication.

  4. an error has arisen in the ATC Controller/Pilot communications loop, so that the controller and the crew have had different understandings of the clearance. In some cases, the pilot has heard not what was said, but what he/she was expecting to hear.

Less Common

[ICAO NAT Doc 007, ¶15.3.2] To illustrate the surprising nature of things which can go wrong, the following are examples of some extremely rare faults which have occurred:

  1. the lat/long coordinates displayed near the gate position at one international airport were wrong.

  2. because of a defective component in one of the INS systems on an aircraft, although the correct forward waypoint latitude was inserted by the crew (51°) it subsequently jumped by one degree (to 52°).

  3. the aircraft was equipped with an advanced system with all the coordinates of the waypoints of the intended route already in a database; the crew assumed that these coordinates were correct, but one was not.

  4. when crossing longitude 40°W westbound the Captain asked what coordinates he should insert for the 50°W waypoint and was told 48 50. He wrongly assumed this to mean 48°50'N at 50°00W (when it really meant 48°N 50°W ) and as a result deviated 50 NM from track.

  5. the flight crew had available to them the correct coordinates for their cleared track, but unfortunately the data which they inserted into the navigation computer was from the company flight plan, in which an error had been made.

  6. at least twice since 1989, longitude has been inserted with an error of magnitude of times 10. e.g. 100°W instead of 10°W, or 5°W instead of 50°W. Because of low angles of bank, the aircraft departed from track without the crews being aware, and both lateral and longitudinal separations with other aircraft were compromised.
  7. I was once flying from Anchorage, Alaska to Tokyo, Japan when our navigator made the classic east versus west error in our longitude. When the INS got to that waypoint the airplane made a sharp right turn. That was a good thing, it got all of our attentions. We were lucky it wasn't a more subtle error.

  8. a crew based at and usually operating from London Heathrow was positioned at London Gatwick for a particular flight. One pilot inadvertently loaded the Heathrow coordinates into the INS, instead of those for Gatwick. This initialization error was only discovered when the aircraft had turned back within the NAT after experiencing a GNE.

  9. the pilot of a flight departing from the Caribbean area input the wrong departure airfield coordinates prior to departure. This error was discovered when deviation from cleared route seriously eroded separation with two other opposite direction aircraft.
  10. I was once asked to audit a company GNE where the crew simply downlinked the Europe to White Plains flight plan from satellite and saw 99 waypoints loaded but for some reason KHPN was missing from the last leg. They typed in KHPN and called it good. At 30°W the airplane cycled from the 99th waypoint, which was at 30°W, directly to KHPN. The crew wasn't plotting or even monitoring headings at each waypoint. I recommended the crew be required to face the consequences.


Do GNE's Occur Frequently?

[ICAO NAT Doc 007, ¶16.1] During the monitoring of navigation performance in the NAT MNPS (HLA) airspace, a number of lateral deviations are reported. There were 57 in 2012 and 66 in 2013. A lateral deviation of 25NM or greater is classified as a Gross Navigation Error (GNE). Of the 57 lateral deviations in 2012 19 were GNE’s and of the 66 lateral deviations in 2013 10 were GNE’s. Such errors are normally detected by means of long range radars as aircraft leave oceanic airspace but are increasingly confirmed by means of ADS-C waypoint reporting. In addition, however, on 51 occasions in 2012 and 71 occasions in 2013, potential navigation errors were identified by ATC from routine aircraft position reports (from “next” or “next plus one” waypoints) and ATC were able to intervene to prevent incorrect routing by the aircraft. The vast majority of these instances were attributable to a crew error of following of the filed flight plan route rather than the cleared route.

A Three Day Snapshot in 2016

[Flight Service Bureau]


What Happens after a GNE?

[ICAO NAT Doc 001, ¶5.5]

[ICAO NAT Doc 001, ¶5.10] Follow-up Action on Observed and Reported GNEs


How to Avoid a GNE?

Cross Check!

[ICAO NAT Doc 007, ¶15.4] Never relax or be casual in respect of cross-check procedures. This is especially important towards the end of a long night flight.

Cross-checks begin approaching each waypoint. See: International Operations / En Route / Approaching Each Waypoint.

Radio Procedures!

[ICAO NAT Doc 007, ¶15.4] Avoid casual R/T procedures. A number of GNEs have been the result of a misunderstanding between pilot and controller as to the cleared route and/or flight level. Adhere strictly to proper R/T phraseology and do not be tempted to clip or abbreviate details of waypoint coordinates.

Initialization!

[ICAO NAT Doc 007, ¶15.4] Make an independent check on the gate position. Do not assume that the gate coordinates are correct without cross-checking with an authoritative source. Normally one expects coordinates to be to the nearest tenth of a minute. Therefore, ensure that the display is not to the hundredth, or in minutes and seconds. If the aircraft is near to the Zero Degree E/W (Greenwich) Meridian, remember the risk of confusing east and west.

Systems that use GPS for initialization are far less likely to have this problem. Make sure you follow your aircraft manufacturer's latest procedures. I once flew a Challenger 604 that allowed the initialization be updated at the end of the runway but the procedure discouraged this practice if GPS was installed. Some of our pilots would always update the initialization with runway position because that's what they did before GPS. They were, of course, decreasing the accuracy of the system.

[ICAO NAT Doc 007, ¶15.4] Always return to the ramp and re-initialize inertial systems if the aircraft is moved before the navigation mode is selected. If after getting airborne, it is found that during initialisation a longitude insertion error has been made, unless the crew thoroughly understand what they are doing, and have also either had recent training on the method or carry written drills on how to achieve the objective, the aircraft should not proceed into NAT HLA airspace, but should turn back or make an en-route stop.

Proper Waypoint Loading!

[ICAO NAT Doc 007, ¶15.4] Before departure, at least two pilots should independently check that the following agree: computer flight plan, ICAO flight plan, track plotted on chart, and if appropriate, the track message. In flight, involve two different sources in the cross- checking, if possible. Do not be so hurried in loading waypoints that mistakes become likely, and always check waypoints against the current ATC clearance. Always be aware that the cleared route may differ from that contained in the filed flight plan. Prior to entering the NAT HLA ensure that the waypoints programmed into the navigation computer reflect the Oceanic Clearance received and not any different previously entered planned or requested route.

See: International Operations / Departure / Flight Plan Entry.

Coast-Out Navigation Accuracy Check!

[ICAO NAT Doc 007, ¶15.4] Before entering Oceanic Airspace make a careful check of LRNS positions at or near to the last navigation facility – or perhaps the last but one.

There are many ways to do this, some more accurate than others. See: International Operations / Navigation Accuracy Check.

Stay on Altitude, Especially When on Course!

[ICAO NAT Doc 007, ¶15.4] Never initiate an on-track uncleared level change. If a change of level is essential and prior ATC clearance cannot be obtained, treat this situation as a contingency and execute the appropriate contingency offset procedure, when possible before leaving the last cleared flight level. Inform ATC as soon as practicable.

This may seem almost nonsensical but it does happen. See: International Abnormal Procedures / Loss of RVSM Capability in Oceanic Airspace and International Abnormal Procedures / Weather Deviation in Oceanic Airspace.

Cross-Check Present Position at Each Waypoint

[ICAO NAT Doc 007, ¶15.4] Do not assume that the aircraft is at a waypoint merely because the alert annunciator so indicates. Cross-check by reading present position.

Flight Deck Drills!

[ICAO NAT Doc 007, ¶15.4] Flight deck drills. There are some tasks on the flight deck which can safely be delegated to one member of the crew, but navigation using automated systems is emphatically not one of them, and the Captain should participate in all navigation cross-check procedures. All such cross-checks should be performed independently by at least two pilots.

Plot!

[ICAO NAT Doc 007, ¶15.4] Use a flight progress chart on the flight deck. It has been found that making periodic plots of position on a suitable chart and comparing with current cleared track, greatly helps in the identification of errors before getting too far from track.

Pilot message boards are filled with self-assured oceanic pilots claiming plotting is unnecessary. "I've been flying oceanic for thirty years," some of these will say, "and I've never plotted!" What you don't see are comments from all those sorry saps who got caught by personal error or just plain circumstance who could have been saved by a plotting chart. I've met several seasoned veterans who simply didn't know how and were afraid to admit that. Well, help is on the way: Navigation / Plotting 101.

Do not keep more than one copy of the master document on the flight deck

It is very easy to find yourself with several copies of your flight plan as the trip planners flood you with paperwork and the trip evolves with changing winds and finally the actual clearance. The best way to avoid using the wrong information is to keep that information out of the cockpit in the first place. Even if you have two versions of the exact flight plan, you are unlikely to annotate both with changes. Once you've decided which flight plan is your master document, annotate it as such and purge all other copies from the cockpit.

[ICAO NAT Doc 007, ¶8.2.6] Misuse of the Master Document can result in GNEs occurring and for this reason strict procedures regarding its use should be established. These procedures should include the following:

  1. Only one Master Document is to be used on the flight deck. However, this does not preclude other crew members maintaining a separate flight log.
  2. I think this is a poor technique but if you insist on giving both pilots a copy, ensure only one says "MASTER DOCUMENT" on it and do not write on the other copy to avoid confusing which one has the relevant data. Once you get into the second page of the flight plan it is easy to lose sight of which one is the actual master document.

  3. On INS equipped aircraft a waypoint numbering sequence should be established from the outset of the flight and entered on the Master Document. The identical numbering sequence should be used for storing waypoints in the navigation computers.

  4. For aircraft equipped with FMS data bases, FMS generated or inserted waypoints should be carefully compared to Master Document waypoints and cross checked by both pilots.

  5. An appropriate symbology should be adopted to indicate the status of each waypoint listed on the Master Document.
  6. See: International Operations / Waypoint Notation.


References

ICAO NAT Doc 001, Guidance and Information Material Concerning Air Navigation in the North Atlantic Region, Seventh Edition, January 2002

ICAO NAT Doc007, North Atlantic Operations and Airspace Manual, v 2016-1