Professional seafarer Mark Glover, 64, was a volunteer relief cook on the Pelican of London when he fell from the gangway of the sail training vessel into the water on the night of 2 October 2023.

His absence was not noted by the crew until the next morning; a search began on 3 October and his body was recovered by police divers in Sharpness shipyard in Berkeley, Gloucestershire.

The Marine Investigation Branch (MAIB) found that the gangway was not rigged safely, as the gangway guard ropes and safety net did not prevent Glover from entering the water.

A postmortem examination concluded that Glover was also under the influence of alcohol at the time of the accident and due to possible cold water shock, was unable to climb out of the water and subsequently drowned.

Glover had 190 milligrams (mg) per 100 millilitres (ml), equivalent to 190mg per decilitre (dl), of alcohol in his blood and 212mg/dl in his urine. The Railways and Transport Safety Act 2003 prescribed a seafarer’s blood alcohol limit as 50mg/dl and urine alcohol limit as 67mg/dl.

Risk assessments by Seas Your Future, the owner of the Pelican of London, were also found to be not robust.

CCTV image showing Mark Glover returning to the Pelican of London. Credit: Image courtesy of Sanders Stevens as part of Victoria Group/MAIB

The MAIB report reveals Glover had drunk at least nine double whiskies and ice on the evening of 2 October before returning to the ship alone at 2307.

He slowly ascended the gangway before pausing to step down towards the deck via the bulwark ladder; he then lost his balance and fell from the left-hand side of the top of the gangway, landing with a splash into the dock.

This alerted the vessel’s chief engineer who quickly arrived on the well deck; he checked the area but failed to notice movement in the water directly underneath the gangway.

The chief engineer went on to check the gangway and went ashore and searched the area forward of the gangway before returning to bed, having seen nothing amiss.

When Glover was noted absent from the Pelican of London in the morning, a search was started and the CCTV footage covering Sharpness Port was reviewed. The police were then notified and Glover’s body was recovered at 1401 by police divers.

At the time Glover fell into the dock, the in-water visibility was “very poor”. Sharpness shipyard is non-tidal and water levels in the dock had remained near constant since Pelican of London had arrived for scheduled repairs and maintenance.

Pelican of London is a 34.6m mainmast barquentine sail training vessel, with three decks. It is coded to The Code of Practice for Safety of Large Commercial Sailing and Motor Vessels,1997, as amended, and was not required to comply with the International Ship and Port Facility Security Code requirements for maintaining a gangway security watch.

The vessel’s gangway was 5.6m in length, built from two separate 2.8m sections.

The gangway had a total of four guard rope stanchions fitted on each side and these were each threaded with two guard rope lines, the top line being at a 1m height.

On arrival in Sharpness, the gangway had been rigged from the forward end of the starboard well deck to the shore.

Later that same day, the gangway was shifted slightly and rerigged.

The guard ropes from the stanchions on the inboard end of the gangway were tied off aft on the shrouds near the top of the bulwark, and forward low down on the starboard aft boat deck upright.

This left significant gaps in the effective fencing between the top of the bulwark ladder and the inboard end of the gangway on both sides.

These gaps were worsened by the electric cable that ran across the guard ropes and did not provide a sufficient barrier to prevent anyone from falling overboard from the top of the gangway.

The Pelican of London underwent a 12-year refit before she started sailing again. She was originally a fishing trawler, built in 1948. Credit: Seas Your Future

The safety net, which should have stopped the fall of anyone toppling from the gangway, was rigged without a spreader bar. With the net’s outer edges tied low onto the shrouds aft, and onto the bulwark forward, the net sloped downwards away from the gangway, creating a chute that did nothing to prevent Glover’s fall.

The re-rigged gangway was not inspected by a crew member holding a Maritime and Coastguard Agency (MCA) Efficient Deck Hand certificate to ensure it complied with Code of Safe Working Practices for Merchant Seafarers (COSWP) guidance.

“Without reference to the COSWP, the Nautical Institute’s Mooring and Anchoring Ships publication or a local work instruction, those rigging and inspecting the gangway had no direction to assist them in their duties. This meant that there was a reliance on crew learning best practice from experience; however, without those formal references and guides, crew replicated what had become accepted as normal and were unaware it was unsafe,” stated the MAIB.

The MAIB concluded that the gangway “exposed all gangway users to serious hazard as they traversed the gangway, whether they were conducting administrative duties, carrying stores or returning from recreational time ashore.”

“An onboard procedure for the rigging of Pelican of London’s gangway, based on industry guidance, would have provided a sound basis for both crew training and post-rigging inspection to ensure the gangway was safe to use.”

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Seas Your Future, the owner of the Pelican of London, did have a volunteer code of conduct about drug and alcohol use, stating: “Consumption of alcohol…prior to and/or during a work shift is not allowed. Consumption of alcohol…should be enjoyed in moderation. You must ensure that your actions do not bring into question the professionalism of yourself or the charity.”

The ship’s operations manual highlighted excerpts of a drugs and alcohol policy though did not reference which one and referenced the alcohol limits detailed in the Railways and Transport Safety Act 2003. The policy did not specifically mention crew returning on board from recreational time ashore, though it did state that the only guarantee [to stay under the prescribed limits] is not to drink for several hours prior to a duty period. This guidance was not replicated in the volunteer code of conduct.

The MAIB concluded that: “The drug and alcohol policies did not help crew members recognise the limits that applied to crew
returning from recreational time ashore. There were early indications of a problem with the relief cook’s alcohol consumption, but this did not result in an effective intervention.”

Since the accident, Seas Your Future has:

• Revised its procedures and introduced an approved process for rigging and making the gangway safe;
• Fitted bulwark stanchions to provide secure handholds when joining or departing the ship and to assist in the adequate fencing of any gap between the bulwark ladder and the inboard end of the gangway.
• Issued and promoted a revised drug and alcohol policy that is consistent across policies, induction proforma, code of conduct and joining instructions, and on local noticeboards.
• Introduced an audit process to ensure the adoption of best practice.
• Amended emergency procedures to include procedures for missing persons and introduced a flow process to triage potential emergencies.

The MAIB has also issued a safety flying to the shipping industry, highlighting guidance on how to safely rig a gangway.

To read the full Pelican of London report. Click here.

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