Source · Deaths in custody
PPO Fatal Incident Reports
6,395 incidents
5,660 published
1,165 recommendations
1,632 self-inflicted
3,362 natural causes
Deaths in custody investigated by the Prisons and Probation Ombudsman. 26% of deaths are self-inflicted. Source: PPO.
Top recommendation themes
Learning & thematic publications
| Title | Type | Date | Source |
|---|---|---|---|
| PPO response to JSC Inquiry into Children and Young Adults in the Secure Estate | Consultation response | Jun 2026 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 21: Segregation | Learning Lessons Bulletin | Mar 2026 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 22: Self-inflicted deaths in reception prisons | Learning Lessons Bulletin | Mar 2026 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 20: Epilepsy | Learning Lessons Bulletin | Nov 2025 | |
| Annual Report 2024 to 2025 | Annual report | Jul 2025 | |
| Policy into Practice: Handling of prisoners’ property | Policy into Practice | Mar 2025 | |
| Policy into Practice: Handling of property complaints | Policy into Practice | Mar 2025 | |
| Complaints Investigations Learning Lessons Bulletin Issue 11: Property complaints | Learning Lessons Bulletin | Mar 2025 | |
| PPO response to JSC Tackling Drugs in Prison Inquiry | Consultation response | Feb 2025 | |
| PPO response to JHAC Inquiry into Prison Culture | Consultation response | Feb 2025 | |
| PPO response to JSC inquiry into Rehabilitation and Resettlement | Consultation response | Feb 2025 | |
| Policy into Practice: Emergency Response | Policy into Practice | Jan 2025 | |
| PPO response to the Independent Sentencing Review 2024/25 call for evidence | Consultation response | Jan 2025 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 19: Post-release death investigations 2 | Learning Lessons Bulletin | Jul 2024 | |
| Annual Report 2023-24 | Annual report | Jul 2024 | |
| Annual report 2022-23 | Annual report | Jul 2024 | |
| Policy into practice: Use of force | Policy into Practice | Feb 2024 | |
| PPO response to the inquiry into prison population and capacity | Consultation response | Nov 2023 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 18: Self-inflicted deaths of IPP prisoners | Learning Lessons Bulletin | Sep 2023 | |
| Investigating deaths after release from prison – a pilot evaluation | Learning Lessons Bulletin | Jan 2023 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 17: Post-release death investigations | Learning Lessons Bulletin | Jan 2023 | |
| PPO response to the inquiry into the Prison Operational Workforce | Consultation response | Jan 2023 | |
| Annual Report 2021-22 | Annual report | Oct 2022 | |
| Policy into Practice: Use of restraints on escort | Policy into Practice | Sep 2022 | |
| PPO Response to the Inquiry into IPP sentences | Consultation response | Jan 2022 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 16: Second wave COVID-19 related deaths | Learning Lessons Bulletin | Dec 2021 | |
| Annual Report 2020-21 | Annual report | Sep 2021 | |
| PPO responses to the Inquiry into Women in Prison | Consultation response | Aug 2021 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 15: COVID-19 PPO fatal incident investigations | Learning Lessons Bulletin | Feb 2021 | |
| Complaints Investigations Learning Lessons Bulletin Issue 10: COVID-19 PPO Complaints | Learning Lessons Bulletin | Dec 2020 |
Incidents
| Name | Establishment | Cause | Status | Date of death | Recs |
|---|---|---|---|---|---|
| Quang Nguyen | HMP Thameside | Pending inquest | — | — | |
| Garry Robshaw | HMP Hull | In progress | — | — | |
| Jermaine Robinson | HMP Woodhill | Pending inquest | — | — | |
| Andrew Marsh | HMP Onley | Pending inquest | — | — | |
| Shaun Hill | HMP Stocken | Pending inquest | — | — | |
| Rikki Brackett | HMP Bullingdon | In progress | — | — | |
| Grenville Blower | HMP Littlehey | In progress | — | — | |
| Joshua Price | HMP Leeds | In progress | — | — | |
| Stefan Adi | HMP Maidstone | Pending inquest | — | — | |
| Niarena Ryan-Harriott | HMP/YOI Downview | Pending inquest | — | — | |
| Philip Brindle | HMP Wymott | Pending inquest | — | — | |
| Michael Smith | HMP Norwich | Pending inquest | — | — | |
| Aftab Alam | HMP Manchester | In progress | — | — | |
| Dean Sykes | HMP Lindholme | In progress | — | — | |
| Shay Andrews | HMP/YOI Parc | Pending inquest | — | — | |
| Anthony Shackell | HMP Bullingdon | In progress | — | — | |
| Kenneth Murphy | HMP Haverigg | In progress | — | — | |
| John Murtagh | HMP Birmingham | In progress | — | — | |
| Lewis Young | HMP Wealstun | In progress | — | — | |
| Justin Lewis | HMP/YOI Parc | Pending inquest | — | — | |
| Johnathon Maarschalk | HMP Lincoln | In progress | — | — | |
| Simon Gerrard | HMP Isle of Wight | Natural | Published | — | — |
| Lee Martin | HMP Winchester | Natural | Published | — | — |
| Jake O’Brien | HMP Forest Bank | Pending inquest | — | — | |
| Ashley Nolan | Lawson House Approved Premises | In progress | — | — | |
| Lloyd Twells | HMP Nottingham | In progress | — | — | |
| Pascal Blasio | HMP Rochester | In progress | — | — | |
| David Almond | HMP Liverpool | Natural | Published | — | — |
| John Saterlay | HMP Fosse Way | Pending inquest | — | — | |
| Davidson Charles | HMP Erlestoke | Pending inquest | — | — | |
| John McGovern | HMP The Verne | Natural | Published | — | — |
| Jacob Blow | HMP Exeter | Pending inquest | — | — | |
| Steven Wood | HMP Frankland | Pending inquest | — | — | |
| Malcolm James | HMP/YOI Parc | Pending inquest | — | — | |
| Michael Pigott | HMP Birmingham | In progress | — | — | |
| John Palmer | HMP/YOI Doncaster | In progress | — | — | |
| Brian Fletcher | HMP Hewell | In progress | — | — | |
| Anthony Rowbotham | HMP Durham | Pending inquest | — | — | |
| Liam Wood | HMP Hewell | In progress | — | — | |
| Robert Butler | HMP Fosse Way | In progress | — | — | |
| Keith Whitworth | HMP Frankland | Pending inquest | — | — | |
| James Glendenning | HMP Manchester | Pending inquest | — | — | |
| Gareth Jones | HMP Peterborough | Pending inquest | — | — | |
| Kevin Lees | HMP Sudbury | Pending inquest | — | — | |
| Amanda Fitzpatrick | Edith Rigby House Approved Premises | Other | Published | — | — |
| Steven Collins | HMP Wymott | Pending inquest | — | — | |
| George Haldenby | HMP The Verne | Pending inquest | — | — | |
| Darren Snowdon | HMP Ranby | In progress | — | — | |
| Stuart Cordner | HMP Standford Hill | Pending inquest | — | — | |
| Richard Glenn | HMP Lincoln | Self-inflicted | Published | — | — |