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.

Learning & thematic publications

74 cross-establishment publications

Learning Lessons Bulletins (50), thematic reviews (2), consultation responses (11), Policy into Practice (5) and annual reports (6): the systemic patterns the Ombudsman draws from many investigations.

TitleTypeDateSource
PPO response to JSC Inquiry into Children and Young Adults in the Secure Estate  Consultation response Jun 2026 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 21: Segregation Learning Lessons Bulletin Mar 2026 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 22: Self-inflicted deaths in reception prisons Learning Lessons Bulletin Mar 2026 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 20: Epilepsy Learning Lessons Bulletin Nov 2025 PDF
Annual Report 2024 to 2025 Annual report Jul 2025 PDF
Policy into Practice: Handling of prisoners’ property Policy into Practice Mar 2025 PDF
Policy into Practice: Handling of property complaints Policy into Practice Mar 2025 PDF
Complaints Investigations Learning Lessons Bulletin Issue 11: Property complaints Learning Lessons Bulletin Mar 2025 PDF
PPO response to JSC Tackling Drugs in Prison Inquiry Consultation response Feb 2025 PDF
PPO response to JHAC Inquiry into Prison Culture Consultation response Feb 2025 PDF
PPO response to JSC inquiry into Rehabilitation and Resettlement Consultation response Feb 2025 PDF
Policy into Practice: Emergency Response Policy into Practice Jan 2025 PDF
PPO response to the Independent Sentencing Review 2024/25 call for evidence Consultation response Jan 2025 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 19: Post-release death investigations 2 Learning Lessons Bulletin Jul 2024 PDF
Annual Report 2023-24 Annual report Jul 2024 PDF
Annual report 2022-23 Annual report Jul 2024 PDF
Policy into practice: Use of force Policy into Practice Feb 2024 PDF
PPO response to the inquiry into prison population and capacity Consultation response Nov 2023 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 18: Self-inflicted deaths of IPP prisoners Learning Lessons Bulletin Sep 2023 PDF
Investigating deaths after release from prison – a pilot evaluation Learning Lessons Bulletin Jan 2023 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 17: Post-release death investigations Learning Lessons Bulletin Jan 2023 PDF
PPO response to the inquiry into the Prison Operational Workforce Consultation response Jan 2023 PDF
Annual Report 2021-22 Annual report Oct 2022 PDF
Policy into Practice: Use of restraints on escort Policy into Practice Sep 2022 PDF
PPO Response to the Inquiry into IPP sentences Consultation response Jan 2022 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 16: Second wave COVID-19 related deaths Learning Lessons Bulletin Dec 2021 PDF
Annual Report 2020-21 Annual report Sep 2021 PDF
PPO responses to the Inquiry into Women in Prison Consultation response Aug 2021 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 15: COVID-19 PPO fatal incident investigations Learning Lessons Bulletin Feb 2021 PDF
Complaints Investigations Learning Lessons Bulletin Issue 10: COVID-19 PPO Complaints Learning Lessons Bulletin Dec 2020 PDF

Incidents

6,395 records
Name Establishment Cause Status Date of death Recs
Matthew Hayward HMP Peterborough Pending inquest
David Holyoak HMP Berwyn Pending inquest
Kyle Watts Deer Park Approved Premises In progress
David Wood HMP Oakwood In progress
David Hancock HMP Nottingham Pending inquest
Wesley Martin HMP Lincoln Pending inquest
Jacob Blow HMP Exeter Pending inquest
George Armstrong HMP Holme House Pending inquest
Paul Miller HMP Kirklevington Grange Pending inquest
Nelson Harvey HMP Long Lartin Self-inflicted Published
Michael Davies HMP Rye Hill Pending inquest
Jeffrey Long HMP/YOI Moorland In progress
John Casey HMP Birmingham In progress
Carl Hyde HMP Stocken Pending inquest
Jason Walker HMP Lincoln Pending inquest
John Digweed HMP Garth Pending inquest
Michael Beer HMP Cardiff Pending inquest
Khia Dawe HMP Exeter Pending inquest
David Kettle HMP Erlestoke Pending inquest
Richard Littlewood HMP/YOI Moorland Pending inquest
Cameran Anthony HMP/YOI Parc Pending inquest
Wayne Domeney HMP Isle of Wight Pending inquest
Hallum Elgood HMP Norwich Self-inflicted Published
Peter Dodd HMP North Sea Camp Pending inquest
Glenn Brown Holbeck House Approved Premises Pending inquest
Billy-Jo Howe HMP/YOI Eastwood Park In progress
William Clark HMP Wormwood Scrubs Pending inquest
Darren Thomas HMP/YOI Parc In progress
Thomas Griffiths Pending inquest
Matthew Harris HMP Hull Pending inquest
Thomas James HMP Wandsworth In progress
John Shannon HMP Bure In progress
Robert Wiseman Lightfoot House Approved Premises In progress
Uttam Thapa HMP Belmarsh Pending inquest
Gerald Martin HMP Wymott In progress
Gareth Jones HMP Peterborough Pending inquest
Andrew Cox HMP Guys Marsh Pending inquest
Emmett Morrison HMP Long Lartin Self-inflicted Published
Mahir Abdulrahman HMP Fosse Way In progress
Reuben Rhodes HMP Nottingham In progress
Connor Bresland HMP Exeter In progress
Derrion Adams HMP Birmingham Pending inquest
Paul Griffiths HMP Wymott In progress
Colin Storey HMP Northumberland Self-inflicted Published
Billy Payne HMP Belmarsh In progress
Craig Watson HMP/YOI Doncaster In progress
Ben Merritt In progress
Nicholas Brown HMP Isle of Wight Pending inquest
Michael Maharaj HMP Brixton Pending inquest
Adam Clark HMP Hewell Pending inquest