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
Michael Dawson HMP Lindholme Natural Published
Scarlet Witch HMP Send Pending inquest
Ronald Beamish HMP Chelmsford Pending inquest
Patrick McCann HMP Forest Bank Natural Published
Thomas McMurray HMP Brixton Pending inquest
Charles Stevens HMP Swaleside Other Published
Georgina Vilella HMP Send In progress
Darren Clarke HMP The Verne Pending inquest
Warren Manners HMP/YOI Parc Pending inquest
Colin Clapham HMP Littlehey In progress
Jonathan Ross HMP Highpoint Pending inquest
William Glasgow HMP Wymott Pending inquest
Uziel Mendoza-Sillerico HMP Lowdham Grange Natural Published
Jarmeh Eleto HMP Rochester In progress
Jordan Harvey HMP Humber Pending inquest
Mahir Abdulrahman HMP Fosse Way In progress
Arthur Hodgson HMP Northumberland Natural Published
John Wilkes HMP Fosse Way Pending inquest
Colin McSweeny HMP Gartree Pending inquest
Victor Rochester HMP/YOI Parc Pending inquest
John Cox HMP Bristol Pending inquest
Andrew Thompson HMP/YOI Doncaster Natural Published
Dean Boness In progress
Anthony Miles HMP Hewell In progress
Phillip Lawson HMP Wealstun In progress
Michael Watson HMP/YOI Moorland In progress
Simon Webber HMP/YOI Portland In progress
Michael Considine HMP Littlehey Pending inquest
John Sadler HMP Liverpool Pending inquest
Radoslaw Czubinski HMP Hull Pending inquest
Khalif Abdi HMP Wormwood Scrubs Pending inquest
Dalton Barnett HMP Holme House Pending inquest
Emma Borowy HMP/YOI New Hall Pending inquest
Darryl Rees HMP Swansea Pending inquest
Lindsay Phair HMP Whatton Natural Published
Max McTaggart HMP Erlestoke Pending inquest
Thomas Lenthall HMP The Mount Pending inquest
Clare Dupree HMP/YOI Eastwood Park Pending inquest
John Slater HMP Norwich In progress
Waleed Ali HMP Wandsworth Self-inflicted Published
Lee Wilson HMP Leeds In progress
Guy-Scott Pallemaerts HMP The Mount Pending inquest
Edwin Withers HMP Holme House Pending inquest
Robert Henry Royan HMP/YOI Parc Pending inquest
Thomas Brain HMP Winchester In progress
Klayton Smith HMP Lowdham Grange In progress
David Glass HMP Altcourse Pending inquest
Moses Hailemichel HMP Pentonville Pending inquest
Rebecca McBrien HMP/YOI New Hall Pending inquest
Ann Browning HMP Send Natural Published