Source · Deaths in custody

PPO Fatal Incident Reports

6,563 incidents 5,801 published 1,698 recommendations 1,676 self-inflicted 3,427 natural causes

Deaths in custody investigated by the Prisons and Probation Ombudsman. Among the incidents indexed here, 26% are recorded as self-inflicted. Source: PPO.

Theme: communication · Remove

Incidents

105 records

Anthony O’Connell

HMP SwalesideDate of death 18 September 2022

Self-inflictedInvestigation: Report published9 recommendations indexed

PPO entry published 8 July 2024

Thomas Oleisky

HMP WealstunDate of death 11 September 2022

Self-inflictedInvestigation: Report published5 recommendations indexed

PPO entry published 25 July 2025

Anthony Christian

HMP LittleheyDate of death 18 August 2022

Natural causesInvestigation: Report published1 recommendation indexed

PPO entry published 21 February 2025

Neil McKenna

HMP LittleheyDate of death 19 July 2022

Natural causesInvestigation: Report published2 recommendations indexed

PPO entry published 6 September 2024

Nathaniel Humphreys

HMP LittleheyDate of death 11 July 2022

Self-inflictedInvestigation: Report published2 recommendations indexed

PPO entry published 4 September 2025

Kayleigh Melhuish

HMP/YOI Eastwood ParkDate of death 7 July 2022

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 28 October 2024

Michael Higginbottom

HMP StaffordDate of death 5 June 2022

Natural causesInvestigation: Report published4 recommendations indexed

PPO entry published 27 November 2025

Isaac Ayeni

HMP AylesburyDate of death 16 May 2022

Other non-naturalInvestigation: Report published2 recommendations indexed

PPO entry published 1 August 2025

Jeremie Simmons

HMP WakefieldDate of death 4 May 2022

Self-inflictedInvestigation: Report published6 recommendations indexed

PPO entry published 22 November 2024

Ricardo Cotteral

HMP SudburyDate of death 24 April 2022

HomicideInvestigation: Report published5 recommendations indexed

PPO entry published 28 February 2025

Lewis Petryszyn

HMP/YOI ParcDate of death 15 April 2022

Other non-naturalInvestigation: Report published4 recommendations indexed

PPO entry published 29 April 2025

Gordon Dunn

HMP The VerneDate of death 31 March 2022

Natural causesInvestigation: Report published5 recommendations indexed

PPO entry published 9 August 2024

King, Alun

HMP WinchesterDate of death 22 March 2022

Natural causesInvestigation: Report published1 recommendation indexed

PPO entry published 15 May 2024

Musse, Hamdi

Bullingdon Post-releaseDate of death 13 January 2022

Natural causesInvestigation: Report published8 recommendations indexed

PPO entry published 1 May 2024

Ian Davies

HMP BristolDate of death 6 December 2021

Self-inflictedInvestigation: Report published7 recommendations indexed

PPO entry published 11 July 2025

Diana Grant

HMP BronzefieldDate of death 20 November 2021

Self-inflictedInvestigation: Report published6 recommendations indexed

PPO entry published 14 July 2025

Maqsood Asif

HMP StaffordDate of death 18 November 2021

Natural causesInvestigation: Report published5 recommendations indexed

PPO entry published 19 June 2025

Doherty, James

HMP Wormwood ScrubsDate of death 18 November 2021

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 23 April 2024

Azroy Dawes-Clarke

HMP ElmleyDate of death 10 November 2021

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 16 July 2025

MacGillivray, Christopher

Durham Post-releaseDate of death 14 October 2021

Self-inflictedInvestigation: Report published4 recommendations indexed

PPO entry published 22 April 2024

Ashley Wood

HMP ExeterDate of death 9 September 2021

Self-inflictedInvestigation: Report published9 recommendations indexed

PPO entry published 19 June 2025

Benjamin Walter

HMP Lowdham GrangeDate of death 20 August 2021

Other non-naturalInvestigation: Report published1 recommendation indexed

PPO entry published 6 September 2024

Daniel Ayers

HMP WinchesterDate of death 25 July 2021

Self-inflictedInvestigation: Report published14 recommendations indexed

PPO entry published 25 July 2025

Keith Williams

HMP DovegateDate of death 12 July 2021

Self-inflictedInvestigation: Report published14 recommendations indexed

PPO entry published 20 September 2024

Akhtar Hussain

HMP ManchesterDate of death 8 July 2021

Self-inflictedInvestigation: Report published12 recommendations indexed

PPO entry published 27 November 2024

Shahrooz Ghassemian

HMP WandsworthDate of death 21 June 2021

Self-inflictedInvestigation: Report published10 recommendations indexed

PPO entry published 3 October 2024

Lukasz Lukasik

HMP HullDate of death 27 May 2021

Self-inflictedInvestigation: Report published6 recommendations indexed

PPO entry published 18 July 2025

Sebastião Lucas

HMP WandsworthDate of death 12 May 2021

Self-inflictedInvestigation: Report published6 recommendations indexed

PPO entry published 6 January 2026

Coysh, Edward

HMP WymottDate of death 26 April 2021

Natural causesInvestigation: Report published8 recommendations indexed

PPO entry published 21 May 2024

Przemyslaw Wozniak

HMP WandsworthDate of death 17 February 2021

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 11 September 2024

Deejay Blampey

HMP ExeterDate of death 2 February 2021

Self-inflictedInvestigation: Report published7 recommendations indexed

PPO entry published 16 August 2024

David Reid

HMP Rye HillDate of death 11 January 2021

Natural causesInvestigation: Report published5 recommendations indexed

PPO entry published 24 March 2025

Robert Frith

HMP BerwynDate of death 14 November 2020

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 24 February 2025

Baltrunas, Karolis

HMP The MountDate of death 27 August 2020

Self-inflictedInvestigation: Report published7 recommendations indexed

PPO entry published 19 April 2024

Charnley, Bradley

HMP RisleyDate of death 13 August 2020

Self-inflictedInvestigation: Report published4 recommendations indexed

PPO entry published 2 May 2024

Dean Briant

HMP LittleheyDate of death 18 July 2020

Self-inflictedInvestigation: Report published2 recommendations indexed

PPO entry published 8 November 2024

Marek Witulski

HMP PeterboroughDate of death 9 July 2020

Self-inflictedInvestigation: Report published5 recommendations indexed

PPO entry published 17 October 2025

Timothy Smith

HMP RisleyDate of death 20 May 2020

Self-inflictedInvestigation: Report published3 recommendations indexed

PPO entry published 19 December 2024

Ryan Nash

HMP BedfordDate of death 30 April 2020

Self-inflictedInvestigation: Report published10 recommendations indexed

PPO entry published 22 August 2024

Peter Tauroza

HMP WandsworthDate of death 6 March 2020

Self-inflictedInvestigation: Report published8 recommendations indexed

PPO entry published 16 August 2024

Coath, Andy

HMP PentonvilleDate of death 23 February 2020

Self-inflictedInvestigation: Report published3 recommendations indexed

PPO entry published 4 April 2024

Sundeep Ghuman

HMP BelmarshDate of death 19 February 2020

HomicideInvestigation: Report published3 recommendations indexed

PPO entry published 14 November 2025

Keith Turner

HMP HumberDate of death 9 January 2020

Self-inflictedInvestigation: Report published11 recommendations indexed

PPO entry published 26 September 2024

Liridon Saliuka

HMP BelmarshDate of death 2 January 2020

Self-inflictedInvestigation: Report published15 recommendations indexed

PPO entry published 19 December 2025

Alan Johnston

HMP LiverpoolDate of death 27 November 2019

Self-inflictedInvestigation: Report published5 recommendations indexed

PPO entry published 12 September 2024

Matthew Singh

HMP BerwynDate of death 23 November 2019

Other non-naturalInvestigation: Report published4 recommendations indexed

PPO entry published 5 December 2025

Brandon Johnson

HMP WandsworthDate of death 12 September 2019

Other non-naturalInvestigation: Report published5 recommendations indexed

PPO entry published 6 December 2024

Malacai Samson

HMP PentonvilleDate of death 23 August 2019

Self-inflictedInvestigation: Report published7 recommendations indexed

PPO entry published 22 July 2024

Daniel Short

Glogan House Approved PremisesDate of death 14 August 2019

Other non-naturalInvestigation: Report published8 recommendations indexed

PPO entry published 12 December 2025

Thomas Moffett

HMP PrestonDate of death 6 August 2019

Natural causesInvestigation: Report published5 recommendations indexed

PPO entry published 25 April 2025

Top recommendation themes

healthcare (299) safeguarding (238) emergency_response (158) record_keeping (140) communication (130) policy (125) mental_health (115) safety (106) training (91) medication (80)

Learning & thematic publications

112 cross-establishment publications

Learning Lessons Bulletins (50), thematic reviews (2), consultation responses (11), Policy into Practice (5), annual reports (7) and FOI responses from the Ombudsman's disclosure log (37): the systemic patterns the Ombudsman draws from many investigations.

Title	Type	Date	Source
The number of complaints received by the PPO from 1 January 2023 onwards by people held in immigration removal centres and in short-term holding facilities	FOI response	Jul 2026	PDF
Annual Report 2025 to 2026	Annual report	Jul 2026	PDF
To provide information on prisons in the United Kingdom with forty or more self-inflicted deaths in the last ten years, alongside their total	FOI response	Jul 2026	PDF
The three English prisons with the highest number of self-inflicted deaths between 2016 to 2026 (excluding HMP Leeds), with annual breakdowns	FOI response	Jul 2026	PDF
The total number of prison deaths that occurred while the individual was located in a segregation unit per calendar from 2021 to 2025	FOI response	Jul 2026	PDF
The number of drug-related deaths in prisons in England and Wales from 2010 to 2025	FOI response	Jul 2026	PDF
A breakdown of the epilepsy deaths in Welsh prisons from the PPO’s Learning Lessons Bulletin on epilepsy deaths	FOI response	Jul 2026	PDF
The number of people held in prison, either serving a sentence or on remand, who have died by suicide between 2016 to 2026, broken down by each prison in Yorkshire	FOI response	Jul 2026	PDF
PPO response to JSC Inquiry into Children and Young Adults in the Secure Estate	Consultation response	Jun 2026	PDF
The number of upheld complaints made to the Prisons and Probation Ombudsman (PPO) about accommodation from 2024 to 2025.	FOI response	Apr 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
HMP Elmley prisoner deaths by year from 2010 to 2025	FOI response	Feb 2026	PDF
Complaints to the PPO about inadequate access to sanitary products since 2020	FOI response	Feb 2026	PDF
The number of health-related deaths in prison	FOI response	Feb 2026	PDF
How many complaints did IPCI receive from prisoners during 2024?	FOI response	Feb 2026	PDF
How many complaints has the PPO received regarding lost property by HMP Peterborough	FOI response	Feb 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
The number of deaths linked to drug taking in prisons in England and Wales between 2020 to 2024	FOI response	Jun 2025	PDF
How many prisoner deaths has the PPO been notified of each year, or started investigating, where there is a suspicion the death was drug-related?	FOI response	Jun 2025	PDF
The number of prisoners who died where no care plan was in place as found in PPO fatal incident investigations (1 February 2023 to 16 September 2023)	FOI response	Jun 2025	PDF
Provide a list of deaths by suicide in English prisons since 2022	FOI response	Jun 2025	PDF
The PPO response time for all cases in last three and current financial year	FOI response	Jun 2025	PDF
The number of self-inflicted deaths recorded in prisons from 2019 to 2024	FOI response	Jun 2025	PDF
The number of individuals in prisons, young offender institutions and approved premises in England and Wales and/or within 14 days of being released from prison were at the time of their deaths subject to an IPP	FOI response	Jun 2025	PDF
To confirm when the Prisons and Probation Ombudsman’s (PPO) Yarl’s Wood special investigation report was completed	FOI response	Jun 2025	PDF
To provide the total number of Prevention of Future Deaths (PFDs or Regulation 28 letters)	FOI response	Jun 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