Source · Deaths in custody
PPO Fatal Incident Reports
6,470 incidents
5,745 published
1,502 recommendations
1,653 self-inflicted
3,404 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 |
|---|---|---|---|
| Annual Report 2025 to 2026 | Annual report | Jul 2026 | |
| 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 inquiry into Rehabilitation and Resettlement | Consultation response | Feb 2025 | |
| PPO response to JHAC Inquiry into Prison Culture | Consultation response | Feb 2025 | |
| PPO response to JSC Tackling Drugs in Prison Inquiry | 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 2022-23 | Annual report | Jul 2024 | |
| Annual Report 2023-24 | 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 | |
| Fatal Incident Investigations Learning Lessons Bulletin Issue 17: Post-release death investigations | Learning Lessons Bulletin | Jan 2023 | |
| Investigating deaths after release from prison – a pilot evaluation | 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 |
Incidents
| Name | Establishment | Cause | Status | Date of death | Recs |
|---|---|---|---|---|---|
| Davey Price | HMP Forest Bank | Self-inflicted | Published | 27 Oct 2023 | 3 |
| Karl Quincey | HMP Wakefield | Self-inflicted | Published | 21 Oct 2023 | 2 |
| Andrew Hague | HMP Wealstun | Other | Published | 15 Oct 2023 | 2 |
| Muxsin Awjama | HMP Nottingham | Self-inflicted | Published | 5 Oct 2023 | 2 |
| Piotr Zmijewski | HMP Maidstone | Self-inflicted | Published | 9 Sep 2023 | 3 |
| Andrew Winspear | HMP Hull | Self-inflicted | Published | 8 Aug 2023 | 1 |
| Davina Canning | HMP Hewell | Self-inflicted | Published | 29 Jul 2023 | 3 |
| John Rombach | HMP Stafford | Natural | Published | 17 Jul 2023 | 2 |
| Mark Beresford | HMP Ranby | Self-inflicted | Published | 7 Jul 2023 | 1 |
| Rajwinder Singh | HMP Wandsworth | Self-inflicted | Published | 25 Jun 2023 | 6 |
| Filmon Brhane | HMP Maidstone | Self-inflicted | Published | 12 Jun 2023 | 8 |
| Damon Hardman | HMP Lewes | Self-inflicted | Published | 8 Jun 2023 | 3 |
| Lee Gorst | HMP Manchester | Self-inflicted | Published | 25 Apr 2023 | 1 |
| Kevin Smith | HMP/YOI Doncaster | Self-inflicted | Published | 22 Apr 2023 | 2 |
| Steven Hart | HMP Bedford | Self-inflicted | Published | 29 Mar 2023 | 4 |
| Frank Ospina | Colnbrook Immigration Removal Centre | Self-inflicted | Published | 26 Mar 2023 | 4 |
| Rolandas Karbauskas | HMP Lowdham Grange | Self-inflicted | Published | 25 Mar 2023 | 6 |
| Keith Gadd | HMP Bristol | Self-inflicted | Published | 9 Mar 2023 | 2 |
| Christopher Beddall | HMP Dovegate | Self-inflicted | Published | 26 Feb 2023 | 1 |
| Karl Reavy | HMP Liverpool | Other | Published | 15 Feb 2023 | 1 |
| Fallon Adams | HMP Peterborough | Other | Published | 9 Feb 2023 | 1 |
| Roy King | HMP Littlehey | Self-inflicted | Published | 30 Jan 2023 | 5 |
| Mohammed Eumda | HMP Chelmsford | Self-inflicted | Published | 30 Jan 2023 | 2 |
| Colin Ryan | HMP Bristol | Self-inflicted | Published | 29 Jan 2023 | 1 |
| Weighman, Daniel | HMP Chelmsford | Self-inflicted | Published | 6 Jan 2023 | 3 |
| Oliver Davies | HMP Hewell | Self-inflicted | Published | 31 Dec 2022 | 3 |
| Thomas Goldring | HMP Winchester | Self-inflicted | Published | 29 Dec 2022 | 4 |
| Uddin, Mohammed Sayeef | HMP Highpoint | Self-inflicted | Published | 28 Dec 2022 | 4 |
| Matthew Xavier | HMP Highpoint | Natural | Published | 16 Dec 2022 | 2 |
| Ben Hyland | HMP Leeds | Self-inflicted | Published | 11 Dec 2022 | 1 |
| Ian Kettles | HMP Bristol | Self-inflicted | Published | 11 Nov 2022 | 4 |
| Ahmed Alshbli | HMP Durham | Self-inflicted | Published | 10 Nov 2022 | 2 |
| Russell Irvine | HMP Durham | Self-inflicted | Published | 7 Nov 2022 | 5 |
| Tyrone Richards | HMP Manchester | Self-inflicted | Published | 25 Oct 2022 | 1 |
| Kevin McDonnel | HMP Nottingham | Self-inflicted | Published | 29 Sep 2022 | 2 |
| Dale Samm | HMP The Mount | Self-inflicted | Published | 25 Sep 2022 | 2 |
| Anthony O’Connell | HMP Swaleside | Self-inflicted | Published | 18 Sep 2022 | 9 |
| Thomas Oleisky | HMP Wealstun | Self-inflicted | Published | 11 Sep 2022 | 5 |
| Sebastian Mularz | HMP Hull | Natural | Published | 17 Aug 2022 | 6 |
| Sion Evans | HMP/YOI Parc | Self-inflicted | Published | 12 Aug 2022 | 5 |
| Max Marchant | HMP The Mount | Other | Published | 25 Jul 2022 | 13 |
| Tyrone Beresford | HMP The Mount | Other | Published | 14 Jul 2022 | 7 |
| Kayleigh Melhuish | HMP/YOI Eastwood Park | Self-inflicted | Published | 7 Jul 2022 | 8 |
| Marc Skelly | HMP Lindholme | Self-inflicted | Published | 22 Jun 2022 | 4 |
| Wilson, John | HMP Forest Bank | Natural | Published | 17 Jun 2022 | 2 |
| Ricardo Cotteral | HMP Sudbury | Homicide | Published | 24 Apr 2022 | 5 |
| Lewis Petryszyn | HMP/YOI Parc | Other | Published | 15 Apr 2022 | 4 |
| Angela Thompson | HMP/YOI Styal | Self-inflicted | Published | 11 Apr 2022 | 3 |
| James Bailey | HMP The Mount | Self-inflicted | Published | 1 Mar 2022 | 6 |
| Craig Steadman | HMP Winchester | Self-inflicted | Published | 27 Feb 2022 | 5 |