Source · Deaths in custody
PPO Fatal Incident Reports
6,488 incidents
5,759 published
1,642 recommendations
1,658 self-inflicted
3,411 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 property complaints | Policy into Practice | Mar 2025 | |
| Policy into Practice: Handling of prisoners’ property | Policy into Practice | Mar 2025 | |
| Complaints Investigations Learning Lessons Bulletin Issue 11: Property complaints | Learning Lessons Bulletin | Mar 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 | |
| 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 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 |
Incidents
| Name | Establishment | Cause | Status | Date of death | Recs |
|---|---|---|---|---|---|
| Hibberd, Nathan | Portland Post-release | Other | Published | 10 Sep 2022 | — |
| Holloman, Anthony | HMP Winchester | Natural | Published | 6 Sep 2022 | — |
| Hooley, Derrick | HMP Moorland Closed | Natural | Published | 5 Sep 2022 | — |
| Lees, John | HMP Whatton | Natural | Published | 5 Sep 2022 | — |
| Bishop, Ian | Lewes Post-release | Other | Published | 4 Sep 2022 | — |
| Individual at Leeds Post-release | Leeds Post-release | Other | Published | 4 Sep 2022 | — |
| Fielding, Daniel | Meneghy House | Other | Published | 2 Sep 2022 | — |
| Thorpe, Christopher | HMP Nottingham | Natural | Published | 30 Aug 2022 | — |
| Individual at Berwyn | HMP Berwyn | Natural | Published | 30 Aug 2022 | — |
| Individual at Frankland | HMP Frankland | Natural | Published | 29 Aug 2022 | — |
| Steven Haldane | HMP Stafford | Natural | Published | 29 Aug 2022 | 2 |
| Daniel Berry | HMP Lewes | Other | Published | 28 Aug 2022 | — |
| Shane Davies | HMP Cardiff | Self-inflicted | Published | 28 Aug 2022 | 1 |
| Milburn, Ross | Leicester Post-release | Other | Published | 27 Aug 2022 | — |
| Foster, Karl | Bullingdon Post-release | Other | Published | 26 Aug 2022 | — |
| Lisa Sherrington | HMP/YOI Low Newton | Natural | Published | 26 Aug 2022 | 1 |
| Leigh Brydges | HMP Humber | Other | Published | 25 Aug 2022 | 1 |
| Individual at Wakefield | HMP Wakefield | Natural | Published | 24 Aug 2022 | — |
| Tomlinson, Michael | HMP Birmingham | Natural | Published | 23 Aug 2022 | — |
| Brennan, Ryan | HMP Buckley Hall | Self-inflicted | Published | 23 Aug 2022 | — |
| Gerald O’Rourke | HMP Risley | Natural | Published | 23 Aug 2022 | 1 |
| Hale, Peter | HMP Wayland | Natural | Published | 20 Aug 2022 | — |
| Anthony Christian | HMP Littlehey | Natural | Published | 18 Aug 2022 | 1 |
| Sebastian Mularz | HMP Hull | Natural | Published | 17 Aug 2022 | 6 |
| Marlon Burrows | HMP Garth | Other | Published | 16 Aug 2022 | 6 |
| Hillsden, Stephen | HMP Wymott | Self-inflicted | Published | 15 Aug 2022 | — |
| Parkinson, Michael | Altcourse Post-release | Other | Published | 15 Aug 2022 | — |
| Sion Evans | HMP/YOI Parc | Self-inflicted | Published | 12 Aug 2022 | 5 |
| Individual at Gartree | HMP Gartree | Natural | Published | 12 Aug 2022 | — |
| Individual at Portland Post-release | Portland Post-release | Other | Published | 12 Aug 2022 | — |
| Price, David | HMP Garth | Natural | Published | 12 Aug 2022 | — |
| John Reid | HMP Winchester | Natural | Published | 10 Aug 2022 | 5 |
| Hartigan, Raymond | HMP Wymott | Natural | Published | 10 Aug 2022 | — |
| Lewis, Robert | HMP Norwich | Natural | Published | 9 Aug 2022 | — |
| Lindley, Ian | HMP Ranby | Other | Published | 9 Aug 2022 | — |
| Scotland, Chereen | Peterborough Post-release | Other | Published | 6 Aug 2022 | — |
| Keene, David | HMP Swaleside | Natural | Published | 6 Aug 2022 | 1 |
| Avtar Bhara | HMP Exeter | Natural | Published | 1 Aug 2022 | — |
| Gill, Anil | HMP Woodhill | Self-inflicted | Published | 31 Jul 2022 | — |
| Robb, Derek | HMP Elmley | Natural | Published | 31 Jul 2022 | — |
| Rebecca Parkinson | HMP/YOI Styal | Other | Published | 31 Jul 2022 | 2 |
| Haynes, Terry | HMP Rye Hill | Natural | Published | 30 Jul 2022 | — |
| Lewis, Kenneth | HMP Littlehey | Natural | Published | 27 Jul 2022 | — |
| Heather, Darren | HMP Bure | Natural | Published | 26 Jul 2022 | — |
| Doyle, Eamonn | HMP Rye Hill | Natural | Published | 25 Jul 2022 | — |
| Max Marchant | HMP The Mount | Other | Published | 25 Jul 2022 | 13 |
| Individual at Rye Hill | HMP Rye Hill | Natural | Published | 24 Jul 2022 | — |
| Lightbourne, Terrance | HMP Preston | Natural | Published | 24 Jul 2022 | — |
| Individual at Altcourse | HMP Altcourse | Natural | Published | 23 Jul 2022 | — |
| Lawton, Michael | Stoke Heath Post-release | Natural | Published | 22 Jul 2022 | — |