Source · Deaths in custody

PPO Fatal Incident Reports

6,401 incidents 5,674 published 1,165 recommendations 1,633 self-inflicted 3,373 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 22: Self-inflicted deaths in reception prisons Learning Lessons Bulletin Mar 2026 PDF
Fatal Incident Investigations Learning Lessons Bulletin Issue 21: Segregation 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 2022-23 Annual report Jul 2024 PDF
Annual Report 2023-24 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

6,401 records
Name Establishment Cause Status Date of death Recs
Individual at Wymott HMP Wymott Self-inflicted Published 9 Dec 2013
Individual at Wakefield HMP Wakefield Natural Published 7 Dec 2013
Individual at Brixton HMP Brixton Natural Published 4 Dec 2013
Individual at Gartree HMP Gartree Natural Published 4 Dec 2013
Individual at Low Newton HMP Low Newton Self-inflicted Published 2 Dec 2013
Individual at Eastwood Park HMP Eastwood Park Natural Published 27 Nov 2013
Individual at Leeds HMP Leeds Natural Published 26 Nov 2013
Individual at Wormwood Scrubs HMP Wormwood Scrubs Natural Published 23 Nov 2013
Individual at Sudbury HMP Sudbury Natural Published 21 Nov 2013
Individual at Isle of Wight HMP Isle of Wight Natural Published 20 Nov 2013
Individual at Nottingham HMP Nottingham Self-inflicted Published 16 Nov 2013
Individual at Peterborough HMP Peterborough Self-inflicted Published 15 Nov 2013
Individual at Chelmsford HMP Chelmsford Self-inflicted Published 15 Nov 2013
Individual at Risley HMP Risley Natural Published 15 Nov 2013
Individual at Northumberland HMP Northumberland Natural Published 14 Nov 2013
Individual at Isle of Wight HMP Isle of Wight Natural Published 14 Nov 2013
Individual at Hewell HMP Hewell Self-inflicted Published 14 Nov 2013
Individual at Belmarsh HMP Belmarsh Self-inflicted Published 13 Nov 2013
Individual at Woodhill HMP Woodhill Self-inflicted Published 10 Nov 2013
Individual at Bedford HMP Bedford Self-inflicted Published 7 Nov 2013
Individual at Forest Bank HMP Forest Bank Self-inflicted Published 6 Nov 2013
Individual at Isle of Wight HMP Isle of Wight Self-inflicted Published 4 Nov 2013
Individual at Norwich HMP Norwich Self-inflicted Published 3 Nov 2013
Individual at Lincoln HMP Lincoln Homicide Published 31 Oct 2013
Individual at Brixton HMP Brixton Natural Published 27 Oct 2013
Individual at Preston HMP Preston Natural Published 23 Oct 2013
Individual at Long Lartin HMP Long Lartin Natural Published 20 Oct 2013
Individual at Norwich HMP Norwich Natural Published 19 Oct 2013
Individual at Holme House HMP Holme House Natural Published 13 Oct 2013
Individual at Altcourse HMP Altcourse Self-inflicted Published 12 Oct 2013
Individual at Holme House HMP Holme House Natural Published 11 Oct 2013
Individual at High Down HMP High Down Natural Published 11 Oct 2013
Individual at Preston HMP Preston Natural Published 7 Oct 2013
Individual at Kirkham HMP Kirkham Natural Published 5 Oct 2013
Individual at Blundeston HMP Blundeston Self-inflicted Published 5 Oct 2013
Individual at Winchester HMP Winchester Natural Published 1 Oct 2013
Individual at Stafford HMP Stafford Natural Published 1 Oct 2013
Individual at Preston HMP Preston Self-inflicted Published 30 Sep 2013
Individual at Glen Parva HMP Glen Parva Self-inflicted Published 29 Sep 2013
Individual at Norwich HMP Norwich Natural Published 29 Sep 2013
Individual at Holme House HMP Holme House Natural Published 27 Sep 2013
Individual at Holme House HMP Holme House Self-inflicted Published 27 Sep 2013
Individual at Liverpool HMP Liverpool Natural Published 24 Sep 2013
Individual at Holme House HMP Holme House Self-inflicted Published 21 Sep 2013
Individual at Cardiff HMP Cardiff Self-inflicted Published 20 Sep 2013
Individual at Elliott House Elliott House Other Published 18 Sep 2013
Individual at Liverpool HMP Liverpool Natural Published 17 Sep 2013
Individual at Brighton Brighton Self-inflicted Published 16 Sep 2013
Individual at Isle of Wight HMP Isle of Wight Natural Published 14 Sep 2013
Individual at Wakefield HMP Wakefield Natural Published 13 Sep 2013