Adam Benton

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Independent investigation into
the death of Mr Adam Benton,
a prisoner at HMP Stafford,
on 15 January 2025
A report by the Prisons and Probation Ombudsman
Third Floor, 10 South Colonnade Email: mail@ppo.gov.uk T l 020 7633 4100
Canary Wharf, London E14 4PU Web: www.ppo.gov.uk
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OFFICIAL - FOR PUBLIC RELEASE
© Crown copyright, 2025
This report is licensed under the terms of the Open Government Licence v3.0. To view this licence,
visit nationalarchives.gov.uk/doc/open-government-licence/version/3
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1. The Prisons and Probation Ombudsman aims to make a significant contribution to
safer, fairer custody and community supervision. One of the most important ways in
which we work towards that aim is by carrying out independent investigations into
deaths, due to any cause, of prisoners, young people in detention, residents of
approved premises and detainees in immigration centres.
2. If my office is to best assist His Majesty’s Prison and Probation Service (HMPPS) in
ensuring the standard of care received by those within service remit is appropriate,
our recommendations should be focused, evidenced and viable. This is especially
the case if there is evidence of systemic failure.
3. On 16 September 2024, Mr Adam Benton was sentenced to twelve years and nine
months in prison for sexual offences. He began his sentence in HMP Birmingham
before being transferred to HMP Stafford on 4 October.
4. Mr Benton died of high-grade glioma of brain (an aggressive type of brain cancer)
on 15 January 2025. He was 51 years old. We offer our condolences to Mr Benton’s
family and friends.
5. The Ombudsman’s office contacted Mr Benton’s brother, his nominated next of kin,
to explain the investigation and to ask if he had any matters he wanted us to
consider. Mr Benton’s brother did not respond.
6. The PPO investigator investigated the non-clinical issues relating to Mr Benton’s
care. We did not find any non-clinical issues of concern.
7. NHS England commissioned an independent clinical reviewer, to review the clinical
care that Mr Benton received at Stafford. The clinical reviewer’s report is attached
as Annex 1. The clinical reviewer concluded that the clinical care Mr Benton
received at Stafford was of a good standard and more than equivalent to that which
he would have received in the community. She identified evidence of a very good
multidisciplinary team approach to Mr Benton’s care, which was provided with
compassion.
8. We shared the initial report with HM Prison and Probation Service. They did not
identify any factual inaccuracies.
9. The inquest into Mr Benton’s death concluded on 27 June 2025, and recorded a
verdict of natural causes.
Adrian Usher August 2025
Prisons and Probation Ombudsman
Prisons and Probation Ombudsman 1
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Third Floor, 10 South Colonnade Email: mail@ppo.gov.uk T l 020 7633 4100
Canary Wharf, London E14 4PU Web: www.ppo.gov.uk
OFFICIAL - FOR PUBLIC RELEASE