Andrew Savage

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Independent investigation into
the death of Mr Andrew Savage,
a prisoner at HMP Channings
Wood, on 24 February 2026
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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© Crown copyright, 2026
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
Where we have identified any third-party copyright information you will need to obtain permission
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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 20 March 1986, Mr Andrew Savage was sentenced to life in prison for sexual
offences. He died in a hospice of metastatic adenocarcinoma of the bowel
(advanced bowel cancer that has spread to other parts of the body) on 24 February
2026, while a prisoner at HMP Channings Wood. He was 64 years old. We offer our
condolences to those who knew Mr Savage.
4. No next of kin were identified following Mr Savage’s death.
5. NHS England commissioned an independent clinical reviewer to review Mr
Savage’s clinical care at HMP Channings Wood. The clinical reviewer’s report is
attached as Annex 1.
6. The clinical reviewer concluded that the clinical care Mr Savage received at
Channings Wood was of a reasonable standard and was equivalent to that which
he could have expected to receive in the community. She found that following Mr
Savage’s transfer to hospital, and latterly to a hospice, good communication was
maintained between healthcare staff at Channings Wood and the hospital and
hospice staff. The clinical reviewer made one recommendation not related to Mr
Savage’s death that the Head of Healthcare will wish to address.
7. The PPO investigator investigated the non-clinical issues relating to Mr Savage’s
care. We did not find any non-clinical issues that warranted a recommendation but
bring the Governor’s attention to the below.
8. We shared the initial report with HM Prison and Probation Service (HMPPS) and
Oxleas NHS Foundation trust. They did not find any factual inaccuracies.
Governor to note
Release on Temporary Licence (ROTL)
9. The Release on Temporary Licence (ROTL) Policy Framework sets out that a
Special Purpose Licence (SPL) can be issued in response to a specific event or
circumstances that would not usually require release. It says that an SPL may be
granted for prisoners to attend medical outpatient appointments, or inpatient
requirements.
10. The policy framework says that if a prisoner is subject to a restricted ROTL (which
sets limitations on ROTL due to sentence, offence, or risk) they are still eligible for a
SPL for medical treatment, providing:
Prisons and Probation Ombudsman 1
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• the prisoner needs essential medical treatment in the community; and
• a senior manager chaired ROTL board has sat; and
• the Governor or deputy governor has agreed SPL is appropriate in all the
circumstances.
11. On 19 February 2026, Mr Savage was admitted to a hospice, where he remained
until he died on 24 February. While prison staff appropriately started to complete an
application for early release on compassionate grounds (ERCG - the means by
which prisoners who are seriously ill, usually with a life expectancy of less than
three months, can be permanently released from custody before their sentence has
expired), no consideration was given for ROTL. (Mr Savage died before the
application for ERCG was completed.)
12. Prison staff told the investigator that there was no time to consider other measures
such as ROTL, and so Mr Savage’s case was proceeded directly to consideration
under ERCG. Staff added that given the nature of Mr Savage’s conviction, and the
level of risk he posed towards children, approval for ROTL (which would have
meant Mr Savage would not be under escort by prison staff at the hospice) would
not have been granted.
13. However, in applying for ERCG, both prison and probation staff recorded that given
Mr Savage was bed bound and unable to move without assistance, the level of risk
he posed to others was sufficiently reduced to support early release. In addition,
prison staff told us that Mr Savage was in a single room at the hospice and had no
contact with other residents.
14. Given that prison and probation staff were in support of early release, it would have
been appropriate for them to consider ROTL for Mr Savage at the same time that
they completed his application for early release on compassionate grounds. In
many instances ROTL, can be expedited sooner than ERCG and therefore should
have been considered.
15. In March 2026, our report into the death of a prisoner at Channings Wood
recommended that the Governor should ensure that decisions for ROTL are based
on the prisoner’s individual circumstances. The prison accepted this
recommendation and identified that the Head of Safety has now created a
multidisciplinary team meeting agenda item to consider, on a case-by-case basis,
whether ROTL is applicable for prisoners with a terminal diagnosis. We do not
therefore make a further recommendation.
Adrian Usher June 2026
Prisons and Probation Ombudsman
Inquest
16. At an inquest held on 28 July 2026, the coroner concluded that Mr Savage died
from natural causes.
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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
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