Duncan Abrams

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Independent investigation into
the death of Mr Duncan
Abrams, a prisoner at HMP
Hewell, on 4 September 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, 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
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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
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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. In July 2025, Mr Duncan Abrams was remanded to prison and taken to HMP Hewell
for allegedly breaching his Sexual Harm Prevention Order. He died of
adenocarcinoma of the rectum with metastases to liver and lungs (cancer that
started in the rectum and spread to the liver and lungs) on 4 September, in a
hospice. He was 66 years old. We offer our condolences to Mr Abrams’ family and
friends.
4. The Ombudsman’s office wrote to Mr Abrams’ next of kin to explain the
investigation and to ask if they had any matters they wanted us to consider. They
did not respond.
5. NHS England commissioned an independent clinical reviewer to review Mr Abrams
clinical care at HMP Hewell.
6. The clinical reviewer concluded that the clinical care Mr Abrams received at Hewell
was of a good standard and equivalent to that which he could have expected to
receive in the community. The clinical reviewer made a recommendation not related
to Mr Abrams’ death that the Head of Healthcare will wish to address.
7. The PPO investigator investigated the non-clinical issues relating to Mr Abrams
care.
8. We did not find any non-clinical issues of concern. We make no recommendations.
9. The initial report was shared with HM Prison and Probation Service (HMPPS).
HMPPS did not find any factual inaccuracies.
Adrian Usher March 2026
Prisons and Probation Ombudsman
Inquest
The inquest hearing was held on 29 April 2026. The Coroner concluded that Mr Abrams
died of natural causes.
Prisons and Probation Ombudsman 1
OFFICIAL - FOR PUBLIC RELEASE
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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