Malcolm James

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Independent investigation into
the death of Mr Malcolm James,
a prisoner at HMP Parc,
on 5 October 2024
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
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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 12 July 2024, Mr Malcolm James was sentenced to three years imprisonment
for sexual offences. He died of metastatic bowel cancer on 5 October, at HMP Parc.
He was 85 years old. We offer our condolences to Mr James’ family and friends.
4. The Ombudsman’s office wrote to Mr James’ next of kin, his wife, to explain the
investigation. Mr James’ wife said there had been a significant delay in allowing Mr
James access to a telephone. She also asked about the decision-making around Mr
James’ discharge from hospital and whether the prison had considered early
release on compassionate grounds. She praised the prison’s family liaison officer
for his caring support.
5. Healthcare Inspectorate Wales commissioned an independent clinical reviewer, to
review Mr James’ clinical care at Parc. The clinical reviewer’s report is attached as
Annex 1.
6. The clinical reviewer concluded that the clinical care Mr James received at Parc
was equivalent to that which he could have expected to receive in the community.
He found that appropriate care plans were in place, with dignified end of life care.
The clinical reviewer made recommendations about the need for healthcare staff to
make timely applications for early release on compassionate grounds and training
to use a syringe driver, which the Head of Healthcare will wish to address.
7. The PPO investigator investigated the non-clinical issues relating to Mr James’
care. We did not find any non-clinical issues of concern. We make no
recommendations.
8. We sent a copy of our report to Mr James’ next of kin. She did not report any factual
errors.
9. The initial report was shared with HM Prison and Probation Service (HMPPS). They
found no factual inaccuracies.
Director to note
10. Mr James was unable to make telephone calls from his cell for the first 20 days at
Parc, due to a fingerprinting fault in the prison’s Custodial Management System and
his wife did not know where he had been taken until 10 days after he was
sentenced. After Mr James’ wife contacted the prison, a manager arranged for him
to use an office telephone to keep in touch until the fault was resolved. However, it
Prisons and Probation Ombudsman 1
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is unclear why staff had not facilitated Mr James’ statutory entitlement to send a
letter on reception or make a telephone call within 24 hours of his arrival, to inform
his family of his whereabouts.
Inquest
11. At an inquest held on 4 June 2025, the coroner concluded that Mr James died from
natural causes.
Adrian Usher
Prisons and Probation Ombudsman September 2025
2 Prisons and Probation Ombudsman
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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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