Terence Lobb

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Independent investigation into
A report by the Prisons and Probation Ombudsman
the death of Mr Terence Lobb,
a prisoner at HMP Oakwood,
on 10 November 2023
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, 2024
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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 January 2020, Mr Terence Lobb was sentenced to four years imprisonment
for sexual offences. He died in hospital of heart disease on 10 November 2023,
while a prisoner at HMP Oakwood. He was 58 years old. We offer our condolences
to Mr Lobb’s family and friends.
4. The PPO family liaison officer wrote to Mr Lobb’s wife to explain the investigation
and to ask if she had any matters she wanted us to consider. Mr Lobb’s wife asked
us to investigate the healthcare Mr Lobb received at Oakwood when he became
unwell. This is addressed in the clinical reviewer’s report.
5. NHS England commissioned an independent clinical reviewer to review Mr Lobb’s
clinical care at Oakwood.
6. The clinical reviewer concluded that the clinical care Mr Lobb received at Oakwood
was of a good standard overall and was largely equivalent to that which he could
have expected to receive in the community. The exception was the failure to identify
that he had reported similar significant symptoms on two consecutive days before
he was fully reviewed. The clinical reviewer noted that since Mr Lobb’s death, the
Head of Healthcare had introduced a new process to ensure that prisoners who
reported sick were reviewed by nurses the same day. The clinical reviewer made
three recommendations which the Head of Healthcare will wish to address.
7. The PPO investigator investigated the non-clinical issues relating to Mr Lobb’s care.
8. We did not find any non-clinical issues of concern. We make no recommendations.
9. We shared our initial report with HMPPS and with the healthcare provider at
Oakwood. They pointed out some factual inaccuracies in the clinical reviewer’s
report, which has been amended.
10. We sent a copy of our initial report to Mr Lobb’s wife. She responded with some
comments but did not identify any factual inaccuracies.
Adrian Usher May 2024
Prisons and Probation Ombudsman
Inquest
The inquest heard on 3 June 2024 concluded that Mr Lobb died from natural causes.
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