Learning and research documents
50 learning and research documents
Fatal Incident Investigations Learning Lessons Bulletin Issue 22: Self-inflicted deaths in reception prisons
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This learning lessons bulletin summarises research from Prisons and Probation Ombudsman (PPO) investigations into the self-inflicted deaths of prisoners in reception prisons over the past five years.
Fatal Incident Investigations Learning Lessons Bulletin Issue 21: Segregation
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This Learning Lessons Bulletin has been prompted by the deaths of prisoners in segregation units. The bulletin summarises learning and areas which require further attention to ensure segregation is used and managed appropriately.
Fatal Incident Investigations Learning Lessons Bulletin Issue 20: Epilepsy
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This Learning Lessons Bulletin has been prompted by concerns about the treatment of epilepsy in prisons. The bulletin summarises learning and areas which require further attention.
Complaints Investigations Learning Lessons Bulletin Issue 11: Property complaints
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The first in a series of publications on property, this bulletin summarises learning from PPO investigations into property complaints received from prisoners over the last five years.
Fatal Incident Investigations Learning Lessons Bulletin Issue 19: Post-release death investigations 2
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This learning lessons bulletin summarises the learning from PPO investigations into the deaths of those who died within 14 days of release from prison.
Fatal Incident Investigations Learning Lessons Bulletin Issue 18: Self-inflicted deaths of IPP prisoners
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This learning lessons bulletin has been prompted by the worrying increase in self-inflicted deaths of prisoners serving Imprisonment for Public Protection (IPP) sentences in 2022. The PPO have continued to see self-inflicted deaths of IPP prisoners in 2023.
Investigating deaths after release from prison – a pilot evaluation
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This report presents the findings from the Prisons and Probation Ombudsman’s (PPO) evaluation of its post-release death investigations pilot.
Fatal Incident Investigations Learning Lessons Bulletin Issue 17: Post-release death investigations
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This learning lessons bulletin summarises the learning from PPO investigations into the deaths of those who died within 14 days of release from prison.
Fatal Incident Investigations Learning Lessons Bulletin Issue 16: Second wave COVID-19 related deaths
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This learning lessons bulletin summarises our findings from the second wave of COVID-19 related deaths in prisons.1 It covers deaths notified to us and investigations started between 8 October 2020 and 20 April 2021.
Fatal Incident Investigations Learning Lessons Bulletin Issue 15: COVID-19 PPO fatal incident investigations
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In March 2020, COVID-19 was declared a pandemic and brought substantial changes to how prisons, Approved Premises (APs) and immigration removal centres (IRCs) were able to function.