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recurance

Lack of basic life support training among prison officers

Closely relatedConfidence 0.90 · high4 reports · 2016–2026No published response to an earlier report One-page brief (print or PDF)

Ministry of Justice received 4 coroners' reports about this hazard between 21 Apr 2016 and 18 May 2026.

They came from 4 different coroners in 4 coroner areas. A similar concern was raised again 3 times after the first warning.

A published response was found for 1 of the 3 earlier reports, stating 1 specific action.

4
reports
4
different coroners
2016–2026
years
0.90
lowest link confidence

The story, report by report

Spacing grows with the time between reports.

  1. First warning

    Derrick Rose-Fowler↗

    21 Apr 2016 · John Ellery · Shropshire, Telford and Wrekin

    “it is a matter of concern that in December 2010 only one of four officers were first aid trained”
    Original on judiciary.uk ↗

    No published response from Ministry of Justice was found for this report.

  2. 3 years 2 months later

    Raised again · 1st time

    Darren McGuin↗

    26 Jun 2019 · Sarah Slater · South Yorkshire (East)

    Closely relatedConfidence 0.90 · higha different coroner
    “There was clearly a delay between Mr [name redacted] being found unresponsive by the prison officers and the commencement of CPR by members of the healthcare staff.”
    Original on judiciary.uk ↗

    No published response from Ministry of Justice was found for this report.

  3. 5 years 4 months later

    Raised again · 2nd time

    Stephen Sleaford↗

    14 Oct 2024 · I M Cartwright · Leicester City and South Leicestershire

    Identical hazardConfidence 0.90 · higha different coroner
    “basic first aid training (including CPR training) has been omitted from the foundation training programme for those training to be prison officers”
    Original on judiciary.uk ↗

    Repeated from the earlier report:firstofficers

    Ministry of Justice responded, stating 1 specific action.Response (PDF) ↗

    “attention. The HMPPS First Aid Policy Framework was re-issued nationally in August 2023. The revised policy highlights the training requirements for Emergency First Aid and First Aid in prisons, including the importance of Governors ensuring that there is an appropriate number of trained staff on duty at all times. To achieve this, a detailed local first aid risk assessment must be produced to determine the number of First Aiders at Work (FAW) and Emergency First Aiders at work (EFAW) required at an”

    Stated timescale: August 2023

    Web search (Tavily): No evidence found either way

    Workplace First Aid 2026: Are You Compliant? | Garland Training ↗
  4. 1 year 7 months later

    Raised again · 3rd time

    Jake O'Brien↗

    18 May 2026 · Michael Pemberton · Manchester West

    Identical hazardConfidence 0.92 · higha different coroner
    “No ongoing training had been provided to prison officers since initial training on basic life support or first aid, meaning that officers confronted with discovery of a ligature situation were unable to provide immediate and basic life support due to a lack of confidence and unfamiliarity of what to do in a situation when every second can count in promoting the chances of an optimal recovery.”
    Original on judiciary.uk ↗

    Repeated from the earlier report:trainingprisonofficersbasiclifesupport

  5. All reports to Ministry of Justice

Next

This shows that a similar concern was raised again after an earlier report. It does not say why, and it is not a finding about any organisation or person. To report an error, see the corrections route.

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Source: Prevention of Future Deaths reports and responses published by the Courts and Tribunals Judiciary at judiciary.uk. Crown copyright, used under the Open Government Licence v3.0. Data updated 26 Oct 2026.

A link shows that a similar concern was raised again, not why. It is not a finding about any organisation or person. Methodology and responsible use · Report an error