Dear Dr Shaw, Re: Death of Matthew Brierley (Ref: 11873028) Thank you for your report dated 8 January 2025 in relation to the death of Mr Matthew Brierley. As I understand from the detail of your report, on 16 March 2024, Mr Brierley was arrested in connection with indecent images of children and subsequently placed on police bail. He died in the car park of Buttermere Hotel, Cumbria, on 24 April 2024 having taken his own life by . I note within the body of your report, that three areas are of concern, and that you have asked for a response (as per your statutory duty). The areas of concern are;
1. That men in Matthew’s circumstances are at a markedly elevated risk of suicide
2. The examination process for devices (connected with such investigations) & application of bail conditions (whether standard or otherwise).
3. The risk assessment process following release from custody & proactive contact As you may be aware, the College of Policing is the professional body for everyone working across policing. It is an operationally independent non-departmental public body. In this context, I have provided a reply under each heading to both assist you and respond as thoroughly as possible.
1. That men in Matthew’s circumstances are at a markedly elevated risk of suicide The College of Policing recognises that suspects of child sexual exploitation, possession/distribution of indecent images of children and other sexual offending are at

increased risk of suicide (such as those matching Mr Brierley’s demographics). We have produced comprehensive practitioner advice for officers and staff that outlines a series of measures to mitigate against this risk and have also added the latest guidance document from the Faculty of Forensic and Legal Medicine on how to care for suspects of sexual assault in police custody. (Please find further details here).
2. The examination process for devices (connected with such investigations) & application of bail conditions (whether standard or otherwise). As operationally independent organisations, each police force will have provisions for the forensic examination of mobile phones and other digital devices. The context of each investigation will also shape the extent of both lines of enquiry and the depth or otherwise, of those examination processes, which will invariably have an impact on the time taken to complete those examinations. Similarly, the context of each case and presentation of risks would also help inform decision makers. Given the case specifics here, I would expect that officers appropriately recognise their responsibilities to safeguard children under Working Together 2023 and the Children Act 1989 and that this had a strong bearing on the bail conditions imposed. I would also expect the application of those bail conditions to have had a duration and scrutiny in compliance with the law (please see here for further information). I shall outline wider risk-assessment provisions when addressing point 3, below.
3. The risk assessment process following release from custody & proactive contact The Detention and Custody Authorised Professional Practice (APP) has a detailed chapter under ‘Detention and Custody Risk Assessment’ where it provides clear guidance to Custody Officers that the National Decision Model should be used to assess the threat(s) and risk(s) throughout the period of detention. It also makes clear that the risks can escalate towards the point of release and that custody officers should engage with detainees and offer the relevant support where applicable. Outside of the College, there is the National Custody Strategy (2022), produced by the National Police Chiefs’ Council (NPCC) which is also referenced in the custody APP. It contains six strategic principles and makes explicit reference to working in partnership with key stakeholders (such as Liaison and Diversion). I note that Mr Brierley was offered and declined the support of Liaison and Diversion (which is in line with APP) and that you have understandably queried whether proactive support was offered post release. Without further case information I am unaware as to what extent the investigating officer(s) made further contact/offers of support but would expect there to have been an appropriate investigation plan and bail management position while Mr Brierley remained a suspect. As you will appreciate, each police force also has a separate local partnership support arrangement which may or may not have been applicable here.

I trust that the above assists in answering your queries and that you are reassured by the provisions and guidance that are in place. Please do not hesitate to contact me or my lead for Crime and Criminal Justice, Chief Superintendent

if you need any further information or assistance.

Dear Dr Shaw,

Thank you for your email of 28 April to the Home Secretary regarding the Prevention of Future Deaths report relating to the death of Matthew Brierley, a Border Force employee, in April 2024. I am replying as Minister of State at the Home Office, and I apologise for the delay in responding to your letter.

At the outset, I wish to express my most sincere condolences to Matthew’s loved ones for the distress they will have experienced following Matthew’s death.

The Detention and Custody Authorised Professional Practice (APP) produced by the College of Policing (henceforth ‘the College’) sets the standards for police engagement with detainees after their arrest, including any offers of support. This includes operational advice on managing the risk of suicide for persons under investigation, such as Matthew. The College is independent of government; its role is to set high professional standards for policing; sharing what works best; acting as the national voice of policing; and ensuring police training and ethics is of the highest possible quality.

How the APP is followed is an operational decision for individual police forces. The Home Office has no authority to intervene in operational policing matters. I cannot comment on the action and decisions taken by police officers in the course of their duties because operational matters are the responsibility of the Chief Officer of the force concerned.

I have had sight of the responses by the National Police Chiefs’ Council (NPCC) and College of Policing to your report. These set out the relevant guidance that police officers should follow in order to support detainees after their arrest and prevent custody and post- custody suicides. I am satisfied that there is current police guidance on this matter which is readily available to forces and clearly sets out the actions for police officers.

I am also reassured by the commitment of the NPCC to ensure that detainees are offered support, post-arrest, in order to decrease the likelihood of suicide post-custody, including consideration of mandatory referrals to partner agencies when an offer of support is declined.

I would like to take the opportunity to set out the support Matthew was offered by the Home Office as a Border Force employee.

Hampshire Police informed Border Force officials of Matthew’s arrest on the weekend of 16 March 2024. Matthew was contacted by a Border Force Deputy Director and support was offered. Subsequently a welfare point of contact was identified. A decision was made to suspend Matthew on full pay, in line with HR guidance. This decision was explained to Matthew, whilst emphasising the importance of his welfare. Matthew was given assurances that the situation would be managed discretely and confidentially.

The ‘keeping in touch’ process was explained, and all relevant welfare support contact numbers were shared with Matthew. A week later, following a conversation with Matthew, his Border Force IT equipment was collected during an offsite meeting with a Border Force official, a standard formality in these circumstances. The offer of employee support was reiterated during this meeting. The following day, Border Force officials were informed of Matthew’s death.

Following this tragic news, Border Force officials maintained contact with Matthew’s wife and have written to Matthew’s father on two occasions to assure him that HR guidance was followed appropriately.

The Home Office Independent Professional Standards Unit conducted a formal review of the management and support for Matthew during and after his arrest. The report concluded that “following Matt’s arrest, the steps taken under the relevant policies were appropriate” and that “Matt was provided with appropriate support and treated with due sensitivity”. The report also found that aside from one occasion, keep-in-touch discussions occurred regularly and well within the agreed ten-day period.

I hope this letter assures you, and Matthew’s family, that proper processes were followed, and that appropriate guidance is in place to support Home Office employees in these circumstances. My thoughts remain with Matthew’s family.

Dear Dr Nicolas Shaw Thank you for including the NPCC Custody porƞolio within your prevenƟon of future deaths report concerning Mr MaƩhew Brierley. and I, took over the Custody porƞolio in October 2024 and the overarching priority behind all of our strategic objecƟves, is to make custody as safe as possible for detainees and those working within the custody environment. To that end, we are heavily involved with the healthcare providers and what is oŌen referred to as, Liaison and Diversion services within custody. We recently re-established the healthcare providers working group and meet regularly with the IOPC, and also aƩend the Ministerial Board on Deaths in Custody, working to prevent both deaths in custody and post custody suicides. Today, I have also aƩended a naƟonal meeƟng of police, healthcare providers and stakeholders including the Independent Office of Police Conduct, Independent Custody VisiƟng AssociaƟon, Independent Advisory Panel on Deaths in Custody, College of Policing and others, where I raised the death of MaƩhew as a primary example of what it is we are working to improve. I detail the aforemenƟoned with the intenƟon of making you aware of the importance this porƞolio places upon all deaths in or following custody. The death of MaƩhew is an extremely tragic example of where improvements are required. I will address each of your maƩers of concern in turn. 1 and 3 – A lot of research has been undertaken already, to try and idenƟfy any commonaliƟes between instances of post custody suicide. The objecƟve is to establish a post release risk assessment process that will idenƟfy those most at risk, and iniƟate a process to miƟgate that risk, with further support such as a mandatory referral to support agencies. The current research has idenƟfied from a review of five years of data from the IOPC: 439 deaths 288 occurred within 48 hours of release 151 occurred outside 48 hours of release Staff Officer to CC NPCC lead for Custody and Movement of Prisoners Wootton Hall Wootton Hall Park Northampton Northamptonshire NN4 0JQ Direct Line: 4th March 2025

The next phase of the research discussed today, will be for each force from which one of those deaths occurred, to answer further qualitaƟve quesƟons to idenƟfy commonaliƟes. At present, we do not ask the key quesƟons that idenƟfy the impact upon somebody’s life, following their arrest. QuesƟons proposed include subjects such as: Did they have to change their place of residence as a result of bail condiƟons? Was their access to children restricted? Was their employer noƟfied? These were all applicable to MaƩhew. Answers to these and other quesƟons, will be analysed to draw any staƟsƟcal conclusions available, that can then be used to idenƟfy those most at risk in the future. The Ɵmetable for this next stage of research, is to submit the request to all forces by the end of April and allow 4 months for the return of the requested informaƟon. Once received, the analyƟcal work will be undertaken, with a Ɵme esƟmate of 6 months. Whilst this work will take Ɵme to complete, communicaƟon with strategic custody leads is conducted via a quarterly strategic board meeƟng and the regular sharing of informaƟon and guidance such as the findings within this report and others, so as not to delay any learning. I note in MaƩhew’s case, he was offered support, which he declined, but as aforemenƟoned, we are seeking to introduce an evidence led process to idenƟfy individuals where a mandatory referral to partner agencies for support following a release from custody is made, so the onus is not on the individual to accept the support offered during their detenƟon, as it is recognised many individuals will decline this for different reasons as you have outlined. 2 – In relaƟon to the examinaƟon of digital devices, Ɵmescales vary between forces, but it is not uncommon for those considered to be linked to lower risk invesƟgaƟons, not to be processed for many months. It will be for the officer in charge (OIC) of the invesƟgaƟon to idenƟfy all risks within their submission to their Digital Forensics Unit (or equivalent), which is then used to prioriƟse the examinaƟon of those devices. The factors in this invesƟgaƟon should have resulted in a much quicker interrogaƟon of the device than the 18 months esƟmated. The fact that MaƩhew was on bail, should have seen the invesƟgaƟon progressed within the requisite bail periods, but I cannot comment upon any individual backlogs or otherwise that the force concerned may have been managing. It appears however, that the risk of suicide was not weighted heavily enough in any triage of the mobile device that took place. Assessments of risk should always be individualised. Whilst there will be a quesƟon set used to conduct a pre-release risk assessment, the responses should be applied to the individual circumstances of the invesƟgaƟon, by the OIC and raƟfied by their supervisor when making a disposal decision. Bail condiƟons should only be applied where it is necessary and proporƟonate to do so. There is a

presumpƟon for uncondiƟonal bail, unless condiƟons are required to manage the risk of further offences, interference with witnesses or ensure the suspect aƩends future proceedings. I have shared a copy of this prevenƟon of future deaths report with all custody leads within the UK, with a recommendaƟon to ensure that the risk of suicide within cohorts such as MaƩhew’s, are included within the invesƟgaƟve strategies and parƟcularly the triage of digital devices, and that risk assessments are tailored to the individual circumstances of the invesƟgaƟon. I hope the contents of this leƩer have been useful and offer some reassurance of the ongoing work and seriousness and I place on all instances of post custody suicide. Please do contact me if I can be of any further assistance.

Dear ,

Please can you see the attached Regulation 28 Report to Prevent Future Deaths and associated letter.

The report was issued by Assistant Coroner, Dr Nicholas Shaw following the Inquest of the late Mr. Matthew Brierley.

Kind Regards, Coroners Officer Tel: 0300 303 3180 Mob: Email: Contact us about this case

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