Fatal Accident Inquiries - prison custody deaths: Ministerial Accountability Board - final report

3. Purpose of this report

This report aims to provide a clear understanding of the role of the Ministerial Accountability Board (MAB) and the approach it adopted to oversee the implementation of 43 recommendations and commitments across multiple organisations, including the Scottish Government, the Scottish Prison Service (SPS), and Forth Valley Health Board.

It summarises the work undertaken by the MAB between June 2025 and March 2026 and presents an overview of progress to date.

The report includes reflections from the MAB, acknowledges actions delivered by responsible organisations, and sets out independent recommendations for future priorities.

In addition, it captures lessons learned from the MAB’s experience in fulfilling a time-limited oversight role. These insights are intended to inform the development of any future oversight model for monitoring the implementation of Fatal Accident Inquiry (FAI) determinations, recommendations, and related findings across Scotland.

This report is significant because it provides transparency and accountability for the actions taken after three reported Fatal Accident Inquiries into deaths in custody. It shows what progress has been made, what challenges remain, and how lessons learned can shape future oversight and systemic reform to prevent further tragedies. It is the first and only report of its kind where progress on implementing FAI recommendations and related government commitments has been collated and publicly documented.

All publications associated with the MAB including Terms of Reference, workplan, minutes, updates to Parliament and progress reports can be found on the government website here: Fatal Accident Inquiries: Ministerial Accountability Board - gov.scot