Ministerial foreword

The digital phone switchover is a necessary upgrade to our underlying national digital infrastructure as the old analogue landline network is becomingly increasingly unreliable. If we want to stay in touch with the rest of the world we need a complete overhaul.

However, our old landlines are still vital lifelines for very many people, including users of telecare, and it is crucial that we take people through the digital phone switchover safely. Upwards of 2 million people in the UK use telecare - the most common example being personal alarm pendants or buttons that many of us have seen family members use - and most of these telecare devices have historically relied on the analogue landline network.

Telecare users have been identified as being at risk during the digital phone switchover, with past serious incidents underscoring the importance of safeguarding these individuals.

The Department of Health and Social Care (DHSC) and Department for Science, Innovation and Technology (DSIT) have worked collaboratively and closely with stakeholders from across the telecommunications and adult social care sectors to produce this Telecare National Action Plan. At the heart of this plan is protecting telecare users. We must avoid a situation where someone’s care line fails during a fall in the middle of the night because nobody made sure it worked properly with new technology.

We have recently secured support from communications providers for further safeguards to protect vulnerable customers in a new non-voluntary migrations checklist. But no one organisation or set of stakeholders can ensure the safety of telecare users. It requires a joint effort, and this government wants to ensure that effort is co-ordinated and impactful.

This plan is predominantly for the use of communication providers, local authorities, housing providers, third sector organisations and commercial providers. But it also demonstrates to the wider public that the government is committed to working with the sector to protect telecare users during the digital phone switchover. This plan applies to England only, but the digital phone switchover will affect all devolved nations and we are working closely with the devolved governments to share best practices.

This plan will be reviewed and iterated with the main stakeholders every 6 months to ensure that the response to the digital phone switchover remains effective and timely.

The government recently announced an independent commission into adult social care as part of its critical first step towards a national care service, chaired by Baroness Casey. Even while the Casey Commission carries out its work, the government is committed to reforming the system and has announced immediate actions to improve adult social care services. This includes the development of new national standards and trusted guidance for technology in social care, including telecare. The new standards and guidance will make it easier for providers, commissioners and people who draw on care to identify the technologies that will work best for them.

One of this government’s priorities is to improve adult social care for those who draw on it, helping people to stay independent in their own homes, joining up services and improving the quality of care. Technology enabled care (TEC) plays an important part in achieving this. The action plan sets out our vision for how to transition telecare provision into a modern, digital and resilient part of adult social care. The migration to digital telephone networks will lay the foundations for a next generation of telecare services so that care is personalised and preventative.

Stephen Kinnock, Minister of State for Social Care, Department of Health and Social Care

Sir Chris Bryant, Minister of State for Data Protection and Telecoms, Department for Science, Innovation and Technology

Summary

In 2017 communication providers announced their intention to retire the analogue landline network (also known as the public switched telephone network or PSTN) and replace it with a digital landline network. Stakeholders have been working together for several years to mitigate telecare risks associated with the digital phone switchover. This is the replacement of analogue telecommunication infrastructure with voice over internet protocol (VoIP) technology, which carries voice calls as data using internet protocols (IPs) and technology over a broadband connection. This digital upgrade is broadly expected to be fully completed in 2027.

This joint action plan from DHSC and DSIT builds on work to date by outlining the steps that stakeholders need to take to safeguard telecare users during the digital phone switchover.

The safety of telecare users throughout the switchover is government’s utmost priority. The actions in this plan are set out against the main outcomes government expects to see delivered to safeguard telecare users. This action plan also includes several examples to highlight the diverse and novel approaches that are already being taken across England in support of these outcomes.

Outcome 1

Telecare service providers and local authorities hold valuable information about telecare users. Data should be shared by local authorities to ensure that telecare users can be correctly identified, and the necessary safeguards are put in place.

Telecare users should not be put at risk and should only be migrated to digital landline services if either communication providers, the customer, the telecare supplier, or the telecare service provider confirm they have functioning telecare in place.

Government is encouraging a risk-based approach to working through the digital phone switchover, ensuring that the most vulnerable people are protected first. Telecare users who are most at risk should be identified and prioritised.

Ofcom, the regulator and competition authority for the UK communications industry, introduced an incident reporting framework in spring 2024 to monitor the nature and volume of incidents. Ofcom will continue to operate their incident reporting framework and report to DSIT on a quarterly basis.

Outcome 2

For analogue telecare devices to be phased out, the sale and purchasing of analogue devices needs to be stopped. Companies that supply telecare equipment, known as ‘telecare suppliers’, should no longer be manufacturing analogue equipment and government expects sellers to have stopped selling them. We also need to ensure that telecare buyers, both large-scale buyers like local authorities and personal buyers, understand that they should not purchase analogue devices.

Government also expects that telecare service providers will phase out the redeployment of analogue alarm devices that are already in circulation. These are devices capable of using analogue signalling (non-digital alarm signals). An analogue-only device has no capability to use digital signalling standards or IP connectivity (both should be used to remove the risk of failed alarm call connections). Government will work with telecare suppliers and telecare service providers to establish a feasible timeline for analogue telecare devices to be phased out and will communicate a deadline in the coming months.

While analogue alarm devices are still in use, there should be ongoing testing of analogue telecare devices and any interim solutions on digital telephone lines and alarm reliability should continue to be monitored while analogue telecare equipment continues to be used. The results of tests should be shared.

Alarm receiving centres (ARCs) are the contact centres where operators accept emergency calls from telecare devices. An ARC receives a signal when an alarm is triggered and quickly actions the appropriate response, if necessary. Given the switch to digital telecare devices, ARCs also need to be interoperable to ensure they are compatible with new digital equipment. ‘Interoperable’ means that products and solutions created by different manufacturers can link together to share data and insights.

Outcome 3

Stakeholders need to raise awareness of the digital phone switchover among telecare users and their support networks. Government is working with organisations that are important sources of consumer information. This includes working closely with the telecommunications industry (who provide telephone services) on a national communication campaign to be launched in early 2025.

Telecare service providers at a more advanced stage of the digital phone switchover have demonstrated how telecare users can be protected during and after the migration process. There needs to be increased awareness and adoption of best practice approaches and guidance among telecare service providers.

The digital phone switchover will impact telecare within social care settings. DHSC will work with the Digital Care Hub, among others, to improve awareness of the digital phone switchover among social care providers.

Government is encouraging communication providers to be as transparent as possible with their rollout plans. This should include sharing migration plans with telecare service providers and customers on when and how telephone lines will be migrated to digital.

Outcome 4

The Telecare Action Board (TAB) was established in January 2024 and is the primary vehicle for ongoing engagement for stakeholders for telecare and the digital phone switchover. The board will drive progress of this action plan.

Beyond the action board, DHSC and DSIT will continue working with wider telecare stakeholders to identify and address issues of the digital phone switchover for telecare users.

There will be ongoing engagement with the telecommunications sector to ensure compliance with the PSTN charters outlined within this plan and Ofcom’s General Conditions, as well as regular engagement to understand challenges and opportunities within the sector.

The telecare industry is complex and there is currently limited data on the market. DHSC will work with stakeholders to improve evidence gathering to use this to identify where further action may be needed.

Given the complexity of the issue, it is possible that additional necessary actions might be identified to ensure that telecare users are safeguarded during the digital phone switchover. DHSC and DSIT will review progress against this action plan every 6 months, monitoring implementation and effectiveness. We will identify and introduce new actions as needed.

Opportunities created by the digital phone switchover

Telecare provides an array of benefits to service users, their families, care providers, the wider public service network and society as a whole. Like-for-like replacement of telecare devices will maintain the safety of users, but technology is continuously evolving and there are new TEC solutions available that could equal and expand on the benefits provided by telecare.

The move to digital telecare is likely to require significant change to existing telecare services and equipment. As such, when upgrading telecare devices, government encourages telecare service providers and other buyers to future-proof new technology as far as possible. This future-proofing can, and should, go further than ensuring continuity of existing (like-for-like) operational functionality. The plan provides case studies of where local areas are using new care technologies, making links with wider developments in digital infrastructure where possible.

Introduction

Telecare (or ‘telecare services’) are ‘end-to-end’ monitored services made up of 2 main components:

• a device, such as a personal alarm, that can be carried or worn
• ARCs, which are dedicated call centres staffed by professional call handlers that are alerted if individuals experience a problem, such as a fall

Telecare enables individuals to easily access help when needed and offers the reassurance of a prompt response.

An estimated 2 million people in the UK currently use telecare services^{[footnote 1]}. Often telecare users are older and/or more vulnerable people. These services support users to live more independently and are a vital lifeline in an emergency. One of the main benefits of telecare is the reassurance of a direct alert and expected timely response if a user is in need. One of the UK’s largest telecare suppliers alone reports handling 4 million calls annually across its monitoring centres^{[footnote 2]}. The number of annual calls across all suppliers will be much higher.

Digital phone switchover - migration of the PSTN

In 2017 BT Group announced its intention to retire the analogue landline network (also known as the public switched telephone network or PSTN) and replace it with a digital landline network (also known as Voice over Internet Protocol or VoIP). Other communication providers are also switching off their analogue networks. This process is referred to as the ‘digital phone switchover’ or ‘PSTN migration’ and most customers can expect their telephone lines to have made the switch by the end of January 2027.

This switchover is necessary because the analogue landline network is decades old and failure rates are increasing as the infrastructure ages. The analogue landline network will soon no longer be able to be maintained since some of the required equipment is no longer being manufactured, meaning spare parts are difficult to access in case of hardware failure in the network. Furthermore, the telecommunication engineers who are experts in the network are increasingly retiring, meaning there is a knowledge gap forming in the industry.

The need for action

The digital phone switchover means traditional analogue devices, such as telephone handsets and telecare units that are currently connected to the analogue landline network, will need to be reconnected to the digital network. There is a risk that the process of migrating telecare users to digital landlines will disrupt their telecare services. Care must be taken to avoid this. Furthermore, devices designed to operate on analogue landlines have a higher rate of failure when they are connected to digital telephone landlines, so these telecare devices will need to be replaced with digital devices as quickly as possible to mitigate any risk of failure or disruption.

There have been serious incidents, including a small number of fatalities, where telecare devices have failed to work properly after the switchover. Incidents have occurred where telecare users have not been correctly identified and/or there were technical issues with how the devices were connected after the customer had been migrated to a digital landline.

Following these incidents, the major communication providers signed the Public Switched Telephone Network charter committing to concrete measures to protect vulnerable consumers, particularly those using telecare alarms. A similar charter specific for network operators, such as Openreach and City Fibre, was also agreed. These charters have contributed to putting safety at the heart of the switchover. For more details about the charters see the section, ‘Work to date to protect telecare users’.

The digital phone switchover is a complex technology migration process that requires multiple stakeholders to work collaboratively to mitigate risks to telecare users.

This action plan includes actions for individual stakeholders and sets out a holistic approach to tackling the challenges associated with the digital phone switchover and telecare.

Overview of essential stakeholders

The digital phone switchover is being led by communication providers who have no direct involvement in the telecare market. There are over 600 communication providers, whose services are delivered through multiple different network operators, which manage communications network infrastructure, enabling data transmission and communication services. Communication providers control the timeframe for migration from analogue to digital lines.

There are hundreds of telecare suppliers, including some based outside of England who manufacture and sell to customers within the country. Telecare suppliers have a role to play in ensuring devices are compatible with digital lines and in stopping sales of analogue-only devices.

The TEC Services Association (TSA) is the independent advisory body for the TEC sector. Acting as a strategic convenor across care, health and housing, TSA connects commissioners, providers and suppliers to TEC services and solutions that support over 2 million older and disabled people across the UK.

There are also numerous telecare service providers. Telecare users may be provided with a telecare device through many different routes. Telecare might be commissioned for their use on their behalf by local authorities and housing providers or be used within a residential care setting. Some telecare users choose to buy a device independently, without support from local authorities or charities. Telecare can be provided as a single unit or as grouped scheme in supported housing schemes. Telecare users and those who provide their telecare need to be aware of the risk from the digital phone switchover and take appropriate safeguarding actions.

Other parts of the telecare service solution, such as ARCs, also need to be upgraded and migrated to digital lines and equipment. The compatibility of devices and ARCs needs to be continuously tested during this migration and after.

While the switchover is an industry-led initiative, central government, local government and regulators also have important roles to play in ensuring people’s safety both in the short and long term.

In addition to the broad stakeholder landscape, there are several factors that contribute to this risk and/or complicate the ability to mitigate this risk, including:

• variability in terms of preparedness for the digital phone switchover among different stakeholders and there is not one centrally held view on the scale of risk and rate of risk reduction
• gaps in information sharing between telecare service providers, for example:
  • local authorities who are best placed to identify some users
  • communication providers, who are responsible for ensuring ‘safe’ migration from analogue to digital lines
• low public awareness or understanding of the digital phone switchover and implications for telecare devices
• the fact that digitally enabled devices create new future risks as these devices are reliant on communication networks continuing to operate in the event of a power cut (more information below)

The range of stakeholders and complicating factors mean that cross-sector collaboration and co-ordinated action are essential for mitigating the risk of further serious consumer incidents if telecare fails to operate effectively on digital lines. Central government has a fundamental role to play in this co-ordination to ensure that telecare users are safeguarded throughout the switchover.

The switchover is an ongoing process, and many stakeholders have taken important steps to protect users of telecare (see the section ‘Work to date to protect telecare users’). It is also important to note that the digital phone switchover creates opportunities. Some telecare service providers are grasping the switchover as an opportunity to review their use of TEC and how it is delivered. The final section of this action plan, ‘Opportunities created by the digital phone switchover’, provides more information on work going on in this space.

Switch-off of 3G and 2G mobile networks

In addition to the digital phone switchover, it is important to note that the UK’s mobile network provision is also evolving.

The UK’s mobile network operators have confirmed to the government that they do not intend to offer 2G and 3G mobile networks beyond the end of 2033 at the latest. This is to support the rollout of 4G and 5G networks which will offer faster and more reliable services for customers. All 2G and 3G devices will need to be upgraded to at least 4G by this point. This will include some telecare devices, which may rely on these networks either directly where 2G or 3G is the main source of connectivity or indirectly where 2G or 3G is used as a backup to the analogue landline network.

As with the digital phone switchover, the process for retiring the 2G and 3G mobile networks is led by the telecommunications industry and individual mobile network operators are working to different timescales. All mobile network operators expect to retire their 3G network before switching off 2G. Vodafone and EE have already completed their 3G network switch-offs, while Three and Virgin Media O2 are expected to conclude their programmes in 2025. The mobile network operators will continue to offer 2G connectivity for longer and are yet to announce detailed plans for the full retirement of these networks.

Importantly, some telecare devices may connect to these networks using international or roaming SIMs, which enable devices to connect to the network with the strongest coverage in any given location. Such devices may be affected by Virgin Media O2’s plans to withdraw roaming services on their 2G network from October 2025.

It is critical that these network changes and the longevity of mobile network connected telecare equipment are considered alongside the digital phone switchover, both to mitigate connectivity losses and to avoid replacing telecare devices that rely on the analogue landline network with 2G or 3G dependent equipment that has a limited lifespan.

DSIT is monitoring the planned 2G and 3G switch-offs. DSIT officials are working to feed in issues from this planned switch-off into the digital phone switchover, for example by warning about the risks involved with relying on 2G and 3G enabled devices for resilience and working with mobile network operators to increase awareness of these network changes.

Telecare National Action Plan

This Telecare National Action Plan (‘action plan’) has been jointly developed by DHSC and DSIT. It sets out the actions that stakeholders are taking or need to take to safeguard telecare users through the digital phone switchover.

This action plan supersedes the existing DHSC Telecare stakeholder action plan (first published December 2022, and updated September 2023) to provide a single point of reference for the sector and industry about the areas of highest priority.

The safety of telecare users throughout the switchover is government’s utmost priority. It is clear throughout this action plan that the safety of telecare users is reliant on co-ordinated action by stakeholders across the sector. As such, the plan also sets out the co-ordinating role and actions being taken by central government.

Actions are set out against the main outcomes government expects to see delivered, which are that:

• no telecare user will be migrated to digital landline services without the communication provider, the customer or the telecare service provider confirming that the user has a compatible and functioning telecare solution in place
• use of analogue telecare devices is phased out to ensure that only digital devices are being used
• telecare users, their support networks and their service providers understand what actions they need to take
• stakeholders collaborate to safeguard telecare users through the digital phone switchover

This action plan is a foundation for ongoing work. DHSC and DSIT will continue to monitor whether further actions are necessary to safeguard telecare users through the digital phone switchover.

Throughout this action plan we use case study examples to demonstrate the diverse and novel approaches being undertaken, particularly at a local level, to safeguard telecare users.

TAB will make progress towards delivery of this action plan. DHSC and DSIT will also engage regularly with action owners. DHSC and DSIT will jointly report on progress against actions every 6 months (see the section ‘Actions to achieve outcome 4’ for more details).

Our vision for telecare in the context of the digital phone switchover

It is paramount that telecare users are protected throughout the digital phone switchover and beyond. In the long term, it is government’s position that users of telecare should have a fully digital alarm device (that is, a device that transmits digital signals) that offers resilience in the event of a power cut.

We recognise that it is not feasible to immediately replace all analogue telecare devices with digital devices. There are legitimate barriers to this, including financial and resource barriers, but also issues around the readiness of the digital offering by some suppliers and solutions for people in areas with limited digital and broadband coverage.

Furthermore, there are interim solutions available (such as convertors, which maintain the functionality of elements of analogue technology) that provide necessary protection for users of analogue telecare devices during and after their migration to digital phone lines. As such, in the short-to-medium term, we are content for communication providers, telecare suppliers and telecare service providers to use interim solutions as necessary as long as the rationale for doing so can be directly linked to maintaining the effective functionality of telecare devices and ensuring the safety of telecare users.

The reliability and associated risk of interim solutions can vary depending on the mix of equipment and telephone services used. Because of this, risk assessment and appropriate testing and monitoring of each installation is required to ensure service user safety.

The PSTN charter signed by the major telecommunication providers is an important source of protection for telecare users, but users cannot indefinitely remain on analogue phone lines. Analogue lines will themselves cease to operate effectively over time given the degradation of the underlying infrastructure. Therefore, it is critical that telecare users are migrated to digital phone lines, even if not all telecare devices will be digital at the point where the analogue landline network is switched off.

To support the long-term ambition that analogue telecare devices will be fully phased out and users of telecare will have a fully digital alarm device, government will work with telecare suppliers and telecare service providers to establish a feasible timeline for this and will communicate a deadline in the coming months.

Resilience in the event of a power cut

As noted above, digital telephones and telecare devices come with new risks. Essential among these is their resilience in the event of a power cut.

The analogue landline network provides sufficient electricity to power a basic wired handset during a power cut to be able to make emergency calls. Following the digital phone switchover, landline telephones will typically operate using a socket on a customer’s broadband router that relies on mains power to work. Therefore, corded landline telephones will only work in a power cut if the router has a battery back-up solution, where electricity is provided to the device in the event of a mains power failure.

Ofcom is the regulator and competition authority for the UK communications industry. It requires communications providers to provide a free resilience solution for customers that are reliant on their landline to call emergency services during a power cut. To meet this requirement, communications providers need to provide a resilience solution which provides power for at least one hour, although some solutions last longer. Many (but not all) communication providers meet this requirement by providing eligible customers with a battery back-up unit, which provides back-up power to a home router. In turn, the router enables home phone solutions to make calls and sometimes also allows other devices linked to the network to continue operating (depending on the configuration of the router and the battery back-up unit).

As part of the PSTN charter, communication providers have agreed to work towards solutions that exceed Ofcom’s minimum requirement of at least one hour of battery back-up provision. Government expects communication providers to continue to take steps to improve battery back-up solutions, and to consider how these can be used to protect telecare users. Furthermore, Ofcom and government are reviewing options for improving the power resilience of the UK’s digital infrastructure overall, including the resilience of mobile networks.

There is no regulatory requirement for communication providers to ensure uninterrupted access for telecare devices.

The primary use case for battery back-up is if a customer needs to make an emergency call during a power cut (defined as calls to 999). As telecare devices do not dial 999, there is no obligation to ensure uninterrupted access to telecare calls.

A telecare alarm will not operate during a power cut if one or more of the following happen:

• the telecare alarm does not have an internal battery
• the telecare alarm does have a battery, but it runs out of power
• the telecare alarm is connected to a digital telephone line via a router and that router does not have a battery back-up

Telecare users will want to ensure that their telecare set-up has in-built resilience. Existing analogue telecare devices typically provide between 12 and 24 hours of operation via an internal battery in the result of a power failure. Many digital telecare alarms have an in-built roaming SIM, meaning they will connect to a mobile phone mast in the event of a mains power cut. Some, but not all, mobile masts have some level of power resilience, such as local back-up generators.

Use of interim solutions and importance of testing

We are aware of several interim solutions already in use or being developed that can support the continued functionality of current telecare devices. As set out above, reliability of these interim solutions can vary, and risk assessment and appropriate testing and monitoring of each installation is required.

There are different issues for dispersed alarm devices, which are telecare devices in a single home or residence, and devices in grouped schemes, where an alarm will provide telecare services to all users in a facility, such as a care home or sheltered housing. Different interim solutions are available for each.

Use of analogue terminal adaptors

Analogue telecare alarms, both in-home ‘dispersed’ alarms, and in grouped schemes, can be connected to the analogue terminal adaptor (ATA) port provided on many of the internet routers used to deliver digital telephone line services.

This ATA port provides support for legacy telephone handsets and other devices that use voiceband signalling.

While analogue telecare alarms can be connected to a digital telephone line using an ATA, the digital line may corrupt the alarm’s signalling and relies on mains power being available. The reliability of using ATAs can vary depending on the mix of equipment and telephone services used - appropriate testing and monitoring of each installation is required to ensure any risks are understood and managed.

BT Wholesale pre-digital phoneline service

BT has stated that it intends to launch a pre-digital phoneline (PDPL) in 2025 to support customers until they are ready to move to a fully digital landline. This is a technical solution which will keep customers without broadband connected as they are moved off the PSTN, providing an interim solution until they can switch to a digital landline. The PDPL is expected to be available until the end of 2030. The PDPL is not a ‘telecare solution’ as it will apply to customers with and without telecare.

PDPL retains the existing analogue telephone line into a customer’s home, meaning the current analogue telecare alarm and phone line setup can continue to be used. The telephone line will also continue to be provided with power in the event of a power cut to the home. It should be noted though that PDPL may not be available to, or suitable for, all customers. For example, we know that PDPL is not compatible with lines connected to broadband. Appropriate testing and monitoring of telecare alarms using PDPL is required to ensure any risks are understood and managed.

Use of an analogue digital protocol converter device or service

In grouped settings, an analogue to digital protocol converter device can be added to an existing analogue grouped solution.

The converter ‘translates’ analogue telecare signalling into a digital protocol (typically BS8521-2 or NowIP) which can be then sent over the internet. Since the solution does not send analogue signalling over a phone line, the risk of calls failing due to signal corruption is eliminated.

An analogue to digital protocol converter service is similar to a convertor device, but instead of the analogue to digital protocol conversion being completed by an onsite device, it is instead completed using a cloud-based service.

The analogue grouped scheme solution still uses analogue telecare protocols and dial-up telephone calls. Instead of alarm calls going to the ARC they are directed to the digital bridging service which answers them and converts the signalling to a digital protocol. This digital signalling is then sent over the internet to the ARC.

This solution still relies on sending analogue signalling over a phone line for part of the alarm path, meaning the risk of calls failing due to signal corruption still exists.

As noted above, the key to effective use of any interim solution is appropriate testing and monitoring to assure that they work.

Testing of analogue telecare devices on digital telephone lines has shown that reliability can be affected by a range of factors, including the model of telecare alarm, the telecare signalling protocol being used, the telephone line type and provider, and the ARC equipment.

This means that telecare service providers must ensure the reliability of the specific combination of equipment and services they use.

As recommended in the Local Government Association (LGA) digital switchover telecare checklist, alarm reliability should continue to be monitored while analogue telecare equipment continues to be used. This will ensure any service reliability issues are identified and addressed.

Work to date to protect telecare users

Stakeholders have been working together for several years to produce guidance and take steps to mitigate telecare risks associated with the digital phone switchover. This action plan seeks to build on work to date. This section provides detail on some essential examples of work to date.

PSTN charters for communications providers and network operators

In December 2023 the UK’s major communication providers signed a voluntary agreement with government to protect vulnerable customers when they are moved onto digital services. The charter commits communication providers to ensure that:

• any non-voluntary migrations to digital landlines are not undertaken until the communication provider has full confidence that it is taking all possible steps to protect vulnerable people through the migration process
• no telecare users will be migrated to digital landline services without the communication provider, the customer, or the telecare company confirming that they have a compatible and functioning telecare solution in place
• where battery back-up solutions are provided, communication providers will work to provide solutions that go beyond the Ofcom minimum of one hour of continued, uninterrupted access to emergency services in the event of a power outage
• they will collectively work with Ofcom and government to create a shared definition of ‘vulnerable’ customer groups that require greater support, specific to the digital landline migration
• they will conduct additional checks on customers who have already been non-voluntarily migrated to ensure they do not have telecare devices they were unaware of, and if they do, ensure suitable support is provided

Network operators supply and manage the communications network infrastructure, enabling data transmission and communication services. The network operator charter, developed in March 2024 commits to the following:

• before ceasing any analogue voice service, network operators will provide at least 12 months’ notice to communication providers and will discuss suitable migration options with communication providers that will enable them to migrate customers in accordance with the December 2023 charter
• network operators will work with Ofcom, government and communication providers to create a shared definition of ‘vulnerable’ customer groups that require greater support, specific to the digital landline migration
• when network operators migrate customers to digital landline services, they will work with internet service provider (ISP) partners to check if they have a telecare device
• network operators will not migrate a known telecare customer to a digital landline service without the customer, the communication provider or the telecare company confirming to the network operator that they have a compatible and functioning telecare solution in place that will work following the migration process

DSIT monitors compliance with the 2 charters on a quarterly basis. This process involves:

• bilateral meetings with each of the companies that have signed either of the charters
• asking the signatories to submit written returns, whereby they set out the measures they have in place to ensure adherence to the charters and provide a general status update on how their switchover programme is progressing

DSIT ‘supported journeys’ definition

The PSTN charter commits communication providers to working with Ofcom and government to create a shared definition of vulnerable customer groups that require greater support, specific to the digital landline migration. In response to this, a shared definition of customers that will require additional support during their migration journeys has been created. See Supported journeys: defining vulnerability during the PSTN migration.

This guidance does not explicitly seek to identify ‘vulnerable’ groups, but rather those that communication providers should provide additional assistance to during their migration journeys. This includes customers that are telecare device users, and those that are entirely landline dependent. Customers (or their carers) also have the option of self-identification if they feel they require additional support during the migration. While this guidance sets out the expectation that these groups of customers should receive additional support, it does not seek to be prescriptive as to how communication providers provide this.

DSIT local authority guidance

DSIT has created local authority guidance that provides background information on the digital phone switchover, as well as setting out the rationale for switching from analogue to digital networks.

The guidance outlines the types of devices and services affected by the migration, including but not limited to telecare devices, and provides suggested actions for telecare service providers and local authorities to successfully migrate these devices and services.

The guidance encourages local authorities to conduct audits of the devices and services they use and/or provide that rely on the analogue network. The guidance also encourages local authorities to contact their communications providers to jointly develop a clear picture of the scale and types of risk that the switchover poses to their authority, and the solutions that they can implement with their communication providers’ support.

Local Government Association digital switchover hub

The LGA has developed the Digital Switchover Hub to host information and materials regarding the digital phone switchover, mobile network sunsetting and steps to address digital exclusion. The hub features the following materials to promote awareness of the switchover and its implications in people around those who use telecare devices:

• social media assets and printable leaflets for partners to use to raise awareness of the digital phone switchover - see the digital switchover partner toolkit page
• a landline switchover readiness survey and a 2G/3G impact switch off impact survey with councils
• guidance and templates drafted by the London Office of Technology and Innovation (LOTI), on behalf of and in consultation with the LGA working group for the digital phone switchover - see Digital switchover telecare data sharing)
• a closed hub for councils to share best practice, ask questions and contribute to national discussions

Local Government Association data sharing agreement template

To address concerns that local authorities have around data sharing with communication providers, the LGA and LOTI have worked with communication providers to agree a template ‘data sharing agreement’ and ‘data sharing impact assessment’ (see under ‘Background’ on the Digital switchover telecare data sharing page).

The Minister of State for Social Care and the Minister of State for Data Protection and Telecoms jointly wrote to directors of adult social services in September 2024, encouraging them to reach out to communication providers and use these templates to share vital data.

Telecare Action Board

A Telecare Action Board (TAB) has been established to ensure that relevant stakeholders work together effectively to protect telecare users throughout the digital phone switchover. BT Consumer led the formation of TAB in January 2024.

Central members of the board include government departments (DSIT and DHSC), Ofcom, communication providers, network operators, telecare suppliers, telecare service providers (including regional local authority representatives and housing associations), telecare users and third sector organisations.

Ofcom’s incident reporting framework

Ofcom, the independent telecommunications regulator, has introduced an incident reporting framework whereby communication providers need to report any known incidents of telecare users being harmed by the PSTN migration.

This enables Ofcom to monitor the nature and volume of incidents, so that lessons can be learned to prevent further similar incidents. The framework was developed in spring 2024 and Ofcom provided their first report to DSIT in July 2024.

Ofcom’s digital phone switchover guidance

Ofcom has created guidance outlining the specific roles and responsibilities of different organisations, and its expectations of communication providers in relation to telecare users.

The guidance sets out that telecare service providers will need to test their equipment to see if it will continue to function over IP and then replace, upgrade or reconfigure it as appropriate. They also need to make sure that their customers are aware of the issue and take any necessary steps to maintain their service. The guidance also outlines Ofcom’s expectations around how communication providers will communicate with, and provide support to, their customers to ensure that the digital phone switchover delivers good outcomes for them, and that there are adequate protections in place for those that are at greater risk of harm.

For further information see The future of fixed telephone services on the Ofcom website.

Updated TSA Quality Standards Framework

Since the digital phone switchover was announced, the telecare sector has made considerable efforts to understand the reliability of their analogue devices on digital telephone lines, develop new interoperable digital products and inform their customers of the importance of transitioning to digital telecare as the industry-led digital phone switchover takes place.

TSA has developed member guidance on the digital phone switchover, held webinars and hosted podcasts. TSA has called on the technology enabled care (TEC) sector to ready themselves for the shift, upgrade their systems and recognise the opportunity digital connectivity represents to devise new service and product offerings.

TSA introduced the Quality Standards Framework (QSF) in 2022. Suppliers of telecare devices certified against the QSF can no longer manufacture analogue-only equipment. According to TSA, as of November 2022, no new analogue-only telecare devices have been manufactured for the English market.

Digital Care Hub

The Digital Care Hub consortium works in partnership with DHSC to develop guidance and host events on the digital phone switchover to help increase awareness and preparedness of care providers ahead of the changes.

TechUK awareness raising

TechUK has been commissioned by communication providers and network operators to identify where common challenges to the digital phone switchover can be best resolved through a collaborative approach - from enhanced communications and consistency of messages to increased awareness raising.

Similarly, TechUK has produced a series of leaflets with information about the switchover and has launched a digital phone switchover website which contains guidance, information and events, including on telecare.

Next steps: our action plan to protect users of telecare

As outlined above, actions are grouped under the main outcomes that government is seeking to achieve.

Actions to achieve outcome 1

Action 1.1: data is shared to ensure that telecare users are correctly identified, and the necessary safeguards are put in place

Telecare service providers (predominantly local authorities) hold valuable information about their service users. This data is important to enable communication providers to identify telecare users in their customer base and put additional safeguards in place, such as delaying any non-voluntary migration. Government expects telecare service providers to take necessary action to share data to help communications providers to identify telecare service users. These are individuals who use telecare services either within their homes or within sheltered housing settings. They may have a range of care needs and may or may not be in receipt of state funded care - in many cases, telecare is privately funded by individuals.

As outlined above, the LGA and LOTI have developed a template data sharing agreement to support with data sharing.

TAB reviews a monthly report on data sharing, including data on the number of agreements required by communication providers and the number signed. This transparency allows TAB to understand whether further action is needed to encourage or support more data sharing.

TSA is also working with communication providers to build a comprehensive list of the numbers that telecare numbers dial to contact ARCs. This list can also be cross-referenced against communication providers’ customer records, enabling them to identify additional telecare users.

Owners

The owners are communication providers and telecare service providers, supported by:

• DHSC
• DSIT
• the LGA
• Association of Directors of Adult Social Services (ADASS)
• TSA

Timeline

The timeline is ongoing. Communication providers will periodically cross-reference telephone numbers shared with their customer records.

DSIT and DHSC will engage with local authorities who have not signed data sharing agreements to understand the barriers to doing so. This work commenced in winter 2024 and will continue into 2025 as required.

Action 1.2: telecare users are only migrated to digital landline services if they have a compatible and functioning telecare solution in place

Telecare users should only be migrated to digital landline services if either communication providers, the customer, the telecare supplier or the telecare service provider confirm they have functioning telecare in place. Communication providers have already committed to this action in the PSTN charter and the network operator charter.

As set out above, government’s long-term ambition is that users of telecare will have a fully digital device (that offers sufficient resilience in the event of a power cut). In the short to medium term, to ensure the safety of telecare users, we are content for communication providers, telecare suppliers and telecare service providers to use interim solutions as necessary. However, the use of interim solutions needs to be underpinned by robust risk assessment, and appropriate testing and monitoring of each installation.

Communication providers should play an important role in facilitating testing before and after a migration to ensure that migration is only completed when compatibility of the device is assured.

In order to achieve the long-term ambition of fully phasing out analogue telecare devices and users of telecare having a fully digital device, government will work with telecare suppliers and telecare service providers to establish a feasible timeline and will communicate a deadline in the coming months.

Owners

The owners are:

• communication providers
• network operators
• telecare service providers
• telecare suppliers

DHSC and DSIT will provide oversight and work to establish a deadline for analogue devices being fully phased out.

Timeline

The timeline is ongoing. A deadline for analogue devices being fully phased out will be agreed and communicated in the coming months.

Action 1.3: telecare users who are most at risk are identified and prioritised

Government is encouraging a risk-based approach to working through the digital phone switchover, ensuring that the most vulnerable people (either vulnerable due to personal circumstances or vulnerable because of external factors such as having had a non-voluntary migration) are protected first.

Decisions on risk profiling can be taken at a local level based on local conditions. Examples of how this has been achieved by some local authorities are provided below. Work by communication providers to identify customers in need of additional support should further support telecare service providers to identify and prioritise telecare users who are most at risk.

‘Supported journeys’

Communication providers and network operators in the PSTN charter and the network operator charter have committed to agree a shared definition of ‘vulnerability’ in the context of the PSTN migration.

To meet this commitment, DSIT has been working with a range of stakeholders to produce guidance about who will require additional support (a ‘supported journey’) when their landlines are migrated from analogue to digital networks. This guidance is intended to supplement Ofcom’s broader expectations in relation to vulnerable customers as set out in Ofcom’s rules (General Conditions of Entitlement and Ofcom’s guide for providers on treating vulnerable customers fairly (see under ‘Main documents’).

This guidance defines ‘supported journeys’ as applicable to users that may be at a heightened risk of suffering harmful outcomes (this includes, but are not limited to, incidents posing risks to life or risks of injury, but also issues like heightened sense of anxiety, stress or loneliness as part of the switchover) as part of the migration, where additional support and protection is required to mitigate or avoid the risk of these outcomes occurring. Therefore, certain customers may require additional support to install upgraded devices. Certain customers are more likely to need quick access to emergency services and, in the event of a power cut, may require additional mitigations to ensure continued access to these services, such as a battery back-up unit.

Owners

The owners are telecare service providers and communication providers.

Timeline

The timeline is ongoing. Those most at risk should continue to be prioritised until the digital phone switchover is complete.

Action 1.4: Ofcom continue to operate their incident reporting framework

As outlined above, Ofcom introduced an incident reporting framework in spring 2024. This enables Ofcom to monitor the nature and volume of incidents, so that migration processes and other processes can be iterated to prevent further similar incidents. Ofcom will monitor and report to DSIT quarterly on the nature and volume of incidents of telecare users being affected by the PSTN migration.

Owners

The owners are Ofcom and communication providers, with oversight from DSIT.

Timeline

The timeline is ongoing. Ofcom to report quarterly until the digital phone switchover is complete.

Actions to achieve outcome 2

Telecare devices that are only functional on analogue lines have increased risk to telecare users. Over the coming years, government expects analogue telecare devices to be fully phased out and users of telecare to have a fully digital device. Phasing out the use of analogue telecare requires action to stop the manufacture, sales and purchase of new devices, in addition to the replacement of the current stock of devices in use by telecare service providers.

Action 2.1: stop the sale and purchase of analogue telecare devices

As outlined above, as of 2022, TSA QSF-certified suppliers of telecare devices should no longer be manufacturing analogue equipment. Government also expects sellers of telecare devices to have stopped selling analogue-only devices. The Minister of State for Care and Minister of State for Data Protection and Telecoms jointly wrote to telecare suppliers in September 2024 to reiterate this expectation. We also need to ensure that telecare buyers, both large-scale buyers like local authorities and personal buyers, understand that they should not purchase analogue devices.

Personal telecare buyers

To support people who privately purchase telecare for their own use or for family members, we are working with consumer-facing organisations to encourage them to feature clear messaging about the risks associated with analogue telecare devices on their websites, ensuring consumers are well-informed as the digital phone switchover progresses. Examples of organisations that have already provided this sort of information are provided below.

We are also working with stakeholders, including Trading Standards and Citizens Advice, to understand how any continued sale of analogue telecare devices interacts with the Consumer Rights Act and legislation on consumer protection for unfair trading. Personal telecare buyers are also encouraged to look out for devices that meet TSA’s Quality Standards Framework to ensure they are purchasing high quality devices.

Telecare service providers

The LGA’s Digital Switchover Hub includes a digital phone switchover toolkit for commissioners. This is a practical tool to enable commissioners within councils, housing associations and third sector organisations to understand the implications of the digital phone switchover for technology enabled care and to provide guidance and signposting to where and when action is required.

The resource is intended to cater for a range of approaches - whether the ambition is to safely move telecare users and suppliers on a like-for-like basis from analogue to digital technology or if the ambition is to take this ‘one-off’ opportunity to deliver a more transformational approach to care technology. It sets out a toolkit and step-by-step process for commissioners to follow, along with examples of how other local authorities have addressed the digital phone switchover.

TSA also features TEC commissioner and buyer guidance on its website. To support commissioners of telecare, government will work with these stakeholders to understand whether any additional support is required.

Government assurance of telecare devices

To support future buyers of telecare devices to secure the highest-quality technology, DHSC is exploring options for assurance of TEC. As announced on 3 January 2025, this includes defining and publishing a minimum set of standards that care technologies including telecare should meet.

Owners

The owners are:

• telecare suppliers
• telecare service providers
• private telecare consumers

The will be supported by DHSC and DSIT.

Timeline

The timeline is ongoing.

Action 2.2: phase out the redeployment of analogue alarm devices already in circulation

Government also expects the redeployment of analogue alarm devices already in use by telecare service providers to be phased out.

Government will not be prescriptive about how telecare service providers replace their current stock of devices, and, as outlined above, government is content for communication providers, telecare suppliers and telecare service providers to use interim solutions as necessary as long as the rationale for doing so can be directly linked to maintaining the effective functionality of telecare devices and ensuring the safety of telecare users.

As detailed in the ‘Opportunities created by the digital phone switchover’ section of this action plan, we are encouraging telecare service providers and other buyers to futureproof new technology as far as possible. This future-proofing can, and should, go further than ensuring continuity of existing (like-for-like) operational functionality as there is an array of new TEC opportunities. The LGA’s commissioner toolkit provides practical guidance on phasing out analogue devices and on taking a more transformational approach to care technology.

Government will work with telecare suppliers and telecare service providers to establish a feasible timeline for analogue telecare devices to be phased out and will communicate a deadline in the coming months.

Owners

The owners are telecare service providers, supported by the LGA and DHSC.

Timeline

A feasible deadline for fully phasing out analogue telecare will be established and communicated.

Action 2.3: ongoing testing of analogue telecare devices on digital telephone lines and sharing results

As outlined above, we are aware of interim solutions that can extend the effectiveness of analogue devices. We support the use of these interim solutions in the short-to-medium term provided appropriate risk assessment and testing and monitoring of each installation is undertaken.

Testing of analogue telecare devices on digital telephone lines has shown that reliability can be affected by a range of factors, including the model of telecare alarm, the telecare signalling protocol being used, the telephone line type and provider, and the ARC equipment. This means that telecare service providers must ensure the reliability of the specific combination of equipment and services they use.

As recommended in the LGA’s ‘digital switchover telecare checklist’, alarm reliability should continue to be monitored while analogue telecare equipment continues to be used. This will ensure any service reliability issues are identified and addressed.

Telecare service providers are expected to regularly test the functioning of telecare devices, as well as to monitor and analyse failure rates. Opportunities to share results, identify trends and respond to them should be explored.

Owners

The owners are telecare service providers and communication providers.

Timeline

The timeline is ongoing, until analogue telecare devices have been phased out.

Action 2.4: ARC platforms should be interoperable

Given the switch to digital telecare devices, ARCs also need to be interoperable to ensure they are compatible with new digital equipment. This will streamline the process for telecare service providers phasing out analogue devices.

DHSC will work with relevant stakeholders to understand the transition process for ARCs and to ensure they are focused on interoperability.

Owner

The owner is DHSC, working with relevant stakeholders.

Timeline

Expected to be complete in early 2025.

Actions to achieve outcome 3

Action 3.1: raise awareness of the digital phone switchover among telecare users and their support networks

Telecare users and their support networks (including family, friends, carers and other organisations that telecare users seek information from) need to be aware of the digital switchover. This includes what the digital phone switchover is, why it is happening, and the importance of safety of telecare users during the process.

Telecare users and their support networks are urged to inform their communication provider if they have a telecare device in their home, so that their communication provider can ensure they are not migrated without functioning telecare.

In addition to the consumer information flagged under action 2.1, there are numerous additional examples of awareness raising among essential organisations operating in the adult social care sector.

Government will support other organisations that are likely to be important sources of consumer information about telecare to display similar messaging about the digital phone switchover and its impact on telecare.

Owners

This action is reliant on the support of a range of stakeholders, with oversight from DHSC and DSIT.

Timeline

The timeline is ongoing.

National communications campaign

DSIT and Ofcom are working closely with the telecommunications industry to monitor their plans for raising awareness of the digital phone switchover. Industry is leading on preparations for a national communications campaign to be launched in early 2025.

This campaign will be tailored to the unique characteristics of telecare users and their support networks.

Wider impacts of the digital phone switchover - consumer scams

The transition from analogue to digital technologies has created new opportunities for criminals to target vulnerable residents. For example, criminals may use phishing emails, fake websites, or phone calls to trick residents into providing personal information, such as bank account details or passwords.

The LGA has developed guidance on how local authorities can raise awareness among residents to prevent and disrupt anyone from using the digital phone switchover to advance criminal activity. It has provided examples of how some councils have addressed this.

The LGA recommended actions to avoid scams including to:

• ensure frontline staff are aware of the digital phone switchover and understand how to report concerns
• report potential scams or fraud to trading standards
• ensure co-ordination between trading standards and adult and children social care teams
• consider undertaking a proactive awareness-raising communications campaign
• use language which reflects the criminal nature of this issue

TSA has also produced a guide for telecare users warning them of scam calls relating to the switchover. This work was produced alongside the National Trading Standards team and aims to raise awareness and showcase helpful techniques.

Action 3.2: improve awareness and adoption of best practice approaches and guidance among telecare service providers

The digital phone switchover will have a significant impact on telecare service providers. Over time telecare service providers will need to phase out the use of analogue telecare devices and move towards a fully digital operating model. Existing operational procedures, staffing and skills will be impacted by this transition.

Telecare service providers are at various points on the journey. Those that are at a more advanced stage have demonstrated how telecare users can be protected during and after the migration process. Awareness of these example approaches will support telecare service providers, particularly local authorities, to phase out analogue devices more quickly.

The LGA, as part of their digital phone switchover support, runs a closed hub for councils to share best practice, ask questions and contribute to national discussions.

Throughout this action plan, DHSC and DSIT have sought to use case study examples to demonstrate the diverse and novel approaches being undertaken, particularly at a local level, to safeguard telecare users. We will continue to seek and disseminate examples of best practice, working with stakeholders including TSA, the LGA, local authorities and so on.

Owners

This action is reliant on the support of a range of stakeholders, with oversight from DHSC and DSIT (with support from DHSC and TSA gathering information on reasons best practice cannot be adopted).

Timeline

The timeline is ongoing.

Action 3.3: improve awareness of the digital phone switchover among social care providers

The digital phone switchover will impact telecare within social care settings. The Digital Care Hub includes information and guidance for social care providers to help them navigate the digital phone switchover and mitigate any potential risks to service users.

DHSC will continue to work closely with the Digital Care Hub to identify and develop guidance and webinars needed by social care providers.

Owners

The owners are DHSC and the Digital Care Hub.

Timeline

The timeline is ongoing.

Action 3.4: communication providers to share migration plans with telecare service providers

Government is encouraging communication providers to be as transparent as possible with their rollout plans. This should support planning by telecare service providers. Communication providers should also provide customers with reliable information on when and how their telephone line will be migrated to digital.

DSIT and TechUK will engage with major communication providers to encourage them to publicly share their approach to the digital phone switchover. TechUK, as the industry body, can support this by providing a brief summary of each of the major communication providers’ high-level plans on their Digital Switchover website. This should provide more information and reassurance as to why there may be important differences in their approaches.

Owners

The owners are communication providers, with the support of TechUK.

Timeline

The timeline is ongoing, until the digital phone switchover is complete.

Actions to achieve outcome 4

Action 4.1 the Telecare Action Board will drive progress of this action plan

As outlined above, TAB was established in January 2024. During summer 2024, TAB agreed terms of reference that includes the board playing a role in driving progress against the actions set out in this action plan.

TAB members have agreed to:

• drive progress on migrating telecare users from analogue communications networks to digital equivalents
• drive progress against the joint objectives set out in the Telecare National Action Plan
• mitigate risks associated with the migration and identify joint mitigation strategies
• agree workstreams, actions and delivery timelines aimed at ensuring the migration happens safely and securely; and ensure that these workstreams are delivered to agreed timelines
• protect users’ long-term interests and ensure new telecare users are aware of the future-proof technology

TAB is the primary vehicle for ongoing engagement between the essential stakeholders for this issue.

Owners

The owners are:

• BT Consumer
• DSIT
• DHSC

Timeline

The timeline is ongoing. TAB meets monthly.

Action 4.2: ongoing engagement with wider telecare stakeholders

Beyond TAB, DHSC and DSIT will continue working with wider telecare stakeholders, to identify and address broader issues and potential impacts of the digital phone switchover. By maintaining open lines of communication, this engagement allows for the early identification of risks and vulnerabilities.

Owners

The owners are DHSC and DSIT, with support from others including the LGA and TSA.

Timeline

The timeline is ongoing.

Action 4.3: ongoing engagement with the wider telecommunications sector

DSIT monitors how all signatories to the PSTN charters for communication providers and network operators, respectively, adhere to the commitments within the charters.

DSIT also regularly engages with the telecommunications sector to understand broader challenges and opportunities in the sector, including where they want more support and collaboration from central government, local government, or other important stakeholders.

Separately, Ofcom regularly meets with telecommunications companies to monitor compliance with its General Conditions and understand wider developments in the sector.

Owners

The owners are DSIT and Ofcom, with the co-operation of communication providers.

Timeline

The timeline is ongoing.

Action 4.4: improved evidence gathering to identify where further action may be needed

The telecare industry is complex and there is currently limited data on the market. For example, there is no data available on how many telecare users purchase services or devices from private suppliers. This makes it challenging to know how far actions (such as engaging with local authorities and housing providers) go to safeguard users. DHSC will work with stakeholders to gather more information on the digital readiness of the telecare sector to help identify where further action may be needed.

TSA is currently developing an ‘analogue to digital (A2D) dashboard’, providing monthly updates on the UK TEC sector’s A2D migration progress. The sector has lacked a single, regularly updated, credible source of A2D progress and TSA is best placed to provide this ‘near to live’ dashboard. The dashboard will showcase TEC digital readiness across 3 core aspects of the transition:

• dispersed connections in individual homes
• grouped living schemes connecting many residents on a single network
• ARC platforms responsible for handling emergency calls from both dispersed and scheme connections

The data is being collated by TSA from approximately 163 UK ARCs and a monthly report providing both actual and forecasted transition will be produced every month. TSA will also share out monthly updates to all TEC services via their dissemination channels.

Owners

DHSC to co-ordinate stakeholders (with support from BT and TSA).

Timeline

The timeline is ongoing. First TSA dashboard to be presented at TAB by December 2024.

Action 4.5: maintain a national action plan (the Telecare National Action Plan)

Given the complexity of the issue, it is possible that additional necessary actions might be identified. As such, we will review progress against this action plan every 6 months, monitoring implementation and effectiveness. We will identify and introduce new actions as needed. All updates and new actions will be documented and engaged on with stakeholders to ensure transparency.

Owners

The Telecare National Action Plan is jointly owned by DHSC and DSIT.

Timeline

Progress updates every 6 months until outcomes have been achieved.

Opportunities created by the digital phone switchover

As outlined above, the move to digital telecare is likely to require significant change to existing telecare services and equipment. This change is also being managed against a backdrop of wider shifts, such as the upcoming switch-off of 2G and 3G networks.

As such, when upgrading telecare devices, we’re encouraging telecare service providers and other buyers to future-proof new technology as far as possible. This future-proofing can, and should, go further than ensuring continuity of existing (like-for-like) operational functionality.

Telecare provides an array of benefits to service users, their families, care providers, the wider public service network, and society as a whole. Like-for-like replacement of telecare devices will maintain the safety of users, but technology is continuously evolving and there are new solutions available that could equal and expand on the benefits provided by telecare.

Developments in technology enabled care

There are several new technologies that could offer similar functionality as telecare, alongside further capabilities. For example, lifestyle monitoring technology that allows people to stay in their own home for longer could generate savings for councils by delaying or preventing people from needing to enter more expensive care settings, such as sheltered housing and residential care.^{[footnote 3]}

The move to digital presents significant opportunities to enhance both the range and quality of technology enabled care (TEC) services offered, fundamentally transforming service delivery. By transforming telecare services, additional benefits can be realised, including improved use of data analytics, to support a shift toward proactive and preventative services. Less than 10% of telecare services are using predictive analytics to provide proactive care, with most systems remaining focused on reactive emergency responses where technology is used after an incident has occurred.

The opportunity to review technology enabled care

The digital phone switchover provides buyers, including local authorities, housing providers and individuals, with an opportunity to re-evaluate the technology they are using and ensure it is still the most effective solution for them.

Several local authorities have grasped this opportunity created by the digital phone switchover to re-evaluate their use of technology.

Using wider digital infrastructure developments

Other local authorities have linked their need to address the digital phone switchover with wider developments in digital infrastructure. For example, the West Midlands is leveraging its success as a 5G Innovation Region to transform and scale TEC use in the region, which will simultaneously help mitigate the risk from analogue telecare devices.

5G Innovation Regions are part of DSIT’s wider programme to drive 5G adoption. 5G Innovation Regions receive funding to lead on delivering government’s vision for communities to take full advantage of the transformative effect that advanced wireless connectivity and digital technologies can provide. These Innovation Regions can tailor interventions to their specific local needs and existing strengths, promoting the development and scaled adoption of 5G and other advanced wireless technologies, in businesses and in the delivery of public services, to generate value and growth at the local level.

Technology enabled care - beyond telecare

Several local authorities are trailblazing the trial and use of new care technologies beyond the context of the digital phone switchover. Detail is provided below on some of these initiatives to further demonstrate developments in care technology and the benefits of using these technologies.

Wiltshire Council

The Technology for our Ageing Population: Panel for Innovation (TAPPI) project has led the way in how local authorities and housing organisations are embracing future-focused approaches to technology in housing and care for older adults. One example is the TAPPI2 phase, which involves 6 testbed locations, including Wiltshire Council. These testbeds implemented technology that enhanced the independence, safety, and connectivity of elderly residents. Their care facilities focus on the integration of assistive technology that enables residents to maintain independence and safety through smart devices like sensors and automated alerts.

Sunderland City Council

Sunderland City Council has introduced the use of assistive technology into adult social care services with the support from the TEC team. This team works closely with social workers and social care staff and together they have adapted their approach to how adult social care is provided in and around Sunderland. Products like the Amazon Alexa, smart lightbulbs and heating, as well as home and environment sensors, have many benefits that can support people to remain in their own home and control their own environment. This initiative is part of a larger effort by Sunderland City Council to integrate smart technology into social care, improving real-time monitoring and communication for residents with health conditions. This approach not only promotes independence but also allows care providers to allocate resources more efficiently.

Cumberland Council

Careium’s partnership with Ethelcare, a virtual care service, has shown Ethelcare effectively enhancing care delivery, promoting independence, and reducing care costs, through a recent pilot project with Cumberland Council. The partnership revealed that some service users were even able to transition to a fully virtual care model, which allowed them to receive care and support from the comfort of their own homes. This not only improved their quality of life but also reduced the need for costly in-person visits and potential hospital admissions or readmissions. At the heart of the Ethel solution is a large ‘always on’ touch screen device that is specifically designed for all, including the elderly, and has a range of features to support independent living including video calling and can include additional features including vital signs monitoring, automated alerts and medication reminders. The care circle can be expanded and adapted to include family and friends so they can monitor and see any interaction and use the platform to make calls, receive messages, view notes and so on.

Redbridge Council

The use of AI and ‘big data’ can automatically analyse digital alarm call usage patterns. If potential concerns are detected, for example an increase in the frequency of alarm calls, a proactive wellbeing call to the alarm user’s emergency contacts is triggered to check in on the alarm user. The unique proactive service helps manage the health and independence of older adults by making family members aware of potential issues earlier. The service automatically monitors and analyses digital alarm call usage, including the frequency, timing and nature of the calls.

The Adult Social Care Technology Fund has supported numerous local authorities to use new technologies to support the delivery of their adult social care services.

Redbridge Council successfully bid for a £1 million grant from the Adult Social Care Technology Fund to rollout innovative care technology to 300 residents, which can prevent falls and automatically alert carers to a medical issue. As part of the programme, Redbridge has selected 4 innovative care technologies and is testing them in reablement, care homes and extra care settings. The technologies being piloted are:

• 4D mapping technology to track movement and detect falls through sensors placed around the home
• conversational artificial intelligence (AI) with sensors to manage and support chronic conditions
• health monitoring kits to detect early health issues
• electricity monitoring to monitor unobtrusively independent living activities

Redbridge, in partnership with NHS North East London integrated care board, Public Health, and Care City, a community interest company, will be at the forefront of using new technology to keep local residents safe and well at care settings across the borough. The 18-month pilot forms part of Redbridge Council’s broader assistive technology programme, which is exploring how care technology can improve services for people drawing on care services and for staff, while also saving costs through early intervention and prevention. Through consultation with technology providers, local residents and staff to identify opportunities and challenges, the programme seeks to determine the best models for care technology implementation and ensure the right culture, data skills and operational practices are in place. This collaborative approach brings together people with different perspectives. It has helped to embed a culture change around assistive technology within the adult social care service, working with providers and service users to understand their attitudes and concerns around technology and its increasing role in care. The work will be evaluated and will help inform a wider rollout of the technology.

Reading Borough Council

Reading Borough Council is part of a group of local authorities that commissions TEC through NRS Healthcare. Reading is currently also leading a research study to understand how technology may help people to live independently for longer within their own homes. The TEC is being trialled in several situations, including when people have first been discharged home from hospital with reablement care support. The sensor-based data helps to check their movements, patterns and abilities once home. It also gives their families reassurance that they are safe and well. The data has also supported a sheltered housing resident living with dementia to remain in the community. During one review, the TEC provided reassurance to their family and professionals by showing that the person had not been leaving their flat at night or leaving the front door open, which had been a previous concern. These good news stories have provided evidence that:

• favourable results were achieved
• participants have remained living in their own homes in the community
• participants’ families are reassured about their wellbeing

Reading Borough Council’s evaluation partner is the University of Reading, which is hosting sessions with participants to understand their views about TEC. TEC requires an internet connection, but some residents did not have broadband, so SIM cards and routers have been installed as part of the project. At the moment, there is no cost to the resident for the system or the equipment needed as it is funded by the Digitising Social Care (DiSC) programme and the Adult Social Care Digital Transformation Fund (ASC DTF).

Shropshire Council

In 2023 Shropshire Council was successful in a bid for care tech funding, securing almost £1.2 million from DHSC to develop Shropshire’s Virtual Care Delivery Service. The Virtual Care project delivers an alternative approach to care and support to alleviate pressures on demand while delivering positive outcomes for individuals receiving the service. The Virtual Care project uses technology to help deliver flexible care services, combining technology, data and virtual care advisors to deliver non-intrusive care and support. Virtual care delivery is a blended mix of virtual, technological and face-to-face care and support. A dedicated team schedules virtual care calls based on the user’s needs, as well as live monitoring and dashboard reporting.