The government has launched an action plan to safeguard telecare users from the switching off of the UK’s analogue phone network.

Its replacement by a fully digital network will mean that existing services connected to the copper-based system, including many telecare devices, will need to be switched over by January 2027.

The switchover was initiated by the telecommunications industry, independently of government, with companies migrating customers to a digital service against an initial deadline of the end of 2025.

However, in December 2023, the then government said there had been a number of “serious incidents” in which telecare users’ devices had failed following migration, putting them at significant risk.

‘Telecare users must be protected’

“There is a risk that the process of migrating telecare users to digital landlines will disrupt their telecare services,” said minister for care Stephen Kinnock, in a statement launching the telecare action plan.

Stephen Kinnock (photo: Richard Townshend Photography)

“Telecare users must be protected during the digital phone switchover and every effort must be taken to avoid these risks.”

The telecare national action plan, which is targeted at councils, telecare providers, telecoms companies and housing providers, has four objectives:

1. That no telecare user will be migrated to digital landline services without the communication provider, the user or the telecare service provider confirming that the user has a compatible and functioning telecare solution in place.
2. That use of analogue telecare devices is phased out to ensure that only digital devices are being used by a deadline that the Department of Health and Social Care (DHSC) will set following talks with stakeholders.
3. That telecare users, their support networks and their service providers should understand what actions they need to take to ensure a safe migration to digital phone lines.
4. That stakeholders identified within the plan collaborate to safeguard telecare users through the digital phone switchover.

Councils sharing data with telecoms sector

The DHSC and Department for Science, Innovation and Technology (DSIT), which are jointly responsible for the action plan, said a key priority under objective 1 was that councils and telecare providers shared data about service users with telecoms providers, so they could put additional safeguards in place for them.

The Local Government Association (LGA) and London Office of Technology and Innovation (LOTI) have drawn up a data sharing template to streamline the process of councils and telecoms providers reaching agreements.

This stated that the lawful basis for councils sharing the data was “substantial public interest”, based on it being in the best interests of people with care and support needs using social care for them to do so.

The DSIT and DHSC said they would engage with local authorities who had not signed data sharing agreements to understand the barriers to doing so.

Continued use of analogue devices

The departments said objective 2 required action to stop the manufacture, sales and purchase of new analogue telecare devices. Ministers wrote to telecare suppliers in September 2024, requesting that they do not sell analogue-only devices, while the departments are also working with consumer groups to highlight the risk of people purchasing such equipment.

However, they added that, while their long-term ambitions were for telecare users to have fully digital devices that were resilient to power cuts, interim solutions that enabled the use of analogue devices on digital phone lines were permissible in the medium-term, so long as there was adequate risk assessment, testing and ongoing monitoring.

The action plan said testing had shown that the reliability of such devices was dependent on the model, the telephone line type and provider and equipment used by the alarm receiving centre, meaning telecare providers needed to “ensure the reliability of the specific combination of equipment and services they use”.

Raising awareness among telecare users

It added that a national awareness raising campaign on the switchover, to be launched by the telecoms industry in early 2025, would be “tailored to the unique characteristics of telecare users and their support networks”.

The action plan also highlighted the risks of criminals exploiting the switchover to target people with scams, by tricking them into sharing personal information.

It pointed to LGA guidance on the issue, which advised councils to ensure that frontline staff were aware of the switchover and reported potential scams to trading standards while also raising them as safeguarding concerns.

The LGA guidance also urged co-ordination between children’s and adults’ social services teams and trading standards to identify which residents may be vulnerable to scams and to proactively safeguard them, for example, through setting up call blocking services.

Alex Wright is a reporter for Comms Business, a sister publication of Community Care, which is running the Fit to Switch campaign to raise awareness of the switch-off of the analogue phone network

First the good news: Britain is heading towards a world-class digitally interconnected future where all telecommunications and data transactions take place over reliable, high-speed fibre optics. Everything from streaming TV to sending emails to making voice calls is faster and easier over high-speed optical fibre cables.

Now the bad news: your existing call-handling, automated key-holder alerts, fire alarms and remote back-office support services will probably stop working as a result.

Switch-off deadline

That’s because the UK’s existing analogue legacy phone network will be switched off by 31 January 2027, and replaced with a fully digital network that uses internet protocol (IP) technology across a fibre-based service.

That means every phone line in the country will become digital, routing calls over IP rather than the traditional public switched telephone network (PSTN) or the integrated services digital network (ISDN).

Any services that aren’t switched to the new network will be lost. It’s not just phone services that will be affected either. There are large amounts of equipment that remain connected to soon-to-be-retired telecoms infrastructure.

This includes lift emergency lines, building entry systems, fire and door alarms, burglar alarms, CCTV, vending machines, a range of medical equipment and telecare alarms and devices.

That’s why Comms Business has launched the Fit To Switch campaign to raise awareness about the PSTN switch-off and any associated issues.

Critical affected services

Any interruption or disruption to essential care services, and the key communications system and infrastructure needed to support them, can be potentially life-threatening.

However, many social care managers may be unaware of the need to switch over affected devices, particularly if the costs associated with renting the line and maintaining the equipment are covered by ongoing contracts.

For many organisations, devices such as automated burglar alarms, emergency call-lines in lifts, remotely monitored process fail-safes or even credit card payment systems are services they buy on recurring monthly terms from specialist third-party providers.

These specialists install dedicated telephone lines to ensure their call handlers or data centres are automatically contacted the moment the customer needs their services.

This wasn’t a problem when we had a copper telephone network for those services to quietly run on. But now all these lines are going to have to transition from copper to fibre. And that is not just a matter of unplugging one piece of kit and plugging in another.

The old copper network provides ‘always on’, fail-safe functionality. The system runs on its own 48Volt DC power supply, regularly pulsing a ‘chirrup’ up the line to check continuity of signal. It is this pulse which provides the familiar dial-tone, reassuring the user that there is a working line to the exchange equipment. But once the copper line is retired, the 48Volt equipment will no longer work.

Implications of switch-off

By contrast, the fibre line is entirely passive until it is ‘lit’ by equipment at the business end. Lighting the line requires a modem and a power source.

So, we are moving from a system that powers itself remotely to a system that has to be powered from the user’s end. This raises two major questions:

• Firstly, is your alarm or process provider equipped to update your kit ahead of the copper switch-off?
• Secondly, what happens if there is a mains power failure?

Beyond that, the logistical implications for the organisation are obvious. Is there even power available to the equipment? Will it need to be re-sited? Does it need to be wired into the emergency circuits? Will it need battery back-up or a dedicated 5G modem?

When Comms Business raised the issue with the trade associations who represent two of the most obvious ‘at risk’ service sectors – lift suppliers and fire alarm companies – their responses yielded only referrals to articles and supplier sales presentations made at past industry conferences.

There was no specific guidance for their members. There was no directory of members whose systems are tested and ready for the non-copper future.

The need to start planning today

With the old copper infrastructure due to be phased out completely across the UK by 31 January 2027, it’s vital for organisations to start planning for the switchover today.

Everything connected to your phone lines needs to be audited and reviewed to identify affected services so that you can order timely technology upgrades.

Rather than being a negative, however, the switch-off represents a prime opportunity for the social care sector to undergo a digital transformation that should drive improved outcomes and experiences, as well as seamless communication and collaboration among care  staff.

For more information about Fit to Switch and the PSTN switch-off, visit the campaign website.

To find out if your organisation is affected, complete the Fit to Switch survey.

By Louise Eastwood

While many local authorities decided to diversify staff responsibilities to encompass telecare within existing services, Hull Council decided that in order to maximise support for residents in a way that did not compromise ongoing social care, it would create a dedicated telecare team to offer help and guidance to residents, carers and service providers 24 hours a day.

Hull is home to a population of 265,000; 14% are over 65 and nearly 29% have a long-term illness or disability. Given the nature of the local population, it’s our responsibility to deliver services that support residents as their needs become more complex.

Telecare team

The telecare team was established to improve the safety and welfare of residents in the city, particularly those who are older, perhaps with dementia; those who have been recently discharged from hospital; and carers.

There are eight members of staff: four co-ordinators who go out to assess each referral and four technicians who fit the equipment and carry out annual maintenance calls. The background of the co-ordinators is varied; two have a care background, one has a housing background and the other came from the voluntary sector.

They work very much as a team and share knowledge and understanding of the products. Together they carry out monthly meetings with a telecare support engineer from Tunstall to reaffirm their understanding of programming the equipment, ensuring we get the best results for our residents.

Many referrals are received from hospitals when patients are ready to be discharged. Kingston Care Lifeline Service advises the team each time it gives a lifeline to a new user, who will then be contacted to establish whether they would benefit from additional telecare sensors. Everyone who receives a social care assessment will also be automatically offered the telecare service.

In some cases patients cannot be discharged until they have a live telecare service at home, and up to 10 times per week the team will undertake a same day telecare assessment and installation to enable and support rapid discharge.

The assessments are generated and integrated onto the council’s database CareFirst. When a new service user is logged onto the system, it automatically generates a referral to the telecare team to follow up. The social worker or social work assistant is then able to follow the progress of the referral and see what equipment is being installed. An equipment agreement is recorded on CareFirst so anyone involved with the case can see what has been installed and why.

We do not currently set eligibility criteria for telecare; it is purely needs-based and therefore anyone can have environmental equipment such as smoke alarms, as long as they have a lifeline. Any sensors that help with specific needs such as enuresis sensors (for incontinence) are based on the actual need of the service user.

Support for carers

The telecare team also offers support for carers with dependent relatives, often using a lifeline home unit and sensors linked to a pager. This enables the carer to undertake normal daily tasks, such as going out in the garden, having a good night’s sleep or enjoying leisure time, in the knowledge that they will be alerted if the person they care for needs assistance.

Carers can also be supported during the night by the Hull out of hours team (HOOHT). From 9pm–7am, all alerts from the telecare sensors can be directed to HOOHT, who will send a response officer rather than waking the carer. This gives carers respite by providing a safety net where incidences during the night are rare. Telecare and the out of hours team are reducing the need for more costly interventions, such as waking night care or residential care, saving money and protecting people’s privacy.

Telecare and dementia

There are approximately 800 people in Hull registered with care services who are living with dementia. Using telecare solutions means that they are safeguarded, and their carers are under less stress.

The council recently launched the Hull Dementia Academy Action Alliance which aims to help professionals and carers provide improved support to people with dementia, improving the quality of life for people with the condition and helping to reduce the number of admissions to hospital and residential care. Telecare is reducing the need for waking night home carers, supporting Hull to become a dementia friendly city.

For example, one woman with dementia who still lives independently has a prompt reminder on her lifeline that is recorded in her daughter’s familiar voice reminding her not to go out when it’s dark. This is linked to a sensor on the front door so the message plays when the door is opened. The sensor alerts the call centre if the door opens and they then contact the daughter. And as this client is still quite active in the kitchen, a heat head has been fitted in case something burns or is set on fire.

We have also used the CareAssist pager very successfully for couples where one of them has dementia, The CareAssist pager can be used with fall sensors, door exit sensors and bed and chair occupancy sensors depending on the need. It allows the carer peace of mind to know they will be alerted should a front door open or the cared-for person falls or gets up and they are not in the room.

And telecare can support people in assisted living environments, as well as in their own homes. For smaller residential homes without integral communication systems, a pager can be used to enable telecare to be deployed to support residents and staff. Hull is currently developing 400 new extra care apartments, which are due to be completed in 2016, where telecare forms an integral part of the development.

Working with the fire service

Whenever Hull’s fire and rescue service identifies a need for a smoke alarm it will install a battery operated smoke detector as a safeguarding measure, then refer the user to the telecare team to have a monitored smoke detector installed.

In circumstances where an individual is at risk of fire due to cigarette embers, smoking sprinkler systems can be installed. Hull’s fire and rescue service is seeing the benefits of monitored smoke detectors; approximately 15 systems are currently in place and they raise an alert at Kingston Care’s control centre if a potential fire is detected, even if the sprinkler action means the smoke detector isn’t activated.

Positive difference

We are still trying to evaluate the impact of telecare on social care, although we already know that several lives have been saved by the monitored smoke alarm alerts. We have found that we are deploying more complicated equipment to help people with complex needs to stay at home. At present there is a project manager looking at how to monitor and record the savings that telecare can provide.

Overall, the telecare team is making a positive difference to hundreds of people’s lives in the city and enabling health, housing and social care providers to support people with long-term health and care needs in a more cost-effective way.

Louise Eastwood is older people mental health team manager at Hull Council

The majority of adult services directors feel they need more evidence on the benefits of assistive living technologies, a survey by the Association of Directors of Adult Social Services (Adass) has found.

The survey, which gives a national picture of telecare services for the first time, was unveiled today at the National Children and Adults Services Conference (NCASC) in Manchester.

Most of directors who responded to the survey said that more evidence on the benefits of telecare was needed to help implement services, but councils were keen to share their examples of good practice with others.

The study also found that 70% of respondents saw older people as the group most likely to benefit from telecare, due to the ‘multi-faceted’ nature of their care needs.

A further 41% ranked people with learning disabilities either first or second in benefiting from telecare services, while 37% made the same claim for carers.

Adass president David Pearson said: “What is clear from the results is that we are a sector undergoing change, with a number of responses being qualified by comments relating to service reorganisation and the Better Care Fund implementation planning.

“We hope our investment in resources to support members with their telecare service development can now be focused in the areas that make the most difference.”

Linda Sanders, assistive technology lead at Adass, added: “These findings will help us to support directors to generate further momentum locally, to help understand needs, and decide what to focus on nationally.”

Other key findings from the survey include:

• 61% of English local authorities provide telecare services
• Personal budgets were being used to fund telecare in 32% of councils
• 26% of councils are considering using Skype
• 12% of local authorities are using social media for older people

Telecare has long been heralded as the future for helping keep patients out of hospital, now the London Borough of Havering is providing the proof.

In 2013, the council commissioned an independent evaluation to look at the effectiveness of their On Track telecare initiative. Over an 18 month period, the scheme had reduced hospital admissions by 50% among participating service user groups and delayed residential or nursing care admissions by between two and seven months.

Speaking ahead of the National Children’s and Adults Services Conference, where she will be presenting a session, Joy Hollister, group director for children’s, adults and housing services at Havering Council, spoke to Community Care about the success of telecare in the borough.

Q. What were the main aims of the scheme?

A. We have a hospital in special measures in Havering and we also have the biggest failure of A&E four hour targets in the country, so the Clinical Commissioning Group and our health colleagues were keen that we look at a range of initiatives to prevent hospital admissions. We had three main criteria for the On Track initiative: to prevent admissions to hospital, to delay or prevent admissions to residential and nursing care and to improve the quality of life for service users and their carers.

Q. Tell us more about the evaluation…

A. The findings were pretty astonishing really. We took two cohorts – cohort A had homecare and assisted living technology in place and cohort B just had homecare – and we looked at the difference between the admission rate of those two groups. In group B, admissions to hospital increased by 16% but for the service users with telecare we achieved a 9% decrease in admissions. This contributed to the overall 50% reduction of hospital admissions in the borough.

Q. What has been the main outcomes of telecare for service users?

A. Our evaluation found 95% of service users felt safer in their own homes as a result of using assisted technology. We’ve also evaluated our wristwatch technology, which uses a GPS system to track people with dementia who wander. This has had amazing results for carers – people feel they can leave the person with dementia alone for periods of time and get out and about shopping.

Q. What about the implications for social work practice?

A. One of the biggest things we’ve found with assisted technology is that we’ve had to win the hearts and minds of the staff who are doing assessments. If you can’t convince the social workers and the carers that this is a good idea then people aren’t going to use it. We found that the evaluation report encouraged more social care staff to recommend telecare as a way of keeping people at home.

Q. What would be your advice for other local authorities looking at setting up a telecare service?

You’ve got to know what you want to achieve in terms of outcomes and you’ve got to be able to evaluate against those outcomes. I would stress that those outcomes need to be as much about quality of life as cost avoidance. Focus on the carers as well as the person using it and don’t just look at social care, look at how you win the hearts and minds of GPs and the wider nursing network. Stick to the faith and really just believe in it.

Q. Finally, what’s been the key to success?

People. The technology allows the alert to happen but actually if your responders don’t respond in a timely and effective way then people lose faith in the equipment. Technology and equipment on its own is not the end of the story. It has to be backed up with really excellent staff who are customer focused, quick responders and who are well trained.