Across London, several hundred thousand older and disabled residents rely on a telecare alarm — a wearable pendant or wristband button, or a fixed unit in the home — to summon help at the press of a button. These devices sit at the centre of "independent living": they are the piece of assistive technology that lets someone stay in their own home rather than move into residential care, precisely the kind of social-care integration this review exists to track. But a nationwide change to the UK’s telephone network, largely invisible to most households, is now forcing councils, care providers and families to check whether the alarms already installed will keep working at all.
What a telecare alarm actually does
A telecare pendant alarm is a small radio transmitter, usually worn round the neck or wrist, that connects to a base unit plugged into the household telephone line. Pressing the button opens a call to a 24-hour monitoring centre, which can talk to the resident through the base unit’s speaker, alert a nominated family member or neighbour, or dispatch emergency services. More advanced units add fall detectors, which trigger automatically if the wearer collapses and cannot press the button themselves. Local authorities across London typically commission this equipment through their adult social care or occupational therapy teams, sometimes free of charge following a needs assessment, sometimes through a small weekly rental fee; charities and some GP referral schemes also provide devices to residents who meet eligibility criteria.
The analogue-to-digital switchover, and why it matters here
The relevant background is a telecoms-wide project, not a social-care one. The UK is replacing its ageing analogue telephone network (the PSTN) with a fully digital, internet-based service. New analogue landlines stopped being sold from 5 September 2023, and the full switch-off of the old network is scheduled for completion by January 2027. For most households this is a routine upgrade. For telecare users it is not, because many existing pendant alarms were built to send analogue tones down a copper phone line, and those tones are not always read correctly by digital connections — industry and government guidance has recorded cases of distorted signals, failed transmissions and delayed responses where alarms were migrated without being tested first. An estimated two million people across the UK currently depend on telecare services of this kind, which is why the switchover has become a live safeguarding question for every local authority telecare service, London’s included.
Power, broadband and the loss of a landline’s own current
A second, less obvious change compounds the risk. Traditional analogue phone lines carried their own low-voltage electrical current, so a landline — and anything plugged into it, including a telecare base unit — kept working during a power cut. Digital phone lines run over the customer’s broadband router and home electricity supply, so without power the connection can drop unless a battery back-up is in place. Ofcom has responded by requiring telecoms providers to guarantee at least an hour of access to emergency services during a power cut, through battery back-up units or another fallback such as a mobile connection. For a resident whose only means of calling for help is a telecare pendant, that guaranteed hour — and confirming it is actually installed and tested — is not a technicality.
Who is responsible for getting this right
Because a failed migration can genuinely put a vulnerable resident at risk, oversight now sits across several bodies rather than one. Ofcom sets the regulatory requirements for providers on emergency-call continuity during power loss. Major communication providers signed a voluntary PSTN Charter in December 2023, followed by a second Charter for Network Operators in March 2024, committing not to migrate a known telecare user until a compatible, tested digital alternative is confirmed. The Department of Health and Social Care and the Department for Science, Innovation and Technology jointly published a Telecare National Action Plan in February 2025 setting out what providers, councils and telecare services each need to do. The Local Government Association has worked with providers on data-sharing arrangements so councils can identify which of their residents use telecare equipment before a line is migrated, and the TEC Services Association — the sector’s industry body — has pushed for clear, accessible communication with users who are not digitally confident. A cross-sector Telecare Action Board, bringing together around thirty organisations from government, telecoms and local authorities, was formed in January 2024 to coordinate the response.
Analogue versus digital telecare: what actually changes
| Feature | Analogue (PSTN) telecare | Digital (IP) telecare |
|---|---|---|
| Signal type | Tones sent over copper phone line | Data sent over broadband/IP connection |
| Power during a cut | Line carries its own current; often kept working | Depends on router and mains power; needs battery back-up |
| Compatibility | Reliable on the network it was built for | Requires a digital-compatible base unit, not the old one |
| Migration risk | None — network still live until switch-off | Real if migrated without testing; charter commits providers to check first |
| Who should check it | N/A | Resident, family, council telecare team, and the phone provider |
What London residents and carers can do now
Anyone who relies on a telecare pendant alarm, or supports someone who does, has a short, practical checklist. Contact the telecare provider or the local council’s adult social care team to confirm the household’s equipment has already been tested against a digital line, rather than waiting for a migration letter to arrive. Ask specifically whether a battery back-up has been fitted and how long it lasts in a power cut. If a landline provider writes to say the household is due to be moved to a digital line, that letter should not be actioned until the telecare provider has confirmed compatibility in writing — the PSTN Charter exists precisely so that providers do not migrate a known telecare line without that confirmation, but a resident or family member flagging the account as telecare-dependent is still the most reliable safeguard, since not every council has been able to share its full list of telecare users with every provider.
Conclusion
Telecare alarms are a small, unglamorous piece of infrastructure, but they do exactly what "Better Health for London" argued the wider system should do: keep people well and independent in their own homes rather than in a hospital bed or a care placement they do not need. The digital switchover does not make that equipment obsolete, but it does mean nobody should assume an alarm fitted years ago will still work unchanged. For residents, families and the boroughs commissioning this equipment, the practical task between now and January 2027 is straightforward — confirm, test, and do not wait to find out the hard way.