Telecare services are used by an estimated 1.8 million people across the UK and around 167,000 in Scotland.
Installed in the homes of elderly citizens or those who may need extra help looking after themselves, telecare offers remote contact with council-run or private telecare providers to give them support.
Scottish telecare service providers spend around £39 million delivering telecare services each year, and of telecare users in Scotland in 2020, 71% are over 75 years of age.
How is telecare changing?
Traditionally, telecare is installed on analogue phone lines. However, in 2025, and some cases as early as 2023, telecoms providers are aiming to switch their analogue lines over to digital versions.
This would leave hundreds of thousands of patients without the connection required to access telecare services, with potentially fatal consequences.
It has now become imperative that telecare service providers across the country move to switch from analogue to digital to ensure that vulnerable service users still have access to the vital telecare services they rely on.
Digital Telecare for Scottish Local Government, facilitated by the Digital Office and funded by the Scottish Government TEC Programme, is providing information, and driving collaboration between telecare service providers to facilitate the move to digital systems.
Telecoms providers are switching off the analogue telephone service network, or PSTN, as it is technically known, and replacing it with an all-IP digital service as early as 2023,” says Martyn Wallace, Chief Digital Officer at the Digital Office for Scottish Local Government and Senior Responsible Officer for Digital Telecare.
“Traditional telecare services are designed to send voice calls over a PSTN network, whereas the digital devices that are coming will connect via the alarm receiving centres using a digital network,” he says.
Part of Wallace’s role is to ensure that, as soon as 2021, the switch over is underway. Telecoms providers have already begun replacing analogue phone lines, so Wallace believes that there is no time to lose.
The consequences could be fatal.
When asked what the consequences of telecare service providers not switching in time would be, Wallace has a very direct answer: “At the end of the day, there could be fatal consequences, which is already being seen in other parts of the world,” he says.
“If they do not move right away and collectively do this, they will either be trying to implement something last minute and the service will go wrong, or it will be a rushed job and people will have an issue at the start trying to get the service embedded.
“It is going to take at least 18 months. 2023 is not far away, and the fact is that we are already seeing challenges at the moment where certain media companies are already changing over to digital telephone services,” he says.
Wallace believes that, if the switch is left it any later, then telecare service providers will fail to implement the tech in time. This will create operational, staff and service user challenges as people will not have the correct kit in their homes.
“At the end of the day, people could die because they are not getting the information, support or help that they need if they have a fall in the house, if they are feeling unwell, or something has happened to them.”
This risk is something that Wallace wants to convey as much as possible, and he insists that telecare service providers need to start moving with urgency. Commenting on the transition, he says they need to start now or early 2021: “at the very, very, very latest”.
Where are we now?
Wallace says his team have been working on the transition for the last three years and that changes are beginning to gain traction.
Covid-19 has also had a positive impact. Whereas some sectors are being negatively hit by the virus, the accelerated pace of digital adoption due to the pandemic has helped with the digital telecare transition.
“As with all transformation at the moment, there has been an opportunity for digital technology through the pandemic in the last 10 months. We are more accepting as a culture to take these things on,” Wallace says.
From the perspective of the service providers, Wallace says The Digital Office has set up a community and a dedicated team to support that transition: “It is about working with partners, understanding where they are on their journey and then helping them to accelerate and get funding, and we have had grants in to help with the early adopters.”
Similarly, the team is working on a digital maturity assessment for telecare provision, as well as a supplier scheme to ensure they are cyber secure and ready for what comes next.
It is hoped that, through a new bronze, silver, gold and platinum reward type system, his team can “coerce” telecare service providers to start implementation as soon possible; but this comes with its own set of challenges.
“The big challenge we have is that budgets are even tighter than before and there is a higher expectation from the end-user of the service that is been provided,” Wallace says.
“We have got, I think, 167,000 people using the service in Scotland at the moment, and that is going to grow. They will expect more, and we have to support that.”
What other positives does switching bring?
There are several additional benefits – besides saving lives – that would come with switching from analogue to digital. Wallace suggests things such as better call management reliability for the user and bringing new devices that can be “tailor-made”.
There is also more choice over how technology is installed in homes. With the digital upgrade, alarm systems can be located anywhere rather than having to be installed close to a phone line socket.
Digital also increases reliability and connectivity with a user, Wallace says. “You have got fewer instances of failed calls. Because it is an IP you can look for a heartbeat that a device is still connecting.
“You can also have live monitoring from multiple devices to develop a bigger picture of what’s happened to the individual if they have had a fall.”
From the perspective of the telecare providers, he says there is greater flexibility in the service: “Calls can be routed from different sensors going off so you could do a pre-emptive call, rather than a reactive because traditional services are reactive.”
As well as this, the service could also solve one of the biggest concerns during the Covid-19 pandemic – office working. “Call takers do not have to be in one building. You can have a distributed call centre, which is ideal for the current situation we find with the pandemic, so you could be based at home,” he says.
Where do we go from here?
Digital Telecare for Scottish Local Government has created and released a ‘playbook’ of all of the necessary steps that telecare service providers need to take to make the switch successfully.
“We have produced the national briefing document which sets out timescales of when you need to carry out each step of the work to get to the overall solution,” Wallace comments.
And he believes this is an opportunity for Scotland to be a world leader in digital telecare, and for service providers to collaborate and “get a service that is right for Scotland”.
More importantly, however, Wallace says that switching quickly and effectively is about giving the best service possible for the vulnerable people across the country.
“Fundamentally, people expect more, and people expect a helping hand sitting behind them that is there when they need it,” he says.
“Having digital telecare means that people can live independently; not having to be hospitalised and not having to go into a home because they can live from their own home with a service around them that can then support them the way they want to be supported.
“It is giving that operation of choice, and that is key as a great opportunity for us to work together to create that for the individual because the people working on the service are going to no doubt use the service at some point as well, so do we want to have the same experience that some of our customers are getting just now? Absolutely not.”