Closing the Gaps: Protecting Telecare Users in the Shift from Analogue to Digital
Explainer: Telecare and the PSTN switch-off
Telecare systems are used by approximately 1.8 million households in the UK and they support people with healthcare needs to live safely and independently. They are designed to alert a call centre or caregiver in the event of a medical or home emergency. Telecare systems use a set of devices, typically a base unit and a wearable alarm trigger like a pendant, to link a user to an Alarm Receiving Centre (ARC).
For decades, the communications network underpinning landline voice calls has been the Public Switched Telephone Network (PSTN) which is a system of communications infrastructure that transmits analogue signals over copper wires. This analogue infrastructure is not only ageing but becoming prohibitively expensive to maintain. In contrast, digital landline networks (where calls are connected via the internet) offer a significant upgrade to the reliability and quality of connections and provide greater flexibility to meet long-term consumer needs. However, the move towards digital landline networks has massive implications for the reliability of older analogue-based telecare systems.
The full retirement of the traditional phone network is set for January 2027, and the migration to digital is already well underway. In June 2025, the government confirmed that over two-thirds of all lines had been migrated to VOIP (Voice over Internet Protocol). Ofcom estimates that over a quarter (27%) of UK residential landline customers, approximately 5.2 million, were still using the PSTN in December 2024.
Risks to consumers
Once the PSTN is fully decommissioned, analogue telecare systems may not work reliably, meaning they may be unable to transmit an alarm signal during an emergency. This failure to alert an ARC will prevent the dispatch of emergency services to the user.
The potential for device failure in an emergency situation presents a critical risk to health, safety - and even life. In June and November 2023, two people died when their telecare devices failed following the industry-led switchover. In response, the UK government directed telecoms providers to pause non-voluntary migrations until stronger protections were in place. The regulator, Ofcom, requires communication providers to take all necessary measures to ensure uninterrupted access to emergency organisations and that they establish and comply with policies and procedures for the fair and appropriate treatment of vulnerable consumers.
While communication providers have since made additional efforts to identify and support telecare users, including signing up to the Public Switched Telephone Network charter and non-voluntary migration checklist, a report from an incident earlier this year suggests that failures can still occur.
Analogue telecare devices may sometimes have partial functionality on digital networks but cannot be relied on in an emergency. Tests of analogue devices on digital networks demonstrate a concerning risk of call failure. The Telecare Services Association (TSA) reports a call failure range of 2.3% to 3.4%, while data cited from the consultancy FarrPoint estimates a failure rate of 5%. In specific cases, call failure rates have been reported as high as 11.5%. Although these estimates do not provide comparisons of call-failure rates prior to migration, they do suggest potentially concerning reliability issues. Considering that ARCs manage call volumes well into the tens of millions each year, even a single percentage point of failures represents hundreds of thousands of households. Since analogue telecare devices typically exhibit signs of functionality on digital networks, this may lead consumers to underestimate the risks when it comes to accessing emergency services.
In addition, issues with the legacy phone network may also present other risks to telecare users. A July 2025 survey of over 1,000 Which? Connect Members who own a home phone or landline showed that since their landlines were switched to digital voice, 7% experienced having no service and being unable to make calls [1]. This highlights how the switch-off threatens emergency service access, even for households without telecare. The top 3 issues cited by survey respondents included customers being unable to use their landline due to a power outage (11%), customers being unable to use their landline due to a broadband outage (9%) and some phone functions (e.g. answerphone, call blocking) not working as they did before (7%). The survey also found that of those who experienced an issue, 47% contacted their provider to resolve it. Of those, 41% in total were dissatisfied with how their provider handled it.
Sales of analogue telecare devices
Despite these risks, a new investigation by Which? finds that three in seven of the largest telecare providers in the UK continue to sell analogue telecare devices and monitoring services directly to consumers.
Although some online listings contain information alerting customers to possible compatibility risks due to the PSTN switch-off, this is not sufficient as consumers may not register them, may overlook or misunderstand them, or may reasonably assume that any product available for purchase with well-established telecare providers is safe to use.
In addition, unmonitored analogue telecare devices remain available for consumers to purchase on major online marketplaces. These subscription-free devices do not connect to a formal monitoring service but use the PSTN to automatically call family or caregivers during an emergency. Because these are private transactions, the users are unknown to local authorities and to network operators managing the digital transition.
Off the Radar
The risks of call failure are perhaps most acute within the private telecare market as the identification of the full user base is incredibly complex. As there is no centrally held data on the number of private telecare consumers, it represents a significant blind-spot to Government, regulators and communication providers managing the network transition.
This blind-spot may be addressed with better data sharing between telecare and communication providers and communication providers cross-referencing customer records with ARC call numbers. But even with these measures, this would not capture consumers using privately purchased telecare devices that are configured to alert personal contact numbers but are not actively monitored by an ARC.
Although initiatives like the BT and VM02 sponsored National Telecare Campaign are welcome in driving consumer awareness and identifying additional telecare users, they do not foreclose the potential risks. So long as these analogue devices remain available for consumers to purchase, the aperture of this blindspot will widen and with it the risk to consumers.
Regulators must act
The UK government recognises the risks associated with the continued sale of analogue telecare devices as the PSTN is withdrawn. In August 2024, Ministers from the Department for Science, Innovation and Technology (DSIT) and the Department for Health and Social Care (DHSC) wrote to telecare providers expressing concern that new analogue telecare devices remained available for consumers to purchase online. The subsequent National Telecare Action Plan, released in February 2025, reiterated an expectation that telecare providers should stop selling these devices. However, our new investigation clearly demonstrates that these efforts have not had the desired effect.
The Telecare Services Association (TSA) requires telecare providers to discontinue selling analogue devices as a condition of the Quality Standards Framework, but compliance with this framework is voluntary.
To date, efforts from industry and government have failed to tackle this problem. On this basis, we recommend that the Government must work with Trading Standards and the Office for Product Safety and Standards (OPSS) to ensure these products are removed from sale and that action is taken against companies who continue to do so. These devices are often marketed as life-saving, yet may fail to operate during emergencies. The lack of transparency, combined with the possible vulnerabilities of users—typically older or disabled people—amplifies the potential for harm and makes regulatory oversight both urgent and necessary. Alongside this, DSIT should work closely with Ofcom to ensure that communication providers adopt comprehensive measures to identify telecare users and support them to migrate safely.
The government and Trading Standards should conclusively determine whether the ongoing sale of analogue telecare devices breaches consumer protection law. If breaches are identified, regulators must be prepared to take decisive enforcement action — including pursuing individual providers, issuing product recalls, or implementing a market-wide ban on the sale of new analogue telecare equipment. The fast-approaching January 2027 deadline requires urgent regulatory intervention. Trading Standards will be critically important in this context, but this does not discount the need for longer-term structural reform to address the regulator's capacity to protect consumers and take enforcement action, as argued in a recent Which? Report.
Under the Consumer Rights Act, it is a statutory requirement (amongst others) that goods be 'fit for a particular purpose' and of ‘satisfactory quality’. Consequently, in circumstances where a telecare device will lose its core functionality due to the upcoming digital switchover, this calls into question the durability and essential purpose of the device. Providers (whether major or small) must ensure they don’t breach these provisions.
In addition, providing misleading information (including a product's risks) or omitting material information relating to the purchase of an analogue telecare device might be considered a misleading omission or action, depending on the circumstances, pursuant to provisions 226 and 227 of the DMCC Act. If analogue devices stop working reliably or at all on a digital-only network, they may no longer meet consumer law provisions even if they were functional at the time of sale.
Furthermore, online marketplaces must also act to prevent the sale of analogue telecare devices. Currently, several platforms continue to list these products, which are often sold second-hand to consumers. The Product Regulation and Metrology Act 2025 paves the way for new laws to clarify and strengthen responsibilities for online marketplaces, empowering OPSS to take proactive enforcement action against online marketplaces.
With less than 18 months left until the complete withdrawal of the PSTN network and the digital switchover, vulnerable consumers remain at risk of relying on telecare devices that will not function when needed most. Strong regulatory intervention is essential, and urgently needed, to ensure that products on the market meet legal standards, protect public safety, and uphold consumer rights.