- Openreach is retiring the analogue Public Switched Telephone Network (PSTN) as part of the all-IP migration scheduled to complete in 2027.
- Telecare pendants, nurse-call systems and lift alarms that dial out over the analogue line may not work reliably on a digital line without testing and reconfiguration.
- Ofcom requires communications providers to identify and protect vulnerable customers who depend on their line for telecare during the migration.
- Lift alarm autodiallers are expected to meet the BS EN 81-28 standard for two-way emergency communication, which assumes a working line at all times.
- Ofcom and industry have agreed measures including battery back-up provision so that an outbound emergency call can still be made during a power cut on a digital line.
Care homes must audit every device on the analogue line, telecare, nurse-call, lift alarms and emergency phones, then migrate to digital with battery back-up and tested resilience before the 2027 PSTN switch-off.
Last reviewed: June 2026
Why the PSTN matters in a care setting
Residential and nursing care depends on communications that simply cannot fail. The traditional analogue telephone line has historically carried far more than ordinary voice calls in a care home. It powers nurse-call pendants and pull cords, telecare base units that summon help when a resident falls, lift autodiallers that connect a trapped occupant to a monitoring centre, fire panel signalling, door entry intercoms and the main switchboard used for emergency calls to the ambulance service. Because the copper line drew its power from the exchange, many of these devices kept working even during a local power cut, which gave operators a degree of resilience they may not have consciously planned for.
The analogue network is being withdrawn. Openreach is moving every line onto an internet-protocol platform as part of the all-IP migration scheduled to complete in 2027. After migration, voice no longer travels over the legacy analogue circuit; it runs as digital voice over a broadband connection. For a typical household this is a straightforward swap, but a care home is a critical environment where a missed alarm signal can have serious consequences. That difference is exactly why the sector needs a deliberate, documented migration plan rather than a like-for-like replacement.
The devices most at risk during migration
The largest hidden risk is the autodialler. Telecare base units, lift alarms and some intruder and fire systems work by seizing the line and dialling a pre-set monitoring number. Many older units use analogue signalling tones or protocols that do not always pass cleanly across a digital voice service, so a unit that appears healthy can fail at the moment it is needed. Every dispersed and grouped alarm device should be identified, listed and individually tested end to end with the monitoring centre after any line change.
Power resilience is the second concern. The analogue line carried its own power; a broadband router does not. If the mains fails, the router and any connected alarm stop working unless battery back-up is fitted. Ofcom and industry have agreed that providers should offer a solution allowing at least one emergency call during a power cut, and care operators should confirm what back-up is supplied and whether it covers every life-critical device, not just the main handset. Battery units also need a maintenance regime, because a flat or aged battery defeats the purpose entirely.
Care sector PSTN switch-off migration checklist
The table below sets out the core stages a care provider should work through, in order, before relying on a migrated digital line for any safety-critical function.
| Stage | Action | Why it matters |
|---|---|---|
| 1. Inventory | List every device on the analogue line | Hidden autodiallers are the main failure point |
| 2. Risk assess | Rank devices by life-safety impact | Telecare and lift alarms take priority |
| 3. Engage provider | Flag vulnerable, telecare-dependent users | Triggers Ofcom protections and support |
| 4. Power back-up | Fit and test battery back-up | Routers lose mains power; lines did not |
| 5. Test end to end | Place live test calls to monitoring centre | Confirms signalling passes over digital voice |
| 6. Document | Record results and review periodically | Supports CQC evidence of safe systems |
The regulatory backdrop for care communications
Care providers in England are registered with and inspected by the Care Quality Commission. The CQC does not regulate telecoms, but it does assess whether a service is safe and well-led. A reliable way to summon help, raise an alarm and contact emergency services falls squarely within that remit, so a provider that allowed a critical alarm to be left untested through a network change could struggle to demonstrate safe systems. Communications resilience therefore belongs in the home's risk register and business continuity planning, not just in an IT contract.
On the telecoms side, Ofcom places obligations on communications providers to identify customers who rely on their line for telecare and to protect them during migration, including ensuring access to emergency services. Lift alarms are expected to provide the two-way emergency communication described in the BS EN 81-28 standard, which assumes the line is always available, so any change that interrupts that capability needs to be planned around. Reading these duties together, the safest position is to treat every life-critical device as in scope and to keep written evidence that each was tested after migration.
Planning a safe migration
A safe migration starts early and treats the deadline as a backstop rather than a target. Providers should not wait to be moved; they should audit their lines now, contact their communications and telecare suppliers, and agree a sequence that keeps a working route to emergency services at every step. Where a device cannot be confirmed compatible, it should be replaced with a digital-ready unit before the analogue line is withdrawn, not afterwards. Staff should know what to do if an alarm path is temporarily unavailable, and any interim manual checks should be written into the daily routine.
Responsibility is shared but not vague. The communications provider must deliver a resilient service and protect vulnerable users; the telecare or lift maintenance company must confirm equipment compatibility and reprogramme units as needed; and the care provider, as the registered manager of resident safety, must commission, oversee and document the whole process. Clear ownership across these three parties, with a single named lead inside the home, is the most reliable way to avoid gaps. The goal is simple to state and demanding to deliver: at no point should a resident lose the ability to call for help.
Frequently Asked Questions
What does PSTN switch-off mean for care homes?
It means the analogue telephone line a care home has used for decades is being withdrawn as Openreach completes its all-IP migration in 2027. Voice and any connected alarms will run over a digital broadband connection instead. Care homes must check that telecare, nurse-call and lift alarms still work on the new service and that battery back-up covers a power cut.
What regulations apply to care home communications?
The Care Quality Commission assesses whether a service is safe and well-led, which includes the ability to summon help and reach emergency services. Ofcom places duties on communications providers to protect telecare-dependent and vulnerable customers during migration. Lift alarms are expected to meet the BS EN 81-28 standard for two-way emergency communication.
How do care homes ensure emergency communications post-switch-off?
The reliable approach is to inventory every device on the line, fit and test battery back-up so an emergency call can still be made during a power cut, and place live end-to-end test calls to the monitoring centre after migration. Any device that cannot be confirmed compatible should be replaced before the analogue line is removed. Results should be documented and reviewed periodically.
What is the CQC position on telecare and PSTN?
The CQC does not regulate telecoms, but it inspects whether a service keeps people safe, and a dependable means of raising an alarm is part of that. A provider is expected to risk-assess the switch-off, plan the migration and keep evidence that safety-critical alarms were tested. Failure to maintain a working emergency communication path could affect a safety judgement.
Who is responsible for migrating care home communications?
Responsibility is shared across the communications provider, the telecare or lift maintenance company and the care provider itself. The provider delivers a resilient service and protects vulnerable users, the maintenance company confirms and reprogrammes equipment, and the registered care home oversees and documents the whole process. A single named lead inside the home helps prevent gaps between the parties.
