5 March 2026 · 10 min read · Arviteni
The UK's analogue phone network is being switched off in January 2027. For care homes, this affects telecare alarms, nurse call systems, lift phones, and more. Here is what is changing, what is at risk, and how to prepare.
The UK's analogue telephone network is being switched off on 31 January 2027. Every device that currently connects through a traditional phone line will stop working. For most businesses, this means replacing some handsets and updating a broadband contract. For care homes, it is significantly more serious.
Telecare pendant alarms, nurse call systems, lift emergency phones, door entry intercoms, and fire alarm diallers all depend on analogue phone lines in many care settings. When those lines go dead, the systems connected to them go dead too. For a care home, that is not an inconvenience. It is a safeguarding risk.
This is not a distant problem. The switchover has already begun, the deadline is less than ten months away, and legacy line costs are rising sharply throughout 2026. Here is what care providers need to know and what to do about it.
The Public Switched Telephone Network (PSTN) is the copper wire infrastructure that has carried voice calls across the UK for over a century. Openreach, the BT Group subsidiary that owns and maintains this infrastructure, is permanently retiring it. Every analogue and ISDN service will be replaced by internet-based alternatives running over broadband (known as Voice over Internet Protocol, or VoIP).
A national "stop sell" has been in effect since September 2023. No new analogue phone lines can be ordered anywhere in the UK. The original switch-off date was December 2025, but following two deaths linked to telecare failures during early migration phases, the government intervened and the deadline was pushed back to 31 January 2027.
That deadline is now firm. Openreach is actively discouraging delay by escalating the cost of legacy lines: a 20% price increase from April 2026, a further 40% from July, and another 40% from October. By the end of 2026, keeping an old analogue line will cost roughly double what it does today, for a service that will cease to exist weeks later.
Over 500,000 business lines across the UK still have not migrated. Care homes that have not started planning need to start now.
The switchover affects far more than telephones. Care homes typically have multiple systems that depend on analogue lines, and some of them are life-safety critical.
This is the single most important system at risk. Pendant alarms, fall detectors, and health monitors worn by residents signal an Alarm Receiving Centre (ARC) when activated. An estimated 500,000 people in care homes, supported housing, and sheltered living use telecare services that rely on analogue signalling.
These devices use tone-based analogue signalling (DTMF) that does not transmit reliably over digital networks. Research by the Telecare Services Association found a 7.5% first-time call failure rate for analogue telecare devices already operating over partially digitalised networks. In some areas, failure rates exceed 11%. Falkirk Council recorded over 1,200 alarm call failures in a single month.
A failed pendant alarm means a resident who has fallen or is in medical distress cannot reach help. In June and November 2023, two people died when their telecare devices failed following early switchover migrations. Those deaths directly prompted the government to pause the rollout and introduce safeguards.
Many legacy nurse call systems connect to the PSTN for external alerting, escalating unanswered calls to on-call managers or external monitoring services. Systems hardwired to analogue phone lines will need replacement or adaptation to IP-based alternatives.
Lifts in care homes are legally required to have emergency communication under BS EN 81-28. Many use analogue phone lines to connect trapped passengers to an operator. Openreach data from February 2026 shows over 12,000 lift lines nationally still need migration. Without an upgrade to IP or GSM alternatives, care homes risk non-compliant or inoperable lift phones.
Some care homes use the PSTN for intercom-linked door entry systems, allowing staff to buzz visitors in remotely via phone. These will stop working when the analogue line is disconnected.
Monitored fire and intruder alarm systems that use phone-line diallers to contact monitoring centres will lose their connection. If your alarm system calls out over a phone line when triggered, it needs migrating.
Older CCTV systems hardwired to analogue lines for remote monitoring or alert transmission will fail. While most modern CCTV systems already use broadband, legacy installations in older care homes may still depend on phone lines.
Card payment terminals in reception areas that connect via phone lines will need replacing with broadband or mobile-connected alternatives. Fax machines used for medical correspondence with GPs and pharmacies do not work reliably over VoIP and should be replaced with secure email or NHS-compliant messaging.
Traditional analogue phone lines are powered from the telephone exchange. They work during power cuts. VoIP phones and routers require mains electricity. During a power outage, every VoIP-dependent system in the building goes down simultaneously: phones, telecare, nurse call, door entry. For a care home, losing all communication during a storm or grid failure is a serious operational and safeguarding risk.
Battery backup (UPS) is essential for all VoIP infrastructure. Telecoms providers are required to offer at least one hour of battery backup free of charge to vulnerable customers, but care homes should plan for longer outages.
Some providers offer Analogue Telephone Adapters (ATAs) as a bridge, allowing analogue devices to plug into a digital router. The government's own guidance warns that "the reliability of using ATAs can vary depending on the mix of equipment and telephone services used" and that digital lines "may corrupt the alarm's signalling." ATAs are a temporary stopgap, not a permanent solution, particularly for life-safety telecare equipment.
Non-functional alarm systems could constitute CQC compliance failures. Care providers have a duty of care, and knowingly operating with non-functional safety systems after the switchover exposes them to regulatory action. Lift emergency phones are a legal requirement, not optional.
Following the two deaths in 2023, the government took several steps:
In December 2023, leading telecoms providers signed a voluntary charter committing not to migrate telecare users unless device compatibility is confirmed, to provide battery backup, and to send engineers for in-home testing.
In November 2024, the government reached a more prescriptive agreement with telecoms firms, including a shared definition of "vulnerable customer," at least 12 months' notice before enforcing switchover, and keeping non-engaging telecare users in a continuous engagement loop rather than disconnecting them.
In February 2025, the Department of Health and Social Care published the Telecare National Action Plan, establishing a risk-based approach that prioritises the most vulnerable. The plan states that no telecare user should be migrated without confirmed functioning equipment in place.
In December 2025, Ofcom fined Virgin Media O2 £23.8 million for "serious systemic failures" in handling its PSTN migration, including failure to identify telecare customers, putting thousands of vulnerable people at direct risk of harm.
The protections are welcome, but they do not remove the deadline. The PSTN is still being switched off in January 2027. The responsibility for preparing sits with care providers.
Walk every building and identify every device connected to an analogue phone line. This includes telecare units, nurse call systems, lift phones, door entry systems, fire and intruder alarm diallers, CCTV, payment terminals, fax machines, and all voice telephone lines. If you are not sure what connects where, your IT provider or telecoms provider should be able to map it.
Care England has partnered with Orbital Net to provide free internet and telephone audits for care providers. Contact 0330 324 4444 or solutions@orbital.net.
Establish your migration timeline. Understand when your exchange will be switched and what services your provider offers for the transition. Make sure your provider knows you are a care facility with vulnerable users, as this triggers additional protections under the government charter.
VoIP requires stable, adequate broadband. If your care home is still on ADSL or an older fibre-to-the-cabinet connection, you may not have sufficient bandwidth or reliability to support voice calls, telecare, and data simultaneously. Fibre to the premises (FTTP) is the preferred option. Consider a managed broadband service with quality-of-service (QoS) prioritisation for voice and alarm traffic.
If you are unsure whether your current broadband is adequate, our care home Wi-Fi guide covers bandwidth requirements and network design for care settings.
Do not rely on ATAs for telecare. Migrate to IP-based or mobile-connected telecare devices that use digital signalling protocols natively. Many modern digital telecare alarms connect over 4G/5G mobile networks with an internal SIM and battery, meaning they continue to function during mains power cuts. This makes them significantly more resilient than VoIP-dependent alternatives.
For all VoIP equipment (routers, switches, IP phones), install uninterruptible power supplies. Plan for outages longer than the one-hour minimum that telecoms providers offer. A care home losing all communication for several hours during a power cut is a scenario that needs a tested contingency plan.
Do not assume a migrated system works. The Telecare National Action Plan states that telecare users should only be migrated if functioning equipment is confirmed in place. Request an engineer visit to personally test all alarm devices, nurse call escalation, lift phones, and fire alarm diallers after migration.
Make sure staff understand what has changed, how to identify faults in new systems, and what the fallback procedures are during power outages or broadband failures. Update your business continuity plan to reflect the new infrastructure.
Inaction is expensive. Legacy line rental costs are doubling through 2026. After January 2027, analogue lines will simply stop working. Lines not migrated by April 2027 will be classified as "orphaned assets" by Openreach.
More importantly, care homes that arrive at the deadline without preparation risk losing critical safety systems overnight. The government has made clear that the deadline is firm. The protections put in place after the 2023 deaths are designed to ensure safe migration, not to delay it indefinitely.
Ten months is enough time to audit, plan, and migrate, but only if you start now. Care homes that began preparation in 2024 and 2025 are already operating on digital infrastructure. Those that have not started are running out of time.
As a managed IT provider built for the care sector, we handle digital switchover migrations as part of our infrastructure work. That means auditing every analogue-dependent system in your buildings, designing the replacement architecture, managing the migration, and testing everything before the old lines are disconnected.
If you are not sure where your care home stands with the switchover, get in touch. We will tell you what needs to change and what the timeline looks like.