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Telecare – the industry needs to pause and rethink

Simon Woodhead

Simon Woodhead

5th June 2025

For more than 15 years, customers of Simwood have come to us having experienced difficulty with Telecare / red button devices when migrating to a SIP based solution for the end user. This could be a SIP based residential solution or it could indeed be aggregation of a network where SIP operates simply from the green cabinet back into the core network, with the end-user equipment untouched. Throughout this time we have advised that carrying such calls over SIP is ill advised and whilst it may work in isolation it cannot be relied upon to work every time. If one of my family members was carrying a red button I would want and expect it to work every time. That feels like the very essence of a solution designed to save lives.

One of the challenges is that these devices use custom tones played over an analogue channel which potentially no longer exists. We are essentially looking at analogue-over-digital and in some cases analogue-over-digital-over-analogue-over-digital. Whilst voice and music and other sounds can be conveyed reliably over this medium, tones present a particular challenge not least the fact that telecom devices are configured to intercept known tones – i.e. the 0-9 DTMF digits you press on the keypad – and convey them in a more reliable way. This is fine when the tones intercepted are those which are intended to be intercepted but problematic when a custom tone is misinterpreted and effectively mangled. This does not usually happen with voice or even music but can with custom tones. No telecoms equipment recognises these tones because, by definition, they are a custom creation of the telecare industry, or maybe manufacturer specific. Some providers talk about turning that interception off – ta da – letting the tone pass uninterpreted but that is just through the equipment they control. The next piece of equipment in the chain, on someone else’s network or elsewhere on their own, will almost certainly still intercept it because that is the right thing to do to ensure that all other customers can do their telephone banking or navigate call-centre menus reliably.

For this entire time our advice has been that the telecare user needs an IP based solution, i.e. push a button and send a packet over the Internet or over 4/5G rather than relying on a phone-call. This is the best engineering solution for the use case in the modern age and not subject to the vagaries and problems of trying to send custom tones over a voice channel whether analogue or digital. Unfortunately it seems the telecare industry hasn’t quite gotten to this stage or indeed, where it has, end users haven’t adequately adopted the solutions that they offer. As a result a large number of vulnerable users still rely on the red button and custom tones over a phone-call. 

Now, the government, our regulator and indeed industry are wise to this and have responded. Unfortunately I’m concerned that the response is misplaced, and accepting assurances where they cannot truly be given. A number of large providers have reassured other stakeholders that no vulnerable user will be migrated without their service being fully tested. Some providers including, reassuringly, Simwood customers have signed up to a Charter for this which hypothetically provides good comfort that the end-user’s service will be left working after changeover. That is great, as far as it goes.

The problem and the concern I have is that this is not a one-time test scenario. It is all well and good testing the migration of the end users service does not impact the operation of the red button at time of switchover but what about the rest of the telephony network in the days, weeks and months after? The path phone calls take across networks will generally be fairly consistent but it will not always be the same. For the red button to work the tones need to traverse the entire path unencumbered, not just leave the end-user’s premises. Equipment fails and calls are rerouted, providers upgrade equipment (including as part of this project), multiple providers come and go in the chain due to commercial and network changes causing traffic to flow different ways. There are myriad reasons why two pushes of the red button can result in dramatically different performance on the voice channel and ultimately make the difference between it working and it not working. 

I don’t like posing problems without solutions but equally I dislike old people dying more! That is what is at stake here – the current push at the current time is offering false reassurance to enable progress to happen. The ultimate solution of course remains that telecare devices operate over IP and arguably that industry has been remiss in not making this happen sooner. But two wrongs don’t make a right and the telecommunications industry attempting to paper over the cracks and putting vulnerable people at risk is not acceptable. Offering reassurances to pacify a regulator and government pushing this agenda forwards, in order to enable compliance with their requirement for the agenda to move forwards, will end in tears because those reassurances are not real.

We know this blog is widely read, from competitors looking to crib for their newsletters, and by members of the government and our regulator – that is why we have used this as a vehicle to make this point. As always myself and members of the Simwood team remain available to help anyone in this space address the problem but in the numerous conversations we’ve had lately both with Simwood customers at the consumer end of the chain and telecare providers at the other end of the chain our message is clear: IP is the solution here and whilst we may be able to deliver a solution which will work today, and probably better than others, there is no guarantee that changes outside of our network won’t break it tomorrow. The advance of the project and the push-pull of dictat and reassurance needs to pause until there is a properly engineered solution in the hands of our vulnerable.

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