PSTN Switch Off guide for care providers

For over a hundred years, copper wire has been the backbone of the UK’s telecommunications. Connecting all of our most vital services, from schools to hospitals and emergency services. These wires power everything from the smart meters in our homes, the card machines in our stores, and the care devices protecting our most vulnerable. 

During this time, all of these devices have run off BT’s copper-based public switched telephone network (PSTN) – an analogue system that connects via specific phone numbers. But after operating for over a century, the PSTN has become outdated and difficult to maintain, with both the parts and the skills needed to install them increasingly difficult to source. Which is why new digital services like Voice over IP (VoIP), where voice calls are transmitted the same way that broadband works, are being implemented.

With all of this innovation, the PSTN is officially being retired on January 31st, 2027, following years of work by Openreach to remove all technical barriers to migration. But, as we enter the final countdown, there are still around a million lines on the PSTN network that need to migrate, with around 300,000 of these serving business premises, including care providers. 

Care providers no longer have a reason or the time to delay migration, especially when they can take advantage of Openreach’s Prove Telecare services. This dedicated workforce of specially trained engineers can safely transition vulnerable telecare users to the new digital VoIP network. Because if life-safety systems such as telecare pull cords, emergency lift phones, warden call buttons, and door entry panels are left on old copper lines, the operational hazards are severe. Not only would this inaction breach Care Quality Commission (CQC) compliance, but it also leaves facilities exposed to legacy line costs, which are set to increase by 40% on October 1st 2026. 

It can be easy to overlook, but so many of the essential care and healthtech devices that care providers use daily could be reliant on the PSTN network. Without the correct migration, these devices could stop working entirely following the switch-off. These include:

• Telecare and Personal Safety Equipment: Devices that transmit emergency signals to an Alarm Receiving Centre (ARC) or to on-call carers via an analogue tone signal (DTMF) over copper wires. Such as pendant & wristband alarms, fall detectors, bed/chair pressure pads, environmental hazard monitors, wander management devices, property exit sensors and more. 

• Facility and Building Infrastructure: Lift emergency call buttons, door entry and intercom systems, and fire and intruder security panels could be reliant on the copper PSTN network to operate. 

• Administration and Operational Devices: Both the standard lifelines and cordless handsets used by caring staff, the fax machines still often used in social and healthcare environments, dial-up Electronic Point of Sale (EPOS) systems, and the utility and telemetry meters common in older buildings that send automatic billing and usage data could be operating off of the PSTN network.

As well as the direct connectivity impact of the PSTN network switch-off on these devices, the power impact also must be considered. The older copper PSTN lines carry their own low-voltage electricity through the line, often serving as both the connectivity and power source for these devices. So, migration needs to take place promptly, leaving time for not just the transition to VoIP but for the installation of batteries for these digital routers, as well as the installation of backup battery systems and cellular failovers to ensure functionality, even in the event of local power outages. 

Financially, the ramifications of failing to migrate should also be a major concern for care providers. Those providers that leave migration to the last minute face higher charges as the switch-off date draws closer. As previously confirmed by Openreach, a tiered price increase is already in place for those on the legacy PSTN-dependent products. In most cases, it is already cheaper today to be on the new all-IP products than the older, copper-reliant offering. Previous price increases occurred on April 1st and July 1st 2026, with the final set to take effect from October 1st 2026 - after which, the rental cost of legacy lines will have effectively doubled when compared to the 2025 rates. 

Care providers may already have noticed these increases in charges from their Communication Providers (CP) – costs that eat into the precious budget needed to provide care to vulnerable care residents and dependents. And if these charges have come without adequate communication from the CP, care providers must investigate and enquire about the migration of their products. They can also access Openreach’s free testing laboratories to bypass the bottlenecks created by inactive CPs. 

The switch-off also brings legal and compliance implications that care providers need to consider. These largely concern the care devices used in daily operation, as well as the more general health and safety equipment. In turn, these are the devices most likely to be impacted by the switch-off:  

• Safe Care Delivery Equipment - Regulations like the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 stipulate that providers are legally required to provide care safely via equipment such as emergency call buttons and fall detectors. And, equipment used to deliver care must be properly maintained and fit for purpose. Mismanaging the PSTN switch-off could impact these devices and might be seen as a failure to meet compliance.  

• Fire Alarms - The Regulatory Reform (Fire Safety) Order 2005 gives providers a legal duty to protect the health and safety of both staff and visitors - including residents. If an alarm system loses its functionality when the copper line is disconnected, the system becomes non-compliant, potentially triggering a breach and invalidating insurance coverage.  

Regulatory bodies could also downgrade a home or a provider's rating to ‘Requires Improvement' or 'Inadequate', as well as issue formal Warning Notices, suspend registrations, or force the closure of facilities found to be non-compliant. 

That’s not to mention the complications that can arise with Insurance Invalidation plus the risk of losing NHS contracts - most breaches of regulatory standards allow for immediate termination and removal of funding.  

Because the transition affects critical infrastructure, Care Providers should consult with compliance, insurance or legal professionals to understand their exact obligations and requirements. 

In January 2027, the UK’s digital landscape will change forever. Care providers should not wait for this deadline, or for their communications providers to reach out.

Care providers that believe they may be impacted, or are unsure about their current PSTN status, should take action now and follow the Review, Test, Switch Process. 

Review 

First, care providers should start by reviewing their connectivity estate to identify any equipment still relying on PSTN. Rather than assuming that their CP has done the necessary work, providers must reach out to them to double-check. And they must carry out similar checks physically on location too, tracing every wall jack, alarm panel, lift shaft, and door terminal to map any hidden copper connections across older or expanded care premises. 

Test

Any unmigrated hardware can be tested in Openreach’s free labs to verify its full operational performance on a digital IP network before any commitment to line switches is made. To find out more or to book a visit, click here: Test Lab

Switch 

Once certain that their equipment is compatible, care providers should migrate to a digital solution as soon as possible ahead of the switch-off on January 31st, 2027. Openreach is offering a range of resources to help care providers navigate this transition, including support for edge cases and temporary solutions where needed. As part of this switch, facilities teams on site must ensure all modern IP routers and telecare hubs are fitted with battery backup units rated for at least one to four hours of continuous operation during mains power cuts.