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The development of telecare services across the UK has been supported by grants from the respective governments of Scotland and Wales, and by the DH in England. New services are being established to sometimes operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce the use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed so that service users can choose appropriately if offered direct payments. Two different service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine where the former includes all such services offered in the service user's home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three different technology groups designed to make people more independent or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.

The development of telecare services in the UK has been supported by grants from the respective governments of Scotland and Wales, and by the Department of Health in England. New services are being established, sometimes to operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed if service users are to be able to choose appropriately if offered direct payments. Two service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine, where the former includes all such services offered in the service user's home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three technology groups designed to make people more independent, or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.

The sudden expansion of telecare services in the UK may have resulted in items of equipment either being left unused on the shelves or being discarded after use without being recycled. Obviously, this is an inefficient use of resources. It has been difficult for local authorities and telecare service providers to share such equipment for a number of reasons including warranties and the need to put a value on such items. A new Tel‐e‐Cycle exchange service is proposed but within a context of using such benefits to stimulate innovation and new products from suppliers of equipment so that investment in research and development is not compromised. This paper describes how such a Tel‐e‐Cycle scheme might operate.

An increase in the ageing UK population is leading to new ways of looking at how we deliver health and social care services in the UK. The use of assisted living technology (ALT) and telecare is already playing a part in these new models of care. Yet despite the current advances in the range of technology and networking capabilities in the home, ALT and telecare solutions have not been taken up as eagerly as might have been anticipated. The study reported here used scenario‐based focus groups with a wide variety of stakeholders in home care to identify the existing barriers to the successful uptake of ALTs and telecare in Scotland. Six focus group sessions were conducted with individual stakeholder groups (social care workers, policy makers, telecare installation technicians, older users, informal carers) and five conducted with mixed stakeholder groups. The focus groups used the same home care scenario to identify and categorise the different perceptions, attitudes, and expectations of the various stakeholders when discussing telecare implementation for a fictitious older couple. The emerging themes from the focus groups were analysed and categorised according to the Framework Analysis approach. We present a synthesised list of the current barriers to the uptake of ALTs and telecare ‐ and discuss how each of these barriers might be overcome. If these barriers are addressed, we believe telehealthcare technologies will be better designed, more usable, easier to prescribe effectively, more acceptable to more users in more contexts, and ultimately more common place in homes throughout the UK.

The purpose of this paper is to discuss how and to what extent users can become involved in the process of selecting and implementing telecare and telehealth technologies in local health care services.

The discussion is based on data from a project in one local authority in Norway. About 100 persons have participated in focus group interviews where issues regarding new telecare and telehealth technologies for the elderly were discussed. The focus groups involved different groups of product users and stakeholder groups, i.e. “older senior users” (over 65 years), “younger senior users” (55-65 years), relatives, health care professionals and general practitioners (GPs).

Different user groups have different stakes in the technology. It is difficult to involve “older senior users” in the selection process due to their lack of information about potential solutions, while “younger senior users” are more informed and positive towards the introduction of telecare and telehealth technologies. The results also indicate that professionals are ambiguous towards new technologies; on the one hand they expect services to be better, but on the other they are concerned about ethical and working life issues that have not been fully explored as yet.

This paper provides an understanding of how different groups of product users and stakeholder groups relate to and can be involved in an expanded implementation process of telecare and telehealth technology which allow older people to remain in their homes for longer.

This paper asks how the introduction of “smart” digital technologies might affect the goals that can be attributed to telecare for older people, by those coordinating its provision.

A total of 29 in-depth, qualitative interviews were conducted with local authorities, housing associations and other organisations coordinating smart telecare provision, as well as telecare manufacturers and suppliers. Interviews were analysed by using qualitative thematic analysis.

The analysis reveals discrepancies between the goals and outcomes of smart telecare provision, according to those coordinating service delivery. This study concludes that the goal for smart telecare to be preventative and cost-efficient may be complicated by various organisational and operational challenges associated with coordinating provision.

New, “smart” telecare technology for older people stands apart from earlier, user-activated or automatic devices. It may have distinct and under-researched organisational and ethical implications.

Most local authorities now offer a telecare service to people who are eligible for community services under Fair Access to Care Services (FACS). Others also offer telecare in a prevention mode to people with lower levels of risk alongside traditional social (or community) alarm systems. A survey of local authorities, mainly members of the Centre for Usable Home Technologies (CUHTec), was performed to gauge the service provision options available and the charging strategies that have been adopted. Results from 39 authorities across the UK indicate significant differences between English shire counties and the unitary authorities elsewhere in the country in terms of eligibility and provision. The majority of authorities have yet to confirm a charging policy, using the principle of ‘pilot project’ to delay a decision until their Preventative Technology Grant (PTG) or telecare grants have run out. Some authorities with more mature services have chosen to make telecare free to particular groups on the grounds that they will reduce costs elsewhere in the health and/or social care economy. Most are introducing charges in the range of £5 to £10 per week indicating a generous subsidy from the council.

The use of telecare with appropriate domiciliary care packages may provide the means to manage many of the risks associated with the increasing number of older people who wish to continue to live independently in their own homes. Those who become especially frail or disabled can retain their independence and quality of life if their homes are made ‘smart’. This paper discusses the range of services that are available, or under development, for the prototype ‘MIDAS’ (Modular Intelligent Domiciliary Alarm System) telecare system, which enable traditional community alarm, telecare and assistive technologies to be used in an integrated and intelligent fashion. A range of services that allow autonomous operation within the home (and hence increase the perceived independence of a client by decreasing the reliance on a response centre operator) known as ‘HAMISH’ may be used. It offers a wider range of cost‐effective services of relevance to both the individual, and to society, in different types of home environment including dispersed housing and new sheltered housing schemes.

Telehealth and telecare innovations have the potential to improve quality of life, reduce unnecessary hospital and care home admissions, and support care integration by providing care and disease management from multi‐disciplinary care teams linked remotely to users. About 1.7 million people benefit from telecare services in the UK, but telehealth services have only around 5000 users, many of whom receive services through the Department of Health's Whole System Demonstrator (WSD) Pilot Programme. There is an identifiable chasm between early adopters and wider uptake of telehealth and telecare solutions. Key barriers include lack of robust evidence on cost‐effectiveness, of a consumer market and of interoperability of the technology between service sectors, and the implications for professionals and organisations of changing their established methods of practice. Telehealth and telecare could be combined to provide a common platform to integrate care for people requiring both health and social care support, but relatively few people are judged suitable for joint care. This is related both to the nature of the technology and the profile of those people who can use it, and to the different ways in which health and social care systems assess who is most 'at risk', which makes it difficult to assess which individuals might best benefit from an integrated response to their care needs. While there is considerable interest and policy momentum behind the adoption and diffusion of telehealth and telecare in England, more understanding of their benefits is required to convince commissioners and providers of its potential.