The Invisible Plumbing.

Part 4 of 10 in our TEC Pathways series, following the journey from first plan to proven outcomes.

The promise leaves the house

Three steps in, and something important has happened. The organisation knows why it is doing this and what success will be worth, the place has been mapped street by street, and a person at a kitchen table has told the service what a good day looks like for them. Promises have been made, to a board, to a community and to a household, and every one of them now depends on something nobody at that table mentioned.

A pendant press, a fall detected in the night or a quiet drift away from someone's normal routine means nothing unless the signal gets out of the house and reaches somebody who can act on it. Between the sensor on the wall and the person who responds sits the fourth step of the pathway, connectivity, and it is the plumbing of the whole endeavour, the part nobody compliments when it works and everybody notices the moment it fails.

Inside the home

Start where the person lives. At the heart of most modern set-ups sits a digital home hub, sometimes called a gateway, which is the box the sensors talk to. The devices chosen at step 3 reach it in different ways depending on what they are, and the variety is deliberate rather than untidy.

Some connect over Wi-Fi, Ethernet or Bluetooth, the same technologies most households already use. Many of the most important ones do not, and for good reason. Pendants, fall detectors and door sensors usually use dedicated radio links, on standards such as Zigbee, a low-power radio protocol designed for small devices, or the RF 869 band, a slice of radio spectrum set aside in Europe for exactly this kind of alarm equipment. A pendant that depended on the household Wi-Fi would stop working the day the broadband provider changed and someone forgot the new password. A radio-linked one keeps working regardless, sips its battery for years, and neither knows nor cares what is happening to the router.

The practical point for anyone planning a service is that the hub has to speak all of these languages at once, because the alternative is choosing devices for how they connect rather than for what the person needs, and that is the principle of step 3 quietly dying in the wiring.

Out of the house

Getting the signal to the hub is half the journey. Getting it out of the building is the half that keeps service managers awake, and it is where the work done at step 2 starts to pay its way.

The main routes out are broadband over a digital line and a SIM card using the mobile networks, and the best hubs use both. Some sensors take a different road altogether. LoRaWAN, which stands for long range wide area network, lets small, low-power sensors send tiny amounts of data straight to a LoRaWAN network over surprisingly long distances, without going through the hub at all. That makes it well suited to things like damp and temperature monitoring across a whole housing estate. Each route has its place, and the right answer for a sheltered scheme in a town centre is rarely the right answer for a scattered rural caseload.

The connectivity map drawn at step 2 matters here, because the black spots it found are the streets where a SIM-based service will struggle and the homes where the installation plan needs a different answer. Finding that out on a map costs nothing, while finding it out one failed alert at a time costs trust, and sometimes far more. It is also worth remembering that not every household has broadband, and the people least likely to have it are often the people a service most needs to reach. A deployment designed on the assumption of a home internet connection quietly leaves them out, which is why hubs with their own mobile connection matter, and why independence from home broadband belongs on the requirements list rather than the wish list.

The switch-off that cannot move again

This is also where the deadline lives. The analogue phone network closes for good on 31 January 2027, having already been pushed back once from the end of 2025 to protect telecare users, and Openreach has said plainly that there will be no further extension. Most of the country has already moved, but around 1.5 million lines were still on the old copper network in the summer of 2026, and the telecare alarms that have whispered down those lines for 40 years stop being reliable the moment their exchange goes digital.

Any service still running analogue units is not planning a migration now, it is racing one, and the race gets harder every month as engineer diaries fill up. The work is not only swapping the box on the wall. It is knowing exactly which homes still have an analogue unit, which of those people live alone, and who will check that the new digital alarm actually reaches the monitoring centre on the day it goes in.

The next switch-off is already on the calendar

The phone line is not the only network being retired. The 3G mobile networks have already gone, and the mobile operators have now set dates for 2G, with EE starting from May 2029, O2 from the summer of 2029 and Vodafone during 2030. That matters because many alarms and pendants were built to fall back to 2G when nothing better was available, and some still depend on it.

The lesson from the analogue switch-off is that a date several years away feels like plenty of time right up until it does not. A service buying equipment today should expect it to work on 4G and beyond, ideally with a SIM that can roam across more than one network, and should ask every supplier for a straight answer on it before signing. It is far cheaper to buy the right device once than to replace a whole estate in a hurry in 2029.

Open standards, or somebody else's padlock

Now the principle that sits over this entire step, which is that everything should talk to everything else, and open standards exist to make sure it can.

The one to know by name is SCAIP, the Social Care Alarm Internet Protocol, an open standard for sending alarm signals over the internet. When an alarm platform speaks SCAIP, any monitoring centre that also speaks it can receive the call, which sounds like a technicality and is actually the difference between a market and a captivity. A service built on open standards can change its monitoring provider, add a new sensor from a different manufacturer, or replace a platform in 5 years' time without ripping out everything in every home. A service built on a closed system can do none of those things without the permission of the company that owns it, and that company knows it.

This is where the conversation at the kitchen table either survives or dies. The widest range of devices, chosen for the person's needs and never for the platform, only stays possible if the plumbing is open, because a closed system narrows every future choice to whatever its owner happens to sell. Lock-in is not a technical detail. It is a tax on every decision the service will ever make, and buyers should ask for open standards in writing from every supplier before a contract is signed. Ask early and watch how the question is answered, because a vague reply at the procurement stage rarely becomes a straight one after go-live.

Designed for the worst night, not the best demo

There is one more requirement, and it is the one that separates systems that reassure from systems that merely function. Everything fails eventually. Broadband drops, masts go down for maintenance and power cuts happen, and a care technology service is only ever as good as its worst night.

The answer is resilient fallback paths, which is the plain idea that no signal should have only one way out. If the broadband fails, the hub falls back to its SIM, and if the mains power goes, the battery carries it through. A well-designed service knows within minutes that a home has gone quiet for technical reasons, rather than discovering it days later or, far worse, never. None of this is exotic, but none of it happens by accident either, and it is precisely the kind of unglamorous requirement that vanishes from a procurement when the conversation starts at the shiny end of the catalogue.

Done well, this whole step disappears, and that invisibility is the point.

The step nobody should ever notice

The family never thinks about radio bands, the person at home never learns what SCAIP stands for, and the promises made at the kitchen table are kept quietly, every hour of every day, by infrastructure nobody sees. That is earned at exactly this stage of the pathway or not at all.

What the plumbing carries, though, is where the value of the whole programme starts to show. The next article in this series follows the data itself, gathered continuously from every home, and how raw signals are turned into the 3 things a service actually needs, alerts that say act now, trends that say something is changing, and reports that give evidence for decisions.

If you are planning a technology enabled care service and the connectivity questions keep being answered by whatever a supplier's brochure assumes, that is exactly the conversation we help with. We are independent, we work across the whole market, and we work for you, not for any vendor. Get in touch, we can help you.

Harry MacLean is the Founder and Managing Director of Creating Better, a strategic business advisory with a specialist care technology practice. He has spent his career making complicated things simpler and broken things better, and he has not finished yet.