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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 aim of this paper is to present a conceptual valuation framework to allow telecare service stakeholders to assess telecare devices in the home in terms of their social, psychological and practical effects. The framework enables telecare service operators to more effectively engage with the social and psychological issues resulting from telecare technology deployment in the home and to design and develop appropriate responses as a result.

The paper provides a contextual background for the need for sociologically pitched tools that engage with the social and cultural feelings of telecare service users before presenting the valuation framework and how it could be used.

A conceptual valuation framework is presented for potential development/use.

The valuation framework has yet to be extensively tested or verified.

The valuation framework needs to be tested and deployed by a telecare service operator but the core messages of the paper are valid and interesting for readership.

In addressing the social and cultural perspectives of telecare service stakeholders, the paper makes a link between the technologies in the home, the feelings and orientations of service users (e.g. residents, emergency services, wardens, etc.) and the telecare service operator.

The paper is an original contribution to the field as it details how the sociological orientations of telecare technology service users should be valued and addressed by service operators. It has a value through the conceptual arguments made and through valuation framework presented.

Telecare promises to deliver healthcare services more efficiently while, at the same time, improving the quality of care. The purpose of this paper is to challenge these promises by analysing the implications of introducing telecare in the rehabilitation of patients suffering from chronic obstructive pulmonary disease.

Empirically, the paper is based on interviews with and observations of rehabilitation therapists and patients taking part in a Danish telerehabilitation programme. Theoretically, the paper draws on Science and Technology Studies.

The introduction of telecare alters rehabilitation practices in multiple ways. First, several new time-consuming work routines, carried out in collaboration between therapists, patients and technical professions, emerge. Although crucial in establishing and maintaining telerehabilitation infrastructures, this work remains invisible in evaluations of the programme. Second, rather than simply increasing patient agency, responsibilities are redistributed and negotiated in subtle and non-uniform ways. These negotiations make it less transparent where one responsibility begins and where another potentially conflicting one ends.

Evaluations of telecare technologies should pay more attention to work- and responsibility-related effects of introducing telecare in order better to account for predicted and unpredicted as well as desirable and undesirable socio-technical changes.

Using an ethnographic approach, the paper points to the discrepancy between simplistic political promises that telecare technologies can serve as tools for improvement, on the one hand, and the substantial changes in the organisation and management of healthcare observed in practice, on the other. Rather than regarding telecare as technologies of improvement, it is more productive to regard them as technologies of change.

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.

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.

This paper aims to report on a structured attempt to develop new directions for research into telecare. Current research evidence suggests that telecare in the UK is not optimally cost-effective and does not deliver better outcomes than more traditional forms of care and support. To address this problem, an analysis of expert opinion about future directions for research is provided.

Two electronic surveys of UK based academic experts were conducted. Participants were drawn from a range of professional disciplines, including medicine, social care, occupational therapy and social policy and identified were by their contribution in this, or allied fields. The first survey included nine questions intended to identify at least one new research question that could form the basis of a funding proposal to the Nuffield Foundation, which provided “seedcorn” funding to support this work. Ten themes were identified following thematic analysis. The second survey asked participants to prioritise three of these themes.

Key themes emerging as priority areas for future research were as follows: the role of assessment in ensuring technology deployment meets the needs of service users; ethical implications of technology and how these might be addressed in the future; and the use of end user co-production/co-creation approaches in the development of new assistive technologies and digital enabled care.

The findings are based on academic expert opinion; perspectives of practitioners, service users and family members are unrepresented.

The findings of this study could contribute to development of new directions for telecare research, and future strategic funding decisions in this rapidly changing field.

Evidence for sub-optimal outcomes for telecare requires new thinking. The authors are not aware of any other study that offers an analysis of expert opinion of fruitful areas for new research into telecare.

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.

The purpose of this paper is to look at the implications of the increasing use of Assisted Living Technology in the social care sector and to assess the implications for the workforce in terms of job roles, skills, knowledge, training, and support.

A mixed methods approach was used, through a quantitative electronic survey of staff working in social care (as well as some health care) organisations in England, and three qualitative case studies of local authorities.

The research shows that the organisations involved in delivering Assisted Living Technology, the types of Assisted Living Technology being introduced, and the way in which it is being delivered, have implications for job roles and the skills and knowledge needed by staff. The associated training and workforce development similarly varies across the social care sector; it is ad hoc, disparate, and provided primarily by individual employers or by suppliers and manufacturers.

There is a need for a standardised Assisted Living Technology workforce development approach which can be used across the social care sector.

The varied nature of Assisted Living Technology providers and delivery models presents a challenge to the development and implementation of a standardised programme of workforce development.

This paper presents the results of new empirical research arising from a quantitative and qualitative study of the workforce development implications of Assisted Living Technology in the English social care sector.

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.