Hillingdon Council Cabinet Member and Officer Decisions
Review of Telecare Model
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Democratic Services Location: Phase II DDI: 01895 250185 CMD No: 2026/1785 To: COUNCILLOR SUSAN O’BRIEN CABINET MEMBER FOR ADULTS, CHILDREN, HEALTH & CARE COUNCILLOR EDDIE LAVERY CABINET MEMBER FOR FINANCE C.C. All Members of the Children, Families, Health & Care Select Committee C.C. Sandra Taylor – Corporate Director of Adult Social Care & Health C.C. Sarah Baker, Adult Social Care & Health Date: 13 August 2026 Non-Key Decision request Form D Review of Telecare Model Dear Cabinet Members, Attached is a report requesting that a decision be made by you as an individual Cabinet Member. Democratic Services confirm that this is not a key decision, as such, the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012 notice period does not apply. You should take a decision on or after Friday 21 August 2026 in order to meet Constitutional requirements about publication of decisions that ar e to be made. You may wish to discuss the report with the Corporate Director before it is made. Please indicate your decision on the duplicate memo supplied and return it to me when you have made your decision. I will then arrange for the formal notice of decision to be published. Liz Penny Democratic Services Title of Report: Review of Telecare Model Decision made: Reasons for your decision: (e.g. as stated in report) Alternatives considered and rejected: (e.g. as stated in report) Signed ……………………………………………………… Date…………………….. Cabinet Member for Adults, Children, Health & Care / Cabinet Member for Finance Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 1 Review of Telecare Model Cabinet Member Lead Cabinet Member for Adults, Children, Health & Care (Cllr O'Brien) Consulting Cabinet Member Cabinet Member for Finance (Cllr Lavery) Chief Officer responsible Corporate Director of Adult Social Care & Health Report author Sarah Baker/ Assistant Director Commissioning and Business Delivery Report classification and reason Public Relevant Committee Children, Families, Health & Care Electoral Ward All Wards 1. Executive Summary This report seeks approval to undertake a public consultation on proposed changes to the Council's Telecare service to ensure it remains sustainable, equitable and fit for the future whilst continuing to support residents to live safely and independently at home. Telecare is a key part of the Council's wider Technology Enabled Care (TEC) offer and currently supports 6,534 residents through alarm monitoring, emergency response and assistive technology solutions. The majority of telecare users do not have a statutory need and, whilst the council recognise the value of the service, the council is introducing charging to move towards a cost recovery model in response to increasing demand, and in preparation for the national transition from analogue to digital telecare services. Currently, more than 90% of service users receive telecare free of charge due to historic age- related exemptions. Whilst this has supported access to preventative services, it is no longer considered financially sustainable and is inconsistent with wider Adult Social Care charging arrangements. The consultation will seek views on: • Introducing a structured charging model for telecare services, including existing users. • Directing new non- statutory referrals to an external telecare provider from an agreed implementation date. • Transitioning existing non- statutory users to a fully outsourced telecare model, with an external provider responsible for service delivery and income collection. The service operates with a gross annual budget of £856,250. Financial modelling indicates that introducing a structured charging model would support the long-term sustainability of the telecare Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 2 service, helping to ensure that resources remain available to meet increasing demand and future investment requirements, including the transition to digital telecare technology. The consultation will engage telecare users, carers, families, advocacy organisations, providers and other stakeholders. Consultation findings, together with equality, financial and operational assessments, will inform a further report to Cabinet in November 2026 setting out the preferred approach and final recommendations. The overall aim is to deliver a fairer, equitable and digitally enabled telecare service that continues to support residents to remain safe, independent and connected within their communities. 2. Recommendation(s) That the Cabinet Member for Adults, Children, Health & Care in consultation with the Cabinet Member for Finance: 1. Approve public consultation on introducing a structured charging model for telecare services, including charges for existing users of all adult ages, in line with Adult Social Care charging principles and subject to financial assessment where applicable. 2. Approve consultation on a revised access pathway, including a defined start date for directing all new telecare requests to an external provider, supported by appropriate information, advice and signposting. 3. Approve consultation on the development of a transition strategy to support existing users without eligible Care Act needs to move away from Council -funded provision to a fully outsourced telecare delivery model, with an external provider responsible for onboarding, monitoring, installation, maintenance and income collection. 4. Note that a further report will be presented following the consultation, setting out the outcomes, equality impact assessment and final recommendations for decision, including the preferred delivery model and implementation approach 3. Reasons for decision The recommendations respond to the Council ensuring that it undertakes a review of services such as telecare, which are helpful, preventative, and can continue to be delivered by alternative suppliers to the Council. In mirroring what other local authorities are doing, these recommendations aim to achieve full cost recovery of telecare for the Council, whilst continuing to ensure that services are available to those in need or wishing to use this type of support and prevention service particularly as the telecare services move to digital, with the switch over in January 2027. Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 3 The current model, which provides telecare free of charge to most residents due to historic age- related exemptions, now results in over 90% of users receiving services without charge. While this supported preventative access, it has created inequity which has resulted in inconsistent charging arrangements. Under the Care Act 2014, the Council must meet eligible care and support needs, with telecare forming part of assessed care packages where applicable. A clear distinction is therefore required between statutory provision and preventative services, with contributions determined through financial assessment where appropriate. The proposed consultation on introducing a structured charging model, including existing users, will support a fairer and more sustainable approach aligned to Adult Social Care charging principles, while maintaining protection for those with eligible needs. It is proposed that a £5.00 per week charge is introduced for the standard telecare service Level 1, which includes the lifeline unit, pendant, monitoring and ongoing maintenance. This level has been set to bring Hillingdon more in line with other local authorities’ charging levels, while remaining affordable for residents. Benchmarking shows that adjacent boroughs such as Brent and Harrow currently charge £5.67 per week for a comparable baseline telecare service, with higher charges applied where additional response services are included. Setting the charge at £5.00 per week places Hillingdon slightly below these rates, ensuring the service remains competitive and proportionate, while supporting the long-term sustainability of the telecare service. Consultation is also proposed on a revised access pathway, directing all new telecare requests to an external provider from a defined start date. This will establish a market -based approach, enabling the Council to focus resources on statutory duties, with residents supported through information, advice and signposting where needs are not eligible. A transition strategy will be developed for existing users, focused on introducing charging and supporting those without eligible needs to move away from Council -funded provision to a fully outsourced telecare model, transferring delivery responsibilities to an external provider. This will support a more streamlined and manageable transition as the non-statutory cohort reduces. The consultation will ensure residents, stakeholders and partners can inform the future model. Final recommendations will be reported following consideration of consultation feedback, equality impacts and financial modelling. 4. Proposal Telecare is a key component of Technology Enabled Care (TEC), providing 24- hour monitoring and alert systems that support residents to live safely and independently in their own homes. The service offers reassurance to residents, carers and families by ensuring that emergency assistance is available when needed. It includes a range of innovative and preventive solutions, such as: Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 4 • Personal and environmental sensors • Continuous monitoring via an Alarm Receiving Centre (ARC) • Immediate and appropriate emergency responses • Integration of preventive and digital technologies In Hillingdon, the telecare service currently supports a large resident cohort, with the majority of users aged over 75. The current model provides telecare free of charge to most residents due to historic age- related exemptions, resulting in over 90% of users receiving the service without charge. While this has supported access to preventative services, it has created inequity and is not financially sustainable in the longer term. In addition, a proportion of users receive telecare as part of a statutory care and support package under the Care Act 2014. This requires a clear distinction between services provided to meet eligible needs and those that are preventative in nature. There are currently 6,534 residents in receipt of telecare broken down as follows: Client Type Number of clients Hillingdon/Own responder Self-Monitoring 89 Does not go through to the Alarm Response Centre (ARC) Sheltered/Extra Care ( 21 Sheltered Schemes and 3 Extra Care settings) 1,104 Hillingdon Responder TCL Level 1 2,091 Own Responder TCL Level 2 2,873 Hillingdon Responder TCL Level 3 146 Own Responder TCL Level 4 231 Hillingdon Responder Totals 6,534 Strategic Context and Drivers for Change The telecare service is operating within a context of: • Increasing demand associated with an ageing population and increasing complexity of need • Inequity in the charging arrangements for people using telecare. • Ageing infrastructure and the requirement to transition from analogue to digital telecare systems • The Council’s wider ambition to embed Technology Enabled Care as a core component of service delivery, supporting prevention, independence and demand management. The current delivery model, which is largely subsidised, does not fully reflect the cost of provision, the level of service received, or residents’ ability to contribute. This limits the Council’s ability to invest in modern, scalable and resilient services. The recommendation proposes that the council Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 5 firstly moves to a full cost recovery model and secondly reviews the ongoing service model for the delivery of telecare. Telecare may form part of a statutory care package where needs are assessed as eligible under the Care Act 2014. However, where telecare is provided as a preventative or non- statutory service, the Council has discretion to determine how the service is delivered and funded. This requires a clear and consistent approach to: • Differentiating between statutory and non-statutory provision • Aligning charging arrangements with Adult Social Care policy • Ensuring compliance with legal and equality duties Proposed Changes The report seeks approval to consult on a set of interrelated proposals that, together, establish a sustainable and future-proof telecare model. 1. Introduction of a Structured Charging Model Consultation is proposed on introducing a structured charging model for telecare services, including for existing users, aligned to Adult Social Care charging principles. This would: • Support a fairer and more equitable approach, reflecting ability to pay and level of service • Support the long-term viability and resilience of the service • Maintain protection for residents with eligible Care Act needs through financial assessment 2. Revised Access Pathway A revised access pathway is proposed, whereby new telecare requests from a defined start date would be directed to an external provider. Residents would be supported through information, advice and signposting where needs are not eligible This will: • Establish a market-based approach for preventative services • Enable the Council to focus its resources on statutory responsibilities • Align with wider commissioning and market-shaping objectives 3. Outsourced Delivery Model Consultation is also proposed on moving to a fully outsourced telecare model which will include a transition strategy to support existing residents without eligible needs to transition away from Council-funded telecare provision to an external telecare provider responsible for: • Onboarding, installation and maintenance • Monitoring and Alarm Receiving Centre (ARC) functions Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 6 • Income collection and customer management This approach will: • Ensure residents are supported through a managed and proportionate transition • Simplify service delivery and create a more streamlined operating model • Support digital transformation and innovation • Reduce operational complexity within the Council Financial Implications The Gross Expenditure Budget for the Telecare service is £856,250 and funded through the HRA, General Fund and BCF Contribution. The table below provides the impact of increasing the weekly rates for the telecare service. The provision of services at Level 1 and 2 is mainly where the income to cover the costs of the service would be met. Based on the current number of users and applying sensitivity of users who would pay, results in the income recovery of £594k (40%), £742k (50%) and £891k at 60%. Levels 3 and 4 income would be included in part of the Client’s Financial Assessment as levels 3 and 4 would only be provided as part of a statutory Adult Social Care package. Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 7 If the Council recovers income from 60% of service users from options 1 and 2, this would be sufficient to cover the current costs of providing the service and be sufficient to exceed the medium-term financial strategy savings target of £700k from the Telecare service review. Below are some charging comparisons with other Northwest London LA’s Local Authority Type of Service Weekly/Monthly Charge Brent Standard baseline, pendant, maintenance and monitoring £5.67 per week Provided by Harrow so premium offer not available Ealing Ealing Careline closed on 31 March 2024. Ealing Council is no longer offering an in-house telecare monitoring service. Harrow Standard baseline, pendant, maintenance and monitoring £5.67 per week Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 8 Standard baseline, pendant, maintenance and monitoring plus emergency response call outs, smoke detector and key safe £9.51 per week Hounslow Bronze service is 24/7 monitoring, alarms and sensors £19.98 per month 24/7 monitoring, alarms and sensors GPS, medication prompts when required, keysafe and responder service £41.75 per month 5. Corporate implications Financial (mandatory) Y Equalities impact assessment Legal (mandatory) Y Workforce Alternative options (mandatory) Y Public Health Risk management (mandatory) Y External partners Asset Communications Procurement Committee comments Social Value (from contract) Digital Planning Other Climate Change Other a) Financial Corporate Finance have reviewed this report and concur with the Financial Implications set out above, noting the recommendations to approve to consult on the proposed structured charging model, revised access pathway to an external provider, and the develo pment of a transition strategy to support existing users without eligible Care Act needs to move away from Council - funded provision to a fully outsourced telecare delivery model. To note that a further report will be presented following the consultation, s etting out the outcomes, equality impact assessment and the final recommendations for decision, including the preferred delivery model and implementation approach. Furthermore, it is noted there are no direct financial implications to the General Fund, in relation to the recommendations within this report. The proposed consultation on introducing a structured charging model, including existing users is intended to su pport a fairer and more sustainable approach aligned to Adult Social Care charging principles, while maintaining protection for those with eligible needs and to ensure that residents, stakeholders and partners can inform the future model. To further note, the current Telecare Service has a gross annual expenditure budget of £856k, funded through a combination of General Fund, Housing Revenue Account and Better Care Fund. The proposed charging model for consultation under Options one and two, is forecast to generate Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 9 and estimated annual income of £594k, £742k and £891k based on income recovery rates of 40%, 50% and 60% of service users respectively. At the upper assumption of 60%, income generation would fully offset the current cost of the service provision on the General Fund and contribute to the savings target already contained within the approved 2026/27 budget for the telecare review. Under the 40% and 50% recovery scenarios, whilst the additional income would offset the current cost of the service provision on the General fund the level of savings would be lower, and further mitigation measures would need to be identified to ensure the saving target is achieved. b) Legal Legal Services confirm that the proposed public consultation on the changes to the telecare service is consistent with the consultation expectations set out in the Care and Support Statutory Guidance, including engagement with affected service users, carers, families, and relevant stakeholders before any final decision is made. Subject to the consultation being undertaken fairly, with sufficient information provided and conscientious consideration given to the responses received, there are no legal impediments to the recommendations set out in this report. c) Alternative options Option Summary Recommendation Option 1: Do Nothing - Maintain Current In-House Model Continue delivering the existing telecare service with most users receiving the service free of charge. Not recommended as it would perpetuate inconsistent charging arrangements, limit opportunities for service modernisation and reduce the Council's ability to respond to future demand. Option 2: Charging Only Introduce charges for existing users while retaining the current in- house service model. Not recommended as it only partially addresses sustainability challenges and retains operational risks within the Council. Option 3: Partial Outsourcing (Hybrid Model) Retain Council provision for statutory users and outsource non- statutory users to an external provider. Not recommended due to increased complexity, potential resident confusion, and a more complex operating model, potentially resulting in inconsistent user experience and fragmented service delivery., d) Risk management Risk Mitigation Residents disengage due to cost Financial assessment, clear communication phased introduction Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 10 Impact on vulnerable residents Exemptions and protections for those with eligibl care needs Reputational risk Strong communication and engagement strategy Administrative burden Clear processes aligned with existing chargin systems e) Other implications NIL 6. Consultation & engagement The benefit or impact upon Hillingdon residents, service users and communities Consultation & Engagement carried out (or required) The proposed consultation will seek views from: • Telecare users and their families • Carers and advocacy groups • Providers and system partners The proposed consultation will provide: • Information on the rationale for the proposed changes, the consultation period, who is invited to participate, how responses will be considered, and the next steps in the decision- making process. • Clear explanatory information setting out the proposal to introduce charges for telecare services and seeking views on the proposed charging approach. • The consultation will also include questions to capture demographic information to help assess whether responses reflect a broad and representative cross -section of residents and groups with protected characteristics. • Opportunities to respond online, with paper copies available on request to support accessibility. A direct mailing will be issued to all current telecare users, their representatives where appropriate, and relevant stakeholders. The consultation will also be promoted through the Council's website and social media channels. • A commitment that consultation feedback will be analysed and considered alongside financial, operational and equality considerations. The consultation will inform: • The final service model • The charging approach • The implementation and transition strategy A further report will be presented following the consultation, setting out: • The consultation outcomes Executive Decision Report Cabinet Member 13 August 2026 Classification: Part 1 Public Page 11 • Equality Impact Assessment • Final recommendations for decision, including the preferred delivery model and implementation approach 7. Timetable for implementation Activity Timescale Develop consultation proposal and supporting materials, including consultation questions, Equality Impact Assessment, communications and engagement plan August 2026 Consultation document prepared and quality assured with support from the Communications Team By end of August 2026 Consultation packs issued to existing telecare service users By end of first week of September 2026 Wider public consultation launches Week commencing 7 September 2026 Engagement activities with residents, service users, carers, providers and stakeholders Throughout consultation period Consultation period (6 weeks) 7 September to 9 October 2026 Consultation closes 9 October 2026 Analysis of consultation responses and preparation of consultation findings report October 2026 Cabinet report setting out consultation findings and recommendations November 2026 Cabinet Communication of Cabinet decision and implementation planning November to December 2026 Implementation of agreed charging arrangements January 2027 List of appendices attached None at this stage List of Background Papers Copies of any other documents supplied to in connection with the item. If no background papers, mark this as NIL
View Decision / Minutes Text
Executive Decision Notice – 24 August 2026
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
OFFICIAL EXECUTIVE DECISION NOTICE
PUBLISHED BY DEMOCRATIC SERVICES
Notice is hereby given that the following decision(s) have been made today by
Cabinet Members at the London Borough of Hillingdon:
Title of decision Review of Telecare Model
Reference No. 2026/1785
Date of decision Monday 24 August 2026
Call-in expiry date Tuesday 1 September 2026
Relevant Select
Committee
Children, Families, Health & Care Select Committee
Relevant Wards All Wards
Decision made
Cabinet Members making
the decision
Councillor Susan O ’Brien – Cabinet Member for Adults,
Children, Health & Care
Councillor Eddie Lavery – Cabinet Member for Finance
Decision Agreed
That the Cabinet Member for Adults, Children, Health &
Care in consultation with the Cabinet Member for
Finance:
1. Approved public consultation on introducing a
structured charging model for telecare services,
including charges for existing users of all adult
ages, in line with Adult Social Care charging
principles and subject to financial assessment
where applicable.
2. Approved consultation on a revised access
pathway, including a defined start date for
directing all new telecare requests to an external
provider, supported by appropriate information,
advice and signposting.
3. Approved consultation on the development of a
transition strategy to support existing users
without eligible Care Act needs to move away
from Council -funded provision to a fully
outsourced telecare delivery model, with an
external provider responsible for onboardi ng,
monitoring, installation, maintenance and
income collection.
4. Noted that a further report will be presented
following the consultation, setting out the
outcomes, equality impact assessment and final
Executive Decision Notice – 24 August 2026
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
recommendations for decision, including the
preferred delivery model and implementation
approach
Reason for decision Since publication of the report, further consideration was
given by Cabinet Members to the benchmarking data. They
have therefore agreed that the proposed charge be set at
£5.67 per week instead of the £5 proposed, aligning
Hillingdon with neighbouring authorities offering comparable
services. This approach will support the full recovery of
telecare service costs, whilst maintaining access to an
important preventative service for residents who need or
choose to use it.
Alternative options
considered and rejected
The options to continue providing the existing telecare
service free of charge to most users, or to introduce charges
while retaining the current in- house model, were not
recommended as they would perpetuate inconsistent
charging arrangements, limit opport unities for service
modernisation, and fail to fully address long- term
sustainability and operational challenges. A further option to
retain Council provision for statutory users while outsourcing
services for non-statutory users was also rejected due to the
increased complexity it would create, the potential for
resident confusion, and the risk of inconsistent service
delivery and user experience.
Classification Part I - Public
Link to associated report Report can be found here
Relevant Officer contact
& Directorate
Sarah Baker – Adult Social Care & Health
Any interest declared by
the Cabinet Member(s) /
dispensation granted
N/A
Implementation of decision & scrutiny call-in
[Internal Use only]
When can this
decision be
implemented by
officers?
Officers can implement Cabinet Member decision in this notice only
from the expiry of the scrutiny call-in period which is:
5pm on Tuesday 1 September 2026
However, this is subject to the decision not being called in by
Councillors on the relevant Select Committee. Upon receipt of a
valid call-in request, Democratic Services will immediately advise
the relevant officer(s) and the decision must then be put on hold.
Councillor scrutiny
call-in of this
decision
Councillors on the relevant Select Committee shown in this notice
may request to call-in this decision. The request must be before the
expiry of the scrutiny call-in period above.
Executive Decision Notice – 24 August 2026
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
Councillors should use the Scrutiny Call-in App (link below) on their
devices to initiate any call-in request. Further advice can be sought
from Democratic Services if required:
Scrutiny Call-In - Power Apps (secure)
Further information These decisions, where applicable, have been taken under The
Local Authorities (Executive Arrangements) (Meetings and Access
to Information) (England) Regulations 2012.
This is the formal notice by the Council of the above executive
decision, including links to the reports where applicable.
If you would like more information on this decision, please contact
Democratic Services on 01895 250636 or email:
democratic@hillingdon.gov.uk.
Circulation of this decision notice is to a variety of people including
Members of the Council, Corporate Directors, Officers, Group
Secretariats and the Public. Copies are also placed on the
Council’s website.
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