Key messages

• the testbed combined community 5G connectivity with connected health and social care services
• reported outcomes included reductions in GP visits and telecare costs
• improved connectivity supported access to digital health and care services
• the programme focused on deployment in disadvantaged areas
• infrastructure investment was central to enabling service use.

Policy implications

• investment in free or low-cost connectivity can support access to technology-enabled care
• connectivity infrastructure should be considered part of health and social care enablement
• place-based digital infrastructure can complement service redesign
• partnerships across local government, health services and technology providers are important.

Gaps

• evidence is based on a case study evaluation
• limited comparative or controlled analysis of outcomes
• uncertainty about scalability and longer-term sustainability
• limited detail on differential impacts across population groups.

Commentary
This programme shows how digital infrastructure can shape access to technology-enabled care. By focusing on connectivity in a disadvantaged urban area, the testbed addressed a foundational barrier that often sits outside traditional health and social care planning.

The reported reductions in GP visits and telecare costs suggest that connectivity can support more efficient use of services. However, these outcomes appear closely tied to local context, programme design and the availability of complementary services.

Rather than treating digital access as an individual responsibility, the testbed illustrates the effects of structural investment. Providing reliable, low-cost connectivity created the conditions for people to engage with connected care who might otherwise have been excluded.

Overall, the Liverpool 5G testbed highlights the role of infrastructure as an enabler of equitable technology use in care. Its findings point to the importance of aligning connectivity investment with service delivery, while also underlining the need for stronger evaluation to understand wider applicability.

Key messages

• technology-enabled care services (TECS) are positioned as tools for prevention and early intervention
• TECS can support people to live at home for longer, potentially reducing reliance on institutional care
• local authority budget cuts have constrained innovation and service development
• infrastructure limitations within care systems hinder effective deployment of TECS
• TECS are not always well aligned with integrated health and social care planning

Policy implications

• sustainable funding models are needed to support long-term delivery of TECS
• commissioning approaches should integrate TECS into wider health and social care pathways
• investment in digital infrastructure is required to support implementation in care settings
• clearer frameworks for assessing value may help systems evaluate TECS more consistently

Gaps

• limited evidence on the effectiveness of TECS within integrated care pathways
• lack of long-term outcome data linking TECS to prevention or cost savings
• uncertainty about how value is defined and measured across health, social care and local government stakeholders

Commentary
This case study examines how technology-enabled care services are commissioned and implemented within a regional health and social care system. While TECS are frequently promoted as tools that support prevention and independence, the study highlights how their effectiveness depends heavily on local financial and organisational conditions.

Local authority funding pressures emerge as a major constraint. Budget reductions limit the ability of councils and care systems to invest in new technologies, redesign services or scale promising initiatives. As a result, the potential benefits of TECS are often difficult to realise in practice.

The research also highlights structural challenges around infrastructure and system integration. Where digital systems, care pathways or organisational responsibilities are poorly aligned, technology-enabled services may remain peripheral rather than embedded within everyday care delivery.

From a care equity perspective, these findings raise questions about how technological innovation is distributed across the care system. If the implementation of TECS depends heavily on local financial capacity, areas facing greater fiscal pressure may have fewer opportunities to develop or sustain technology-enabled services. This could contribute to uneven access to preventative tools that help people remain independent at home.

The study therefore suggests that the benefits of technology-enabled care cannot be separated from wider system conditions. Ensuring that TECS support equitable access to care may require stable funding, coordinated commissioning across health and social care, and clearer evaluation of how these services improve outcomes for different populations.