April 1st 2026
There is growing interest across the adult social care sector in how other countries are using technology to support people to live independently. Last week, Katie Thorn from the Digital Care Hub reflected on insights from a study visit to Spain, highlighting opportunities and considerations for England.
Katie visited Madrid as part of an Independent Living Study Tour sponsored by Tunstall UK. The visit focused on shared learning rather than product demonstration, offering an opportunity to explore how Spain has embedded telecare within its national system.
A national approach to telecare
Spain introduced the Ley de Dependencia in 2006, establishing a legal right to access care and support services, including telecare, for people with assessed dependency needs. Today, around 1.3 million people in Spain use telecare services, with nearly 90% funded by the public sector.
In Madrid, responsibility for telecare sits with the regional government, which commissions services from private providers through five-year contracts. This differs from the more locally varied approach in England.
Katie noted several distinctive features of the Spanish model:
- Telecare providers directly employ social workers to carry out assessments and match people with appropriate technology
- The system is highly data-driven, enabling regional authorities to access anonymised insights for service planning and research
- Assessments focus on levels of dependency, rather than the strengths-based approaches more commonly used in England
“These differences really stood out,” Katie said. “It shows how policy and system design shape not just services, but also how people’s needs are understood and responded to.”
Combining telecare with consumer technology
The study tour also included a visit to Amazon in Spain, where delegates learned about a partnership with the Spanish Red Cross. Through this initiative, around 20,000 people have been provided with Alexa-enabled devices as part of a managed support service.
The devices are used to help people stay connected, reduce social isolation, and access remote support. Importantly, this is combined with human interaction. Volunteers from the Red Cross carry out monthly in-person visits to help people use their devices and build digital skills.
Over the past year, the programme has recorded around 10 million interactions between users and Alexa devices, with 96% of these being voice-led. An evaluation is currently being carried out by the University of Barcelona.
Katie reflected that while similar pilots have taken place in England, the scale and integration of this approach are notable.
“Given that more than half of UK homes already have an Alexa, it’s likely these devices will play an increasing role in care, whether we plan for that or not,” she said.
Opportunities and risks
The use of consumer technology in care brings both potential benefits and challenges. Devices such as smart speakers are often more affordable than specialist equipment, familiar to people and families, and already present in many homes before formal care is needed.
However, Katie cautioned that these technologies are not designed as care or medical devices:
“Depending on how they are set up, there can be questions around device ownership, data privacy, and how they fit within existing care models.”
Recent developments, such as the launch of Alexa+ in the UK, powered by generative artificial intelligence, may further increase adoption. These newer systems are designed to be more conversational and context-aware, which could make them more appealing and accessible for people receiving care at home.
Implications for England
The experience in Spain highlights the potential of combining traditional telecare with widely available consumer technologies, supported by human interaction where needed. Katie concluded:
“In a world where more people are already using smart devices and wearables, we need to think about how these fit within our existing telecare models. The Spanish approach, blending technology with in-person support, offers useful insights for the future.”
As adult social care in England continues to evolve, international learning can play an important role in shaping how technology is used to support people to live well and independently.
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